The Secret to Understanding Your Fertility (with Dr. Lauren Sundheimer)
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Hello, Secret Squad. It's Wednesday, my favorite day of the week. I'm back with a brand new episode of I've Got a Secret, and it's going to be packed full of information. Dr. Lauren Sunheimer is a reproductive endocrinologist at Newport Fertility Center, a CCRM Orange County clinic. She is brilliant. She is a fertility, pregnancy, and family planning expert.

I have received a lot of feedback from the Secret Squad that these are topics you want. So you want to know more about it, we're here tackling the secret to understanding your fertility. As a mother of two,

lot to talk about on these topics as well. I can't wait. Dr. Sondheimer, thank you so much for taking time out of your very busy schedule to chat with me today. It is my pleasure. Thank you so much for having me. I'm excited for our chat. I am too. I meant it when I said just now that the Secret Squad have all written in, so many written in and asked to talk about these very topics, fertility,

pregnancy, family planning. And I have to tell you, I agree. It's a very important topic for all women and of course, and men, but especially women. And you are just the one to be answering all of these very important questions. So let's get started. How about it? Yes, absolutely. Okay. So talking about fertility can be, I think, a very sensitive topic. Can you first speak to how common fertility issues actually are?

Yeah, so that's a great point. It is very common. It's something that we're starting to hear more and more about because women are having a more dialogue about it. So I think that that's great. It can be very sensitive. And unfortunately, getting pregnant isn't as easy as they made it seem in sex ed back in the day. So a woman is at her peak fertility when she's in her 20s.

And even then it's not super efficient. It's only about 25% per cycle. So women in general can have trouble getting pregnant. And then women who are infertile or are unable to get pregnant despite their attempts is very common. It's about one in eight couples. So there's a good chance that either you or somebody you know is affected. And so it's out there. And I think it's great for us as women to talk about it so that it's becoming more of a topic.

I agree. The women here in the office that work with me, we've had a lot of conversations about it and they all agree it's not talked about enough.

They're all young. I have a lot of young women in their early 30s that are really, really wondering about what to do and what to think about it. And they're all saying, you know, there's just not enough conversations going on about it. And I really don't know what to do. Should I do this? Should I do that? So that's why I'm happy that we're having this conversation. And for you to say one in eight couples suffer from issues is really scary. Yeah.

Yeah, it's super common and people don't even realize and it can be very isolating. But if we start talking about it more and more, people realize they're not alone and there's things we can do. And so it's great that we're having discussions about it. Yes. OK, what factors can affect a woman's fertility?

So really, age is one of the biggest factors. Unfortunately, there's nothing we can really do about that. But age is something that contributes. And so that's why we recommend women trying to get pregnant at a younger age or if they know they don't want to get pregnant, then freezing their eggs or their embryos or doing something to preserve their fertility. The other things that can influence fertility are things that we need to get pregnant. So

ovaries and the eggs inside of the ovaries, if the woman isn't ovulating regularly, or if her fallopian tubes are blocked for whatever reason, or if, for example, there's an issue with the uterus. So any of these factors can contribute to a woman's inability to get pregnant. Wow. So are you saying that the sooner you start thinking about your future pregnancy, the better?

Yeah. So if it's something that, you know, you want for the future and you have the ability to preserve your fertility at the current moment. So the youngest eggs are the best eggs. So what you have right now is the best it's going to get because it only gets older with time. So if you're able to preserve your fertility and know that that's something that you want for the future, I highly encourage anybody who's considering it. I've never had a patient who was like, oh, you know, I really wish I would have waited longer. They're always so happy they did it when they did or they wish they had done it sooner. Yeah.

Wow. I've said many times I always knew I was put on this earth to be a mother. So I'm not saying that I started in my teens looking towards that future. I knew it, but I didn't do anything towards that goal. But I do remember that I started learning.

seeing the doctor just simply because my mother thought that that was important that I I had three sisters so she had her four daughters in the doctor's office having our regular checkups and such and so I always knew I was going to be a mother and I did do my checkups like I needed to and I was very thankful that I got pregnant right away when Phillip and I decided to start our family I had our first son at the age of 26 because

And because I'm 66, I can say that back then at that time, 26 seemed kind of old to start my family. In my generation, 19 and 20, 21, 22 years old was about the time people started having children. And waiting until I was 26, Phillip and I decided at that age we would start our family. And that seems quite young in this day and time.

A lot of people are focused on career and other things that they want to travel or meet the right person or get their education. And so I think that we're seeing more women delay their their family planning and fertility timeline. And so that's why it's great that we have the option to do fertility preservation like egg freezing so that women can still do the things they want to do and know that they still have that as an option for the future.

So that was going to be my next question. So even though 20s seem young now in this day and time, do you suggest that women in their 20s start looking into freezing eggs?

Women in their 20s absolutely can. It's something that you have to weigh kind of your own personal choice. So it's something that you can do. A lot of women in their 20s kind of want to keep the door open and maybe they're going to meet Mr. Right and start their family soon. So I would say I mostly see women in their 30s, sometimes in their 20s. But it really depends on the woman and what her goals are, what her preferences are. So what are some of the signs that a woman can look out for that she might have trouble getting pregnant?

So it can be anything from not having any sort of signs, which is always the most concerning because some women just don't know. But if they have symptoms like irregular menstrual cycles, or they have something like endometriosis, where they have really painful periods, if they have certain hormonal conditions, or they know that they have a uterine anomaly, so it's something that just they were born with, all those things are kind of predisposing you to having issues and difficulty getting pregnant. And so if you have those, then it's always recommended to seek out a

fertility doctor or see your doctor to talk about options early. And do genetics play a part? If your mother had trouble conceiving, does it mean that you might as well? It could potentially. So what is linked definitely to genetics and when your mom went through menopause is very tied to when you're likely to go through menopause. So if your mom did go through early menopause, then it would be worth talking to your doctor about maybe what you should be doing or thinking about because there's a chance that you could go through early menopause too.

I think that plays such an important part in a woman's overall medical history to learn as much as she can while your grandmother and your mother is still alive and living and healthy and always do that before it's too late. Don't you agree? Absolutely, because you never know what information you're going to get. And so it's always good to have more information than less. How do you feel like birth control can affect a woman's fertility?

So in general, it shouldn't really impact a woman's fertility. Women, if they're on birth control pills, even for a long time, shouldn't have any sort of fertility issues. It doesn't contribute to having any sort of fertility problems being on birth control for a long time. It may, however, mask an issue that you didn't know was there. So birth control can help regulate menstrual cycles. So for example, if a woman has irregular cycles, but it's on birth control, she won't ever know that her cycle is irregular because she's been on the birth control.

So it can kind of mask certain things, but it itself should not be an issue. It used to be that women wouldn't get IUDs or intrauterine devices because it was thought to not be good for fertility, but that's no longer the case. The only exception really to the rule is that there's a birth control shot

called Depo-Provera, and that is something that can delay a woman's ovulation. So even after she's had the shot, it can take a little bit of time for her body to come back and ovulate again or release an egg. And so for women who are wanting to become pregnant, I would maybe recommend a different form of birth control if you're planning a pregnancy in the near future.

How long does that shot take to allow you to then ovulate once you quit taking the shot? It kind of depends. Each woman is different. Most women will still go on to ovulate and be okay, but there are some cases where it can take up to a year and a half or two years even for the ovulations to resume back. So it's just something that if you're even thinking about it, try a different form of birth control so that you don't have to have that be a future issue. So how do you feel that birth control affects a woman's overall health?

So for a woman's overall health, birth control can help in a lot of ways in addition to just contraception. So to prevent pregnancy is obviously a huge benefit and one that's most commonly used. But birth control is great for a lot of other reasons. So women who take birth control pills have a protective effect on ovarian cancer and uterine cancer. It's also good to help regulate menstrual cycles, as we talked about. And it's also good for things like decreasing the flow. So women who have heavy periods,

It also helps for women who have painful periods, if they have acne or PMS. So there's tons of good options that birth control can help with. Wow, that's wonderful to hear. So let's talk about freezing eggs because, as I mentioned earlier, I have a staff of some young women, and that was one of the topics we've been talking about lately. So let's talk about freezing eggs. What is the average age range that you see come in for this process? Yeah.

So I would say it's probably women in their 30s. We don't have any sort of cutoff at the center that I work at, CCRM. And so we just talk to women about the pros and cons of whatever age you're at and if it's worth it and whatnot. So there's no kind of strict cutoff, but really the best eggs are when they're younger. So whenever you can do it, I still do it. So what does the egg freezing process entail?

Great question. So you always start with kind of initial evaluation. So you would talk to the doctor, you would go through the process and do some initial screening and what's called testing your ovarian reserve. So looking at your ultrasound, your blood work, making sure your hormones look good and that you're a good candidate to freeze your egg.

And then once we've determined that you are, we do a process of kind of taking over your body's natural hormones with our injectable hormones. So a woman will do about 10 to 12 days of injections each day, plus or minus. And then once she's ready and her eggs are appropriate size based on our ultrasound and our blood work, then she does a trigger shot, which is the very last injection before we then remove the eggs from her body and freeze them.

Wow. Can you give us a price range of the entire procedure? So it varies from clinic to clinic. There's no kind of set in stone across the board cost. It is a relatively expensive procedure to do. It costs anywhere from the range of maybe $15,000 to $20,000. It depends, again, on your location. And there's also a medication cost that goes along with that because each woman has different medication requirements. So it kind of varies.

Well worth it, though, I should say. Is there an annual fee to keep the eggs frozen? There is. So you do pay a yearly storage fee, and that's to guarantee that the eggs are still safe and frozen and that the security measures are all in place so that you can have them for use when you're ready. Is it common to have the facility that retrieved your eggs freeze your eggs?

Yeah, so it's all tied directly to where your eggs are removed, because once the eggs are removed, they go straight into the embryology lab where they're then there. You have to remove the extra outer cells from the eggs and then they get frozen right away. So you have to have it kind of directly there. And then some locations store their eggs and their embryos at different places. But here at CCRM in Orange County, we store our embryos on site.

And I know there's no real way of knowing exactly how long someone's going to keep their eggs frozen, but what's the healthiest amount of time to keep an egg frozen?

So there's really no cutoff by a point at which you need to use the eggs. It depends on a personal choice. We do know that it's the ovary and the eggs that contribute to the difficulties in pregnancy. It's not the uterus that's getting older. So you can put the eggs back once they've been frozen whenever a woman is ready. So the process would be to thaw the eggs and fertilize them and put them back. I would say most people do it within weeks.

five years or so, but we can do it up to 10 years and potentially even longer. Wonderful. Is egg freezing a guarantee for a future pregnancy?

Oh, I wish it was. I wish that I could guarantee anyone who wanted a free fee. But unfortunately, it's not. Nothing is 100%. The more eggs you have, the younger eggs that you have, the higher your chances. But there's no guarantee because unfortunately, we're just looking for the good egg, the healthy egg, and we don't know when that's going to be. What's an average amount of eggs do you retrieve for that fee?

So it depends on where a woman is starting. So each woman starts off from a different place and we can grow the eggs that she has. We can't necessarily create eggs that she doesn't already have. So if a woman has a certain number of eggs to start with, usually we can kind of estimate out where she's going to be. It kind of just depends, but I would say a good kind of goal is usually about 10 to 15 approximately. Wow. How exciting. Now, again, I apologize if I

if I'm asking stupid questions, but I'm very curious about this. So let's say a woman comes in, you've retrieved 10 eggs, 10 healthy eggs, and she wants to attempt to get pregnant. Do you thaw all 10 eggs and implant or know how many are healthy enough to implant at that point? And then are you able to refreeze them?

So yeah, so we're able to, when a woman says, okay, I'm ready, I want to sort my family, I want to fertilize the eggs. The process then is that we would want to check with partner, make sure that the sperm looks good that she wants to use. And then we thaw the eggs. We then fertilize the eggs with a procedure called ICSI, which is the cytoplasm sperm injection. And that's where we actually push the sperm into the egg. And then we watch to see how the fertilization occurs.

So then once the egg is fertilized, it's called an embryo, and we can then allow that to grow for about a week before we then can do extra genetic testing if interested on the embryo and then put it back into her body. If the embryo is going to have a genetic testing, we do freeze it again to wait for those results. Otherwise, we can potentially time things up if needed, but I would say most of the time it does get frozen again.

Oh, I see. Interesting. If a woman previously successfully conceived a child naturally, is it still possible she could experience difficulties conceiving naturally a second time? And why? Yeah, unfortunately. So this is called secondary infertility. So having not had any issues with the first pregnancy and having the baby and then crying again.

Unfortunately, a woman can have difficulty and it can be for any of the same reasons for having difficulty for the first time. So anything from issues with the sperm and making the sperm all the time. So that can change. But there can also be maybe scar tissue or a previous infection that can have issues with the uterus or the foreskin too.

issues with the ovaries, et cetera. So all these things are kind of dynamic and they can change with time and a prior pregnancy can modify things. So we'll always, if you're having trouble getting pregnant again, a second time, we want to have an evaluation to see if there's anything that can be corrected.

Could it also be just something environmentally or just what's going on in her life at the time? Her stress levels have changed. So many things have changed. That is very likely a possibility, correct? Yes. Yeah. There's a lot of factors that go into fertility beyond the anatomic. So there's things even, you know, sleep and stress and all these things can kind of impact you and your stress level, your hormones are all influenced by each other. So really trying to get in your best mental state, physical state, all of that is important. Yeah.

You know, I can remember when I was pregnant with our first child and even our second child. And I'm one of those that just I have to research everything I can with whatever's going on with my body and of course with pregnancy. And I can remember going to the library and the bookstore and buying all these books. And it really hit me the true miracle that pregnancy is in that when you really stop and think about that, a woman is actually creating life inside of her. It's a true miracle.

It really is. A lot has to happen and it all has to happen at the right place and the right time to create these beautiful little babies that are so cherished and loved. It is so true. It is so true that at that very second in life, the right things happened.

It came together. And now I remember thinking that like, oh, my God. And so now I have this child that I'm creating a child, a real human being inside me. It's it's a true miracle. So let me ask you this. How common is male infertility?

So men are affected by infertility almost equally compared to women. So it's about 30% infertility due to a female and 30% is about due to a male. The rest is due to both male and female combined. And then another category called unexplained. So they're pretty equally affected. Why do you think that we hear more about a woman's infertility than a man's infertility? Why is that?

So men make new sperm all the time. They are making sperm well into their later ages. However, women have a more finite reproductive span. So I think that because men have more time to have a pregnancy result, you don't hear about it as much because there's not the biological clock, if you will. But it is something that's important. Men do have issues later in life. They just don't have kind of as defined of a time span as women do.

That's so true. How would a couple determine if the male is struggling with the infertility instead of the woman? Just this basic test? It's not something that you necessarily will know. It's sperm or microscopic. So you have to have an analysis of the sperm called a semen analysis. And so we look at the different parameters in terms of the volume of the sperm that's produced, how many sperm are there, how they're swimming, what they're shaping, all of those things. And that's really the best test to look at a male's fertility. Okay.

And so then does the man go for treatment for his infertility? Potentially. It depends on how severe the abnormality is. Sometimes it can be just a mild thing and supplements may be able to help. Sometimes doing certain fertility procedures just themselves can overcome certain barriers. So something like an insemination or sometimes IVF with certain procedures, it just kind of depends on what the abnormality is.

So I guess the question is, can anything be done to improve a low sperm count or poor sperm quality?

So potentially, sometimes if it's caused by genetics, then there's no kind of quick fix for that. And if it is very, very low count, then usually a male will be seen by a reproductive urologist and go through more detailed and extensive testing. If it's on the more mild end, first step is always lifestyle modification. So making sure you're avoiding hot cubs and saunas and anything that can increase the testicle heat content, because that is important.

important. Sperm is sensitive to temperature, but otherwise eating well, making sure you're taking care of yourself and your medical conditions, all those kinds of lifestyle things can really help. But it does take about three months from when a sperm is produced in the body to when it's released. So any of those lifestyle changes do take a little bit of time before we see a change in the sperm parameters. So it's educate yourself, research and educate yourself when you're about to make this very important life decision.

On average, how long should a couple try for pregnancy before seeking help?

So that's sometimes dependent on age. We usually would recommend for women who are under 35, you can try for about a year or so. And then if, if you're not pregnant yet, then I would seek some specialist help for women who are 35 and older. And the timeframe is a little bit less because of this time window that we have. So usually about six months. And I always recommend for women who are over 40 to see a fertility specialist right away, because again, time is of the essence and you don't want to waste any of that time. Um,

And then if you have any sort of known causes or risk factors for infertility, like having PCOS or endometriosis, if you had a history of like a pelvic infection, et cetera, then I would say come in sooner so you can get some help and talk about the options. Yeah, I agree. I think that's great. This episode is brought to you by Progressive Insurance. Do you ever think about switching insurance companies to see if you could save some cash? Progressive makes it easy to see if you could save when you bundle your home and auto policies.

Try it at Progressive.com. Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states. This episode is brought to you by Progressive Insurance. Do you ever think about switching insurance companies to see if you could save some cash? Progressive makes it easy to see if you could save when you bundle your home and auto policies. Try it at Progressive.com. Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states.

This episode is brought to you by Progressive Insurance. Do you ever think about switching insurance companies to see if you could save some cash? Progressive makes it easy to see if you could save when you bundle your home and auto policies. Try it at Progressive.com. Progressive Casualty Insurance Company and Affiliates. Potential savings will vary. Not available in all states.

I want to take this opportunity right now to do something that is consistent that we do in every podcast. We do two things. The first thing is a drink of the day. And so sadly, we're not together. We're doing this virtually. But I've created something that if we were together, we'd be sharing it. But as you can see, I have in my hand a teacup.

And this drink was created by Rachel here in the office, and she even named it. So it's called the Fertilla Tea. And it consists of two bags of raspberry tea, one teaspoon of honey, one fresh lemon wheel. So you steep the tea for a few minutes in boiling water, add in the honey, and garnish with a fresh lemon wheel. Because raspberry is said to ease cramping during pregnancy. Do you believe that's true? Yes.

If it helps, sure. Okay, great. So I'm going to do a cheers to you and your brilliance and for being here today with this fertility.

tea. Thank you, Rachel. So I want all of the secret squad out there to know that they can go to I've Got a Secret with RobinMcGraw.com and you can see the image of our fertility and you can get the recipe and enjoy some for yourself at home. And just remember, raspberry is said to ease cramping during pregnancy. So enjoy.

Okay, so let's move on. So what are the most common routes of treatment for some couples that might be having some issues getting pregnant? The two most common treatments are insemination or intrauterine insemination, IUI for short, or IVF, in vitro fertilization. Okay, so what's the difference between those two?

So IUI is intrauterine insemination. It essentially requires the body's normal functions to still be intact. So you still have to have the sperm that has to swim. You have to have mobile fallopian tubes and the egg has to be released.

So we help the egg and we can kind of tie it appropriately, but it still relies on the body. So we can wash the sperm, optimize the sperm and get the best sperm and put it as close to the egg as possible. But the sperm still has to swim to get to the egg. It has to get inside and fertilization still has to occur.

IVF or in vitro fertilization, we can kind of overcome some of these things because essentially we take the eggs out of the body after they're grown and are appropriate. We can help put the sperm directly into the egg to optimize fertilization to occur. And then we watch the embryos grow. The fertilized eggs, once they've been fertilized, are called embryos. They grow and they develop. And we can actually do genetic testing of the embryos to determine the genetic health of a pregnancy.

And so because we're doing all of this outside of the body, before we put it back into the body, we know if it's genetically balanced and healthy, likely to result in a pregnancy. And it kind of takes out some of the question that you aren't able to address. Does insurance help or cover either of these procedures?

So it depends on the insurance. There are some insurances that do cover it. Sometimes they'll cover the diagnosis phase of the cycles and not the treatment part. Sometimes they cover everything. Sometimes they cover nothing. So it really depends. But there are a lot of employers now that have coverage through other kind of outside sources. And so that's really great. So I would talk to your employer and see if you have any sort of facility coverage, if it's something that you're looking to do.

So how many times should a couple try IUI before moving on to IVF, do you think?

That's a personal choice. It really depends on kind of the reason why they're doing the IUI to begin with. But I would say most people probably get pregnant within the first three to six cycles or so. I always kind of check in with patients each time to see how they're feeling and what they want to do. IVF is a little bit more time intensive and more costly. It does have a higher success rate and chance for pregnancy. So it really is a personal choice.

Wow, it's so wonderful. Science is so amazing. Are there additional precautions that need to be taken when using either of these treatments?

So I always tell people, act as if you're pregnant. So get into the good habits. Start getting yourself used to, you know, taking your prenatal vitamins and not drinking alcohol, making sure you're avoiding drugs and smoking. Limit your caffeine. I would say avoiding heat exposure is important as well. Not doing certain beauty procedures like laser hair removal or chemical peels, things like that.

Once you're doing IVF, for example, so the ovaries do start to get enlarged. So you want to kind of reduce your activity. You don't want to do anything that could potentially cause the ovary to twist on itself, which can be an emergency. So kind of just taking it easy, taking care of yourself and acting as if you're pregnant. I love that instruction because mind plays such a big part in everything. So just think that way. Think and act as if you're pregnant so that your body and your mind change.

is part of it. I love that. What are some of the common side effects when undergoing these treatments? Each woman is different. We are manipulating the hormones. So some women will feel a little bit more hormonal. But some women in doing that can actually feel really great and have a lot more energy and feel like they're just super enthused. Other women feel a little bit more tired and lethargic.

Sometimes women will complain of headaches. As the ovaries do get bigger with the treatment, women will start to feel a little bit more fullness in their abdomen or feel a little bit bloated or have some pressure. But the procedure is very safe. We do it all the time. Every day it's very common that women experience some of these, but not all of them and not usually they're very severe. And because the IVF shots are only about two weeks or so, it's generally self-limiting in a short period of time.

Let me ask you this. Is conceiving twins or triplets common when undergoing treatments? And I'm really curious about this because I'm actually a twin. I have a twin brother. My daughter-in-law is a triplet. And my mother got pregnant with those twins naturally. Her mother got pregnant with them, the triplets, naturally and such. But it is something that we hear a lot, that when you do these treatments, you can conceive twins or triplets. Is that pretty common when undergoing these treatments?

I wouldn't necessarily say common. I think it's one of those things that really the goal is one healthy pregnancy at a time. And if you have twins or triplets, even naturally or with fertility treatment, it really depends on how many eggs grow in that cycle. So the number of eggs that you have is the number of eggs that potentially fertilize and can result in a pregnancy.

Sometimes in the case of identical twins, it's one egg that's been split, but usually we know how many eggs are growing and responding. And so then we can kind of anticipate what may happen. It is a gamble when you're growing more than one egg that you get more than one pregnancy, but sometimes you have to take that gamble because you've had trouble conceiving up to that point. So it does happen, but I think the goal is generally one healthy embryo at a time.

and our one healthy pregnancy at a time, excuse me. But with IVF, we can't control the number of embryos that we put back. So we can know that we're only putting back one at a time. So that's a little bit less common. Yeah.

It's such a miracle when my daughter-in-law is one of three identical triplets. And, you know, I look at them, I think every time I see them, I think, what a miracle it is that they're identical. And it was just a natural pregnancy for her mom. And I have a twin brother. So, of course, we're not identical at all. But it's fun to be around and see them. So are there increased risks when carrying multiples? Yes.

So there's increased risks of early delivery, so preterm delivery, and then that often results in a neonatal ICU admission for the baby. The babies that are born early or resulting from twins can also have increased risks of stillbirth or neonatal death.

There can be risks of kind of neurodevelopmental issues down the road, such as autism, cerebral palsy. It's also higher risk for the mom, too. So moms who are pregnant with twins have a higher risk of having increased blood pressure in pregnancy. There's higher rates of gestational diabetes. And this is true of whether or not their pregnancy is a result of fertility treatment or not. It's just kind of having more than one pregnancy puts you at higher risk.

What if a woman simply cannot carry a pregnancy to term? What are her options? So it depends on the woman and where she's at. There's different stages of pregnancy loss. All of them are equally devastating. But the number one cause of miscarriage is genetic issues. So we do have ways that we can test embryos to look at the genetics and then know that we can just put the healthy embryos back to decrease the chance of a miscarriage.

We also know that there's other conditions that can cause women to have recurrent miscarriages. So depending on how far into the pregnancy they get, we can do specialized testing to see if there's a blood clotting disorder or some other endocrine thing that's causing the miscarriages.

But otherwise, for women who we don't know what's going on, they've tried multiple things or something called third party reproduction. That's where you can use either donor eggs or sperm or a gestational carrier or surrogate to carry the pregnancy if you're not able to do so yourself. Oh, that's so wonderful. I know the psychological aspect to looking into your fertility as a couple is really tough. How do you keep people feeling positive and hopeful?

I'm so glad that you asked this question because it's so important to me. And I think that trying to remain positive and optimistic is so important for patients themselves. From my perspective for the patient, I always want to just kind of put out good energy and feel positive.

I think it's important for couples who are going through this. It's a struggle. So for them to focus on themselves and to know that they're a team and to make sure that they still kind of keep their own romance alive and taking care of yourself. So if it's going to therapy or going to acupuncture, support groups, I think it's really important. And for women who are...

My youngest son is

and his fiance are pregnant right now. I have a little granddaughter coming and I'm so excited. She's due on Valentine's Day. So it's just a sweet little precious bundle coming. And I wanted to ask you just a few things. We're now not talking about trying to be pregnant or getting pregnant. I want to ask you a few questions about

once someone is already pregnant. And I love how you said being positive and uplifting and just having a very positive attitude. And my son told me recently, he said, you know, I really feel like my mission right now, my job is to make sure her life is just as perfect

as possible through this pregnancy. He said, if she's tired, I'm going to make sure she rests. If she's hungry, I'm going to prepare her whatever she wants to eat. If she needs anything, I'm going to get it for her. And I said to him, I went, sweetheart, you are exactly what every woman wants when she's pregnant. Yes, you raised

such a great son. What a gentleman. She's so lucky to have him. She is blessed to have him. She is lucky to have him because when he said that to me, I just thought, oh my heavens. He said, well, I'm not taking just taking care of her. I'm taking care of now two very important women in my life. And I was like, oh, it just keeps coming. You must be

She's so proud. It's so exciting. I am so proud. And I loved hearing that. And I think, and so when you just said that, I thought, oh, wow, if he only knew how very important his feelings and his focus is right now. So I'm going to tell him what you just said about staying uplifted and positive and that he's doing his job just like he wants to.

So I wanted to end this part on a really positive note. Can you share a success story from one or more of your clients?

Sure. I love success stories. It's why I do what I do. It's my favorite part. Um, so one that I think is a nice one that actually happened recently was I had a patient who I saw and, um, fertility doctors usually just follow patients in the beginning part of their pregnancy and then they go back to their general OBGYN. Um, so I'm always super happy and get my patients pregnant. And I recently got the delivery announcement from one, um,

It was a patient who I saw and she had a lot of difficulty with another doctor and then came to me. We were able to get her pregnant. She was so happy. And then I got to have the delivery announcement. She just delivered her baby. So it's always fun for me to see kind of the baby pictures and it's so heartwarming. I love. And then another one that's kind of not as common, but talks to some of the cool technology that we have with IVF is a patient.

who is going through the IVF process and she has a genetic condition where she's at risk for 50% of her children to have that condition.

So by doing IVF, we're able to test the embryos that she creates to look for the genetic condition in those embryos. And then we can put back the embryo to her that does not have that condition. So we're not only able to kind of help eliminate that disease from her family, but improve the quality of life for that child. And so it's a really cool technology that not only can we help people, but we can also kind of

increase their chance of happiness and health for the future too. So it's a really great field and I'm really happy to be able to help my patients in all these different ways. Wow, that is so wonderful. I'm sure that you absolutely love that part of your profession, creating life and making sure that they're happy and healthy.

So now we've come to the part of the podcast that we do with every podcast, and that's playing a game. How do you feel about games? I love it. Okay, good. Okay, so I'm going to read off some of the most commonly Googled pregnancy myths, and you're going to tell us if there's a truth to it or if it is totally false. Okay. Okay.

So here's the first one. If you have a lot of heartburn, your baby will be born with a lot of hair. I have heard that one. And there's really no truth to that. It depends on on a woman's body. It doesn't have to do with the pregnancy itself.

Oh, my gosh. Well, can I just tell you, I had so much heartburn in my first pregnancy. I carried around in every photo of me being pregnant. I had a bottle of indigestion medicine in my hand and my first son came out with so much black hair. But I'm going with the expert. So that's just a bit. OK. Morning sickness only happens in the morning.

That is false. Morning sickness can happen at any point. And any woman who's suffered through it will tell you that. It can happen morning, noon, night. It can happen at any point. My morning sickness started about 4 p.m. and lasted throughout the evening. And then sometimes it was during the day. But yes, it can happen all day long. And it's horrible. Okay. Will eating spicy foods induce labor?

So that's an interesting thing. I don't know if there's any actual data on that, but I know that certain people swear by certain kinds of spicy foods or there's certain salad dressings and there's all sorts of things that people believe in. But really your body is going to go into labor when it's ready. And there's these little tips and tricks and if they actually help, I don't know for sure, but the body goes into labor when it's ready. When it's ready. Okay. Dyeing your hair is harmful for the baby.

So a lot of women color their hair during pregnancy. It's often recommended to avoid it in the first trimester if you can, because that's the critical time when a lot of things are developing and occurring. But in general, women can dye and color their hair. And if you can use a vegan or organic formulation, I think that's preferred. If you do it, you want to make sure you're in like a well-ventilated area. But in general, women do color their hair in the first trimester.

That's great to know. Okay, so when pregnant, women need to eat twice as much. That's not true. You do have increased caloric requirements because you're growing a baby, but not twice the amount. So it depends on how many babies you're carrying, but you do want to eat a little bit more, but not double the amount because your growing fetus doesn't eat as much food as you as an adult. So a little bit more, but not double.

Darn. I had so much to eat with my first pregnancy. We would go out to dinner and I'd order two entrees. I was so hungry. You get carbs every now and then, right? Right. I'll take the fried chicken and the cheeseburger. Okay. Cocoa butter prevents stretch marks.

The stretch marks are kind of a genetic thing. You can use all sorts of creams and lotions, but it really, it depends on kind of your own skin type and your family. If your mom maybe has stretch marks with you, you're probably a little more likely to get them, but any sort of cream don't necessarily fix it. I've always heard that. I'm glad to hear from the expert that that's true, that it is a genetic thing. It's inherited. Okay. Can night terrors be a pregnancy side effect?

Some women do have sleep changes and disruptions in pregnancy. A lot of women are getting up frequently to go pee at night because they have this big baby on their bladder. Nightmares can happen and it can also just be associated with sleep disturbances and not sleeping as well. So it all kind of goes hand in hand with that.

Yeah, my new daughter-in-law has experienced one night terror, and she'd never had one before the pregnancy. And my new future daughter-in-law, and she's only had the one. Okay, your belly shape and how you carry reveals the baby's gender.

So this is also a myth. The shape of the belly kind of depends on the position of the baby inside of the uterus and the tilt of the uterus. Every woman's uterus is in a different position and so that kind of determines how and when she shows the baby. The baby's head up looks different than the head down. So

Oh, that's so interesting to know. And I'm so glad. The reason I put that in there is because I had two boys, carried two boys, and carried them completely differently. They're like high schoolers.

and wide and low and long, completely different. So everyone said with the second, oh, it's a little girl, must be a little girl. We didn't have ultrasounds with the first one. So of course it was a surprise. In the second one, they had ultrasounds. Our doctor was a friend of ours. And so we went into his office and did quite a few, but you just really couldn't tell. So I really

I really didn't know what I was having with either one. Technology has come a long way. Now we can see so much, but definitely not as much earlier. Yeah. Yeah. I, you know, I really didn't care. I really, I was hoping to have a son the first time, but really didn't care. And every woman is the same, just a healthy baby. So the last one is pregnant women shouldn't drink coffee.

So pregnancy is a condition that is kind of like a health condition. You can drink coffee and we just recommend limiting it. So I would say no more than one cup of coffee a day because you don't want to have too much exposure, but there's definitely some people who need their coffee to function. And so a little bit of coffee is okay. If you can avoid doing it and you don't need it, then I would say avoid it if you can, but if you really need it, then one cup a day is okay to do.

Now, let me ask you this. I said that was our last game question, but let me ask you this because this was a topic recently over dinner. How do you feel about pregnant women drinking alcohol after the first trimester? And I'm asking you this only because someone at the dinner party was told by her doctor, and this is not my future daughter-in-law, so was told by her doctor that

a beer was a good idea to drink during her pregnancy.

So I think to be kind of very formal about it, the recommendation is no alcohol in pregnancy. That's kind of really the safest way. If you talk to Europeans and other people in other places, they will have a glass of wine with dinner and do other various things. But really to be kind of formal and strict, I would say avoiding alcohol would be the best way to go. I agree. I agree. And I was so surprised to hear that a beer was recommended. Okay.

Okay, so that is unfortunately all the time we have for today. Let me just say, wow, that was so informational, Dr. Sondheimer. Thank you for tackling a topic that I don't think we talk about enough as women. Could you tell all of the listeners how to find out more about your practice?

Yes. So I'm a fertility specialist with CPRM Orange County, with CPRM Fertility as kind of the bigger name. But we're located in Newport Beach, California, and I'm happy to see egg freezing patients, fertility patients, anybody with reproductive issues, however I can help you. And I look forward to getting you to your future goals.

Wonderful. And can you give us all of your social media contacts? Yes. So my social media is SuntimerMD, and that's on Facebook, Instagram, Twitter, etc. I have a website, SuntimerMD, and then also our website for CCRM is CCRMids.com.

That's wonderful. So Secret Squad, head on over to I've Got a Secret with RobinMcGraw.com to recap all of the wonderful information from today's episode, along with other fun extras that only the Secret Squad has access to. I'll see you next week. Bye-bye.

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