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- [00:01]
A
I cannot believe we're here. This is episode 100 of the Erica Taught Me podcast. And I just wanted to start by saying that I'm beyond grateful for each of you for joining me in this journey. From day one, which was in October of 2022, to now, your support has made every episode possible. And this has honestly been a dream come true to be able to talk to these experts, these thought leaders, these entrepreneurs that I've always dreamt of speaking to. I actually went to my bookshelf and collected some of the books of the incredible speakers we've had on the podcast, like Scott Galloway, Ramit Sethi, Seth Godin, Arianna Huffington, Tim Ferriss, who I love, and he was the first one who introduced me to this concept of not following the traditional 9 to 5 corporate path. And then we have Charles Duhigg, who taught us all about habits, Jim Kwik, who taught us about how to make our brains healthier and smarter, Dave Ramsey, who is an original OG finance expert, and Chris Voss, who I remember hearing about when I was in law school as this expert former FBI hostage negotiator who taught us how to negotiate and so many more people. And it's just been a dream come true to be able to learn from the greatest minds through, through the Eric Taught Me podcast. So thank you for all of your support in making this possible and getting us to episode 100. I also never imagined that the Erica Taught Me podcast would make it to the top of the charts. It was number one on the business podcast, and it's been number two in all podcasts in the U.S. so thank you, thank you, thank you from the bottom of my heart for making this happen. Today's episode is special not just because it's our hundredth episode, but but because I'm sharing something very personal with you. As some of you might know if you follow me on Instagram, I'm currently going through ivf. And I remember how it felt five years ago when my husband and I, we got tested and found out that we wouldn't be able to have babies the normal way. We would have to go through IVF if we wanted to have babies. And in that process, I felt so alone and ashamed and confused and devastated and a whole range of emotions that I can still remember how it felt. I can't necessarily describe it, but I just felt hurt and alone. And I think one of the things I've realized with my platform is I have such a unique opportunity to share some of these vulnerable, raw aspects of my life. Because maybe if I share on my platforms, someone else who is going through this will feel like they're not alone and that others are going through this, too. Because when I think back to five years ago, when I found out of all of those emotions, the strongest feeling was feeling alone. And so that is why, even though I'm usually very private with my personal life, I wanted to come out and share with you that this is something I'm going through. And if you are going through this as well, I hope that, you know you're not alone. And we're here. We're in it together. So I felt that it was only fitting to make this episode my 100th episode, because it's a topic that is so close to my heart right now. As I was preparing to go through the IVF process, there was one book that so many people recommended to me that absolutely transformed the experience for me because it made me feel so much more empowered and knowledgeable and. And strong in the situation. And that book is called It Starts with the Egg. It's by an author named Rebecca Fett. Rebecca is an expert in the field, and she breaks down the process and offers advice that could be invaluable to anyone going through or considering this journey. And she actually hasn't done an interview in over two years. But while I was going through the IVF process and just injecting myself every night, I begged her to come on the podcast. I said, look, your book has absolutely transformed things for me, and I want this message to go out to so many people and help all the people that I know it can help. And so, thankfully, she agreed to come on the podcast, and I am now so excited to present you with my interview with Rebecca Fett. I'm Erica Kohlberg, and you're listening to the Erica Taught Me podcast. First of all, I want to say that your book, It Starts with an Egg, was absolutely transformational for me. When I found out that I couldn't have children, naturally, I didn't know really where to turn to. And a lot of people recommended your book to me, and sure enough, I read it, and I felt so much more sure and safe and knowledgeable in the process. So thank you for your book. I really appreciate it, and it's such an honor to have you on the podcast.
- [04:53]
B
Thank you. I mean, that's really nice to hear, because that's really sort of my objective in writing the book is I want to be there kind of by your side when you're going through that tough time and try to make it a little easier and make you feel better about the whole process. So if it did that for you, then I feel really good about that.
- [05:07]
A
It did. And we're both lawyers, so I think the way that you so eloquently stated everything in the book, but it was all so well researched, was perfect for my analytical mind. Like, I wanted to know everything and about IVF and the eggs and how to do things right for your body to. To get the best result. And I feel like you just put all the research, like, I'm sure the thousands of pages of research that you went through into a nice, readable book, and it was so helpful for me.
- [05:36]
B
That's really great to hear.
- [05:38]
A
So for people who maybe they've just found out that they may have to go through IVF or they don't know what it is exactly, can you give just a broad overview of what is ivf?
- [05:50]
B
Sure. So the kind of. The goal of IVF is to circumvent issues with either ovulation or sometimes sperm quality or physical issues with fallopian tubes. So it can kind of get around various different problems. And it's often the go to when they don't know what the problem is. So the female partner will typically get medications for several weeks or sometimes it goes on for longer to encourage her to develop multiple eggs at one time. So instead of just getting one egg growing for ovulation, you're getting many eggs, and it might be 10 or sometimes 20 or more in some cases. And then at a very specific point in their development, there'll be another injection, and that will tell the eggs, okay, time to mature. Let's do the final push. And then there'll be a medical procedure where the doctor, you'll be sort of usually under anesthetic. You'll be asleep. The doctor will go in, take the eggs out, your partner will give their sperm sample, and then those will be combined in the lab. The embryos will grow up, usually three or five days, and then one embryo will usually be transferred. Sometimes that process is a little different. If you want to genetically test the embryos to see whether they have any abnormalities, then usually they'll take a little tiny sample from each embryo. On day five, freeze all the embryos. Then when the results come back, they can plan a transfer of the one best embryo.
- [07:03]
A
And how did you become so passionate about empowering people and teaching people about IVF in the process?
- [07:09]
B
Yeah, it's not something I ever planned on, obviously. I was in my late 20s. I figured IVF was going to be Easy for us. We had to do that because I have back issues and autoimmune issues, so I couldn't carry a pregnancy myself. And so we were going down the surrogacy path, and I figured, I'm young, It'll be fine. It'll be easy. I'll just do IVF once. We'll get our embryos. And then I had that initial evaluation. It was kind of just this bombshell of, you have very severely diminished ovarian reserve, probably as a result of autoimmune things. And they said, there's not really much we can do. We'll give it a try, but the prospects are not good. At that point, I used my biochemistry degree and really delved into all the research. I found all this great information. I put it into practice for myself and had great results. And I sort of realized there are so many other people out there being told, your chance is not good, there's not much you can do. And I just really wanted to help them because it's just absolutely heartbreaking to have that feeling of the thing I want most in the world is out of my hands, out of my control. I'm helpless. No one's trying to help me. There's nothing I can do. Like, if I can save anyone from feeling that way, like, you know, that's what I've accomplished something in my life, you know, and the longer I've been in that world. So my first edition of my book came out 10 years ago now, and I have since then always been in touch with readers and answering questions and helping them. And I just see what so many people go through, and I just want to keep the book up to date of every new discovery we can to address all these situations and just help as much as I can with the new research coming out. So last year, I came up with a new edition that had all of these new chapters on the things that can go wrong with embryo implantation and autoimmune conditions. And what if your ovarian reserve is really, really low? Sort of, you're in your 40s, and what are some of the things that are not quite yet proven, but you might want to give a try? So that's sort of. I came up with this new addition to address every last little thing you can possibly do when the odds are against you.
- [09:05]
A
For people who may have just gotten the news from their doctors that, hey, I don't think you're going to be able to conceive naturally. You're going to have to go through IVF and for those people who think that there's nothing they can do to alter their chances for success, what do you say to that?
- [09:21]
B
There's just so much evidence that there are many steps you can take that really make a difference. We're often told that when you have age related infertility, it's because your eggs have aged over the course of your lifetime. They're all old, they're all damaged, you can't go back and undo that damage. But actually what happens is if you're a little bit older or you have diminished your ovarian reserve for some other reason, it is those final stages of egg development that get affected the most a couple of months before ovulation. So in that time, right when the egg is doing this very important process of separating chromosomes, if you provide the ideal conditions and help that egg make energy and protect it from damage during that critical couple of months, it has a much higher chance of developing correctly without these genetic errors. And those genetic errors are the number one cause of failed MVF cycles. An egg with an error won't fertilize, it won't grow. Well, if it does grow into a five day embryo, chances are it won't implant. If it does implant, chances are it'll miscarriage. So at every step you're trying to avoid these genetic errors because they really have the biggest impact on success rates. And we know from now, you know, two decades of research that what helps an egg mature without those errors is supporting its energy production. And that means these little structures inside the cell called mitochondria. So you want to feed those up and protect them. And we can do that with supplements. We can do that by minimizing toxins. We can do that, believe it or not, through diet, because really having high blood glucose affects mitochondria as well. So there's all these kind of angles we can attack the problem. And there's just so much research out there showing that it makes a difference.
- [10:59]
A
If you had to pick, like if someone said, I don't want to do the list of 15 things that you recommend, I only want to do one thing. So if you had to pick the one thing that you think has the most impact on creating higher quality eggs, what would you say that is?
- [11:12]
B
I would say the number one thing would be to take CoQ10 because it's this molecule that's found in every single mitochondria in our body, every cell in our body, and it participates in the reaction that makes energy. So your cells need CoQ10 and there's very good studies showing that makes a difference. But for someone who's really overwhelmed and doesn't want to go the whole way into all of it, rather than just picking one thing, I would do a very sort of half baked approach to everything, if that makes sense. So just do a little bit on the toxins, you know, perhaps stop wearing perfume, just do a little bit on the diet, you know, switch to having a bit more protein and fat with your meals and like a little smaller portion of carbs, and then have a couple of supplements. So if you do each angle just a little bit, that's probably even better than doing one angle. Instead of taking all the supplements you possibly can and ignoring diet and toxins and things, just do a little bit in each category.
- [12:04]
A
Okay, so let's take this approach of maybe we can go through the categories of things that impact egg quality the most and the best things you can do for yourself in those categories. So I know from reading the book, supplements are really important. And like you said, Coq10 you recommend as the number one thing if they do nothing else. So can we start with supplements? Can you give us a broad overview of why supplements are important and maybe what some of the supplements are that research shows are the most important?
- [12:32]
B
Sure. So the supplements, the goal with these is really to provide the nutrients that your cells and your mitochondria need and also to provide this kind of antioxidant force field, this protection against oxidative damage, because that's what can damage the eggs and damage the mitochondria. And so we want to take a really good prenatal because that will have the vitamins and minerals that will protect egg quality. And then CoQ10, those are the two ones that are sort of across the board. Pretty much everyone can benefit from those. And then vitamin D is another one that's really important because it balances your immune system and it has these hormonal effects as well. And so people who are really vitamin D deficient, it actually suppresses their markers of ovarian reserve. And I've seen so many people who had a vitamin D deficiency, had low AMH and corrected the deficiency and their AMH went up. And the doctors say, oh, that shouldn't happen. You know, there's no scientific explanation for that. There actually is. And there's good studies reporting on that. So vitamin D, another one that's really important. And then beyond that, it sort of depends on your situation, depends how far down the line you are of all these fertility treatments, if you're really, you know, you've been through multiple failed IVF cycles. Then there's a whole list of antioxidant supplements like vitamin C, vitamin E, N, acetylcysteine, alpha lipoic acid. You can read about all of those in the book. And then if you have pcos, there's different supplements that are helpful. So it kind of depends on your situation. But the big three would be prenatal COQ10 and vitamin D. Pretty much anyone can benefit from those.
- [14:03]
A
So after reading your book, I took pages and pages of notes. I think literally, oh, this is actually cute. I'm looking in the folder now. We had two documents. One is called Erica's notes on it starts with an egg or it starts with the egg. And then one is my husband's notes on it starts with the egg. So we each had like, we read the book separately and then had our individual notes and then came back and compared our notes. And my notes are 31 pages. And so I followed everything in your book to a T for the supplements. So for the supplements, I had 12 different supplements that I ended up taking on a daily basis for three months before starting ivf. And then the other things which we'll cover in a bit, the avoiding toxins and diet, I wasn't as strict with. Let's just say I did like a half baked approach. Is there anything else for supplements that we should be considering?
- [15:03]
B
So for the people who have had, you know, really difficult problems with IVF or fertility or they're over 40, there's another chapter in the book that covers some extra things. For the main chapters in the book, I focused on the supplements with very clear evidence and really good studies. There's some other supplements where the evidence isn't quite so clear, but it's possible they may help and the benefits, we think sort of outweigh the risks. So for those that sort of things like Trinidad and Serovital and I would think about those ones, if you've really sort of tried everything else and you're just not getting good results because those ones seem to make a difference, but we just don't have the data yet. Hopefully in a couple of years we'll get better data on those ones.
- [15:42]
A
What do you think about acupuncture? Because I wasn't aware of it, but I saw when I posted on Instagram that I was going through ivf, a lot of people messaged me to try acupuncture. Do you think it's good or bad or neutral?
- [15:57]
B
I don't know, is sort of My answer? I've seen some really encouraging studies, particularly around the time of embryo transfer. And it's possible that it sort of may improve blood flow to the uterus and that helps the embryos implant. It may sort of reduce some stress hormones and therefore reduce inflammation. The studies are kind of inconsistent, so I just don't know. I've certainly had stories of people who have had good results from it and then stories from people who say it makes no difference and it just stresses them out. It's one more thing to add to their schedule. It's one more cost. So sort of my advice on that would be depends how you feel about it. If going to acupuncture makes you feel good, you feel relaxed, you, it sort of eases the stress of this whole process 100%. But if it's a burden to you and it makes it all more difficult, then I don't think it's sort of worth forcing yourself to go to acupuncture.
- [16:43]
A
Knowing what you now know. Having researched so extensively this topic, what do you wish you would have done differently when you were going through ivf?
- [16:52]
B
I wish I'd been more aware of the autoimmune side of it all because I thought I was just at the time I thought it's just my bad luck that I have this terrible low amh, low follicle count. I now know that was probably autoimmune and I wish I had dialed into that more because I sort of addressed my autoimmune things later on in the process. I'm lucky I actually had good results even just doing the supplements and diet and reducing toxins. But now I would probably do more to address the autoimmune side of things. And for me that's very much diet and I have to avoid carbs if I want to calm my inflammation down. And it's challenge because then I don't sleep well. And it's all of these sort of things you have to balance out. But I probably would have dialed in more to figuring out the triggers for my autoimmune stuff and managing that rather than sort of this band aid approach of, you know, like so dhea, for example, it's really good for people who have autoimmune conditions because they often don't produce enough and that suppresses their ovarian function. So if you just supplement with dha, you kind of dhea, you kind of correct that problem. But the other angle is why do we need to supplement with dhea? Why are the adrenals not working properly? So Sort of more of a root cause approach to it.
- [18:04]
A
And did the doctors, not at the time, not tell you any of this?
- [18:08]
B
No, no. I was doing my IVF probably 12 years ago. The world has changed a lot now. I mean, it wasn't even known then, really, that people who have autoimmune thyroid conditions have low ovarian observed. Now that's pretty much accepted. But I don't think many doctors in the IVF clinics, though, are making that connection as much as they should. And they certainly weren't 10, 12 years ago.
- [18:29]
A
You know what I was surprised about going through this first round of IVF is even though I researched all these doctors and I thought I went with the best one, and I'm sure he was amazing, it still felt like a very factory like process where they have so many patients. They only have four minutes with you. I think for the first three, four appointments, I saw the doctor a total of 15 minutes. Like each time he would come in for three to four minutes max, do the ultrasound and then leave. And if I hadn't read your book, I would know so little about the process because it's not like the doctor is sitting down with you for an hour and teaching you all of this stuff.
- [19:09]
B
Right. They just don't have time. I mean, you're actually quite lucky. Most people might see their doctor for their initial consult and then maybe after their egg retrieval, and in between they'll just see nurses. So the fact that you were actually seeing your doctor at each appointment is kind of unusual. You're getting the silver treatment there.
- [19:26]
A
Oh, I didn't realize that because my husband and I were literally like timing each time he came in and being like, this is ridiculous that we're paying tens of thousands of dollars and we get to see him for four minutes. And it felt very rushed, like you couldn't ask any questions.
- [19:40]
B
Yeah, those four minutes were something you get that most people don't get. So it depends on the clinic, but these doctors really are short on time. They're trying to help as many people as possible in a given day, and they just, they don't have the time to explain all of this. And they also don't really have the time to read all the studies. Right. And so they're usually a couple of years behind what the research is showing, unfortunately.
- [20:02]
A
What is the latest research that has come out that you feel confident and comfortable telling people, hey, this will help you.
- [20:10]
B
I think the testing for, for people who have had embryo transfers fail or just unexplained infertility in general, the testing for hidden infections and microbiome issues in the uterine lining, that seems to just make such an enormous difference for some people. And it's one of those problems that is incredibly common and not being tested enough, I think. I'm trying to remember the exact figure, but it's something like one third of couples with unexplained infertility. There's a microbiome issue that can often be corrected. And the clinics I'm testing for this, they'll say, do ivf. We don't know what the problem is. Do ivf. That will circumvent the problem. Then there's people who will have embryo transfers that will fail or they'll have miscarriages. And then it's like, well, now what? And that clinic just says, keep doing ivf, keep doing every transfers. But about a third of these people, if you test, they have these sort of hidden, asymptomatic, kind of, I would say, infections, but it's more of just an imbalance in the species of bacteria, and they create inflammation in the uterine lining. So the embryo won't implant or it will miscarry. And that is not always fixable. But often one round of antibiotics and a couple of months of probiotics, they do an embryo transfer. It sticks. Healthy, maybe. They probably wouldn't have had to do IVF in the first place if they'd just done that step. It's just extraordinary. That's only been possible to figure out in the past couple of years. There are new tests available that weren't then that look at the DNA of the samples to try to identify the bacteria that are present. And you know that those tests didn't exist a few years ago.
- [21:38]
A
Yeah. I think like most things in the legal and medical field, it almost feels like for ivf, you have to advocate for yourself. Like, you can't necessarily trust that the doctor is going to suggest this solution or this test or this test. You almost have to do the research yourself and know going into the office, hey, I'm having this problem. I think we should test for this, this, and this. Which is crazy to say.
- [21:59]
B
I know. It is crazy. Yeah, it is. It is crazy that we have to do this. I don't know the way around that. And it sort of feels awkward as a patient to try to be in this position where you're sort of trying to do their job. But you know that you're the only one who's really, truly advocating for yourself. Otherwise you'll just be put on this Conveyor belt of standard tests and standard treatments.
- [22:20]
A
I felt like. I'm sure I was one of the most annoying ones because I had done all of this research. I, like, came with my supplements list, and I said, this is my. My supplements list. What do you think? Do you. Would you change anything? And I just always had so many questions. But you have to do like that. You can't just assume that they're going to know best. Even though, of course, like, you're saying, these doctors help so many people and they're very, very busy, but they may be a little behind on the research.
- [22:48]
B
Yeah. And you're the only one who's truly 100% on your side and invested in this fully.
- [22:54]
A
Yeah. So I didn't catch up with you since the round because last time we talked was. I was just. I was. I think I was in the middle of it. I was taking the injections, and two days before the egg extraction surgery, I caught Covid and I called them. And at first they were like, well, if you. If you catch COVID we have to cancel your egg extraction surgery because there's nothing we can do. Like, the anesthesiologist won't put you under, because there are concerns that with COVID and anesthesiologists are putting you under, it's not going to work out. And so we're going to have to cancel your egg extraction. And I was begging them, like, no, no, please don't cancel. Like, please, I'll do anything. And they ended up doing it. But my choice was that I could only. I could do it awake or I could cancel the surgery. So I did it awake. Meaning no anesthetics, no nothing. How was that traumatizing? It was very painful. I think the anxiety leading up to it was terrifying. And then the actual process, even though it's a 15 minute surgery, those 15 minutes were very, very painful. But I have strong willpower. So when I decide I'm gonna do something, like, I don't care how much pain is involved, I'm going to do it. But it was definitely like someone is inside of your body with something and, like, sucking out eggs, and you could feel every egg getting sucked out. It was the worst feeling.
- [24:18]
B
I mean, it's very impressive that you went through that. I mean, I think you may have made the right call that for anyone who is in that situation, I think you probably made the right call if you can deal with that, because Covid really affects sperm quality a lot. And so a couple of months from now, your husband's sperm sample might have been vastly worse. It takes a little while to have that impact, but like two, three months out from COVID Sperm samples are often terrible and it takes a while to recover from that. No one quite knows why, but I think he did the right thing. For what it's worth, what about.
- [24:50]
A
This is another thing that I've struggled with. So until for the last month and a half, so before I even started ivf, I think the anxiety leading up to IVF impacted my sleep. And then during the IVF process, my sleep was impacted. So I was looking at my fitness tracker and I haven't slept like a seven hour night, more than one night in a row for the last month and a half. And now for the last three weeks since the egg extraction, minus the day after surgery when I was just wiped out, I'm not able to sleep more than four hours in a row. Like my body just wakes me up after four hours and sometimes I'll take a nap later in the day, but then sometimes I don't go back to sleep at all. And is that IVF related? Is that Covid related? What is that? Have you heard of that?
- [25:40]
B
That could be anything. It could possibly be IVF related because I know people when they go through menopause or perimenopause and the withdrawal from the hormones causes terrible insomnia. So it's definitely possible that you've had this huge amount of hormones in your body and now they're gone and you have to sort of adjust to that and that could be affecting your sleep. Progesterone has a huge impact on sleep. And when you. It's very sort of a calming hormone. And so when you have, when you don't have progesterone, it's harder to sleep. And estrogen also impacts sleep. So it could be the hormones, it could be the stress, it could be the COVID I think you just have to kind of take it easy on yourself and wait for it to get better. It should get better.
- [26:20]
A
Okay, I like that. The hormones were absolutely crazy. One of the days I was at the airport and I saw this kid walking out and his whole family was there walking, waiting for him with a sign. And I immediately started bawling. And then like every day I would find some reason, like a movie or something to cry.
- [26:41]
B
I remember crying at Subaru commercials and I'm like, that's it, It's a Subaru commercial. And I'm crying. This has to be the IVF hormones, right?
- [26:48]
A
Oh my gosh.
- [26:50]
B
Yeah.
- [26:50]
A
My husband was A little in shock with the emotional volatility. Okay, we've talked about supplements. I got a little off track. But the next category is avoiding toxins. Can you give us a high level overview of why we need to avoid toxins and what toxins we should avoid?
- [27:09]
B
Sure. So, I mean, the first thing to say is you don't need to go all out on this. This is something that some people get very stressed about. I don't think it's worth getting super stressed about. You just kind of do your best, forget about it, move on. But the big ones are BPA and phthalates, and both of those are hormone disruptors and they also cause damage to eggs and sperm. This was kind of discovered in this crazy experiment where these lab mice suddenly had all these eggs with genetic errors and they figured out it was because their plastic cages had been washed with this harsh detergent. So suddenly they were getting exposed to all this BPA and all their eggs had genetic errors. And so people thought, oh my gosh, what is this? Further studies showed this happens in humans too. The good news is, as a population, our level of exposure to these chemicals is coming way down. So when I was going through this, BPA was everywhere. It was in canned food, it was in, you know, drink bottles. We were being exposed to it all the time. Now there's so much more awareness that the levels are so much lower. It's still worth being mindful of. But you don't need to completely overhaul everything, just do sort of a couple of the big ones. So for bpa, it's still minimizing canned foods, particularly canned tomatoes. You switch to glass or for pouches or fresh or frozen. Just minimizing sort of plastic where there's going to be hot food or liquid in contact with that plastic, and then minimizing processed foods, because the more processed something is, the more likely it has been coming into contact with a lot of plastic during the manufacturing process. So those steps, BPA makes a huge difference. Those steps also happen to help immensely with phthalates because those are also found in plastics. The other step for phthalates, though is just sort of minimizing fragrance in general. Nail polish and hairspray, just kind of simplifying your beauty routine, cleaning routine. Go for fragrance free products, look for fragrance free, phthalate free. And that just makes a huge difference to your level of exposure. And if you're just sort of dealing with the main things like that, you'll get there. Right? You don't need to completely avoid these chemicals. It's just about bringing it down a little bit.
- [29:11]
A
Yeah. I'll talk about what I actually implemented and then what I didn't because I honestly got a little overwhelmed when I was learning about all of these toxins and what I had to avoid. Processed food I was pretty good with. But I have some addictions. Specifically there are these tortilla chips with hint of lime and they are so good. And so that was my one exception. Like when I'm having a very bad day, I crave those chips. So that was that.
- [29:41]
B
I think that's totally fine. I think it's when you're eating like every single meal, it's like boxed Mac and cheese. Right. Or every single meal is like fast food or it's got 28 ingredients. Right. But tortilla chips is probably like three or four ingredients. It's probably not that sort of overly highly processed.
- [29:58]
A
Okay. I feel validated. The one that I did stop was no takeout items in plastic containers. I felt like that was pretty easy to eliminate. And then I also went for what I found was super low hanging fruit. Just taking all of my shampoos, my stuff, soaps, my laundry detergent, and just buying the fragrance free versions, everything that you suggested, I basically did an analysis on it of whether it was worth doing it and the impact it would have on my life. And those ones, it's like it's a one time switch. You order the fragrance free versions on Amazon, they come the next day, and then you just hide all of your fragrances in the closet and then bring them out after ivf. Like I felt like that was an easy one to implement.
- [30:43]
B
I think that's the way to go. Right. You don't need this added burden in your mind every single day of with every decision you're making, oh, is this safer? Is this toxic? I don't want people thinking that way. It's just make the swaps, get yourself set up and then kind of forget about it.
- [30:55]
A
Yeah, that was a mindless one. The one I had a hard time with was one of your recommendations is to avoid plastic water bottles and switch to glass. The thing is, I'm very frugal and glass water bottles are like double, triple the price.
- [31:10]
B
Yeah. And that's one of those ones where it's kind of like when it's convenient, like when it makes sense. Right. Like if you're at home, it's better to drink sort of filtered water rather than plastic water. If you're out and you need to buy water, like it's not that big of A deal to drink from plastic water bottles every now and then.
- [31:25]
A
Yeah, I switched for the most part. I would make exceptions, but I did buy like two big boxes of glass water bottles. Okay, let me go through what else I changed. No scented body lotion, no fragranced candles. That was hard for me because I love my candles. But I did avoid those fragrances for the whole time. No perfume, that was fine. Cause perfume usually makes me nauseous anyways. And then no fabric softeners and no dryer sheets. That was hard too. Cause I love my soft, comfy fabric softener things.
- [31:59]
B
Well, I mean, so there's some solutions to that. There are like these wool dryer balls which actually make your clothes a little softer. And then some people put essential oils on the dryer balls to get sort of a little bit of a scent. There are ways around that. But also it's one of those things that you kind of just make the switch and you, you get used to it. You kind of forget about it.
- [32:20]
A
Yeah, I'm almost feeling like I won't go back. Like now I've been using my Asoap soaps because they smell so nice and they make me feel so fancy. But once I decide when I'm going through IVF round two, I going to get rid of those again. Put those in the closet.
- [32:36]
B
Well, they may actually be phthalate free. So you can look up, you can kind of google the name of whatever the company is and phthalates and see, because a lot of kind of higher end companies are avoiding phthalates now.
- [32:47]
A
Oh, is that the thing that. But they have scents. I thought you were supposed to avoid scents too.
- [32:52]
B
The main reason to avoid scents is because products that are scented have often have phthalates in them to make the scents last longer or lingerie. And so that's why we avoid scents. Because the manufacturer is probably putting phthalates in there without labeling it. But if that particular manufacturer says it's phthalate free, it's generally kind of okay to have scented products.
- [33:12]
A
Got it, Got it. Okay. Okay.
- [33:14]
B
It's still like less ideal, right? Like the ideal is still fragrance free just because you're minimizing your total chemical burden. Right. But if it's something that you love that brings you joy, it's phthalate free, it's scented, it's fine. Right, Okay.
- [33:27]
A
I like that. What shampoo conditioner do you recommend? Because the one that I got that was fragrance free made my hair so brittle.
- [33:35]
B
So for years and years I've been using the honest ones. And I love them, but I know some people. It sort of really depends on your hair texture. So I have a list on my website which has kind of some of the recommendations there.
- [33:47]
A
Can you share the link?
- [33:48]
B
Yeah, it starts with theegg.com I believe, productguide, but if you just go to itstartswithearg.com, you'll see along the menu, resources and product recommendations for and that supplements, skincare, laundry, cleaning, you name it.
- [34:05]
A
Okay, perfect. Well, yeah, we'll put that in the show notes. I also think I'm going to share my list of what I ended up doing. So if you just want to go to erica.com egg I'll put my list and then the link to Rebecca's book and anything you need from there as well. Okay. Next, can we talk about diet and what your overview of diet is and how it impacts fertility and what you should do?
- [34:29]
B
Sure. So diet impacts fertility in two big ways. One of them is through blood sugar levels and the other one is through just general inflammation. The blood sugar one is probably the biggest one because when you have these spikes in glucose, you end up having to have, first of all, the glucose is kind of damaging to your cells. It's very reactive. And so if you're having these constant high levels of glucose, that actually does impact egg quality in and of itself, but it also then causes hormonal issues because you then get high insulin and insulin interacts with your reproductive hormones and that's kind of what happens in pcos. And so if you can prevent these huge spikes in glucose, you'll actually protect your egg quality and rebalance your hormones better. And there's various different strategies to do that. It doesn't necessarily mean following a super low carb diet. It's more about the quality of the carbs, the amounts, the timing, things like that. So if you eat carbs on an empty stomach and it's a really highly refined, you know, white bread, and you eat nothing else that will spike your blood sugar level. But if you just ate like a salad and some protein and then you have bread or ideally something less refined, then it will have much less impact on your blood sugar levels. So there's kind of, and I talk about this in the book, there are all these various strategies and you can kind of pick and choose what's easiest for you. Is it easier for you just to reduce the portion sizes of carbs? Is it easier for you to pick high fiber versions to get the timing right? Maybe someday you're feeling terrible, you just need cake, you don't want to eat protein first. Okay, great. Go for a walk afterwards. Right. Like, there's all these different ways you just sort of try to keep your blood sugar levels steady to the extent you can.
- [36:06]
A
So I was very strict about no desserts. I didn't have chocolate. I didn't have cake, cookies, anything. But I love pasta and I love rice. And my mom, she's Japanese, she was like, there's no way rice hurts the eggs. Rice is what we live for. So I kept having rice.
- [36:26]
B
I mean, yeah, like, if you're having rice with vegetables and protein, then, and you're not having a huge, huge portion of it, then, yeah, it's probably okay.
- [36:34]
A
Okay, well, I did it, so. And I don't think I could get that up. That was the one thing where I was like, I don't think I can compromise unless things go very badly for round one, then I'll clean up my act for round two.
- [36:47]
B
The one situation. Well, two situations where it can make a bigger difference and it's worth doing more strictly if you have PCOS or these sort of signs of insulin resistance, like if you have a high bmi, if you really feel terrible after eating carbs, if you have PCOS or very long cycles, you don't ovulate regularly, all these are red flags of insulin is messing with your reproductive hormones, and you really, really need to do everything you can to bring that down. And that means being strict with low carb. And there are new studies out on keto diet for pcos, and it actually seems to work really, really well. So I would consider that for people who have PCOS or very long cycles and all these other things I mentioned, the other situation is if you have an autoimmune condition or you're over 40, being very low carb or keto, like a healthy version of keto, can often make a really big difference. No one quite knows why that is. There's an IVF doctor, Dr. Kiltz, I think it is, who he tells all of his patients who are doing IVF they should be on keto. And he seems to get good results with people who are a little older or have autoimmune conditions. So it's definitely worth thinking about and it's worth trying if you've tried everything else. Oh, wow.
- [37:59]
A
That's helpful. For people who don't know what is PCOS and what are some signs that you might have it.
- [38:04]
B
Sure. So PCOS is one of the most common conditions that causes infertility. It stands for polycystic ovarian syndrome. The main signs are usually very long cycles, you know, 30 days and above, or regular ovulation. It has genetic contributors, so people of Asian descent are much more likely to have pcos. It can have sort of physical manifestations. It makes it very hard to lose weight. They make it excessive as hair fatigue, other things like that. So if you suspect that one of the most useful things to do is some lab testing, check your testosterone level, which is often very high in pcos, and check your fasting insulin level, because if you have high fasting insulin, that shows that you have insulin resistance, and that can cause all of these other downstream hormonal effects that are seen in pcos. And often the most helpful way to address that, one, diet. And two, myoinositol, which is a supplement that I talk about in the book, and it really helps with PCOS and addresses some of the hormonal problems.
- [39:07]
A
For the supplement list, I took basically word for word, every supplement you told me. And then When I started IVF, the doctor told me to stop everything except for COQ 10. Is that normal?
- [39:20]
B
Yes, that makes sense to do that. You don't really need them at that point, and you know, they've done their work. You don't need to keep taking them. Some of the supplements, if you take them very close to egg retrieval, there's this very small theoretical concern that they might increase the potential bleeding. So very rare side effect of egg retrievals is bleeding from your ovaries. And if you've been taking a ton of vitamin E or omega 3s, theoretically that might be a little worse. So it's best to stop those ones earlier and then stop dhea, because you don't want high testosterone during the last couple of weeks. So I think that is. I mean, it depends on the clinic, and it probably doesn't make much difference either way, but it's perfectly fine to stop at that point.
- [40:03]
A
Got it. I'm actually curious, going back to our conversation about having to advocate for yourself, what do you think are some questions that everyone should ask their fertility doctor when they first go in?
- [40:15]
B
That's a really interesting question. I think it's mostly about asking for the lab tests that will show you what's going on.
- [40:20]
A
Right.
- [40:21]
B
And so ask for lab testing for your thyroid. Ask them to check your testosterone level and your DHEA level. A lot of people have very low ovarian function because they're short on dhea, which is this hormone made by the adrenals. A lot of clinics aren't testing for that. And it's something that's fixable. And then thyroid conditions are also often quite important and fixable. Then generally I would just encourage people to ask for the testing instead of going down this path of ivf, which is the doc, an IVF clinic exists to sell you ivf. Right. And so that will be their recommendation almost all of the time. And so you want to try to encourage them to do some testing that might help you avoid ivf. So, you know, checking for potential infections or hormonal issues. Some people only need IVF because they have low progesterone. Right. And so you just want to kind of check off all of these other potential causes that would be easier to diagnose. Rather than jumping into this conclusion. You have unexplained infertility, let's do ivf.
- [41:22]
A
Yeah. And I imagine that's also great too, from a financial perspective, because insurance probably covers some of those tests to diagnose, whereas a lot of insurances won't cover the actual IVF process.
- [41:36]
B
Yeah. And they're more likely to cover it if you go through a regular doctor. Right. If you go to your doctor and say, I feel really tired, please check my vitamin D, my thyroid, you know, all of this. And then the insurance is more likely to cover it. If you have sort of a infertility exclusion on your policy and you go to get these tests through your clinic, chances are you'll have to pay for them. But through a gp, if you have some symptom that suggests that, you know, need to test for these things, that it can be helpful. And then testing for progesterone, actually something you can do at home, There are these kits from various companies that test a metabolite in your urine for progesterone. That can actually be more helpful than a blood test for that, because your progesterone levels kind of have these massive spikes during the day. So when you go in to get your blood test, you don't know were you testing during a lull in your, in that day or were you testing during a spike? And so it's hard to interpret the results. But these urine tests, they kind of measure your levels over the previous 24 hours and they have their weaknesses too. But if you're testing with these kids every day for a whole cycle or for a couple of weeks of a cycle, you can get more information than just like a one time blood test. So I think that's something that's useful to do because if progesterone is the problem, and it is for quite a Few people, then your doctor can just prescribe progesterone during that time of your cycle, during basically the implant, the time before embryo implantation, after ovulation. And it often has very good results for people.
- [43:04]
A
Super interesting. So because people know me for my personal finance tips, I have to ask you, what other money saving tips do you have as it relates to IVF fertility?
- [43:16]
B
I wish I had more because it's such an incredibly expensive process and such a huge financial drain for people. And the reality is it's all down to your employer, right? Does your employer provide fertility coverage? My message to the world would be employers provide fertility coverage for people. As an individual, there isn't that much you can really do except to maximize your chances from any one's IVF cycle. Instead of going ahead if the doctor says, we don't know what the issue is, let's do IVF and find out. I would suggest take a couple of months, do the other tests, try to improve your egg quality as much as you can. Focus on sperm quality as much as you can, because a lot of clinics will tell the male partner, your sperm quality is fine, you don't need to worry about it. When all they've done is look at these very superficial measures like motility, morphology, he may have other problems that aren't readily apparent. You'll go through ivf, the eggs won't fertilize or they'll, the embryos will arrest and then you'll find out, oh, this was probably a sperm quality issue. We should have addressed this from the start. Like, you save money by addressing things up front before you go into the IVF round.
- [44:21]
A
That makes so much sense. And speaking of sperm quality, I think a lot of people don't realize that. They think infertility is always caused from the women having trouble with eggs or all of that. But a lot of cases it's because of male sperm quality or other sperm related factors. Right?
- [44:38]
B
For sure. And they can feed into each other. So if you're very young, your eggs have all these repair mechanisms that can actually clean up damage in the sperm's DNA. And so if you're young, you can deal with a partner who might have some hidden damage. If you're a little older, your eggs can't clean up. His damage, can't repair the DNA. And so if he has damage, then your chance of success is much, much lower. And that won't show up in a regular semen analysis. To figure out whether that's happening, you would need to do DNA fragmentation testing. But that if he has sort of borderline or, you know, not quite optimal DNA fragmentation levels, that will have a much, much greater impact if you also have egg quality issues. So if the female partner has egg quality issues, it's up to the male partner to do every single thing he possibly can. No matter what his firm semen analysis says, he has to do everything right as well. He has to do the diet, supplements, avoiding heat, things like that, because it really makes a huge difference. And I know a lot of men are sort of reluctant to do all of this. You're very fortunate that your husband, it sounds like he was really on board and reading the book and interested. I hear from so many women whose husbands say, I don't want any part of this. Right. Like, my semen analysis is fine. I'm going to show up on the day, give my sample. That's all I need to do. And it's really just not true. It's so important to do everything you can to optimize the male side of the equation. It's literally just as important. And it's so often underdiagnosed.
- [46:08]
A
Oh, yeah, I'm petty. I was basically like, look, if I'm not gonna have wine, you're not gonna have wine either. If I'm not gonna have chocolate, you're not gonna have it either.
- [46:18]
B
That's the way to go.
- [46:20]
A
What else? So, okay, for male infertility, they should follow a supplement regime, they should follow the diet regime. Anything specific that men should also be thinking about in addition to those things?
- [46:32]
B
Yeah, it's just heat is just really important. So if you're using saunas or hot tubs, that will just dramatically reduce your sperm quality. And then cycling, that damages swim. It's not just an old wife's tail like male cyclists really have. You can actually see damage to the morphology of the sperm. So it's important to avoid cycling and just trying to keep things cool. It's really interesting. But the process of creating swim is so sensitive to temperature. It matters much more than people realize.
- [47:04]
A
I actually. So again, because I'm annoying and took 31 pages of notes on this book, I actually made him implement everything. And the hardest thing was one of the tips you gave was to avoid heat in the region. Make sure instead of wearing boxer briefs that kind of condense everything, wear these boxer shorts. And it was actually hard to find boxer shorts. I feel like they were popular 10 years ago, 15 years ago, but they're not so popular anymore, are they?
- [47:31]
B
I guess not. I mean, it's probably that probably is not as important as, like, you know, staying away from, like, heat and biking and things like, you know, having a hot laptop on. Directly on your lap is much more of a problem than which particular type of boxers. I think, like, if you think if he's wearing, like, the cotton boxer shorts and kind of loser pants and not sitting for, like, eight hours a day constantly. Right. That actually does cause heat to build up, believe it or not.
- [47:56]
A
So, yeah, so I was focused on the wrong things. See, I feel like the only thing I needed was for you to tell me what is most important to focus on and what is least important, because I kind of dialed in on things like the boxers.
- [48:09]
B
Yeah, it's hard. There's so many different things you can do, but I think at some level, you kind of have to pick and choose what's easiest for you. Right. So if that one was hard, you'd think, nope, not going to do that one. Um, it's just. It all adds up. You're doing, like, a hundred things that each have, like, a 1% contribution. Right. And you can choose where you get your hundred things from, like, which things you want to do. I say a hundred. It really shouldn't be that many things.
- [48:32]
A
I wish there were a way to see what actually made the most impact.
- [48:37]
B
I do, too, because I'm basically, with this book, I'm giving people the tools to do everything that's suggested in the research. Right. Like, there's studies that say, this helps, this helps, this helps. We can't really compare which things help the most. But if I had to say, I think avoiding the glucose spikes is probably one of the most important things.
- [48:58]
A
And glucose spikes, again, just to remind me, those come from direct sugar, but also things like bread and pasta. Yeah.
- [49:05]
B
Anything starchy and refined, and especially if you eat it on an empty stomach in a big portion.
- [49:10]
A
Got it.
- [49:11]
B
Okay. There's a really good book, the Glucose Goddess. She has a book and an Instagram account, and she shows all these really interesting charts of if you eat this after a salad.
- [49:22]
A
Right.
- [49:22]
B
The exact same food, you have less of a glucose impact. And she created these chats by wearing continuous glucose monitors. So they're really interesting to see.
- [49:31]
A
Oh, that's interesting. I wonder. So is the way to test if I'm having those glucose spikes to get a glucose monitor?
- [49:37]
B
Yeah, you can do that. You can also just. So these are these devices that you sort of basically put on your arm, right. For a month or a couple of weeks, and it connects to your phone, and you get to see exactly what's happening with your blood sugar. That can be really useful and really interesting. Another sort of cheaper, potentially easier way is just to do this little fingerprint blood test. So you can get from Amazon for like, $40, a glucose monitor. And it comes with a little, you know, metal. You make a tiny little prick and you drop a blood onto a piece of paper and put it in the device. And it will tell you what your glucose is at that time. So you can just test when you feel like, oh, you know, an hour ago I ate a ton of carbs. I feel a little tired now, or I feel extra thirsty after eating carbs. I wonder if my glucose is high and then it can tell you. So, I mean, that's the other thing. Like, pay attention to your body. Like, if you, like an hour or two after a meal feel really tired or really thirsty, that's a sign of high glucose. If you get these crashes during the day, like these massive energy crashes, that's a sign that you. And not having any steady glucose levels.
- [50:37]
A
Got it. Okay. For round two, I will have to be more mindful of the glucose levels because I wasn't taking that part that seriously. Besides just cutting out obvious sugars.
- [50:47]
B
Yeah. Well, it probably depends on the person, right? For some people, it may make more impact than others. Like, I can see you're very, like, you know, slim, healthy person. Like, it probably doesn't make as much impact for you. Somebody who has a higher bmi, that's a sign of their insulin is not working as well, so it might make more impact for them.
- [51:04]
A
Got it. I have some random tips to share after going through this, as this is very, very fresh in my mind. Things that worked out for me. So one is for the injections, I found that icing the area like 15 minutes beforehand really helped. It makes you feel just a bit numb to it. And I liked that. I also liked watching videos of injections beforehand because it's help me to prepare. And then I had a really good playlist for during the injections and I would just scream out loud my song while my husband was injecting me.
- [51:41]
B
I love that. That's really good. I remember I would just kind of like, I would see my supplies over there, like on the shelf or on the table, and I would just be like, all right, I know in an hour I'm going to have to do this. And just the dread would build up, right? And then you do anything like, oh, that wasn't so bad. Why was I dreading that so much? Like, it's over. In 30 seconds.
- [51:56]
A
Yeah, it was. The trigger shot was actually terrible. I think I almost fainted. The trigger shot was the one that you put in your butt. And immediately after I felt so nauseous and I felt like I was going to faint. And then within 30 seconds I was throwing up. I was going to call the 911 because I was afraid I was going to die.
- [52:15]
B
Wow, that's unusual. I haven't heard that before.
- [52:18]
A
Yeah, but I also had Covid too, so.
- [52:21]
B
Yeah, maybe your whole body was probably very sensitive and.
- [52:24]
A
Yeah, there were some. There were two times during the injection process where we had to do it in really weird locations. One time we had to fly. So we were at the airport and we used the handicapped bathroom at the airport to do it. But I was scared that we were going to get caught or in trouble or something.
- [52:42]
B
People like, why is couple in the bathroom together? Yeah.
- [52:46]
A
So we prepped it at the airport counter, like one of those counters where you put your computers.
- [52:50]
B
And.
- [52:51]
A
And so we were prepping with these needles and stuff. And then we prepped the needles and went in to minimize time in the bathroom. But I felt very sketchy then. And then another time we had a comedy show and our injection time was 10pm and the comedy show started at 10pm so at 9:45, we were in the parking lot of this gas station beforehand and it's obviously pitch black. So we have one light on in the car and we're like doing these needles and. And people are walking by thinking this is the most sketch, like, druggy situation we've ever seen. But you got to do what you got to do.
- [53:26]
B
You have to do it. Yeah, I know a lot of people have had like so many, like parking lot injections and like work bathrooms and all of these. I was very lucky. It was easy for me. I can't remember why, but I guess I was always at home at that time, so it was fine for me. Oh, yeah. Although we had. We did have to fly because the retrieval when I was doing surrogacy, it was illegal in New York where we lived. And so we had to go down to Texas. And so we had to fly. Like we. I was living in New York doing. We were doing our IVF cycle in Texas, so we had to fly down a few days before the retrieval. So we had to fly with all the needles and boxes and all this stuff. And I was very nervous about that. But no one ever flagged anything. It was totally fine. It's funny, like you. Airport security, all the things you can't take in, but you can take in our entire box of needles in your carry on and nobody cared.
- [54:14]
A
But did you take it out and tell them?
- [54:16]
B
No, they didn't. They didn't say a word.
- [54:19]
A
That's so funny. You're. I read because I knew I was going to be flying. I read up what I'm supposed to do. Plus, like, you know, at airports, because I make a lot of airline related videos, I get recognized all the time and I didn't want to be in security line and like pulled over and everyone's like, is that Erica? So I read up what you're supposed to do. You're supposed to notify the TSA agent, take it out of the suitcase and show them. And then those. Also, the medication shouldn't go through the X ray scanner, so you should tell them that the medication, you want them to not put it through the X rays.
- [54:49]
B
Interesting. Where were you 12 years ago? I could have used that information.
- [54:55]
A
Okay, so now we've got into all the things that we need to do before starting the IVF process in terms of avoiding toxins, diets, supplements to hopefully end up with the best outcome. And I guess to specify the best outcome is to get eggs extracted that are healthy, put the sperm inside of them and create embryos. I know I'm probably doing the worst job explaining, so please correct me. Once you insert the sperm into the egg, then if it works well, it's called fertilized. And then they wait for five days to see if it becomes something called a blastocyst, which is a developed embryo. If it doesn't get to that point, then it's not a developed embryo, it doesn't have a chance of becoming a baby. And then after day five, then I think the choices are to freeze it and send it off for genetic testing or to do what's called a fresh transfer and put it in. Can you. I don't know why I even attempted to explain that. Can you explain that in a better way?
- [56:07]
B
I actually really liked your explanation. Yeah, you combine the egg and the sperm. There's actually two ways to do that. You can do what's called icsi, where they inject one sperm into the egg or you just put them together in a petri dish and it's sort of the best man wins, right? Like the best sperm gets to fertilize that egg. And then you wait and you see how many of the eggs fertilized and how many of those grow up. They'll often check them on day three. Sometimes they'll do a fresh transfer on day three. Usually they'll wait till day five and then it's either, as you say, freeze them to do genetic testing or you transfer on day five.
- [56:40]
A
Got it. And what percent of people freeze them to do genetic testing versus just doing fresh transfer?
- [56:45]
B
It sort of changes over time, but I think it's around two thirds of people are freezing them. The main reason for that is either to do genetic testing or just to give your body a chance to recover from all these IVF meds before you're then trying to get pregnant with this embryo, because that's really what is happening. So the embryo transfer itself is a very quick procedure. You're awake. They just put a little tube in and transfer the embryo in. And often you have medication for a few weeks before that. But then it's really just kind of like this anxious wait of like, are you pregnant? And you can normally, I think about a week after the transfer, if you're taking home pregnancy tests, you can start to see positive results, sometimes a couple of days earlier. It's very sort of anxious time for everybody if you're doing a fresh transfer. Home pregnancy tests are tricky because the trigger shot can give you a false positive. But if you're doing a fresh transfer, a lot of clinics say, don't do home pregnancy tests. Just wait until the blood test. And that's really kind of, it's your call what will be better for your mental health. Right. It's. It's such a difficult time that I think personally I would rather test at home if it's a no. I want to find that out on my schedule, on my time, not with a phone call from somebody. I don't know when maybe I'm at work or whatever. Personally, I would test at home, but I haven't been in that situation because of surrogacy. But then hopefully you get the positive test. You're pregnant just the same as any other pregnancy. At that point. It was hard to get there, but you're in the same point.
- [58:19]
A
And then what do you do once you're pregnant and you get that amazing news is there?
- [58:24]
B
It's funny, that's like the number one question I get asked, right? I've been taking all these supplements to get pregnant. Now I'm pregnant, now what do I do? And so I actually have a new book kind of really focusing on that question because some of them are worth continuing. There's a couple more you might want to add in now that you're pregnant to kind of help support your Baby's growth, things like choline. Um, and so I have a new book on that that really covers all the supplements for pregnancy and all these other things that are really important for pregnancy. If you're taking the same kind of philosophy of, I want to advocate for myself, I want to be proactive. I want to pay attention to what lab tests should be done rather than just kind of passively going along with standard procedures that aren't always, like, capturing all the things that we need to do for healthy pregnancies, especially after IVF or after miscarriage, marriage, pregnancy can be a little bit different. So that's kind of something I wanted to write about. I've wanted to write about it for years. So I'm kind of. I'm really happy that this. This new book is out.
- [59:19]
A
What is it called?
- [59:20]
B
It's called. It Starts with the bump.
- [59:22]
A
Oh, I love it.
- [59:23]
B
Funny, I actually. I asked. So I have a Facebook group from. You know, it starts with the egg. Facebook group and pregnancy Facebook group. And I asked them, like, what should I call this new book? And, like, the overwhelming vote was, it starts with the bump. And I'm like, okay, all right. I wanted to call it proactive pregnancy because that's really what it's about. It's like, how can I be proactive about this? One of the topics is thyroid health. It's normal in pregnancies to test your thyroid at around week 12 when you go in for your first OB appointment. But those first few months, your thyroid is so important for implantation and building a healthy placenta, like around seven to eight weeks. You really want to have good thyroid levels at that point. So I would say test earlier. And so to do that, you're going against kind of the standard practice. So you have to advocate for yourself. You have to be knowledgeable about all these things so that you can ask for what's best for you, what's best for your baby.
- [60:13]
A
Mm, that makes so much sense. That should be. I feel like a completely separate episode, and I'd love to dive into that episode maybe next year. If you had to summarize, like, your top three points from it starts with a bump of what you should know if you're pregnant. What would you say those are?
- [60:31]
B
It's an interesting question. I would say probably dial back your supplement routine. Most of the ones you were taking before IVF you won't need anymore. You will need still your prenatal vitamin D. Those are really important. Choline is something you often need to add. And then just doing the Lab testing. So check your thyroid, right? As soon as you find out you're pregnant, right? Just check in and then just generally. So I have a chapter on kind of the emotional side of it, because if you have really been through health to get to this point, if you've lost pregnancies, if you've had failed IVF cycles and you're finally at this point, the anxiety is just palpable of, like, what if this doesn't go right? What if I do something wrong? And so I really wanted to help with that. I have a whole chapter on sort of strategies to manage that anxiety, how to feel better about it all, how to calm yourself down, how to build up your resilience so that when you do face difficult times, you kind of are better able to manage it. And that really came out of my own sort of anxieties for my second baby, the pregnancy for my second son. We just had a rough road. Like, you know, every little thing was. It's almost designed to make us anxious about it. And so I kind of really missed out on the joy of the whole thing, right? Because I was always expecting it to fail. From the first, you know, positive pregnancy test, then to the beta hcg, all the ultrasounds, it was just always something new to worry about. And I just didn't really believe I was going to get my baby boy until it was actually. He was in his car seat, literally. We were walking out of the hospital. It's like, I was crying. Like, oh, my God, we got him, right? Like, we actually got him. He's healthy. He's like, he's here. Like, I'm gonna cry even now thinking about it, but, like, I just want everyone else, when they're going through their pregnancy to not have that, like, anxiety the whole time that makes you miss out on it, right? Like, feel the joy, experience this amazing, amazing time that you fought so hard for. So sorry I'm making you cry, too. But, like, it's not really a big deal, right? He's nine years old, and it still makes me cry to think about, like, I'm so grateful for him. I'm so grateful for the surrogate, for the IVF even exists, that all these scientists out there are doing this research that allowed me to kind of take things into my own hands and improve my chances, right? Like, I may have missed out on all of this, and I didn't because of these scientists, because of ivf, because of my surrogate. Like, there's this whole world of people who helped me, and because of that, I have these amazing gifts, so. And I'm sure you're going to get there too.
- [62:54]
A
Oh no, I love this. I mean, I think, geez, I didn't expect to get emotional because I was feeling very logical and sound minded for this. But it is, whatever stage of this you're at, it's such an emotional journey and you don't forget those emotions. Like, I can still remember how it felt when, just randomly, because my fancy insurance at the law firm was expiring and after I had quit the job and I just wanted to get tested for everything I possibly could while I still had insurance. So my husband and I went to go get tested for fertility and that's when we found out that we couldn't have, we wouldn't be able to have children naturally. And I remember the devastation there and then just feeling so alone and confused and lost and ashamed and like, why me? Why was I different? Why was I seeing all of my friends? Yeah, why was I seeing all of my friends have all these babies and then I couldn't have them naturally? But like the emotions don't go away. That's five years ago. But I still remember how that felt, right? And then more recently for this ivf, like every step of the way has been so much harder than I would have expected and it's just. And I also like get so down because I'm still so far out from the ultimate goal of having a baby and there's just so many more steps in between, so many things that have to go right. And then I also feel bad because I also feel very privileged. Like as I opened up to my audience about me going through ivf, I feel so privileged that financially I'm able to do this and that I have a supportive husband who's helping me through this. And I almost feel guilt in that way from having. While I can't have them naturally, like I have all this privilege to be able to try everything to have them. And so there's just a lot of feelings, a lot of emotions.
- [64:56]
B
It's a lot. That's a lot. You're going to have that forever. You honestly are like, I remember when we were like the day my IVF supplies arrived in the mail. Like, you know these, you get a shops container and it's sitting there on the table. And then like Princess Kate was pregnant and I was just like, it's so unfair, right? Like I'm sitting here with these box of needles and she gets to just have a baby. And it's like, why is life unfair? But Then, as you say, like, you're so cruel. I was so lucky I even got to do ivf. Right. It's tough, but it makes you as a parent, like, it changes you in a good way, too. Right? Parenting is difficult, but every day you're going to look at that child and be so grateful for them because you fought so hard to get them. And it makes the difficult moments easier because you know how incredibly lucky you are that they're here. Yeah.
- [65:49]
A
This is dark humor, but I keep thinking, like, if after all this, my kid ends up being this, like, terrible brat, like a menace, I'm going to be so mad because I can literally quantify how much money I spent to have this kid.
- [66:04]
B
The thing is, they're not, though, because. Because you're going to approach that child with such, like, love and gratitude for their presence. Like, that will change your child too.
- [66:12]
A
You think so?
- [66:13]
B
Yes.
- [66:14]
A
What if I'm just.
- [66:17]
B
I mean, my boys are bratty sometimes, but. So maybe it's not entirely true, but, yeah, I. I am. I am really still grateful for them, like, every day.
- [66:28]
A
Which, I mean, I'm excited. Even though this has been way tougher than I could have imagined. I'm excited for the light at the end of the tunnel and just, again, grateful to be part of this process and grateful for you. I've truly had a lot of amazing authors that I respect and admire on this podcast, but I never go so hard for their books. I sound like I'm a salesperson for your book, but truly, to you guys listening, if you are going through ivf, I highly recommend this book. It's called. It's starts with an egg, and it just helped me to feel so much more comforted in this journey and just knowledgeable and, like, I could advocate for myself and like, I was doing the right things for my body. So thank you, Rebecca, for writing it, for putting all that love into it, for updating it 10 years later so that it has all the most recent information. And thank you for everything that you do. I really, really appreciate it.
- [67:20]
B
Thank you. It's really nice to hear that. And I sending you all the good luck. I hope you get your little baby soon.
- [67:27]
A
Thank you. So we have a closing tradition. The podcast is called Erica Taught Me, but the podcast today is really about Rebecca Taught Me. So what do you want people listening to be able to walk away saying, rebecca taught me this.
- [67:39]
B
Rebecca taught me that I'm not on my own, that I'm not helpless, that there's things that I can do to improve the odds.
- [67:46]
A
Thank you very much.
- [67:47]
B
Again, thank you so much. It was great to speak with you.
- [67:50]
A
I really hope you enjoyed that episode and I wanted to give you a quick update related to my personal life and the podcast. So, as I alluded to in the episode, I will be going through another round of IVF this fall and I really want to take a short break to focus on my health and this IVF process, which, if you've been through it, you know, is such an emotional roller coaster. And it's physically difficult, it's mentally difficult, it's emotionally difficult. So what I want to do is I think this is the perfect episode, episode 100 to wrap up season one. And I want to take a few months to just focus on going through the next round of IVF and taking care of my health. And then early next year we are going to be back with season two, which is going to be so incredible. We are stepping up the level of production, the guests, the interviews, and I am really excited for you to be part of season two. So I have a huge favor for you. In order to make season two as amazing as possible, I would love your feedback. If you can go to erica.com survey that's E-R-I K A.com survey, fill that out and let me know what you thought about season one and how we can improve season two so that it really provides lots of value to you. And I'll be giving away Amazon gift cards to 10 people who fill out the survey. Again, that is erica.com survey to fill out that survey so we can know how to improve season two for you. And when you fill out that survey, you're going to be signed up for behind the scenes updates, content that I've never shared before for the podcast. And you'll be the first to know when season two drops. So go to erica.comsurvey to fill that out now. Thank you so much. Again, this has been a dream come true to do these first hundred episodes with you and I cannot wait for the next hundred. Bye.