Realfoodology Podcast Episode Summary
Title: The Truth About Egg Freezing + IVF No One Tells You | Sasha Hakman
Host: Courtney Swan
Guest: Dr. Sasha Hackman, REI Specialist
Release Date: February 18, 2025
Produced By: Wellness Loud
1. Introduction
In this enlightening episode of the Realfoodology podcast, host Courtney Swan engages in a comprehensive discussion with Dr. Sasha Hackman, a board-certified OB/GYN and Reproductive Endocrinologist at HRC Fertility in California. The conversation delves deep into the intricacies of egg freezing and in vitro fertilization (IVF), providing listeners with valuable insights into fertility preservation and assisted reproductive technologies.
2. Guest Introduction: Dr. Sasha Hackman
Courtney introduces Dr. Sasha Hackman, highlighting her extensive credentials:
- Board-Certified OB/GYN and Reproductive Endocrinologist
- Medical Advisor at HRC Fertility
Quote:
Dr. Sasha Hackman explains her specialized training, "[...] it takes after med school, residency, fellowship, and then board certification about 15 years to get there." (04:49)
3. Overview of Egg Freezing and IVF
Courtney shares her personal experience of freezing her eggs at 36 and expresses her curiosity about the subsequent steps in her fertility journey. She emphasizes the need for a deeper understanding of egg freezing and IVF processes, especially for those contemplating fertility preservation.
4. Egg Freezing vs. Embryo Banking
Dr. Hackman clarifies the differences between freezing eggs and embryos:
- Egg Freezing: Maintains autonomy over the eggs, allowing individuals to decide their future use without dependency on a partner.
- Embryo Banking: Involves freezing fertilized eggs (embryos), which can lead to complications if relationships change over time.
Quote:
"When you freeze embryos, [...] it really sucks for the female partner, because then if they're much older, they have nothing preserved." (07:14)
Key Points:
- Egg freezing offers greater flexibility and control.
- Embryo freezing may lead to ethical dilemmas if relationships dissolve.
5. Egg Quality and Age
Age is a critical factor affecting egg quality. Dr. Hackman discusses how egg viability declines significantly after age 37, impacting survival rates during thawing.
Quote:
"For women under 37, the average survival rate of eggs that are being thawed is 95%. If you're over that age, then you're looking at about 85% survival rate on average." (09:12)
Insights:
- Quality trumps quantity in egg freezing.
- Advanced technologies like vitrification have improved thaw survival rates.
6. Lifestyle and Nutrition Impact on Fertility
The conversation explores whether lifestyle factors such as diet, exercise, and toxin exposure influence egg quality. Dr. Hackman acknowledges anecdotal evidence but notes the complexity due to genetic factors.
Quote:
"Some studies show that supplementation with antioxidants like CoQ10 can improve egg quality, but it's more nuanced depending on individual health status and genetics." (09:59)
Recommendations:
- Incorporate antioxidants and maintain a healthy lifestyle.
- Understand that genetic factors also play a significant role.
7. Environmental Toxins and Fertility
Both hosts express concerns about environmental pollutants like pesticides and phthalates, which are known endocrine disruptors affecting reproductive health.
Quote:
"Endocrine disrupting chemicals are everywhere, really affecting our overall health and reproductive health." (13:10)
Discussion Points:
- Importance of reducing exposure to harmful chemicals.
- Practical steps include eliminating fragranced products and opting for organic materials.
8. The IVF Process
Dr. Hackman provides a detailed walkthrough of an IVF cycle, highlighting the steps from ovarian stimulation to egg retrieval and embryo culture.
Key Steps:
- Ovarian Stimulation: Injectable medications stimulate the ovaries.
- Egg Retrieval: Minimally invasive procedure to collect eggs.
- Fertilization: Eggs are fertilized using either conventional methods or Intracytoplasmic Sperm Injection (ICSI).
- Embryo Culture: Fertilized eggs develop into embryos over 5-7 days.
Quote:
"An IVF cycle involves injectable medications to stimulate the ovaries, followed by egg retrieval where eggs are aspirated from follicles." (20:05)
9. Sperm Quality and Male Factor in Infertility
The discussion emphasizes the often-overlooked role of sperm quality in fertility. Dr. Hackman explains the parameters assessed during a semen analysis.
Parameters Assessed:
- Volume: Should be at least 1.5 milliliters.
- Concentration: Above 15 million per milliliter.
- Motility: At least 40% should be motile, with 32% progressive.
- Morphology: Typically, only 4% or more sperm appear normal.
Quote:
"Human reproduction is actually quite inefficient—with only about 4% of sperm appearing normal under strict criteria." (25:08)
Insights:
- Both partners' health significantly impacts fertility outcomes.
- Male infertility can be a major contributor and should not be ignored.
10. Egg Retrieval and Embryo Transfer
Dr. Hackman describes the technical aspects of egg retrieval and the subsequent embryo transfer process, including genetic testing.
Process Highlights:
- Egg Freezing: Only mature eggs are frozen to ensure viability.
- Fertilization: Sperm is either injected directly into the egg (ICSI) or combined in a dish (conventional fertilization).
- Genetic Testing: Pre-implantation Genetic Testing (PGT) evaluates chromosomal normalcy.
Quote:
"PGT is not perfect. It does not exclude all genetic abnormalities, but it provides prognostic indicators of embryo viability." (22:55)
11. Protocols for Frozen Embryo Transfer (FET)
Dr. Hackman explains the protocols for FET, distinguishing between medicated (programmed) and natural cycles.
Medicated Protocol:
- Involves estrogen and progesterone supplementation to prepare the uterine lining.
- Mimics the natural implantation window hormonally.
Natural Protocol:
- Relies on the body's natural ovulation cycle.
- May include a trigger shot to facilitate synchronization.
Quote:
"The embryo transfer is a painless process, [...] the most uncomfortable part is having a full bladder." (37:18)
Recommendation:
- Natural protocols may be preferable for those with regular ovulation and seeking a more physiological approach.
12. Birth Control and Egg Freezing
The role of birth control pills prior to egg retrieval, known as priming, is debated. Dr. Hackman discusses the pros and cons.
Key Points:
- Advantages: Potentially more synchronized follicle growth.
- Disadvantages: Possible side effects like intense nausea; some studies show no significant benefit.
- Personalization: Patients may opt for alternative priming methods based on tolerance.
Quote:
"Some data shows it makes absolutely no difference, and then some shows it does." (45:28)
13. PCOS and Fertility
Dr. Hackman delves into Polycystic Ovary Syndrome (PCOS), clarifying misconceptions and discussing its impact on fertility.
Understanding PCOS:
- Criteria: Irregular periods, hyperandrogenism, polycystic-appearing ovaries.
- Not Related to Cysts: The term is misleading as it refers to multiple follicles, not cysts.
- Management: Lifestyle changes, insulin sensitivity improvements, and ovulation induction can enhance fertility.
Quote:
"PCOS does not mean that you can't get pregnant. [...] lifestyle changes can lead to more predictable cycles and even natural conception." (53:10)
Personal Insight: Dr. Hackman's own diagnosis of congenital adrenal hyperplasia, which mimicked PCOS symptoms, highlights the complexity of endocrine disorders.
14. Personal Insights and Experiences
Courtney shares her journey with egg freezing, her challenges with synthetic hormones, and her gradual embrace of weight training for fertility improvement.
Key Experiences:
- Egg Freezing: Initial hesitation due to adverse reactions to hormones.
- Lifestyle Changes: Incorporating weight training has positively impacted her fertility and overall health.
- Emotional Aspects: Overcoming fears and embracing fertility preservation with Dr. Hackman's guidance.
Quote:
"I can see a difference in your butt," highlighting the unexpected but positive physical changes from consistent training. (56:55)
15. Final Takeaways and Recommendations
Dr. Hackman emphasizes the importance of early consultation with fertility specialists and understanding individual fertility profiles.
Key Recommendations:
- Early Action: Younger age is a significant predictor of reproductive success; consider egg freezing sooner rather than later.
- Comprehensive Evaluation: Both partners should undergo fertility assessments to identify any underlying issues.
- Lifestyle Optimization: Maintain a healthy diet, regular exercise, and minimize toxin exposure to enhance fertility potential.
Quote:
"The number of eggs does not predict the likelihood of pregnancy. Your ovarian reserve is a cost-effective marker but not a definitive predictor." (57:24)
16. Conclusion
The episode concludes with a heartfelt exchange between Courtney and Dr. Hackman, reinforcing the crucial steps women can take to secure their fertility future. Dr. Hackman encourages listeners to consult with fertility specialists to make informed decisions tailored to their unique circumstances.
Final Thoughts:
- Proactive Approach: Understanding and preserving fertility is empowering.
- Personalized Care: Each individual's fertility journey is unique, requiring personalized strategies.
- Community Support: Sharing experiences fosters a supportive environment for those navigating fertility challenges.
Quote:
"The number one regret is wishing you had frozen more eggs. Don't let that be you." (58:57)
For more information, listeners are encouraged to visit Dr. Sasha Hackman's Instagram @sashahackmanmd and her website SashaHackman.com. Additionally, trending resources like Sepco and Qualia NAD are mentioned as tools for managing supplement stacks and boosting NAD levels, respectively.
Additional Resources:
- Sepco App: Manage your supplement routine with data-driven insights. sepco.com/realfoodology
- Qualia NAD: Boost NAD levels for enhanced vitality. qualiolife.com/realfoodology
This episode serves as an essential guide for anyone considering egg freezing or IVF, offering clarity on complex processes and encouraging proactive steps towards reproductive health.