Brave & Curious with Dr Lora Shahine

Latest Episodes:

Ep 43 Preventing and Treating OHSS: A Scary IVF Risk Oct 30, 2023

Show notes

Ovarian Hyperstimulation Syndrome (OHSS) is one of the scariest risk factors of IVF, but it doesn't have to be. With preparation, treatment choices, and prevention, you can avoid this uncomfortable and potentially dangerous risk factor from ovarian stimulation.

To maximize the number of eggs retrieved for IVF and egg freezing, fertility treatment involves stimulating the ovaries to mature more eggs. A higher egg number can often predict a higher success rate with treatment, but a side effect can be significant fluid shifts and bloating also known as OHSS.

When OHSS occurs, it can be mild, moderate, or severe, with symptoms ranging from discomfort and bloating to significant dehydration, shortness of breath, nausea, and even hospitalization for recovery.

In this episode, Dr. Shahine does a deep dive into OHSS.

You'll learn

What OHSS is
Why OHSS happens and Who is at risk
Ways to prevent OHSS
Ways to treat symptoms if it occurs so you have a speedy recovery

This week's fertility story is about an OHSS patient Dr. Shahine will never forget from her training. It's a reminder to never to ignore your care team's instructions.

In this episode you'll hear:

[00:00] Intro: What is OHSS and why is it scary?

[01:07] My experience caring for patients with OHSS over the years

[02:13] OHSS Definition, Classification

[05:29] Physiology of OHSS – Why does it happen?

[07:12] Risk factors for OHSS – Who is at risk?

[09:41] Treatment options to prevent and recover quickly from OHSS

[09:55] Prevention of OHSS

What to know before you start stimulation
Choosing a protocol and medications to add to decrease risk
Metformin, trigger shot, cabergoline, and more

[21:47] Treatment if OHSS happens

How to recover faster
Increasing electrolytes and protein at home,
When do you need IV fluids or hospitalization to recover (rarely)

[25:58] Fertility story of Dr. Shahine's Patient: Warning of the dangers of OHSS

[31:51] Outro and thank you

Resources mentioned:

Try LMNT daily during your stimulation process to increase electrolyte intake and decrease the symptoms of bloating during IVF and egg freezing. Mix one packet in 40 ounces of water and sip throughout the day.

LMNT has sodium and potassium to help decrease bloating as well as magnesium to prevent constipation (common after egg retrieval)

Using this link: drinklmnt.com/DrShahine or code DrShahine at checkout to get a sample pack of all flavors with your first purchase.

Dr. Shahine's YouTube Videos on OHSS

Mastering OHSS Prevention

OHSS is the Biggest Risk Factor for IVF: What you need to know

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

Follow @drlorashahine

Instagram | YouTube | Tiktok | Her Books

Studies mentioned in podcast

Who is at risk of OHSS?

Younger age: One study showed 60% of women who got OHSS were less than 35 yo
- https://academic.oup.com/ajhp/article-abstract/65/12/1148/5127940?redirectedFrom=fulltext
Lower BMI: Some studies show a higher risk of OHSS if BMI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851086/
- A higher ovarian reserve predicts higher risk of OHSS: AMH > 5 https://www.sciencedirect.com/science/article/abs/pii/S0002937814001689
- Antral Follicle count >24 https://www.sciencedirect.com/science/article/abs/pii/S0015028212005961
- For more information on ovarian reserve testing see my video: https://youtu.be/bYJWXIY6GHg
Patients with PCOS often have a high AMH and high AFC – if you're diagnosed with PCOS – ask about OHSS risk in IVF
A high response to stimulation in the IVF cycle can predict risk of OHSS
- Estradiol levels at time of trigger >3500 pg/mL: https://pubmed.ncbi.nlm.nih.gov/12773437/
- More than 20 follicles https://www.tandfonline.com/doi/full/10.1080/14647270601021743
- More than 15 eggs retrieved https://www.sciencedirect.com/science/article/pii/S0015028213034584

Aspirin and OHSS: https://www.sciencedirect.com/science/article/pii/S0015028209001320

Metformin and OHSS: https://academic.oup.com/humrep/article/26/8/2178/645906

Trigger shot and OHSS: https://www.sciencedirect.com/science/article/abs/pii/S1472648310602003

Cabergoline and OHSS: https://academic.oup.com/jcem/article/92/8/2931/2597480

Ep 42 Busting Fertility Myths with Angel Investor and Author Leslie Schrock Oct 23, 2023

Show notes

Like our own expert Siri, Leslie Schrock should be available on-demand for anyone who's struggling with fertility.

And she can be! With two books and now on an episode of Baby or Bust, everyone can access her informed and sensitive approach to miscarriage, medically necessary abortion, and other fertility challenges.

Leslie Schrock is an author, entrepreneur, and angel investor who has been involved in health and fertility for pretty much her entire working life. Her first book, Bumpin': The Modern Guide to Pregnancy mixes clinical research with practical advice for working families. Her second book, Fertility Rules, does the same for fertility.

After working in advertising for many years, Leslie helped found and grow Rock Health, a digital health startup incubator and venture fund and was named one of the Most Creative People in Business by Fast Company.

In this episode you'll hear:

[00:37:] Thank you to sponsors

[01:10:] Learn more about author, Leslie Schrock

[02:23:] Episode starts — How Dr. Shahine found Leslie's books and what was different about 'Bumpin' and 'Fertility Rules'

[04:54]: Leslie's fertility story — expectations crashed, recurrent pregnancy loss, terminating a highly desired pregnancy, a tough pregnancy and delivery, and more

[09:18:] What's different about Leslie's writing and her motivation – giving facts without fear, allowing all the feelings and frustrations without shame and guilt

Busting fertility myths with Leslie Schrock

[16:34:] Myth #1 "Fertility is a Woman's Problem" The role of men in reproduction — "Men need a seat at the fertility table!"

[24:00:] Myth #2 "Supplements Cure Infertility" — What you need and don't need while trying to conceive and how to find what's safe

[27:21:] Myth #3 "We Always Know the Cause of Miscarriage" — The patients with easy conception but miscarriage experience a different kind of infertility. Is it really just "bad luck"?

[32:46:] The Hope Trial at Stanford — enroll to learn more about genetics and recurrent miscarriage

[34:50: Myth] #4 "Abortion is NOT healthcare" — Sometimes abortion is not a choice. Terminating a highly desired pregnancy for a lethal anomaly was a heartbreaking experience for Leslie

[39:25]: Learn about the non-profit Doctors for Fertility

[39:43]: Myth #5 "Once you have a baby, no more infertility" — Secondary infertility impacted both Dr. Shahine and Leslie

[42:45:] Wrapping up and thank you

Resources mentioned:

leslieschrock.com

Bumpin' by Leslie Schrock

Fertility Rules by Leslie Schrock

doctorsforfertility.com

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

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Ep 41 Tips for Choosing a Sperm Donor with Seattle Sperm Bank's Director Angelo Allard Oct 16, 2023

Show notes

Baby or Bust is back - better than ever.

After a little break, your podcast about all things fertility is back. Same host, Dr. Lora Shahine, same goals to educate and support the fertility community but new format and new production team. We're moving away from seasons and delivering weekly content. We listened to your feedback and will continue interviews but adding episodes with in-depth education from Dr. Shahine on certain topics.

Send us topics you'd like to learn about and interview suggestions to hello@drlorashahine.com

In this episode, we answer the question: How does a sperm bank work with donors to meet the needs of patients?

Host Dr. Lora Shahine interviews Angelo Allard, the General Supervisor at Seattle Sperm Bank (SSB) — one of the largest and most respected sperm banks in the country. For almost 15 years, Angelo has been working with patients to find the right donors and build happy, healthy families.

Angelo explains in-depth every step of the process, from how SSB vets and approves donors, through the regulation and oversight of sperm banks and how SSB supports recipients in choosing their donor, to how much gametes cost, and even how you can return unused vials.

Angelo also answers listeners' questions, so if you still have unanswered questions after the episode, be sure to connect with Dr. Shahine or the Seattle Sperm Bank for answers!

In this episode you'll hear:

[0:00-03:28] Intro

[03:29-4:54] Angelo's role at Seattle Sperm Bank

[04:55-11:54] Can anyone donate? Learn how donors are screened

[11:55-14:27] Are sperm counts really falling around the world? Angelo says "Yes."

[14:28-16:50] Are sperm banks regulated? Learn about lab and sperm bank oversight.

[16:51-26:18 ]How do recipients choose a donor? What do they learn about the donor? Photos?

[26:18-30:02] How do you know what type of sperm preparation to buy? Learn about the different labels and preparation.

[30:03-30:21] How much does donor sperm cost?

[30:22-32:55] How many vials of donor sperm should someone buy?

[32:56-33:22] Can you return donor sperm you don't use?

[33:23-36:17] Can a donor truly be anonymous?

[36:18-39:01] How many children can a donor have from donation?

Questions from Instagram:

[39:02- 40:16] How do you appeal to different races and ethnicities to donate?

[40:17-42:03] Any impact on sperm banks or use of donor sperm after overturn of Roe v Wade?

[42:04-44:02] How do recipients learn about any new health information on donors in the future?

[44:03-48:16] Angelo's memorable and inspirational patient story

[48:17-49:55] Outro

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

Follow @drlorashahine

Instagram | YouTube | Tiktok | Her Books

Ep 40 Chris Charbonneau on Planned Parenthood and Reproductive Rights May 29, 2023

Show notes

Since Roe v. Wade was overturned, reproductive rights have been called into question—including IVF. On this episode of Baby or Bust, our host Dr. Lora Shahine meets with Chris Charbonneau, the longest-serving CEO of Planned Parenthood and host of the Fall of Roe podcast, for her take on what's coming.

Roe v. Wade is about much more than elective abortion, and this timely episode breaks down the national implication for American residents. Chris shares her wisdom on the anti-choice movement, the misunderstandings about abortions, the power of words, and why fertilized embryos for IVF may also be at risk.

Connect with Dr. Lora Shahine on social media.

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This episode of Baby Or Bust is produced by Mark Ramsey, Jaime Solis, and Greg Moga and executive produced by Paul Anderson and Nick Panella for Workhouse Media. Baby Or Bust is produced in partnership with the Seattle Sperm Bank.

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Ep 39 Dr. Lee Hullender Rubin on Acupuncture and Fertility May 22, 2023

Show notes

If you're struggling with infertility, you'll often try anything to get that family you desire—including acupuncture. Dr. Lee Hullender Rubin, an internationally recognized and award-winning doctor of acupuncture, meets with host Dr. Lora Shahine to dispel myths and share truths about Eastern Medicine and fertility.

With over 30 peer-reviewed research publications about acupuncture and fertility, Dr. Lee Hullender Rubin is a true master of the craft. In this episode, she teaches about the Eastern Medicine approach to fertility care, including lifestyle modifications, herbs, and acupuncture, along with the science behind this approach.

Connect with Dr. Lora Shahine on social media.

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Ep 38 Mikki Morrissette on Choosing Single Motherhood May 15, 2023

Show notes

There's a movement of single women creating families by choice—and today's guest is a leading voice on the topic. Host and reproductive endocrinologist Lora Shahine is joined by Mikki Morrissette, author of Choosing Single Motherhood and founder of the online resource Choice Mom.

As a single mom by choice, Mikki is deeply familiar with the unique fulfillments and challenges of starting a family solo. In this episode, she details the financial considerations and career implications of becoming a choice mom, discusses finding a sperm donor, shares benefits of being a single mom by choice, and more. This episode

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Ep 37 Brett Russo on Her Memoir About IVF May 08, 2023

Show notes

When you're used to checking off boxes for life's milestones—college, husband, career, friends—infertility can be a tough pill to swallow. In this episode, our Baby or Bust guest Brett Russo dishes the details behind her memoir The Underwear in My Shoe: My Journey through IVF, Unfiltered with host Dr. Lora Shahine.

While there are many infertility memoirs out there, Brett's story takes honesty to a whole new level. In this episode, she details starting pregnancy in her late 30s, witnessing friends get easily pregnant, going through IUI, experiencing IVF, grief, and what she would change if she could do it all over again.

Connect with Dr. Lora Shahine on social media.

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Ep 36 Dr. Lariah Edwards on Environmental Toxins and Fertility May 01, 2023

Show notes

You are what you eat, but you can also be what you apply and breathe. In this episode of Baby or Bust, environmental research scientist Dr. Lariah Edwards shares her findings on the latest research about toxins and reproductive health with our host Dr. Lora Shahine.

As a research scientist in the Department of Health Science at Columbia University and alumna of the Agents of Change in Environmental Justice Fellowship, Dr. Edwards is an expert in hormone-altering chemicals. Together with Dr. Shahine, she shares where we can find toxins, the impact on fertility, how chemical regulation works, and where to start with reducing exposure.

Connect with Dr. Lora Shahine on social media.

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Ep 35 Louise Brown on Being the First IVF Baby Apr 24, 2023

Show notes

On July 25, 1978, family building changed forever when the world's first IVF baby was born. On today's episode of Baby or Bust, our host and reproductive endocrinologist Dr. Lora Shahine meets with now-adult Louise Brown to discuss her experience as a living symbol of the powers of fertility medicine.

Over 10 million babies have been born through in vitro fertilization worldwide, and Louise Brown was the first. She shares her parents' journey of choosing IVF, questions she got from friends growing up, and how she advocates for IVF.

Connect with Dr. Lora Shahine on social media.

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Advertising Inquiries: info@audiotocracy.com

Ep 34 Arden Cartrette on Pregnancy Loss Apr 17, 2023

Show notes

Miscarriage is common, but many feel alone and unsupported as they process their loss. On today's Brand Therapy episode, host and reproductive endocrinologist Dr. Lora Shahine meets with Arden Cartrette, The Miscarriage Doula, to discuss grief, support systems, miscarriage doulas, and pregnancy loss.

A certified birth and bereavement doula, Arden established an online community and team of doulas to help bring empathetic support to people who have experienced miscarriages. As someone who's experienced infertility and recurrent pregnancy loss, Arden shares how people process miscarriage, the risks of toxic positivity, pregnancy after miscarriage, triggers, and the benefits of a miscarriage doula.

Connect with Dr. Lora Shahine on social media.

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Advertising Inquiries: info@audiotocracy.com

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