This is Episode 1 – Trimeser Zero, from Season 2 of the Juna Women Podcast. Season 2 is about planning your family. 

Trimester zero. It’s not a term you hear often, but reproductive endocrinologists would like to change that.

In this 2nd episode of our family planning series we talk with Dr. Aimee Evayzzaeh and Dr. Lucky Sekhon – both fertility experts and reproductive endocrinologists.

Getting reproductive care as early as possible could mean the difference between having one or more successful pregnancies or struggling for years with infertility and heartache.

By the end of this episode, you’ll have a clear picture of fertility and feel empowered to advocate for yourself and your future family.

trimester zero podcast art

I want women to take, take charge of their fertility and understand it in their 20s when their eggs are the healthiest. If there’s a chance you want kids and maybe are open to more than one, talk to your doctor, get your hormones checked. Think about egg freezing. I want everyone to know about so that potentially you don’t have to go through the same heartache that my patients who are coming to me now at the age of 40 are going through. – Dr. Aimee Eyvazzadeh

Full Interview with Dr. Aimee Eyvazzadeh

Fertility and Aging

Think about your eggs it as a very harsh version of American idol, where if you don’t make the cut, you basically die off and you don’t get to audition again.

That’s the life cycle of your eggs. You are born with all of the viable eggs you will ever have in your life so it makes sense when you use the analogy of an appliance or a car or something that you can’t replace parts or taken to be service. It’s going to break down over time. So even in your 20s it’s been two decades and your eggs aren’t perfect.

Your twenties are your most fertile prime years, and so that’s your starting reference point and it just gets worse as you get older. It’s not like every year there’s this X percent increase in the rate of decline — it stays largely the same, mostly the same throughout most of your 20s and to your early thirties.

Not everyone’s chronologic and biologic age are equivalent. We start to see things change where the proportion of embryos that are genetically abnormal start to rise at 30 and beyond.

It’s a very subtle increase initially, but once you get to 35 you start to see a more drastic increase. That’s why 35 is that number that everyone is worried and stressed about. But, it’s not like you turn 35 and all of a sudden all your eggs turn, it’s just that things start to become a little more accelerated.

By 37 and 38 years old about 50% of any embryos that would be generated from your eggs are going to be genetically abnormal. And by the time you get to 40 it’s like. 70% and 45 you’re looking at about 90%.

That very clearly illustrates why it’s so difficult, especially as you approach age 40 and beyond, to get pregnant using your own eggs — unless you froze eggs or if you’re willing to use donor egg.

Freezing Eggs

The premise behind egg freezing is to remove eggs from their environment and freeze them. Let’s say you do that at 32. You’ve now preserved your 32-year old eggs. The idea behind it is you should still try to get pregnant when you’re ready to, let’s say 37 years old.

But if you are 37 and trying to get pregnant and it’s just not happening, then you go back to your Dr. and get a checkup. From there they’ll have recommendations, and it’s possible IVF is the best course of treatment for you to get pregnant. But because you froze your eggs ahead of time you get to skip the hormones and ovary extractions. You just dip into your frozen egg supply.

Viability Rates of Frozen Eggs

There is a lot of inefficiency in human reproduction and we are limited by that inefficiency.  Not every egg is going to thaw out successfully, and not every egg that thaws out successfully is going to fertilize. And not every fertilized egg is going to turn into an embryo and definitely not every embryo is going to be normal, even if you’re a 20 year old, right?

So there’s a lot of drop-off and inefficiency in a high rate of attrition. The average thaw survival rate for frozen eggs using the most up to date technology that’s been around for the last decade — vitrification — is about about 85%.

Getting A Reproductive Checkup in Your 20s

Reproductive endocrinologists recommend getting a checkup in your 20s – even if you’re not thinking about having kids yet. Here are the questions you want to ask them and the things you want to be tested for:

T – Tubes
U– Uterus
S – Sperm.
H – Hormones
Y – Your genetic profile.

The first letter of each thing spells out Tushy so it’s easy to remember.

Additionally you want to let your Doctor know if there’s anything you’ve experienced that may impact your fertility. Things like STDs, ovarian cysts, abortions, etc. The more your Dr. knows, the more they can advocate for the right path for you.

The Cost of Reproductive Care

Unfortunately, insurance doesn’t cover all of this and it can get expensive. The recommendation is to get a quote from your OB or your doctor for how much this would all cost.

A lot of OBS might tell you it’s not worth it if you’re otherwise healthy, but depending on your financial situation, you could wind up saving a lot of money down the road by doing these tests upfront, freezing your eggs, freezing your sperm, etc.

It’s a personal choice, but rather than write it all off as too costly, do your research and see if it’s something you can fit into your budget.

If you know, having a family is of the utmost importance to you, there are ways to make it happen.

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Egg Freezing, Infertility, IVF, In vitro fertilization, IUI, Family Planning, Starting a family, pregnancy, trying to conceive, fertility lifestyle, sperm testing, sperm donor, sperm freezing, female reproduction, reproductive endocrinologist

Featured in this episode:

Dr. Aimee Eyvazzadeh, MD
Fertility Expert, Reproductive Endocrinologist, Egg Whisperer

Dr. Aimee Eyvazzadeh believes in getting personal when it comes to your fertility.
Whether it’s helping you outline what your fertility options are for the future or guiding you through a specific treatment today, it always starts with understanding YOU. This high-touch and highly personal approach to fertility care has made Dr. Aimee internationally recognized as a visionary in fertility medicine. She offers hope when all hope feels lost. Thousands have had babies as a testament to her loving and positive approach that blankets the cutting-edge reproductive technology she utilizes.

Dr. Lucky Sekhon, MD
Reproductive Endocrinologist and Infertility Specialist

Dr. Lucky Sekhon is a reproductive endocrinologist and infertility specialist and board certified obstetrician and gynecologist who cares for patients at RMA of New York’s Manhattan and Downtown (SoHo) Offices. She specializes in diagnosing and treating reproductive issues and has particular expertise in fertility preservation (egg freezing), LGBTQ family building, and in vitro fertilization with preimplantation genetic testing of embryos. She also uses minimally invasive techniques such as laparoscopy and hysteroscopy to treat a variety of surgical conditions including endometriosis and uterine factor infertility.