WHOOP Podcast - Debunking Fertility Myths: Dr. Lucky Sekhon's Guide To Understanding Reproductive Health

Episode Date: June 17, 2026

Fertility is often misunderstood. On this episode of the WHOOP Podcast, WHOOP SVP of Research, Algorithms, and Data Emily Capodilupo sits down with board-certified reproductive endocrinologist, fertil...ity specialist, and OB-GYN Dr. Lucky Sekhon to separate fact from fiction when it comes to fertility and hormonal health.Together, they explore the real science behind fertility, hormone health, menstrual cycles, sleep, stress, exercise, nutrition, and aging. Dr. Sekhon explains why fertility is deeply connected to overall health, debunks common myths about birth control and conception, and shares what everyone needs to understand about reproductive health.Whether you're trying to conceive, planning for the future, or simply want to better understand your body, this conversation offers empowering insights grounded in science.(01:18) Dr. Lucky Sekhon: Reproductive Endocrinologist & Fertility Expert(05:01) What Most People Don't Know About Getting Pregnant(09:16) Why it Essential To Track Your Cycle?(16:22) Advocating For Your Health: When to See A Physician For Fertility Issues(18:22) How Can WHOOP Data Help Have Effective Conversations With Your Doctor?(21:23) Impact of Sleep on Reproductive Health(22:42) Impact of Stress on Reproductive Health(28:16) How To Manage Stress Levels For Overall Health(30:50) Impact of Exercise on Reproductive Health(34:13) How Much Does Age Really Influence Fertility?(39:06) The Practical Habits Anyone Can Do To Aid Fertility Health(42:09) Myth or Truth: Does Birth Control Cause Infertility (47:44) What Your Menstrual Cycle (And Monthly Symptoms) Say About Your Health(50:00) Essential vs Overhyped: Habits For Someone Trying To Get PregnantFollow Dr. Lucky Sekhon:InstagramLinkedInWebsiteOrder The Lucky Egg by Dr. Lucky SekhonSupport the showFollow WHOOP:Sign up for WHOOP Advanced LabsTrial WHOOP for Freewww.whoop.comInstagramTikTokYouTubeXFacebookLinkedInFollow Will Ahmed:InstagramXLinkedInFollow Kristen Holmes:InstagramLinkedInFollow Emily Capodilupo:LinkedIn 

Transcript
Discussion (0)
Starting point is 00:00:00 I want to start off with dispelling a common myth that we hear online that I think is very damaging and doesn't help it hurts people, which is this idea that your stress levels cause your fertility issues. And it's not that simplistic narrative that we're fed over and over online, right, for people to sell you things. It's a stressful experience if you're trying to get pregnant month after month and it's not happening, right? So there's definitely this association. But telling someone, just relax, take a vacation, that helped my neighbor or my friend, that's not helpful. knows how they respond to stress. So if you get to a place where you have an energy deficit, because you are working all hours of the night, you're not sleeping, you're not taking in enough
Starting point is 00:00:41 nutrition, you're physically training for something, you're not doing the things that you need to do for proper recovery or to really sustain yourself, you have this imbalance. Survival is the goal. And if we start to fear that there's not enough resources to support survival, then it will shunt that energy and the resources away from reproduction because that's just like this extra thing. We can't support growing another human being. We're just barely hanging on. That's what your brain is detecting. We need to sort ourselves out before we bring someone else into the picture. Hi everybody. I am Emily Capitalupo, Whoop Senior Vice President of Research Algorithms and Data, and today I am joined by the incredible Dr. Lucky Sicon.
Starting point is 00:01:26 Dr. Lucky Sicon is a board-certified reproductive endocrinologist and OBGYN, known for combined, clinical expertise with a highly accessible mist-busting approach to fertility and hormonal health. Through her medical practice and large social following, she translates complex reproductive science into clear, actionable insights, making her a trusted voice for individuals looking to better understand their bodies and long-term health. This conversation will explore how modern behaviors like sleep disruption, chronic stress, training load, and lifestyle habits interact with reproductive health and hormone function. The arc moves from debunking, fertility myths to reframing fertility as a reflection of overall physiological health and ultimately
Starting point is 00:02:08 towards empowering individuals with practical strategies to optimize both current performance and future potential. Dr. Lucky, thank you so much for being here. Thank you for having me. To get us started, I'd love to talk a little bit about this book that you've just written came out in January. Yes. And it is called The Lucky Egg. Tell us about the book, why you wrote it, who's it for? Yeah, I never actually thought of myself as someone who would write a book, but it felt like it was necessary after years and years of clinical practice, treating and diagnosing thousands and thousands of patients and helping them to overcome various forms of infertility. I recognized very early in my career that there wasn't really a trusted resource. And that was part of the reason why I really stepped out of my comfort zone and did something I'm not medically trained to do, which is start making content online. And then even though I continue to do that and I find it very fulfilling and I think it's a great tool that I can use as a megaphone to really set the record straight and give people the information they need, it often feels very fragmented.
Starting point is 00:03:12 And I felt like I wanted an all-encompassing resource because I've recognized for far too long there's been a huge fertility knowledge gap. And I think part of that knowledge gap extends to us just not having the foundation to begin with. I mean, let's be real. Most people haven't thought of their fertility since they were in grade school in health class. And the goals were very different back then. So I'd love to understand, like, how is it that in January of 2026 this book needed to be written? Like, how did we get to a place that this didn't exist yet? I kind of waited around the first couple of years when I was seeing patients and I'm like, someone will do it.
Starting point is 00:03:50 Someone will do it. And it just never happened. And patients continued to come to me and asked me about one particular. particular resource, which is still, you know, trending as like the top resource, not written by a fertility doctor, not even written by a doctor at all. And it has a lot of magical thinking, a lot of emphasis on the role for supplements and, you know, just kind of shortcuts that aren't really rooted in science and often can lead people astray where they're not only wasting time and money, but I think, you know, a lot of hope goes into that. And frustration and feeling
Starting point is 00:04:24 burnt out when you try all of these things that aren't actually really effective, and then you end up back at square one. So I don't know. I don't know why it doesn't exist or didn't exist until now, but I really put it together to act like a health class 2.0. I call it the fertility Bible, because they really think it can meet people wherever they're at. And my hope is that women, men, women will look at this in their 20s and say, hey, what do I need to know as I start adulting and trying to balance my professional and my personal goals, what should I be thinking about when it comes to my reproductive health? You know, it's so interesting what you're talking about. And I think, like, so many of us, like, really only get what you're talking about,
Starting point is 00:05:06 like that grade school, sex education, which is about, like, don't be stupid. Don't have sex. You'll definitely get pregnant. You'll definitely get an STD. And there's a lot of fear. Right. But it also kind of leaves you with this, like, sense that it is so unbelievably easy to get A hundred percent. And so then fast forward 20 years. And like now that's actually the desired outcome. And I think people get so confused and so wrapped up and like what's wrong with me. And then, you know, I think it's so incredible that you are so active on social and we will
Starting point is 00:05:35 share your socials in the show notes because I think so much of what's out there is not by certified, you know, OBGYN. So much noise. There's so many influencers trying to sell you something weird or just trying to build a following. and they're not giving you good advice. And they perpetuate this idea of like, it's probably your fault. You're just not taking this miracle elixir or doing the thing or whatever it is. So I think it's so interesting how many of us just don't understand our bodies and don't realize that there's this whole space. Yeah, I think something I tell my patients, probably I say it at least 50 times a week, is human reproduction is extremely inefficient.
Starting point is 00:06:14 And a lot of the people that walk through the door of my clinic for a consultation don't actually have. have a problem or don't need treatments. Sometimes they just need reassurance and education that it takes a lot to get pregnant and it takes repetition and persistence and taking multiple shots on goal. You know, when you ovulate one egg each cycle, and that's if you're someone who has a regular cycle each month, there's maybe like a 20% chance max in your 20s when you're considered to be in your reproductive primaries that all the things that need to happen line up and you actually get pregnant. I always say it's like playing the slots, right? And maybe that plays into my book title and my name, but it really is like pulling the lever
Starting point is 00:06:53 is what you can control, and that is understanding when you're ovulating and timing your attempts around that. But whether everything lines up after that, the egg gets fertilized, is able to turn into an embryo, is able to make its way to the uterus and implant. Those are very much out of our control. And the rate of success is low on a per cycle basis. And so it takes time and persistence to get your cumulative probability to an acceptable level and actually get pregnant.
Starting point is 00:07:18 And so people need to hear that because they often think, well, my neighbor or my friend, you know, they got pregnant the first time they tried. Well, I also think there's a bias towards those people being the one to shout their story from the rooftop. But it's not the reality for most. It really is. And I think like what happens to so many of my friends who have dealt with infertility or pregnancy challenges is like when they tell somebody all of a sudden it's like, oh, me too, me too, and you realize like half your friends had a miscarriage you never knew about. Correct. They're such a bias in reporting. Because, yeah, we don't talk about it, right?
Starting point is 00:07:47 But of course, the other people tell these crazy stories when, you know, they have a kid and then somehow five months later they're pregnant again. Right. It's just like, oh, yeah, it just happened. Yeah. And that does happen. Honestly, that is why I called my book The Lucky Egg because there isn't always a rhyme or reason. And it's so frustrating. So many of my patients are, you know, high achieving women and they're coming to me in their whole life.
Starting point is 00:08:09 It's like the amount of effort you put in, you got product out of it. And this is just one area of life where you cannot control things to that degree. You can do everything right. And we're going to talk a lot today about lifestyle and the levers we can pull. But you can also be someone that did everything right. And it's still not lining up or working out for you. And that might be something that requires medical intervention. And there's no shame in that.
Starting point is 00:08:33 So one of the things that I think is unfortunate and not your fault about fertility specialties and all these things is that often by the time you get there, you're a year and sometimes more into this process. of struggling and probably not getting a lot of very useful help along the way. So we have this opportunity on the podcast, and I think one of the things that's so great about the material you put out on social to catch people before they would get referred to you. And so what are some of the things that for people who are listening and kind of wondering
Starting point is 00:09:02 if this episode's for them or whatever, if the book's for them, what are the things that you just kept hearing people getting wrong, that you were like, okay, this is why I need to write a book because I want everybody to know these three things. Well, one is the importance of tracking your cycle. People often will only start tracking their cycle and thinking about what it means, you know, what is ovulation and what do I need to be looking out for once they're actually ready to start trying. And at that point, you're starting with zero data if you haven't been paying attention, right? So it is very helpful for everyone to write down day one of their period. It is very helpful to write down associated symptoms. Are your periods painful?
Starting point is 00:09:44 Are you noticing that you have to take Advil around the clock for those first few days? Are you someone that in growing up as an adolescent you missed days of school because of your period? That's not normal, right? Or being like, I need to work from home today because I'm on my period. I mean, if it's impacting your ability to show up and, you know, it's a quality of life issue, that's something that we need to dig into. Or similarly, if it's very heavy. Like your period is like a vital sign, right? And it can give you a window or insight into
Starting point is 00:10:17 gynecologic conditions like PCOS, endometriosis, fibroids. These do not always cause infertility, but they definitely have a strong association. And depending on the nature of the condition, I mean, it's something that you would be wise to know about early on and have it monitored, right? Something I talk about at length is the fact that a lot of women, when they come to me, have never even had a pelvic ultrasound. You know, it's something that only comes up when there's a problem, and I think all too often we are reactive, we aren't proactive. And it's such an easy test. You're not being exposed to radiation. It's ultrasound. You're already there to get your pap smear. Why not have an occasional ultrasound, especially as we enter our 20s and our 30s, so that it's
Starting point is 00:10:59 not this big mystery once we're actually ready to start trying. Yeah, so this is a very, whoop is very aligned with this idea that your period is a vital sign. And so much so that it is incredibly important to track it, even if you are 100% convinced that you never want to have a child. So like there's an argument to be made that, you know, if you're 25, 30 years old and not yet ready, you should go deal with these things or make sure there's no problem so that when you're ready, it'll be smooth sailing.
Starting point is 00:11:26 You'll already have dealt with any issue. But it's also very important, even if you never, ever want to use your uterus for reproduction, that it's healthy. And so can you talk a little bit about why your period and your uterus are important for health, even if you never use them to reproduce? Absolutely. I'll use the example of an irregular or absent cycle. There are a lot of people that are complacent about this because we're like, well, I'm not trying. I don't even know if I want to have children. Or they even look at it as convenient. Yeah. I don't have to deal with this. Yeah. And maybe it does feel nice in the moment, but it could be a sign or a symptom
Starting point is 00:11:59 of something bigger that's going on with you. One of the most common causes of, of irregular or absent ovulation or menstrual cycles. And people might be not familiar with this concept of linking your ovulation to your menstrual cycle. When you ovulate, you release an egg from one of your ovaries and you start producing progesterone. And if that egg doesn't turn into a pregnancy, the progesterone level drops and your lining that has been built up
Starting point is 00:12:22 during that cycle breaks down and you get a period. So the best way to know if you're ovulating is to look at what your menstrual pattern is. And if you're someone that's not getting a regular period or you never get a period, the number one cause of that is polycystic ovary syndrome. PCOS is an extremely common condition. I'd say about a third of my patients that I'm treating for infertility habit. And the number one mechanism of how it causes infertility is that if you're not ovulating,
Starting point is 00:12:47 you're not in the game, right? But it can have a huge metabolic component. You know, in more than half of cases, these patients will also have insulin resistance. And we know that there's a strong lifetime association in any person with PCA, with long-term risk of cardiovascular disease, metabolic syndrome, so things like high blood pressure, type 2 diabetes, cholesterol issues, even fatty liver, which is a really strong sign of insulin resistance. Insulin resistance is a very inflammatory condition, and it causes, you know, cellular breakdown
Starting point is 00:13:20 and wear and tear, it accelerates aging. It does also negatively impact fertility, but beyond that, everyone should be caring about it, right? because it's all about your health and the long term, your longevity, and it's so tightly tied to our cardiovascular risk factors. So, I mean, that is enough of a reason that everyone should be thinking about, am I getting a period regularly? And if I'm not, I should understand why. Another common but less so than PCOS cause of irregular absent cycles is if your brain is not sending the signals to the ovary to tell it to ovulate, this is something that you might see in people
Starting point is 00:13:56 that are overtraining and under-fueling, right? Or for other reasons that are organic that can be picked up on imaging, but you're not going to know unless you're investigating this. And that can be a state of chronic long-term estrogen deficiency, which is also not good for your bones. It's not good for your cardiovascular health. So it really matters, and we should all be paying attention to our periods. Yeah, I think one of the biggest sort of disservices that we ever did to women
Starting point is 00:14:25 was we called all these things like reproductive hormones. Absolutely. When in fact, like estrogen and progesterone play an enormous role in, you know, every function in our body. And, you know, even if you have a whole bunch of children, you're probably only spending a couple years out of decades of your life actually pregnant. Well, yeah, or pregnant, right? So like these hormones are doing a whole bunch the rest of your life.
Starting point is 00:14:53 And we see this when. during menopause when these hormones sort of naturally change, right? We see changes in mood and memory and bone health and heart health and all of these different things, right, to tell you how important these hormones are. Yeah. It's finally getting its moment in the spotlight. I think people are talking about it more. But it's shocking that this is happening now in 2026, as you said, right? It is all too often considered really niche when I'm like, not to sound dramatic guys, but even if we're focusing on the fertility aspect of my job, we're talking about the perpetuation of the human race.
Starting point is 00:15:25 Yeah. All these countries are saying, we have a dwindling population. I mean, this is, you know, something we need to tackle, but we're not really giving people the education or tools or support to really be able to figure out what they need to know and to make sure that this is an option for them in the future. Yeah, and I think what a lot of people don't realize is you have very specialized training.
Starting point is 00:15:45 Yes. And a lot of reproductive specialists aren't necessarily covered by insurance or can be hard to get to. And a lot of primary care physicians often will, like, represent as a if they have this training. They'll say, you're fine or you're, you know, 25. You don't worry about it. Yeah.
Starting point is 00:16:00 Sometimes I can feel like a generalist is kind of gatekeeping because they're the one that maybe decides whether you warrant being referred to a specialist. And I try to encourage people in my book and in the conversations I have online to empower themselves and seek out an expert opinion if they feel like they're not getting the answers that they want and never be afraid of a second or a third opinion. So what would you say to some? somebody who's like, maybe their period's a little bit irregular, but they've talked to their girlfriends about it. And they're like, hey, me too. That's normal. And they ask their doctor and
Starting point is 00:16:34 their doctor's like, yeah. But they're kind of have this nagging sense. Maybe they've read your book or see your content. And they're like, how do you advocate for yourself in this in between stage? I think you have to know what to ask for. It's really hard to advocate for yourself if you're kind of just like nudging someone else to give you the answers. But if you're going to someone, you don't have to have all the answers. You're not the expert. But this is where I think reading resources like my book, The Lucky Egg, are helpful because you can actually go to your doctor and say, well, here's what I was thinking. Like, what do you think about these things? And it shouldn't be your job, but unfortunately, we do have to self-advocate. And I think if you give someone the tools and
Starting point is 00:17:13 also if you present as someone who is more informed, unfortunately, that's the way it goes, that that's probably going to lead you to getting more direct answers. And if it's not, I honestly think you should have a low threshold to see a different specialist. It's not wrong to say, I'm going to skip some steps and go talk to someone who this is what they deal with all day every day because the truth is, we can't all be experts in every area. And we have to be, as doctors, willing to admit, when something is outside of our purview and a patient is better served actually talking to an expert who deals with that every day. What's up, folks, if you are enjoying this podcast or if you care about health, performance, fitness,
Starting point is 00:17:55 you may really enjoy getting a whoop. That's right. You can check out whoop at whoop.com. It measures everything around sleep, recovery, strain, and you can now sign up for free for 30 days. So you'll literally get the high performance wearable in the mail for free. You get to try it for 30 days, see whether you want to be a member. and that is just at whoop.com. Back to the guests.
Starting point is 00:18:21 I'm curious, since this is the WOOP podcast, how can people use wearable data to maybe help them have these conversations better? I mean, I think that knowledge is power and a lot of times we're so busy in our day to day that we're not paying attention to the physiologic signs that are shifting. Wearable data when it comes to how it can help us track things to do with our reproductive system, our hormones, you know, the most obvious thing is that you're going to see a change in temperature. You're going to see a rise in temperature when you're ludial, which means when you're in the second phase of the menstrual cycle that's marked between ovulation and then the next period. And so I think that's just like a sanity check to be like, yes, not only do I know I'm getting
Starting point is 00:19:04 a period, but I also am seeing that this temperature rises happening. And if you have a really regular cycle, that can, especially plugged in with certain apps that are period trackers and ovulation trackers, it can help give feedback to that system where it's going to more precisely allow you to project in your next upcoming cycle. When does ovulation predicted to happen? Also, things just like resting heart rate, right? Your heart rate variability, we know that these are cardiovascular markers for fitness. And I always say that heart health and fertility go very hand in hand.
Starting point is 00:19:40 We see it on the male side. We know that men who have poor sperm quality when we do a semen analysis, there are associations with long-term health risks, whether you're talking cardiovascular, there's associations with metabolic health, obesity, a sedentary lifestyle. There's even association with certain cancers. And so when we think about fertility tests, we shouldn't be just thinking about one-track mind, getting to a baby. We should also be thinking, hey, I'm testing.
Starting point is 00:20:10 these things in people who are in their 20s and 30s well before some of these chronic health conditions become obvious because it's like your body compensates. Our body is always compensating and adjusting, and then you sort of lose those compensatory mechanisms as we get older and our bodies continue to break down. But I always say when you're in the phase of trying to get pregnant and also when you are pregnant, it's almost like a mini stress test. It's revealing things about your long-term health. and that provides you with not only the opportunity to fine-tune things that might improve your overall fertility and chance of success, but your overall health in the long term.
Starting point is 00:20:47 Yeah, I think it's so interesting what you're talking about because obviously, you know, so much of your work is focused on helping people who want to get pregnant and get pregnant. But there are lots of people who will be hormonally unhealthy and still get lucky and just get pregnant easily. Yes. And people who are hormonally healthy but struggle also sort of bad luck. the opposite. But it's so important for everybody to be familiar with their cycle, to track their cycle, whether or not it's for reproductive purposes, because it's this gift that men don't necessarily get this monthly check-in on something that's going to give you this broader picture. And sleep is a huge one too, right? We're sleep. We're not paying attention to the quality of our
Starting point is 00:21:28 sleep. We just know we might feel crappier on certain days and better on other days and more well-rested. But if you start seeing that there is this pattern and we know that your hormone, even beyond reproductive hormones, your thyroid function, so many things tie into sleep quality. And there is a real relationship between chronic sleep deprivation and disturbance and rising cortisol. And how does that affect our brain's ability to send appropriate signals to our ovaries or to the testes to make enough estrogen, progesterone, and testosterone, it really can have an effect. And the thing is, is that correcting those underlying sleep disturbances, you might actually see a change within days to weeks in some of the markers like insulin resistance and inflammatory markers
Starting point is 00:22:12 this is documented. So it's really gratifying to be able to say, hey, I'm identifying a problem and a pattern with this objective data. And now I'm going to make changes and rectify it. And also, in turn, I'm going to see these markers improve. Yeah. And I think I let your message around these things improve quickly. It's not like you need to be a perfect sleeper for a year to get pregnant or anything like that.
Starting point is 00:22:36 like you will respond pretty quickly. So high ROI on focusing on sleep. A hundred percent. Can we talk about stress? Yes, please. So whoop measures stress. You talk about stress a lot in your book. What's the relationship between stress and fertility? Well, I want to start off with dispelling a common myth that we hear online that I think is very damaging and doesn't help. It hurts people, which is this idea that your stress, your stress levels cause your fertility issues. And it's not that simplistic narrative that we're fed over and over online, right, for people to sell you things. It's a stressful experience if you're trying to get pregnant month after month and it's not happening, right? So there's definitely this association.
Starting point is 00:23:17 But telling someone, just relax, take a vacation, that helped my neighbor or my friend, that's not helpful, right? And I think there is a distinction between psychological stress, the day-to-day stress. Oh, my God, I have a boardroom meeting. Oh, my gosh, I'm juggling all these things. and when that spills over into physiologic stress, right? And so if we are massively psychologically stressed and we do not have coping mechanisms in place or support system, and we allow that to trigger not sleeping or overeating or not eating at all. I mean, everyone knows how their body, how they respond to stress.
Starting point is 00:23:53 And people will feel like they need to snack all the time. They have so much food noise. Other people will say, like, I can't eat a single thing. I'm so stressed and I'm losing weight as a result of it. So if you get to a place where you have an energy deficit because you are working all hours of the night, you're not sleeping, you're not taking in enough nutrition, or let's say you're physically training for something, you're not doing the things that you need to do for proper recovery or to really sustain yourself. You have this imbalance. And what happens is it sends,
Starting point is 00:24:24 your body's always, your hormones are always kind of monitoring the situation. And it's kind of like survival is the goal. And if we start to fear that where there's not enough resources to support survival, then it will shunt that energy and the resources away from reproduction because that's just like this extra thing. Like we can't support growing another human being. We're just barely hanging on, right? So that's what your brain is detecting. And your hypothalamus and your pituitary are two glands that really are like the master glands that control so many of the different hormones that matter, our adrenal glands, our thyroid, and then, of course, you know, our reproductive system. And so if you're shutting off signals to the reproductive system, that's when you stop
Starting point is 00:25:08 ovulating or you start to have ovulation that's really erratic. And it's a, your body's very smart mechanism of saying enough, we need to sort ourselves out before we bring someone else into the picture. Yeah. So I was a gymnast growing up, and it was like very much a point of pride to be able to train yourself into amenorrhea. Really? Oh yeah, because you wanted to be thin and you want to train hard and the girls who were really good lost their periods. That's so toxic.
Starting point is 00:25:34 That's so toxic. Yeah. And I've heard the same thing with swimmers, basically anything where you have to perform in a leit harder. So it's like a marker of success. Yeah, because it means you're thin enough and training hard enough. That's so terrible. Yeah.
Starting point is 00:25:47 That's so damaging. And I hope that things have gotten better for all the gymnasts and swimmers and ballet dancers out there. I didn't realize it was a point of pride. I knew it was a thing that happens a lot. It's a thing with runners too. I hear a lot. Oh, my God. I have something to say about that. Please do. I think it's a complicated relationship. I have patients who have come to me after, you know, dealing with eating disorders or maybe they were elite athletes, especially in their adolescence. I feel like a lot of remodeling can happen at that early stage. And it's a hard issue because when your body shuts off those signals, I've had patients work with nutritionists. Like they've been in a good place for many, many, years, it doesn't always come back. It doesn't always automatically come back. And that is a source of frustration for so many of my patients that are working so diligently and they've rehabilitated their way of
Starting point is 00:26:36 thinking and the way that they've treated their body. And they have a lot of blame and shame around it because they're like, I did this to myself. And I want to just say, if anyone's listening and they feel like they're in this situation, the only way to move forward is to move forward and not look back. And all you can do is change your behaviors moving forward. And a lot of us make decisions about how we treat our bodies without having the proper knowledge of what the consequences could be. But I want to put out a big PSA that it's not like a light switch. It's not like, okay, and now I'm going to stop doing this and it's just going to come back. It can be variable. For some people, it comes back and it's no issue within months. For others, it can be like years or lifelong just where your cycle kind of
Starting point is 00:27:17 shows up when it wants to show up. And that can be a reason why people come see me as a fertility doctor. Yeah, and I like the way that you framed it too where it's like if you're not getting enough energy, your body just says, you know, we don't have enough energy to reproduce. We're going to turn this off. And I think like for all the athletes out there, if you don't have enough energy to reproduce, you also don't have enough energy to perform. So I just like also really want to dispel the myth that like somehow it means you're like training hard enough. And it's really bad for your bone health. Being good. Oh yeah. It's bad for so many reasons and should be a big warning sign. And I wonder if you would agree with sort of the faster you catch and try and fix it, the more, the greater the likelihood that things will bounce back.
Starting point is 00:27:56 Absolutely. Absolutely. Right. Because if you're chronically wired a certain way, it's going to be very hard to undo that. And I do think there is this really vulnerable period of time that we see in your adolescence where you can really rewire your body in a way that makes it stubborn and it's not necessarily going to listen and show up on time. So let's talk about the stress that doesn't get you to that. point. Yes. So that looks sort of not stressed enough that you're noticing your cycle change. Yeah. Maybe it is a little bit, but maybe it's sort of within sort of the noise that you would write it off. Yeah. Is that stress also damaging your fertility? And how should people think about that? I wouldn't call it like a one-to-one relationship. You know, I, there's no patient that I've ever seen that where I've said, oh, the reason why you guys aren't getting pregnant is because, you know, your job is too stressful. I think it also depends on how we react. to stress, right? Like there are people that are very stressed or have high-powered jobs and, you know, they're juggling a million things, but they're working out. They talk to a therapist.
Starting point is 00:29:01 They are making sure that they're surrounding themselves with good relationships. Like they are, they are creating the infrastructure for them to be able to dissipate that stress where it's not spilling over into the physiologic. And there are people that aren't sleeping. They're not eating or they're overeating or they're drinking or they're smoking. Like those are behaviors that we know can have a physical impact on fertility via a variety of mechanisms. So I think it's all in how you handle the stress. And stress management is so important. I think sleep and stress management are probably two of the most underrated tools to improve our general health and our fertility. I like what you're saying here too. And I think it's going to resonate with people that,
Starting point is 00:29:38 like you don't necessarily have to remove the stressors because some of them are very good, right? Like having an important job or family or just a lot of commitments and things you're doing. but you do need to have a healthy outlet participating. Yeah, I mean, I've had patients who are like, I'm contemplating taking a sabbatical from work or quitting my job and I want to focus on my fertility. And I'm like, I don't know if that's going to help you. I think that might drive you nuts, you know,
Starting point is 00:30:02 because now you're going to be less able to focus on, you're going to feel like you're giving up even more in your life, you know. And unless that's something that you want to do personally anyway, I just think we have to find a way to fit it into our lives as we exist. And I think trying to create this perfect situation, it might be a letdown because I don't think the main driver of why people aren't getting pregnant when they're not getting pregnant is because they had too many deadlines at work. You know, I think it's maybe how they dealt with that, but there could be so many other factors.
Starting point is 00:30:36 And so you don't want to blow up your whole life over this. I think you want to find a way to fit it into your life. It needs to be a more balanced approach. It can't be this like all or nothing, black or white. So you talked a little bit about like exercise being a healthy outlet for stress. Is exercise good for fertility generally? Can you talk about that? Absolutely.
Starting point is 00:30:55 Yeah. And it's a hard thing to study in isolation, right? But when we look at the sum of our behaviors in our lifestyle, the things that correlate better when it comes to exercise and fertility are cardiovascular exercise and the amount that's been steadied and shown to make a difference in overall outcomes, whether trying on your own or going through treatment to conceive is cardiovascular exercise in the amount of 150 minutes on average per week. Now, that doesn't have to be that you're doing, you know, you're training for a marathon. Obviously, that would be many more minutes. But even like a brisk walk
Starting point is 00:31:30 to get your heart rate up in a sustained way for 30 minutes a day, Monday to Friday. I mean, I think that we, a lot of times, most of us are leading very sedentary lives. People really fixate on things like their step count, and they should because movement is medicine, and it's not only good for your mental health, but there's a huge tie between behaviors that are better for heart health and better for fertility. We see it when we look at diet and sleep and all of the other things that we're talking about, but certainly exercise, not just cardiovascular, but also resistance training. And people don't really often realize the link between building muscle and improving your fertility, but it comes down to insulin resistance. When you build muscle,
Starting point is 00:32:11 that shifts things metabolically where you're able to more effectively listen to insulin and store blood sugar. And so it leads to a less inflammatory environment. Insulin can actually affect how your ovaries behave. It can cause your ovaries to overproduce testosterone and make an unhealthy imbalance where you basically have an environment that's more conducive to errors occurring in the eggs that are being ovulated. And so really focusing on things that are going to allow your body to more effectively store blood sugar is so key. So when we think about diet, on top of exercise, having a diet rich in fiber and in protein to really stabilize those blood sugars is key. Yeah, I think the other, like, big plug for strength training when you're trying to get
Starting point is 00:32:55 pregnant is people don't realize, like, how much of an endurance and strength event pregnancy and, like, postpartum actually is. Yeah. Like, you have to carry around that baby all the time. And your blood volume increases significantly, so your heart's pumping, has to pump more effectively. Absolutely. Absolutely. And we see better outcomes. And more comfortable pregnancies. More comfortable pregnancies, better chance of a successful vaginal delivery and avoiding surgical intervention if you can. And all of the things that are potential negative adverse outcomes in pregnancy, the risk of them are lowered in women who are regularly exercised throughout all three trimesters. Yeah, I think in almost every podcast we talk about the importance of exercise. Yes. Another reason was. is important. You're invited to join the waitlist for WOOP Advanced Labs.
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Starting point is 00:34:13 I'm curious how much age comes in to play. Like, you know, I recently turned 35. I feel like that's like the age where you become geriatric, which is such a unfriendly term. I've never used that term. I appreciate that. You know, what actually happens when, you know, you turn 35? Yes.
Starting point is 00:34:34 How should people think about age? It's definitely not like Cinderella at the ball at the strike of midnight, But that's how people feel, I think. You know, I have patients come to me at 34 and they're like, but I'm turning 35 next week. When can we start the egg freezing? And I'm like, it's not, there's not a magical thing that happens. It's on a continuum. It's not a cliff, right?
Starting point is 00:34:51 But it's our biological clock. And I won't get too into the details because I don't want to overwhelm everyone listening. But I think it's important to understand what that means. We are born with all the eggs that we're ever going to have. We don't make new eggs. We don't regenerate them or have repair mechanisms. So two things are shifting as we age. is the quantity of eggs and then the other is the quality of the eggs. Most people aren't aware
Starting point is 00:35:14 of this, and this is why they should all read my book and do the Health Class 2.0, but you're only ovulating one egg each time you have a cycle. And so how many eggs you have is actually less of a fertility marker, even though it's marketed as a fertility test. You know, check your AMH level anti-malarion hormone as a blood test. Or do a follicle count where we look at the ovaries on the ultrasound. Those are quantitative markers that tell us how many eggs are around or available stockpile. And yes, if you're doing treatments, if you're doing something preventative like egg freezing or you're going through IVF to overcome various forms of infertility, knowing how many eggs I can get to and access in a given cycle, for sure, that's meaningful and can definitely
Starting point is 00:35:55 affect your prognosis and your chance of success, right? But when you're ovulating, we're all on a level playing field. We're all ovulating only one egg at a time. So it's really about what are the odds of ovulating a healthy egg? And that's very much tied to our age. There is no test for egg quality and nobody has perfect eggs, even in our 20s. If I took all the eggs out of a 20-something-year-old's ovaries and tried to turn them into embryos and genetically tested them and that's kind of like the surrogate marker for egg quality and we do that all the time as part of IVF treatment, we test embryos. We see that 20 to 25 percent embryos have typos or errors in them, genetic imbalances,
Starting point is 00:36:32 even coming from the eggs of a 20-something-year-old. So anyone can have a cycle where they just ovulate an egg that wasn't ideal. It had one of these typos or errors, and it could result in an embryo, but maybe that embryo doesn't implant. That's the most common thing to happen if it inherits those typos. Or it can implant and then grow for a bit and then stop growing because it doesn't have what it takes. And that's the number one mechanism behind first trimester miscarriages. And thankfully, we're talking about that as a society more and more. And people are like, what's going on? Is it something in the water? It seems like everyone's having miscarriages. They are extremely common, right? And that's your floor. 20 to 25 percent
Starting point is 00:37:08 of embryos coming from our eggs in our 20s are going to be abnormal, but the large majority, up to three quarters, are going to be healthy, right? Now, if you look at someone at 35, it's changed. The ratio of normal to abnormal has shifted to one-third abnormal, two-thirds of embryos being healthy, and it's 50-50 by the time we reach 37-38. And then by the time we're 40, you still have normal eggs that you can ovulate. There are plenty of 40-year-olds that will never need to see me because they can ovulate their lucky egg and get there. But it's about 70% odds that an embryo coming from their eggs at that age are going to have those errors or typos.
Starting point is 00:37:44 30% won't. And by the time we hit 45, it's like 90-10. So you can see that people worry about turning 35 because you start to see an acceleration and an uptick in the rate of errors that, you know, are in the eggs that we naturally ovulate. And our body, I wish a common misconception is, well, my body, will know how to choose the best one. It's a random selection process. Again, coming back to the book title, there's a lot of luck involved. It's like a lottery. And, you know, some months you're going to have a better chance at ovulating a healthy egg and some months you won't, but it's not something
Starting point is 00:38:20 that you can control and taking things like supplements or, you know, doing what that influencer told you to do on Instagram isn't going to move the needle. I think it's really about following the boring, non-specific advice of, okay, the things that are better for your general health and your heart health are going to be better for your fertility. It's going to be more conducive to creating that healthier environment and not adding to the errors. But the errors that crop up in our eggs and our resulting embryos are always going to be there. There's three things that are certain in life. Death, taxes, and the biological clock. So you can be healthy and you can be tracking your health, you know, markers and eating all the right things and exercising all the time. But at the
Starting point is 00:38:59 end of the day, that doesn't negate the biological clock and how things shift over. time. Let's talk about the good things you can do though. Because we definitely do know that lifestyle plays a factor. Absolutely. Can't do anything about my age. The clock's ticking. But I actually can do a lot. So what are some of the things we talked about sleep? We talked about stress and exercise. What are the lifestyle things that are you're just, you got to get dialed before we talk about the weirdo. Well, I think diet is a big one to talk about. Right. And so the Mediterranean style diet, which is very balanced. You're like eating the rainbow.
Starting point is 00:39:37 You're basically consuming a variety of fruits and vegetables. You're getting healthy fats. Nothing restrictive, right? You're eating lean protein. You're prioritizing carbohydrates that are healthy. You're trying to minimize processed foods. We haven't really talked about smoking and drinking, and that's important. We know that smoking can accelerate the rate at which we lose our eggs and the rate at which
Starting point is 00:39:59 egg quality changes set in. So that's never going to be something that I say. is okay. And if you were smoking the past, that doesn't mean you're doomed to have fertility issues, but all we can do is change your behaviors moving forward. And that's yet another reason to quit, right? Vaping is less well characterized in the data just because there's been a shorter runway of time to really study it. But there's a lot of similarities and overlap between smoking and vaping. So I wouldn't assume, hey, this is much healthier. And, you know, I think we're going to get a lot more data in the coming decade about the effect that it might be having on fertility,
Starting point is 00:40:30 particularly because we're seeing a lot of people doing it in their 20s and early 30s. Drinking, alcohol has become a big topic of conversation. There's a lot more acknowledgement that it is a carcinogen. Excessive drinking has been linked to a whole host of chronic health issues. And we know that a pattern of more than four drinks in a given week exceeding that is associated with lower pregnancy rates, whether trying on your own or with the assistance of treatment. So those are like the high level things. And I don't mean to, you know, discount it when I say it's boring, but it's just it pales in comparison to the sexy advice that you see from like longevity influencers, you know.
Starting point is 00:41:11 But I think all too often people are going to med spas and getting like NAD infusions and doing all these things. But they're not thinking, hey, how much protein am I eating? You know, when's last time I eat a vegetable? Like we need to focus on the fundamentals. Yeah. And I think that that's one of the things that I hear over and over. It's like NAD feels like something that's fancy and it feels like I'm taking control of my health. And there's like a weirdly empowering thing about it.
Starting point is 00:41:36 But it's like that's a micro-optimization. So like your diet isn't where it needs to be. And frankly, if your diet's where it needs to be, you'll produce enough NAD in your own. And the stats are staggering when you talk to public health experts. I mean, the proportion of the population that's not adhering to dietary recommendations and guidelines. Oh, yeah, it's like pretty much. It's abysmal, right? And so I really think focus on the fundamentals, focus on the basics. And the basics are boring. It's not going to be the sexy advice, but it's so important because that's what actually is going to move the needle. And it's going to set yourself up for success. So slightly off the sort of basics, obvious, although I'm glad we talked about it. There's a lot of hype on social media around the role that birth control plays, especially like for people who are on it, you know, from teenage years. Maybe they got prescribed in their early teens.
Starting point is 00:42:26 because of acne and stay on it for 20 years. Does birth control impact fertility? What should people know? Birth control has never been a cause of infertility. In a single patient I've ever seen it, it's never like, oh, it's because you were on birth control all these years, right? If anything, I think a lot of people that have been on long-term birth control have been unknowingly treating underlying gynecologic issues that in a way that may have been protective towards their fertility. Definitely PCOS, right? Yeah, but also endometriosis is a big one. This is a very common condition. It's an inflammatory condition. It's very much tied, has links to, you know, autoimmune disease. You see a lot of
Starting point is 00:43:07 people with endometriosis also have a propensity towards autoimmune conditions or inflammatory conditions. It is a very enigmatic disease. It affects at least 10% of the population. It takes an average of 7 to 10 years to get a diagnosis. It's a condition where cells that act like the inner lining of the uterus that build up and are hormonally responsive and then eventually break down when you menstruate are for some reason found in other parts of the body outside of the uterus, usually the pelvic cavity. And I think it's because of a perfect storm for a lot of people. You know, we all have this system where we menstruate, but we can also have retrograde menstruation where some of that menstrual fluid actually exits the tubes and ends up in our pelvic cavity.
Starting point is 00:43:51 and then, you know, our immune system is like a janitor that's constantly patrolling and says, oh, these don't belong here. Let's get rid of these cells. But for some, those cells can evade detection by the immune system and they can set up shop. And they have invasive properties because they're supposed to be sticky and allow for an embryo to implant, right? And so they're really good at forming blood vessels. There's a lot of, and I don't mean this in a scary way, but there are a lot of really interesting biological similarities between the way endometriosis.
Starting point is 00:44:21 and cancer cells behave. They are invasive. They can spread. They can even spread to remote parts of the body. I've had patients who have endometriosis in their lung cavity. Every time they get a period, they have collapsed lungs. And so we have to prevent them from getting a period. That's an extreme example. So it's not only a huge quality of life issue, because imagine just having such pain every month and it's unrelenting and it's getting worse and progressive with each menstruation, but also it can cause blockages in the fallopian tubes. It can make it a less, conducive environment because it's so inflammatory where an embryo has a harder time implanting, it can affect how quickly we lose our eggs. It can be destructive to the ovaries. There's so many
Starting point is 00:44:59 different ways that it can look. I'd love to just finish this thread because even though it started as a tangent, I think it's really important for a couple reasons. One is that like a very common thing with endometriosis is very painful period. Yes. And I think unfortunately we normalize that with our friends a lot. Absolutely. I think it's one in nine women have endometriosis. Yes. And so it's really easy to find a friend who's like, oh yeah, me too. It's normal. And then you don't think you're supposed to go to the doctor. So can you talk about, like, when is a painful period, like, you know, fine? And when is it like, ooh, like, you should go and talk to a specialist because, you know, the way you're talking about it, right?
Starting point is 00:45:36 Like, if you go on birth control, you can actually stop the development of endometriosis. You can save yourself a tremendous amount of discomfort. You can prevent a lot of damage to reproductive organs and pelvic cavity. People, I guess what I wanted to say was shutting down the process that feeds that disease can be very helpful, not only to your quality of life, but maybe even to prevent progression, right? Especially when it's recognized very early on. I think a lot of people, the pill backlash is because they either don't remember or it wasn't told to them because they were so young and it just wasn't explained. And I think there might have been more paternalism in medicine back then as well, right? It's like, just take this.
Starting point is 00:46:16 The doctor tells you to take this. Now people are asking more questions, which is a good thing. So I see this. It's a tale as oldest time. Women come to me and they're like, I was put on it at 13. I had terrible periods. And then like I went through my life relatively unscathed, no issues. And now I'm off of it and I'm, my cycles are irregular.
Starting point is 00:46:33 Or now I'm off of it and now my periods are painful and I'm not getting pregnant. And you're telling me I probably have endometriosis. Why the hell am I finding out about this now? Why wasn't this told to me when I was a teenager? And so I think there's a lot of anger. there's a lot of people feeling like they wish they asked more questions and they're like, you know, the pill is just like this band-aid. It's just masking. But I think, you know, OB-G-1s get a bad rap because we're also very knowledgeable about the fact that it can help
Starting point is 00:47:02 so many of these other conditions, right? It can help balance out some of the hormonal imbalances. It can help soak up the excess testosterone that someone with PCOS have and it can help them lead a more normal life. So I think the key is the pill is not causing infertility. the pill is not the devil, I think the problem stems from not having this explained to people and not properly diagnosing them or working them up, just kind of saying, okay, here's a tool that we think will help you, but we're not going to investigate why. And I think it's damaging because if you go your whole life, not realizing, hey, I have this major gynecologic condition that does relate to fertility problems for a lot of people, you feel blindsided and you maybe would have made
Starting point is 00:47:40 different decisions and been more proactive about your health and your fertility, right? When do you know that the pain is like normal pain versus I should go get a workup pain? That's such a great question because pain is so subjective. And if you've gone through this your whole life and it's never been treated, you're like, this is all I know, right? This is your perception, your experience. But the hallmark findings when I talk to a patient are when someone says, I would stay at home, I've had to miss work, I would faint, I would have nausea or diarrhea or, you know, urinary.
Starting point is 00:48:13 or GI symptoms in association with their period. That's kind of a dead ringer. But then I think the other piece of it is, okay, and then I went on X. I went on this type of birth control, and then it all went away because that tells me the underlying driver is hormonal. And when you stopped driving that process, the pain went away. I mean, I think that those are all the very clear signs and symptoms. I think, you know, taking an Advil on the first day of your period, fine. But if you feel like you're taking it around the clock for that first couple of days, that might not be normal, right? And I think you should err on the side of being paranoid, err on the side of asking for answers, and the guidelines were just updated. It used to be that you had to get your
Starting point is 00:48:54 official diagnosis of endometriosis by undergoing surgery and having a tissue diagnosis is what we call it, where we do a biopsy and send it off for analysis. But the guidelines just got updated, I believe in 2026, it might have been at the tail end of 2025 where they're like, actually, it can be a clinical diagnosis. I was like, that's what I've been doing all along. I don't send everyone into the operating room, I tell them, hey, I'm convinced there's nothing else that this could be. And sometimes MRI is better than ultrasound at picking it up, but you won't always see it a negative or normal MRI doesn't mean you don't have it. This is, I think, really helpful. And I think one of the things for people to watch out for is that it can run in families. And so it's easy to like,
Starting point is 00:49:32 my mom has this, my sister has this, so it's normal. Yeah. And then to be dismissive. But, But, you know, and I like the sort of that bar at a minimum. Like if you are canceling social plans, missing work because of your period. That's not normal. Yeah. Like it might be normal in your family. It might be common. And it actually is very common, right?
Starting point is 00:49:52 It's about one and nine women. But it doesn't mean that you have to endure it. And there's a lot that incredible people like you can do to help people. Exactly. If you were going to give people some just like really practical things to think about as they think about. as they think about their own fertility and just like the simple changes that they can make. So I think like a lot of people have been told smoking and, you know, those are important for sure. But I think most of our listeners are probably already not smoking, already not heavy drinkers.
Starting point is 00:50:25 What are the things that are easy enough to do and really impactful that people should be thinking about? So start a prenatal vitamin, make sure it has folic acid in it, ideally three months preconception. because that's going to make sure that you have the building blocks to make a healthy baby, right? That's not so obvious to people. And I think also making sure that you're ruling out and correcting any chronic deficiencies, something that's really common, especially in women, is a ferretin deficiency, right? So if you're like, oh, I run a little low, I was told to get on iron, but I wasn't really paying attention. There's actually an association between an iron deficiency, anemia and subfertility.
Starting point is 00:51:03 Right? it makes sense because iron's so important for a proper oxygenation of all of our tissues and blood flow. And so I think, you know, vitamin D is another one that people often aren't checking or even if they know that they have a low level of deficiency. They're not necessarily repleting their levels. Those are things I would focus on for sure. And 80% of Americans are vitamin D deficient. Yeah. And so this is like a very common one. Yeah. And there's many different tie-ins between vitamin D and our ovarian health.
Starting point is 00:51:32 There's some studies that have shown a relationship between vitamin D and how quickly we lose our eggs. I think it's a really important and easy thing for us to focus on. Controlling chronic medical conditions, this might sound obvious, but there are a lot of people walking around that lifelong have had asthma and they haven't really gotten it fully under control. And so they're kind of in this chronic inflammatory state. I had a patient once who had really high isanophils in her blood work. and that was just on like a standard complete blood count when I was just screening for anemia.
Starting point is 00:52:05 And I was like, oh, and she's like, yeah, I always, that's always there because I have this like chronic asthma. And we in a very targeted fashion worked to get that under control. And she was able to get pregnant. And I don't want to make it sound so simplistic. But if you have a war that's being waged in your body because you have a chronic health issue that's flaring constantly, that's not going to be good for your fertility. And that actually is something you should really focus on. Sedentary lifestyle. I mean, we got to move our bodies. It doesn't have to be perfect. It doesn't have to be like perfect attendance to all of the workout classes. But you'd be surprised how much sitting we do and how little movement
Starting point is 00:52:41 we do. And if you're tracking it, then you're going to be more aware of that, right? Sleeping seven to eight hours a day, stress management, stress reduction, taking care of your mental health that is going to spill over into better physical health. And anything in all that you can do to make your body more responsive to insulin, whether that be through X, exercise, diet, all the things that we're talking about, it really matters. And for some people, it isn't a moral failing for anyone. And for some people, no matter everything that they do, they're metabolically wired in such a way. And it's part of their genetic makeup a lot of the time where they're just never going to fully respond to insulin. And that's where we maybe consider
Starting point is 00:53:21 options like metformin. That's a very commonly used medication in my field, as well as sometimes GLP one agonists. You use GLP ones with people who are trying to get pregnant. We'll use it sometimes to help optimize people before they're going through a process, like in the lead up to an egg retrieval, for example. And then usually you should be off of it for at least two months pre-conception. So it's a bit tricky. It's not something that you're going to be on while you're trying. Ideally, that's not recommended because it's hard to know you're pregnant until you have that positive test. And so we really want to make sure you have an adequate washout period just because there's a lack of safety data about pregnancy and GLP1s.
Starting point is 00:54:00 I want to do the opposite now. So you just gave us highest impact things that you can do. What are the lowest impact things that you hear people doing sort of in the spirit of increasing fertility but are just a waste of time and money? Yeah. I would have to say supplement overload is number one, right? I think sometimes you're actually counteracting your efforts because you're overloading your body with an unregulated substance and you're not always aware or knowing what you're getting
Starting point is 00:54:29 in every bottle. Oftentimes, it's recommended in amounts that are so excessive that it could actually be toxic. I have friends in cardiology and hepatology that talk all the time about people having liver issues, you know, and needing to kind of like detox afterwards or having arrhythmias because of imbalances, yes. I mean, I've had patients bring bags and bags of supplements and, like, spill them onto my desk and say, can you help me sort out which ones I should be focusing on? And I just think less is more. I really take a less as more approach. I'm not saying that there isn't a role, and I talk about supplements in my book at length. You know, the best-studied supplement that could be worth taking or trying is co-Q-10. Co-enzyme Q-10 is an antioxidant. It is
Starting point is 00:55:16 important for mitochondrial health. The mitochondria is a part of the cell that generates energy, and that's actually a really important component of egg health and the ability of an egg to turn into an embryo. And studies have shown, and again, they're not the perfect studies, but there's many different studies that have been pooled together, and there seems to be a general trend towards better pregnancy rates and, you know, being able to respond better if you're going through fertility treatments and getting better quality embryos out of those treatments. And so I think because the adverse effects are considered very low in terms of side effects and, you know, the profile is not considered high risk. I would say that's one that I'm like, it could help, it's not going to hurt,
Starting point is 00:55:57 and it could be worth adding to your regimen. But the vast majority don't fall within that category. There's two little data, sometimes no human data or such small biased studies. And you have to always ask who's funding these studies. A lot of it's massively biased. And I think, think that it drives people nuts, right? They're getting burnt out. Yeah. I appreciate you listing this as your first kind of low ROI thing because we did mention, you know, prenatal vitamins, making sure your iron's where it needs to be, making sure you're enough vitamin D. And I agree that stuff's really important. But, you know, that doesn't mean and, and, and for everything that you've heard an influencer talk about. So do the ones that matter. Don't go crazy with the other ones. What else are you going to
Starting point is 00:56:41 put on your list of low ROI things not to get fooled with? Well, this is not only low ROI, but it's also potentially harmful, overly restrictive extreme diets. I have seen everything promoted online, sometimes actually from other quote unquote fertility experts, where they're like keto diet or carnivore diet. And yes, in the short term, maybe for someone who has insulin resistance, by restricting carbs to that degree, you're going to see an improvement in that. But overall, it's not that balanced nutrition that you need to really meet the needs of a future pregnancy and to create an environment that's balanced and physiologically where we should be at, right? And so I think any sort of fad diet or anything extremely restrictive is not only low
Starting point is 00:57:30 ROI, but again, going to burn you out and could be restrictive to the point of being not good for you. Yeah, that feels like good advice for life generally too. Yes. Anything else that feels worthy of being on this list? In terms of low ROI. Stuff influencers love to push that. I mean, it's all kind of in the same vein as supplements, right? Like fertility teas.
Starting point is 00:57:54 Really like specialized things that just don't make sense. You're like, how is that at all connected, right? There's a lot of like mysticism. And listen, I think if something can't hurt, it's not going to break the bank. If it makes you feel better, fine. I don't have any problems with that. But like, for instance, acupuncture, there's a lot of ways that I think acupuncture are helpful to people. I've done acupuncture as a Western medicine doctor.
Starting point is 00:58:18 When I had a bad migraine, I was like, let me just try this out. It felt great to take a nice, relaxing nap in a quiet room. And I did feel great after. And I was like, I don't know how much of that is placebo. I know that the data doesn't show that it moves the needle, pun intended, on live birth rates after treatment. And there's some small positive studies, and there's some, you know, studies that show no difference. But the totality of the data doesn't suggest that that's the number one thing you should be focusing on. But if someone enjoys doing it, that's not harmful.
Starting point is 00:58:48 Definitely. And so it's all about kind of taking that lens of could it be harmful, could it be helpful? What does the data suggest? You know, I think that we have to work and partner with patients so that it's not just like cold and clinical and all about the data and the science, but we're also thinking, is this improving someone's quality of life? Dr. Lucky have so enjoyed this conversation, and I imagine that so many of our listeners have as well. For the people who love this conversation, where can they find more of you? So I'm on Instagram at lucky.ccon, s eK-H-O-N.
Starting point is 00:59:21 I'm on TikTok at Dr. Lucky Egg. And I have a blog. It's actually the same title of my book, The Lucky Egg.com, but it predates my book by years. And it not only has helpful information like what we've discussed today, but also really helpful practical tools and calculators of all sorts. So you could plug in your age and your AMH level and it will show you based on real world data where you fall. So you can kind of put it into context. There's also like an egg freezing calculator. I think so much of the science can be hard to really apply practically to your actual situation.
Starting point is 00:59:56 And so I really try to make this information as accessible and easy to understand as possible. Amazing. It's such important work. Thank you for doing that. And for people who want to find your book, where's the best place to buy it? It's everywhere. You can buy it online. There's an e-book version. The audio book is narrated by me as well. So it's wherever books are sold. Well, we'll definitely put a link in the show notes. And thank you so much for sharing all your expertise with us. Thank you for having me. If you enjoyed this episode of the WOOP podcast, please leave a rating or review. Check us out on social. At Woop, at Will Ahmed. If you have a question to answer it on the podcast, email us, podcast at whoop.com. Call us 508, 443-4952. If you think about joining whoop, you can visit whoop.com.
Starting point is 01:00:38 Sign up for a free 30-day trial membership. New members can use the code will, W-I-L, to get a $60 credit on Woop Accessories when you enter the code at checkout. That's a wrap, folks. Thank you all for listening. We'll catch you next week on the WOOP podcast. As always, stay healthy and stay in the green.

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