Can you be too old to conceive? What does it really mean when celebrities have babies over 50? And when fertility treatments like IVF, donor eggs, frozen eggs, and embryo transfer make pregnancy possible after menopause, how do we decide when it is safe, ethical, and medically appropriate?

In this episode of Brave & Curious, Dr. Lora Shahine explores one of the biggest and most emotionally loaded questions in reproductive medicine: when is it too late to have a baby? Using the latest 2025 American Society for Reproductive Medicine guidelines as a starting point, Dr. Shahine breaks down advanced reproductive age, age-related infertility, IVF success with own eggs versus donor eggs, pregnancy after menopause, and the very real health risks that can come with pregnancy over 45 or 50. She also looks at paternal age, sperm health, and why age matters for both partners when building a family.

Listeners will understand that there is no one-size-fits-all answer—only thoughtful counseling, informed consent, and brave conversations about the risks, benefits, and possibilities of family building at an advanced reproductive age.

In this episode you'll hear:

• [00:56] Age & Fertility overview
• [01:41] Record-breaking pregnancy stories
• [02:37] Why does it get more difficult to get pregnant as we get older?
• [07:52] Health risks of pregnancy
• [09:15] Men: reproductive age and health of pregnancy
• [10:07] Ethical considerations
• [11:13] 2025 ASRM guidelines
• [13:42] Next steps

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

Can acupuncture really support IVF success? When should you start fertility acupuncture if you're trying to conceive? And how do you know whether an acupuncturist is truly trained in fertility care, or just really confident with a sign on the door?

In this episode of Brave & Curious, Dr. Lora Shahine welcomes Hannah Pearn, a fertility acupuncturist based in London and host of the podcast. Together, they explore how acupuncture, traditional Chinese medicine, and Western fertility treatment can work side by side to support patients through IVF, embryo transfer, egg quality concerns, endometriosis, PCOS, recurrent pregnancy loss, male factor infertility, and the emotional stress of trying to conceive.

Listeners will learn what to expect at a first fertility acupuncture appointment, how acupuncture treatment may change during different stages of IVF, what questions to ask when choosing a practitioner, and why the evidence around acupuncture and fertility is promising but still complicated.

Dr. Shahine and Hannah also answer listener questions about needle fear, PGT-A testing, microbiome testing, follicle count, and the balance between doing everything you can and remembering that infertility is never your fault.

In this episode you'll hear:

• [1:09] Fertility acupuncture basics
• [7:28] Hannah's acupuncture path
• [11:18] Finding specialists and Questions to Ask
• [29:46] Acupuncture meets IVF
• [34:34] Needle fear
• [36:58] PGT-A testing
• [42:43] When to start
• [47:31] Can you boost your egg count?
• [50:38] Microbiome testing
• [54:46] Evidence and acupuncture

Resources mentioned:

donttellmetorelax.coc.uk

@donttellmetorelax on IG

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

Can a hormonal IUD affect your fertility later? If you used a progestin IUD, should you take it out months before trying to conceive? And how do patients make sense of fertility advice when even doctors are debating the evidence in real time?

In this episode of Brave & Curious Dr. Said Daneshmand joins Dr. Lora Shahine for a thoughtful, nuanced conversation about hormonal IUDs, endometrial lining, uterine adhesions, and fertility planning.

Their conversation is sparked by a recent online debate in the reproductive medicine community. Dr. Shahine and Dr. Daneshman explore what is known, what is still being studied, and why clinical experience matters alongside published research.

Listeners will learn how levonorgestrel IUDs may affect the uterine lining in a small subset of patients, what current research says about return to fertility after IUD removal, and why "rare" does not mean "impossible."

This episode offers reassurance, context, and practical guidance for anyone using an IUD, planning pregnancy, navigating infertility, or trying to make informed decisions about contraception and reproductive health.

Ongoing Research Study through UCSF: FeRTILE Study is being done to learn whether long-term use of an intrauterine device (IUD) affects how long it takes to become pregnant. By taking part, participants may help researchers learn more about fertility and birth outcomes after IUD use. Learn more here.

In this episode you'll hear:

• [0:40] What is the IUD and Fertility Controversy?
• [1:11] IUDs: Benefits and Context
• [7:43] What We're Seeing in Our Practice
• [15:25] Dr. D's Research on IUDs and Endometrial Lining
• [20:45] Reflection on Topic
• [33:56] Future Research Plans

Resources:

Studies mentioned

Abel 2021 J Assist Reprod Genet

Carr 2021 Contraception

Peipert 2022 Am J OBGYN

Dr. Daneshmand Instagram

Fertilitea with Dr. D Podcast

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

Could your sleepless nights, mood swings, joint pain, or "I just don't feel like myself" feelings be connected to perimenopause? Do you really need hormone testing to know what is happening? And is menopause hormone therapy actually as scary as we were once told?

Dr. Rebecca Dunsmoor-Su and Dr. Amy Voedisch, hosts of OvaryActive and co-authors of Estrogen, Interrupted, join Dr. Lora Shahine for this episode of Brave & Curious. Their conversation opens up a thoughtful, funny, and myth-busting conversation about menopause, perimenopause, hormone health, and why women deserve to understand their bodies.

They also explain the difference between menopause and perimenopause, why symptoms can start years before periods stop, why hormone labs often do not tell the full story, and how symptoms like hot flashes, night sweats, insomnia, anxiety, vaginal dryness, weight changes, itchy ears (yes, we said "itchy ears"), burning mouth, and joint pain can all fit into the bigger picture.

Perimenopause is often a "story-based" diagnosis rather than a single lab result, and treatment options are available. This conversation will walk listeners through all of that and more. Listeners will feel informed, validated, and ready to ask better questions.

In this episode you'll hear:

• [0:24] Meet The Doctors of Ovaryactive Podcast
• [10:45] Defining menopause and perimenopause
• [14:55] Common Symptoms (More than Hot Flashes)
• [18:37] Why labs fall short
• [23:07] Unusual menopause symptoms
• [28:05] Diagnosing perimenopause and menopause
• [32:17] Non-hormonal treatment options
• [42:18] The WHI study
• [50:45] Breast cancer risk and Hormone Therapy
• [59:51] Talking to your doctor

Resources mentioned:

perimenopausedrs.com/ovaryactive

Follow the show @OvaryActive Instagram | YouTube

Estrogen, Interrupted by Dr. Rebecca Dunsmoor-Su & Dr. Amy Voedisch

More information about Dr. Rebecca Dunsmoor-Su:

Gennev: www.gennev.com/clinician/dr-rebecca-dunsmoor-su

LinkedIn @rebecca-dunsmoor-su

More information about Dr. Amy Voedisch:

Stanford Medical Clinic: stanfordhealthcare.org/doctors/v/amy-voedisch.html

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

What if the "final frontier" of fertility care is not IVF technology, but the aging ovary itself? Can science help improve egg quality, mitochondrial function, and reproductive lifespan? And how do patients sort through what is proven, what is promising, and what is still very much in the "ask your doctor before you try this" category?

In this episode of Brave & Curious, Dr. Lora Shahine welcomes reproductive endocrinologist Dr. Roohi Jeelani for a fascinating conversation about ovarian rejuvenation, age-related fertility decline, and the future of fertility treatment.

Together, they discuss why age remains one of the biggest factors in IVF success, how egg quality changes over time, and why topics like oxidative stress, mitochondrial health, inflammation, and lifestyle optimization are becoming such important parts of the fertility conversation.

In this episode you'll hear:

• [1:07] Meet Dr. Roohi Jeelani
• [2:32] Age and fertility
• [4:23] Egg quality basics
• [8:06] Sleep and fertility
• [9:35] Stress and cortisol
• [14:58] Movement and PCOS
• [16:54] Nutrition for fertility
• [18:51] Trimester zero prep: Small, sustainable changes
• [29:25] CoQ10, Inositol, Melatonin
• [35:38] NAD and egg quality
• [43:56] GLP-1 fertility questions
• [47:22] Peptides and PRP
• [55:33] Ovarian rejuvenation research
• [1:01:04] Future fertility medicine

Resources mentioned:

onto.health

@roohijeelanimd on Instagram | LinkedIn

@onto-health-co on LinkedIn

Your Leggings Could be Causing Infertility? with Dr. Lora Shahine on YouTube

Can CoQ10 Improve Egg Quality and Sperm Health for TTC? with Dr. Lora Shahine on YouTube

Does Growth Hormone Improve IVF Outcomes? with Dr. Lora Shahine on YouTube

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

Have you been told your fertility tests are normal, but pregnancy still isn't happening? What does unexplained infertility actually mean when it clearly feels like something is going on? And how do age, egg quality, sperm function, endometriosis, inflammation, and implantation issues factor into a diagnosis that can feel more frustrating than reassuring?

In this episode of Brave & Curious, Dr. Lora Shahine takes a compassionate deep dive into unexplained infertility to explain how it's diagnosed, why it affects so many patients, and what may be happening behind the scenes when standard fertility testing does not reveal a clear answer.

Listeners will learn the most common hidden contributors to unexplained infertility, treatment options, and when moving to IVF may be the most effective path forward.

In this episode you'll hear:

• [0:49] Dr. Lora Shahine's personal fertility story
• [3:06] How Diagnosis Works
• [4:31] How Common is Unexplained Infertility?
• [8:07] Possible Cause #1: Age & Fertility
• [11:51] Possible Cause #2: Hidden Sperm Factors
• [13:48] Possible Cause #3: Egg Quality Unknowns
• [14:13] Possible Cause #4: Implantation Mysteries
• [15:19] Possible Cause #5: Tubal Function Problems
• [16:49] Possible Cause #6: Endometriosis Link
• [19:233 Possible Cause #7: Inflammation and Lifestyle
• [20:39] What to Do Next
• [23:38] Treatment Plans: IUI vs IVF
• [31:31] Wrap up and next steps

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

Are you frustrated by a diagnosis of unexplained infertility? What if a "normal" semen analysis is not telling the whole story about sperm health? Could a new male fertility test help explain why fertilization is not happening, even when sperm count, motility, and morphology look fine?

In this episode of Brave & Curious, Dr. Lora Shahine welcomes Jeff Lysiak, PhD. He is a reproductive biologist, and co-founder and Chief Science Officer of PS Fertility. He is here to to talk about what standard semen analysis may miss.

Together, Dr. Shahine and Dr. Lysiak explore the science behind sperm fertilization competence, the role of phosphatidylserine (PS) on live sperm, and how Dr. Lysiak's research led to PS Direct, a diagnostic test designed to measure sperm's ability to bind and fertilize an egg beyond traditional semen parameters.

Dr. Shahine and Dr. Lysiak also discuss the future of male reproductive health research, including lifestyle factors, environmental exposures, and the growing need for more precise answers earlier in the fertility journey.

In this episode you'll hear:

• [0:39] Meet Jeff Lysiak, PhD
• [2:01] From Placenta to Sperm
• [3:24] PS Discovery Explained
• [5:01] How Sperm Meets Egg
• [9:02] From Lab to Clinic
• [10:19] Limits of Semen Analysis
• [12:46] PS Score and Misdiagnosis
• [14:12] At Home PS Test Kit
• [18:20] Where PS Fits Clinically
• [21:13] Varicocele & Repair Surgery
• [24:14] Using PS to Guide Care
• [27:26] Lifestyle Factors
• [33:006] Future Research Directions
• [34:21] Where to Find the Test & Connect with Jeff

Resources mentioned:

PSFertility.com

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was sponsored by PS Fertility.

This episode was produced by Audiotocracy Podcast Production.

What if the hardest part of your fertility journey isn't the medicine, it's affording the best treatment? How do you plan for IVF costs when coverage is unclear or incomplete? And is there a smarter, more supported way to navigate the financial stress of building a family?

In this episode of Brave & Curious, Angela Rastegar, CEO and founder of Sunfish, joins Dr. Lora Shahine. They are honoring National Fertility Week through their conversation that explores the real cost of fertility care and why financial planning is just as critical as medical care.

Angela shares her deeply personal fertility journey, including multiple rounds of egg freezing without financial support, and how that experience led her to build a platform designed to support patients through every step of their family-building journey, from egg freezing and IVF to surrogacy. Dr. Shahine and Angela talk about the hidden gaps in insurance coverage, the rising reality of fertility-related debt, and how Sunfish's data-driven, AI-powered programs aim to reduce uncertainty with personalized care plans, cost transparency, and even financial protections for IVF and egg freezing outcomes.

In this episode you'll hear:

• [0:34] Angela Rastegar's personal journey, without financial support
• [3:28] Along comes Sunfish
• [5:45] The IVF Success Program
• [8:35] The hidden costs of IVF
• [13:40] Common misconceptions with insurance coverage
• [19:53] Step-by-step breakdown of cost
• [23:01] Grants, loans, and creative solutions
• [27:08] New AI-powered egg freezing program
• [30:55]The "silent tax" of egg freezing
• [37:00] Getting connected to Sunfish

Resources mentioned:

joinsunfish.com

Sunfish provides personalized financial plans using proprietary software to estimate costs for each Program. If actual costs exceed projections, eligible patients may receive a partial refund under program terms. Sunfish is not a medical provider. Terms and conditions apply.

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

IVF is under fire. So, what happens when access to IVF is suddenly at risk? How much power should policy have over your ability to build a family? And what can one voice, or one story, really do to protect fertility care for millions?

In this timely episode of Brave & Curious, Dr. Lora Shahine is joined by Danielle Melfi, the new CEO of RESOLVE, who brings a powerful blend of policy expertise, personal fertility experience, and a deep commitment to family-building equity.

Airing at the start of National Infertility Awareness Week, Dr. Lora Shahine and Danielle are talking about the real-world impact of recent legislative threats to IVF, including the Alabama ruling that temporarily halted treatment. They explore how advocacy organizations mobilize quickly to protect patients.

Danielle shares her own egg freezing journey, her background in government and healthcare advocacy, and how RESOLVE is working to expand access, improve patient education, and fight misinformation in an increasingly complex fertility landscape.

In this episode you'll hear:

• [1:41] Meet Danielle Melfi, CEO of RESOLVE
• [5:45] Why IVF Stopped in Alabama
• [10:55] What RESOLVE Does
• [14:15] Fertility Care Coverage in California and Recent Advocacy Wins
• [19:29] The Power of Fertility Stories
• [21:48] Restorative Reproductive Medicine Movement: A Threat in Disguise?
• [23:12] Personhood Bills Explained
• [36:55] RESOLVE's Strategic Plan
• [38:31] Get Involved

Resources mentioned:

resolve.org

@resolveorg on Instagram

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

What if your PCOS diagnosis is about more than fertility? What if the symptoms you've been told to "just manage" are actually your body asking for deeper support? And what if you could take back control in a way that feels empowering rather than restrictive?

In this episode of Brave & Curious, Dr. Lora Shahine sits down with registered dietitian and author of PCOS is My Power Cory Ruth, RDN to explain all about Polycystic Ovary Syndrome (PCOS) and why it's often misunderstood. Cory shares her personal journey to diagnosis and how it shaped her mission to help women better understand the metabolic, hormonal, and reproductive components of PCOS.

Dr. Shahine and Cory cover the diagnostic criteria, common misconceptions (like "just lose weight"), and the evolving science around lifestyle interventions, blood sugar regulation, and long-term health outcomes.

This episode will give listeners a clearer understanding of how to manage PCOS through sustainable nutrition, movement, and mindset shifts, without falling into restrictive or shame-based approaches. Cory's refreshing expertise helps us reframe PCOS as a potential catalyst for lifelong health—giving you the tools to feel informed, supported, and back in the driver's seat.

In this episode you'll hear:

• [1:56] PCOS "triple threat": reproductive, metabolic, & hormonal
• [5:40] Cory Ruth's personal journey
• [8:01] Early signs of PCOS
• [11:43] The Rotterdam criteria
• [17:33] PCOS is a weight issue: MYTH
• [19:09] Nutrition is the foundation of PCOS management
• [22:24] Simple, realistic meal ideas to support PCOS
• [31:25] Intermittent fasting & PCOS
• [34:27] Mental health & PCOS
• [37:35] Long-term risks of PCOS
• [40:10] Sustainable lifestyle changes that actually work
• [43:05] Reframing PCOS as an opportunity for lifelong health

Resources mentioned:

www.thewomensdietitian.com

@thewomensdietition on Instagram

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.

Are you struggling with unexplained infertility and wondering if endometriosis could be the missing piece? Have you been told that surgery is the only way to get a diagnosis? What if a simple test could offer answers without going into the operating room?

In this episode of Brave & Curious, Dr. Lora Shahine welcomes guest Dr. Bruce Lessey, a double board certified OBGYN and Reproductive Endocrinologist with decades of research experience and over 150 peer-reviewed publications. Together they explore a groundbreaking question in reproductive medicine: can we diagnose endometriosis without invasive surgery?

Dr. Lessey and Dr. Shahine explain the science behind BCL6 testing, a biomarker found in the uterine lining that may signal inflammation linked to endometriosis. Dr. Lessey also shares how this research evolved from studying implantation markers to developing a potential non-invasive diagnostic tool, and why timing in the menstrual cycle is critical for accurate results.

They also discuss the realities of delayed diagnosis, the connection between endometriosis and unexplained infertility, and how this test is already being used in clinical settings.

In this episode you'll hear:

• [1:21] Meet Dr. Bruce Lessey
• [4:27] Why does diagnosing endometriosis take years?
• [7:16] Introducing BCL6 testing
• [16:20] Timing the biopsy window
• [22:51] IVF outcomes study
• [25:42] Fresh vs. frozen transfers
• [27:22] Treating expected endometriosis
• [28:44] Lupron and surgery explained
• [30:42] BCL6 in recurrent pregnancy loss and recurrent implantation failure
• [33:04] Progesterone resistance and benefits of letrozole
• [40:48] Timing and testing pitfalls
• [43:02] Future research and wrap up

Resources mentioned:

Overexpression in Eutopic Endometrium of Women With Endometriosis. doi: 10.1177/1933719116649711.

Endometrial BCL6 testing for the prediction of in vitro fertilization outcomes: a cohort study. doi: 10.1016/j.fertnstert.2017.09.017.

Unexplained recurrent pregnancy loss and unexplained infertility: twins in disguise. doi: 10.1093/hropen/hoz021.

This episode is sponsored by Cicero Diagnostics.

Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations

Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!

This episode was produced by Audiotocracy Podcast Production.