Episode 41: Tips for Choosing a Sperm Donor with Seattle Sperm Bank's Director Angelo Allard

Secondary infertility — difficulty conceiving or carrying a subsequent pregnancy — comes with a unique set of challenges. Being a parent with infertility can create tension between feeling grateful for the family you have yet grieving the family you desire. 

In this episode, Dr. Lora Shahine talks with Allie Karagozian, occupational therapist, business owner, and podcaster. Allie shares her own fertility journey and why she created a special way to support those suffering with secondary infertility. Through her podcast, Secondary Infertility, and her support groups, Holding Both, Allie provides support for mothers struggling with secondary infertility. 

In this episode you’ll hear:

[0:00] What is secondary infertility?

[3:20] What are the unique challenges of secondary infertility?

• Guilt for wanting “more” 
• Providing a sibling for an existing child
• Age gaps between children and societal pressure to have more

[11:18] Secondary infertility support groups

• Lack of support for those experiencing secondary infertility
• The need for a safe space to discuss the challenges
• The importance of emotional support and community

[20:07] Secondary infertility support for men

• Men are often sidelined during fertility challenges
• Men also need emotional support

Resources mentioned: 

One and Only by Lauren Sandler: https://www.laurenosandler.com/the-book

Episode with Miscarriage Doula Arden Cartrette: drlorashahine.com/podcast/arden-cartrette-on-pregnancy-loss

Finding Allie Karagozian:

Allie on Instagram: @holdingboth 

Allie’s Website: www.holdingbothllc.com 

Allie’s Podcast on Instagram: @secondaryinfertility.pod

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“I am so sorry, but the baby has stopped developing.”

A  “missed” or “silent” miscarriage is when the fetus has stopped developing, but the body hasn’t gotten the message to end the pregnancy yet. It can be devastating, and unfortunately, there are often decisions that the pregnant person will need to make.

In this episode, Dr. Lora Shahine talks about what a missed miscarriage is, what actions you may need to take if diagnosed with a missed miscarriage, and what the pros, cons, and risks are of the different options.

In this episode you’ll hear:

[0:00] What is a missed miscarriage?

• What questions might you have for your doctor?
• What are the symptoms that a missed miscarriage may be occuring?
• Why is it sometimes referred to as an “abortion”?

[4:54] What are the medical options for proceeding after a diagnosis?

• There are options to pursue, with pros and cons.
• Will the body naturally miscarry the fetus? Is there a risk of infection?
• What are the emotional impacts?

[10:22] Medical management of missed miscarriages

[13:22] Surgical management of missed miscarriages

• Who might need surgical intervention?
• What does it entail?
• Diagnosing chromosomal imbalances

[20:22] Advocating for care

• How to talk to your care team about interventions
• Dr. Shahine’s book Not Broken: drlorashahine.com/books
• Understanding it’s not the pregnant person’s fault and how to advocate for care
• Resources for support and healing
  

Resources mentioned: 

Dr. Shahine’s books: drlorashahine.com/books

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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How much does what we eat impact our fertility?

Certainly food influences pregnancy and fertility much more than most of us know, possibly more than our doctors know! Fortunately, a book is coming that can change all that, and in this episode, Dr. Lora Shahine is talking with the authors about fertility, food, nutrition, the science of food and fertility, the myths surrounding nutrition and reproduction (hint: it’s NOT all about BMI), and so much more.

Dr. Angela Thyer is a reproductive endocrinologist and Judy Simon is a registered dietitian and reproductive health nutritionist in Seattle, and together they’ve written Getting to Baby: A Food-First Fertility Plan to Improve Your Odds and Shorten Your Time to Pregnancy. 

Getting to Baby is a deep dive into choosing the right foods to reduce inflammation and support a healthy body; eating to support conception, healthy pregnancy, and IVF treatments; and actually enjoying shopping, cooking, and eating.

In this episode you’ll hear:

[0:00] Introducing the idea of fertility nutrition with a focus on plant-based foods

[0:51] Nutrition's impact on fertility with medical doctor and registered dietitian

[2:31] Nutrition and fertility with a focus on evidence-based information

[3:55] Creating a supportive community for people with fertility issues

[5:03] Fertility, nutrition, and cooking with guidance from a reproductive endocrinologist and a dietitian

[9:55] The importance of plant-based foods and limiting processed foods

[15:33] What does a “holistic approach” to nutrition and fertility look like?

[21:11] Avoiding restrictive dieting

[22:56] Nutrition accessibility

[31:03] Lifestyle tips for better health

Resources mentioned: 

Getting to Baby by Angela Thyer, MD and Judy Simon, RDN (find at Penguin Random House Books)

Judy Simon, RD on Instagram - @fertilenutrition

Angela Thyer, MD on Instagram @angelathyermd

More education on nutrition and fertility:

Improving Fertility with Diet and Nutrition with Dr. Lora Shahine

https://youtu.be/Lxwv0VLZyEk

Foods that Improve Your Fertility with Dr. Lora Shahine

https://youtu.be/tBJo9ggmdzA

Foods to Avoid When You’re Trying to Conceive with Dr. Lora Shahine

https://youtu.be/Ch86VS6yxPE

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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Whether you’re convinced of their medicinal properties or not, the pineapple is a wonderful and long-lived symbol of hope and strength in the fertility community. 

In this episode, Dr. Lora Shahine explains a little about where the symbol comes from, a couple myths to watch out for, and how the pineapple symbol can help you on your fertility journey, 

In this episode you’ll hear:

• [1:14] Pineapples are everywhere in the fertility community!
• [2:37] The medical connection to the pineapple
• [5:09] The symbolic connection the the pineapple
• [6:02] Summary

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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Many people struggling with infertility are curious about the claims that acupuncture will improve fertility and decrease time to pregnancy, but they don’t explore this option because of…needles. 

What if you could get the potential fertility-boosting benefits of acupuncture without the sticks? 

In this episode, doctor of acupuncture, teacher, researcher, and practitioner of integrative East-Asian Medicine Dr. Lee Hullender Rubin talks with Dr. Shahine about the recent research and claims that Laser Photobiomodulation (PBM) (or needleless acupuncture) can improve fertility, PCOS, male factor infertility, and more.

In this episode you’ll hear:

[0:00] Innovative acupuncture treatment without needles: hooray for the needle-hesitant!

[2:04] Non-invasive acupuncture using laser therapy: what are the benefits?

[5:00] LED and laser therapy for fertility: how does it work?

[9:43] The effectiveness of laser therapy in fertility treatments

[14:46] Some results from laser acupuncture for fertility treatment

[21:25] Regulating hormones for fertility treatment: how laser can help regulate EMH levels for fertility benefits 

• PCOS patients
• Egg quality for IVF cycles

[27:49] Using laser therapy to improve IVF outcomes

[27:58] What about sperm? Does laser affect sperm numbers or motility?

[32:18] Two fertility cases with different outcomes

[37:50] The future of acupuncture for fertility 

Resources mentioned: 

Baby or Bust, Episode 39: Dr. Lee Hullendar Rubin on Acupuncture and Fertitlity drlorashahine.com/podcast/dr-lee-hullender-rubin-on-acupuncture-and-fertility

Dr. Lee Hullendar Rubin’s website: www.rosefinchhealth.com

Dr. Lee Hullendar Rubin on Instagram: @rosefinhhealth

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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Many say raising children “takes a village,” but what about the team you create on your family building journey through infertility, miscarriage, IVF and early pregnancy? The “trying to conceive” village can include doctors, nurses, therapists, acupuncturists, friends, family, and maybe a fertility coach. 

If you’re curious about what a fertility coach is and are considering working with one, you’ll learn all about it in this episode in which Dr. Shahine interviews fertility coach Ceire Nevins. 

You’ll finish knowing what’s different about a fertility coach - how they help you meet your goals, support you on the journey, and more. Be sure to pay attention to the red flags Dr. Shahine and Ceire review, so you also know what you DON’T want in a fertility coach.

In this episode you’ll hear:

[0:00] What is fertility coaching and how does it help?

[6:29] Fertility coaching and empowering clients to advocate for themselves 

• Non-medical advice and advocacy for patients undergoing fertility treatments
• Ceire’s personal journey with infertility and how it led her to become a fertility coach

[12:06] Fertility coaching and holistic health

[17:47] How to find a qualified fertility coach 

• Personal experience with infertility and credentials
• Coaches who promise unrealistic results 

[24:01] Fertility coaching and support for individuals undergoing IVF

• The importance of support and self-care 
• Reframing the mindset from goal-oriented to system-based

Resources mentioned: 

Ceire’s Fertility Mama website: www.thefertilitymama.com

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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PGT-A, PGT-M, PGT-SR, Carrier Screening, Karyotype — oh my! The options available for genetic screening in fertility testing and IVF treatment can get confusing.

Understanding testing available to you BEFORE treatment as well as DURING the IVF process is key. These tests can decrease risk of disease and miscarriage and improve success rates with a single embryo transfer, but there are pros and cons for every intervention. It can be difficult to keep it all straight and overwhelming to know what to do. 

In this episode, Dr. Lora Shahine goes in depth on what tests are available, what they are screening for, who is a good candidate for genetic testing, and what your options are when the results come in.

You’ll finish this episode understanding genetic testing and screening in fertility and IVF and knowing what questions to ask your doctor about what’s right for your personal situation.

As always, please share this episode with others on or considering a fertility treatment journey — if you don’t know anyone (or know you know anyone), consider leaving us a review to help others find the podcast.

In this episode you’ll hear:

[0.00] Genetic testing of embryos for IVF patients. 

• genetic screening of embryos for infertility patients, including testing for specific mutations and benefits
• genetic testing options for embryos, including PGT-A, PGT-M, and PGT-S

[3:10] Genetic testing for embryos before IVF

• preimplantation genetic testing (PGT) for single gene disorders in IVF
• genetic disorders and the importance of carrier screening before IVF 
• the option to test embryos for specific mutations
• PGT Sr. is preimplantation genetic testing for structural rearrangement, which requires knowing what to look for before testing embryos

[10.23] Balanced translocations and their impact on pregnancy

• what are balanced translocations and what is their effect on fertility
• what are your management options
• testing embryos for chromosome content to reduce miscarriage risk

[15:58] Genetic testing for embryos during IVF 

• preimplantation genetic testing for aneuploidy (PGT-A)
• the risk of chromosomal abnormalities 
• what are your options when the results come in

[21:58] Karyotype test for people having recurrent pregnancy loss

• this week’s fertility story: couple with 10 miscarriages
• both partners should test for a balanced translocation with a karyotype test
• the importance of seeking a second medical opinion and not giving up hope on fertility treatments

Resources mentioned: 

ASRM Committee Opinion of Preimplantation Genetic Testing for Monogenic Conditions 

ACOG summary of Preimplantation Testing 

ACOG FAQ’s about Genetic Carrier Screening 

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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Infertility advocate and health enthusiast Adelaide White is an invaluable source of light and hope to so many on TikTok and Instagram, Dr. Shahine included.

In this episode, the tables are flipped as Adelaide interviews Lora on All Things Fertility Journey, from the educational journey of a reproductive endocrinologist to the differences among the fertility treatment choices to the many causes of infertility to the heartbreak of recurrent pregnancy loss.

Through it all, one message is clear: infertility and pregnancy loss are not your fault. Culturally, we have such a tendency to blame infertility on the partner who plans to carry the pregnancy, and that’s both wholly inaccurate and hugely unhelpful. Shame and guilt have no place in this process, and that’s why podcasts like Adelaide’s and Dr. Shahine’s exist, so please share widely to spread the word. 

In this episode you’ll hear:

[0:00] Fertility treatments with a reproductive endocrinologist — what to expect

[8:43] Fertility success rates with IVF

[14:16] Fertility treatments and hormone levels 

[19:12] Fertility treatment options and miscarriage risk 

[22:51] Miscarriage causes, egg retrieval pain, and IVF success and why recurrent pregnancy loss is not your fault 

[28:06] Fertility treatments and when to seek medical help: is one year enough? 

[33:30] Fertility treatment options and why advocating for oneself is so important 

[40:40] Infertility and its impact on various cultures, races, and socio-economic groups

[43:37] The fertility journey and advocacy

Resources mentioned: 

Adelaide’s podcast The Waiting Room: podcasts.apple.com/us/podcast/the-waiting-room/id1588061814

Adelaide’s Instagram: www.instagram.com/adelaide_awhite/?hl=en

Dr. Shahine’s books, including Not Broken: drlorashahine.com/books 

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Those undergoing IVF sometimes hear they shouldn’t exercise or they might put the process at risk. However, we know a sedentary lifestyle isn’t healthy for your fertility either.

For many, exercise doesn’t just keep their bodies healthy, it’s also critical to managing stress, aiding with sleep, and managing mental health — which can also impact fertility.

So how much exercise is too much when trying to conceive and in early pregnancy? In this episode, Dr. Shahine helps us understand the facts and decide what is right for your personal situation.

In this episode you’ll hear:

[00:00] Intro

[01:36] The controversy around exercise and fertility 

[02:38] Reviewing the research 

[04:01] Exercise during IVF – what’s the worry?

[07:50] Fertility Story: Exercise extremes, the stress of cutting back for many patients, and the Female Athlete Triad 

[12:09] Outro

Resources mentioned: 

Studies mentioned referenced in these blog posts by Dr. Shahine

My Recommendations on Exercise and Fertility

IVF and Fitness: What You Need to Know

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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We considered posting this episode on New Year's Eve, when toasting in the New Year is likely to happen, rather than New Year's Day, when many celebrants are waking up to a sore head, a fuzzy tongue, and second thoughts about that third round of shots.

It's OK to celebrate — but alcohol is a tricky question when it comes to fertility. How much is too much?

In this episode you’ll hear:

[00:00] Intro

[2:20] Stopping alcohol in pregnancy message is out but what about while trying

[4:28] Research of female fertility and alcohol intake – studies resources listed below

[8:30] Research of male fertility and alcohol – studies and resources listed below

[10:44] Recap of the evidence for reproductive health

[11:23] What I tell my patients about alcohol and fertility 

[14:23] Fertility Story – alcohol and fertility

Resources mentioned: 

Female reproductive health research:

Eggert, J et al. Effects of alcohol consumption on female fertility during an 18-year period Fert Ster 2004;81:379-383

https://www.sciencedirect.com/science/article/pii/S0015028203027171

Anwar MY, et al. The association between alcohol intake and fecundability during menstrual cycle phases. Hum Reprod 2021;36:2538-2538.

https://academic.oup.com/humrep/article/36/9/2538/6294415?login=false

Mikkelsen EM, et al. Alcohol consumption and fecundability: prospective Danish cohort study. BMJ 2016;354:i4262

https://www.bmj.com/content/354/bmj.i4262.long

Tolsrup JS, et al. Alcohol use as predictor for infertility in a representative population of Danish women. Acta Obstet Gynecol Scand. 2003 Aug;82(8):744-9. doi: 10.1034/j.1600-0412.2003.00164.x.

https://pubmed.ncbi.nlm.nih.gov/12848646/

What does ASRM say?

In their Optimizing Natural Fertility Practice Committee Guideline:

https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/optimizing_natural_fertility.pdf

Male reproductive health research:

Finelli R, et al. Impact of Alcohol Consumption on Male Fertility Potential: A Narrative Review. Int J Environ Res Public Health. 2022 Jan; 19(1): 328.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751073/

Hassan M, et al. Negative lifestyle is associated with a significant reduction in fecundity. Fert Ster 2004; 384-392.

https://www.sciencedirect.com/science/article/pii/S0015028203028462

What does ASRM say?

In their Optimizing Natural Fertility Practice Committee Guideline:

https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/optimizing_natural_fertility.pdf

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

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