Want a Family but Haven’t Met Someone Yet? (Watch This) [Video]
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When you’re looking for a partner to have a family with, the pressure of the timeline imposed on you by your biological clock can make the whole process overwhelming. (Not to mention, when you’re fearful that time is running out, you can end up making bad dating choices.)
So much information gets thrown around on the subject of fertility, and that can leave you with more questions than you had to begin with . . .
Today’s new video is the most important conversation I’ve ever been a part of on this topic. I’m joined by Dr. Serena H. Chen, a fertility doctor, and Dr. Ioana Baiu, a surgeon who’s gone through the egg-freezing process, as we dive deep into the benefits and challenges of family planning.
Transcript provided by YouTube:
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for a really long time I have a thought very hard about the biological clock and
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how it affects people in their dating lives the way that if we’re panicked
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because we think that our goal of having children is suddenly threatened by our
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timeline and we think that we’re not going to meet someone in time that can be a disaster in our dating
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life it can affect us in all sorts of ways both conscious and unconscious it
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can make us live in fear and anxiety that it’s not going to happen it can
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make every day that we don’t meet someone and find a serious committed relationship seem harder and harder it
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can affect our energy on a date when you go on a date and there is a a nervous
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energy when there is a sense of I I need you for this that creates so much power
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in the other person’s hands and it robs us of our power in the situation it robs us of the power to have standards about
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how we’re treated it robs us of the power to walk away if the situation
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isn’t right and it risks us settling for something that we shouldn’t be settling for
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I wanted to create a a conversation that
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could help anyone in this position to get their power back their personal power in the situation so that they
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could get back to a place of Peace where they can make good decisions and make it
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much more likely that their goal of having a family happens so I invited two really wonderful people
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to the conversation who are far more educated than me when it comes to
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fertility and the issues that not just women face but people face in these areas and I
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think you’re really going to enjoy this I hope that it Sparks a conversation that maybe you’re not having in your own
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life or that you just haven’t been able to find out there in the online world uh
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and um I look forward to your feedback on it so without further Ado I present
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to you this podcast on the biological clock [Music]
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I have with me today Dr Johanna bayu who
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is a general surgeon at Stanford and a former pediatrician she obtained her medical degree and a masters in public
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health from Harvard her professional interests are in women’s health health care administration and she uses writing
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as a tool for Advocacy she also wrote a an article called freezing the future
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about her own Journey with egg freezing and I’m really excited to talk more about that alongside her we have Dr
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Serena Chen Dr Chen is a director for the division of Reproductive Medicine at
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cooperman Barnabas Medical Center in Livingston New Jersey and the institute for Reproductive Medicine and science
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with several locations throughout New Jersey and New York she graduated from Brown University and Duke University
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School of Medicine trained in Gynecology obstetrics reproductive endocrinology
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and infertility at the Johns Hopkins Hospital she is a clinical associate
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professor at Rutgers New Jersey medical school in Newark and Rutgers Robert Wood
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Johnson Medical School in New Brunswick New Jersey that is all a mouthful
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uh um but uh so happy to have the two of
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you here I was very excited just to get people who live in this world in one way
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or another either through personal experience or through their professional path to weigh in on this subject so
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hello to both of you hello thanks for having us hi it’s my pleasure well I I
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kind of I suppose I’ll keep this open between all of us and feel free to just
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jump in where you see fit because I won’t always know where a question is
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best directed but I think that you know I’d love this to just be a very uh
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casual conversation between the three of us and to try and get somewhere interesting with it could you help
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educate me firstly on fertility in general and what the windows are in
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2022 2023 um for people right now because I
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understand some of the data out there is more historic in terms of what fertility windows are what is it right now for
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both women and men so in general we know that age is one of the most powerful
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factors that impact fertility your General Health impacts fertility but age is a powerful Factor you know people
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come in all the time and they’re like please test my fertility I want to find out what’s going on and yet you know
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um we can tell a lot without any testing just like looking at your General Health looking at risk factors like smoking
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which is negative for fertility and things like chemotherapy and then your
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age and the the younger you are once you
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you know once you go through puberty the the more fertile you are
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um so honestly Mother Nature really
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um wanted us to have you know our 10 kids by the time we turn you know 25 and
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then die of exhaustion by 35 I think so you know today’s society doesn’t really
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fit with that plan and we do consider we have these arbitrary designations Advanced maternal age 35 Advanced
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paternal age 30 it’s 40 and we um we do see you know there’s some data on higher
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risks of things like fertility issues miscarriages birth defects um above those ages but it’s not like
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you fall off a cliff and there is some variation between people but age does mean a lot when it comes to
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fertility there really there really is a biological clock in other words so given
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everything you know about the statistics when you’re dealing with women in your
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own life women that you care about who you’re thinking they’re coming to you
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for advice and saying by what point should I really get a move on what age are you
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telling them because obviously there’s always going to be a range and that range is going to fluctuate for different people but but is there have
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you kind of gotten to a point where you go there’s an age in my mind as a fertility doctor that I kind of think by
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that point people really do need to start taking it very seriously well I I
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feel like there’s you know a lack of information and education which is why I’m so glad that you were talking about
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this and that really little tiny girls from the beginning should understand
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their reproductive Health they should understand how to get pregnant and how not to get pregnant and what are all the
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ways they can keep themselves healthy and be proactive about it from contraception to things like preserving
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your fertility and so um and you know meanwhile we spend a lot
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of time trying to prevent pregnancy and then we forget to tell people about the
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impact of the decline in fertility so I feel like everybody should know about it
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from a very young age uh and that way if you have risk factors like an or family
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history of early menopause you have surgery on your ovaries or you need chemotherapy or you’re a smoker or you
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have a very high BMI or you know you have like some risk factors to your fertility you can you know go in earlier
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and talk with your doctor about it but if you’re everything no risk factors at all everything’s perfectly healthy
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um then I really want people to start thinking about start thinking about it around 30 and getting information and
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you know maybe creating having a good connection with a good Doctor Who’s
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going to support them to preserve their fertility and um and understand the finances and
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things like that because really fertility you know fertility presentation should be covered for
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everyone not you know right now where you know our medicine is is a little bit
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misogynist and biased against women and this is considered a women’s problem and
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elective and it’s really about the whole human race it affects men and women affects families so
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um and affects the economy too you know we have high rates of infertility and a declining birth rate that’s an impact on
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the economy so it’s um it’s really it’s really very much a
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global issue but not everybody should freeze their ex like you know I really feel like this is everybody should have
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access to egg freezing and everybody should get information about egg
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freezing and it should be covered if you want it but you should be able to to make that decision for yourself so I
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don’t feel like anybody should feel pressured to do it but I want everybody you know by the time you’re 30 I want
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you if you haven’t had kids and you want to have a family or you you’re you think you might
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because things change throughout life you should have that you should be thinking about that option and understanding it I don’t know that’s a
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long question no it’s it’s an answer to your question it’s a wonderful it’s it’s
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a wonderful kind of context setting for for this whole conversation so it’s great
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um Dr Bayou you you went on that that path yourself of egg freezing what was
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the age that you began thinking about that as an option for you and what made
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you go for it at the time that you decided to go for it what what was the
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deciding factor that kind of pushed you into that camp from continuing to to
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wait that’s a great question I you know I’m originally from from Europe and I
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feel like priorities are a little bit different so I I never imagined that I would consider
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this as a possibility I’ve thought about having a family and
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um when I was in my 20s I’d heard of people doing this when I was a pediatrician we would have like a friend
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said you’d have patients who are diagnosed with cancer at a very young age so you start talking about fertility preservation with them but that just
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somehow feels like a very separate type of situation um so I always imagined that I would
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just have a family and not ever have to think about this or consider it so I think once I once I once I turned 30
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it’s really when it started hitting me that um you know there’s a little bit more time pressure
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um and of course like we we discussed and I think unfortunately in 2020 this is still a major problem
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um it’s financially prohibitive for a lot of people and so it’s it’s one thing to say sure I’ll you know take the sleep
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of faith and go through the process and I know it’s going to be
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um you know emotionally and physically draining to go through it and it can it’s you really pushing your body to an
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extreme in some ways but it’s also you have to then consider the financial aspect of it so it’s not just wanting to
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do it it’s can you actually afford to do it and it’s anyway I understand anywhere between six and ten thousand dollars for
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the for the full in fact usually a tremendous amount yes yeah I think the
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one thing that I didn’t is um and and I think this is why it’s
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important to talk about these kinds of things and be open is that depending on the age of which you do it then that you
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know how healthy you are how um you know what you’re where you’re kind of shape your body is in you we
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often need more than one round and so we often will talk about you know it’s 10 15 20 000 per round but the majority of
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women end up needing more than one round um so it really just adds up each time
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and the fact that that’s not an elective or the fact that that’s considered an elective and not covered makes it an
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unbelievable Financial commitment for most people yes it is and it really it
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really should be covered but that’s kind of a radical idea like the the the idea
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that you brought up Matthew of every every woman should think about it
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um I think is is something that women Physicians or physicians in women’s
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health specifically in fertility medicine we believe that but that is
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that is not an idea that’s widely accepted
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um you know at all and you know I just wanted to mention that Dr bayou’s
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actually she looks perfectly healthy and beautiful but she is a very hot she’s
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very high risk for infertility uh because she’s a physician so
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um you know it’s just ironic that we’re in you know we’re in this field that puts us at risk at significant risk
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could you explain that to me in general the the the general population risk for infertility and this
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is really only you know we’re only talking about like cisgender heterosexual population I mean obviously
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there’s there’s the whole lgbtq population transgender males should you
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know consider freezing eggs also um but in the physician population the
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numbers seem to be at least double of having trouble
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um having babies so one in Four Women Physicians and if you look at the surgery population you know Dr value is
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specifically a general surgeon that that may be as high as one in three we don’t understand it very well but
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probably the lifestyle the training a lot of it is age the delay in
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childbearing um but we are seeing this in a lot of different
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um surveys of Physicians you know we I really think we are putting our future
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you know our future physicians at risk and yet we’re not supporting them by um you know providing coverage is is
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something that I’m working on it Rutgers and it sounds like Dr Bai is also working on at her
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institution that hopefully we those are things that we can change and that’s not just a product of uh them having
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kids later than others because of their schedules and because of the years of training and so on you’re saying it’s
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also related to stress factors in that profession and just the general wear and
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tear lifestyle of the hours the um what we think we don’t know for sure
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there’s so much in women’s medicine and Reproductive Medicine that we do not
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understand well because there’s a you know there’s a bias in terms of research
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dollars and just the way research is carried out uh that you know most
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studies are done in in men and um you know so we we don’t have a lot of
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really strong data but yes that’s what we think we not just fertility issues
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but you know we do see especially the surgical Specialties have much higher
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pregnancy complications the thing about regardless of you know if you’re a physician a surgeon whatever
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profession you may be I think and we can all say in 2022 at
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least in America or Western Europe I always say the social biology is out
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of sync with human biology so patient you know people just don’t have children
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when they’re 18 19 20 right away the majority you know the age at which
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people have children is getting further and further delayed and it doesn’t matter again what what your career is or
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what your career priorities are in general um we are delaying this more and more and so automatically your risk of
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infertility is going to increase I’ll say that there is a study that was published a couple of years ago looking
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at surgeons and again like Dr Chen said just the thought that maybe the work
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hours the stress may impact things and so it’s hard to know is it you know the being a surgeon is just a high stress
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career going to impact your night anecdotally um you know I’ve done two cycles
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um of uh quiet preservation and I have friends who’ve again done multiple cycles and
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um in all the cases that I’ve spoken with whenever you know one of us has
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done it while we’re on a very kind of difficult work life balance situation when you’re
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working 24 hours in a row and then you’re just you know working 100 100 hours a week
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um the risk of success is was significantly lower than when you are able to take time off and focus on
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yourself and you’ll be a little bit more relaxed and really kind of be in the best possible condition you can and
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where you can actually have higher yields so deciding when you’re going to do this matters I think
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um because it’s not you can just randomly pick a date it really is worth
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thinking and planning it so that you can have the highest yield you can I get different
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stories from different people some of whom say it’s extraordinarily uh
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difficult on the body and others who said it was fine and it was you know a
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fairly fast process um could you talk us a little bit through
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just the procedure in general so that any woman out there who is listening to
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this has an accurate idea of what they actually will have to go through as a process if
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they’re considering egg freezing so I’m happy to talk about it as a as a patient and maybe Dr Chen can give her
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professional opinion but I think you know I’ll just I’ll start saying that I am a surgeon I’m used to working with my
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hands I’m used to working with syringes the day I got home and then just spilled
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everything on my dining table and there were just these hundreds of syringes and
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all these bottles that you had to mix micrograms of medications and you have to be very careful what goes in the
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fridge what you give when and what time like every single hour mattered um it was overwhelming
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um and I think that’s just something that if you know it’s going to be overwhelming um or it can be overwhelmed that it’s a
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little bit easier to just kind of prepare yourself for it um everybody’s a little bit different and there are
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a lot of different regimens I think part of the reason why many women end up
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doing more than one cycle is that the first cycle often you’ll try a kind of formula of a variety of hormones and see
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how your body reacts and then based on that experience your physician will then decide on the second cycle how to tweak
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things around what to change what worked when um and so you can have a more successful
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second cycle um I know everybody’s a little bit different and some people will have more
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side effects than others I think the first time I went through it it was fairly minimal I just felt bloated but
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didn’t really have any emotional ability or anything else that was significant um and really the hardest part was the
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recovery after the retrieval of the eggs which I I didn’t expect I thought once I’m done with the shots kind of
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celebrated this is over the procedure is done and then it was really the week after the retrieval that was very
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difficult and particularly this second time around when I did it we essentially just try to have an even higher yield
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and so pushed things even you know closer towards the limits towards the extreme so to say and I had
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a I had some complications afterwards um it’s very rare to get ovarian hyper
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stimulation syndrome it’s essentially when you’re just stimulating the ovary so much that um
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you can have some hormone imbalances and I felt pretty ill after the retrieval
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and so it took me a couple of weeks to recover and really feel like I’m back to normal and that’s something that I didn’t expect I thought the actual
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giving myself the injections was going to be the toughest part but it turned out to be the recovery afterwards where
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I had you know a belly full of ascites and Felts just really heavy and
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um you know very fatigued it’s hard to breathe so on and so forth and that’s it’s a rare complication but it’s
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certainly something that you have to think of how long does that one round of
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the procedure take in total so it took me about 10 days
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um and it depends a little bit on your health and your physiology and what you decide with your physician I thought
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what was extremely interesting and helpful was that you can control and manipulate things to the hour and so I
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always happening to be a trainee at that time I was a resident I was a surgery resident so I had you know very narrow
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breaks and times when I would say I could come between this hour and that hour and so we were able to schedule everything around a very tight schedule
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and so um you had to give yourself the medications a certain times like the day before the retrieval at you wake up at
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three in the morning because I have to be exactly so many hours before the procedure um but the whole thing takes about 10
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days and then the recovery how it took how long after that so for the first time around it was just the I don’t know
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three four days the second time around is a couple of weeks having so you’re now uh you’ve done your
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second round you’ve been through this process twice correct yes having been
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through it twice has your view on whether it’s
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um worth doing changed at all do you still feel like ultimately it’s
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entirely worth it because of the option that it’s given you
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um or has the calculation changed now that you’ve been through it no I think I think it takes the pressure from making
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that decision I think this is what’s changed because without it you kind of
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feel a little bit of a rush and stress of oh my goodness what if I don’t have a
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family now will I be able to have it later will there be more complications or you know obviously the health of your
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eggs matters and then it’s affected by your age so the older you are
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um the difference the quality of your eggs is going to be so the younger you are when you freeze your eggs in some ways the healthier embryos you may have
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it’s on that the one of the questions I wanted to ask is there a
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um expiration date on those eggs if you had it done at 25 do they become
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less viable over time or no yeah the answer is no you know once you once you
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freeze that that is the technology today it’s called vitrification and it just
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came uh became widely used maybe about 10 15 years ago and
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um and it’s literally like pressing the pause button
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so eggs are full of water so it was challenging to freeze them because much
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more challenging than sperm we’ve been freezing sperm really well for decades and decades but uh eggs have been really
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tough because they’re very complicated there’s lots of organelles and and water and things like that because the egg is
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responsible for all the cellular functions in the first three days of the embryo’s life whereas the sperm is just
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like a little DNA missile so um freezing that big cell was really
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difficult and the first Frozen egg baby was like in the like 1981 but then there are like no Frozen egg babies through
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the 90s and then and then we figured out how to do it much better and now a lot of people are freezing eggs because the
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pregnancy rates are much better and a frozen egg once you thought behaves almost exactly the same way as a fresh
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egg although the shell is a little bit harder so to get the sperm to fertilize
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you do have to inject the sperm into the egg with a process called ixy intracytoplasmic sperm injection but
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the eggs you should put them in your will because you don’t want crazy people doing things with them you know after
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you’re gone because they are definitely going to be around for longer than you are and there was that just that
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incredible news story with the um the babies that were born after being
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frozen for 30 years and that is a much older technology those babies are alive
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and well and healthy so uh and we think the current Technologies even better
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than that now but it is a numbers game you do need you
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it you know you usually need multiple eggs and and that’s why you know Dr
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Bayou is talking about doing multiple Cycles although I would say most of my
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patients do just one retrieval because ultimately you know I would love for
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people to have 18 to 21 eggs in the freezer that’s about a 95 chance of
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having one healthy baby on average you know depending upon your age
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um you need more if you’re older maybe less if you’re younger but a lot of this is about no regrets
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because we even if you have a hundred eggs you might not necessarily have a
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baby from those eggs I do have a patient who froze over 100 eggs 10 retrievals and and is very happy now with her donor
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egg baby and I have a patient who was only able to freeze one egg and it has a little
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boy from her one Frozen neck so we do not have complete control over
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the future this a lot of this is about really making a very informed decision
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for yourself that you feel good about so you can sleep at night have no regrets and like
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Dr Bayou said and I think like you have said Matthew that you’re taking some pressure off yourself you’re turning
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down the sound of that biological clock a little bit because you feel like
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you’ve made a good decision for yourself and if you decide you know I’ve gotten
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all the information this is not for me hopefully you could also feel like okay I made an
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informed decision you know that’s that’s not for me what is the success rate
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of um uh of egg freezing when it actually
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comes time to use the eggs like how what’s the percentage so there are some
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calculators out there and tables that give you General ideas and if you’re let’s say healthy
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and the and you know less than 35 years old 35 or less and these are healthy
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normal eggs I would say every half a dozen eggs it would give you
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um you know maybe one or two nice umbrellas and each embryo is about a 50 take-home baby right and that comes out
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to being 8 to 21 eggs being about a 95 percent
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take-home baby Ray which is really difficult because you know
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either you’re pregnant or you’re not you’re not 95 pregnant or 50 pregnant you know it’s it’s hard to know that it
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can vary widely but that’s those are good General numbers for the United
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States good programs in the United States who are experienced with egg freezing using the current technology of
28:48
vitrification I feel like you know most doctors across the country will give those kinds of numbers if you’re over 40
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um then the numbers can vary widely and and some people feel like you know once you turn 43 you probably you might need
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over 100 eggs to make the baby not that anybody’s ever done that but those you
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know those are extrapolations of data where people try to calculate
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things to give people an idea of what the pregnancy rate would be so it
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you know it strikes me that it’s uh it must be a very very kind of a
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difficult decision for so many people to do this because you’re having to do it
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often at a time where it’s a very preemptive proactive
29:43
measure um if Well I obviously I see a biased population like I I do see people are
29:51
like not necessarily positive they’re going to freeze their eggs but I feel like everybody really wants the information
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you know I think most women a lot of women are are very proactive about their
30:06
health guys not as much but women seem to be very proactive about their health
30:11
and and very curious about the process and a lot of the issue is the money
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that’s that’s hard you know some people like you know don’t like needles and things like that but but the the lack of
30:24
insurance coverage uh is a big barrier and and also you
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know we’re you know Dr myu and I are both on the coast where there’s a lot of IVF programs that are really good the
30:35
middle of the country is is definitely a lot harder there’s um it you know there’s just not as many
30:41
IVF programs in the United States as there are in say Europe because I know we had we had a uh one of our podcast
30:49
listeners who wrote In I think she may have been I think she was 42 and
30:56
she decided at that age to do IVF and it was successful and she sent in a
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picture of oh that’s her and her her baby which was lovely um but she you know one of the comments
31:09
that she made and I’m curious to know what your thoughts on this are uh and of course to some extent her view
31:16
is based on the fact that it worked for her to wait that long and then to have
31:21
IVF but she suggested that the you know these treatments are a you know
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billion dollar industry that obviously benefits a lot from people having
31:38
um doing egg freezing and her point was that there’s the window for women is
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often exaggerated in an attempt to uh get a lot more people buying into
31:51
these treatments yes that’s why it has to be no regrets we can’t say everybody should freeze their eggs because
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everybody shouldn’t freeze their eggs and nobody should feel pressure to do
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that uh and it is a billion dollar industry and people and you know uh you
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know I’m I’m near New York and in New York there’s this company that’s famous for riding around in yellow trucks
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testing people’s amh levels and telling them oh my God your amh doesn’t look good you need to freeze eggs right now
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and and that’s not really a great way to go about it now having said that I will
32:27
tell you um as a reproductive endocrinologist I’m board certified in OB GYN and
32:33
reproductive endocrinology and infertility and all the OB GYN female
32:38
Physicians are all want to freeze their eggs and real really feel strongly that
32:44
it is a good proactive reproductive Health thing to do and and we you know
32:51
for our residents we you know we try to just get it covered and find free drugs
32:57
for them and things like that because we feel like we you know they we want them all to freeze their eggs if that’s
33:03
something they want so you see experts who are you know taking care of patients and
33:09
living this every day and really seeing the power of this technology we really
33:14
believe in our own technology so yes there is a billion dollar industry and I
33:19
don’t think people should be pressured or and and fear-mongering is not good
33:25
because like by the way amh everybody thinks amh predicts fertility and it doesn’t just because your amh is low
33:32
might mean you would have a low response to fertility drugs but it does not mean
33:37
you are going to be infertile and honestly we’re not very good at predicting that so I think people have
33:45
to it has to be a very personal personal decision and you have to have a conversation and get a real evaluation
33:52
with a board-certified reproductive endocrinologist who has experienced
33:58
freezing eggs and you should never feel pressure if you feel pressure to freeze your eggs you need to find a second
34:03
opinion like that is no one should feel that kind of pressure you know you’re
34:09
getting me worked up Matthew no I mean I’m happy I’m happy with doing this I you know I don’t mind worked up
34:16
um I’ve been doing what I do for 15 years now and
34:21
it’s been a subject that has has felt important to me for a very long time
34:28
uh as a man in my twenties I didn’t feel too confident in Wading in on on the
34:36
subject um and but but the truth is for a long time I
34:43
was dealing with women where the elephant in the room right was that they were on dates
34:51
trying to find an amazing partner at the same time as trying to
34:58
make this life goal a reality for them of having a family and that’s like two
35:05
really difficult things that you’re trying to do together um you know it’s hard enough just to
35:11
find someone who you would want to spend your life with uh without the pressure added of being
35:20
on a certain timeline and these women in knowing that there’s this thing that
35:27
they want so badly what was really sad to me for a long time was I saw them behaving as if they
35:35
had no Leverage and like the there was something that in
35:41
their minds they had to have this other person for and therefore it was almost as though
35:48
every day subconsciously or or just in a way that
35:53
they never vocalized they felt like they were coming to the negotiating table from a place of no power
36:00
and that was for me what started me feeling like even if I’m coming to this
36:06
from a biologically ignorant place
36:12
I know the pain that I’m seeing day in day out in people and I can see the bad
36:18
decisions that they’re making because they’re acting out of fear not out of a
36:25
place of certainty and a feeling of control and confidence and so to kind of put this conversation
36:33
in a different a slightly different gear I I want to present to you my
36:39
kind of crusade and then for you to tell me
36:44
you know what you think how you think women should be thinking about it from
36:50
your expert knowledge because I have only ever I’m happy to wait in ignorantly and make mistakes for the
36:57
purposes of giving women more control and getting them to have conversations that there otherwise wouldn’t be having
37:04
and I’m a bit of a control freak myself so if I was a woman I know my nature
37:12
would be to try to control the situation as much as I possibly could and if I
37:18
knew there was an option out there that could buy me a a Lifeline in some way if
37:25
it could give me if it could extend the window if it could give me a backup plan
37:30
I would want that if for no other reason then then when I was on a date I could
37:38
you know if it worked great and if it didn’t work ultimately I don’t need you
37:43
and my publisher Karen Rinaldi who’s a staunch feminist
37:49
and a very very formidable woman we were walking along the street in New York one day and I’m 35 now I must have been 24
37:57
at the time because it was when I was publishing my first book and I said to her what you know what do you say to
38:05
women who you know a risk of making really bad decisions about who they end up with
38:10
because they’re they’re in a rush and it’s also not to mention it’s just changing their energy around a person
38:16
and it’s making them accept less than they deserve they’re lowering their standards
38:21
um they’re accepting bad behavior all because they want this goal to happen and her view was if you know this is a
38:30
life goal of yours and that it is something you really really want to do why would you rely on
38:36
a man for that why would you give a man power in that situation and this was
38:42
someone who ended up having her own children but uh uh with a partner but
38:47
she was more than ready to do it on her own if that didn’t happen
38:53
so I I suppose I I put it to you
38:59
how important do you think it is I know that you say that it’s a personal decision for everybody and maybe I need
39:05
to kind of for a moment remove the financial issue because I think that’s that’s a its own
39:12
its own barrier but if you remove the financial variable and control for that
39:18
and just say should in do you believe personally that in order to give
39:24
themselves that power and sense of control and to make better
39:29
decisions that people in their early 30s do you lean towards they should do it rather than they shouldn’t do it I lean
39:36
towards they should definitely think about doing it so but I I think I’m biased
39:44
what do you think your honor are you I’m going to use the phrase that you used in your other podcasts when you make the
39:51
difference between settling for something or settling on something and I think just to bring it to your
39:58
point as I I feel like when you’re feeling that pressure and and kind of the stress that you’re running out of
40:04
time that’s when you risk settling for someone just because you’re running out of time as opposed to settling
40:10
on someone because they’re the right person and it’s the right time and now you’ve taken this other variable out of
40:16
the equation um I do think it’s a personal decision I do lean towards
40:23
I I think you should consider doing it get your data get your facts and talk
40:28
about it because that doesn’t cost you anything um and then you can make a more informed decision but I think
40:33
I do think it empowers you at the end of the day it’s to set your own schedule um it empowers you to take control of
40:39
your body to make your own decisions um and to just control your own biology
40:46
to a certain extent and it doesn’t it’s not that if you know there’s first
40:51
of all there’s no guarantee as I could Trend said but also just the fact that you’ve done it doesn’t mean that you are now obligated to have children
40:58
um with someone or on your own I mean the only downside and not not to bring it back to the finances but the only downside is that once you’ve done it you
41:04
do have to pay every year for those eggs to be frozen
41:10
it depends on the place I’m sure I think in my place is something between 600 and a thousand dollars
41:17
um so it’s not a you know a year like something a year yeah every year a year
41:22
yeah so it’s something that you just at some point if you’ve decided okay I’m definitely not going to do this then you
41:28
can stop paying for it presumably but um you always have that option open as
41:34
long as you’re willing to do it so I do think it empowers you um to make a decision later and it just
41:39
in some ways kicks the ball down the court and you make the decision a later time if you if you choose to yeah oh
41:46
please no I was going to say just one other one other thing because I have had friends who’ve done this um there is a
41:51
difference between freezing your eggs and freezing embryos um and I think that that’s something that it’s worth thinking about as we uh
41:59
discuss you know relationships and um or marriages and people who decide to
42:05
have children um I do have friends with frozen embryos and and then ended up breaking up with
42:11
that person and they never actually had eggs frozen uh I hadn’t thought of that yeah we we
42:18
have to talk about that because there’s a little bit of a patriarchal attitude
42:25
in our field with many programs or maybe just an archaic attitude that looking at
42:32
old data that it’s better no it’s patriarchal it’s really patriarchal
42:38
um saying it’s better to freeze embryos we have more data on Frozen embryos because it’s been around for longer and
42:46
um but you know for long-term future storage if you are not ready to have a
42:52
baby right now you really shouldn’t be praising embryos honestly you know I do have
42:58
people embryo banking where they have one baby and they want to you know they want to have two or three babies and
43:04
they’re already like 38 and they’re doing IVF anyway so they want to store some embryos I think that’s perfectly
43:10
reasonable but for somebody who’s really not ready to have a family yet
43:16
um to do this as to do embryo preservation as fertility preservation
43:21
really doesn’t really does not make sense and
43:27
um Dr Bayou is absolutely right we’ve seen some really terrible cases where people are stuck
43:33
um with these embryos you know once we put the sperm in there we can’t take it apart and to tell somebody oh the
43:40
pregnancy rate’s a little bit better with frozen embryos that’s that’s a little bit of a myth if you’re at a good program that’s doing a good job of
43:47
freezing eggs it it’s not it’s not better it’s really almost exactly the
43:53
same people do that because they’re already in a relationship but neither one of them is ready to have
44:00
children and they it therefore is preserving a child that
44:06
you can have with this person is that correct because of the circumstances under which you would do it
44:12
no I’ve even seen people like saying yes and and with this idea that somehow
44:19
medically freezing Ambrose is better but it’s not it’s potentially a huge
44:24
disaster I mean you know we have like over a 50 divorce rate in this country yeah yeah yeah so you’re you’re like
44:30
flipping the coin like am I going to be able to use these embryos or not it’s always better to freeze eggs and by the
44:36
way now that Roe v Wade has been overturned the Frozen embryos take on
44:42
even more of a risky proposition we do
44:48
not know what is going to happen with all this legislation in the wake of Roe
44:55
v Wade and people are proposing some really crazy things and it’s much better to have frozen eggs than to be dealing
45:03
with frozen embryos in long-term storage so if you um I wouldn’t be purposely making Embers that you are not ready to
45:11
use but if you break up with that person that embryo can it be legally used
45:19
yeah it could be legally used if both parties agree but it needs sign up there
45:24
from both parties court cases where people are fighting and fighting and
45:30
fighting and the lawyers are getting you know the lawyers are benefiting but
45:35
nobody else is but does it need to sign off by both parties it caught in other
45:41
words it does but people change their minds I have a case uh we have a case in New Jersey where this woman had cancer
45:47
and froze embryos with her fiance and they drew up legal documents uh that
45:53
said he in the case of divorce uh she would be able to use these embryos to
45:58
conceive and you know they broke up she survived her
46:05
cancer she got ready to use her Ambrose he changed his mind they had a legal agreement he changed his mind and he
46:12
could he could easily have won because there are depending upon the judge and the situation
46:17
on most cases rule that you cannot force somebody to procreate against their will
46:24
uh but this judge uh said that these were this was her last chance to have
46:30
genetic children and I think ultimately she won the lawsuit but it was it was a
46:36
lot of pain and suffering this is perhaps down the rabbit hole a little bit but that does it I’m finding this a
46:42
little bit quite this is kind of fascinating because I’d never even considered that eventuality does oh
46:48
Matthew there’s so many rabbit holes in Reproductive Medicine right just quickly learning that I so does in that sense
46:56
does he still have if she’s choosing to go ahead and he’s saying I don’t want
47:01
this does he in the same way of normal pregnancy does he have an obligation
47:09
there or I think the the Judgment was he did not have to pay child support but
47:15
his you know if she has a child he’s got uh you know progeny out there wow how fascinating so
47:26
that’s a that’s a really interesting distinction so ultimately even if you’re in a relationship
47:33
having your eggs frozen rather than an embryo Frozen it’s still it’s a still a
47:40
version of Greater options um which I hadn’t even more flexibility
47:45
yeah yeah more options yes and Matthew uh you know you’re you’re 35
47:52
and um I tell all my guys I would like them you know to either finish their
47:58
family by 40 or or maybe freeze some sperm by 40 because there there is
48:04
Theory theoretically some increased risk not as much as women but some increased risk in uh to the child with uh older
48:12
dads and some of that can be addressed by you being super healthy but some some
48:19
probably not and banking sperm is much easier than making eggs and so if you
48:26
know if you have that option there’s there’s tons of great sperm banks around that will store your sperm and you know
48:32
so that’s something to that I want I would like men to think about because I am as a fertility doctor seeing more and
48:40
more first-time dads significantly over 40. and um and having more fertility
48:48
issues and you know being more at risk of having you know kids with issues
48:54
because of Advanced paternal age um and when you have an older wife and
49:00
an older sperm that is in some ways you know adds to the risk and adds to
49:06
the infertility risk yes yeah it’s a great example of um the wise men aren’t actually
49:14
in you know I think so many men aren’t even in the conversation of their own facility uh fertility I should say
49:21
um uh there’s a there is I think an assumption among so many men that it’s women who have these issues it’s not men
49:27
who have these issues which is uh something that I suspect a lot of men find out too late that it’s uh they have
49:35
their own factors at play um do you want to and if this is too
49:41
personal a question feel free to tell me and we can edit this out um but I’m curious as to how far your
49:50
kind of internal planning has gone um you know if you don’t meet a certain
49:57
if you don’t meet a person by a certain time have you decided that you would do
50:03
this on your own and if for any reason as an additional kind of uh eventuality
50:11
you couldn’t um you know it didn’t take I don’t know what the right term for that is
50:18
um but if it didn’t have you considered that you would adopt or you would go a
50:24
different route I’m just curious I’m curious how many different ways you’ve played out the scenarios in your head
50:30
that have given you comfort or just you haven’t gone there yet I think it’s a
50:35
great question and the answer will will vary depending on who you ask because it’s a very personal decision
50:42
for me I wanted to have the the option open
50:47
um and I decided that I would only do this if I were able to have a family
50:53
with somebody else like I wouldn’t want to do it I wouldn’t want to raise a child Alone um or have somebody else’s child that I
50:59
didn’t know it wasn’t you know um doesn’t mean anything though I know
51:05
women who’ve done this um exactly because they wanted to be empowered to have children with or
51:10
without a partner and I think that’s perfectly Fair some women wanted to
51:15
um you know would just didn’t matter if it was their own egg or somebody else’s and would be open to adoption
51:23
um some other women I know and this was actually somebody asked me this I don’t think a lot of people know this but you
51:28
can also donate your eggs to couples who are infertile or who’ve not been able to
51:36
um either go through the process of IVF or they have and they weren’t able to fertilize and so there are some options
51:41
where you can um you can potentially give your eggs away or to friends or homosexual couples
51:47
if you have friends who actually are looking for for something like this so there’s there’s really many things that
51:53
you many different directions you can go um with this and it’s really just the completely personal choice with this
52:00
technology you’ve you have given people the option to as you said Matthew to
52:06
totally separate the search for a partner from the the family building
52:12
part you you can separate if you want and you can you don’t have to do it in the
52:19
traditional order you can have the baby first and find the partner later if that’s
52:24
what you want all those kinds of things Joanna have you is speaking to that have
52:30
you know when you have decided that for you the blueprint is either that you find
52:37
someone um or you choose not to have children
52:43
um is that has the not having children think been something that you have
52:48
kind of you feel that in in any way you’ve already made peace with if it doesn’t happen or has the kind of
52:57
urgency that you perhaps would have felt earlier just been transferred to later
53:04
by freezing your eggs yeah I think I think did it took the pressure off I
53:09
think my my theory is that you know I personally would want to have a family
53:14
with somebody that wants to have a family and so and I think it makes a big difference if you’re in a relationship
53:21
where you are both on the same page um so I don’t think it’s a it’s a decision that it’s not been cemented in
53:29
my mind and it could still very much go either way and I haven’t you know settled on one on one side or
53:35
the other it really it’s given me options essentially that I didn’t have before yeah no we we don’t want people
53:42
like we want to take pressure off people but we don’t want them to delay too long because as as you get older it
53:51
does become harder to carry your baby and you do have higher risks in pregnancy like diabetes high blood
53:58
pressure things like that as you get older which can be somewhat addressed by a very healthy
54:04
lifestyle but um you know that that is something to think about as
54:11
well at what age do you see those things really starting to kick in in a significant way they start I think we
54:19
start to be able to measure it a little bit over 40 but um
54:24
um we usually stop doing train embryo transfers
54:30
um uh at around age 50 maybe up to 53.54 it varies by
54:37
program but in general in the United States the age limit is around 55 for getting people pregnant
54:44
um those are you know once you once you had 43 44 usually people are if they
54:49
don’t have their own frozen eggs that they froze earlier are usually using donor eggs to conceive
54:56
um but we you know in terms of maternal health
55:01
we um we stop around you know early 50s
55:07
um because when you say those risks Embryo transfer that’s the term referring to implanting
55:14
the embryo in the subject yeah yeah okay I mean they’re they’re they have like in
55:21
India I know they’ve done some transfers to people in their 60s but you know there’s a very
55:27
upsettling case a couple years ago where you know the woman like she died soon
55:33
after the baby was born when she was in her 60s because it you know your heart it really impacts your heart so
55:41
um so we do have to think about that you know not to torture people but we we do have to think about that and then I
55:47
think I do want people to you know hearing Dr BYU’s personal experience
55:56
um I think really helpful I I would say that I think as a surgical resident
56:01
probably squeezing it in between cases is is tough and that does probably lead
56:07
to more side effects because I think if you can make your schedule really light and you can give yourself enough time to
56:14
get extra sleep and naps when you need it yeah because most people need that and drink at least two to four liters of
56:22
water a day most people really tolerate this process very very well just add
56:28
another layer of complexity there depending on how you’re planning on doing this whether you pay for it on
56:35
your own or go through the insurance company I think the in general the advice is that you would always try to
56:41
have a natural fertilization so you’d always try to have a child naturally so just the fact that you have your
56:47
eggs frozen or your embryos doesn’t mean that that’s automatically you know you
56:52
you decide to have a child and this is your your go-to I think right recommendations which are still that you
56:58
try to do it and if not then you go through it you might not need them yeah
57:03
so that’s but that’s interesting to me because I would have thought from
57:08
everything that’s been said that if you’re 39 and trying to conceive
57:15
but you have eggs frozen and you had those eggs frozen at 30 then there’s
57:22
potentially less risk of complications with younger with with eggs that you
57:27
uh retrieved when you were younger than at 39 am I completely wrong about that
57:33
in other words is there a greater risk of complications by using your eggs at 39 that at 30.
57:41
you you’re right and you’re wrong like there’s a lot of things to think about but it’s costly you know you you’re
57:47
doing an extra cost you’re doing an extra procedure to thaw your eggs and and inseminate them and put them in the
57:55
vast majority of IVF babies are really healthy but there is a slightly higher reported birth defect rate for IVF
58:02
babies eight percent instead of the normal five percent we think most of
58:07
that is because most of the data is from infertile people but we don’t
58:13
know for sure we are growing embryos in a dish um and a Frozen thawed Embryo transfer
58:20
we are seeing slightly higher rates maybe of um high blood pressure and pregnancy
58:26
things like that is that an IVF effect it’s it’s nothing crazy and we feel like
58:33
most people do really really well um but
58:38
um yes there’s there’s a risk of you know miscarriage and things like that when you’re when you’re a conceived 39
58:45
but we and it’s really up to the patient um but
58:51
you know a lot of people think okay the the eggs are a backup plan if you don’t get pregnant on your own easily then we
58:58
use those because we kind of think that of them as a type of fertility treatment but you don’t have to do it that way yes
59:05
that’s pretty typical firstly that I really appreciate all of this
59:10
information because this is without a doubt been the most useful conversation I’ve ever had on this subject
59:16
uh and I feel so much more educated on this side of it
59:21
than going into it it’s funny I I made a glib comment not
59:28
so long ago that you know I felt like you know I was coming from an uninformed
59:33
place of saying well surely everyone should do this um why wouldn’t why would you not do
59:39
this I mean finances aside obviously I would I said if you had the money why wouldn’t you do this and I’ve had a
59:46
couple of emails back from people saying well let me tell you why and and I
59:51
quickly realized how uninformed I was but what’s interesting about everything
59:58
that’s been said here is that while I feel like there are
1:00:04
there’s much more energy and cost and
1:00:10
and just you know the the effects of the process
1:00:16
are much more dramatic than I perhaps realized I don’t know that it changes how I feel
1:00:24
about the whole thing because I it’s I I still feel like I’m inclined to say
1:00:31
if there was a woman that in my life that I love and she got to her early 30s
1:00:39
and knew without a doubt that having a child was something she wanted to do or
1:00:44
she felt like there was a good chance that at a certain point she would end up wanting a child
1:00:50
I would want her to have the personal Leverage
1:00:56
of having created options um despite the the process and the cost
1:01:03
and some people it’s very sad to me that some people will never be able to do it because of the cost and I totally agree
1:01:11
with you Dr Chen that the idea that this is solely a women’s issue is
1:01:16
unbelievably ignorant and um and there is an inbuilt misogyny
1:01:22
um to that and two not having it be um something that’s covered I I I’m with
1:01:28
you on that yeah so let’s work on that because um we got we got we passed some egg
1:01:33
freezing laws in New Jersey and there’s nine states that have um mandated coverage for egg freezing
1:01:40
for cancer patients uh but I think you know we we should you should continue to
1:01:45
say controversial things because at least we keep the conversation going right I love that you’re having us here
1:01:53
to talk about it because the more people hear about it that I think it will
1:01:59
you know it’s an educational process that’s that’s something hopefully we can motivate some people to learn more about
1:02:06
their reproductive health and at least have a conversation with the doctor um and so they you know they can make
1:02:12
this decision for themselves I do want people to know that you know that’s like
1:02:18
such a striking image Dr Bayou what you said of the syringes all over it does
1:02:25
seem really scary but it it is all relative you know we’re talking about having a baby having a baby is much much
1:02:32
um more physically demanding and and riskier medically than you know doing
1:02:38
egg freezing uh there are risks to everything but um you know for a healthy woman egg
1:02:46
freezing is is really relatively low risk I’ll say one other thing Matt and
1:02:52
this is again just from anecdotal and experience of just having friends have done this there
1:02:58
the pressure can be tremendous from a partner I mean I have friends who’ve gone through the process
1:03:04
because they felt pressure from their partner and um and sometimes that’s a decision that’s
1:03:12
mutual and can be made by both people and sometimes it there is that Sensation
1:03:18
that you know the the woman has to go through a process that can be painful and
1:03:25
distressing um because her partner really wants to have a family at some point
1:03:31
um it’s the pressure that he you know let’s say he wants a family at some point but
1:03:37
he doesn’t want it now and that’s the pressure that he’s saying I wrote the option of us doing this and you have to
1:03:43
go and freeze your eggs so that we have the options essentially and I mean this is and I’m talking I’m thinking uh of
1:03:50
some friends who’ve had a very similar situation and the one thing that I I do think it’s really
1:03:56
worth mentioning is that you know we’ve talked about the success of that freezing and you kind of go into
1:04:02
it and let’s say you have all the money and all the support that you you want it sometimes you know you it’s sometimes
1:04:09
it is luck and you can be healthy and young and you might not get the yield that you’re hoping um or might not get
1:04:16
any yell tonight and I know women who’ve taken this very personally and just felt
1:04:22
like this was a personal failure that they weren’t able to freeze their eggs despite going through
1:04:27
the motions going through the efforts choosing a great fertility doctor paying the money doing all of it and then just
1:04:33
not being able to do it and so all of a sudden they’re faced with this reality that’s that’s pretty tough to to take in
1:04:39
when you weren’t expecting you’re you’re thinking that you’re doing this because you want to be proactive and you want to
1:04:44
save an option and all of a sudden you realize you can’t do that um and so it can be emotionally hard on
1:04:52
some on some people and it’s just something that it’s worth thinking about um you know it it’s again I think a lot of
1:04:59
it is personal but I think just being informed and making informed decisions is critical it’s much more than you know
1:05:05
a decision about a medical procedure you’re really talking about making a decision about your your life really
1:05:11
because all those things come into play in that decision
1:05:16
but in a way you’re you’re also doing the opposite right you’re giving yourself
1:05:22
you’re just keeping doors open in life um to not do it is also a decision about
1:05:28
is a potential decision about the the future and I I have to assume that if if
1:05:34
someone’s yield wasn’t what they thought it was is that that is a reflection of their fertility anyway correct so right
1:05:42
if you’ve learned something yeah right so to that extent in a way you’re learning something painful but you’re
1:05:48
only learning something painful that you would have learned anyway down the line right you’re just learning
1:05:55
I think I think it just yeah it just hits people sometimes hard if they’re like 30 and all of a sudden you’re
1:06:01
realizing yeah oh this is happening and and I can’t do it and I don’t have that option saved and it’s yeah you know just
1:06:08
making you wonder is it too late have I waited too long and so it can be emotionally yeah but I I would
1:06:15
have thought almost that if you delayed it another five years you would only
1:06:21
increase that feeling of I should have done something sooner right if I I feel
1:06:26
like the person who does it at 30 is already kind of they’re already being
1:06:33
a very proactive person and so I I would hope that people would
1:06:39
try at least to feel that message of actually what I did was an incredible thing it may not have worked but I’m the
1:06:46
kind of person who took action uh and I had no control over whether that action
1:06:52
was you know aside from some of the factors that maybe I can have some control over ultimately uh it’s my body
1:06:59
we’re dealing with and the I would hope that people would be incredibly proud of themselves for having taken a very
1:07:05
proactive step even if that proactive step didn’t pay off the way that they wanted it to
1:07:11
and ultimately is still information you know I I I feel like that’s hopefully
1:07:16
from this call I’m hoping that so many people listening men included feel like this is just information I mean even for
1:07:24
me you know it’s given me a sense of urgency about just you know
1:07:33
having some key internal and couple conversations uh with my partner in in
1:07:39
just making a you know deciding what the plan is and what options are in front of us so I think that you know even for me
1:07:47
it’s been really educational in that respect I think I think you’re right about all of that I think
1:07:53
you know you’re right people should feel um good about themselves for you know
1:08:00
even having the conversation and or listening now you you are getting more
1:08:07
educated and and that is empowering and the more education you have about your
1:08:14
your body and your health you can make a difference even though sometimes the outcomes may not be what you want but
1:08:21
you are making a positive difference absolutely and even feeling that fear because these conversations are kind of
1:08:26
scary but even even feeling that fear of you know because you’re treading in deep
1:08:31
water all of a sudden thinking about all of these things I I feel like even the fear is a
1:08:37
reflection of progress because your your having it means you’re having
1:08:43
the difficult conversations you’re no longer putting them off and if you’re having the sooner you’re having
1:08:48
difficult conversations within yourself the the sooner you’re bringing about the
1:08:53
the peace from having resolved them one way or another whatever the outcome and
1:08:59
what you mentioned about feeling proud of you’re doing something I feel like once you embark on the train and you
1:09:05
decide you’re going to do this and you follow the steps there are things that are outside of your control
1:09:10
and so you just have to remind yourself that you’ve literally done everything you possibly could yeah you literally
1:09:16
have done your best you’ve pushed your body as hard as it possibly could get
1:09:21
pushed and whatever the result is is the result and it’s not because you’ve done
1:09:28
something wrong or because it just needs really you know I think it’s important
1:09:33
not to beat yourself up um and just absolutely be proud that you’ve done it and no matter what your
1:09:40
yield is or what your result is the important thing is that you’ve taken that decision and you’ve thought it
1:09:45
through and um and you tried I agree
1:09:51
I thank you so much to to both of you for for joining me today it’s it’s been
1:09:57
lovely talking to you both and and you have such a lovely way of sharing the information
1:10:03
um that uh I just feel really grateful we could have you know there were any number of people that we could have had
1:10:08
join us on this subject and I’m really really glad it was the two of you thank you I’ll leave it with one other thing
1:10:14
just to kind of keep it out there is just don’t go through this alone
1:10:20
um I do think it makes a tremendous difference to have friends or family know that you’re going through this
1:10:26
because it is hard it’s you know I think it was so nice to have somebody that
1:10:35
could pick you up after you know on the daily procedure drop you off and pick you up and
1:10:40
you know get you home with good food and kind of celebrate the fact that you’ve done you
1:10:46
know this incredible thing and um and it’s over and so I think it makes a tremendous difference to not not be
1:10:52
lonely in it a hundred percent I totally agree lovely
1:10:57
well thank you both and please stay in touch and if you’re ever listening to anything I’m doing and you think I’m
1:11:04
missing something crucial please know that uh your opinions are always welcome and I’d love to hear from you well I’m
1:11:11
subscribing yeah very good thank you both take care
1:11:18
[Music] I just wanted to say thank you for
1:11:24
watching this if you’re a woman I hope that this helped and I hope that it gave you much
1:11:31
needed information if you’re a man I hope that this gave you much needed information and I hope that it created a
1:11:38
sense of perspective and empathy about what women go through in this area
1:11:44
I would love to hear from you all on this leave me a comment feel free to reach out and and message us on
1:11:51
Instagram or by email but just let us know what this meant to you because I want to continue having these kinds of
1:11:58
conversations I think they really matter and I think they’re going to make a big difference to a lot of people’s lives so thank you for watching and I’ll see
1:12:06
you in the comments [Music] foreign [Music]
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This post was previously published on YouTube.
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