Dr. Aimee: Tonight’s topic is how to prevent future pregnancy loss. I’m so excited because a special friend of mine, fertility expert and miscarriage expert, Dr. Lora Shahine joins me tonight.
Hi, Dr. Shahine.
Dr. Lora Shahine: Hi, Aimee. I’m so excited to be here. Thank you.
Dr. Aimee: You’re very welcome. We are so thrilled to have you live with us on tonight’s show. Why don’t you tell us a little bit about yourself and about your practice? Go ahead…
Dr. Lora Shahine: Sure. I am in Seattle, in a private practice. It’s Pacific Northwest Fertility here in Seattle. I’ve been up here for about eight or nine years. I did my fellowship training at Stanford. When I was there, my mentor Ruth Lathi was starting her own center for recurrent pregnancy loss. I learned a lot, being in the right place at the right time. I really wanted to bring this knowledge to Seattle and help the people here.
Dr. Aimee: One of the reasons why I wanted you to be a guest on the show is because you just wrote a book. Can you tell us a little bit about it?
Dr. Lora Shahine: Absolutely. The book is called Not Broken: An Approachable Guide to Miscarriage. I did this as a way to help people. I’ve seen a lot of patients with recurrent miscarriage and pregnancy loss, and so many people come to me feeling broken. They feel that their body is failing them, that their body is rejecting the pregnancy, and that it’s something they’ve done wrong. Science really doesn’t support that, but there’s not a lot of great information out there in the world of doctor internet. I needed and I felt a passion to get something out to people that is evidence-based but hopeful and readable and reality.
Dr. Aimee: It’s in your title, approachable. I love your book. I read it before it was even published. I recommend it to my patients. I think it’s a great guide because I think even doctors don’t necessarily know, doctors who aren’t in our specialty don’t necessarily know exactly what to do for patients. I think this is so just spot on for everybody, whether you’re an OBGYN, a general doctor, or a patient who is going through this.
I follow you on Instagram and I love your posts there. They’re fun. You just went on a family vacation as well as a book tour. Can you tell us a little bit more about your book tour?
Dr. Lora Shahine: Sure. I don’t know if you can really call it a book tour. It was just an idea I had as a way to increase awareness of miscarriage and people with recurrent pregnancy loss. I want my book to get out there because it does have good information. I’m very humble, but I believe it has very accurate information. It also remains very hopeful.
I was going on a vacation to London and Paris, and I just had this idea why not share my book with people in Europe. So, I took several copies of my book with me. I wrote in the front of each copy, just who I am, why I wrote the book, and that I want to give this to people. I left it at some pretty famous spots, like the Tower of London, Big Ben, The Eiffel Tower, and train stations. I just really had a lot of fun with it.
Dr. Aimee: Did you ever leave the book somewhere and then someone came after you saying you forgot your book?
Dr. Lora Shahine: I did leave it and I saw someone who was cleaning the train station pick it up. I don’t know if it went into the trash right after that, but I did actually see someone pick it up, and I’m just going to leave it at that.
Dr. Aimee: That’s so fun. I would say that the number of questions we got was overwhelming for this show, so I’m certainly going to do my best to answer everybody’s questions. Since you’re here, let’s just talk about all the questions that people have related to something that is so common and part of the human condition, which is miscarriages.
First of all, I hate the term miscarriage. Don’t you?
Dr. Lora Shahine: Yes.
Dr. Aimee: Just the thought that somehow we missed carrying something, or we lost a pregnancy. I hate terms like cervical incompetence. These words just make us feel so bad about ourselves.
Dr. Lora Shahine: Right.
Dr. Aimee: While you and I are smiling and we’re having a really lighthearted conversation about this, we certainly both know that it’s not all smiles. Certainly, there are a lot of heartbroken people out there.
Dr. Lora Shahine: Absolutely.
Dr. Aimee: We’re hoping that this show definitely helps you out there deal with something in a way that can make this a little bit better. Let’s get to the first question.
What’s the difference between a biochemical pregnancy, blighted ovum, and a miscarriage? What do you tell your patients, Dr. Shahine?
Dr. Lora Shahine: Very common question. A miscarriage in medical literature is an established pregnancy that can be documented with an ultrasound or with a tissue diagnosis that doesn’t come to term, but that doesn’t fit so many people’s personal experiences. With home pregnancy tests being so sensitive now and many times blood tests being positive or a urine home pregnancy test being positive and then a menses or period happening a little bit later, those are pregnancies.
Egg and sperm are fertilized, the cells start dividing, and the embryo is implanted, that is a pregnancy, but the medical community and the experts don’t really know exactly what to do with it yet. In expert opinions and in textbooks, it clearly states that a miscarriage is a clinically recognized pregnancy that doesn’t continue. It’s very often that biochemical miscarriages – that means positive pregnancy test but doesn’t get to the point where you can see anything on ultrasound – are left out of the information and guidelines.
Dr. Aimee: That is so frustrating for our patients, too, to have those types of biochemical pregnancies.
Dr. Lora Shahine: Absolutely.
Dr. Aimee: Then the blighted ovum, what’s the difference?
Dr. Lora Shahine: A blighted ovum just means that the pregnancy gets to the point where you can see your gestational sac on the ultrasound, so a pelvic ultrasound is done and you can see something in the uterus, but it really stops developing before the pregnancy gets to the point where you can see a heartbeat or see a fetal pole.
Dr. Aimee: For our patients who are going through things like this, you and I tend to see patients really early in pregnancy. Positive pregnancy test, we follow the levels, maybe two or three times, maybe then a week later before we can do a patient’s first ultrasound. But a lot of times when patients find themselves pregnant, they go to their OBGYN at 12 weeks of pregnancy, and they see that gestational sac and they’re told that it’s a blighted ovum, and that can be so confusing. You and I both know that it could just mean that the pregnancy stopped growing and there was indeed a fetus there, but by the time you got to the doctor at 12 weeks, it wasn’t there, so the body can naturally take care of this.
Another question that someone emailed asks, “What can I do to increase my chances so miscarriage doesn’t happen again?” What would you say?
Dr. Lora Shahine: I think something that’s important is to get an evaluation. Textbooks often will say you need to have three clinical miscarriages before it’s recommended to do an evaluation, but in 2012 The American Society of Reproductive Medicine came out with new guidelines and said that, yes, for studies and looking for interventions, it might help, maybe classically we should say three miscarriages, but to start an evaluation for our patients and for people who are struggling to complete their family, it’s okay to start an evaluation after two. That’s a big deal for patients.
Dr. Aimee: It is. I can’t imagine telling someone you need to go through something really horrible three times before I can help you. It’s cruel. The other thing I’ve heard patients get told is, “I’m not going to test your pregnancy for the chromosomes until you have three,” and that’s actually so inaccurate and not true.
If you find that you’ve had a miscarriage, you can do genetic testing of the pregnancy. For example, in the Anora test, doing some sort of microarray analysis can actually tell you what’s wrong. You don’t need to wait until it has happened two or three times to find out exactly what happened. If you know the pregnancy was genetically abnormal, then you know what kind of workup to have. Don’t you agree?
Dr. Lora Shahine: Yes. Having a chromosome imbalance or a genetically imbalanced embryo is the most common cause of first-trimester miscarriage. A lot of reasons that providers are hesitant to do the test is they’re worried about the cost to the patient, they’re worried that it might not change future steps like evaluation and treatment, but I argue that it will.
Then the traditional way of doing genetic testing of a carrier type in a lot of hospitals really relies technically on growing cells. If you use that technology, it can be up to 60% of the time you don’t get an answer. What you mentioned is the type of test you can use, new technology. You don’t have to grow cells anymore. You can do testing on something that has been in pathology for a while.
Dr. Aimee: Right. Like a paraffin block. I tell patients it’s like having a CD case. Patients come to me and say, “I really wish that I could have learned from those previous pregnancies,” and they’re so surprised when I say I can actually go back and grab a slide, send it to this genetic testing company, and they can extract DNA. It’s almost like something out of CSI. Patients want answers, they want to know why they suffered through that loss or why that loss occurred so that hopefully that information can help guide us in the future.
Another question. This can be so confusing when patients show up and they have no signs that the pregnancy stopped. The question is, “Why didn’t my body give me some warnings like bleeding or cramping?”
Dr. Lora Shahine: That’s such a good question. Most of the time, the body will do that. Everybody’s body is just different. If the pregnancy stops developing at about six weeks, some people will get the message as far as bleeding or cramping or feelings that change. At six weeks, seven weeks, it can take up to four weeks or longer after a pregnancy stops developing for our bodies to get that message.
Dr. Aimee: Right. That’s so true. This is a question about diet, “How does diet play a factor in all of this? Would being gluten-free, for example, help?” I’m sure that you get those questions just as much as I do.
Dr. Lora Shahine: Absolutely. There is still so much that we have to learn, but there are some small studies that are suggesting that if people really do have Celiac Disease and they do have miscarriages if they change their diet and go gluten-free, that might help decrease the risk of another miscarriage. But those are a certain subset of patients, so that doesn’t mean everybody should go out and all of a sudden go gluten-free. It’s hard to take information on somebody that truly has a disease that may change an outcome and have an outcome. It doesn’t mean it’s going to work for everyone, but it is something to investigate.
Dr. Aimee: That’s true. A lot of people just think if they go gluten-free it will fix the problem because it’s something that they read online, but it’s certainly not the answer for everybody. If you have Celiac Disease, then potentially it could help.
Are there any supplements you would recommend taking to help with egg quality for patients who have had miscarriages?
Dr. Lora Shahine: Again, I still think we have a lot to learn. I think a really interesting resource is Rebecca Fett’s book It’s All About the Egg. She does go into animal studies and to a molecular level learning about certain supplements that might affect DNA replication, and that’s a big part of a healthy established pregnancy. She has gone into some of the studies there.
I think we have a lot to learn to go from animal studies and what we’re seeing with mice to seeing what’s going on with humans. She has talked about antioxidants and how they might be helpful. CoQ10 is considered possibly helpful.
I do think a good prenatal vitamin is important. I often have patients look for one that has something called methylated folate because it’s often easier for our bodies to process and we know that’s important for preventing neural tube defects. I try to focus on that. I think also focusing on a healthy lifestyle and doing all of those things that we need to do and trying to get your nutrients from a really good diet.
I think it’s a little bit too easy to think that you can just go to the store and buy a pill and that’s going to make everything better. I want that, too. It’s just not there yet.
Dr. Aimee: Right. I actually bought a copy of your other book. You do an awesome job going through the literature as to all of the supplements that are out there and what benefit they could possibly have. Patients ask me all the time if acupuncture helps and why would it help. I love this book, you and your co-author did an incredible job.
Dr. Lora Shahine: Thank you.
Dr. Aimee: I think you also do a good job going through all of the supplements as well, like CoQ10, melatonin, and all of the data as to how it may improve egg quality. Thank you for writing that book, it’s so awesome.
Dr. Lora Shahine: Thank you.
Dr. Aimee: Now, are there blood tests for clotting or autoimmune disorders? Tell me…
Dr. Lora Shahine: Yes. There are tests, but it might not make a huge difference to do a lot of those tests, and it might not make a huge difference to act on the results of those tests. This is a hugely controversial topic. It plays into women feeling guilty and blaming their bodies for miscarriage in order to focus on immune issues or blood clotting issues. It’s a big part of my book, there’s a whole chapter on this.
Twenty or thirty years ago, there was a huge push to focus on blood clotting issues causing miscarriages, but that has not been proven to really cause first trimester miscarriages. People who have these blood clotting disorders that we look for don’t necessarily have a higher chance of miscarriage. Even when they’re treated with anticoagulants, they don’t have a significantly lower chance of miscarriage.
Dr. Aimee: The sun is setting where you are in Seattle. I’m sure it’s absolutely gorgeous outside your window, but I’m missing your face. That’s awesome. How does that look? That looks gorgeous. Turn your camera just a little bit more. We don’t want to miss any bit of you.
Beautiful. That’s perfect. Thank you. Perfect.
Next question, “When should I get evaluated for miscarriages, and who does that kind of evaluation?”
Dr. Lora Shahine: Great question. I think that you should ask for an evaluation after two losses. Some primary care doctors and OBGYNs might be able to do it. Usually, it’s people who sub-specialize, so a traditional reproductive endocrinologist like Dr. Aimee or myself would really focus on recurrent miscarriages. Then some maternal-fetal medicine physicians, so those are perinatologists or people who focus on high-risk obstetric issues, might be able to do a great evaluation as well.
Dr. Aimee: Excellent. Here’s another question along the same lines as what we’ve just been talking about. Someone emailed and said, “I’m 33 years old. I’ve had three consecutive miscarriages due to chromosomal abnormalities. All tests are normal, my carrier type, my husband’s carrier type, coagulation studies, and endocrine. Would it be better to turn to IVF with PGS? And is it possible to have a healthy baby naturally without it?” I know I’m not giving you too much information because this is an emailed question, but can you answer that question for us?
Dr. Lora Shahine: That’s an excellent question. This person knows exactly why she’s had those three miscarriages because whoever is helping to take care of her is testing the pregnancies and she knows. It’s not her body rejecting her husband’s sperm or her body rejecting the embryo. It’s the egg and sperm when they came together there was just not a good match of chromosomes.
Her options are two extremes. One is to just try again, because the very next time she tries to conceive, her chance of a healthy pregnancy can be as high as 60%, maybe even 70%. All it takes is a good egg and a good sperm.
The other option that she has instead of this trying and miscarriage and the fear that she has put herself out there again is she has the option of screening the embryos before she even conceives. We do have the ability to take eggs out of the body with IVF, fertilize them with sperm, watch the embryos develop, and when the embryos are ready we can actually test them and we could only put back an embryo that has the right balance of chromosomes.
Instead of trial and error, it could be considered more efficient to screen the embryos outside of the body.
Dr. Aimee: Certainly, if she hasn’t had kids yet, it might help preserve her fertility as well if she’s starting here at 33, so that when she is ready for baby number two she potentially has another normal embryo for her.
Dr. Lora Shahine: Exactly.
Dr. Aimee: These questions have more to do with the procedures related to once you’ve had a miscarriage that’s been diagnosed, what to do. Someone has asked, “Do you double-check to make sure there is a heartbeat before you do a D&C procedure?”
Dr. Lora Shahine: Yes. We do that routine in our clinic. We have an ultrasound right in the procedure room. Absolutely.
Dr. Aimee: Good. And do you do your D&C procedures under anesthesia as well?
Dr. Lora Shahine: We do. Every clinic is different. We just have an IV that gives patients medication and they go to sleep. It’s very brief. They’re intubated, but they’re asleep. They don’t remember anything, they don’t feel anything, and we take really good care of them.
Dr. Aimee: Another question, “How long should a patient expect to be out of it after a D&C procedure?”
Dr. Lora Shahine: When you say out of it, do you mean recovering from the medication?
Dr. Aimee: Exactly.
Dr. Lora Shahine: We use a medication that wears off very quickly. They’re in our office for about an hour to an hour and a half total, and they go home feeling okay.
Dr. Aimee: Can the patient drive herself home?
Dr. Lora Shahine: No. Because they’ve had anesthesia, we recommend that she has somebody to drive her home.
Dr. Aimee: How long do you tell your patients the physical recovery will take after a procedure like this?
Dr. Lora Shahine: Everybody is really different. Some people have a little cramping that day or the next couple of days. Some people still have bleeding. Usually, people rest and relax that day, and maybe consider taking the next day off, but I do have a lot of patients that go right back to work the next day.
Dr. Aimee: Do you tell them to have any restrictions on their physical activity, like exercise?
Dr. Lora Shahine: What I say is see how you’re feeling. I wouldn’t use tampons or have intercourse or anything in the vagina for at least about a week, just because your body is healing and recovering. I wouldn’t do any heavy exercise for about a week or two, but walking, light exercise, light weights, as long as you’re feeling okay. Just try it and be very gentle.
Dr. Aimee: If you’ve documented a miscarriage and the patient was on progesterone, what do you tell them to do about their progesterone?
Dr. Lora Shahine: You’re saying that somebody is taking progesterone and they come in for an ultrasound, and we see that there’s not a heartbeat?
Dr. Aimee: Right.
Dr. Lora Shahine: One option is to stop the progesterone, and that might help their body get the message that the pregnancy is no longer developing, and they might have a natural miscarriage. But if somebody really wants to have the D&C, they’re nervous about having a miscarriage at home, they don’t want that to be a surprise, and they want to have a procedure, then we’ll have them continue the progesterone until that procedure.
Dr. Aimee: Exactly. Then they basically stop it after the procedure, until they’re ready to try again. Right?
Dr. Lora Shahine: Yes.
Dr. Aimee: Good. When you screen the embryo in your clinic, how long do you tell patients it will take for the results to get back?
Dr. Lora Shahine: I say about 7 to 10 business days.
Dr. Aimee: Do they come back to your office to review the results and do a post-op check or post-miscarriage check?
Dr. Lora Shahine: We actually see them about two or three weeks later, kind of closer to when probably their natural period might be coming, but we call them with the results as soon as we get them because we know that they’re anxious to hear those results.
Dr. Aimee: Absolutely. I get this question all the time. I bet you get it all the time, too. Is there any benefit physically to waiting longer than one period to start the process and try to get pregnant again?
Dr. Lora Shahine: It depends on when the miscarriage happened. If it’s in the first trimester, there’s really no physiologic benefit from waiting another period. If someone has a significantly later loss, in the second or even third trimester, then it might be better to let the body recover and let the uterus get back to where it needs to be to have the best chance of a good pregnancy.
Dr. Aimee: Excellent. I have another emailed question. This is a patient who had two miscarriages and she is now pregnant. Typically, what happens is everything goes fine until her six-week ultrasound. She goes in for the ultrasound, then she starts to cramp, bleed, and then at seven weeks, she has miscarried. Right now, her HCG levels went from 187 to 494, she’s bleeding and cramping again. She works in a store. She is very confused. Would you take her out of work?
Dr. Lora Shahine: Oh gosh. I wish it would be that easy. It’s so hard because there are people that have very strenuous jobs or get pregnant in the middle of war and famine and very emotionally and physically draining situations, and their pregnancies are just fine. More than likely, the miscarriages are from a chromosomal issue that working has no control over.
Patients call me bleeding all the time and I say, “If there was a medication I could give you, if there was a procedure I could do, if there was anything that I could do, if bedrest worked, of course, I would tell you to do that.” It’s just not that easy.
Dr. Aimee: Of course. Another question is would fibroids cause a miscarriage?
Dr. Lora Shahine: Sometimes. Fibroids in and of themselves are very common. Some studies say up to 50% of women have fibroids, which are what they call benign tumors, kind of like these little muscle balls in the uterus. Not all fibroids cause miscarriages. It depends on the location and the size of the fibroids.
We believe, and some studies suggest, of course, that if there is a fibroid that is inside the uterine cavity where an embryo would implant, we call that a submucosal fibroid, it makes sense that if the embryo were to implant on that fibroid, there might not be a very good blood supply, and it could be a cause of recurrent miscarriage. Then people really are trying to figure out if there is a size connection between the size of a fibroid and miscarriages. The jury is still out on that. Some people worry if they’re over 5 centimeters. Other studies say it doesn’t matter unless they’re over 8 to 10 centimeters.
I think you have to take the whole person into account and look at everything else and then really weigh the pros and cons of taking care of fibroids because it requires surgery. You really want to think through it.
Dr. Aimee: Right. What about aspirin? When you go online and go to Doctor Google, it’s like aspirin seems to cure everything. What do you tell your patients about aspirin and miscarriages?
Dr. Lora Shahine: Again, if it were that easy, that would be great. Big studies looking at whether aspirin helps with unexplained recurrent miscarriage do not support it, they say it’s not helpful. Knowing that I know all of my patients are taking it, I don’t think that it’s really harmful to most people, as long as they don’t have an allergy or a GI issue that aspirin can upset.
Aspirin is the first-line treatment for the one immune issue and blood clotting issue that we do look for with recurrent pregnancy loss, something called antiphospholipid syndrome. If someone is diagnosed with that, one of the first-line treatments is to take aspirin.
So, it’s definitely something to think about. It’s not super simple. Please, if you do take aspirin, make sure that your provider is aware. It’s something that you can easily pick up at the drugstore, but you should definitely take it under the care of a provider.
Dr. Aimee: Thank you. I want to go through some fertility truths or myths. I’m going to ask you a few questions here. That was all of the emailed questions that we got, so thank you for going through all of those questions with us.
Okay. Fertility myth or truth, having a miscarriage means you’ll have a higher chance of future pregnancy?
Dr. Lora Shahine: Both. I want to be able to say that if you have a miscarriage that means that you’re more fertile. Patients ask me that all the time. What I think is let’s focus on the positive. I don’t have a study that can say, yes, you’ll be more fertile. But think about all of the hurdles that you had to get through to get to that miscarriage in that the egg and sperm liked each other and implantation happened. That’s really positive. I want it to be encouraging.
So, I’m going to say both. I’d like to err on the side of truth because that might make people feel more hopeful. That’s kind of the whole point to keep trying.
Dr. Aimee: Okay. Next one, and we kind of talked about this a little bit already. IVF with PGS, which stands for preimplantation genetic screening, can decrease the chance of miscarriage.
Join Dr. Aimee for The IVF ClassDr. Lora Shahine: Yes for a lot of people, but not for everyone. The biggest limitation of IVF is we’re only working with the eggs and sperm that we have. If someone has a very poor ovarian reserve, or in an IVF cycle we might only get one or two eggs, it’s really hard to justify using all of those resources when it might not be successful. But for someone else that could just do one cycle and maybe have lots of embryos to test, yes, it could.
Another way to put it is IVF really is considered more efficient. It’s screening. You’re not trying just with one egg each month. If you could do IVF and get 12 eggs, that’s like a year’s worth of trying. That’s great. Then your body isn’t doing the selecting and having to go through another miscarriage. The selection is going on in the lab.
If someone is 40 years old and they were to conceive naturally, the miscarriage rate is close to 50%, maybe even higher if they’ve had miscarriages before. But if someone is 40 years old and they do IVF and they have an embryo that tests okay to transfer, we call that euploid embryo, and they transfer that, the miscarriage rate is less than 10%.
Dr. Aimee: What a big reduction. That’s huge. That’s really powerful. That’s something that you offer, you do that in your clinic, that’s what you do every day, all day.
Dr. Lora Shahine: Yes. I do. I also am humbled by the fact that some of my patients who do IVF, for this reason, transfer a euploid embryo and 10% of the time they have a miscarriage.
Dr. Aimee: It’s so heartbreaking.
Dr. Lora Shahine: So, it’s not perfect. It’s so much better than what we were doing 10 years ago, 20 years ago, which was just patting people on the head and saying, “Good luck, honey.” But it’s really a lot. It’s a very thoughtful decision and you should have a really good provider that walks through the pros and cons.
Dr. Aimee: Right. Next one. Egg freezing can help prevent future miscarriages. What do you think?
Dr. Lora Shahine: The most common cause of miscarriage is from a chromosome abnormality in the embryo, and it’s older eggs that have a higher risk of not doing the chromosome work correctly, so if you can freeze eggs when they are younger, they are going to have a lower chance of resulting in embryos that will be a miscarriage.
I talk about this all the time. There is a huge connection, and it’s a circular relationship between age, diminished ovarian reserve, miscarriage, and recurrent miscarriage, and they’re all tied into the fact that if the egg is not able to do all of the genetic work that it needs to correctly, it’s going to result in an embryo that is not going to be a healthy pregnancy. It ties all together in that way.
Dr. Aimee: It definitely does. You did such a good job in your book addressing the emotional support and emotional needs of patients. What kind of resources do you have in Seattle for your patients?
Dr. Lora Shahine: We have a wonderful network up here. We have four or five RESOLVE groups, which is a patient-run fertility network that is actually national. They have a wonderful website where you can put in your zip code or city and find if there are any RESOLVE support groups in your area. We have about four or five in Seattle.
We actually have some miscarriage support groups that are through RESOLVE, but also through some churches up here, too, and they’re not faith-based. That’s another resource. Some women’s and children’s hospitals often have support groups for people with loss, so that’s another resource.
I think individual counseling can be really wonderful and appropriate. There are some wonderful books out there.
There’s a really good app called FertiCalm. I don’t know if you’ve done that. It’s a free app that you download and it walks you through stressful situations and mindfulness ways, like breathing techniques and wonderful ways to help you get through a stressful situation.
There are so many different ways to find support. Sometimes yoga for fertility. Everybody is so different, we talk about lots of different options.
Dr. Aimee: Right. So, where can we get your book?
Dr. Lora Shahine: Right now, it’s on Amazon and you can order it in print form or on the Kindle.
Dr. Aimee: You sent me a copy, but I read it on the Kindle. It was very easy, it was a great read. Thank you for that. It was informative and it’s a wonderful book.
Dr. Lora Shahine: Thank you.
Dr. Aimee: Let me see if there was anything else that I wanted to ask you tonight while you’re here. Tell us about your clinic location and where people can find you.
Dr. Lora Shahine: Sure. My clinic is Pacific Northwest Fertility here in Seattle. Our main office is right in Seattle, and then we have another office where we see patients sometimes out in Issaquah. We have a wonderful website, it’s a good resource.
For me, I really enjoy writing. We’ve obviously talked about my two books, but I really enjoy writing blogs and I’ve been on Huffington Post. It’s really become a passion because it’s a way that I can get information to people, so I do have a website at LoraShahine.com, and you can see other writings and things that I’ve done there.
Dr. Aimee: Thank you for all you are doing to help women deal with something really horrible, maybe not seem as bad because they know that they have someone like you to support them. Is there anything else that you want to tell our audience tonight before we end the show?
Dr. Lora Shahine: Yes. I want people to hopefully leave the show and read my book and get the message to try and stay hopeful. No matter what tests you do, no matter what treatments you do, if you can just try again, most of the time everything is going to be okay. I know we talked about interventions and I know we talked about tests, but if somebody doesn’t do a single thing, all it takes is the right egg and the right sperm. Just find that network, find the people that are going to support you and help you keep trying.
Dr. Aimee: That’s great. Thank you again for your time. Thanks for being on our show.
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