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Many women reach their 30s and suddenly feel an invisible pressure set in. The clock gets louder. The messaging gets scarier. And fertility, something that once felt distant or optional, becomes charged with fear, urgency, and self-blame.
This episode is for anyone who has ever wondered if they waited too long, if their body is betraying them, or if turning 35 means everything has suddenly changed.
This is not a failure of timing.
This is not a lack of effort.
And it is not a fertility cliff.
In this hol+ conversation, Dr. Taz sits down with double board-certified reproductive endocrinologist and infertility specialist Dr. Lucky Sekhon to dismantle one of the most anxiety-producing myths in women’s health: that fertility suddenly collapses at 35.
Dr. Lucky explains why fertility is a continuum, not a deadline, and why the panic surrounding age often does more harm than the biology itself. Using clear science and compassionate language, she breaks down the difference between egg quantity and egg quality, why egg quality cannot be directly tested, and what actually changes as women age.
This episode explores why fertility struggles are increasing worldwide, even among young women, and how factors like insulin resistance, PCOS, endometriosis, inflammation, environmental toxins, and chronic stress quietly shape reproductive health long before pregnancy becomes a goal.
Dr. Taz and Dr. Lucky also reframe painful and irregular periods as vital signs that should never be ignored, explain why many fertility diagnoses remain unclear, and clarify how treatments like IUI and IVF work not because the body is broken, but because human reproduction is naturally inefficient.
From fear-based fertility messaging to evidence-based clarity, this conversation offers a grounding reset. If you are trying to get pregnant, thinking about egg freezing, navigating fertility anxiety, or simply want to understand your body better, this episode replaces panic with perspective and urgency with informed choice.
Dr. Taz and Dr. Lucky Sekhon discuss:
• Why fertility does not suddenly end at 35
• The difference between egg count and egg quality
• Why egg quality cannot be directly tested
• The real drivers behind declining fertility rates
• PCOS, endometriosis, and insulin resistance as fertility blockers
• Why painful or irregular periods are red flags
• What fertility treatments actually improve and what they cannot
• How to approach pregnancy with clarity instead of fear
About Dr. Lucky Sekhon
Dr. Lucky Sekhon is a double board-certified reproductive endocrinologist, infertility specialist, and OB/GYN based in New York City. She is widely recognized for her compassionate, evidence-based approach to fertility care and her ability to translate complex reproductive science into language women can actually understand.
Dr. Lucky is the author of The Lucky Egg: Understanding Your Fertility and How to Get Pregnant Now, a practical and empowering guide designed to help individuals and couples navigate fertility decisions with confidence, clarity, and realism. Her work focuses on demystifying fertility testing, treatment options, and the emotional toll of trying to conceive.
In addition to her clinical work, Dr. Lucky is a trusted educator across social media and digital platforms, where she helps women move beyond fear-based fertility narratives and make informed choices aligned with their life goals.
Order the Book
This episode is for anyone who has ever wondered if they waited too long, if their body is betraying them, or if turning 35 means everything has suddenly changed.
This is not a failure of timing.
This is not a lack of effort.
And it is not a fertility cliff.
In this hol+ conversation, Dr. Taz sits down with double board-certified reproductive endocrinologist and infertility specialist Dr. Lucky Sekhon to dismantle one of the most anxiety-producing myths in women’s health: that fertility suddenly collapses at 35.
Dr. Lucky explains why fertility is a continuum, not a deadline, and why the panic surrounding age often does more harm than the biology itself. Using clear science and compassionate language, she breaks down the difference between egg quantity and egg quality, why egg quality cannot be directly tested, and what actually changes as women age.
This episode explores why fertility struggles are increasing worldwide, even among young women, and how factors like insulin resistance, PCOS, endometriosis, inflammation, environmental toxins, and chronic stress quietly shape reproductive health long before pregnancy becomes a goal.
Dr. Taz and Dr. Lucky also reframe painful and irregular periods as vital signs that should never be ignored, explain why many fertility diagnoses remain unclear, and clarify how treatments like IUI and IVF work not because the body is broken, but because human reproduction is naturally inefficient.
From fear-based fertility messaging to evidence-based clarity, this conversation offers a grounding reset. If you are trying to get pregnant, thinking about egg freezing, navigating fertility anxiety, or simply want to understand your body better, this episode replaces panic with perspective and urgency with informed choice.
Dr. Taz and Dr. Lucky Sekhon discuss:
• Why fertility does not suddenly end at 35
• The difference between egg count and egg quality
• Why egg quality cannot be directly tested
• The real drivers behind declining fertility rates
• PCOS, endometriosis, and insulin resistance as fertility blockers
• Why painful or irregular periods are red flags
• What fertility treatments actually improve and what they cannot
• How to approach pregnancy with clarity instead of fear
About Dr. Lucky Sekhon
Dr. Lucky Sekhon is a double board-certified reproductive endocrinologist, infertility specialist, and OB/GYN based in New York City. She is widely recognized for her compassionate, evidence-based approach to fertility care and her ability to translate complex reproductive science into language women can actually understand.
Dr. Lucky is the author of The Lucky Egg: Understanding Your Fertility and How to Get Pregnant Now, a practical and empowering guide designed to help individuals and couples navigate fertility decisions with confidence, clarity, and realism. Her work focuses on demystifying fertility testing, treatment options, and the emotional toll of trying to conceive.
In addition to her clinical work, Dr. Lucky is a trusted educator across social media and digital platforms, where she helps women move beyond fear-based fertility narratives and make informed choices aligned with their life goals.
Order the Book
Connect further to Hol+ at https://holplus.co/- Don’t forget to like, subscribe, and hit the notification bell to stay updated on future episodes of hol+.
Follow Dr. Lucky Sekhon
Instagram: https://www.instagram.com/lucky.sekhon
Website: https://theluckyegg.com/
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Subscribe to the audio podcast: https://holplus.transistor.fm/subscribe
Subscribe to the video podcast: https://www.youtube.com/@DrTazMD/podcasts
Get your copy of The Hormone Shift: Balance Your Body and Thrive Through Midlife and Menopause
Host & Production Team
Host & Production Team
Host: Dr. Taz; Produced by ClipGrowth.com (Producer: Pat Gostek)
Creators and Guests
Host
What is hol+ with Dr. Taz MD | The Future of Medicine is Holistic?
hol+ with Dr. Taz MD is redefining holistic medicine as the future of healthcare—integrating modern science, functional medicine, and time-tested healing systems to treat the whole human, not just symptoms. As a 2025 Webby honoree and pioneering show, hol+ dares to enter the next dimension of health-where both science and spirit converge to drive our health, happiness, relationships and family ecosystems.
Recent guests include mental health advocate and author, Sophie Gregorie Trudeau, best-selling author, Katherine Schwarzenegger, Emmy-winning host, actor, and health enthusiast, Cameron Mathison, supermodel Carol Alt, veteran actress and sometimes medicine woman, Jane Seymour, author and journalist, Tamsen Fadal, wellness advocate and cancer thriver, Kris Carr.
From cutting-edge and innovative experts to celebrities and thought leaders, veteran TV personality, author, and trople board-certified physician, Dr. Taz MD, the host of hol+, leads these game-changing conversations - redefining the future of medicine.
On the heels of her successful 8-year-long podcast, Super Woman Wellness, which boasted over 1 million downloads, hol+ continues to be recognized as a show to watch, recognized in the same category as the Mel Robbins Podcast in the 29th Annual Webby Awards.
[00:00:00] Dr. Taz: Before we get into today's topic, I just wanna say thank you to everyone who's been [00:00:05] listening and reaching out. Your dms mean the world. They tell me what's helping, [00:00:10] what's confusing, and what's next for you. So if you haven't yet, come connect with me on [00:00:15] Instagram at Dr. Taaz md. I'd love to hear your story and what brought you to Whole [00:00:20] Plus.
[00:00:20] Dr. Taz: Now let's dive in.
[00:00:21] Dr. Lucky Sekhon: It can't reverse the clock, but I can inform [00:00:25] people. Society has done a great job reminding women about, you know, the fragility of their [00:00:30] fertility. And I have people that come to me at 35 and they're like, oh my God, I'm turning 35 [00:00:35] tomorrow. Am I gonna fall off a fertility cle? Right? And that's not true either
[00:00:38] Dr. Taz: with a worldwide [00:00:40] declining fertility rate.
[00:00:41] Dr. Taz: I continue to meet patients every single day, struggling [00:00:45] to get pregnant, looking for answers and honestly feeling hopeless. That's [00:00:50] why I invited Dr. Lucky Sicon onto the show. She's a double board [00:00:55] certified reproductive endocrinologist and infertility specialist and an O-B-G-Y-N based
[00:00:59] Dr. Lucky Sekhon: [00:01:00] in New York City.
[00:01:00] Dr. Lucky Sekhon: There's a, an appropriate level of urgency because there is a [00:01:05] clock and contrary to what you might see in your Instagram feed, there isn't always a way to [00:01:10] reverse that, or, you know, there isn't like an easy supplement to take to fix that or freeze it at the same [00:01:15] time. It's on a continuum. It's not a cliff.
[00:01:17] Dr. Lucky Sekhon: Yeah. So. I'll explain it this way. You're [00:01:20] born with all the eggs that you're ever gonna have. You don't make new eggs, you don't repair your eggs. I like to [00:01:25] use this analogy of like a pantry. Imagine at the core of both ovaries, you have this pantry, the [00:01:30] stockpile that you're born with, and every cycle you have a, an [00:01:35] unlocking of the pantry in it.
[00:01:36] Dr. Lucky Sekhon: Situation that you can't control. I can't manipulate it as a fertility doctor, [00:01:40] but a few of those eggs escape and imagine they're like pulled outta the pantry into the kitchen [00:01:45] cabinets. That's what I can see on an ultrasound in bubbles of fluid that we call follicles. Each one [00:01:50] containing an egg. When I scan a person, I'm able to look at their ovaries and kind of get a count, and it's a [00:01:55] cohort that is easy to count.
[00:01:56] Dr. Lucky Sekhon: It's like 10, 15, 20. It varies from person to person. Mm-hmm. [00:02:00] But it's like rationing, which is why I use this pantry analogy, because the more you have in your stockpile in a [00:02:05] given timeframe, the more you tend to bring to the surface and bring out. But [00:02:10] really matters is what is the chance of ovulating a healthy egg.
[00:02:13] Dr. Lucky Sekhon: Mm. And. So much harder for people to [00:02:15] understand 'cause there's no direct way to test anyone's egg quality. Mm.
[00:02:18] Dr. Taz: She helps [00:02:20] individuals and couples at every stage of their reproductive journey. She wrote The Lucky Egg, [00:02:25] understanding Your Fertility and How to Get Pregnant Now. A clear, compassionate [00:02:30] evidence-based guide designed to demystify fertility
[00:02:33] Dr. Lucky Sekhon: for everyone and [00:02:35] help people make informed choices.
[00:02:37] Dr. Lucky Sekhon: Please join me in welcoming Dr. Sicon to [00:02:40] the show.
[00:02:40] Dr. Taz: Dr. Sicon, thank you for joining me today. This is such an [00:02:45] important issue. I'm dealing with it within my family. I was telling you about my sister and kind of her [00:02:50] journey to colleagues, to patients that are coming in every single day [00:02:55] really struggling with getting pregnant.
[00:02:57] Dr. Taz: And it's not an age thing, it's, you know, these are [00:03:00] young women as well. Women in their twenties and, and such. What's going on? [00:03:05] Why is. Is fertility so challenging? When we look at statistics, we know that the fertility rate is [00:03:10] declining. Mm-hmm. Across the globe. And I know we can debate all the different reasons for that, but it seems like even [00:03:15] when there's the intention, right?
[00:03:16] Dr. Taz: Yeah. To get pregnant, it's such a challenge. Yes. I am so [00:03:20] curious what you're seeing and what you think of all of this.
[00:03:22] Dr. Lucky Sekhon: Well, when I first started out in my career, we used to [00:03:25] use this statistic. One in eight couples or individuals will have infertility, and [00:03:30] now it's actually been recently updated by the WHO to one in six.
[00:03:33] Dr. Taz: Oh, wow.
[00:03:34] Dr. Lucky Sekhon: And so I [00:03:35] think you're right that it does seem like it's getting more prevalent, and I do think a huge [00:03:40] factor is age for a lot of people because we're seeing a major societal shift. [00:03:45] Um, you know, even in my own life, and you know, my, my sisters, myself, [00:03:50] my friends, it's very normal and commonplace for people to really settle [00:03:55] down and start building their families more so in their thirties right and beyond.
[00:03:59] Dr. Lucky Sekhon: Whereas our [00:04:00] parents' generation and definitely our grandparents' generation, it was. Unheard of to wait till you're [00:04:05] thirties, right? Mm-hmm. To start building your family. And there's some good things about it. I think it's great that people know [00:04:10] how to contracept and family planning is a thing. Um, I do think, [00:04:15] uh, people are, are not settling and they're waiting for the right relationship, the right [00:04:20] situation.
[00:04:20] Dr. Lucky Sekhon: They're waiting to be financially stable. So all of that though does not line up [00:04:25] with our biology.
[00:04:26] Dr. Taz: Right.
[00:04:27] Dr. Lucky Sekhon: And it can make it harder and more challenging. But as you said, it's not [00:04:30] always age. And there can be other factors, like a common factor outside of age [00:04:35] is PCOS. Yeah. Polycystic ovary syndrome. I
[00:04:37] Dr. Taz: have that.
[00:04:38] Dr. Taz: Our whole family has that.
[00:04:39] Dr. Lucky Sekhon: Lot of
[00:04:39] Dr. Taz: [00:04:40] times and talking about it ad nauseum, but
[00:04:41] Dr. Lucky Sekhon: Yeah. Yeah. A lot of times it's how you're genetically wired. Yeah. Right. And there are certain [00:04:45] populations, like I'm South Asian background. Mm-hmm. And so much type two [00:04:50] diabetes and insulin resistance in my family. Yeah. And so we do see certain, uh, [00:04:55] demographics have more.
[00:04:55] Dr. Lucky Sekhon: Problems like PCOS and a lot of it is genetics. Some of [00:05:00] it's environmental, some of it has to do with how, you know, our, our, um, [00:05:05] bodies are wired from the diets that our ancestors had. Yeah. And now we can't adjust [00:05:10] as well to a western diet. So there's so many theories, but that can cause irregular cycles.
[00:05:14] Dr. Taz: [00:05:15] Right.
[00:05:15] Dr. Lucky Sekhon: And that is a major cause of infertility. If you're not ovulating or you're, you don't know when your next [00:05:20] ovulation is going to be, you're often not in the game when it comes to trying to conceive. And then [00:05:25] there's definitely environmental factors. We talk a lot about, you know, mi microplastics, [00:05:30] right?
[00:05:30] Dr. Lucky Sekhon: There's a lot more awareness of how industrialization and has affected us. [00:05:35] Yeah. How we package our food and the things we're putting in and on our bodies. All of that [00:05:40] can impact our health. And I don't think that we're ever gonna have a full handle on. You [00:05:45] know, the, the gravity of all of these environmental exposures and how they can impact both [00:05:50] male and female fertility.
[00:05:51] Dr. Taz: It's such an important conversation to have because I do feel like the landscape [00:05:55] of human biology not to be too, like theoretical is shifting. Right. You know, I feel [00:06:00] like when you talk about microplastics and you talk about some of these things and. We still don't [00:06:05] yet have all the information to be super tactical in the exam room.
[00:06:09] Dr. Taz: Right? Yes. Yeah. [00:06:10] But we know we need to be aware of it. One of the things we can do you, you mentioned [00:06:15] like skipping periods or things like that, or you know, not having regularity is at least [00:06:20] educate young women to pay attention to that, right? Right. Yeah, I think so many young, there's
[00:06:24] Dr. Lucky Sekhon: [00:06:25] so many red flags that go ignored.
[00:06:26] Dr. Taz: What are some, let's go into that though, because I think, you know, for so long, you know, you're going [00:06:30] through your teenage years and your early twenties and you're busy. Yes. And you know, I wrote, you know, in the hormone shift I [00:06:35] called them, you know, the rock stars and the hustlers. 'cause you're all over the place and you're burning the candle at both ends [00:06:40] and you think you're kind of invincible.
[00:06:41] Dr. Lucky Sekhon: Yeah.
[00:06:42] Dr. Taz: And you're ignoring a lot of these red flags. Right. So if we can get on the [00:06:45] front end of that, what are some of the red flags that you would really, I
[00:06:48] Dr. Lucky Sekhon: feel called out because that's how I'm [00:06:50] leading my life these days, you know? Yeah. Well I
[00:06:52] Dr. Taz: did too.
[00:06:52] Dr. Lucky Sekhon: Right? I know that's
[00:06:53] Dr. Taz: how I got in trouble. But,
[00:06:54] Dr. Lucky Sekhon: um, know, of course.
[00:06:54] Dr. Taz: [00:06:55] But
[00:06:55] Dr. Lucky Sekhon: I think your period is like a fifth vital sign, right? For people that don't know [00:07:00] what vital signs are. It's like your pulse. Your blood pressure. These are all considered objective [00:07:05] findings that you can gain some insights into someone's health, but people rarely [00:07:10] think about their periods in that fashion.
[00:07:12] Dr. Lucky Sekhon: Right. And so if you have irregularity in your period, [00:07:15] that could be a sign of medical problems like PCOS, and that can often be associated with a [00:07:20] really ubiquitous problem with insulin resistance, which can lead to greater [00:07:25] incidence of heart disease and all sorts of medical problems that can affect not just your fertility, but your [00:07:30] overall general health and quality of life.
[00:07:32] Dr. Lucky Sekhon: But what about painful periods? Right? Right. It takes about [00:07:35] eight to 10 years on average to be diagnosed with a condition called endometriosis. [00:07:40] Mm-hmm. And this is a common gynecological condition that affects up to 10% of women [00:07:45] that's probably under called. Yeah. 'cause so many people are walking around normalizing their [00:07:50] pain and saying, yeah, I might have missed a lot of work and maybe growing up I missed school [00:07:55] because of my period.
[00:07:55] Dr. Lucky Sekhon: And I always have to tell them that's not normal.
[00:07:57] Dr. Taz: Right.
[00:07:58] Dr. Lucky Sekhon: Right. It is normal that you're gonna have [00:08:00] some cramps. But I think it's hard for people to differentiate what's normal and what's [00:08:05] not.
[00:08:05] Dr. Taz: Is there a way to like help people with because for, okay. First question. [00:08:10] Why does it take so long to diagnose endometriosis?
[00:08:12] Dr. Taz: And I know, okay. The conventional [00:08:15] answer is that you have to do a laparoscopic yes. Surgery. Yes. Right. But has [00:08:20] technology evolved at all? Has laboratory, like I read somewhere, doing a CA 1 25 might be [00:08:25] helpful. Mm-hmm. Is there a way to get an earlier diagnosis? Because I know this is coming up over and over [00:08:30] again,
[00:08:30] Dr. Lucky Sekhon: right?
[00:08:30] Dr. Lucky Sekhon: So endometriosis for anyone that might not be familiar, right?
[00:08:33] Dr. Taz: Yeah.
[00:08:33] Dr. Lucky Sekhon: Is a condition [00:08:35] where cells that behave like the cells that that typically line the inner cavity of the [00:08:40] uterus. So they're dynamic, they build up with estrogen stimulation and then they break [00:08:45] down and you get a period. For some reason, cells that behave that way are found in other parts of the [00:08:50] body.
[00:08:50] Dr. Lucky Sekhon: There used to be, you know, the top theory of how this happened is that women, [00:08:55] obviously, when they menstruate. They have vaginal bleeding, but this can actually go backwards through the fallopian [00:09:00] tubes and land in the pelvic cavity. And we know that all women have retrograde [00:09:05] menstruation. That's what we call it.
[00:09:05] Dr. Lucky Sekhon: To some degree, your immune system should recognize when cells are [00:09:10] in parts of your body that they shouldn't be. Mm-hmm. And it's like they come through like the janitor and clean them up. Right. [00:09:15] But. We think about, you know, endometriosis as being this perfect storm. [00:09:20] Not only might there be be mechanical reasons like retrograde menstruation, and sometimes people with [00:09:25] uterine different shaped, shaped uterus or uterine anomalies are more prone to that, [00:09:30] right?
[00:09:30] Dr. Lucky Sekhon: Right. So you do see an association, but why isn't their immune system recognizing these foreign cells? And [00:09:35] sometimes it evades the immune system. So there might be an autoimmune component to this. See
[00:09:39] Dr. Taz: that right.
[00:09:39] Dr. Lucky Sekhon: [00:09:40] And it allows these cells to kind of set up shop. And if you think about what the lining of your uterus [00:09:45] is supposed to do, when a pregnancy is established, they're sticky and they're kind of invasive and [00:09:50] they work with the embryo to allow it to burrow within and you know, turn into a pregnancy and [00:09:55] they can become sticky and invasive in other places.
[00:09:57] Dr. Lucky Sekhon: Mm. And they set up shop and turn into these, what we call [00:10:00] implants, and they are able to respond to hormones. So every month, if someone's not [00:10:05] on the birth control pill, if someone's able to ovulate, they have these monthly hormonal [00:10:10] fluctuations that feed these implants. And then you also have, you know, breakdown [00:10:15] and bleeding and inflammation and it can lead to scar tissue formation.
[00:10:18] Dr. Lucky Sekhon: So I always say [00:10:20] no two patients with endometriosis are exactly alike. One of the reasons why it's hard to diagnose [00:10:25] is it manifests in so many different ways. For some people, it means you see cysts on the [00:10:30] ovaries very clearly that look like endometriosis.
[00:10:32] Dr. Taz: Interesting.
[00:10:33] Dr. Lucky Sekhon: For some people, their ovaries look perfect.[00:10:35]
[00:10:35] Dr. Lucky Sekhon: It might be in the muscle wall of the uterus. These are examples where it might be obvious if you're [00:10:40] doing a scan, but not everyone gets a scan, a pelvic ultrasound as standard of care, which [00:10:45] is a, a bone issue that I have to pick.
[00:10:46] Dr. Taz: Me too,
[00:10:47] Dr. Lucky Sekhon: right? Because you can learn a lot,
[00:10:49] Dr. Taz: right?
[00:10:49] Dr. Lucky Sekhon: But. [00:10:50] The absence of those findings doesn't mean you don't have endometriosis because it can be really insidious.
[00:10:54] Dr. Lucky Sekhon: It can be [00:10:55] in the side pelvic wall. Yeah, and this is really weird. It can show up in your, [00:11:00] the cavity that surrounds your lungs. It can even show up in the brain that's not as common. It can show up in
[00:11:03] Dr. Taz: your lungs.
[00:11:04] Dr. Lucky Sekhon: Yes. [00:11:05] There are some people when they get their period every month, they'll have like a lung [00:11:10] collapse.
[00:11:10] Dr. Lucky Sekhon: Like this is very rare, but it's Right, right. Not a common
[00:11:12] Dr. Taz: one, but,
[00:11:12] Dr. Lucky Sekhon: but it is a type of endometriosis, so [00:11:15] it can look very different for different people. It doesn't always cause infertility. [00:11:20] Not every person with endometriosis is gonna have trouble getting pregnant. But for some people it can [00:11:25] cause blocked tubes.
[00:11:26] Dr. Lucky Sekhon: For some people, it can cause them to lose their eggs at a faster rate, [00:11:30] or it can affect their egg quality or even the ability for the embryo to implant, especially if it's [00:11:35] infiltrating the muscle of the uterus. Hmm. So I think because it can manifest in so many different ways, [00:11:40] it's hard to kind of pin down.
[00:11:41] Dr. Lucky Sekhon: I think also as a society and you know, the, the [00:11:45] field of medicine has a longstanding. Dark history of, you know, [00:11:50] minimizing women's pain and not adequately treating it.
[00:11:52] Dr. Taz: Mm-hmm.
[00:11:53] Dr. Lucky Sekhon: And I think women, ourselves, we've [00:11:55] internalized a lot of that. And, you know, don't often speak up for ourselves. Right. And even [00:12:00] when we do, sometimes it's dismissed.
[00:12:01] Dr. Lucky Sekhon: So I think it's this vicious cycle that has led to this real delay in [00:12:05] diagnosis.
[00:12:05] Dr. Taz: Can we dial into the pain for just a second? I have a 17-year-old daughter and I'm pretty [00:12:10] convinced. In fact, I think we have our ultrasound appointments coming up, but I'm pretty convinced she's got [00:12:15] endometriosis, just the way she presents.
[00:12:17] Dr. Taz: But there is pain that is crampy [00:12:20] pain. You don't ki you know Right. You don't feel great, you know, the week before your cycle or whatever. But then [00:12:25] there's pain that is severe and sometimes even signs. I always educate my patients [00:12:30] like rectal pain and some of those things during your period or, or big warning signs or big red [00:12:35] flags.
[00:12:35] Dr. Taz: Mm-hmm. Where is that like. Pain crossover where, okay, these are not just [00:12:40] cramps. Yeah. We need to think a little bit more. Is there any kind of tactical or like Yeah, more [00:12:45] like a less emotional, more logical way to like identify that
[00:12:49] Dr. Lucky Sekhon: there are [00:12:50] validated pain questionnaires that researchers have used.
[00:12:53] Dr. Lucky Sekhon: Because otherwise it seems like a [00:12:55] subjective thing. Right?
[00:12:55] Dr. Taz: Right.
[00:12:56] Dr. Lucky Sekhon: If you're trying to study different interventions, it's hard to compare and it's not a [00:13:00] perfect tool and not everyone's gonna have access to or, or know which ones to to [00:13:05] use. But I think the simplest thing for any lay person is, you know, just keep a [00:13:10] menstrual diary.
[00:13:10] Dr. Taz: Right?
[00:13:11] Dr. Lucky Sekhon: And a lot of times people will come to me and they're charting their [00:13:15] information and kind of saying like, this is when I feel this pain, this is, and it gives you a lot more objective information to go [00:13:20] off of versus just depending on recall and being able to think back to, well how painful was it?
[00:13:24] Dr. Lucky Sekhon: [00:13:25] Because psychology is a weird thing where you can kind of minimize, you know, past experiences [00:13:30] and it's almost like a defense mechanism. So I think keeping a diary.
[00:13:33] Dr. Taz: Okay.
[00:13:34] Dr. Lucky Sekhon: Um. But [00:13:35] it's, it's a really challenging thing because everyone has a different pain tolerance or threshold. [00:13:40] Right. But I think if it comes down to interfering with your day-to-day ability to [00:13:45] function, so that's why I always ask about like attendance when it comes to school or you know, calling out of work.
[00:13:49] Dr. Lucky Sekhon: [00:13:50] Of course. Yeah, yeah. Or having to modify your activities, like having to change your plans around your [00:13:55] period. I don't think that's ever considered normal. And to go back to your original question. [00:14:00] Yes, the standard way to diagnose and the standard teaching has been, [00:14:05] you should do a laparoscopy, which is, you know, it's invasive, right?
[00:14:08] Dr. Lucky Sekhon: It's doing a small incision in the [00:14:10] belly button and going in with a camera and looking directly, instead of using ultrasound or other indirect [00:14:15] ways of assessing and being able to even, not just see an implant, but [00:14:20] to take a small biopsy, even send it off and say, okay, is this endometriosis? Mm-hmm. Does this look like [00:14:25] the lining of the uterus instead of what it's supposed to be?
[00:14:28] Dr. Lucky Sekhon: And I don't [00:14:30] think that that is always necessary as a fertility specialist. Our field, I can tell you, [00:14:35] we used to do laparoscopies on so many people, and then they had these big studies that [00:14:40] came out that were like. You know, we're taking a lot of people for laparoscopy. Statistically speaking, [00:14:45] you probably have to take like 30 women to surgery to improve, you know, the fertility of one [00:14:50] person.
[00:14:50] Dr. Lucky Sekhon: Mm. Okay. And that might not make, make sense. It might not be, you know, the [00:14:55] safest approach for something that is technically invasive. It might not be a good use of resources. [00:15:00] And I think that we can make the diagnosis clinically. Mm. Right. If someone says to me, I have [00:15:05] painful periods, here's my menstrual diary.
[00:15:07] Dr. Lucky Sekhon: This is how it's affected my life. And by the way, [00:15:10] when I was on the pill for five years, all of this went away.
[00:15:13] Dr. Taz: Wow.
[00:15:13] Dr. Lucky Sekhon: And now I'm off and it's kind of [00:15:15] back. I'm like, okay, well that is a telltale sign. Mm-hmm. What else could that be? Right? You don't always need the [00:15:20] proof and you don't always necessarily have to have surgery.
[00:15:23] Dr. Lucky Sekhon: There's a role for [00:15:25] surgery, but I don't think every single person that thinks they have endometriosis necessarily needs it.
[00:15:29] Dr. Taz: I [00:15:30] think that's pretty hopeful to so many people. Yeah. Listening today. 'cause I think that's a big block. Like, I don't wanna [00:15:35] go for surgery. Let me just put up with this for longer.
[00:15:37] Dr. Lucky Sekhon: Right.
[00:15:38] Dr. Taz: What about the CA 1 [00:15:40] 25, which. Is a marker, you know, that I've seen some recent reports or literature on is [00:15:45] maybe using that and following and tracking that. Yes. To see what's going on there. I love that you [00:15:50] talked about sort of the autoimmune component of that. I think that's a lot of how I think [00:15:55] about mm-hmm.
[00:15:55] Dr. Taz: Both PCOS and endometriosis. Like, we need to stop thinking about these as hormone diseases and think [00:16:00] about them more as autoimmune diseases and look at things like inflammation. You know, [00:16:05] curious if. If there's any marker or tracker mm-hmm. That a clinician could, [00:16:10] could use Yeah. Or a patient could use to sort of understand what's going on.
[00:16:14] Dr. Lucky Sekhon: Yeah. [00:16:15] So ca 1 25, uh, is a test that scares a lot of people, right? [00:16:20] Because the way it's traditionally been used is as a marker for certain types of ovarian [00:16:25] cancer, but really it's a marker of inflammation. So if you have inflammation of your ovaries, [00:16:30] often you're gonna have really high levels. And it's used as a a way to screen people.
[00:16:34] Dr. Lucky Sekhon: It's [00:16:35] not the perfect screening tool. Ovarian cancer is a very difficult gynecologic, yeah. Cancer, [00:16:40] because it's often picked up at later stages. But for people with a strong family history, often they're getting. [00:16:45] You know, yearly or bi, you know, biannual, uh, pelvic ultrasounds and getting these [00:16:50] levels checked.
[00:16:50] Dr. Lucky Sekhon: Mm-hmm. And if there's a rise, then maybe they, you know, are watched more carefully. But [00:16:55] we also know you can get these false positives and especially at lower level elevations, there is an [00:17:00] association between that and endometriosis. Mm-hmm. Now, I don't wanna scare people who are listening to [00:17:05] this and who are thinking, Hey, I might have endometriosis, but it is a known fact that, [00:17:10] um, people with endometriosis can have a slightly increased risk of a specific type of [00:17:15] ovarian cancer called clear cell carcinoma.
[00:17:17] Dr. Taz: Okay.
[00:17:18] Dr. Lucky Sekhon: But it makes sense because it can [00:17:20] involve the tissue of the ovary. And so you know, you can test a CA 1 25, but if it's [00:17:25] normal, that doesn't mean you don't have endometriosis. Gotcha. So I think that markers, there [00:17:30] have been a lot that have been studied, like even BCL six, that's another inflammatory marker that a lot of [00:17:35] fertility doctors nowadays are doing biopsies of the inner lining of the uterine cavity [00:17:40] and looking for a certain level elevation in this marker.
[00:17:42] Dr. Lucky Sekhon: In some studies, not all, it hasn't really been [00:17:45] validated. What's
[00:17:45] Dr. Taz: the number? What's the
[00:17:46] Dr. Lucky Sekhon: BCL six?
[00:17:47] Dr. Taz: BCL six. And can we routinely test that or not? [00:17:50]
[00:17:50] Dr. Lucky Sekhon: You can. I mean, there's a company that will run it on a biopsy of the lining of the uterus. Okay. [00:17:55] But there have been many cases of people that have said, yeah, mine was negative.
[00:17:58] Dr. Lucky Sekhon: And then I ended up [00:18:00] going for a laparoscopy because I had all the signs and symptoms, and guess what? I had stage four [00:18:05] endometriosis. So these markers are not perfect. Right. And they aren't as sensitive or as [00:18:10] specific as we need them to be. To truly say this can be part of the diagnostic criteria.
[00:18:14] Dr. Taz: [00:18:15] Gotcha.
[00:18:15] Dr. Taz: So there's still so much more work to do. So between endometriosis and PCOS, [00:18:20] are those the two primary blocks to fertility that you are [00:18:25] seeing in your practice?
[00:18:26] Dr. Lucky Sekhon: I mean, we also see people with blocked tubes. Mm-hmm. Right. And sometimes [00:18:30] it's because they have conditions like endometriosis, right? Sometimes it's because they had a ruptured [00:18:35] appendix when they were younger, and it led to like a local inflammatory reaction.
[00:18:39] Dr. Lucky Sekhon: So these [00:18:40] are the things I ask people about when, when I talk about their surgical history and they'd say, oh, I had [00:18:45] appendicitis. I always ask, was it ruptured or not, right? Mm-hmm. Um, I always ask [00:18:50] about chronic medical conditions. There are some uncontrolled chronic medical [00:18:55] conditions that can run concurrently alongside infertility or even recurrent [00:19:00] pregnancy loss.
[00:19:00] Dr. Lucky Sekhon: So people with really, um, poorly controlled autoimmune conditions where they're [00:19:05] constantly having flares. That's not great for your general health. It's not gonna be great for your fertility either.
[00:19:09] Dr. Taz: Yeah. [00:19:10]
[00:19:10] Dr. Lucky Sekhon: Deficiencies. A lot of people don't realize that iron deficiency anemia can make it [00:19:15] harder to get pregnant.
[00:19:16] Dr. Taz: Are there other nutritional deficiencies that you've seen?
[00:19:18] Dr. Lucky Sekhon: Vitamin D is [00:19:20] a little bit harder to nail down the exact role. Yeah. But there's many different proposed ways that it [00:19:25] could impact fertility and pregnancy health. So I check everyone for vitamin D deficiency, and [00:19:30] if I detect it, it's quite common, you know, being in the Northern hemisphere.
[00:19:33] Dr. Lucky Sekhon: Yeah. Especially going into [00:19:35] the winter. It's something that I really keep my eye on and I always replete it because you just don't wanna have [00:19:40] any unchecked. Deficiencies.
[00:19:42] Dr. Taz: Are there genomics that you are tracking as [00:19:45] well, or, or not necessarily? I don't know if you get into M-T-H-F-R or any of these sort of [00:19:50] genomics that might have a higher risk.
[00:19:52] Dr. Lucky Sekhon: So yes, we do. I mean, when I, [00:19:55] when I am working up cases of recurrent pregnancy loss, meaning two or more [00:20:00] miscarriages, I often will look at, again, an immune marker that can also affect [00:20:05] your, uh, risk of blood clotting. Mm-hmm. These are called antiphospholipid syndrome [00:20:10] antibodies.
[00:20:10] Dr. Taz: Okay.
[00:20:10] Dr. Lucky Sekhon: Um, and if those are elevated, there could be a role for giving baby aspirin while trying to [00:20:15] conceive an even a, a more potent injectable, blood thinner called Lovenox once pregnant.[00:20:20]
[00:20:20] Dr. Lucky Sekhon: Um, sometimes part of that panel, you know, will look for other blood clotting disorders. Even [00:20:25] though blood clotting disorders are not really an established risk factor for recurrent [00:20:30] losses, they're often. Are on the panel that we use to run for, uh, ruling out [00:20:35] antiphospholipid syndrome.
[00:20:35] Dr. Taz: Mm-hmm.
[00:20:36] Dr. Lucky Sekhon: Which are three specific markers.
[00:20:38] Dr. Lucky Sekhon: And M-T-H-F-R comes up on that [00:20:40] panel a lot. Mm-hmm. So, um, you know, this is a, an enzyme that helps us break [00:20:45] down folate. Mm-hmm.
[00:20:46] Dr. Taz: And.
[00:20:47] Dr. Lucky Sekhon: There are many people, it used to be called a [00:20:50] mutation, but now we talk about it more like a variant. Interesting. Okay. And there are many people that have this variant. [00:20:55] Yep.
[00:20:55] Dr. Lucky Sekhon: And it's not necessarily a problem if you ask me or my colleagues, like [00:21:00] 10, 20 years ago, people would be like, oh my gosh, if you have this variant, like you need a different type of folic acid, you need [00:21:05] to do this. Mm-hmm. Um, you know, you need to be on baby aspirin. Nowadays we recognize that up [00:21:10] to 30 to 40% of the population has a variant.
[00:21:12] Dr. Lucky Sekhon: Has that,
[00:21:12] Dr. Taz: right? Mm-hmm.
[00:21:12] Dr. Lucky Sekhon: And there's so many different pathways for folate to [00:21:15] be broken down, that it's usually not a problem for people. Now, if there's a [00:21:20] specific block that leads to backup of, you know, one of the things that's supposed to [00:21:25] be broken down, backup of something called homocysteine. Mm-hmm.
[00:21:27] Dr. Lucky Sekhon: That can actually be a problem. So [00:21:30] anytime someone has M-T-H-F-R tested for, there's always usually [00:21:35] reflexive testing to look at homocysteine levels. And if those are normal, this is not considered clinically relevant [00:21:40] in most cases. And it's a source of confusion because. Really and truly, we want people [00:21:45] to take folic acid in their prenatal vitamin right.
[00:21:47] Dr. Lucky Sekhon: To, to prevent neural tube defects problems like spina [00:21:50] bifida. But there has been a lot of this like legacy information that is [00:21:55] very hard to uncouple from this issue where people feel very worried about taking folic [00:22:00] acid. They wanna take a very specific type.
[00:22:01] Dr. Taz: Right?
[00:22:02] Dr. Lucky Sekhon: But that's usually not relevant. So if you have the [00:22:05] M-T-H-F-R mutation or variant, then get your homocysteine level check.
[00:22:08] Dr. Lucky Sekhon: That's the takeaway.
[00:22:09] Dr. Taz: And follow that. [00:22:10] That might be the big thing. And we've seen that in practice as well with homocysteine being high. Yes. Or [00:22:15] inflammation in the body.
[00:22:16] Dr. Lucky Sekhon: Right.
[00:22:16] Dr. Taz: You know, we don't necessarily track that in the cases of [00:22:20] PCOS and endometriosis, but it is interesting to look at as well.
[00:22:23] Dr. Lucky Sekhon: For sure.
[00:22:23] Dr. Taz: You know, one of the things I, [00:22:25] I saw recently, and you probably saw the study too, is, and this is where it's so [00:22:30] confusing. For our women and for younger women. I'm all about having a career. I'm all [00:22:35] about getting out there and doing what you're meant to do in the world. Yes. Right. And I don't want women to think [00:22:40] that they have to, to necessarily choose, but one of the things I saw recently was a study [00:22:45] that talked about the rising rates of prenatal androgens in [00:22:50] moms, you know, in moms, like from a preconception standpoint and from a early kind of [00:22:55] embryonic standpoint, and some of that being connected to, you know, the early onset of [00:23:00] PCOS and endometriosis and those type of things.
[00:23:02] Dr. Taz: I'm only bringing that up because if you could wave a magic [00:23:05] wand, and I know we're gonna get into more fertility stuff, but if you could wave a wand and [00:23:10] say, I wish that teen girls, children, teen girls, and young women [00:23:15] in their early twenties knew this.
[00:23:17] Dr. Lucky Sekhon: Mm-hmm.
[00:23:17] Dr. Taz: What would you say to them?
[00:23:19] Dr. Lucky Sekhon: I [00:23:20] mean, how many, how many answers do I get?
[00:23:22] Dr. Taz: You get five, you know.
[00:23:23] Dr. Lucky Sekhon: Okay. I will [00:23:25] say, uh, smoking is always a bad idea. Right. We know that there are certain [00:23:30] things that are fearmongering and then there are certain things that we know are exposures that truly can have [00:23:35] a negative impact on. Our fertility can accelerate how quickly we go into menopause, which [00:23:40] technically means, you know, how quickly our egg supply runs low.
[00:23:43] Dr. Lucky Sekhon: Right. To a point where our ovaries stop [00:23:45] functioning. Smoking is one of those things, so this isn't to shame anyone, but it's to give you [00:23:50] motivation that there's so many. And does
[00:23:50] Dr. Taz: that include vaping? Right.
[00:23:52] Dr. Lucky Sekhon: So we don't have all of the studies that we [00:23:55] do on tobacco and cigarette smoke, but it makes sense.
[00:23:58] Dr. Lucky Sekhon: Yeah. That there's an extension. Right, right. Yeah. And [00:24:00] I, I think that this idea that e-cigarettes and vaping are like a healthier form of smoking, [00:24:05] I don't think you can say that. Yeah. I think you're, you're inhaling, you know, combusted [00:24:10] chemicals, there's all sorts of toxins and things that you are ingesting that just aren't good for your general health and they're [00:24:15] not gonna be good for your fertility.
[00:24:16] Dr. Lucky Sekhon: Yeah. Um. I think something else that people really need to [00:24:20] recognize, not even just young people. Everyone needs to be a little bit more aware of the role that [00:24:25] insulin resistance can play. Mm. It's a big one in our health and in our fertility and you [00:24:30] know, when we talk about, um, how to make our egg quality better, it seems [00:24:35] like this magical concept and often it is kind of used that way to market certain things like [00:24:40] supplements.
[00:24:41] Dr. Lucky Sekhon: But the one meaningful thing you can really do to improve the [00:24:45] environment where the eggs are maturing inside your ovaries, that's where all the genetic [00:24:50] reorganization is happening. When an egg is maturing. Becoming ready to ovulate, actually going through [00:24:55] ovulation and then fertilizing. Those are moments where your chromosomes are being [00:25:00] duplicated, rearranged, and they can be more error prone those eggs if they're in an environment [00:25:05] that doesn't serve them.
[00:25:06] Dr. Lucky Sekhon: So if there's excess androgens, like excess [00:25:10] testosterone, and a lot of that people don't realize can be linked to the role of high insulin [00:25:15] levels. Interesting. 'cause your body's trying to get your cells to store sugars so the insulin levels [00:25:20] go up if your body tends to be resistant to those signals. And insulin can act like a [00:25:25] growth factor on your ovaries.
[00:25:26] Dr. Lucky Sekhon: So I see it all the time where people are like, I've been tested for that. [00:25:30] My hemoglobin A1C is normal. Normal. Oh yeah. Or my insulin levels. All of these things are normal, but they have these [00:25:35] indirect signs like high testosterone.
[00:25:37] Dr. Taz: Yeah.
[00:25:37] Dr. Lucky Sekhon: And we know where that's coming from. And then when we. [00:25:40] Correct. The insulin resistance, all of that seems to normalize.
[00:25:42] Dr. Lucky Sekhon: And I've had patients go through more [00:25:45] than one attempt. Maybe they're coming to me for a second opinion, and they do seem to do a lot better when [00:25:50] we get those things under control.
[00:25:51] Dr. Taz: And as you mentioned, there's a huge, you know, if you're of South [00:25:55] Asian descent
[00:25:55] Dr. Lucky Sekhon: Yeah.
[00:25:56] Dr. Taz: Even Hispanic descent. Yes. I think there is a huge [00:26:00] epidemic.
[00:26:00] Dr. Taz: I don't know why, I don't know if you have any explanation, but there's an epidemic of insulin [00:26:05] resistance. Yes. At a young age. Yeah. Not even like, you know, later we can blame diet and this and that, but there is an [00:26:10] epidemic of, of insulin resistance for sure. Yeah. So I think it's so important to be aware of that.
[00:26:14] Dr. Lucky Sekhon: [00:26:15] One of the greats in the field of reproductive endocrinology. I'm proud to say that he was my [00:26:20] mentor. He was at Mount Sinai, he actually passed away recently, within the past year. His name's Nathan [00:26:25] Case.
[00:26:25] Dr. Taz: Okay.
[00:26:25] Dr. Lucky Sekhon: And he's an endocrinologist. Um, who. Did so much work. He did a lot [00:26:30] of menopause work, but he also focused a lot on trying to understand the [00:26:35] origin, the etiology of PCOS.
[00:26:37] Dr. Lucky Sekhon: Yeah. And he talked a lot about these [00:26:40] certain populations. Yeah. And he talked a lot about immigration.
[00:26:43] Dr. Taz: Mm.
[00:26:44] Dr. Lucky Sekhon: And how I [00:26:45] was, I alluded to it earlier, like our ancestors were in a different environment, [00:26:50] eating a different diet, and that genetic. Wiring still exists in us today. Mm. [00:26:55] And our bodies maybe aren't as equipped to deal with the Western diet.
[00:26:58] Dr. Taz: Interesting.
[00:26:59] Dr. Lucky Sekhon: As [00:27:00] someone whose ancestors grew up in this environment. Right? Yeah. So could this shift over time as we have now [00:27:05] settled here and will have generations and generations follow us, you know, in this [00:27:10] environment? We don't know. I mean, there's so many other factors, but I think that is a, a prevalent [00:27:15] the, that is a major theory as to why it's so prevalent in certain populations.
[00:27:18] Dr. Lucky Sekhon: That's
[00:27:18] Dr. Taz: so [00:27:20] interesting. Anything else you would. Tell you I love the insulin resistance piece. I think if we could get [00:27:25] everybody to dial into that mm-hmm. How would, how would you have them look at that? 'cause I've had those [00:27:30] conversations with patients and they're like, same, A1C is fine. Fasting insulin's fine.
[00:27:34] Dr. Taz: What's a better [00:27:35] way? Yeah. To understand if you, if that might be your block. Right. That might be your fertility block.
[00:27:39] Dr. Lucky Sekhon: So [00:27:40] other labs that are kind of objective findings, like I mentioned, um, high testosterone. Yes.
[00:27:44] Dr. Taz: [00:27:45] Okay.
[00:27:45] Dr. Lucky Sekhon: High D-H-E-A-S, which is another testosterone like hormone mm-hmm. That a lot of people [00:27:50] don't know about.
[00:27:50] Dr. Lucky Sekhon: It's not as familiar as testosterone. Um, there's another one that sometimes is [00:27:55] elevated depending on the functioning of your adrenal glands. Your adrenal glands are little glands that sit on top of your [00:28:00] kidneys on either side, kind of back here, and they, they make androgens. Mm-hmm. [00:28:05] And so sometimes you can have this other androgen elevated called androstenone.
[00:28:08] Dr. Lucky Sekhon: Mm.
[00:28:09] Dr. Taz: Mm-hmm.
[00:28:09] Dr. Lucky Sekhon: Some [00:28:10] people are born with, you know, a problem with one of the enzymes in their adrenal gland. And this can lead to an [00:28:15] abnormal buildup of androgens. So there's a lot of different. Reasons or causes behind it. But we know [00:28:20] insulin resistance can be a cause of a buildup of androgens. And so you can measure those.
[00:28:24] Dr. Lucky Sekhon: You [00:28:25] can also do, um, what's even better than a hemoglobin A1C, which is really just kind of a, [00:28:30] a overall, an an overview of your sugar control over the past 90 [00:28:35] days, which a lot of people who have insulin resistance are churning out enough insulin at a [00:28:40] higher level that they're able to compensate. Yeah. So it's not that you're gonna see an elevation in their blood sugar, [00:28:45] but you might uncover it by giving them a glucose challenge.
[00:28:48] Dr. Lucky Sekhon: Yeah. And doing something called an oral [00:28:50] glucose tolerance test, where, you know, two hours later you're measuring their levels and seeing how did they handle [00:28:55] that glucose load. And if it's kind of elevated, even if it's not diabetic range, that can also be a [00:29:00] clue. But then other things that are kind of more insidious is.
[00:29:03] Dr. Lucky Sekhon: Asking about family history. [00:29:05]
[00:29:05] Dr. Taz: Mm.
[00:29:05] Dr. Lucky Sekhon: So, you know, I have patients that'll say, oh yeah, everyone in my family has type two diabetes. Yeah. And you're like, [00:29:10] okay, there you go. Or I've been gaining weight and especially in my midsection, and it's been really hard. [00:29:15] No matter what I do, I just can't take it off. I have acne that seems [00:29:20] hormonal.
[00:29:20] Dr. Lucky Sekhon: Like there's all these things that are tied together. Symptoms. Yeah, exactly.
[00:29:23] Dr. Taz: Yeah. So [00:29:25] interesting. And I really hope, you know, if you're watching and listening that you're spreading this information [00:29:30] because I think there's just so much heartache and frustration and I feel like if we got again, on the front end [00:29:35] of it Yes.
[00:29:35] Dr. Taz: Then it would prevent some of the journeys I've seen so many different people take.
[00:29:39] Dr. Lucky Sekhon: And [00:29:40] sometimes there's a lot of really simple lifestyle measures. Like we know having built up, [00:29:45] building up muscle in your body can promote being more sensitive to [00:29:50] insulin. Mm-hmm. And conversely, having more fat deposition on your body, especially around the [00:29:55] midsection, kind of opposes the effects of insulin.
[00:29:57] Dr. Lucky Sekhon: So just in our day-to-day behaviors [00:30:00] and how we work out and treat our bodies, we can make a meaningful [00:30:05] difference and we can prevent these things, which. Seem to get more common as we get older, but [00:30:10] it's not always your fault. Sometimes you can do all the right things and you, it's doesn't be wired
[00:30:13] Dr. Taz: just the way you're wired.
[00:30:14] Dr. Taz: Right. And [00:30:15] literally within our family, everyone's got high insulin.
[00:30:18] Dr. Lucky Sekhon: Yep.
[00:30:18] Dr. Taz: It shows up differently. Right. You [00:30:20] know, my, I have one sister that has trouble with weight, another one that has trouble with like acne. [00:30:25] I had trouble with hair. Like, everyone's different, you know?
[00:30:27] Dr. Lucky Sekhon: Yep.
[00:30:28] Dr. Taz: So I think it's really important to [00:30:30] understand and dial into that concept, you know, aggressively to, to get a handle on it.
[00:30:34] Dr. Taz: I'm [00:30:35] curious, are you like an advocate for medications like metformin or the [00:30:40] GLP ones? Absolutely. Absolutely. Where, where do they fit into the conversation around fertility?
[00:30:44] Dr. Lucky Sekhon: I think [00:30:45] lifestyle changes are important and great, and they're not mutually exclusive with medications. I [00:30:50] think sometimes people can find it really hard, especially to kind of kickstart the [00:30:55] process.
[00:30:55] Dr. Lucky Sekhon: Um, it's almost like. You know, you need some help. Yeah. Especially at the beginning and then it [00:31:00] becomes easier, um, to see, you know, changes with lifestyle Right. Measures. [00:31:05] Um, so I think that it's a wonderful thing, especially in light of the fact that fertility is so time [00:31:10] sensitive. Mm-hmm. I don't think it's a realistic goal to just say, you know, eat, try to eat [00:31:15] healthy, right?
[00:31:15] Dr. Lucky Sekhon: Try to avoid insulin, calories, calories out, and all that stuff. Right. Sometimes it's really difficult [00:31:20] because you're already wired in such a way where high insulin levels can really bottom you out and make [00:31:25] you have these periods of low blood sugar where not only are you having major pangs of [00:31:30] hunger.
[00:31:30] Dr. Lucky Sekhon: But you're feeling sick, right? You're feeling nauseous. It's, it's sometimes really hard. You have to [00:31:35] break this vicious cycle and sometimes medication can be the best tool to do so. I have a [00:31:40] lot of patients who take metformin.
[00:31:41] Dr. Taz: Yeah.
[00:31:41] Dr. Lucky Sekhon: And I tell them, you know, let's be doing all the things all at [00:31:45] once because we wanna make the most impact in the shortest amount of time because we don't wanna [00:31:50] be, you know, only doing this and not focusing on the fertility.
[00:31:53] Dr. Lucky Sekhon: A lot of people are, [00:31:55] are, you know, dealing with other time sensitive issues, right? Like a lower egg count and so, and, and age and [00:32:00] the effect it can have on their egg quality. So you really wanna try and. And be as efficient as [00:32:05] possible.
[00:32:05] Dr. Taz: I like that. And some of the blocks that I've heard from folks too is like, well, I don't wanna be on a medication [00:32:10] forever, or I'll become
[00:32:11] Dr. Lucky Sekhon: dependent on it.
I'll
[00:32:12] Dr. Taz: become dependent on it. I, those are the two things I hear. But that's not [00:32:15] the case.
[00:32:15] Dr. Lucky Sekhon: No.
[00:32:15] Dr. Taz: Like it's not the case.
[00:32:16] Dr. Lucky Sekhon: It's not like your pancreas becomes lazy or pancreas is what turns out [00:32:20] insulin. It's not like, oh, it becomes lazy because, you know, now you're just helping it along. [00:32:25] That's not really true. I think your overall health can improve dramatically because insulin [00:32:30] can be very pro-inflammatory.
[00:32:31] Dr. Lucky Sekhon: Yeah. Um, and so, and I think it makes [00:32:35] it easier to exercise. It makes it easier to, uh, be conditioned in a way where [00:32:40] you can actually maintain a healthier lifestyle. So, um, that's something that I really [00:32:45] think is a huge mental block for a lot of people. Like, how long am I gonna have to be on this? And I always say, right.
[00:32:49] Dr. Lucky Sekhon: I'm trying to get you [00:32:50] pregnant or I'm trying to improve your outcome, you know, for egg freezing or Right. Making [00:32:55] embryos, and you don't have to stay on this long term, but I have some patients that are like, I feel so much better, better
[00:32:59] Dr. Taz: on it
[00:32:59] Dr. Lucky Sekhon: than hear about. Yeah. But [00:33:00] I actually do wanna stay on it long term, even though I'm done with whatever I was doing with you.
[00:33:03] Dr. Lucky Sekhon: Yeah. Can you please gimme some [00:33:05] refills?
[00:33:05] Dr. Taz: Yeah. And I think these are all like, actionable things that people watching and [00:33:10] listening can take advantage of.
[00:33:11] Dr. Lucky Sekhon: Yes.
[00:33:11] Dr. Taz: Right. Yeah. So, you know, but that brings us now, [00:33:15] okay, that's the preventive stuff. That's what you should be dialing into maybe early on. What [00:33:20] about those people who have now entered the conversation around, I'm ready to get pregnant.
[00:33:24] Dr. Taz: Mm-hmm. [00:33:25] And are just struggling and kind of the mind game, you know, is [00:33:30] like, oh my God, you know, this is how old I am, I gotta hurry up. If I don't hurry up, then [00:33:35] X, y, Z is gonna happen.
[00:33:36] Dr. Lucky Sekhon: Yeah.
[00:33:36] Dr. Taz: So the ticking clock, the time [00:33:40] bomb that damn clock, you know, help us with that.
[00:33:44] Dr. Lucky Sekhon: Yeah. [00:33:45] I mean. Uh, the best way that I can help.
[00:33:48] Dr. Lucky Sekhon: I can't make it go [00:33:50] away. I can't reverse the clock, but I can inform people because, you know, I think [00:33:55] society has done a great job. Maybe they've, it's overperformed at reminding women [00:34:00] about, you know, the fragility of their fertility. And I have people that come to me at, you know, [00:34:05] 35 and they're like, oh my God, I'm turning 35 tomorrow.
[00:34:07] Dr. Lucky Sekhon: Am I gonna fall off a fertility cliff? Right. And that's not [00:34:10] true either. Yeah. Right. So I, I think that I have a very balanced view. There's a, an [00:34:15] appropriate level of urgency because there is a clock and, you know, contrary to [00:34:20] what you might see in your Instagram feed, there isn't always a way to reverse that.
[00:34:24] Dr. Lucky Sekhon: Or, you know, there isn't [00:34:25] like an easy supplement to take to fix that or freeze it, but at the same [00:34:30] time it's, it's, um, on a continuum. It's not a cliff. Yeah. So I'll explain it this [00:34:35] way. You're born with all the eggs that you're ever gonna have. You don't make new eggs, you don't repair your eggs. [00:34:40] Right. I told someone that earlier today.
[00:34:42] Dr. Lucky Sekhon: Who's in her late thirties, and she was like, oh my God, I've never heard that [00:34:45] before. Mm-hmm. So I feel like even though it's not the, the most fun fact to share, it's an important one [00:34:50] to be real about, that we just have different biology. You know, men have a biological [00:34:55] clock too, right? But they're always able to make new sperm, right?
[00:34:57] Dr. Lucky Sekhon: Every 74 days or so, and new [00:35:00] sperm cell is generated, we don't make new eggs. So we're born with a stockpile. And I like to use this analogy of [00:35:05] like a pantry. Imagine at the core of both ovaries, you have this pantry, the stockpile that you're born [00:35:10] with, and every cycle, you know, you have a, an unlocking of the [00:35:15] pantry in a.
[00:35:15] Dr. Lucky Sekhon: Situation that you can't control. I can't manipulate it as a fertility doctor, but [00:35:20] a few of those eggs, a very limited subset kind of escape and imagine they're like pulled outta the pantry [00:35:25] into the kitchen cabinets. Mm-hmm. And their's see-through. Right. That's what I can see on an ultrasound in [00:35:30] bubbles of fluid that we call follicles, each one containing an egg.
[00:35:33] Dr. Lucky Sekhon: I am able, at any given [00:35:35] time point, when I scan a a, a person, I'm able to look at their ovaries and kind of get a count. And [00:35:40] it's a count a, a, a size of a cohort that is easy to count. It's like 10, [00:35:45] 15, 20. It varies from person to person.
[00:35:47] Dr. Taz: Mm-hmm.
[00:35:47] Dr. Lucky Sekhon: But it's like rationing, which is why I use this pantry [00:35:50] analogy, because the more you have in your stockpile in a given timeframe, the more you tend.
[00:35:54] Dr. Lucky Sekhon: Bring to [00:35:55] the surface and bring out, and then what your body does naturally. Once you go into [00:36:00] puberty and you start being someone that can ovulate, your brain sends a signal called [00:36:05] follicle stimulating hormone, where basically it sends a signal out and like a [00:36:10] lottery, one of these eggs is selected to mature and it's a random selection, right?
[00:36:14] Dr. Lucky Sekhon: And [00:36:15] then it gets matured and you're able to kind of open one cabinet or the other and access just one [00:36:20] egg. Mm-hmm. One egg gets ovulated, everything else is a perishable item in those cabinets and gets thrown away. [00:36:25] And then a new set come outta the pantry. Right? So that is always kind of depleting our stockpile.
[00:36:29] Dr. Lucky Sekhon: We're [00:36:30] losing hundreds to thousands of eggs each month in these waves of recruitment, and we don't [00:36:35] really know why this system exists. And the reason why it's important to understand that this is happening in all of [00:36:40] our ovaries, and people are walking around with no idea about this magic that's happening in our bodies.[00:36:45]
[00:36:45] Dr. Lucky Sekhon: But you have to understand it because this explains why when you ovulate one egg. [00:36:50] In your fertility is so inefficient. Yeah, right. That one egg is a long shot. It's [00:36:55] not that you're ovulating. If people see 20 eggs on their ultrasound, they're like, oh, I'm so fertile. 'cause they're assuming [00:37:00] that now they have more chances to ovulate, but you're only ovulating one.
[00:37:04] Dr. Lucky Sekhon: And not every egg [00:37:05] is going to be healthy and actually fertilize and grow into an embryo and implant. [00:37:10] And you know, when we talk about numbers, the only reason it matters is because [00:37:15] I, as a fertility doctor, do have the knowledge and technology and knowhow to open [00:37:20] both kitchen cabinets and try to the best of my ability to remove everything before it [00:37:25] perishes and goes away.
[00:37:25] Dr. Lucky Sekhon: I can actually remove. And so the more you have available in the [00:37:30] stockpile, the more you have available for me to take out.
[00:37:32] Dr. Taz: Right.
[00:37:32] Dr. Lucky Sekhon: And the more eggs you freeze or the more eggs you [00:37:35] try to turn into embryos, the better treatment outcomes tend to be, the more efficient treatment [00:37:40] tends to be. But ultimately, whatever egg count you have is not gonna determine your natural [00:37:45] fertility, your ability to get pregnant from one egg that's ovulated.
[00:37:48] Dr. Lucky Sekhon: So that's [00:37:50] quantity, right? And why it matters. It only matters if you need treatment, which you, you don't have a crystal ball, right? Maybe if you do, [00:37:55] it's nice to know, hey, you have a lot of eggs that we can stimulate and access. But [00:38:00] really matters is what is the chance of ovulating a healthy egg. Mm. And that's so much harder for people to [00:38:05] understand 'cause there's no direct way to test anyone's egg quality.
[00:38:08] Dr. Taz: Mm.
[00:38:08] Dr. Lucky Sekhon: I wish there was a blood test. I know. [00:38:10] Where we could say, okay, 30% of eggs that you have at this current state could turn unhealthy into healthy [00:38:15] embryos. Right. That would be so helpful.
[00:38:16] Dr. Taz: Yeah.
[00:38:17] Dr. Lucky Sekhon: And we also don't have a test that tells us how quickly we're [00:38:20] gonna lose our eggs. We know that we tend to lose them at a faster rate as we approach 35 and [00:38:25] older.
[00:38:25] Dr. Lucky Sekhon: So this is why that number is in everyone's, you know, at the forefront of their consciousness. They're like, [00:38:30] oh God, I'm turning 35. Right. It doesn't mean you're gonna lose all your eggs. But you will start to lose them [00:38:35] faster.
[00:38:35] Dr. Taz: Mm.
[00:38:36] Dr. Lucky Sekhon: But the other thing that also happens at 35 is it's never perfect for [00:38:40] anyone in your twenties.
[00:38:41] Dr. Lucky Sekhon: If I was to take all the eggs that I could get from the kitchen cabinets and [00:38:45] turn them into embryos and tested them, even then 20 to 25% of them are gonna have typos or [00:38:50] errors that don't allow those eggs to turn into babies. Right? That number rises to about [00:38:55] 35% at 35, but then by the time you get to 37, 38, it's like 50, 50, 40.
[00:38:59] Dr. Lucky Sekhon: [00:39:00] It's more like 70% of embryos tend to be abnormal. Mm-hmm. And not have reproductive potential, and [00:39:05] 30% will be normal. So that's why turning 35 matters. It's not that. [00:39:10] All of a sudden you're destined to have infertility age related problems with egg quality and [00:39:15] quantity. It's that it can become more challenging to have randomly hope to ovulate a [00:39:20] healthy egg.
[00:39:20] Dr. Lucky Sekhon: And this means it often takes many more ovulations to get to a pregnancy and there's a higher [00:39:25] risk of miscarriage when pregnancy does occur. But I always say, because I'm an optimist, you [00:39:30] know, this also explains why some people. We'll say I got pregnant on my own without a fertility. [00:39:35] Doctor's help at 42 because hey, there's still 20% of embryos that could be normal at that age, actually could be that [00:39:40] age.
[00:39:40] Dr. Taz: Do you believe we can reverse the ovarian age? I know there's a lot of work around PRP [00:39:45] and stem cells and I don't know what you think about that science since I know it's probably
[00:39:49] Dr. Lucky Sekhon: I want to [00:39:50] Yeah, I, I I would love that. I I would love that. Unfortunately, you [00:39:55] know, this is something I'm very much abreast of and constantly reading new, right, right.
[00:39:59] Dr. Lucky Sekhon: New data [00:40:00] that comes out. Um, currently there's no convincing evidence mm-hmm. That [00:40:05] any of those things work to do that.
[00:40:06] Dr. Taz: Gotcha.
[00:40:07] Dr. Lucky Sekhon: I think it's great that we're continuing to study it though. 'cause [00:40:10] PRP can work in many different fields of medicine. Right. Especially like, you know, for joint [00:40:15] issues. Like we know there are certain tissue in our body that you can actually cause [00:40:20] regeneration of cells and there, there is a real role for regenerative medicine, right?
[00:40:24] Dr. Lucky Sekhon: Mm-hmm. The [00:40:25] ovaries are tricky because we just don't have that same ability to make new eggs. And [00:40:30] so I'm not saying it's not gonna be possible, but right now that is still very much in the [00:40:35] experimental research phase, and right now all of the data that has ever [00:40:40] shown like a small associated rise in a MH level or egg count markers, [00:40:45] it's probably more because of the disruption of the follicles.
[00:40:47] Dr. Lucky Sekhon: When you're piercing it with a needle and [00:40:50] injecting it, you're creating an inflammatory response and then releasing more A MH. Mm-hmm. Coming from those [00:40:55] follicles. Interesting. We're not really seeing, there's two major randomized control trials, which is like the data [00:41:00] we want. Right. That came out in 2024.
[00:41:03] Dr. Lucky Sekhon: Before that we didn't really have [00:41:05] much to go off of, and both of them failed to show any sort of difference. Yeah,
[00:41:09] Dr. Taz: Uhhuh.
[00:41:09] Dr. Lucky Sekhon: [00:41:10] So I, I hope so. I think what would really be an amazing breakthrough, if any scientists are listening [00:41:15] and are wanting to work on this problem, I would love if I could somehow [00:41:20] program the ovaries to say, you know what?
[00:41:21] Dr. Lucky Sekhon: I know there's a low number in the pantry and we're bringing [00:41:25] fewer to the surface as a result, but I'd like you to recruit more because then I could tell someone [00:41:30] who's 40 and maybe dealing with a lower egg count, but also egg quality issues. Yes, I'm gonna [00:41:35] deplete your stockpile faster. 'cause right now people worry about like an egg retrieval, right?
[00:41:39] Dr. Lucky Sekhon: Am I gonna go into [00:41:40] menopause sooner? And the, the, the reason why I go into this analogy is when you realize [00:41:45] that whatever we are getting to would've been thrown out anyway. Yeah. That alleviates that concern.
[00:41:49] Dr. Taz: Yeah.
[00:41:49] Dr. Lucky Sekhon: But [00:41:50] sometimes I wish that I could say, Hey, this might actually deplete your egg count faster, your [00:41:55] overall supply, but let's just for this moment.
[00:41:58] Dr. Lucky Sekhon: To make sure that your [00:42:00] cycle is successful. Like let's start out with 30 eggs.
[00:42:02] Dr. Taz: Yeah.
[00:42:02] Dr. Lucky Sekhon: I wish I could do that. Mm. You know, and I feel [00:42:05] like that's probably a more realistic path forward just from what, what I know about the science of the ovaries [00:42:10] and
[00:42:10] Dr. Taz: regenerating the,
[00:42:11] Dr. Lucky Sekhon: yeah. Yeah. I think like just being able to access more would be a game changer.[00:42:15]
[00:42:15] Dr. Taz: Do you still like A MH and F-S-H-L-H ratios? Yeah. And all that [00:42:20] stuff is markers, yeah. Of equality.
[00:42:22] Dr. Lucky Sekhon: I love the information I can get.
[00:42:23] Dr. Taz: Maybe explain what those [00:42:25] are. Fsh.
[00:42:26] Dr. Lucky Sekhon: Yes.
[00:42:26] Dr. Taz: Do you like the ratio to lh and why is that relevant? [00:42:30] Yeah. And do you still like a MHI
[00:42:31] Dr. Lucky Sekhon: use all the information I can get, right? So a MHI love [00:42:35] a MH.
[00:42:35] Dr. Lucky Sekhon: Anti-malaria hormone is a hormone that's produced by [00:42:40] all the little, uh, cells that line each of the bubbles of fluid that we call follicles. So I was [00:42:45] mentioning how a bunch of eggs come out of the stockpile and they're visible each in bubbles of fluid. [00:42:50] Um, so the number that come out, obviously that's going to correlate with how much a [00:42:55] MH is being produced by all the little cells that line each of those bubbles, right?
[00:42:58] Dr. Lucky Sekhon: Mm-hmm. So it's not. Telling you [00:43:00] anything that different, but it's a different way of looking at egg quantity. Why do I like [00:43:05] it? I think it helps me more than it helps my patients. It's harder for them to kind of interpret it, it with, with the [00:43:10] right context, but for me it really helps me figure out the right dose of medication to use to best [00:43:15] stimulate their ovaries and how they might respond.
[00:43:17] Dr. Lucky Sekhon: Ah,
[00:43:17] Dr. Taz: okay.
[00:43:18] Dr. Lucky Sekhon: Um, it's also just nice to kind of [00:43:20] compare if someone has a lower, lower response, you have this objective data point to say, oh, well your A [00:43:25] MH is different now. This is how it's kind of shifted. Um, and so I do think it's a [00:43:30] helpful thing because unlike FSH and some of these other markers that come from the pituitary gland, [00:43:35] those get shut off.
[00:43:36] Dr. Lucky Sekhon: Mm-hmm. If people are on the pill. Right. A lot of people are coming to me, not [00:43:40] necessarily with infertility, but for fertility checkups or to talk about egg freezing and when they're on the [00:43:45] pill. I can't necessarily check those other levels accurately, but a MH doesn't [00:43:50] really get affected.
[00:43:50] Dr. Taz: Gotcha.
[00:43:51] Dr. Lucky Sekhon: Okay. We, long, long-term pill use sometimes can falsely suppress a [00:43:55] MH, but that's not always the case.
[00:43:56] Dr. Lucky Sekhon: And in general, the teaching is, is you can kind of check it at any point in the [00:44:00] cycle whether or not they're on the pill and you can get a gauge of their egg count. [00:44:05] FSH is helpful because it tells us how hard your brain is working to stimulate the ovaries. And that's why [00:44:10] as we approach perimenopause and menopause, we see much higher levels of FSH 'cause [00:44:15] essentially it's like your brain yelling at the ovary, telling it, come on, do your job, make [00:44:20] estrogen.
[00:44:20] Dr. Lucky Sekhon: LH is another hormone that's produced by your pituitary, and it's the secondary [00:44:25] signal. Once you have that mature egg that's been selected and grown by the FSH, it's the the [00:44:30] signal that really makes you release. The egg. But a lot of women with PCOS tend to have [00:44:35] higher LH levels, much higher LH levels than FSH.
[00:44:38] Dr. Lucky Sekhon: And while it's not part of the diagnostic [00:44:40] criteria, I use it to, to figure out the right relative doses of certain [00:44:45] medications. Women with PCOS going through an egg retrieval cycle [00:44:50] typically need less LH and more FSH. Mm-hmm. And there are some women that have a [00:44:55] different type of problem with their ovulation.
[00:44:57] Dr. Lucky Sekhon: Often it's women who've had histories of [00:45:00] eating disorders or maybe they're competitive athletes. Any sort of situation where the [00:45:05] pituitary might be a little bit stressed because of lack of energy or an energy [00:45:10] deficit, it doesn't produce those same hormones and you typically have too low of an LH and [00:45:15] you actually need more lh.
[00:45:16] Dr. Taz: Interesting.
[00:45:17] Dr. Lucky Sekhon: So I use this information to tailor my [00:45:20] treatments on, on how to best stimulate someone's ovaries.
[00:45:22] Dr. Taz: Such important information. I think this [00:45:25] we've. Sort of established, but I wanna make sure we drive it home. We know we can [00:45:30] improve the eggs environment or its home. Right. Right. Or where, where it's [00:45:35] living.
[00:45:35] Dr. Taz: Yeah. Right. We've talked about insulin resistance. I know nutrients are a big part of that. Yeah. I've talked [00:45:40] about prenatal androgens. Can we really improve egg quality?
[00:45:44] Dr. Lucky Sekhon: I think you [00:45:45] can improve the environment where the eggs are being matured, and therefore you could [00:45:50] potentially neutralize external sources of external [00:45:55] exposures that would contribute more errors.
[00:45:59] Dr. Lucky Sekhon: I don't [00:46:00] necessarily think, I think the background risk associated with age is just, it is what it [00:46:05] is. Right? Right. We're all subject to the effects of aging. You know, human beings have a [00:46:10] specific lifespan, like there's certain things that just can't be avoided. Right. But [00:46:15] we can live our lives in different ways that influence our lifespan.
[00:46:18] Dr. Lucky Sekhon: Mm-hmm. So that's the best analogy that I can [00:46:20] think of. Right? Yeah. Like there are certain behaviors that definitely can lead to poorer egg quality or accelerated [00:46:25] changes in egg quality. We've already talked about some of 'em, like smoking,
[00:46:27] Dr. Taz: right?
[00:46:28] Dr. Lucky Sekhon: And then therefore, there [00:46:30] are things that you can do. On the side of being healthier and sometimes, you know, [00:46:35] there could be a role for supplements.
[00:46:36] Dr. Lucky Sekhon: I definitely think correcting any nutritional, nutritional deficiencies. Yeah. And then [00:46:40] there is some good data on coq 10. It's not the most perfect data that we want, [00:46:45] but enough observational studies and a lack of harm that [00:46:50] kind of brings more comfort to say, you know what, there's some animal data.
[00:46:52] Dr. Lucky Sekhon: There's even some human studies that have been pooled and looked [00:46:55] at where there seems to be a trend towards better outcomes, potentially better response to stimulation, [00:47:00] potentially better quality of the eggs turning into embryos. And maybe it's a subtle [00:47:05] change, but hey, let's do anything in everything that could help.
[00:47:07] Dr. Lucky Sekhon: So a lot of my patients take coq 10. [00:47:10] They usually take it at a dose of about 600 milligrams per day. Okay. But it, I don't. I don't [00:47:15] think it should be touted as like the end all be all. Right. Right, right. It's like it's part of a larger [00:47:20] strategy of just saying whatever we can do. Antioxidants, what do, what do we mean when we talk about [00:47:25] antioxidants, we talk about molecules that protect us from free radicals, which is one of the [00:47:30] mechanisms of aging and cellular breakdown.
[00:47:33] Dr. Lucky Sekhon: Whether it be because of [00:47:35] radiation, you know, toxic exposures. Cigarette smoke, like things like that. [00:47:40] So I think it's a, a protective mechanism. Our body naturally knows what to do a lot of the [00:47:45] time. Like we naturally all produce antioxidants, but you know, maybe some people [00:47:50] are a little bit deficient, right?
[00:47:51] Dr. Lucky Sekhon: It could use more. And I think if it's not gonna do any potential harm, [00:47:55] then you know, if there could be a potential benefit, why not add it to your regimen?
[00:47:59] Dr. Taz: I love that, [00:48:00] and that's something that we see in practice a lot too. That, again, that environment, whether it's insulin [00:48:05] resistance, the high androgens, you know, nutritional deficiencies, those are things that we can [00:48:10] actively work on.
[00:48:11] Dr. Taz: Yes. While you're working on your fertility journey simultaneously, [00:48:15] and many people finally arrive at that point where they decide to step into your office, right? Mm-hmm. Mm-hmm. [00:48:20] You know, they've tried for a year. I think that's the standard. Yeah. It doesn't happen for them, you [00:48:25] know? What are some of the biggest fears, misconceptions.
[00:48:28] Dr. Taz: Myths [00:48:30] around what happens next. Yeah. Whether it's IUI or IVF or some of those things.
[00:48:34] Dr. Lucky Sekhon: [00:48:35] Yeah. I mean, first big misconception is when they walk through my door and they're looking to [00:48:40] find a reason, is, you know, there is gonna be a reason that we identify very [00:48:45] clearly and objectively, and then we'll have a targeted treatment plan.
[00:48:48] Dr. Lucky Sekhon: I think that's the biggest source of [00:48:50] frustration in a lot of, uh, patients who are dealing with infertility. Mm-hmm. Not really having [00:48:55] closure or some sort of clear answer, but I always explain to them, there is no test for egg [00:49:00] quality. Right. And there could be something going on even at a younger age.
[00:49:02] Dr. Lucky Sekhon: Mm-hmm. We don't know for a fact that you're gonna follow [00:49:05] all of the standard statistics.
[00:49:06] Dr. Taz: Right.
[00:49:07] Dr. Lucky Sekhon: And there could be other aspects of your partner's [00:49:10] sperm quality that aren't necessarily picked up on a standard semen analysis, which is [00:49:15] very basic. It's just saying you have enough sperm, there's a, a high enough proportion of [00:49:20] sperm that can swim in a forward direction and that are shaped normally.
[00:49:23] Dr. Lucky Sekhon: But that doesn't mean it's [00:49:25] perfect in all the ways that it needs to be. And so it's minimal
[00:49:27] Dr. Taz: requirements just, just swim in one direction.
[00:49:29] Dr. Lucky Sekhon: [00:49:30] Exactly. Right. But we know chronic medical conditions, obesity, which can also [00:49:35] throw off the testosterone, estrogen balance in men. All these things can have [00:49:40] indirect impacts on sperm quality that you don't see, you know, directly under the microscope when doing a semen [00:49:45] analysis.
[00:49:45] Dr. Lucky Sekhon: So, um, you know, I always explain that. Not getting an [00:49:50] explanation. Unexplained infertility. Right. It's not a lazy diagnosis, it's just we don't [00:49:55] have all of the tools necessary to really know everything there is to know. And a big blind [00:50:00] spot is egg quality.
[00:50:01] Dr. Taz: Yeah.
[00:50:01] Dr. Lucky Sekhon: Right?
[00:50:01] Dr. Taz: Yeah.
[00:50:02] Dr. Lucky Sekhon: But it doesn't mean that there isn't a solution, just 'cause we didn't [00:50:05] find a problem.
[00:50:05] Dr. Lucky Sekhon: So the standard workup is check to make sure there's no blockages in the tubes. Check to make sure there's no, [00:50:10] you know, mechanical things that could get in the way of an embryo implanting in the uterus, like [00:50:15] fibroids or scarring or polyps. Make sure someone is ovulating, you know, [00:50:20] and make sure the sperm is healthy.
[00:50:21] Dr. Lucky Sekhon: Those are the four major components you're addressing. But if everything comes back [00:50:25] normal. There are things that could be going on that you're not directly seeing [00:50:30] Endometriosis. Mm-hmm. Not always obvious on imaging. Right. Not always obvious, even taking a history from a [00:50:35] person because they've kind of normalized what their pain is.
[00:50:37] Dr. Lucky Sekhon: Right. And there's some cases where you don't have so much [00:50:40] pain. Yeah. And that's also kind of a mystery too, that the severity of disease doesn't always [00:50:45] correlate with symptoms.
[00:50:45] Dr. Taz: Mm-hmm.
[00:50:46] Dr. Lucky Sekhon: And then another big one is, like I said, egg quality. Right. [00:50:50] And then I always look at the person as a whole, like is there something else going on with their health [00:50:55] that needs to be addressed that could be indirectly impacting their fertility?
[00:50:58] Dr. Lucky Sekhon: And if we find nothing. [00:51:00] We're just trying to improve the inefficiency of human reproduction. There's really [00:51:05] medicated IUI, which is essentially like speed dating for your reproductive tract.
[00:51:09] Dr. Taz: Mm-hmm.
[00:51:09] Dr. Lucky Sekhon: You're [00:51:10] saying, okay, if one egg is expected to hopefully meet the perfect sperm, and they get together, and the odds of all these things [00:51:15] lining up is about, you know, 15, 20%, even in your twenties, early thirties, it's not that efficient [00:51:20] and you've already kind of given a, a good run.
[00:51:22] Dr. Lucky Sekhon: Now let's bump it up a little bit. Let's give you a [00:51:25] medication, an oral medication to improve the odds or the chance that you could release [00:51:30] more than one egg or more than one long shot. And
[00:51:32] Dr. Taz: that's the Clomid
[00:51:33] Dr. Lucky Sekhon: or, yeah, ch Clomid or Letrozole. Okay. [00:51:35] But then also on the sperm side, let's deliver the sperm closer to where the eggs are being released.
[00:51:39] Dr. Lucky Sekhon: So it's like speed [00:51:40] dating, there's more eggs, more sperm, and you're hoping for an interaction. But anyone who's gone to a speed dating event [00:51:45] knows you're not destined to meet the one the first time you go. Right. It just might improve the odds of [00:51:50] meeting that person, but it might take several cycles. So it's not the most efficient.
[00:51:54] Dr. Lucky Sekhon: And while [00:51:55] it's. Not as burdensome on your body as you know, head-to-head comparison, one [00:52:00] IUI cycle versus one IBF cycle. It can get fatiguing in terms of the mental game of doing something [00:52:05] over and over and expecting a different result. So at a certain point, if that doesn't work, you move on. Or [00:52:10] for some people, especially if they're starting their family at an older age or they have specific challenges, they [00:52:15] might just go straight to IVF, right?
[00:52:16] Dr. Taz: Mm-hmm.
[00:52:17] Dr. Lucky Sekhon: And IVF is a different ball game. A lot more work. You're taking [00:52:20] shots for eight to 10 days. You're trying to get all of those eggs in the kitchen cabinets to grow [00:52:25] and mature because like a banana when it's ripe is easier to peel a bubble of fluid, a [00:52:30] follicle that's expanding. It's easier to pierce and it's easier to remove the egg from each one when you're doing an [00:52:35] egg retrieval procedure.
[00:52:36] Dr. Lucky Sekhon: So eight to 10 days of shots coming in for lots of [00:52:40] check-ins. So there's a lot of poking and prodding. Yeah, you're coming in for like five or six blood draws ultrasounds during the eight to 10 [00:52:45] days, and then you're having a procedure, which is very minor. I've undergone an egg retrieval. [00:52:50] More than once.
[00:52:51] Dr. Lucky Sekhon: Um, you know, it's a great nap. You do feel crampy. You do feel groggy [00:52:55] and out of it for the rest of the day. And it is normal to feel bloated and everyone's different. But the large majority of [00:53:00] patients, it's like that. It, it's a one day thing, and the next day you can go to work, right? But what we're doing is [00:53:05] we're extracting as many eggs as we can vaginally.
[00:53:07] Dr. Lucky Sekhon: And then that part is done, and then you're just [00:53:10] waiting for updates. Maybe we freeze the eggs if you're doing egg freezing. But if we're trying to create embryos the [00:53:15] next day, you'll know how many of those embryos actually fertilize successfully. It's typically like 70 to [00:53:20] 80% a week later, we'll know how many turned into embryos.
[00:53:22] Dr. Lucky Sekhon: It might be like half, maybe 60%. [00:53:25] And an embryo has many cells. So you can remove some of the outer cells without harming the embryo. [00:53:30] They would one day become the placenta and you can genetically test them and freeze them and get a report [00:53:35] back about two weeks later that iden identifies which ones are healthy and which ones are not.
[00:53:39] Dr. Taz: Hmm.
[00:53:39] Dr. Lucky Sekhon: And that's one of [00:53:40] the things that has made IVF much more successful. Yeah, even just putting one [00:53:45] embryo back at a time, it's like a 60 to 70% chance of life birth, and it allows you to freeze [00:53:50] extra embryos for the future.
[00:53:51] Dr. Taz: Right.
[00:53:51] Dr. Lucky Sekhon: And come back at any age. Your uterus doesn't really age.
[00:53:54] Dr. Taz: Mm-hmm. So [00:53:55] you could potentially do, uh, an IVF or an [00:54:00] embryo transplant.
[00:54:00] Dr. Taz: Up to what age? Where would you, I
[00:54:02] Dr. Lucky Sekhon: mean, there are no [00:54:05] hard and fast rules or limits, but every clinic kind of has their own ethical guidelines. Yeah. [00:54:10] And we do look to the American Society of Reproductive Medicine and they do give some guidance, but there [00:54:15] isn't like a black and white because patient care should be individualized.
[00:54:18] Dr. Lucky Sekhon: Right. I wanna make that clear. But in [00:54:20] general, you know, yes, we can get people pregnant and their ability to get pregnant and stay [00:54:25] pregnant, meaning the risk of miscarriage should not be affected by the age of their uterus. Mm-hmm. Which is pretty [00:54:30] miraculous, but. The obstetrical risks, meaning like the risk of [00:54:35] delivery and Yeah.
[00:54:35] Dr. Lucky Sekhon: Yeah. The risk of high blood pressure, the risk of diabetes in pregnancy, risks to the [00:54:40] fetus. All of these things are heightened as we get older.
[00:54:43] Dr. Taz: Yeah.
[00:54:43] Dr. Lucky Sekhon: That risk [00:54:45] starts to set in at 35 and older. Mm-hmm. But it doesn't mean every person over 35 who's pregnant is [00:54:50] gonna have a complication. But your, your chances increase and you're watched more carefully.
[00:54:54] Dr. Lucky Sekhon: And [00:54:55] that becomes even more true in our forties. And definitely even more true over 45 like that every [00:55:00] five years is a very significant increment of time.
[00:55:02] Dr. Taz: Gotcha.
[00:55:03] Dr. Lucky Sekhon: But if you're someone that [00:55:05] is not overweight, you have well controlled conditions, or you're healthy, you don't have any [00:55:10] medical conditions.
[00:55:11] Dr. Lucky Sekhon: Those are all things that are in your corner to promote, you [00:55:15] know, being able to have a healthier pregnancy. Yeah. But age in and of itself can cause wear and [00:55:20] tear, especially to your blood vessels. Right? Right. And so you're more prone to things like high blood pressure. Do you know
[00:55:24] Dr. Taz: 50 year olds [00:55:25] who have
[00:55:25] Dr. Lucky Sekhon: Yeah.
[00:55:25] Dr. Taz: Carried?
[00:55:26] Dr. Lucky Sekhon: Yeah. I mean, I would say most practices will say 50 [00:55:30] might be the limit, or even up to 55 if you're in perfect health.
[00:55:33] Dr. Taz: Gotcha.
[00:55:34] Dr. Lucky Sekhon: But you will hear [00:55:35] crazy headlines that are true in other countries where there's less regulatory oversight of [00:55:40] women having children in their seventies. Wow. But you know, you have to think about the ethical dilemmas surrounding [00:55:45] that.
[00:55:45] Dr. Lucky Sekhon: I, I think the guidelines from the as m is very much, you know, [00:55:50] surrounding not just the health of the mom and the health of the child, but also. Can you [00:55:55] reasonably as a couple, or as an in individual be around to raise your child to adulthood, [00:56:00] like age 21?
[00:56:00] Dr. Taz: Right. What does the future look like for IVF and assisted [00:56:05] reproduction?
[00:56:05] Dr. Taz: Is there anything on the horizon? Is there anything new developing?
[00:56:09] Dr. Lucky Sekhon: Well, I think [00:56:10] we've made remarkable strides. You know, my mentors who were around [00:56:15] when IVF was invented, which was really in like the seventies, which is crazy to think of, that's not that [00:56:20] long ago. Back then they used to say, oh, there was like a 5% or less [00:56:25] chance of calling a patient with a positive pregnancy test after doing IVF.
[00:56:29] Dr. Lucky Sekhon: And they were putting in [00:56:30] multiple embryos. Okay. And they didn't know how to freeze and thaw them. Well. They did not know how to do genetic [00:56:35] testing. And now we're at a place where. I'm hardly ever putting in more than one embryo because the success rates are so [00:56:40] high. It would just really increase the risk of twins.
[00:56:41] Dr. Lucky Sekhon: Yeah. Which is a high risk pregnancy, and we're [00:56:45] able to say, okay, within three transfer attempts of one embryo at a time, if it's [00:56:50] genetically tested, there's a 92% chance of live birth.
[00:56:52] Dr. Taz: That's incredible.
[00:56:53] Dr. Lucky Sekhon: Yes. It [00:56:55] is. And hopeful. Very hopeful. Yeah. So I think we've already made a lot of progress. Progress. I think [00:57:00] what's gonna close the gap, why do one third of high quality, seemingly perfect, [00:57:05] genetically tested embryos not implant because the testing is not exactly perfect.
[00:57:09] Dr. Lucky Sekhon: The testing is very [00:57:10] good, but right now we're just sampling a small number of the cells that actually make up the embryo. And I think if we could [00:57:15] find a way to like collect some of the media around the embryo and get a more holistic view, and [00:57:20] you know, once the resolution of the testing gets even deeper, we're going to know more and be able [00:57:25] to better select which embryo to transfer.
[00:57:27] Dr. Taz: Mm-hmm.
[00:57:27] Dr. Lucky Sekhon: Um, so I think that will probably close the [00:57:30] gap and make success even better. I think finding ways to overcome some of the [00:57:35] difficult problems, like I said. Being able to make more eggs come to the surface. [00:57:40] Like right now that feels like sci-fi, but it doesn't seem like that crazy of a thing for us to figure out.[00:57:45]
[00:57:45] Dr. Taz: Yeah.
[00:57:45] Dr. Lucky Sekhon: Um, so I hope that that becomes something, and I hope, you know, for women that have scarring in their [00:57:50] uterus,
[00:57:50] Dr. Taz: right.
[00:57:50] Dr. Lucky Sekhon: Going back to the idea of regenerative medicine, like finding ways to help them regrowth [00:57:55] their lining up and clean the
[00:57:56] Dr. Taz: lining up.
[00:57:56] Dr. Lucky Sekhon: For sure. Preventing problems like being able to prevent [00:58:00] fibroids, being able to better prevent, you know, things like PCOS and [00:58:05] endometriosis from getting worse.
[00:58:06] Dr. Taz: Do you want women there? This is a debate, but do you [00:58:10] want women to make decisions like, [00:58:15] okay, I'm busy right now, I'm focused on something else right now, I'm gonna freeze my [00:58:20] eggs for later.
[00:58:22] Dr. Lucky Sekhon: It's not that I want them to do that. I [00:58:25] want everyone to think about their li their life goals. And I know that sounds so [00:58:30] like wishy-washy, but as a professional woman.
[00:58:33] Dr. Lucky Sekhon: As someone that [00:58:35] actually did take a moment and froze embryos. You know, I froze embryos with my husband at 34 [00:58:40] after having my first, and I know for a fact I know myself well enough to know that [00:58:45] I never would've done that or made the effort to do it had I not been in this field.
[00:58:48] Dr. Taz: Mm-hmm.
[00:58:49] Dr. Lucky Sekhon: I was just too [00:58:50] busy.
[00:58:50] Dr. Lucky Sekhon: Yeah. It would've been like such a like peripheral thought to me and I would've been like, ah, it's probably all gonna work [00:58:55] out even if I was in medicine. I can admit that to myself. Yeah. Right.
[00:58:58] Dr. Taz: Yeah.
[00:58:58] Dr. Lucky Sekhon: But because it was in my [00:59:00] face, I was like, oh, I need to really strategize this. And even still, I was kind of in denial.
[00:59:04] Dr. Lucky Sekhon: I was like, I [00:59:05] probably will never use this. And guess what? At 38 it was a lot harder to get pregnant. I ended up [00:59:10] needing to rely on what I froze. Mm-hmm. So I was really happy that I did this proactive thing.
[00:59:14] Dr. Taz: Mm-hmm.
[00:59:14] Dr. Lucky Sekhon: Um, [00:59:15] I know that in my career and just how busy, you know, you were saying like, I can't believe you [00:59:20] just came from seeing patients.
[00:59:21] Dr. Lucky Sekhon: It's like, yeah, we're running around on empty a lot of the time. Right. [00:59:25] I think it's very easy, and I see it in a lot of my patients that are in high powered careers to just go, [00:59:30] go, go, right? And never really take a, a beat to think, Hey, what am I doing in my life? [00:59:35] What do I want out of life? Uh, is, are my actions aligning with what I [00:59:40] actually want?
[00:59:41] Dr. Lucky Sekhon: It's really easy to be the goes by in the wheel.
[00:59:43] Dr. Taz: Yeah.
[00:59:43] Dr. Lucky Sekhon: Yes. And time goes by and you [00:59:45] get another promotion and then like, it just slips away from you. So I think people need to a, [00:59:50] take the time to think about their goals and prioritize them. I think b, they [00:59:55] should learn about the option to freeze eggs or freeze embryos.
[00:59:59] Dr. Lucky Sekhon: Um, and [01:00:00] you know, sometimes it's just having the conversation that opens their mind up to even the possibility. There's a [01:00:05] lot of preconceived notions, right? Sometimes people come in and they're like, I know egg freezing doesn't really work. And I'm like, what are you [01:00:10] talking about? Yeah. It can work really well.
[01:00:11] Dr. Taz: Yeah.
[01:00:12] Dr. Lucky Sekhon: It's just never a guarantee because an egg is a single [01:00:15] cell,
[01:00:15] Dr. Taz: right,
[01:00:15] Dr. Lucky Sekhon: and you're freezing potential, but it can give you a massive head start if and should you ever need IVF. [01:00:20]
[01:00:20] Dr. Taz: I think that's incredible. And I do think, you know, you know, I talk about the [01:00:25] Superwoman syndrome and, and I agree. I want women to be out there doing what [01:00:30] they wanna do.
[01:00:30] Dr. Lucky Sekhon: Yeah.
[01:00:31] Dr. Taz: I think one of the things that at least our generation has learned is [01:00:35] that we have to balance our energies and that includes our feminine for fertile energy, [01:00:40] right? Yeah. With all the goal setting and all the things that we wanna accomplish in the world. And I think that [01:00:45] it's incredible that. Women have options today, but I think it begins with thinking about your health [01:00:50] and it begins with thinking about all the determinants of your health and how that ties to fertility and [01:00:55] then what you're gonna do from an actionable standpoint.
[01:00:58] Dr. Taz: Right. In terms of safeguarding your [01:01:00] health and safeguarding your fertility, and then knowing what you're gonna do next. Yes. And I think that's just a [01:01:05] really important conversation to have with yourself, you know? Yeah.
[01:01:07] Dr. Lucky Sekhon: I think a lot of people suppress thoughts [01:01:10] about fertility because it brings up anxiety.
[01:01:12] Dr. Lucky Sekhon: Yes. And it also brings up like an existential [01:01:15] crisis, and often people feel very helpless 'cause they're like, well, only when [01:01:20] the relationship comes. Correct. Yeah. Then this becomes a priority and I. Don't think that [01:01:25] that's how it has to be.
[01:01:26] Dr. Taz: And that can also feel like failure, right? Yes. Well, I'm not able to find [01:01:30] the person, or I'm not able to do whatever.
[01:01:32] Dr. Taz: Right. And then there's just this, again, that shame that [01:01:35] women already have had to live with for centuries. Yeah. Like I think it just, you [01:01:40] know, emphasizes that feeling again. Totally. Again, you know, and there's no reason like, you know, be [01:01:45] logical about your fertility and your health just like you would about your career.
[01:01:49] Dr. Lucky Sekhon: Yeah.
[01:01:49] Dr. Taz: And [01:01:50] let your relationship grow emotionally and maybe illogically like it's [01:01:55] supposed to. Yes. You know what I mean? So it's, I think understanding that there's a difference
[01:01:58] Dr. Lucky Sekhon: Yeah.
[01:01:58] Dr. Taz: Between those two [01:02:00] determinants of, of your life. You know,
[01:02:01] Dr. Lucky Sekhon: there's also a huge difference, um, you know, [01:02:05] in what we're taught growing up and what we see happen when it comes to education and our [01:02:10] career goals where the amount of effort you put in equals the result.
[01:02:14] Dr. Taz: Correct.
[01:02:14] Dr. Lucky Sekhon: When it comes [01:02:15] to relationships, it takes two and like you can't control everything that happens in that arena. [01:02:20] And same with fertility. There's so much that's out of our control that it's not a meritocracy. It's not [01:02:25] like you put in the effort, you get an A, you did the work. Exactly. And that's hard for people like us.
[01:02:29] Dr. Lucky Sekhon: Right. [01:02:30] Yeah. You know, that's like what our career has been built on.
[01:02:31] Dr. Taz: Yeah. Very much. Well, your book is coming out, [01:02:35] the Lucky Egg.
[01:02:35] Dr. Lucky Sekhon: Yes.
[01:02:36] Dr. Taz: Talk to us about that.
[01:02:37] Dr. Lucky Sekhon: So this is a book that was born [01:02:40] from years in practice of patients asking me is there like a one [01:02:45] stop shop resource that I can go to, which will. Help me navigate this crazy [01:02:50] 180 shift that only women it feels like are expected to do.
[01:02:53] Dr. Lucky Sekhon: Like you go through your life, like, [01:02:55] I don't wanna get pregnant. And now all of a sudden you're not equipped with any information and it's like, [01:03:00] okay, bye ovulation predictor kits and figure out your cycle. And everyone's like, oh my God, I have no idea what's going on. And [01:03:05] I meet women who are so smart, so talented, so successful.
[01:03:09] Dr. Lucky Sekhon: They're in [01:03:10] their thirties, they're in their forties, and they don't know the basics. Yeah. And so this is to fill that knowledge [01:03:15] gap. Love it. But it's also to provide like a dictionary. There's even a glossary at the end, because I [01:03:20] always say, getting into the world of fertility, if you do start running into trouble, like what are these [01:03:25] tests mean?
[01:03:25] Dr. Lucky Sekhon: What are the treatment options? It feels like learning a new language. Yeah. And so it's almost [01:03:30] like, you know, a fertility English dictionary of sorts to help people just really [01:03:35] navigate. You know, this transition from not thinking about it to all of a sudden it becoming really important to [01:03:40] them and knowing that it's time sensitive and you wanna be efficient with your time and not get pulled [01:03:45] in all these different directions and you know, with all the noise and bad information.
[01:03:48] Dr. Lucky Sekhon: So it's [01:03:50] evidence-based, it's warm. It's not gonna make you feel like a science experiment.
[01:03:54] Dr. Taz: [01:03:55] Yeah.
[01:03:55] Dr. Lucky Sekhon: It is going to make you feel like you have a best friend that is also a [01:04:00] fertility doctor. Love it. That's here to hold your hand and guide you through every step of the process. And there's [01:04:05] also a really huge part of it that is about mental health.
[01:04:07] Dr. Taz: Mm.
[01:04:08] Dr. Lucky Sekhon: Because one of the major, [01:04:10] um, uh, the major contributions, I should say to people not getting to the [01:04:15] success, to the, to. The finish line, especially in a time where IVF [01:04:20] can be successful for a lot of people is often dropout, premature dropout. [01:04:25] And they've even looked at this and looked at like, is it financial?
[01:04:28] Dr. Lucky Sekhon: Obviously there can be financial barriers, [01:04:30] but the number one contributor to premature dropout is psychological, the mental [01:04:35] burden. Mm-hmm. So I think, uh, really paying attention to your mental health alongside your physical health [01:04:40] so that you can stay in it to win it. And then also there's a whole section on troubleshooting [01:04:45] because I think that's where people really get tripped up, get frustrated.
[01:04:46] Dr. Lucky Sekhon: Yeah. When they have a field cycle and they're like, now what do I do?
[01:04:49] Dr. Taz: Yeah. [01:04:50] I love that it's such an important resource. I know so many of you will benefit from it. Where can [01:04:55] people find you or find the book or Yes. Where would you direct everybody to?
[01:04:58] Dr. Lucky Sekhon: So the book is going [01:05:00] to be sold wherever you can find books.
[01:05:01] Dr. Lucky Sekhon: Right? Okay. Yeah. Um, and you can go to my website, the lucky [01:05:05] egg.com, um, and the landing page, you know, you can pre-order it at various places. [01:05:10] Um, that website is also a great resource. I have a lot of like a MH calculators, egg freezing [01:05:15] calculators, really practical tools alongside blogs and content that will help kind of [01:05:20] explain a lot of important things, um, about testing and treatment.
[01:05:24] Dr. Lucky Sekhon: And then I'm on [01:05:25] Instagram and TikTok, so you can find me there. Um, I try to, you know, make light of things and [01:05:30] bring a lot of levity to something that can traditionally feel very anxiety provoking or fearful, [01:05:35] um, because I think that, you know, education is at the core of what we really need to be pushing forward.
[01:05:39] Dr. Taz: [01:05:40] Yeah. Well, thank you so much for taking time out today. This has been such an incredible [01:05:45] conversation. I'm gonna ask you one final question.
[01:05:47] Dr. Lucky Sekhon: Sure.
[01:05:47] Dr. Taz: What makes you whole.
[01:05:49] Dr. Lucky Sekhon: What [01:05:50] makes me whole, um, honestly, I would have to say. I [01:05:55] think having a purpose. I love it in life. I love it. Having a mission, and I know that sounds so [01:06:00] general, but I really do feel gratitude every day knowing [01:06:05] that I'm doing exactly what I'm meant to be doing.
[01:06:06] Dr. Lucky Sekhon: I feel so driven and passionate about this [01:06:10] mission. I grew up in a matriarchal household. Mm-hmm. And in a culture where, you know, [01:06:15] women didn't necessarily get prioritized. Right. And so for me, it feels so gratifying to [01:06:20] be in this role, educating women, empowering them, giving them options that, like my [01:06:25] grandmother, we could never have dreamt of.
[01:06:26] Dr. Lucky Sekhon: Right. Um, and just making people feel like less [01:06:30] afraid, more seen, and more in control.
[01:06:32] Dr. Taz: I love that. Purpose is, I can [01:06:35] resonate with that so much. So thank you again for. Taking time to be here today. I really [01:06:40] appreciate it, and for everybody else watching and listening to this episode, please remember to share it with your [01:06:45] friends.
[01:06:45] Dr. Taz: And if you have somebody in your life who is in that space, right, that space where they're [01:06:50] feeling discouraged, shameful, hopeless, please share this episode with them. I know I have [01:06:55] met so many people in my journey who have been there, and I wish I could have shared this with them earlier. [01:07:00] Thank you, and I'll see you guys next time
[01:07:01] Dr. Lucky Sekhon: before you go take a second to reflect on what [01:07:05] stood out for you today.
[01:07:06] Dr. Lucky Sekhon: Then if you can leave a quick review wherever you're [01:07:10] listening, it really helps other people discover Whole Plus and start their own healing [01:07:15] journey. And don't
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