Brave & Curious with Dr Lora Shahine

Latest Episodes:

Ep 53 Exercise and Trying to Conceive: Too Much, Too Little, or Just Right? Jan 08, 2024

Show notes

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:

[1:36] The controversy around exercise and fertility

[2:38] Reviewing the research

[4:01] Exercise during IVF – what's the worry?

[7:50] Fertility Story: Exercise extremes, the stress of cutting back for many patients, and the Female Athlete Triad

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 52 To Drink or Not to Drink: All About Alcohol and Fertility Jan 01, 2024

Show notes

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:

[0:00] 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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 51 Family Fertility, Courage, Curiosity, Balance & More from a Woman Wiser than Me: My Mother Dec 25, 2023

Show notes

If you've ever wondered where Dr. Shahine gets her ferocity from, well, meet Charlene.

Inspired by Julia Louis-Dreyfus's Wiser Than Me podcast, Dr. Shahine interviews a woman she truly admires: her mother, Charlene Kelly Ewing.

Despite being "all of 5 feet," according to daughter Lora, Charlene meets every challenge head-on and, at age 79, still pushes herself to do what she's afraid of.

The diminutive Southern belle may have a soft voice, but Dr Shahine knows to listen: her mom has been a guiding force as well as her daughter's biggest cheerleader.

Whether she's impressed by her daughter's ability to watch gnarly medical procedures and still eat pizza, or her drive to help others through not only health care but also health education, Charlene Ewing is as inspired by her daughter as her daughter is by her mom.

Have a listen, then give yourself the gift of talking with a woman you admire.

Happy holidays from Baby or Bust!

In this episode you'll hear:

[00:00] Why Dr. Shahine admires her Mom

[05:02] Mom shares Dr. Shahine's inspiration to be a physician and why she didn't think it would really happen

[10:23] Family Fertility Stories – What we share and don't share and what it means – Mom's fertility, endometriosis and period struggles

[16:02] Secondary infertility and the fear of having kids born far apart in age

[19:42] On balancing work and motherhood – Why Mom worked and how she modeled independence

[25:00] Leading with curiosity

Resources mentioned:

Wiser Than Me podcast: https://podcasts.apple.com/us/podcast/wiser-than-me-with-julia-louis-dreyfus/id1678559416

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 50 Over 25 Years of Taking Charge of Your Fertility with Author Toni Weschler Dec 18, 2023

Show notes

"Why didn't I know all this already?"

- Pretty much everyone who reads Toni Weschler's book

The stigma around women's reproductive systems isn't just an inconvenience, it removes a critical way women get insight into their bodies and health overall: period power.

The menstrual cycle tells us a whole lot more than if we're pregnant or not, or menopausal or not, says author Toni Weschler. Her seminal (oh, the irony of that adjective!) work, Taking Charge of Your Fertility, is all about understanding and taking charge of your reproductive health and being "cycle savvy."

In this episode, Dr. Lora Shahine and Toni Weschler talk about the origin of this amazing work. (Hint: it has to do with women being really angry.) And despite the title, it's not all about helping people who are hoping to become pregnant. It's about, says the author, "teaching women on a day-to-day basis what is going on with their body on that day" and taking advantage of all the insights into your health charting your cycle can give you.

In this episode you'll hear:

[02:26] What is 'Taking Charge of Your Fertility' and why Toni 'hates' the title

[04:44] Toni's inspiration to write the book

[09:50] The difference between the rhythm method and fertility awareness

[11:22] The 3 signs of fertility explained

[14:56] What the menstrual cycle can teach you about your health

[18:51] Being a pioneer: How did Toni research for her book in 1990s?

[26:31] The difficult process of pitching the book – lesson in rejection from Toni

[36:30] The challenges of writing the book – Toni fought for her vision

Fertility Story:

[41:21] Toni's 'Birth Announcement'

[42:23] The responsibility of 'Taking Charge of Your Fertility' and what inspires Toni

[44:42] Instagram Questions:

Nikki: Is there another edition? Yes! 30th anniversary edition out in 2025
Alexa: What fertility or period apps does Toni recommend?
Claudia: How can teens learn about their cycles?

[53:12] Final thoughts: Advocate for Your Care

Resources mentioned:

Toni's website: www.tcoyf.com

Taking Charge of Your Fertility the book: www.tcoyf.com/taking-charge-of-your-fertility

Toni's Cycle Savvy Smart Teen's Guide to Her Body: www.cyclesavvy.com

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 49 Olympic Champion Figure Skater to Fertility Advocate: What Tara Lipinski Learned while Unexpecting Dec 11, 2023

Show notes

No two fertility journeys are alike, but Tara Lipinski's experience is perhaps even more unique than most. The champion, gold-medal-ice-skater-turned-sports-analyst was 35 and still not necessarily ready to start building her family. So she decided to put her options "on ice" — literally preserving eggs and/or embryos until she and her husband Todd were ready.

However, the process turned out to be more complicated than it appeared when a diagnosis of endometriosis sent them down a different path.

What followed was two surgeries, four miscarriages, six failed transfers, and five years of treatment, hope, and heartbreak.

Spoiler alert: perfect Georgie was born in 2023, so there is a happy ending, but the picture on Instagram of Tara, curled up on her couch, heart-broken and clutching pregnancy tests, sent waves through the fertility community. Here was a very public figure speaking very publicly about her struggles to build her family.

Please listen and share to help us continue the conversation.

In this episode you'll hear:

[07:74] Why Tara and Todd shared their story on their Unexpecting podcast

[13:19] How did Tara's athletic career prepare her and NOT prepare her for infertility

[19:51] Reflecting on relationships through infertility, men vs. women on coping

[30:02]When to share and not share the fertility journey

[34:53] When we are surprised by infertility

[38:01] Misconceptions and reality about surrogacy

[46:12] Instagram Questions

Amanda: Did you and Todd ever consider giving up?

Marena: How did you and Todd keep going?

Dana: Advice to someone who is struggling with infertility?

[55:21] Finding Tara and her podcast

Resources mentioned:

Tara on Instagram: @taralipinski

Tara Lipinski: taralipinski.com

Tara Lipinski: Unexpecting Tara and Todd's podcast

Babyquest Foundation Fertility Grants: babyquestfoundation.org

Sunfish financial solutions for fertility treatment:joinsunfish.com

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 48 Tips for IUI Success Dec 04, 2023

Show notes

The good news: IUIs can work! Intrauterine insemination (sometimes laughingly referred to as "the turkey baster method"), or IUI, can help overcome issues like low sperm count or low sperm motility by getting sperm closer to where it needs to be around the time of ovulation.

This method of dealing with infertility is also less expensive and much less invasive for the person hoping to carry the pregnancy. It can also be a great method if you're planning on using donor sperm.

The harder news to hear: it may not work the first time.

That said, there are things you can do to increase your chances of a successful IUI, and in this episode, Dr. Shahine goes into your many options, both medical and behavioral.

In this episode you'll hear:

[00:00] Intro to the Episode

[01:27] IUI review – what it is, how it works, how is it different from IVF

[04:31] Tips BEFORE you do your first IUI

Tip #1 Get testing before you start

Tip #2 Review your family goals with your doctor

Tip #3 Make a long-term plan – how many IUIs?

[06:10] 5 Tips for Success with IUIs

[06:10] Tip # 1 Medications used with IUIs

[07:25] Tip #2 Monitoring with IUI cycle: OPK vs. Ultrasounds

[08:33] Tip#3 Use of Trigger Shots for timing IUI

[09:11] Tip#4 Optimize sperm counts for IUI to improve success

[10:15] Tip #5 Optimize overall health to improve success with IUI

[11:43] Chances of Success with IUI

[12:33] Fertility Story for the week – An indication for IUI that you may not have heard of before

[15:37] Summary and Outro

Resources mentioned:

Drlorashahine.com

hello@drlorashahine.com

Tips for Timing Trying: Dr. Shahine's video on Baby-Making Tips

Tips for Ovulation: Dr. Shahine's video on How to Know When You are Ovulating

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 47 Weight and Fertility: Optimizing Health NOT Restriction and Shame with Dr. Stephanie Fein Nov 27, 2023

Show notes

Ep 47: Weight and Fertility: Optimizing Heath NOT Restriction and Shame with Dr. Stephanie Fein

Weight loss for fertility is controversial and complicated, and to be perfectly honest, more research is needed to fully understand the link between body weight and fertility. Whatever studies find, weight loss for fertility should never involve shaming or guilt.

In this episode, Dr. Shahine talks weight and fertility with Stephanie Fein, MD. Dr. Fein started in social psychology, then moved to Internal Medicine, where she completed a residency program. She then went on to obtain a Masters in Public Health.

All of these skills came together when Dr. Fein was moonlighting at a weight-loss clinic while doing her residency; a conference on weight and fertility solidified her decision to move into helping people optimize their fertility with weight loss.

What does the research really show?

Perhaps most important to understand, no two bodies are the same, and many of the numbers and other information you'll hear on the Internet (and maybe even from your doctor), won't apply for all.

In this episode you'll hear:

Time Stamps

[00:00-03:18] Intro to the show and Dr. Stephanie Fein

[03:19-07:27] Dr. Fein's inspiration from medical doctor to Weight Loss for Fertility

[07:28-16:43] Research on weight and fertility – Why BMI as a marker?

[11:32-15:33] Obesity, reproductive health and Insulin, visceral fat, and hormones

[15:34-16:43] PCOS and inflammation

[16:44:19:15] Realistic weight loss expectations and sustainability

[19:16-26:27] Why people overeat – changing your relationship with food

[26:28-30:13] Dr. Fein's advice on how to talk to your doctor about weight

Dr. Fein answers Questions from Instagram Community Follow @drlorashahie

[30:20]- Trish asks "How does gastric bypass impact fertility and pregnancy"

[31:20]- Sara asks "Can I use Ozempic or Wegovy while trying to conceive?"

[38:14]-Samantha asks "Is it ok to try to lose weight while trying to conceive?"

[36:00-38:14] Summary and finding Dr. Stephanie Fein

If you want information about weight loss and possible impacts on fertility, you can find Dr. Fein on her website: stephaniefeinmd.com

Resources mentioned:

Podcast 'Weight Loss for Fertility with Dr. Stephanie Fein': stephaniefeinmd.com/podcasts/weight-loss-for-fertility

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 46 Tips for Surviving and Thriving Thanksgiving with Infertility Nov 20, 2023

Show notes

Holiday events can mean facing some awkward questions about family building - are you ready?

"So, when are you having another?" "You had a baby? It's about time!" "When are you going to make your mom a grandma?" "Baby weight, huh?" "Should you be drinking that when you're breastfeeding?" UGH.

Holiday conversations — especially when alcohol and holiday conviviality reduces people's inhibitions — can be kind of awful. So this year, please put yourself first. Dr. Shahine has some great tips on how you can do that.

From finding an ally (hint: it doesn't have to be your partner, who is likely fighting their own conversational battles) to designing conversational strategies from polite deflection to well-deserved zingers, being prepared in advance can really help in the moment.

In this episode you'll hear:

[00:00] Intro to Baby or Bust and Episode on Holidays with Infertility

[01:26] Intro Tips for Surviving and Thriving Thanksgiving with Infertility

[02:05] Tip #1 Don't Go

[03:06] Tip #2 Find Your Ally

[04:38] Tip #3 Plan Your Answers to Awkward Fertility Conversations

[06:02] Tip #4 Plan an Exit Strategy

[06:33] Tip #5 Plan Self Care and Recharge

[07:51] Fertility Story: My First Holiday Season with a Baby after struggling with Infertility – the awkward fertility conversations continued

[09:51] Outro and thank you

Learn more from Dr. Shahine www.drlorashahine.com

Send your fertility stories, topics you'd like to learn about, and people you want Dr. Shahine to interview to hello@drlorashahine.com.

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 45 Yoga for Fertility with Author and Yoga Instructor Lynn Jensen Nov 13, 2023

Show notes

In this episode, Dr. Shahine explores the benefits and research supporting Yoga for Fertility with master instructor and author of the first book on the subject, Lynn Jensen.

People on fertility journeys often say they feel like their bodies don't belong to them anymore. Between the tests and the treatments and the theories, it's easy to see how people can feel disconnected physically and emotionally.

Lynn Jensen's Yoga for Fertility classes helps heal bodies AND minds. Lynn has a specialization in yoga for the fertility journey, so her students can trust that they're maximizing their physical and emotional wellness.

Lynn is a Registered Yoga Teacher through the Yoga Alliance and a Certified Yoga Therapist through the International Association of Yoga Therapists since 2013.

Not only does Lynn have highly specialized training, she's been through the journey herself. Her classes often turn into impromptu counseling sessions, and her students make lifelong bonds with her and each other.

In this podcast, Lynn and Dr Shahine talk about the many ways yoga heals and strengthens the body for fertility and the mind for the challenges of the journey.

Find Lynn and sign up for classes at her website, https://yogaforfertility.net/.

In this episode you'll hear:

[00:00] Intro to Episode 45

[03:23] Lynn's Fertility Story and Origins of Yoga for Fertility

[08:46] What Makes Yoga for Fertility Different from Other Practices?

[10:30 Chakra system and relation to hormones

[11:21] Dr. Shahine describes a class she took with Lynn

[12:28] Yoga poses changing through the menstrual cycle

[13:41] Lynn's favorite pose during the two week wait

[14:48] The research that supports the benefits of Yoga for Fertility

[21:03] Lynn's advice on exercise during fertility treatment like IVF

[25:37] Lynn describes a typical class

[28:39] Lynn guides Dr. Shahine through a breathing exercise

Questions from Instagram @drlorashahine:

[33:10] Sandy: Is it ok to do yoga during an IVF cycle?

[33:28] Katrina: Who are your classes for? Egg freezing? Couples?

[35:18] Anne: Can yoga help patients with miscarriage?

[37:19] How to find a certified yoga for fertility instructor?

[38:29] Tribute to Lynn from a former student

[39:11] How to find Lynn and Yoga for Fertility: https://yogaforfertility.net/instructor/

Resources mentioned in the show:

Domar A, et al. Impact of group psychological interventions on pregnancy rates in infertile women Fertil Steril 2000 Apr;73(4):805-11. doi: 10.1016/s0015-0282(99)00493-8.

Dumbala et al 2020. Effect of Yoga on Psychological Distress among Women Receiving Treatment for Infertility. https://pubmed.ncbi.nlm.nih.gov/32669765/

Thakur 2021. Effect of yoga on polycystic ovarian syndrome: A systematic review.

https://pubmed.ncbi.nlm.nih.gov/?term=yoga+and+fertility&filter=simsearch1.fha

Yoga Can Improve Assisted Reproduction Technology Outcomes in Couples With Infertility. https://pubmed.ncbi.nlm.nih.gov/29112941/

Return to Zero: HOPE Kiley Hannish. Support for miscarriage, recurrent pregnancy loss, stillbirth: https://rtzhope.org/

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 44 Listen to Women: Lessons Learned from The Retrievals Nov 06, 2023

Show notes

It's easier to be shocked by the story The Retrievals podcast reports and moves on but extremely important to reflect on why it happened in order to prevent history repeating itself (again).

For months, a nurse at a Fertility Center in the United States replaced the pain reliever fentanyl with normal saline, taking the fentenyl for her own use, but left women undergoing egg retrievals without pain relief.

Patients in pain for a procedure is horrible enough, but it's extremely disturbing that the women who tried to report and question what happened felt like their concerns were ignored.

In this episode of Baby or Bust, Dr. Lora Shahine takes us through what an egg retrieval process should be like and is like, the majority of the time. Dr. Shahine also explores the history of women and the medical community and why women so often have to advocate for themselves to get even a minimum of care. She leaves with tips on how to advocate for yourself so you receive the attention and care you deserve.

Listen and share!

Take a moment to follow the show and leave a review wherever you listen to podcasts!

What you'll hear in this episode:

[00:00] Intro to Episode: The Gender Bias in Medicine

[00:37] Intro to Baby or Bust and thank to our sponsor Seattle Sperm Bank

[01:12] Intro to the Retrievals Podcast by the New York Times and Serial Network: The Story

[04:38] What is pain control supposed to be like for a retrieval?

[04:43] Fentanyl: What is it and What does it do?

[05:12] Midazolam (Versed): What is it and What does it do?

[10:22] What pain control is like at my clinic PNWF in Seattle

[10:40] Propofol: What is it and Why is it different?

[12:15] Dr. Shahine describes her own experience with her egg retrieval

[12:52] Why did this happen? Why is it common for women to feel dismissed in medicine?

[14:43] The gender bias in medicine – pain, endometriosis, and more

[16:15] The book Doing Harm by Maya Dusenbery

[17:02] The knowledge gap – women excluded from medical trials, lack of teaching women's health in medical training, lack of investment in research into diseases that mainly impact women

[18:30] The trust gap: doctors not trusting women's description of symptoms

[19:25] What can be done to change this?

[20:10] Learning how to advocate for YOUR care: Tips for you from Dr. Shahine

[22:31] Recap

[23:46] Fertility Story of the Week: The patient that told Dr. Shahine about the Retrievals Podcast

[25:53] Resources and thank you

Resources mentioned:

Retrievals article in New York Times

The Retrievals podcast on Apple

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

Follow @drlorashahine

Instagram | YouTube | Tiktok | Her Books