In this episode, I’m talking to Dr. Nirali Shah Jain, a fertility specialist and researcher who’s making waves both in the clinic and on social media as @eggspert_md. Dr. Jain brings a refreshing blend of evidence-based medicine and genuine compassion to the often overwhelming world of IVF. We dive deep into her groundbreaking research on PGT-A testing in donor egg cycles, published in Fertility and Sterility, and discuss what it really means for patients making decisions about embryo testing. Her unique background as a trained dancer in Indian classical, modern, and ballet gives her a disciplined yet creative approach to patient care that truly sets her apart.
Throughout our conversation, we explore the practical side of fertility treatment: from navigating the emotional rollercoaster of IVF to understanding the real science behind embryo grading, fresh versus frozen transfers, and the Mediterranean diet’s role in egg quality. Dr. Jain shares her honest perspective on common fertility myths, offers compassionate advice for managing IVF symptoms and stress, and tells a moving story about helping a young cancer patient preserve her fertility before chemotherapy. Her approach is all about empowering patients with knowledge while keeping things accessible, relatable, and sometimes even fun.
In this episode, we cover:
- Dr. Jain’s research on PGT-A testing in donor egg IVF and when genetic testing is truly beneficial
- The difference between embryo grading and chromosomal health—and why they’re not the same thing
- Fresh versus frozen embryo transfers: which approach makes sense for different patient scenarios
- Fertility-friendly nutrition, including the Mediterranean diet and the truth about alcohol during treatment
- Managing IVF side effects, bloating, and stress with practical, accessible strategies
- Debunking the myth that egg freezing depletes your future fertility
- Fertility preservation for cancer patients and the importance of pre-treatment counseling
Resources:
- Follow Dr. Nirali Shah Jain on Instagram: @eggspertMD
- Dr. Jain’s research: Fertility and Sterility journal (donor egg IVF and PGT-A study)
- Where to Find Dr. Jain: RMA New Jersey
- Follow Dr. Aimee on Instagram, YouTube, and TikTok
- Listen to The Egg Whisperer Show on Spotify
Transcript
Dr. Aimee: I’m so excited for today’s guest, someone who is truly shaking up the world of fertility medicine with both science and style, Dr. Nirali Shah Jain. She’s @eggspert_md on Instagram, and is a fabulous fertility doctor and published researcher, a proud educator, and a formally trained dancer in Indian classical, modern, and ballet. She’s known for bringing warmth, wisdom, and clarity to the often overwhelming IVF process, whether she’s breaking down PGT-A data or myth-busting common misconceptions on Instagram.
Today, we’re talking about her latest research on embryo testing, how to eat for egg quality, and the emotional side of fertility care. Let’s dive in. Welcome, Nirali. Thank you for joining me today.
Dr. Nirali Shah Jain: Thank you so much for having me, Dr. Aimee.
Dr. Aimee: Let’s start with your fabulous Instagram handle, @eggspert_md. It’s clever, memorable, and a little cheeky, kind of like me. What inspired you to claim your voice online in such a bold and educational way?
Dr. Nirali Shah Jain: This was something that I had wanted to do since I started medical school, for a long time. But, like most of us in medicine, we constantly have that fear of being like let me get my board certification first, let me make things official on paper before I actually go out there in the real world and try to spread education in a way where people can actually trust me, trust what I’m saying, and know that I’m telling them what’s best for their own interests and their own health.
I will say it took me a lot longer to get online and on my Instagram platform than I initially wanted. Then finally, when I graduated from fellowship from NYU in 2024, I decided it was my time. I was going to do it, and everyone in my new team where I joined as an attending at RMA New Jersey really supported that, so I knew I was in the right place, I knew it was the right time. That handle was kind of just sitting in my brain for a long time, all thanks to my husband. That was where things started.
So many of us find things online, on TikTok, on Instagram, on YouTube, things that probably shouldn’t be there for our patients and confuse the picture, which is already kind of like a blackhole. My goal is just to make things easy, educational, fun, and sometimes funny.
Dr. Aimee: One of the reasons why I brought you on is there’s a study that you’ve published not that long ago that is very widely referenced over and over. It was published in Fertility and Sterility, and it was about donor egg IVF and PGT-A testing. I’d love for you to talk to us a little bit about that.
Dr. Nirali Shah Jain: We had a very large donor program at NYU, and they’re amazing. I did this with my mentor and also a lot of medical students in residence. What we were looking at were frozen and fresh donor eggs and the outcomes after embryo transfers of untested versus PGT embryos once they were created. We learned that when we put donor eggs and sperm together and it’s coming from young donors, they don’t necessarily need to be tested for success, just given that they’re younger embryos that are being created.
Dr. Aimee: That sounds pretty obvious, right? The younger the egg, the less likely they’ll be abnormal.
Dr. Nirali Shah Jain: Then we did a stratified study, it was a very small cohort, but we looked at the lower grade embryos. Once the donor egg and sperm were created embryos, we looked at the grading, which our embryologists typically do all the time. In those lower grade embryos, we looked at whether doing PGT testing was beneficial or not. We found that it likely was.
Embryo grade is subjective. It doesn’t really say anything about the chromosomes themselves, but we’re doing PGT more and more as we get better technology, it becomes more available to our patients, and it gives much more information about the success of the embryo transfer.
Dr. Aimee: I think testing would make sense, especially with the embryos on the lower side of quality. But I’m biased. If I had a chance to, let’s say have a girl, and I had an option, I’m just saying I might want to do testing just to know which one was a boy or a girl.
Dr. Nirali Shah Jain: Exactly. Patients that are pursuing the use of donor eggs already have this family plan envisioned, and I want them to feel that support, I want them to feel empowered when they’re transferring an embryo. Having that information, knowing it’s a chromosomally normal boy or it’s a chromosomally normal girl, having the best chances of implantation, that in itself, knowledge is power. If we have that available, let’s use it.
Dr. Aimee: To test or not to test, what do you tell your patients now if they’re going through donor egg IVF?
Dr. Nirali Shah Jain: I kind of say the same thing. Knowledge is power, we believe in that. For me, anyone walking through this door is going to get recommended for PGT. I want to know the chromosomes, I want to make sure that we say it’s a healthy embryo, these chromosomes look normal, it’s an excellent grade, which we can go into a little bit, but they’re two different things, as you know. A lot of people think it’s an excellent grade, that means the chromosomes should be normal.
I say if you’re using a donor embryo that’s already created, already frozen, it’s probably best to just transfer it if that donor was young at the time of the creation of the embryo. If we’re using fresh eggs, frozen eggs, and creating embryos up front, it’s kind of all happening at the same time, so it’s reasonable to consider doing the chromosome testing up front so that you know the quality is great, but the chromosomes are also great. You can go in with that reassurance, where that small risk of miscarriage, recurring implantation failure is lower. It’s not completely eliminated, but it is lower with genetic testing. Try to just make an informed decision at the end of the day. There’s not that big of a push for testing these donor embryos or even testing donor eggs, if the patient understands those risks and understands that it’s probably normal.
Dr. Aimee: Excellent. One thing that I admire about you is how you blend evidence-based medicine with deep compassion, and you help your patients understand complex decisions. I want to know how you talk to them about things like embryo grading or choosing a day five embryo versus a day six without sending them into information overload.
Dr. Nirali Shah Jain: That’s a great point. As you can probably tell, I’m someone that loves to talk and loves to have these conversations. I’m truly a basic science nerd. I actually have been practicing giving patient education talks with my 4-year-old. If he can understand it, if he doesn’t run away halfway through my talk, I know that it’s captivating and it’s easy to digest.
At the end of the day, you do want to give patients all of this knowledge, all of this power, and you want to tell them everything up front. I feel like I have so much to tell patients at the intake visit or the first visit that they have. I rely on my PowerPoint slides to keep me in order and on track and avoid some type of divergence from what they need to know. On those slides, I digest everything down for them.
I have the two-minute rule. If I’m talking for more than two minutes to you and I don’t hear a response, that’s too long, I’m definitely overloading you with information.
Dr. Aimee: That’s so funny, because I talk in the same way. I always tell patients, “I know it can be overwhelming, so please stop me if you need to.”
Dr. Nirali Shah Jain: I do the same thing, “I’m so sorry. You don’t have to remember anything from our conversation, I can write it down for you.”
Dr. Aimee: Exactly. There’s a lot of buzz around a lot of topics in our industry, fresh versus frozen, especially in donor egg IVF. I want to hear from you and your clinical experience. Are there situations where a fresh transfer still could be better, or do you lean toward frozen in most cases?
Dr. Nirali Shah Jain: That’s a great question. In the practice that I’m currently in at RMA New Jersey, we are typically a frozen embryo center, so freeze all, do everything up front. That’s truly because of safety, improved technology of freezing embryos and then thawing them later on when they’re ready to be used. Also, that risk of ovarian hyperstimulation and allowing that patient to recover from their retrieval before we put in this embryo.
There’s a lot of different reasons that we consider that and that I recommend frozen embryo transfers for the most part. But you’re right, there is a small cohort where rarely we will recommend a fresh embryo transfer for a patient in our fertility world, and that’s if they’re older, we’re worried about that embryo surviving in our lab beyond day three, and we think that it’s probably better to just attempt it without testing it genetically, just transfer and see what happens. Of course, that comes with its risks, so I’m always a little bit wary to counsel patients on that.
Dr. Aimee: Right. I think also when it comes to scheduling things, getting your lining ready, making sure it’s thick enough, and making sure you have the meds and all of the education, sometimes frozen can be the best way forward.
Let’s talk about nutrition. I know you’ve been featured in Veg News for promoting a Mediterranean-style diet. That was very cool. What are some of your go-to fertility-friendly foods?
Dr. Nirali Shah Jain: I think nutrition is one of my little loves where I know there’s not that much evidence behind using the Mediterranean diet or doing dairy-free and gluten-free in our endo patients, but we recommend it. It’s a why not. Why not optimize our nutrition to then optimize our fertility health?
The reason behind the Mediterranean diet, and the reason that more and more providers are supporting it and patients are following it, is because it’s full of antioxidant-rich foods, it’s very clean, and it allows for you to intake your omega-3s and your proteins in a way where it optimizes your overall health. At the end of the day, we’re thinking about the mitochondria and the antioxidants in your ovaries, because that directly correlates to egg quality, we think. That’s why I recommend that to everyone. Not necessarily giving up everything that you love. If you hate the Mediterranean diet, that’s fine.
One thing that I love about it is that you can follow the Mediterranean diet even if you’re a picky eater because there are so many options. It’s just that they’re very clean.
Dr. Aimee: Right. Does wine go with a Mediterranean diet? What do you tell patients when it comes to alcohol?
Dr. Nirali Shah Jain: That is another great point. Conversations we have every day. A lot of patients think that they completely have to give up alcohol. My job as a provider is saying going no-alcohol does improve your chances, but wine does have its benefits. A glass of wine per day, as we know, improves cardiovascular health. We have no reason to believe that it’s harmful. Obviously, once you have a positive pregnancy test, there is no amount of alcohol that’s safe. When you’re going through these treatments, when you’re going through the process or between your IVF cycle and your embryo transfer, there’s no reason that you can’t pick up a glass of wine per day.
Dr. Aimee: You’re so honest on social media about things like IVF bloating, hormones, and body changes. I don’t think a lot of patients get that education, so I think it’s helpful that you put it out there so people can follow you and learn from you. What is one myth about IVF side effects that you wish we could retire forever?
Dr. Nirali Shah Jain: The biggest myth is when my young egg-freezers come in and they think that they’re giving up their future fertility by freezing their eggs. They think we’re going through this cycle and we’re retrieving, I’m not sure the number, but when they describe it, it sounds like hundreds of eggs. They think they won’t be able to get pregnant on their own in the future. For me, I’m like, I just need to get rid of that concept, amongst other concepts that we can get into, but that’s one of the big ones.
I like to say when you’re going through an egg freezing process or IVF, we’re just taking a snapshot of time in your ovary. We’re growing those follicles that would have otherwise died off and we’re saving them for the future. You’re doing the best thing that you can do to ensure your future fertility by freezing your eggs or creating embryos up front.
A lot of people think that they can’t get pregnant on their own or that they have to come back to use their eggs or embryos that are frozen when they’re younger. I wish that we could just empower women and patients to say doing this is great for your health, it doesn’t take away from your future health.
Dr. Aimee: Yes. And it’s not dangerous to have sex to have a baby.
Dr. Nirali Shah Jain: Exactly. Health class failed all of us.
Dr. Aimee: What are your go-to tips for getting through an IVF cycle as smoothly as possible, in terms of the symptoms and the bloat? I would love to hear you share some of those things.
Dr. Nirali Shah Jain: I think some of the biggest tips that I have are stress relief up front. I always say create a regimen before you start your cycle. When you’re going through the talks and going through the actual workup in your fertility practice, create a regimen in your day-to-day health, so your nutrition, your stress management, your sleep hygiene even. Those things are so important. Then think about who you want to involve in this process. Who is your emotional support? Is it just your partner? If you’re unpartnered, is it a family member, is it a friend? Make sure that they’re available to you. I think that this is really hard to go through on your own.
In terms of stress, everyone thinks stress relief means I have to go pay a thousand dollars to sign up for this gym and go get massages every week. That’s not necessarily the case. Something as easy as going for a walk every day as part of your routine could be your stress relief. I just say find something that works for you, that you can guarantee that you’ll do in the day. Especially when you’re going through IVF, when you’re feeling at your worst, you still look forward to that moment of stress relief, so that’s the other big thing.
Then, I kind of just say go easy on yourself. This is the one time in your life where you’re going to prioritize your own health. If that means setting a timer saying 9:00 PM is bedtime, if I’m out with friends, I’m going to head home at this point. Creating a routine that focuses on you as a person versus trying to create all these work commitments and social commitments and trying to do it all. We’re all the do-it-all type these days.
Dr. Aimee: Right. Do it all and please them all, and that’s so hard.
Dr. Nirali Shah Jain: Exactly.
Dr. Aimee: We want people to like us and we don’t want people to be upset with us, but you have to just stop that and prioritize yourself. I look forward to my stress relief, watching Dateline at night. I stream it and it’s so relaxing.
Dr. Nirali Shah Jain: It is so relaxing and so fun. I feel like the shows I love, just unwinding. Taking 30 minutes, no distractions, just whatever you need to unwind.
Dr. Aimee: Right. I want to talk about your formal training in dance, classical, modern, and ballet. How does your training in dance play a role in your work as a fertility doctor? Tell us about it.
Dr. Nirali Shah Jain: I love talking about my dance training. Even people that I’ve just recently met see that side of me, and I love talking about it. I started as a Bharatanatyam dancer, that’s a traditional Indian dance form, and I started when I was two-and-a-half. I was very young. Thanks, mom, for that. I was enrolled in that and it was a very strict dance school, so there was a lot of focus on discipline and regimen, being the best at what you can be. For us in that space, it was Indian classical dance.
That kind of instilled the personality that I still carry through with me today. I did that all the way until I left for college at Northwestern and I moved from New Jersey to Chicago. I didn’t want to give that up, but I also didn’t want to join a recreational dance group because that just wasn’t the fit for me, so that’s when I started my ballet and modern dance training. I minored in ballet and modern dance at Northwestern. That again was part of my routine. I was that girl that was in her leotard in chem class and then scooting over to the ballet studio an hour later.
It was a great balance. It seems like black and white, but it really brought together who I am as a human and who I am as a provider, a mom, a physician, and all those things. It does play a role in the way that I counsel patients.
Dr. Aimee: I love that. I’ve thought about going back to theater, music, piano, all those things from a performance background, but now I’m just so addicted to my cellphone. I can imagine myself doing my pliés and my pas de bourrées, and then somehow dropping my phone. I don’t think they’ll let me bring my phone into class, but I’ve thought about it.
Dr. Nirali Shah Jain: We’re all attached. My 2-year-old recently started ballet, and I’m like this is great. This is going to go one way or another, and I can’t wait to see.
Dr. Aimee: So fun. You’ve done a lot of important advocacy and care work around fertility preservation for cancer patients. I would love for you to share a meaningful story of a patient who froze their eggs or embryos before treatment and then came back to grow their family after remission.
Dr. Nirali Shah Jain: I’m so glad that you asked that question. A lot of my work and my goal for fertility patients is to counsel patients specifically that have a new cancer diagnosis. I know breast cancer is the most common one, but there’s a ton of different cancers that we’re able to see patients prior to chemotherapy and then afterwards.
I had a patient in fellowship that I had followed from my first year. I remember, I was with an attending just taking her intake, taking her history, learning how to counsel a patient for one of the first times as a fellow. She had two weeks before chemotherapy started. For her, she was 24, she was young, it was really hard for her to envision life after chemotherapy or life after breast cancer treatment because she was so young and she just wasn’t ready.
I remember counseling her about freezing her eggs, and she thought it would take away from her time for chemotherapy, she thought it would advance her breast cancer stage with the gonadotropins, the injectable medications that we give. I remember specifically counseling her in that office and telling her all of the different ways these meds work and the ways that we protect the estrogen levels from rising.
She did it, she froze her eggs within two weeks and she was off to chemotherapy. She did amazing. She had Lupron suppression during her chemotherapy. She came back a few years later to create embryos with her husband. To see that story come back and relive itself in a completely new setting for her was just amazing. That really pushed me to say this is something that patients truly see the beginning and the end of, a chapter where it’s so scary and then a chapter where it’s like thank gosh I did this at a time when I didn’t even think there was going to be a future.
I could go on and on, but that was one of the most pivotal stories for me.
Dr. Aimee: That’s a beautiful story. Thank you for sharing it. So many of our patients are navigating uncertainty and intense emotions, especially around finding out if they’re pregnant or not. What are some words of comfort or perspective you offer your patients the night before a transfer if they’re scared, or while they’re waiting for that HCG beta result call?
Dr. Nirali Shah Jain: Going back to my interest in lifestyle, day-to-day, and focusing on yourself, I always tell patients after an embryo transfer, and I think it’s important for providers to say, “I’ll be thinking of you during this time.” You can’t necessarily change outcomes. We know that we’ve optimized everything up until this time. We have very strict guidelines to doing a patient’s embryo transfer, getting their lining optimal, getting their estrogen and progesterone levels where they should be. I always reassure patients, we’ve done everything together up until this point and now it’s either going to work or not, truly. I think hearing that and having your provider say, “I’ll be thinking of you. We’ll see you back in a few days for a progesterone check and then we’ll see you back in a week for a pregnancy test,” and they have these checkpoints to check in with you. I think just hearing that gives patients a lot of reassurance. Saying, “I’ll be rooting for you. Whatever happens, we’re in this together.”
I think the biggest thing is saying if it doesn’t work, I always like to have that plan B, “If it doesn’t work, these are going to be our next steps.” Our patients inevitably will take a pregnancy test at home before they come into the practice, so I think seeing that can be really scary without knowing now what. Having that plan in their mind planted before they leave. If they don’t need that plan B, great. But if they don’t have a positive pregnancy test and they know what’s coming, it makes that news a little bit easier to digest.
Dr. Aimee: It’s so easy to say that. I’m thinking of you. I’m rooting for you. I feel like there should just be a script that all doctors are given so they can learn from your amazing bedside manner. It’s not that hard.
Dr. Nirali Shah Jain: It just takes a few seconds.
Dr. Aimee: Thank you for sharing your brilliance and your heart with us today. You bring such clarity, warmth, and honesty to the world of fertility care. I can only imagine how much your patients adore you. I know our listeners will feel so much more empowered after listening to this show.
If you want to learn more about Dr. Nirali Shah Jain, be sure to follow her on Instagram @eggspert_md. If you loved this conversation, don’t forget to share it with a friend who could use some fertility encouragement or a little bit of evidence-based myth-busting.
Is there anything else that you want to share with us today?
Dr. Nirali Shah Jain: I think the most important thing that I’d love to share is just feel empowered with the education that you have access to and make sure that you’re getting your information from trusted sources. It’s easy to fall into this blackhole, as I said at the beginning of this conversation, but trust the people like Dr. Aimee that are just trying to put information out there and give patients the benefit of the doubt in terms of coming in with the information that they need to have before they start fertility treatment.
Dr. Aimee: Just like you said earlier, knowledge is power. The more you know, the better things will go.
