In this episode hosted by Anne Matthews, a fertility-focused acupuncturist from Energy Tree in Toronto, Canada, Anne discusses fertility issues with Dr. Aimee. Anne reveals how she became a fan of Dr. Aimee’s holistic and patient-centric approach rooted in the TUSHY method, which stands for Testing: Tubes, Uterus, Sperm, Hormones, and Your genetics.
They delve into the inadequacies of common fertility treatments, the importance of comprehensive diagnostic tests, and the role of acupuncture. They also discuss the implications of factors such as polyps, DNA fragmentation in sperm, and the significance of quality embryo grading. Dr. Aimee emphasizes the importance of personalized patient care, thorough diagnoses, and being emotionally and physically prepared for pregnancy, reflecting on her own motivations for specializing in fertility treatments.
The conversation also covers the roles of psychological support, supplementation, and the evolving landscape of egg freezing and IVF.
Resources:
To learn more about Anne and Energy Tree, you can find Anne on Instagram, and on YouTube.
Full Transcript:
This episode was originally hosted by Anne Matthews on Trying to Be Positive. Anne is a fertility focused acupuncturist and owner of Energy Tree in Toronto, Canada. You can find Anne on Instagram at Energy Tree Anne, and be sure to look for her podcast, which we will link in the show notes. Thank you so much for letting us share this conversation, Anne, and let’s get to the show.
Anne Matthews: I have to say that I am your biggest fan probably in Canada. And I’m having a real fan-girl moment because I have been in the fertility space now for about 14 years, I’d say that you were my first real source of information that I felt I could give to any patient because you were so relatable and so kind, and I felt as though you really focused on the patient as opposed to just, like, hard hitting facts.
And all of your advice was very logical. There was no prescription-based advice where it was, like, “everybody can benefit from this and everybody falls under this umbrella.” And I feel like now in the age of social media especially, there’s so much content saying “everyone should do the following.”
And it makes me crazy because it takes the unique aspect of care completely out of the picture. I know, as a raging fan, about your TUSHY method, but I would love if you could dive in because I feel like it is such a useful acronym
Dr. Aimee: I agree. I got so sick and tired of people coming to me with a diagnosis of unexplained fertility and no fertility test done, so I’m just like, this has got to stop.
So I basically took the five tests that we always do for fertility patients, and I just put it into this method. The T is for fallopian tubes. The U is for uterus, S is for sperm, H is for hormones, Y is for your genetics. And then I can use my jazz hands to basically get people to hopefully listen and get this done.
I’m just so tired of women being prescribed Clomid for, like, a year. No one’s ever done an ultrasound or checked the sperm. It keeps happening, so I have to keep talking about the TUSHY method until everyone hears about it.
Anne Matthews: It makes me insane when patients are prescribed either Letrozole or Clomid, and no one has done a sonogram or checked the sperm.
And when you suggest checking the sperm, it’s as though– It’s something that’s, like, really asking for a lot.
Dr. Aimee: Oh yeah.
Anne Matthews: Which feels insane.
Dr. Aimee: Right? Given the extraction process. Yes. So I say, look, if you’re not gonna gimme a sperm sample, send me a selfie of your testicles and I’ll take a look at how big they are and tell you what the sperm count is.
I’m like, “Dude, you gotta give me sperm.” And they’ll be like, “but I got someone pregnant when I was 18,” and I’m like, “previous paternity does not mean current fertility, and she was probably lying to you.” So just saying.
Anne Matthews: I love that you dove first into the sperm conversation because Ryan and I actually did a full episode based on the issues that I’m getting in terms of getting men to go and get, specifically, DNA fragmentation. I know it’s a good first step to do those at-home sperm tests where you’re doing the dipstick, but it’s not sufficient because it’s merely doing count and whether or not there’s any motile sperm. So we don’t know anything about morphology. We don’t know anything about DNA. Do you find in your practice that DNA fragmentation is something that you care a lot about?
Dr. Aimee: I care a lot about it, and we actually have an at-home test for that. So there is a company that has a kit that patients can order and ship to them. It’s just like a little box, so it’s super easy. I know a lot of places it’s a little bit more cumbersome with how it’s done, but we’re just lucky that we are able to do it.
So, because it’s easy, it’s around $350 to $450, like in that range in terms of dollars. So, it’s affordable for a lot of people who are thinking about, let’s say, doing IVF and I like to do it because we wanna know what our diagnosis is and see what we can do to make things even better before they go through IVF.
Anne Matthews: Can we get that in Canada? Just in the states, I’m not sure.
Dr. Aimee: I’m not sure if it’s available in Canada yet.
Anne Matthews: Because I feel like a lot of men have white coat syndrome and so that’s the barrier is that they don’t wanna actually provide anything in the doctor’s office, which feels strange given what their partner’s going through, but, nonetheless, that seems to be the case. Would you say when you are doing this, The TUSHY Method, how big of an issue for you do you find, like, polyps and blocked fallopian tubes? Is it common? Is it uncommon?
Dr. Aimee: It’s common. I mean, I think like 85% of the time a woman will not have blocked fallopian tubes the 15% of the time she will. So that’s a significant percentage of people.
And the thing is, once you find one thing, it doesn’t mean you all of a sudden close your eyes and you’re like, “that can’t be anything else.” People can have more than one thing wrong. Like you can have one blocked tube, you can have a polyp and you can have low sperm.
So you just have to still look at everything. Polyps are common. I mean, they come and go. So just because someone has one in one moment of time doesn’t mean it’s just always gonna be there. But sometimes a woman who makes a polyp can be a polyp maker. Like she just might be someone that makes polyps a lot.
So you have to be really careful, strategic and thoughtful about how and when you remove the polyp relative to when she’s going to do treatment. So for example, if I have someone who keeps making polyps, well, I’m gonna do IVF, freeze the embryos, and then I’m gonna remove the polyp and transfer right away.
I’m not gonna just waste her time removing the polyp before IVF because the IVF can stimulate more polyp growth.
Anne Matthews: Would you ever remove a polyp? Because you think that potentially it could be the issue and they don’t need IVF?
Dr. Aimee: Absolutely. Especially if it’s symptomatic. I mean, if she’s bleeding heavily, she’s spotting in between periods a hundred percent.
It’s kinda like an IUD in a way, right? Especially depending on where it’s located. So the way I describe polyps, it’s like Mount Kilimanjaro and you’re like this little sperm cell. How are you supposed to go over that mountain? I have other doctors like, oh, it’s not a big deal. I’m like, it’s not a big deal to you, because you’re six feet tall, right? You can climb over that polyp, but a little sperm is microscopic. How in the hell is that sperm supposed to navigate that mountain, it can barely navigate a cervix, let alone mount Kilimanjaro. So for me, if you see a polyp, put it in a jar before you get pregnant.
Anne Matthews: Do you find, is it ever an issue, not necessarily with the swimming over the polyp, but actually causing inflammation in the lining? Or is that less of a concern?
Dr. Aimee: Absolutely. Yeah, you don’t really know unless a polyp is adenomyosis. So you can have a polyp, you biopsy it, you send it out, and then the tissue diagnosis comes back, comes back as adenomyosis, and that can cause inflammation for sure.
The polyp can also block the fallopian tube entry into the uterus, so it can make it that your fallopian tubes might be blocked just because of this polyp. And then once you remove it, then that opens the path for the fallopian tubes for the sperm to go up because of where the polyp is located.
Anne Matthews: In your experience with unexplained infertility, , it being potentially like a myriad of those factors, have you ever found that once you’ve tracked all of the tubes, the uterus, the sperm, hormones and the genetics, have you ever been at a loss? And when that happens, where do you navigate that? Like how do you pivot?
Dr. Aimee: So the thing is, if you’re over 35 years old, you’re going through the TUSHY method and everything comes back normal, then you can say it’s most likely egg quality just because of your age.
And that’s so unfair. Can you imagine telling a 35-year-old that? But that’s reality. Our bodies were actually made to have babies by the time we’re 25. Egg quality starts going down at 25, and for some people it happens a lot faster. And for a lot of people it happens in their thirties. You have to assume that it could be an egg quality issue, and if you don’t, you’re going to miss out on your younger eggs when you still have them. So that’s one possibility.
The other possibility there could be some sort of undiagnosed fertilization issue that’s genetic. We don’t have the gene test that we can do. I mean, they’re out there. You can do whole exome sequencing, but few people are doing that. I offer it to my patients who are interested in that to see if you have any genetic defects that affect how your eggs fertilize, how your embryos grow.
Those are the kinds of scenarios that I talk patients through and I say, “look, this is what we know. These are the boxes we can check. What we don’t know are these possibilities. And you might have them and we won’t really know until you do IVF.” Because IVF is basically a very comprehensive fertility diagnostic test.
Because you get to see the eggs, and sperm come together. You get to see if the embryos grow. And then ultimately you get to see if they’re genetically normal, if you put them through PGT testing. And when I say “genetically normal,” that doesn’t mean they’re perfectly normal, just means passing genetic screening and then you can take the embryo and put it into the uterus and see if it implants.
But for the most part, that’s what I think is the reason for a lot of the unexplained infertility. It’s some sort of undiagnosed egg quality issue. Maybe a sperm also fertilizes and the embryos grow.
Anne Matthews: What would you do in a scenario where you’ve now done IVF, the PGT testing has come back with a high number of embryos being normal, what’s your next step after that?
I know a lot of REIs don’t believe in immune factors or clotting being significant. Where’s your stance on that?
Dr. Aimee: Well, first of all, I would celebrate, I’d scream at the top of my lungs and be like, “We did it!” Okay. And then the next thing is, how am I gonna prepare for my transfer? Is the home ready for the most important guest?
And the home has to be ready from head to toe. So are you feeling emotionally ready, and then look over if you’re partnered. Are we ready? Are we doing good? Because no woman gets married to have a baby that she’s gonna split with some other woman for 50% of the time.
So we really have to think through and make sure that going through this experience and looking at him, you don’t wanna kill him. If you wanna kill him, I promise you, you’re not gonna want to love him more once you have that baby. You might wanna kill him. And I don’t wanna see any of my patients on Dateline ever. I love a good dateline. I don’t wanna see a patient of mine on Dateline. And then the next thing to do is do preconception labs.
So make sure your thyroid’s normal, prolactin’s normal, vitamin D blood count. Make sure you’re not anemic. Make sure your immunizations are up to date. Do a saline sonogram. Make sure, just like you said, is there a polyp there. Like, you don’t wanna find out the polyp was there after a transfer. No.
And then last but not least, here we can actually look at the sex of the embryos. In Canada, you can’t. What I do is I look at the implantation rate per embryo, and here I’ll be able to say like, you have two males, three females. This is the implantation rate per embryo. Which embryo do you want to transfer first?
So we’ll talk through: do we have enough embryos for the family size that you want? Should we do another cycle, yes or no? And then we’ll talk about which embryo we’re going to transfer. And then we’re going to say, does it make sense to do even more testing? So even more testing, just like you eloquently brought up, would be immune issues.
So I think that immune dysfunction has a lot to do with why some of these embryos don’t implant and the patients are made to feel stupid for even bringing it up. So if a patient feels like there might be an immune, like there’s something in her gut, I’m like, well, there’s simple tests that we can do.
Very simple. So I use a company, Pregmune, P-R-E-G-M-U-N-E.com, and they’ll run an immune panel for patients. And I have a reproductive immunologist that I send my patients to. I also talk to the patient about her family history, like if her mom had a lot of miscarriages, then I’ll feel even more adamant that we should do a recurrent pregnancy loss panel, even if she’s never had a single miscarriage.
I just feel like I would want someone to look out for me in that way. So that’s why I would want to do that for the patient. And sometimes they say yes, sometimes they say no. And regardless, at least they have their options. I feel like going to a fertility clinic should be like sitting at a restaurant.
Someone gives you the menu and at a restaurant, oh, this is a good one. I mean, when you go to a restaurant, I feel like the waiter spends more time with you than some of these patients get with their fertility doctor, right? They’re explaining to you yes, what is, what the specials are and like, and then the sommelier is coming and talking to you about what you compare with your entree.
And here patients get to see their fertility doctor once for 10 minutes every six months, and they’re treated like garbage and they’re spending way more money than what you would spend at a Michelin star restaurant. I’ll get off my soapbox.
So the other thing is I talk to patients about doing implantation testing. Implantation tests are basically tests done on the lining of the uterus to look at the microbiome to see if there’s silent endometriosis, and to look at the receptivity of the lining. I don’t think everyone needs these tests, but I just want people to learn about them. And then we create a calendar together and we use a protocol that the patient likes and I talk to her about the pros and cons of the different protocols. She chooses the one that – I’ll always present what I think is best for her based on what I know, and then she’ll choose the one that she likes, and then we go from there and I make the calendar for her.
Anne Matthews: When you were discussing the implantation rate per embryo, what does that look like? Is that just the grading or is it something else?
Dr. Aimee: Yeah. So embryos get scores, right? Just like a diamond, right? So a diamond will get cut, color, clarity, right? Embryos get the same thing.
How expanded they are, the quality of the inner cell mass, the quality of the cells that become the trifecta derm. I share with my patient what those values are, and then along with that is the rate at which I think, based on the lab experience I have with this IVF lab, what the chances are that that embryo is going to implant. So that’s really important information for people to have.
Anne Matthews: And you find in your experience that that does correlate with success rate?
Dr. Aimee: Of course it does.
Anne Matthews: Because I know some embryologists. They’re very much saying that it’s a beauty contest, so it feels like there’s a lot of mixed messaging around whether the grade matters or not, and I feel like a lot of my patients are really confused.
Dr. Aimee: It a hundred percent matters, like you can’t go into Tiffany’s and just pick out any diamond and they’re all the same price. You just can’t. That’s just not how it works. Same with embryos, but the thing is an embryo that’s lower quality can still be a very high quality, strong baby.
Because what happens is once you’ve thought the embryo changes, it develops, it grows. It’ll hatch, it’ll attach, and it’ll do all the things that an embryo’s supposed to do, but an embryo that’s really strong from the beginning has a higher chance of doing those things. An embryo that looks kinda, “eh, I don’t know,” it’s like you just don’t know until you try.
Anne Matthews: No. I had one patient, and I’m friends with her doctor, and her doctor told me about this patient that her sixth PGT embryos were the ugliest embryos she’d ever seen. And she was convinced that none of them would’ve been normal. And then they all were. And when I shared this with this patient, I thought she would be “like, oh, who cares? Like I’m pregnant right now.” Right? What a funny story. But she was so upset about having ugly embryos.
Dr. Aimee: I’ve learned lessons over the years. You know, I have a patient and her embryo was a really low quality embryo, and I was like, there’s a chance. It’s about 1% based on the quality. And now her daughter is 11 years old and we call her 1%. Who would’ve known? But we gave her embryo a chance and you just don’t know. I mean, sometimes you can see an embryo is obviously not alive, right? Like there’s no chance it’s gonna work. But if an embryo is alive and you can see it, then you can give it a chance and see what happens.
Anne Matthews: In terms of AMH. So one of the things that I will direct patients to on your website specifically is the tab where we’re finding out our fertility potential. So I love the fact that you actually have a multitude of factors to test, so it’s not just, antral follicle count and AMH, but rather the full spectrum of, you know, AMH, FSH, estrogen… And I know here in Canada there’s a lot of clinics where they’re still just doing AMH, if you could speak to that, I would be forever in debt.
Dr. Aimee: Just doing an AMH does a disservice to a patient because it’s just one snapshot in time.
And I call AMH a few things: always meandering hormone and always mean hormone, right? So it comes up and down and so some, and then also it could be wrong. You can get 1 AMH, it could be 1.5, and the patient’s like, “oh, I’m great. I have the eggs of a 25-year-old and I’m 45.” I’m like, no, that’s not true.
But there’s a high likelihood that AMH could just be a lab error or a lab variation. There’s something wrong with it. So if you get something that just doesn’t seem right, if it’s too low or too high or inconsistent with what you’ve had the year before. So if, let’s say last year it was one and all of a sudden this year is three, one of them is wrong.
So the way you know which one is wrong is, you back it up with other data points like your follicle count. And the thing is you can have a high AMH and a high FSH, and that implies that maybe you have a high number of eggs, but the quality may not be very good. So that’s why I look at them all together.
And the thing is, like, patients are shocked. They’re like, my FSH was eight last month and now it’s gone all the way up to 20. And I’m like, wait a month it’ll go back down. Because FSH fluctuates, right? But watching how it fluctuates and understanding the trends really helps. There’s a company that I refer patients to, it’s Proov.
They have this test called the Complete Testing System. And basically you just check your FSH, it’s a urine test. Nothing too fancy and it’s something that you can monitor over whatever number of cycles that you would like to just get an understanding as to how these levels are changing for you.
Anne Matthews: The thing I think I took away the most from listening to your podcast, was that you spoke a lot about the importance of caring for your patients as a human, and that success rate really would go up when patients felt like they were properly supported by their doctor. And I was wondering if you had what patients should be looking for when they’re interviewing for a doctor, because I think a lot of the time you’re set up with a clinic and then you’re just hoping that that will be good enough.
And I feel like you actually waste more time when you just go with whatever’s the fastest instead of trying to find the right person for you. If you had a list of advice that would be so helpful.
Dr. Aimee: I do have a list. I think the red flags are if a clinic says to you, I guarantee that you’re gonna be pregnant and they give you a date, no one can do that.
No one. If, let’s say, they don’t want to do additional tests, like if they haven’t done an AMH or they’re not looking at sperm, that’s a red flag. Like this is the clinic that just wants to get you into IVF right away. If, for example, they aren’t making your priorities theirs. And what I mean by that is you could be someone that says like, “I really don’t wanna use birth control pills to start off my cycle.
Or “I really wanna use this type of protocol. I want it to be gentler. I just wanna use less meds.” If they’re pushing a different protocol and you don’t feel comfortable with that, those are red flags. If they’re pushing, let’s say freeze all with genetic testing, and that’s not what you wanna do, that’s a red flag.
So you just wanna make sure that the clinic system that you’re working within is set up to honor your priorities and prioritize them and make them theirs and not vice versa. Like you don’t wanna work with a doctor that’s like, “you’re gonna do IVF. If it doesn’t work, then we’re gonna do donor egg and otherwise you’re not coming back here.”
And sadly, there are a lot of clinics that are set up that way. They’re set up and patients tolerate that because they don’t have any other choice. Like, there’s no other clinic within a 200 mile radius from them.
Anne Matthews: So in terms of the actual, like, psychology behind patients that are seeing you, because I follow a couple of your patients as well. And the way that people feel cared for in terms of a psychological level, when you’re approaching somebody, do you have a method that you go into a meeting with or is it sort of consistency and empathy and just being a generally decent human being?
Dr. Aimee: So from start to finish, meaning the start of when they reach out to the practice to finish at that initial consult, I try and make sure they know how important they are to us.
So we take their request to become patients as such an honor and a privilege and I also spend a lot of time reviewing their records, and I have a whole list of things that I request before the first interview. So I want all their records. I want operative reports. I wanna see their PGT reports. I wanna see your Mira app data that you’ve collected for the last five years.
Like, everything I want and I review it ahead of time. I create basically a single-spaced typed summary of everything that you’ve presented to me. Then I write a summary, plus I give all my recommendations at the time of the new patient consult. So I’m reviewing the summary as I’m asking questions about things that maybe were not clear in the records, but then I’m also giving my recommendations in terms of, like, supplements, protocols, additional tests that they should do.
And then I just wrap it up by making sure that they understand what their diagnosis is. What I think their prognosis is and what the treatment options are that they should be considering, and the pros and cons of each. But I basically start off the consult by saying like, “I know it’s been hard for you during this journey, okay? You don’t have to sit here and tell me about every cycle and how many eggs you got. Like I know that, what I want to know is, what do you think is wrong? Like, what have other people not listened to you about?”
And then they’ll be like, “no one is taking me seriously, and this is what I think I have.”
And then I’ll say, like, “that’s exactly what I think you have.” Or I’ll be like, “I think you’re close. But I think it’s something similar to that. I think it’s this.” I spend the time ahead of my new patient appointments, like already going through their records. So I’m not one of those doctors like, tell me what’s going on, you know, and waste like 30 minutes for them to tell me their story.
No, I’ve already read the story. I already know what I want to do and I just wanna make sure that they feel heard and they know what their options are. And then I set up follow up calls afterwards just to answer any questions, review any tests that we do together, and then they’ll do an ultrasound and then we’ll go into treatment. Or I’ll support them during their treatment with another clinic if they’re not doing it with me. If, let’s say they live out of state or out of the country.
Anne Matthews: in Terms of supplements, I have questions about what you think egg quality adjuncts(?), so, like growth hormone, you know, DHEA and whether or not you think that they’re useful, if you suspect that egg quality is a concern.
Dr. Aimee: So I think HGH is worth trying. I don’t know that it’s gonna help everyone, but I’ve seen it help tremendously for enough patients that I feel like it’s worth it. So, Saizen, Omnitrope, and Zomacton, like, I think they all basically perform the same.
DHEA is a no in my book, I think it can cause side effects. Oily skin, acne, changes of the voice, hair loss, and I don’t see that as something that I have ever felt to be that beneficial. The things that I find to be beneficial are really good.
Prenatal, CoQ10, NAD, and that’s through TruNiagen, melatonin. I think I shared with you resveratrol. And then if a patient might have endometriosis, I have her add NAC, and if she has PCOS, I have her add Ovasitol. That’s just typically what I recommend to patients and then, they can clearly choose whatever brand they want and I’ll support them with that.
But I ask them to take it right away after we meet. And I don’t think that they should be on them for three months before we start treatment. I’m fine with them starting them, and then whenever our treatment starts, it starts.
Anne Matthews: I love that you’ve mentioned all of those supplements. I also love that on your website you even have a little section about learning about acupuncture and it is so accurate and a lot of the time the explanations of acupuncture are not.
So, I was wondering how you started encouraging patients to do acupuncture and whether or not that’s been something that you’ve been doing for a while because you’ve anecdotally seen it be helpful or because of just research?
Dr. Aimee: Since the beginning, and it’s all of the above. Basically acupuncture has been shown, I think, to tremendously for a lot of patients decrease nausea, decrease pain symptoms, decrease bloating.
So if you do those things, your physical experience as a patient will go up, your mood will improve. For some patients, not everyone, it decreases stress. It helps them sleep better. It affects their mood in a positive way. And so if you’re going through something that can feel pretty crappy, like getting hopped up on hormones and have cycles that don’t work, having acupuncture as a way to support you during your cycle is great.
I think people need as many cheerleaders on their squad. You need a big squad when you go through something as hard as this. So I tell patients to build their fertility TEAM up front with a therapist and exercise your routine and acupuncturist and a meditation practice.
So I find that acupuncture and the role it plays is really important. For some patients, they don’t enjoy it. They just don’t. I’m like, “don’t. I’m not gonna acupuncture shame you.” But for other patients, I’m like, if you enjoy it, do it. But if you don’t enjoy it, maybe at least consider a pre and post.
But like on the day of the transfer, do a session 30 minutes before and 30 minutes after.
Anne Matthews: Do you have a preference for men’s supplementation as well? Do you incorporate that?
Dr. Aimee: Yeah, same thing. Conception XR, CoQ10, fish oil, vitamin D, and TruNiagen. So those are the typical things that I have guys take. And of course, what are they gonna do?
They’re gonna complain. Oh, it smells gross. Oh, it’s too many pills.
Anne Matthews: I’ve actually, I’ve walked out before because I had a patient who, her partner didn’t wanna stop using, uh, cannabis. Yeah. And she was having to do IVF because his motility wasn’t going up. Yeah. And I was because she was more concerned about his self-care – his cannabis self-care…
Dr. Aimee: Yeah. “It’s gonna hurt his mental state if he stopped,”
Anne Matthews: I left.
Dr. Aimee: Yeah, I know.
Anne Matthews: My receptionist was like, “she’s not coming back.”
Why did you start in infertility? What drew you to fertility?
Dr. Aimee: I went into this field because of my family and my grandfather was an OBGYN. My dad was an OBGYN. It’s very personal. And then my mom went through miscarriages.
And so when I was a young girl, I saw her go through that. And so I decided to do research on miscarriages at a very young age. I started when I was in college, spending my summers in Boston at the recurrent miscarriage center at Harvard. I got a scholarship to do that in my last year of college.
I just knew that being a fertility doctor was the go-to doctor for patients of miscarriages. So that’s basically the story as to why I went into this.
For me, I have this great capacity to show people love and people ask, how are you not burned out? I’m like, I don’t know. I’m just really lucky. I’m so blessed that I actually love the world so much that I want to bring more love into it. And there’s actually no better way of doing that than by helping people become parents.
There’s no better way. So I love the work. And in all seriousness, if someone calls me because their period started and I’m asleep, I am like, that is really important to her. This is a very big deal for her and she’s really upset by it. I’m gonna show her love.
I want my patients to know that they matter, even before they’re a mommy and their life has purpose even without being mommy. A lot of people are made to feel bad when they even have one child and they’re told like, you should just be happy you have one. And I tell my patients like, I would love to help. You have as many babies as you would like. That’s not a sign of selfishness. It’s the opposite. Having kids these days is not selfish.
I mean, my 50-year-old patients, I have a very large practice of 50-year-old patients.
Anne Matthews: You have a large practice of 50-year-old patients.
You heard it here,
Dr. Aimee: You heard it here, Ann, first. My prediction is our children are not gonna have kids until they’re 50. That is the new normal. It’s happening already. It’s happening already in the Bay Area.
Anne Matthews: Is that. With their own eggs or is it with donor eggs?
Dr. Aimee: No, it’s with donor eggs. But because so many in the Bay area, probably 50% of women who are working in a certain industry, at least 50% have already frozen their eggs.
And a lot of them are gonna wait.
Anne Matthews: Right?
Dr. Aimee: And they’re going to wait and they’re going to be showing up at my door at 50 and they’re going to be their own egg donors. Because they would have frozen their eggs.
Anne Matthews: Yeah. So right now I’m actually getting my first batch of patients who were freezing their eggs in their early twenties, late twenties.
But heartbreakingly, they’re not having the sperm checked first. Or they might do something, I’m assuming they’re doing, like, motility at least, but they’re not checking morphology, they’re not checking DNA fragmentation. And then they are using that sperm to fertilize these perfect eggs and ending up with no embryos.
And now they’re having to do retrievals at like 41, 42, right?
Dr. Aimee: It’s ridiculous. This is why I throw egg freezing parties. And now, I mean, I should throw egg thawing parties just to warn people, but I have an article on my website, it’s called Egg Thawing Party: What to Do Before the Big Unfreeze is basically like your checklist of all the things that you should look at, and it includes sperm.
It includes the sperm, the guy taking supplements. It includes advanced genetic tests like carrier screening, chromosome analysis, because you don’t wanna thaw your eggs and find out that he had a chromosome issue and you would’ve that’s not when you wanna find this out, especially when you’re thawing your eggs at an age when you don’t have healthy eggs left.
That’s why I’m so picky about what we do before we thaw eggs.
Anne Matthews: In terms of when you have an older patient who’s wanting to freeze their eggs, are you requesting that potentially they just freeze their eggs or, or do you encourage them to freeze embryos with donor sperm?
Dr. Aimee: Yeah, so what I tell them, look, “you’re freezing your eggs at an age where you, your eggs are most likely not going to be healthy. So you just might be freezing bad eggs. That’s not your fault. It’s just how life is. But I encourage you to go through this process. But if you don’t wanna have false hope around what you’re freezing and actually know if your eggs have a chance to become. A baby. And the only way you know that is if they can become an embryo. Let’s make embryos, let’s do it. Like what are you waiting for?”
And some of them are like, I really want a husband. I’m like, “then let’s wait for that man, but your eggs aren’t gonna wait for you.” So I just tell patients, “why don’t we just change how we think and think about the love of being a mother and a parent and not make this about finding a man. And maybe by being a parent, you might meet the man.”
That’s what a lot of women are doing now. And so being a mother sometimes changes you, changes the crowds that you are in and the friends and the people that you meet, and it just expands your social circle in a way that you might meet that person that was meant to be the father of your child.
I highly encourage that people think about making embryos, if they’re freezing eggs at an age when, more likely than not, their eggs will not be healthy.
Anne Matthews: Well, that’s it. I love when you said that IVF is like a really intense diagnostic test. Because I think of it the same way, and it’s really hard to have patients who are wanting to freeze their eggs. They’re only getting like six, eight eggs. I’m like, “please, I beg you. Fertilize at least four of them.” They’re so opposed to the idea of using donor sperm, but they’re more comfortable with the idea of potentially later using donor eggs.
Dr. Aimee: Isn’t that interesting? We always put the man’s ego first.
Anne Matthews: Yeah.
Dr. Aimee: Even when the man’s even older than you. And so any time I have a patient who, let’s say she’s in her early forties and the husband’s over 50, I say, “look, you could be sacrificing the one good egg you have for his sperm.”
Anne Matthews: Yeah.
Dr. Aimee: And I’ll say, “if you’re okay with that, then let’s do it. But you can’t come back and say, why didn’t you offer me donor sperm? I heard that if a man’s over 50, there’s a higher likelihood that his sperm is gonna be genetically abnormal. Why did you do that?”
So no one can say that to me. I just tell them how it is.
Anne Matthews: I love that you tell your patients that. Now you’ve told all of our listeners this very important tidbit of advice. Dr. Aimee, thank you so much for taking time out of your extremely busy day and being on this podcast, I can’t even tell you how much I appreciate it.
This is such an honor and I really appreciate it so much.
Dr. Aimee: Thank you for your time. Thank you for all the love you’re giving your patients and all the things that you’re also doing to bring more love into this world.
It really matters and it’s so important.
