199 IVF, Fertility Goals & Improving Egg Quality [Podcast with Lauren Haring]

Fertility drives many women to their PCOS diagnosis. Women start to wonder if IVF might be the right choice for them but wonder where to even start. IVF can seem a little overwhelming, that’s why we’re excited to bring on Lauren Haring to the PCOS Diva podcast. Lauren Haring is a fertility nurse and helps guide people through the complex world of fertility. In today’s episode, Dr. Vinu and Lauren discuss if IVF is different for women with PCOS, why an IVF couch is beneficial, ways to improve egg quality, and more.

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Lauren Haring is a fertility nurse since 2004, with over 16 years of experience on the front lines at a world-renowned fertility clinic.  She is a member of the American Society for Reproductive Medicine (ASRM) and earned the Optimal Fertility Certification from The Integrative Women’s Health Institute.  Lauren is continually expanding her knowledge of integrative fertility wellness support. 

Throughout her years at the clinic, she was lucky enough to serve as a Fertility Nurse Specialist, Clinical Manager of the Fertility Preservation Center, Director of Nursing, Practice Manager, and Practice Development Consultant.

​Lauren was an egg donor and as such, has also been a distinguished speaker at seminars for potential donor recipients.

 

 

Transcript:

Dr. Vinu
Hello, everyone, this is Vinu Jyothi, a Preventive Medicine Specialist and part of the PCOS Diva team. And I’m very happy to be introducing Lauren herring, who is our who’s joining our podcast today. And a little bit about Lauren herring. She is a fertility nurse since 2004, serving 16 years at a world renowned clinic. She brings an extensive medical background. With almost two decades of experience on the front lines. Lauren saw the need for a more comprehensive fertility support and to bridge the gap between clinical care and true integrative fertility support. She created embrace fertility in 2019 and invaluable ally, Lauren uses her professional background to guide and educate, advocate and calm fears during each and every step of a woman’s IVF journey. She has. She’s here to discuss all of your IVF concerns and fertility goals in a very safe and non judgmental space. Welcome to the show. Lauren. We’re really happy to have you here.

Lauren:
I’m so grateful to be here. Thank you.

Dr. Vinu
So I’m gonna start with the very first question. Anytime a woman is diagnosed with PCOS, literally the first question that goes through their mind is, can I conceive, you know, will I be able to have a baby? So is that a message that you would like to tell women who are for the first time diagnosed with PCOS?

Lauren:
Sure, yes, for the well, for the very first time. I mean, gosh, it can be such a long road, we know for so many, you know, but when somebody first receives the diagnosis, I do want them to know they’re absolutely a plethora now of ways to conceive. There’s more conservative treatments to more aggressive treatments, and everybody has a unique path to reach their fertility goals. And so it’s really important to know that it’s absolutely possible, but you may just have to get a few team members and specialists to join you and make sure that you can get there as quickly hopefully as as you would like.

Dr. Vinu
Yeah, that is pretty reassuring, you know, because I know PCOS comes with a ton of other symptoms. But when you are a young woman diagnosed with PCOS, that’s kind of like the first question that runs through your mind, you know, so I’m glad you cleared that up. And so does PCOS, affect fertility? And, you know, we, we kind of know there’s an hormone imbalance. So does it directly affect fertility?

Lauren:
Well, fertility, you know, can mean so many things apart from egg quality, you know, you need to have good eggs and good sperm, but you need to have tubes that work there, there are a lot of different things along the way that that you know, need to go right in order to conceive and deliver a baby. So having PCOS, it will affect some part of fertility. But it doesn’t mean that there’s not a solution. So it could be as you said, when it affects someone’s hormones, then maybe there are certain medications that can help somebody who’s having a problem ovulating. And it could be something as simple as an oral medication versus something a little bit more complex like IVF.

Dr. Vinu
And, you know, you talk about fertility goals in women, right? Will that be any different from a woman who has PCOS? versus someone who does not?

Lauren:
That’s a great question. I think fertility goals are just so unique and individualized, per each person, and each couple, because, you know, there’s obviously more than one person that obviously, you know, often needs to be considered there. So, I don’t think PCOS necessarily mean, someone’s going to have different fertility goals in the end, but they just may have a different path of reaching them.

Dr. Vinu
Yeah. And and when does when does a woman consider IVF? Do you have like a set criteria, you know, things that they do before they would decide on IVF?

Lauren:
Well, so the first thing is knowing when to see a specialist. So often women are diagnosed by their gynecologist or you know, or even they’ve got some more involvement with additional physicians in their care. But once somebody’s having trouble conceiving, ideally, the recommendations are if they’re under the age of 35, and having difficulty conceiving for over a year, then they should see a reproductive endocrinologist or fertility doctor, if somebody is over the age of 35, then it’s not recommended to wait more than six months preferably, so that you can go in and start the conversation, get some testing done and see what’s the best options for you.

Dr. Vinu
And and how is your IVF coaching different from your fertility coaching?

Lauren:
So well, there’s there’s definitely a vast difference between a regular fertility Coach and an IVF. Coach, and this is of course separate from someone going to their fertility center. So they will have their fertility team with their doctor and nurse and their whole care or team at the clinic. But to supplement that having either a fertility coach or an IVF coach can be an invaluable asset for somebody. So regardless of what brings the the woman into the clinic for an IVF consultation, there’s often just so much information thrown at them, and so much to understand about not only their diagnosis, but the medications and what to expect. So as an IVF, Coach, I focus on really educating and empowering my clients. So they understand what is happening to their body every step of the way, what the medications are doing, what to expect, when they go in for monitoring, how to advocate for themselves and the questions that they may need to ask that they wouldn’t have otherwise known without having a IVF coach. Fertility coaching in general, also is a part of that. And that includes, of course, the whole emotional aspect and mindset, which we know is a huge, huge factor in of course, overall stress levels, which all can affect success rates when trying to conceive with or without fertility treatment.

Dr. Vinu
Yeah. And what are some I know, IVF has its own challenges, right? And what the challenges be any different for a woman with PCOS? You know, when they undergo IVF?

Lauren:
That’s a very good question. It’s, it can sometimes be a little bit more tricky. When someone has PCOS. They need to make sure that they’re at a clinic that that obviously has some experience with patients who have that diagnosis, because they’re going to know what types of protocols may elicit the best response. And of course, there’s a concern oftentimes with women who have PCOS, that they are at higher risk for hyperstimulation. So there are protocols that have evolved over the last, you know, several decades to help minimize that risk. But knowing somebody has, you know, coming in PCOS as their underlying condition, that just should make everybody a little bit more hyper aware. And, you know, make sure they’re being as conservative as possible with the treatment and keeping a close eye on everyone.

Dr. Vinu
And what do you mean, when you say hyperstimulation, Lauren, so that our audience have a better understanding of that?

Lauren:
Yeah. hyperstimulation is, is technically the goal of IVF. For all women, we are hyper stimulating the ovaries to produce more follicles than they normally would in a given month. When a woman normally has a menstrual cycle, there’s one follicle that that grows and becomes dominant. And then ovulation happens. If there’s no pregnancy, then a period starts and the whole process begins all over again, with IVF, that would be extremely inefficient to go through that for just one follicle with one possible egg. So taking the stimulation medications with the goal to make the ovaries produce more eggs, that will then lead to an overstimulation of the ovaries. But there are women who are at a risk for severe hyperstimulation, where they can then have an extremely large number of eggs, their ovaries become very enlarged, and there can be a little bit of a fluid shift that goes on in the body. And it’s certainly something that’s manageable, but often, you know, easily preventable with newer technologies. So hyperstimulation has become extremely rare now. In comparison to when I first started that say, almost two decades ago,

Dr. Vinu
okay, yeah, thanks for explaining that. You know, and, and, you know, how, you know, we just discussed women with PCOS, they do have hormone imbalances. And, you know, some of them are overweight, either because of the disease itself, right. And, and then they do have insulin resistance. So, what do you think? Is there a right road map that you have to follow? As in? Would you address all of these problems before you go into IVF? Or is that something you would do simultaneously, you know, kind of hit it from all sides and take care of holistically take care of yourself.

Lauren:
Right. So ideally, you want to go into IVF with the most optimal chance for success. So that would mean getting everything as you know, ideally, as balanced and in the best place, you know, starting a couple of months before that at really the time we have, the cycle of being able to affect our egg quality is about three months. So what someone does within the previous three months matters the most. And so, you know, starting during an IVF cycle wouldn’t be able to get the most benefit, but somebody is looking for. However, no matter when someone starts, that’s the most important thing is that they actually start. So there is definitely data out there that shows weight can affect overall success with IVF. So it’s something that everybody should discuss with their reproductive endocrinologist, because the individual’s success rate is going to be so personalized based on age and their egg quality diagnostic testing, their partners testing, all of that is taken into account. So somebody may be recommended to take six months to work on getting maybe five to 10% of weight loss so that they have a better chance for success. Whereas if somebody else has, let’s say, potentially lower egg quality and concern that they may not respond as well to the medicine, waiting six months may not be the recommendation for them. So doing it simultaneously is certainly better, you know, at that point, and that would be something very individualized with their physician.

Dr. Vinu
And when you brought up the point, right, that your egg quality is determined, you know, three months, whatever you’ve done three months back, it just brings to mind that, you know, I follow someone called Jen Stevens for intermittent fasting. And she says whenever you have hair loss, or you always think of what happened like two or three months before, because it’s reactive to something that has happened earlier and not right now. So you know, it feels like it’s a process, right? I mean, just as an old parts of your body, you know, what you eat all of your health conditions, they kind of carry over. And it’s not just something you’re doing now. But you know, you do it now. So two to three months later, you’re in a healthier state because of that. So you know, it kind of brought that to mind, overall, it seems to be the same trend.

Lauren:
So yes, and that, of course, is for both partners. So it’s, you know, when we think about PCOS, we often are talking about talking about optimizing, you know, the woman’s health, but when you’re looking at growing a family, the partner is equally as important. So it’s really important to be aware of what both partners are putting on and in their body, you know, being aware of their their sleep, and overall, you know, movements and all the things that I’m sure holistically, you know, we we can get into a whole side conversation on that, but they’re all so important for both partners.

Dr. Vinu
Okay, so now that you bring that up, Lauren, so is IVF coaching, then does it involve both partners, is that how the coaching is done as a couple, you know, when, when you’re undergoing IVF coaching.

Lauren:
So I, I tend to work with both partners, when both partners want to be, you know, a part of it. So everybody’s relationship is, you know, is their own. And so, some people are more supportive, and some people feel they have more support than others. And so I do feel it is, of course, best for both partners, when they’re, they’re both there to hear and reinforce everything, and I can answer questions, you know, from different understandings and perspectives. But, of course, you know, at least having the woman do it, it’s it can be invaluable, so that they don’t feel so alone.

Dr. Vinu
Right? Yep. So what resources do you provide to you know, support your clients journey?

Lauren:
So, I do have a very big belief in that handouts. So I give my clients a lot of support along the way, I try to break it up into more manageable pieces, because IVF can be so complex. So in the beginning, we talked about and I give them resources to help with the questions they need to ask before they go into their clinics. So they we don’t know what what they don’t know. To ask which is something so common and everything in life, and then throughout their cycle, I give them resources to help track their results. Things to help make sure they understand what to expect along the way, physically and and medication wise so they understand everything. And then of course, following each major milestone, I give a little bit of information and support so that they can keep referring back to it always. But I do offer for my clients pretty much unlimited access to me because I know how important this is. And it can be anxieties and questions can strike at any time. So whether it’s email or text, I always encourage them to reach out, rather than going to Dr. Google and dropping down the rabbit hole.

Dr. Vinu
Oh, yes, yes. That’s that’s a good point. Right? You google for one simple symptom. You’ve got terms of things that are from least scary to the most scariest you could think of. So, you know, but I live with opinions. Oh, yes. Lots and lots of opinions. Yep. And the other question, you know, women with PCOS, usually ask is, okay, if conceive, I do have a baby. Is there any risk to my baby? Because my PCOS? Or because I did IVF? You know, so, is that something you encounter often, like, you know, people are worried, if it’s all going to be healthy, it’s going to be a healthy baby.

Lauren:
So not necessarily something that is a concern, I’ve heard that as much related to the PCOS aspect, it’s more concern related to age or potentially some other familial genetic thing in their history that, you know, they may be aware of. So it’s not necessarily often that the concern is due to you know, that they have PCOS IVF itself, they do have statistics, and that would be something absolutely to talk to the fertility doctor about, you know, as far as overall success rates, the chance for miscarriage, you know, and the chance for overall live birth of a healthy baby. And all those statistics come based on not just age, but the test results that are interval, individualized to each person.

Dr. Vinu
Lauren, I know there are a lot of people who are kind of scared of IVF, you know, what would your message be to them?

Lauren:
That they are not the only ones. Unfortunately, IVF can be very isolating. And so being scared or anxious just from feeling that is one aspect, but so many people are terrified of the injections. And if I just talk about that for a moment, the one thing I would say to everyone who is worried about getting themselves an injection or getting one from their partner, is that it is nowhere near as bad as you think it is. And it is always easier after the first one 100%. And I do talk a lot with my clients about that, and how to get over some of those concerns that they have, which is something that some women are so terrified about that that could be the reason they don’t go forward. You know, there are financial reasons, there’s a lot of different reasons, but but some of that could be just overall anxiety. And so, you know, I promise it is It may sound big, IVF is complex, but it really is something that anybody can do that, you know, just puts their mind to it. And you have to give, you have to absolutely commit to it. But it’s amazing. The miracle of IVF is amazing.

Dr. Vinu
And I know we kind of touched on this, Lauren, you know, improving equality, how you can start to do things that would help improve equality. So is there something that they you know, that our listeners can work on, you know, before going into IVF? Kind of get them prepared for that next step?

Lauren:
Yes, there’s actually quite a bit and that’s one of the hard things I think a lot of women in this situation feel is that they can’t control a lot of what they’re going through. And there are some things that you can control with your body and trying to give yourself the most optimal starting place. So first thing, of course, is you know, feeding your body making sure nutrition. Ideally, you’re eating the rainbow. A lot of women tend to geared towards the Mediterranean diet, as there are studies showing that it can improve success rates. But of course, women with PCOS may have some other things to consider. So it’s important to make sure your doctors are aware of what your your goals are. And they can help sort of cater and if you’re going to have a dietician or nutritionist help with some meal plans, it’s important for them to know that your goal is trying to conceive and so that they can really help make sure you’re nourishing your body from within, that’s the most important thing because you cannot out supplement a poor diet. And so there are supplements that can be beneficial. But again, those are so unique and customized. And a lot of fertility doctors have their own sort of cocktails that they recommend. But again, time matters. So the sooner somebody were to start these things, the better for their overall Foundation. In addition, it’s so important for movement, and I don’t mean to say like exercise, go out and do bootcamp, but general movement going out and getting, you know, a hike out nature breathing some fresh air, in not exercising until you can’t breathe. You know, it’s it’s really just restoring that that inner balance in your hormones restore with that as well. Sleep is another area that a lot of us especially in this day and age, we are all rushing and you know, busy. And sleep is one of the first things that suffers, and that’s one of the areas where we absolutely can make a positive influence on all of our health with the hormonal balance. And that of course then impacts our egg quality as well. So those are those are some of the main areas and then of course, addressing stress and anxiety overall, those things are important. So whatever techniques, everybody is, of course going to align with something different. But whether it’s yoga or whether it’s going to support groups, that your your religious affiliation, whatever that outlet is where you can help get some stress relief. That again is so important to do, the sooner the better.

Dr. Vinu
So what I’m hearing is Lauren, all of those things that we normally say for a holistic living, you know, to balance your hormones to help you you know D with PCOS, a good diet and good sleep, it seems to really help in multiple ways. Right? Not just for this, but, you know, because we’ve spoken to many people on this podcast, and it seems to be like an underlying theme, you know. And it’s easier said than done. We all know that. But it’s good to have that reinforcement from time to time, that, you know, you can take supplements, but like you said, Nothing beats out a good diet, you know, healthy good diet, and just adding those nutrients in your diet and getting good sleep and exercise and things like that. So, finally, Lauren, I would like your, your take on the different fertility support sessions that you offer. And also, I heard about the empowerment deck of IVF. And anything that you could leave our audience with would be great.

Lauren:
Yes, of course. So I work with my clients in a few different ways. I do have my ultimate IVF coaching experience where I take them, basically, from the time they get the approval to do IVF. And they received their medication protocol, I walk them through every step until they get to the starting gate of their IVF medications to make sure they understand what their protocol is, why their doctor is ordered that for them what their diagnosis may be, you know, make sure they really understand what they’re about to undertake with IVF. And then once they begin, I actually speak with my clients every day of their monitoring, after their clinic gives them their results and instructions to make sure they understand what their hormone levels mean, what the follicle sizes, that they’re getting reported from their clinic mean for the time left until their cycle is going to be up to the retrieval. And then we talk, of course, on days of procedures, and I try to help make sure that they not only are educated enough to understand what’s about to happen and what they’re going through, but that they can feel empowered and advocate for themselves asking questions they may not have known to ask. And so that’s my IVF cycle coaching, where they basically have me the whole way through to contact with any of their concerns big or small. But for people who are not yet in an IVF sort of path, they I can work with in a different capacity, I do offer one on one, fertility support sessions, which are basically 60 minute sessions with me, and we can use them, it’s just a very safe space to talk about any of their fertility concerns. So it may be something that they want to get a little bit more education on that, say a fertility health area, like talking about sleep or movements and some stress management, or a little bit of education on how the overall IVF process works if they’re considering it, but they’re not ready to really, you know, jump into it at that point. Other times, we just talk about how unfair everything is. And they just found out their frustrations. So it’s just a free for all to talk about any concerns or goals. And then you you did mention, I’m very proud that I have my first ever IVF empowerment and IVF milestone cards that are available for pre sale right now. And they are basically something that is a resource for anyone who’s going through IVF to help on the days where they need a little bit of a little encouragement, maybe with a little bit of sass to help lift them up and keep them really moving forward through their IVF cycle and feel like they can really conquer it.

Dr. Vinu
That sounds awesome. Lauren, good luck with that. Yeah. And you know, any place where our listeners can find you on social media or a website that they can reach you at?

Lauren:
Yes, my website is w w w dot embrace fertility.com And I’m on Instagram and Facebook as at embrace your fertility.

Dr. Vinu
Thank you so much, Lauren. This was such a good talk. And I think you really gave us all the information on IVF on when to consider it. You know, what are some of the challenges and anything else that we could think of? Thank you so much for joining us today.

Lauren:
Thank you for having me.