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#352 ‒ Female fertility: optimizing reproductive health, diagnosing and treating infertility and PCOS, and understanding the IVF process | Paula Amato, M.D.
Listen to this episode from The Peter Attia Drive on Spotify. View the Show Notes Page for This EpisodeBecome a Member to Receive Exclusive ContentSign Up to Receive Peter’s Weekly NewsletterView our full terms of useThis is part two of a two-part mini-series on fertility and reproductive health. Paula Amato is a leading expert in female reproductive health and infertility, widely recognized for her contributions to advancing fertility treatment and research. In this episode, which follows last week's conversation on male fertility, Paula explores the biology of female fertility, including how hormonal changes regulate the menstrual cycle and ovulation, what those patterns reveal about fertility potential, and why both partners should be evaluated early in infertility workups. She discusses the role of the fallopian tubes, the causes of miscarriage, the impact of age and lifestyle on fertility, and treatment options for conditions like PCOS—including the emerging use of GLP-1 agonists. The episode also covers the evolution of IVF, advances in pre-implantation genetic testing, egg freezing, and the promise and limitations of next-generation reproductive technologies.We discuss:0:00:00 - Intro0:01:15 - The finite nature of a woman’s egg reserve, how it changes over time, and the basic process of ovulation and fertilization0:03:48 - How hormones influence egg selection, and how and why chromosomal errors lead to most miscarriages0:15:52 - The full journey of conception—from hormonal cues triggering ovulation, to fertilization, embryo development, implantation, and early pregnancy risks0:25:40 - How infertility is defined and diagnosed, and the broader trends contributing to rising infertility rates0:32:21 - Fallopian tube damage: how STDs and scarring impact fertility and raise ectopic pregnancy risk0:42:56 - Unexplained infertility: how doctors evaluate ovulation and cycles—and why more research on women’s health is needed0:46:11 - The defining symptoms of polycystic ovary syndrome (PCOS), its hormonal characteristics, and its relationship with insulin resistance0:48:27 - Managing PCOS without pregnancy: cycle regulation, androgen suppression, and insulin resistance treatment0:52:32 - The treatment approach for women with PCOS who are trying to conceive: GLP-1 use, ovulation induction, and timing protocols0:59:11 - Barriers to getting informed fertility care for PCOS: limited provider knowledge and access, insurance gaps, and next steps when ovulation treatments don’t lead to pregnancy1:06:44 - Fertility treatment for women with unexplained infertility, risk of multiple pregnancies with superovulation, and more1:10:57 - Intrauterine insemination (IUI): process, success rates, and when in vitro fertilization (IVF) becomes the better option1:22:15 - The history of in vitro fertilization (IVF), and how access and acceptance have evolved over time1:25:36 - The step-by-step process of IVF1:33:12 - The IVF lab process: egg retrieval, fertilization, embryo culture, and freezing1:50:00 - Genetic testing and embryo selection in IVF: aneuploidy screening, polygenic traits, and ethical concerns1:57:00 - Embryo transfer in IVF: timing, uterine preparation, and implantation support2:01:00 - Egg donation in IVF: indications, donor guidelines, and other considerations2:05:25 - How to choose the right IVF clinic2:13:34 - Innovations in fertility on the horizon, advice about freezing eggs, and more2:20:12 - Optimizing fertility through lifestyle: diet, stress management, sleep, exercise, and supplementation2:29:25 - Promising areas of fertility researchConnect With Peter on Twitter, Instagram, Facebook and YouTube
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#352 ‒ Female fertility: optimizing reproductive health, diagnosing and treating infertility and PCOS, and understanding the IVF process | Paula Amato, M.D.
Listen to this episode from The Peter Attia Drive on Spotify. View the Show Notes Page for This EpisodeBecome a Member to Receive Exclusive ContentSign Up to Receive Peter’s Weekly NewsletterView our full terms of useThis is part two of a two-part mini-series on fertility and reproductive health. Paula Amato is a leading expert in female reproductive health and infertility, widely recognized for her contributions to advancing fertility treatment and research. In this episode, which follows last week's conversation on male fertility, Paula explores the biology of female fertility, including how hormonal changes regulate the menstrual cycle and ovulation, what those patterns reveal about fertility potential, and why both partners should be evaluated early in infertility workups. She discusses the role of the fallopian tubes, the causes of miscarriage, the impact of age and lifestyle on fertility, and treatment options for conditions like PCOS—including the emerging use of GLP-1 agonists. The episode also covers the evolution of IVF, advances in pre-implantation genetic testing, egg freezing, and the promise and limitations of next-generation reproductive technologies.We discuss:0:00:00 - Intro0:01:15 - The finite nature of a woman’s egg reserve, how it changes over time, and the basic process of ovulation and fertilization0:03:48 - How hormones influence egg selection, and how and why chromosomal errors lead to most miscarriages0:15:52 - The full journey of conception—from hormonal cues triggering ovulation, to fertilization, embryo development, implantation, and early pregnancy risks0:25:40 - How infertility is defined and diagnosed, and the broader trends contributing to rising infertility rates0:32:21 - Fallopian tube damage: how STDs and scarring impact fertility and raise ectopic pregnancy risk0:42:56 - Unexplained infertility: how doctors evaluate ovulation and cycles—and why more research on women’s health is needed0:46:11 - The defining symptoms of polycystic ovary syndrome (PCOS), its hormonal characteristics, and its relationship with insulin resistance0:48:27 - Managing PCOS without pregnancy: cycle regulation, androgen suppression, and insulin resistance treatment0:52:32 - The treatment approach for women with PCOS who are trying to conceive: GLP-1 use, ovulation induction, and timing protocols0:59:11 - Barriers to getting informed fertility care for PCOS: limited provider knowledge and access, insurance gaps, and next steps when ovulation treatments don’t lead to pregnancy1:06:44 - Fertility treatment for women with unexplained infertility, risk of multiple pregnancies with superovulation, and more1:10:57 - Intrauterine insemination (IUI): process, success rates, and when in vitro fertilization (IVF) becomes the better option1:22:15 - The history of in vitro fertilization (IVF), and how access and acceptance have evolved over time1:25:36 - The step-by-step process of IVF1:33:12 - The IVF lab process: egg retrieval, fertilization, embryo culture, and freezing1:50:00 - Genetic testing and embryo selection in IVF: aneuploidy screening, polygenic traits, and ethical concerns1:57:00 - Embryo transfer in IVF: timing, uterine preparation, and implantation support2:01:00 - Egg donation in IVF: indications, donor guidelines, and other considerations2:05:25 - How to choose the right IVF clinic2:13:34 - Innovations in fertility on the horizon, advice about freezing eggs, and more2:20:12 - Optimizing fertility through lifestyle: diet, stress management, sleep, exercise, and supplementation2:29:25 - Promising areas of fertility researchConnect With Peter on Twitter, Instagram, Facebook and YouTube
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#352 ‒ Female fertility: optimizing reproductive health, diagnosing and treating infertility and PCOS, and understanding the IVF process | Paula Amato, M.D.
Listen to this episode from The Peter Attia Drive on Spotify. View the Show Notes Page for This EpisodeBecome a Member to Receive Exclusive ContentSign Up to Receive Peter’s Weekly NewsletterView our full terms of useThis is part two of a two-part mini-series on fertility and reproductive health. Paula Amato is a leading expert in female reproductive health and infertility, widely recognized for her contributions to advancing fertility treatment and research. In this episode, which follows last week's conversation on male fertility, Paula explores the biology of female fertility, including how hormonal changes regulate the menstrual cycle and ovulation, what those patterns reveal about fertility potential, and why both partners should be evaluated early in infertility workups. She discusses the role of the fallopian tubes, the causes of miscarriage, the impact of age and lifestyle on fertility, and treatment options for conditions like PCOS—including the emerging use of GLP-1 agonists. The episode also covers the evolution of IVF, advances in pre-implantation genetic testing, egg freezing, and the promise and limitations of next-generation reproductive technologies.We discuss:0:00:00 - Intro0:01:15 - The finite nature of a woman’s egg reserve, how it changes over time, and the basic process of ovulation and fertilization0:03:48 - How hormones influence egg selection, and how and why chromosomal errors lead to most miscarriages0:15:52 - The full journey of conception—from hormonal cues triggering ovulation, to fertilization, embryo development, implantation, and early pregnancy risks0:25:40 - How infertility is defined and diagnosed, and the broader trends contributing to rising infertility rates0:32:21 - Fallopian tube damage: how STDs and scarring impact fertility and raise ectopic pregnancy risk0:42:56 - Unexplained infertility: how doctors evaluate ovulation and cycles—and why more research on women’s health is needed0:46:11 - The defining symptoms of polycystic ovary syndrome (PCOS), its hormonal characteristics, and its relationship with insulin resistance0:48:27 - Managing PCOS without pregnancy: cycle regulation, androgen suppression, and insulin resistance treatment0:52:32 - The treatment approach for women with PCOS who are trying to conceive: GLP-1 use, ovulation induction, and timing protocols0:59:11 - Barriers to getting informed fertility care for PCOS: limited provider knowledge and access, insurance gaps, and next steps when ovulation treatments don’t lead to pregnancy1:06:44 - Fertility treatment for women with unexplained infertility, risk of multiple pregnancies with superovulation, and more1:10:57 - Intrauterine insemination (IUI): process, success rates, and when in vitro fertilization (IVF) becomes the better option1:22:15 - The history of in vitro fertilization (IVF), and how access and acceptance have evolved over time1:25:36 - The step-by-step process of IVF1:33:12 - The IVF lab process: egg retrieval, fertilization, embryo culture, and freezing1:50:00 - Genetic testing and embryo selection in IVF: aneuploidy screening, polygenic traits, and ethical concerns1:57:00 - Embryo transfer in IVF: timing, uterine preparation, and implantation support2:01:00 - Egg donation in IVF: indications, donor guidelines, and other considerations2:05:25 - How to choose the right IVF clinic2:13:34 - Innovations in fertility on the horizon, advice about freezing eggs, and more2:20:12 - Optimizing fertility through lifestyle: diet, stress management, sleep, exercise, and supplementation2:29:25 - Promising areas of fertility researchConnect With Peter on Twitter, Instagram, Facebook and YouTube
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