How to Optimize Fertility in Males & Females
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Welcome to the huberman lab podcast, where we discuss science and science space tools for everyday life. I'm Andrew huberman and am a professor of neutral logy and optimal gy at stanford school of medicine. Today, we are discussing fertility.

We will discuss male fertility and female fertility. And I should mention that today's discussion is not just for people who are seeking to conceive children or who want to know how their children were conceived, but it's really for everybody. And I say that because this is the story of all of us.

All of us are here because a specialize set of cells called germ cells, that is, the sperm in the egg. And i'll make IT very clear why they're called germ cells a little bit later, has nothing to do with infection. But it's because a sperm cell and an egg cell arrived at one another, either in vivo inside of our mother or in vitro, so called in vitro realization, and they were implanted into our mother and became us.

And so understanding the process of how the ex cell and the sperm cell came to be is really the key to understanding how that fertilization process came to be. I know everyone saying, I know how feriz ation occurs. IT occurs through sexual inner course and so on, and will talk a little bit about that.

But I promise you that if you understand the menstrual cycle, and the menstrual cycle in today's conversation can best be thought of as a biological cycle that occurs in females, that allows the potential for fertilization by the sperm, because that's really what this is. And it's a beautifully orchestrated process that i'll described to you. And I should say all people, males and females, should really understand how the mentor cycle works, how would impact feriz ation, but also how IT impacts the brain and body behavior psychology at sea.

And we will also talk about spermatic genesis, how sperm cells come to be and how they arrive, that is, how they swim to the egg. And the incredible interplay between the biology of the sperm and the biology of the egg leads to this incredible thing that we call embryo genesis and the birth of the child, and, of course, the development of that child into an infant and toddler and at lesson, a teen and an adult. Today's discussion, again, is not just for those of you that are seeking to have children.

And I say that because when you look at the data, you look at the literature on longevity and vitality, ality two themes in biology that often times people lump together, but aren't always the same. For instance, there are a lot of things that we can do to increase our vitality that actually can harm our longevity, but there are a subset of biological rules and mechanisms that went online allow us to maximize both our vital ality and our longevity. And I think it's fair to say that all of those mechanisms and tools are housed in the discussion around maxi zing fertility.

And that's true whether or not your male or female, in other words, if you want children or if you don't, if you already have children, where if you don't understanding how fertility and fertilization occurs in the brain body will allow you to maximize ze your vitality and longevity. And of course, today's discussion will provide and understanding of the biology and many actionable tools that will also help you conceive children if that you're wish. So of course, as this characteristic of this podcast, we will discuss science based tools, including behavioral tools, both the dues and the dots, and we will discuss nutrition base tools and supplementation base tools and some other practices, including things like activcard, which have quite good data to support them in terms of improving fertility.

And we will discuss why those certain practices can work. And we will discuss prescription drugs that your doctor can prescribed to you if, for instance, you have a deficit at the level of hormone product or near a transmitted tr production at the level of the brain or the patuit origin, to explain that all of those things are soon, or the go ads the over and the testers in females and males, respectively. Again, by the entities episode, you will have a lot of knowledge and actionable tools related to maxims ing fertility, and you'll have a lot of knowledge and actionable tools related to maxims ing vitaly and longevity.

Before we begin, i'd like emphasize at this podcast is separate from my teaching and researchers at stanford. IT is, however, part of my desired effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, i'd like to thank the sponsors of today's podcast.

Our first sponsor is element. Element is an electoral light drink with everything you need and nothing you don't. That means plenty of salt magnesium m in patashie, this so called electronic light, and no sugar. Now, salt magnetism in potash are critical to the function of all the cells in your body, in particular to the function of your nerves, also called neurons. In fact, in order for your neurons to function properly, all three electrical lights need to be present in the proper ratios.

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Again, that drink element L M T dot com slash huberman. Today's episode is also brought to us by waking up, waking up as a meditation APP that includes hundreds of meditation programs, mindfulness trainings, yoga eja sessions and n sdr non sleep depressed protocols. I started using the waking up up a few years ago because even though i've been doing regular meditation since my teens and I started doing yoga eja about a decade ago, my dad mentioned to me that he had found an APP, turned out to be the waking up APP, which could teach you meditations of different durations.

And that had a lot of different types of meditations to place, to bring your body into different states. And that he liked IT very much. So I gave the waking up up a try, and I too found IT to be extremely useful, because sometimes I only have a few minutes to meditate.

Other times I have longer to meditate. And indeed, I love the fact that I can explore different types of meditation to bring about different levels of understanding about consciousness, but also to place my brain body into lots of different kinds of states, depending on which meditation I do. I also love that the waking up up has lots of different types of yoga eda sessions, those you don't know.

Yoga eza is a process of line very still, but keeping an active mind is very different than most meditations. And there is excEllent scientific data to show that yogananda and something similar to IT called non sleep deep breath or nsd r can greatly restore levels of cognitive and physical energy, even which is a short ten minute session. If you'd like to try the waking up up, you can go to waking up that com slash huberman and access a free thirty day trial.

Again, that's waking up that com slash huberman to access a free thirty day trial. Let's talk about fertility. And in doing so, let's take a step back from this word, fertility, and ask, what is fertility and fertilization really all about? Well, the obvious ous answer is that it's about producing offspring.

But more importantly, it's about producing offspring that contain the genetic components of both parents, and indeed contained half of the genes from one parent and half of the genes from another parent. Now there are two general types of cells in the body. The most common types of cells in the body.

You're called dramatic cells. So this will be all the cells in your body, except the egg in females and the sperm males. The egg in females and the sperm males are part of what's called the germ line. And again, I has nothing to do with the infection is just that the cells of the germ line have genes that cannot be modified by the behaviour of the individual that houses those genes.

What do I mean by that? Well if I were to tell you that by exercising you can improve my a control function, you can change hormones um by reducing stress, you can reduce courters all by um hitting puberty for instance um you will have the execution of hormones that then change in expression another cells leading to development a body hair, facial hair, deepening the voice breast growth that you say, okay, great now that all makes perfect sense, but that's all occurring in the so called thumb cells. The germ cells are the germ line cells, that is, the egg in the sperm are a very unique and protected set of cells that are generated in a particular way and whose genetic components are not modifiable by experience.

And when you take a step back and you think about, you say, oh, that's right. There's no reason to think that exercising will make the children that you have not yet had stronger. Of course not.

Well, why is that? Well, that's because there is a barrier between the genes of the german line cells and behaviors. They cannot be modified by behaviors and the various things that you do in your lifetime. Now I suppose there's an exception in the negative direction. And what i'm referring hear is if you were to say be exposed to a chemical that could mute the DNA of your eg.

Sperm, or if you were to fertilize an embro at a in a certain way, at a certain stage of life that I got an extra chromosome one, for instance, we'll talk about this a little bit later. Well, then of course, you could end up with offspring that have modified DNA that don't faithfully represent half of the genes from mom and half of the genes from dad. But that's not the same as specific behaviors modifying the genes of those cells, the permanent, the egg cells, in a way that improves the offspring.

Okay, so the key first understand today is that there's a distinction between dramatic cells, which is the vast majority of cells in your body, in the so called germline cells, which are the egg in this perm, the egg's firm, are these highly protected populations of cells that in females actually come to be during embryo genesis. okay. So for all females out there, you generate what today i'm going to refer to as a volt of cells.

You have a volt of of eggs that are your germline. Those eggs all contain all the chromosomes of your DNA. So it's going to be, as most of you know, there twenty three chromosomes and promote ones consist in pairs.

So the way to think about this is h, each pair is one strand, and you have twenty two so called autozone. And then you have one sex chromosome m. The sex chromosome one will be the x or y. So in a female, they have two x chromosomes.

So when each one of the eggs that a woman has and that she's had since SHE was an embryo, and that's contained in this revolt, those that are, of course, going to be very immature at birth, right? He has an underground puberty yet. And certainly as an embro, SHE has an underworld puberty.

And those cells are going to contain twenty three pairs of chromosomes. But this is very important. Twenty three pairs of chromosome ones.

The chromosomes are essentially the wrapped up DNA that contains all the genetic information to create any cell type in the body, and actually to create entirely new individual. Now there twenty three pairs of chromosomes, twenty two of which are called auto zones. Okay ay for that doesn't make sense.

You just remember autism. Okay, there's twenty two of them. And then there's one so called sex chromosome one. The sex chromosomes es are either x or why. But this is a female. So she's going to have twenty three pairs of chromosomes, and she's going have two x chromos for the sex chromosomes.

But if this is already confusing to you, don't worry, i'll make IT very clear how this all relates to fertility and how IT relates to chromosomal segregation and a bunch of things that I think maybe you've heard of and that perhaps were OPEC to you, but I promise to make them clear. But just understand that within each of those eggs, they've twenty three pairs of chromosomes. And for those of you that like naming creature, i'll tell you that those cells are considered a depo loyd, and they called the deploy.

And that means that they have twenty three pairs of romo somes as distinguished from the cells that are haploid d where there's only one set of those twenty three chroma zs. So instead twenty three pairs, there's only twenty three chromosomes, will come back to hell d cells a little bit later. okay?

So when a female is born, SHE has all these eggs in the reserve in this evolved that I shall have her her entire life. She's not going to make anymore. But they are very, very immature.

So when a woman is in embryo genesis, SHE develops these very immature red eggs okay, today we're also going to talk about folk les. And um we will be careful to distinguish folk les from eggs they're often talk about interchangeably online and elsewhere and even by fertility dogs and ob g yen. But well right now we're just talking about the egg cells, okay, the eggs themselves, which are selves.

Now the goal of fertilization is to bring that excel into close enough proximity that IT can be fertilized by a single sperm cell and that sperm cell will bring twenty three chromosomes, es as well. That include, just as in the female egg, it'll have twenty two auto zones and one sex chromosomes. And in the mail, that sex chromosome one can either be an x crime zone, which then would give rise to female offspring, or A Y chromosome one, which would give rise to mail offspring.

And today we're not talking about sexual differentiation. That's the topic of a previous and yet another future episode. But just to give you a sense of how x chroma somes and y chromosomes can actually accomplish that sexual differentiation, both of body and brain, i'll just mentioning two sentences that, for instance, if there's A Y chromosome one, as opposed to next chromosome, that y chromosome taes genes that suppress for since the development of female genevra, and thereby give rise to male janitorial.

So rather than the formation of a claris, the formation of openness and rather than the formation of over is the formation of attaches. okay. So that's more directed towards sexual differentiation.

We're not going to get into that right now. We're get into that in a future episode. But even if you're only tracking about ten percent of what i'm saying right now, I promise you're doing great.

If you're tracking more than ten percent, well, then you're doing terrifically well because the essence of fertility and fertilization is to bring together that haploid sell, that is, the sperm that only has twenty three chromosomes, but not pair of chromosomes, right? Because that's the DNA from dad together with the egg, which is, I told you, already has twenty three pairs of chromosomes. So part of the fertilization process has to be to get rid of one half of those twenty three pairs in the female. You had to get rid of IT, and you have to get the egg in the sperm in proximity so that the egg can potentially be fertilized by the sperm, bringing the DNA, the twenty three single strands of chrome zones from dad, into a cell .

that has twenty .

three single strands from mom OK. So I realized i'm probably being a little bit repetitive here, but I want everyone to understand this because IT really frames up fertility and reproduction in the proper way. We've got a cell phone mom, the eg, wich has twenty three pairs of chromosome ones.

We need to get rid of one set of those pairs so that there is only twenty three chromosomes. We need get rid of half of those chromosomes, and then we need to bring that cell together physically with the sperm cell that contains the twenty three chromosome strength from dad. And we need to bring those together so that you get twenty three chrome mommo pairs from dad and twenty three chroma animal pairs from mom.

And in doing so, you create a cell which then becomes multiple cells. That's going to be the developing embro that has half the genes for mom and half the genes from dad. So I hope that's clear.

That is the biological logic which I realizes a bit of a tune twister. But um forgive me, IT is the most accurate way to describe this process. We're trying to bring together the twenty three single strands of chromosomes from dad and the twenty three single strands of chromosomes from mom into the same cell.

Now that requires a literal, physical contact and pairing of the two cells. But as I mentioned before, all these eggs in mom are sitting in a volt and they're very, very mature. So the oval tory cycle in the menstrual cycle are really about first eliminating half of the chromosomal pairs in that twenty three sets of chromosomes and not getting rid of, for instance, half, you know, just going one to, you know, one to eleven or and then or twelve to twenty three.

That's not the goal. The goal is to have chromosomes one, two, three, four, five, six all the way up to twenty three, but only to have half of the chromosomes there, and to bring that cell together with the sperm cell physically and allow them to fuse and allow the chromosomes es from dad and the chromosomes es from mom to fuse within a single cell and duplicate into cells that contain half the chrome zones from dad and half the chromosomes from mom. That's what the obituary immensity cycle are really all about.

So in taking about IT that way, i'd like to just initiate the discussion by focusing first on the female component or the egg component of fertility and fertilization. As I mentioned before, a female has all the eggs. I'll be at very immature eggs that she's going to have at the time that she's born.

Now puberty will happen at some point and will allow the observatory in the mental cycle to comments. Now one question that you perhaps are asking is what controls the onset of puberty? And there there are a number of different results, each of which could be an entire episode of a podcast on its own.

But I just highlight a few things that we know about the onset of menses remonstrative or IT, sometimes also called the monarchy right? One thing that who knows about today's discussion is that if you were to take any number of your notes online and put them into search function, that you would see a lot of different language you used for the same thing. So for instance, some people talk about the egg in the follow as the same thing, even though they are not.

I'll explain the different soon. Some people talk about menaces or monsters, tion or mani is the exact same thing. And in fact, they are not the exact same thing. But often times these are words are used interchangeably.

I'll do my best today to not overload you with nominal nature, but rather red, to use the most commonly use terms for the different aspects of fertility and fertilization. But when IT comes to the onset of puberty, first of all, most of you have probably heard that the onset of puberty is happening much earlier and females now than IT was some years ago. In fact, that is the case.

And i'll talk about some statistics related to this, which are pretty striking. But don't necessarily point anything detrimental doesn't necessarily mean that something bad is happening. What do we know for sure? Well, we know that there are a number of signals that come both through the brain and through the body, and more likely, both in order to control the onset of puberty and females.

A couple of examples. The first is a mechanistic one. We know, for instance, that the entire process of the arbitrary menstrual cycle is initiated from the brain.

We're going to get IT into this and a lot more detail in a few minutes, but there is a certain number of hormones and neurotransmitters, ors, that are communicated from the brain of structure called the hypothalamus, which roughly sits above the roof your mouth and that communicates with a gland in indicate or hormone releasing gland called the pituitary gland the peaty glam looks like a stock um that essentially extends out of the brain, is also located not far from the roof your mouth and that has two sort of small marble or grape sized um protrusions that the anti per tutti and the poster repeat rata and they released different hormones s into the bloodstream puberty is in part controlled by the fact that up until puberty there are neurons in hypotheses that released a neurotransmitter called gabba, which is inhibitory ory, and that prevents the neurons in the hypothesis from releasing a very important hormone called ganado troopin releasing hormone, or G N R A. So the first thing i'd really like everyone to know and commit to memory today is very easy. G N R H dance for gana trope releasing hormone.

This comes from the brain and will communicate to the paternity to release certain harmons prior to puberty. In both males and females, there are neurons in the brain that are actively suppressing the neurons that released the genre age. It's like, no puberty, no puberty, no puberty can't help everybody, can help puberty.

And in fact, those cells are releasing this no transmitter called gabba because its inhibitory prevents the firing of those neurons. yes. So puberty is actively suppressed up until a certain point.

It's also actively suppressed, at least in some species, and we think at least partially in humans by the tonic release. That means the ongoing release around the clock. Of a hormone called melatonin later in life.

In fact, after puberty, melatonin will be secreted only in the dark phase of each night and around the time that one goes to sleep. But in children, and in particular in children prior to beauty, melatonin is released more, less constantly. Now, melatonin isn't the only source of suppression of puberty.

It's also these neural mechanisms involved in gaba. But IT is certainly a great candidate for one of the reasons why poverty doesn't generally tend to happen to say, age four, eight, five. That would be very unusual. Another component of suppression of puberty is that, typically in children, they have relatively low body fat stores.

Why is this important? Well, we know that one of the things that can trigger the onset of puberty, in particular in females, is that when enough body fat accumulates, that body fat releases a hormone called lepton. And that hormone, lepton, travels in the bloodstream across the blood brain barrier and goes to the hypothalamus, and can trigger the onset of puberty by activating the neurons that released canada open releasing hormone.

So many people believe that one of the reasons that puberty is happening earlier and earlier in females is because of the accumulation of more body fat at Younger ages than was observed thirty or forty, and certainly a one hundred years ago. Now I can already imagine a number of people are thinking of this must be the obesity crisis and indeed there is a crisis of obesity. Obesity, uh, is something that is causing all sorts of um problems with people's health at various levels, brain and body.

And that is far more frequent today than IT was even twenty years ago. So IT is indeed a crisis, because IT has enormous detrimental effects for so many aspects of of a brain body health and longevity. But this whole process of thinking about body fat signaling lept into hype of Thomas and the onset of puberty doesn't necessarily have to do with the O.

B, C crisis IT might relate, but I could also relate to, for instance, improve nutrition, which is allowing body fat stores to accumulate maybe not to the level of obesity, but to accumulate earlier and the Younger ages in females, which is then causing IT earlier puberty in females. To just highlight how that might be possible, I want to review some data to talk about the onset of mencius monsters tion, that is, puberty in females, according to country and according to age, over the last hundred or more years. So what are the general trends in terms of the onset of poverty and females? Well, that's an easy one to answer.

Over the last hundred years or so, the onset of puberty has been occurring much earlier with each passing decade. It's really an incredible set of statistics. Um I will provide a link to these data since I know a number of you are listening and not just watching on youtube.

Um this is from a study in which the onset of puberty has been analyzed from as early as the eighteen fifties, right in certain countries there are date on that out to the one thousand nine hundred and seventy and in other country starting at about nine hundred um extending out to about nineteen ninety. These are ongoing collections of data. But just to give you a sense how the data falling out in a couple of different countries, just to give you a flavor.

But for those of you listening and for those of you watching, the essence of all of these findings is that pure party is happening much, much earlier with each passing decade. So for in the united states, around one thousand nine hundred hundred and one thousand nine hundred and three, the average age of manor cave the onset of puberty in females was about fourteen years old, wherein one thousand nine and ninety the average age is eleven so that's a pretty significant, um we can say, acceleration of the onset of poverty. Now of course, these are averages.

So there will be exceptions. There's a distribution of data today. Still there will be uh, Young females who will undergo puberty at age eleven or ten, or maybe the nine and others who will undergo puberty at age thirteen, fourteen, maybe even in sixteen or seventeen.

However, if we look at prince, the data from norway, which dates back quite far, they have excEllent record keeping to eighteen fifty. What we see is that the average age of the onset of female puberty in eighteen fifty in norway was seventeen years old, where as in nineteen seventy is thirteen years old. This is a dramatic acceleration of the onset of puberty.

And you see a similar trend in other countries as well. So if we were to look up, for instance, in the U K, um they have A A smaller data set um meaning that the only extends back to about nineteen forty. But the average of the onset of poverty in the U.

K. Uh in one thousand and forty was thirteen and a half years old. Again this is just for females and in one thousand nine hundred and seventy IT was closer to thirteen with A A train towards declining even in further unfortunate they didn't continue to collect data out to twenty twenty two.

And as a final point, if we were to look at for instance, in h germany and finland, uh the average uh onset of poverty in eighteen seventy was sixteen and a half years old. By one thousand and forty was down to thirteen and a half years old. So all of these data have born out over and over again regardless of location in the world, which is important because when you start to think about the obesity crisis, you could say, well, that's mainly in developed countries, believe IT or not, or perhaps not surprisingly.

And maybe that has to do with the obesity crisis. And yet, I don't think we can conclude that at all. Something is happening. However, IT could be increased body fat stores due to over reading an obesity. However, IT could also be unrelated to obey.

IT could be, for instance, improve nutrition and the available capability of quality nutrition, which can signal the maturation of the brain and body mechanisms that trigger the onset of puberty. Obligatory cycle administration. So we want to be very careful about leaving the conclusions about what these trends mean, but the trends themselves are very, very apparent.

And as a final point, I should also mention that there are a number of different behavioral and psychosocial, as they are called, interactions that can influence purity as well. This has been most strikingly observed in animals. And so I don't want anyone to be alarmed or to leave any great conclusions about the onset of timing of poverty in humans.

But i'd be remiss if I didn't tell you about a certain result, which shows that if a Young female is exposed to the older, not clearly the ferr mones, right? There's a distinction between oders that we perceive, fair mones, which are subconscious, right, though we don't actively perceive, but that can impact our biology. And faremont affects in humans are very controversial.

But we know, for instance, that if you take a female animal, and there are some evidence from humans, that if you take a Young prepuce dor female and you expose her to the scent of a reproductively competent mail for a series of days, but maybe even as short as a few hours, and SHE is also not regularly being exposed to the scent of her father, that SHE can undergo puberty earlier. That's right. There is something about the older and or fair mones, or perhaps something else that occurs when a Young, preppy, vital female is in the, has a father that she's in regular contact with.

He wouldn't cesspool ily have to live at home. But that is around a lot that her, his smell, excuse me, is registered by hb biological systems that I don't want to say protects because I kind of skills the the veiled to the conversation, but that that offsets or buffers the otherwise observed effect, which is that the scent of a reproductively competent mail, if it's present often enough, or perhaps intensely enough, that IT can trigger the onset of puberty in that female. In other words, the scent of of a male that is not the father, and we think also that is not biologically related to her, can trigger earlier onset of puberty, and that effect can at least be partially buffer by her being in the presence of the sent from her biological father.

Now some of you are probably already looking into conclusions about what this mean and to, you know should you not allow your daughter to be exposed to any males who a reproductive age that certainly not what i'm saying. There is a huge number of considerations that they going to that calculation for everybody and circumstances that but the point is that the odds of individuals, both related in particularly closely related and non related individuals, can shape the neural systems and the hormone systems that can trigger the onset of puberty or suppress the onset of puberty. So whether not we're talking about onset of puberty at this age or that age and whether or not biologically related sale or non biologically related sale sense around IT said, the thing I want everyone to know is that at some point during development, typically nowaday between the ages of eleven and fifteen. Also, again, there's variability there.

The suppression .

of ganeth rope in releasing hormone released from the hypothesis is removed, and then canada open releasing hormone can activate cells within the patio tory. And if you really want to know what is the anti partida ory in particular, and then the anti patuit tory gland, which sits at and kind of bridges the brain and the, because IT allows the release of hormones into the bloodstream, that entered Peterie is going to release two key hormones that everyone should know the name of and what they do.

And when I say everyone, I mean males and females need to know about these four mones because they have an active role in both males and females. And of course, you should want to know and should know about the biology of everyone on the planet, in my opinion, because IT tells you a lot more about humans than if you just focus on your own biology. But those two hormones are called luti zing hormones, which is abbreviated L.

H. And follow stimulating hormone, which is abbreviated efa age OK. So the simple picture that you need, dave, in your mind is gonna cho en releasing hormones from the brain, from hypo thalma in particular, is causing the release of luti zing hormone and follow stimulating hormones.

G N R H, stimulate lh luti zing hormones. And for stimulating hormones, F H, lh and F S H travel in the blood and can access all the cells and tissues of the body. This is one of the incredible things about hormones, is that many hormones and L, H and efficacy included in this group can travel into cells.

And they can actually change the genetic expression of those cells. They can change which genes are turned on and which genes are turned off. And they can also attach the surface of those cells and make those cells take on different property so they can mature those cells of, for instance.

A good example this, outside of the context we've talking about, is the hormones st can travel to the airport ico, and can stimulate changes in the genes of the cells of the hair folio that can make hair grow a different hormone. Estrogen can travel to the cells of the breast tissue and activate genes that controlled enlargement of the cells of the breast. Issue product in a different formal can travel to the memory dux and control the production in the circuit of milk and in males.

That can actually happen in certain cases, although it's rare, but proactive can also travel to areas of the brain that control libido, for instance. Uh just so you'll never forget IT males elevated levels of proactive or actually what set the refractory period after evacuation and prevent erection for some period of time so you'll never forget proactive um the point being that different hormones have different effects on different cells depending on what cells those are right extra gene or extraditions going to have different effects on the breast issue than IT would on skin, although has effects on both. Similarly, when L H N, F H luizi hormones and follow stimulating hormones travel in the blood to the go add, and the goat is an IT will have a certain set of consequences, and when loni zing hormone and folic stimulating hormone travelled in the blood to a go out, and that go out happens to be a testy, then IT will have a different set of biological implications.

So let's focus now on what happens when L H N F sage arrive at the, and let's assume now that we're talking about a female who has already undergone puberty, or perhaps we could even frame this in the context of a female who is about to undergo poverty effort. And lh are now able to be released because she's undergoing poverty. But the same set of processes essentially would occur for any point from puberty onward until menopause, which is the depletion of that vault, that a very reserve of all those amateur eggs.

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Again, that's athletic Greens dot com slash huberman en to get the five travel packs in the year supply of vitamin d three k two. okay. So we're now going to talk about violation adminstration. And let's just remember what this is all about.

This is all about creating the potential for an egg to be fertilized and that egg needs to have half of the chromosome mal pairs, so no pairs, but it's got of twenty three chromosomes just from mom. And we need to position that egg so that the egg can be met by the sperm, and that sperm can penev that egg and donate its twenty three individual strands of chromosomes to that egg so they can bring together the D. N.

A of dad and the DNA of mom. So the auditory mentor cycle occurs when luizi hormones and follow stimulating ing hormones been released. And the obligatory slash metro cycle, here I have to kind of pick what I want to call IT.

Um I guess to be really accurate, we will just call IT the female reproductive cycle, but that includes underneath IT, but the menstrual cycle is that sometimes called in the obligatory cycle. So you decide i'm going to interchangeably discuss the oval tory cycle and the menstrual cycle, the promise when you say me strain. People often think about just the period, the shed ding of the utter in lining when fertilization has not occurred.

So if I start saying obvious tory cycle, just keep in mind i'm referring to the entire thing. Now this is probably also a good opportunity to say that if you heard that the event tory flash mental cycle is twenty eight days long, that's true in some cases, but that's not always true. It's on average twenty eight days along. There are some females for which the oval tory cycle will be shorter, can be as short as twenty one days, and other females for which I will be thirty five days long. Shorter than twenty one days and longer than thirty five days is rare, although IT does occur.

One of the key things, one thing about fertility is if you talk to O G Y S who are focused on fertility, which are have an anticipation of this episode, we'll tell you that whether not your cycle is twenty one days long or thirty five days long is not as much of an issue necessarily unless it's happening to become much shorter or much longer in a kind of erratic way. So if you're somebody who is consistently had twenty three day long cycles and all of them you're having thirty day long cycles, that's not necessarily an indication of anything bad. But if it's twenty one days one month and it's thirty days the next month, that's seventeen days the next month or even if it's always falling within that twenty one to thirty five day long cycle, but it's very variable from each month every other month.

So you probably want to talk to your O B G Y N, because that could indicate a number of different things, which things could have indicate. Well, that will become clear, as I spell out of biology in a bit more detail. Okay, but this idea that the menstrual cycle of the tory cycle is always twenty eight days, that's just false, that's just not true.

Should also mention that there is a common miss conception that because the average amenta cycle is twenty eight days, indeed, the averages twenty eight days, and the lunar cycle is twenty eight days. And of course, there is real biology to support the fact that the lunar cycle can, in fact, impact certain aspects of human behavior. IT does.

And we'll talk about lunar cycles in the future episode. But there is zero data to support the idea that the cycle and the lunar cycle are linked in any kind of calls away. Sorry to break IT you.

The lunar cycle and the title cycles at the ocean are definitely linked in ways that are super interesting, related to the till to the earth and the pull of gravity of different planets, and is an incredible story into itself. But the lunar cycle on the metro cycle, despite having some weak correlation in terms, are there their their duration ation or their social periodicity? No unintended.

Well, there is no cause of relationship. What's ever between the lunar cycle and the mantra cycle, if any of you are aware of any real data that conflict with what I just said, please put that in the comments section on youtube. But this is pretty well established, as far as I know.

okay? So we need to bring together the so called haploid d contents, the twenty three individual strength of chromosomes, from the egg to a place in a position where I could potentially be fertilized by the male. What happens? Luti zing hormones and follow stimulating hormones travel to the over.

These hormones are able to access the over. There's a lot of blood supply to the over and f age and l arrive at the over. The over.

Has this volt, this avery, an reserve of immaturity cells? They resided within what are called followers. The followers are little spherical packages that can potentially provide a nice environment for those extra mature.

And when officiating particular arrives at the over, a small number of those followers will split off from the reserve, they will exit the volt and they will undergo maturation. And the key player here is follow stimulating hormone. And the first fourteen days of the menstrual biliteral cycle is referred to as the folicur phase because of this relationship between F H triggers the maturation of a subset of folk les.

Now typically in the context of a twenty eight day or so observatory menstrual cycle, day one is designated as the first day of the period of the shed ding of the uterine lining from the previous arbitrary menstrual cycle in which fertilization did not occur. A so day one is when the period initiate IT. Is this one through fourteen approximately? right? Because here we're just considering the average of twenty eight day cycle, but IT could be longer, could be short, but the first half of that cycle is the so called phillipe lar phase.

Ea age has triggered the departure of a subset of these followers that contain immature eggs, and IT is trigger the natural of those eggs. Luizi hormones is also present, but also at relatively low levels, and is during the first half of this obbo laty metro cycle that the main goal is to get those folk les to mature. So inside of those folks les, the egg is developing, its growing its mature ing. And in doing so, it's also making its own hormone.

This, I think, is one of the most elegant aspects of the avatar mental cycle, that in a few minutes you'll learn about something which still, to this day, even though i've known about this stuff for decades now because of my training, still just blows my mind that you have one hormone, follow stimulating hormone trigger ing the match oration of some extent of some folk les, and then those followers themselves making another hormone that further is the process. And then soon, as you will learn, create a hormone to trigger the second half of the process. Just a beautiful symphony of expression of different genes and different hormones to make everything work as optimates as possible.

So as these different folks are mature somehow, and we still don't know exactly how one of those folk les containing an egg gets selected, it's either because IT matures the fastest or there's something about IT that is still not completely understood that allows you to be selected and all the other folk les that are matching degenerate and die and they're gone. They don't go back into the ovarian reserve. They are now depleted from that bank account, that is, the ovarian reserve.

They die off. But that single egg, that keeping mind contains twenty three pairs of chromosomes, right? We haven't gotten a rid of one half of those twenty three sets of chromosomes yet, but that one will continue to mature.

And then at some point. That egg will start tuned, undergo a process in which those chromosomes are pulled apart by little components within the egg called spindles. They literally have a physical polling of the chromosomes es apart. So now those twenty three pairs are no longer attached to one another at middle. They were before, like two beds of of strings, or I should say, twenty three short strands of beds that were at once connected to one another now are pulled.

The parts that you have twenty three chromosomes on each side, but they're pulled apart from one another, right? So that deployed cell is now starting to become a cell in which half of the chromosomes, half of those twenty three pairs, are physically pulled away from the others. And then the egg actually starts to form its own, what we call evolution of membrane.

Around most twenty three pairs, one set of them and encapsulates them. So you sort of got an egg with two parts where the two sets of chromosome, two sets of twenty three chromosomes are now separate from one another inside of the egg. And then one of those actually gets ejected from the egg and the name of that thing that gets ejected, it's all like a little hubble pod, is how I imagine IT um you know from from star wars from any kind of uh space otis's movie where something is ready to happen you know a little hubble pot shoots out of the ship.

Well, that twenty three pairs is now ejected from the egg. It's called the polar body and that's going to to generate it's going to go away. And in doing so, take IT the egg ell, which was once deployed.

I had twenty three pairs of chromosomes and making IT haploid. And now what you ve got in ideal circumstances is a beautifully percent egg that was selected for, and has twenty three single strands of chromosomes, twenty two autism and one sex chromosomes. And that sex chromosome one is going to be an x chromosome almost with certainty, because female mother is creating that egg.

So then the egg that contains just the appropriate twenty three single stranded chromosomes is going to fuse with the wall of the over. And that eg will be released and will travel into the floppy tube. Now we'll get back to that egg in a few moments, but in that process, which represents the first half of the obligatory menstrual cycle, again was triggered by F S H, into some extent, leutze zing harmon.

But IT is the ongoing maturation of that egg, which also is the production of estrogen, which allows that whole process to occur. And you can say why? Well, the answer to the why is a very important biological principle that we are going to return to in a number of different context today, both as reference to female and male fertility.

And the principal is a so called negative feedback. So when estrogen is present at relatively low levels and females in the over as IT is during the development of these eggs, some of that asteroid, of course, is going to exit the it's going to go into the bloodstream and it's going to travel back to the petite tory. Now the petite ory can release things like follow stimulating hormone and uti zing hormone.

But the way i'd like you to think about the patuit ory for sake of feedback loops is that it's sort of like a therm etr that you would put into a pool, like a backyard pool that is attached to the heater. And for instance, if you were to put a thermo ter into a pool that you would like to keep IT seventy degrees and the temperature of that pull is sixty degrees. Well, then that thermo ter ought to trigger some sort of mechanism where the pool would heat up until the temperature of the pool hit seventy degrees.

And then you should trigger that thermo ter to turn off the heating system, okay, that to have a negative feedback system that would keep the temperate more less correct. That's a lot of the way that the systems are related to emerging. And also testosterone in these different things, like luizi hormones and policles stimulating hormones work as well. Typically, when the level of hormones is too high, then IT shuts down the production of the hormones that would trigger further production of that money.

I know that's a mouth S A lot to think about, and some of you are probably think i'm getting DIY now with biology, but I promise you can understand this in females, when estrogen is relatively low, but not zero, but is relatively low during that first vicua half of the obituary cycle, IT actually triggers a negative feedback on L H N F S A so that not too much is produced. But then just prior to violation the levels of x rogen and the levels of some other hormones from those eggs, right, you have, the eggs producing estrogen themselves gets high enough that IT actually triggers a positive feedback loop on the petite ory. So the petite teris is essentially observing the amount of estrogen in the bloodstream produced by the over and the amount of asteroid towards the end of the second half of the mentor cycle has increased and triggers a positive feedback loop.

IT triggers the patuit ory to release more effective and L H, and that helps trigger ova tion. Okay, that deployment are the release of that one mature, proper selected egg with that have loaded with the twenty three individual pairs of crime zones into the phillip on to. So this just back up really quickly and just kind of summarize what happened, can out a trop releasing hormone from the hypothesis trigger the release of follow stimulating hormone and uti zing hormone that travels to the over, trigger the release of a subset of immature folk les with immature those immature followers.

And immature eggs start to mature, start to grow because of the presence of a stimulating ormond. The growth of those eggs themselves increases estrogen as the exigent start to accumulate in the environment. Some of that travels back to the petitti. And when levels of estrogen arriving at the Peter tory are relatively low, the paternity, oh, we don't need to release any more folks stimulating and uti zing hormone.

However, at some point, just prior to education, enough east gen has been produced by that one single selected mature egg and some of the other followers around IT that we're maturity but then since died off that the estrogen triggers a positive feedback loop. The Peter tory says, okay, in releases more follow stimulating hormone and luizi hormone and bamb, the egg, which has the proper tuna's components, sets off out of the over and into the floppy too. So called violation has begun.

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That itself, what I just described, constitutes the first half of the obligatory business cycle, which we call the fleur phase. And it's marked by the presence of and some other things. But we can really think about IT as marked by F S H from the petitionary and by exogenous or extra dial made within the over. okay.

Then comes the second half of the obvious laty metro cycle, which I personally think is one of the coolest mechanisms in all of biology, which is that, remember the follow that housed that one egg, that was the selected egg, that became the mature egg, and that follow, which no longer contains the egg, because the egg took off. An evil ted is called the corporate ludie. And the corporate slide um starts to making three hormones, which include extra dial, I think called in hibor.

But the most important hormones, the one that you really need to know about, is that IT starts producing very high levels of protesters on progesterone levels start to increase about the time of violation, although just prior violation. And over the next second half of the odille tory cycle about working days of its a twenty eight days cycle, a bit long, a little IT shorter depending on the the cycle levels of progesterone in the second half of the avila ory cycle are going to increase by fourteen hundred fault compared to what they were in the first half of the obligatory cycle. So again, if we were to charities, the mental obvious laty cycle with in broad strokes, what we would say is that F S H and estrogen mark the initial part, the first half so called policy lar phase, and that the estrogen and F S H set in motion obel tion.

And they prime the system for the production of a corporate ludie, which produces progesterone. And the second half of all of this is called the ludie face. The second half of the auditory motorcycle is the studio phase, because of corpus ludie, this otherwise discarded tissue that produces progesterone.

What does progesterone do? Well, progesterone impacts the uterine lining, so called in demetrian, or the lining, the mucus lining of the uterus, where that egg that's educated is potentially going to implant if it's ferr til zed. And so in a kind of perfect way, or I should say in a um seemingly perfect way, the egg is off on its way.

IT might get fertilized, the remnants of the compartment that let go of that egg produce a hormone that then IT prepares the end metro lining of the uterus for the potential implantation of that, eg. It's basically making the bed for the fertilized egg to potentially embedding, to implant in and then achieve all the nourishment that IT needs to grow eventually into a healthy embryo in child. Just an amazing set of biological mechanisms, if you ask me, because what you're observing here is an incredible economy of function, thereby the same seller components that are producing the egg.

Well, some of them are being discarded, but they are not being discarded without purpose. They're being discarded in a way that trigger the onset of hormonal expression, that then prepares the utilized egg to be in an enriching vironment in which you can thrive. Now, I realized that was a lot of detail, but we have a couple of key themes.

We've got the hypothermia generate. We've got the petitionary with h and and those hormones travel to the over. The over has eggs in a volt, basically immature eggs and volt. Some of those are activated by the presence of effort in l age each month.

And one of those eggs will be selected and will ovate the reminds of the follow and egg that are not selected, the chromosomes that you don't need to disappear in the polar body. And the corpus ludie give rise to process one and sets emotion. The second half of the over the tory mental cycle, which is the ludie phase, which is essentially the potential for that fertilized egg to embedding a nice nourishing environment.

And of course, we should all be thinking if the eggs fertilized and then IT lays down in the nice comments interlining that's been prepared by progesterone in the corporation. Dia, well, then everything's finding good. But what if fertilization doesn't occur? Well, we all know what happens if fertilization does not OCR, if fertilization does not occur for whatever reason, that uterine lining is going to shed. And that's actually what's refer to as the period is the actual removal or the departure rather of the thickened inner medium lining of the uterus st, when fertilization has not occurred.

And of course.

if that happens, we need another observatory, menstrual cycle. So how does that happen? Well, the hormone in hidden is also made by the corporation dian and doesn't go quite as high as the hormonal projection. But I kind of tracks that increase in project raal that occurs in the second half of the obituary cycle. But then if feriz ation does not occur in hidden level, start to drop.

And what I haven't told is what inhibit does, in hibbing, in concert with other hormones like estrogen, feedback to the height thalamus and prevent the further release of the stimulating hormone and uti zing hormone, right? If you have an egg that gets fertilized and can implant, you don't want more eggs to mature, right? You want to hold onto the ones in the volt, you don't want them to mature.

And hormones, I can hibor. And again, working with other hormones are going to prevent the secretion of things like F, H and L, H. Now, typically, people are not getting pregnant every month. In facts, not possible.

In part of the reason is not possible is that if the fertilized egg in plants, there are number different hormones cases that shut down the production of things like G R H, F S H, N L H in ways that prevent further maturation of policles in a funicular phase. But in the instance where fertilization doesn't occur, adminstration occurs. And I should mention that the the duration of adminstration, the actual bleeding typically is anywhere from one to five days.

The court heaviness, the lightness or heaviness of that bleeding will depend on you guess that the amount of progesterone that is a created from the corporate ludic, that's one of the key players there. And adminstration occurs well, then inhibits levels also drop, projection levels also drop. And when that occurs, there's a positive feedback signal .

up at the level .

to patera tory. The petite tory literally can register how much in hibbing and progesterone and exchanging is present in the bloodstream. And if those levels are sufficiently low, well, then G, R, H gets secreted again, F, S, H gets secreted again, and L, H gets secreted again. And the first half, the particular phase of the metro cycle initiates all over again. It's hard to overstate how beautifully orchestrated this entire system is.

The number of feedback loops and feedforward loops, I think if you can just generally understand that the first half of the menstrual avila ory cycle is marked by the maturation the folks in f age, and that the second half is marked by the accumulation of progesterone and the thickening in the user in lining should fertilization and implantation occur, I think that you will certainly understand the female reproductive cycle Better than most people out there. You will also help you understand the number of things that are sometimes associated with the female reproductive cycle. For instance, third data showing that in many, not all, but in many women in the four to five days prior to violation, there is a dramatic increase in libido.

That dramatic crease in label is trigger by a number of things, but some of those things include the spiking F, S, H that occurs, the Spike in L, H that occurs and some associated increases in androgen, things like D A G A. And to stop drone, which Justin males can be related to libido in females trigger libido. You can imagine why this will be an effect mechanism to have in place in females if the goal as IT were um certain in of the egg, perhaps not of the the woman as a whole, but if the goal is to fertilize the egg. So increases in lib to just prior to the onset of violation. There's also been a lot of discussion in interest and Frank data expLoring the malaysia can occur at certain portions of the of dementia cycle, and there's a lot of misconception about this.

A lot of people have focused on the malaysia a that can occur around the time of bleeding, but there are actually stronger data to support the fact that some, again, some, not all women experience kind of male, sometimes associated with aniele, sometimes not that associates with the mid to second half of the ludie phase of the bilateral menstal cycle in that despite what people commonly think is not associated with elevated levels of estrogen, is actually associated with the depletion in estrogen levels that can occur during certain portions of that second half of the ludie phase of the menstrual cycle. So um again, this is highly variable. Um you know for some people they might not experience any malaise at any point during their montral cycle.

Other individuals also, for instance, might not experience any variation in their libido at any point during their montral cycle. Again, highly variable. And yet there are some statistically significant trends that have been that track a very specific corbo al components within the menstrual cycle.

Again, this will all be very contextual. And of course, this can play out in a number of different ways. So for instance, some women experiences very hidden levels of sensitivity to caffeine at certain portion to their mantra cycle. Other women experiences more crap than others. Uh, different portions of the immensely cle tremendous variation from individual to individual.

One of the I view that has an advantage, but one of the things that many females can really do and experience because they have cycles that occur every month that are fairly dramatic in terms of the levels of hormones. For instance, a more than thousand fold increase in protesters, one during the ludie phase of the menstrual cycle. And I should also mention a two hundred fold increase in estrogen during the area just prior to violation.

That's why they always say, x rogen primes project on what you learn and basic under chinois. Gy, when you're learning the metro cycle. S rogen, in the first half of the metro cycle, prime protesters in the second half of the of the obligatory motorcycle.

Well, that those estrogen increases just prior to violation are in part responsible for the increases in label, but it's also the presence of increased androgen just prior to population. So there's a lot of complex interplay. I think what we will do is we reserve the discussion about libido persae and some of the other aspects relate to sexual differentiation that we're talking about earlier for a future episode. But hopefully now you haven't in mind what the bilateral tor cycle is.

IT is a signal from the brain, from the hypothenuse, which then trigger a signal from the petite ary and enduring en gland, which then signals the release of hormones that travel to the over and that control two things, maturation of eggs and the identification of one in particular, and then preparation of the menu, the environment in which that fertilized g could potentially land and mature into a healthy embro and child. So if you have that framed up in your mind, and even if you just extracted maybe ten to fifteen percent of the hormones in different aspects I described up until now, I would consider you far more knowledgeable about this entire process than ninety nine percent of people out there, certainly not the O B G Y S. And neurologist, but then ninety nine percent of individuals out there, IT, also frames up for us the second half of this whole story about fertility and fertilizer ation, which is the generation of sperm and how the sperm eventually arrive at the egg, and how certain sperm are selected to potentially fertilized that egg, where, as others, never really stand a chance.

So next we're going to talk about sperm. We're going to talk about what sperm are, where they are generated and how they are generated and how they need to travel, both within the male and within the female in order to allow fertilization of potential to occur. So we've covered red, the avatar cycle in females.

And I confess IT was a lot of information with a lot of biological Norman creature. But I promise you that many of those same themes, and indeed the same names and naming culture will show up in the discussion that we're going to have now, which is about the generation of sperm. Now, sperm are similar to eggs in the sense that they are part of the german, and they are these protected cells protecting the sense that the activities of an individual are not going to change the genetic makeup of those cells.

Now, again, there are insists in which mugen, such as chemicals, could disrupt the genome of the germ cells and males, just as I could in females. But in general, the activities, the things that we do, the experiences we have, doesn't tend to change the genome of those cells. However, there are a lot of list yle factors, dues and donations, nutrition and supplements and prescription drugs is set up that can indeed modify the quality of the sperm and will talk about what sperm quality means.

But the point is that the sperm cell, much like the egg cell, are both germ line cells. They are not like some atic cells. They are unique populations.

And let's just remember what the job of the firm cell is. The job of the sperm cell is to deliver the genetic material from the father, and to do that in the form of a haploid cell. So that means twenty three chromosomes, twenty two artizans one so called sex chromosomes.

Again, not sex the verb, least not in this case, sex the verb is a disgusting. We're going to have a few minutes, but sex the now the sex chrome can either be an x chromosome or A Y chromosome, a twenty two autozone. And then one sex chromosome is going to be contained within the sperm because it's a haploid cell, not a deployed cell.

Remember, the egg was deploy, then I became haploid. The sperm cells are cells that are created through the division of other cells. But after that division occurs through a process called my oasis, the sperm cell is going to contain twenty three chromosomes consisting of twenty two autozone and one sex chromosome. And the sperm that manages to deposit its DNA contents into the egg to fertilize the egg will either have an x sex chromosome one or A Y sex chrome.

And the y sex chrome has a number of different genes on that chromosome that will suppress, for instance, the development of the female reproductive access of one good example be the malaria inhibiting hormones M I H, the gene for malaria inhibiting hormone, which is a hormone that prevents the formation of the malaria ducks, which is part of the female reproductive structure. Well, that gene controls the prevention of the development of the female gene talia, and in doing so, promote the development of the male Janet. And there are other examples of genes that are on the White chrome zone that give you a what we call male fino type right of genotype and finer type.

By the way, in case you hadn't heard this in a while from your high school biology, or if you never heard IT, no big deal. Carrio type is the compliment of chromosome one xx or X, Y. And there are individuals out there that are xx, y or X Y Y A discussion for our episode on sex or fluctuation that's carrio type with A K then there's genotype, which are the genes that you have and then there's phenotype spell P H P H E N O.

T, Y, P4 type。 And the final type is how the genes, which then code for R N A, which code for protein, how those are expressed in terms of things like eye collars. So ee colors of genotype height is a monotype hair colors of finot.

Pe, I give you a Carry type genotype and genotype. Well, what we need to do is we need to bring together that sperm, which is haploid contains us twenty three chromo strands with either an X A Y sex chromosome is the twenty third crimm. We need to get that cell to the egg. And so when we talk about spermatic genesis, of course we are talking about the generation of sperm cells.

But what we're really talking about is the generation of cells whose job is to deliver the genetic material from dad to the egg within the female, in a way that increases the probability that not only will that would be fertilized, but that IT will progress in a healthy way with each set of chromosomes from mom and from dad. Each set of twenty three chromosomes, that is, we progress in a healthy way, will implant in a healthy way and will maintain and grow in a healthy way to a healthy embryo and child and eventually adult. That's the job of the sperm.

okay. So as we talk about spermatic genesis, let's just remember that and why they're there in the first place. Now a few things about sperm that are interesting, besides the fact they're haploid and besides the fact that, as you all know, they swim, they have a head in a tail. They actually have a head of mid region and a tail.

That mid region turns out to be very important at something will come back to again, again, that mitt region is really key for the ability for sperm to engage in forward progression, to swim forward, and involves the activity of metal country of which are involved in generation of atp, which is involved in all aspects of energy and all cells. But let's just remember that the sperm are swimming cells. And in order to create a really good swimmer or set of swimmers, you need a couple of things.

First of all, within the testes is where the sperm develop. And unlike in females, and unlike in the over, there's no volt of sperm. The sperm are continually being generated, takes about sixty days for sperm to be born from their parent cells because cells actually give rise to other cells that so IT works to be born from their parent cells and then matured to the point where they can be a really good swimmer.

Now that doesn't mean that a bunch of the sperm made on day one and then sixty days later, although spurr deployed in the form of a jaculation, then the cycle starts over again. So it's a little different than the oval latoria mental cycle, rather at any given point time. Like right now, if you have tests, you have some sparing your testes that are immature and cannot swim, cannot deliver those contents uh to those genetic contents rather to the female egg.

And you have some customer mature and you very likely have some sperm that are so mature that they are dying off, that they're dead. Almost certainly also, regardless of your age of some sperm that are healthier than others are Better swimmer than others. This is just the way the system works.

Now the processes super matic genesis involves a couple of things, but a lot of the players are the same as the process of developing this called outside the immature egg we've got generate from the hypotheses that's gonna a player. We have F, H, follow stimulating hormone, although the names is a little bit of a miserable in the context of supermac genesis, because in the context of spermatic genesis, there is no follow what we're really talking about as fh for stimulating the maturation of the sperm cell. So not egalite, but sperm cell.

But we still have generate ea sage L H. And rather than the overall bringing the target of those hormone t, it's going to be the tests. So most everybody should know that the tests and the rovers are the so called go ads.

The testes, of course, reside outside of the body. There are instances where the testes failed to descend during development. Certainly, if the testes don't descend on time, that something that doctors need to be made aware of, the, we be made aware of, because that can prevent fertility.

Why would that be? Well, turns out that the testes reside outside the body in the scrotum, because the temperature conditions under which permai genesis can occur and under which healthy sperm can be maintained are very restricted and is is approximately two degrees cooler than the rest of the body. This is very important.

You know, I think this is something that used to be discussed a lot more, but isn't discuss so much these days. But keeping the testes cool enough doesn't assuredly mean keeping him a cold aleve. There is a place for using cold exposure, deliberate cold exposure, to improve sperm quality and number.

And perhaps even testosterone levels will talk about that little bit later. But keeping the testes about two degrees cooler than the rest of the body is absolutely key. If sperm get too hot, they die.

And if spermatic size the cells that give rise, the sperm get too warm, then often times the sperm that develop are not healthy, not healthy in number ways. Either they can engage in fast for progression, and that is swimming, or they will lack the ability to deposit their DNA contents ts within the egg. So again, whatever is containing the ejaculates is going to be a mixture of different firm qualities.

And sperm of different ages will impact the quality, but also the temperature under which those sperm developed is going to impact their quality. And so we're going to get into tools, little bit letters I mentioned. But just to give you a simple takeaway, if you are hoping to conceive in the next ninety days, right, the sperm genesis cycle take sixty days, but then the sperm actually have to migrate from the testicle into the so called epidium mist, which is a related structure, and then into the vast difference.

And then into the redrored can be part of the attacks late in order for burn to do all that properly, undergo that maturation and then exit in ejaculate in a way that's healthy or that the sperm is healthy. If you plan to conceive children, or to try and conceive children in the next ninety days, you definitely want to avoid exposing your testicles, that is your scrotum, to elevated temperatures. So that means definitely avoiding hot tubs, definitely avoiding hot bath and brief hot baths or hot tub or hot shower isn't going to be a problem.

Although if you're really interested in conceiving, I would avoid hot tubs and and hot zz as much as possible. Hot showers are probably fine, but if you're going to go into a sona, for instance, you might want to rethink that decision. And if you do decide to, you almost certainly would want to bring a cold pack in that you could um well hopefully put some material between the cold pack and in the stroma.

Cy, don't get a cold burn, but put something there, but keep the scroll al tissue cool, keep IT cold to cool because heat exposure can really mutate and disrupt the developing sperm, and IT can kill sperm. And so again, that would be for an entire ninety days leading up to your attempts to to conceive. Again, we'll get into more tools later.

But a number of people also, I ve probably heard of the boxers versus briefs controversy I guess IT is um or whether not people call going command do with no um with no underwear of any kind boxers brief s brief s or otherwise rather turns out that the data that point to the fact that there isn't really a big difference in terms of sperm quality if people wear boxers or briefs or don't wear anything under their genes are shorts at all. Um the scrotum has the ability to move the testicles far enough away from the body in order to achieve lower temperature if IT needs to IT achieves that through a muscle called the crew master muscle, which is a really interesting muscle, believe or not, was reading up on the biology. The crew master muscle, something I never thought i'd spent out too much time on, but that I ended up spending far too much time reading up about.

And it's really fascine. What you have is a, is A A muscle. There's a smooth muscle tissue, unlike skeletal muscle, which is dry muscle that is temperature dependent. So IT has certain nerve dings and IT has certain receptors on IT that allow you to respond to local temperature and then to relax in order to um essentially let the testicles les to descend further from the body or to contract and bring the testicles closer the body in order to try to maintain the optimal temperature range and IT turns out the cream master muscle can achieve that whether not people are wearing boxers or brief s although IT stands to reason that any kind of um the name or undergarments you know know why that word is is just seems kind of antiquated but underage that allows some movement of the of the screw M M and the testicles should be sufficient to allow these temperature uh variations to occur and keep keep things in range.

Um that said a little bit later will go into some detail really because it's important as to why, for instance, if you are somebody who has big size, please or not, that I actually can lower sperm count, substantial. Where are not the big size occur because you're are very moscow. The big size occur because you are overweight.

You can increase the temperature if you're sitting a lot increases global temperature for sure. And there are some other things that can increase scrotal temperature seat heating in cars, for instance. Terrible idea if you just terrible idea if you're hoping to conceive in the near future um and again, hot tub things of that sort.

okay. So temperature modulation of spermatic genesis and sperm quality and function is key. That relates a little bit more to tools.

But what happens? How is the actual sperm develop? Well, contain within the testicle, you have the cells, the so called spermatic ona, which differentiate into so called super matic cites. You don't have to remember all this.

And the supermax ized undergo this process of BIOS is BIOS is is a form of cell division which reduces the chromosome one number to those twenty three individual strands as opposed to pair, right? So IT makes them haploid as opposed to deploy very, very important for reasons that we talk about. And the myo sis process in .

these primordial sperm cells.

these images, sperm cells, is similar to the milosis process that occurs in eggs when the chromosomes segregate, and that involves these spinal like structures within the cell. Now, why do I keep bringing up the spindles? Well, turns out that the function of the spindle in the egg in the sperm is heavily dependent on mda contro function.

And later, when we get into tools for improving and from quality, you're going to hear about a lot of tools improving miton ria. It's not just because the medico involved in in energy demanding aspects of cell biology, but also because the meta country in this context are very, very important for the removal of or the separation of one set of chromosomes. To give you these two sets of haploid cells, the egg in the sperm.

And this is so important because many failures at fertilization, many failures at implantation, many, many miscarriages and many birth effects that do survive after birth that are very detrimental, such as try to mies and things like that, occur because these spindles don't effectively pull apart the chromosomes in the typically the egg, but IT can also occur in the sperm. Okay, so these spindles, in the fact that might a country are rich on the spindle, are very important for generating these haploid. Burma in twenty three individuals, trans crimson, that's occurring inside of the testes.

okay. So there's not as much long distance migration of the supermarket of the super matic sites and the sperm cells as there is the egg, just when you think about the overall architecture of the U. S. And the Philippine tubes compared to the test, but is still a lot of movement. So within the testicle, if you were to look at the testicle and cross section, and I prefer to call IT, that rather than cut the testicle in half.

And any time you talk about anatomy, actually talk about slicing and things that what you would do with that as um my teaching and we do um my laboratory and I Frankly in biological laboratories all over the place. But when you talk about talk about you were to take a visual cross section through the testicle. What you'd find is that there are a lot of different little tubes, lot of ducks, D, U, C, T, S, ducks. Those are pathways. And the main ducks that are important for this discussion are called the semi fous two bills.

Okay, so it's it's a mesh like or network structure of tubes in the testicle and the images perm sit on a little compartment um along the edge of those tubes and as they mature they move towards the center of those tubes and then when they are mature enough, those sperm cells actually drop into the hollow of the tube and they can travel through those tubes to a structure that along the side of the testicle called the epidural mis. The epidemic is again as a series of ducks and then the epidemic is converges. IT was something called the vast of difference.

okay. I think in high school we all remember this. I think about is the vast difference.

I don't know, I don't know who came up with that. Maybe I think IT was a Young girl sitting to the left of me. That was, I go. It's like the vast difference. I never forgot that I know maybe the topic matter maybe is here, maybe was some combination of the two, but in any case, the sun go from the summoning first two bills to the epidium mist, and then to the vast difference, and then are contained in the ejaculate, along with seminal fluid. Now, the seminal fluid is the Carrier fluid for the sperm themselves.

This is important because IT turns out that a lot of things that can both negatively or positive ly impact the quality of the spur m relates not just to the sperm cells of themselves and the temperature, the environment that they were measured in, but also to the seem and quality. For instance, if you are a heavy drinker, if your smoker, or if you are a regular user of cannabis, especially if you smoke cannabis or or VP cannabis, you create a lot of reactive oxygen species that disrupt the chemistry of the seminal fluid, which disrupts the sperm sale. So it's not a direct action always on the sperm cell itself.

Although IT can be sufficient in the form of of smoke tobacco or cannabis, there are a lot of cosine gans and mutants that actually mute the DNA can cause DNA fragmentation and debilitate sperm. But there are also a lot of things created by smoking in particular, whether regardless of what's being smoke, they can create elevated reactive oxygen species and disrupt the seminal fluid that the sperm contained in in the so called the jacket of the cement. Now, this will also become a relevant conversation later when we briefly talk about victimise vacates.

Mies are literally a cutting of the vast difference, which leads to a situation, provided the surgery was done correctly, where men can still achieve all the other aspects of intercourse, I can still um achieve erection, they can still achieve orgasm, they can still ejaculates, but when they ejaculate the seminal fluid is released but there are no sperm contained within the seminal fluid. And IT turns out that um the economies are a very effective form of birth control and they always check to see if zeros firm and confirm the zero s burner being released. Eject late.

They are reversible. That is the sector mies are reversible but not always. There are a subset of cases where it's not reversible, in which case of people still won't have children.

You have to go in and actually surgically extract sperm from the testicles. Les, but it's a process in which the vast difference is altered or severed in a way that the sperm can actually exit the testicle. They can get into the epidemic usually, but not into the vast difference, and so on and so forth.

So if you've ever wonder what of the sector is that? What if acceptor my is? And I mentioned the sector me now, because IT illustrates the difference between the seminal flu at the semen and the sperm that the semen contain.

Okay, so sixty days to generate these this firm another um two weeks or so for this firm to travel through the various ducks to the point where they can be contained in the ejaculate. Let's talk about the sperm selves themselves. The sperm selves again have the twenty three pairs of single stream chromosomes that are hap loyd other and x or y sex crime zone is the twenty third so called sex chromosomes.

And as we all know, they have a head. The head tends to be oval. In most cases, the head contains very important enzyme s and proteins that are designed to fuse with the much larger egg and to actually take the membrane of the l and combined, actually mesh with .

the egg .

cells membrane, and then deliver the genetic contents to the egg l in other words, to fertilize the excel. Now, just behind the head is a region called the midd region. That middle region is a slightly thick region.

And here, of course, i'm talking about healthy sperm cell mythology. Morphology simply mean shape, a mda region. That mid region has a bunch of things related to sell motility and to the ford progression of the cells. First of all, IT is chock a block full of meta contrary. In fact, if you were to look just behind the head of the of the spring, what you'd see is that IT is completely surrounded by meter contra.

There are my contrary elsewhere in the cell, but most of them are contained in this mid region compartment just behind the head of the sperm and that thick region is where the tail movement of the sperm, the um the flag lation back and forth, is actually generated from, much like if you were to hold a rope, you know like a battle rope in the gym um and you were to um you know whip the battle rope. The whip at the one end of the rope is what allows for the the that just called what IT is that the curves in the rope, that the assumptions, the rising and of the robe all the way out to the end, right? This is as the force of the of the whip right at that end, you know, with the battle of you're doing with your hand and with the sperm that is occurring just behind the head of the sperm that is actually going to dictate how fast and how well that firm can swim.

And indeed, this firm has swim very far how far? Well, on a relative scale. And again, these are estimations because they are going to be um how should we say there will be differences in the distance from the head of the penis and where the ejaculation occurs to the service depending on the relative size of the vagina inal canal and the penis that delivers the ejaculates to the vaginal canal but once the sperm arrive at the service x okay, which is at the back of the original canal, just at the opening to the uterus.

Once the sperm arrive there, the distance from the service x to the egg, of course, will vary depending on where that egg is in its orbit, laty trajectory, its pathway. But IT is a kin based, if you scale for size to the distance between los Angeles and san Francisco, which is many, many hundreds of miles. So those firm have to swim very far.

Now, of course, if this perm delivered in the vagina inal canal somewhat further away, they will have further to go. If they're delivered right at the server cal opening, they will have less far to go. The very effective .

swimming .

perm swim very fast, so they are able to accomplish that distance in just a few days. And this relates to a discussion that we will get into in a lot more detail later as to how often couples should have intercourse if they're trying to conceive, makes people might think well every day. However, the more frequently event lation, the lower the concentration of sperm in each ejaculate.

So this is not discussion about how often to have intercourse depending to your preferences for pleasure or bonding or whatever reason. This is a discussion about how often to have intercourse in order to optimize the probability of fertilization of the egg. There are some general rules that, of course, come to mind, which is evacuations close to violation, but before, during, or sometimes after are obviously advantages.

But you will also hear O B G yds and neurologist suggesting intercourse every other day leading up to the day of violation, starting about three to four days out from the day of violation. So we got a little bit side track, i'll be IT, I think, appropriately so, in focusing on fertilization. But what we are talking about right up into the point of that is the anatomy of this problem itself, which is the head, the middle gon, that contains all those midcontinent. And then the tale.

no.

what we haven't discussed is the actual generation of the sperm. So if you're a male or if you're a female, I think it's really important to understand how permanent genesis works. Spermatogenesis works in much in the same way that the generation and maturation of eggs work, although as I mentioned before, it's going to occur ongoing throughout the cycle of the males life after puberty.

We already talked about poverty, and i'll just cover this in two or three sentences as IT relates to males, and it's essentially the same thing. The hypothenuse up until the point of puberty is providing suppression of the released of canada drop and releasing hormone, then some biological clock, which is still not clearly understood. It's probably not lept in coming from body fat again, unlike in the female.

It's probably not left in coming from body that but some other signal arrives to hypothalamus, removes that inhibition and G N R H and nature and releasing hormone is now released onto the petitionary. A bunch of hormones are deployed from the pituitary. As a consequence.

The two most, most important ones for the context of this discussion are follow stimulating hormones, luti zing, hormonal stimulating hormones and lu ti zing. Hormones travel to the tests, and they're going to do two main things. One, they're going to trigger the production of testosterone and they're going to trigger the production of the sperm themselves.

They're going to set in motion for essentially the rest of the life of the the production of sperm. They are going to initiate the sperm ages a cycle, and that cycle is going be ongoing at various stages for different perm. For the rest of .

the mann's life.

there's very different than the trigger ing .

of development .

of oo sites and eggs and females where there's an existing volt that that the vault can be depleted to the point of zero. Where can OCR again? Men can generates burn their entire lifetime.

Of course, there's a diminishment of sperm production in very, very late age, eighties and nineties or hundreds, but believing that they're still sperm being produce, the quality of those firm is another question. So everything we're going to talk about now is essentially puberty onward. Okay, prior to that, testicle s are present, but they're not generating sperm.

The accusation is impossible. Or if IT is possible, it's very unlikely and unusual and it's not going to contain sperm. Everything we're going to talk about now is puberty forward.

Okay, so puberty onward to the rest of life. And l uti zing. Hormones are created from the petite ory acts on the tests and on a very specific cell type in the testes called the lady g cells, or ladies cells, L E Y D I G.

The lady cells. The latest cells of the testes are what produce testosterone. Testosterone is going to have two major effects. And here, I mean, really major, because he has many, many hundreds of effects on different issues of the body. In fact, that's the definition of a hormone really.

It's it's a substance that that act in an indecent fashion that can act on the very tissue that generated IT. So for instance, test astra made by the lid cells within the tests will act on the tests will talk about the moment, but I can also act on other tissues. IT can act on the fairings and layering and deep, and the voice says he does during puberty, connecting on the hair folks, and generate facial hair on the musculature, and generate protein sentences and development muscle, bone, eat a, okay, all the things we associate with puberty.

In with test stone, typically restricting the conversation to the effects of testosterone on the testicle itself. In on supermac genesis, the light cells make testosterone. And keep in mind that some of that testosterone will travel elsewhere in the body and do its thing for gene expression.

In the more acute effects of testosterone on the brain included, but the testosterone within the tests is at extremely high concentration. In fact, the concentration of interest, testicular testosterone, is at least one hundred times higher than the concentration of testosterone anywhere else in the body, even though it's being secreted into the rest of the body. And that's because there are a number of different so called binding proteins and ensigns that sequester the test aste rone within the testers.

So the light of cells are making test astroland. A lot of the test astura is acting on in is restricted to the testes. And that turns out to be very important because testoon within the test acts in concert with a different biological program that starts with eval stimulating hormone that also travels to the testes and acts on a very specific set of cells that are called supporting cells, or more specifically, they're tally cells.

The seti cells are the cells that generate something called A, B P, or androgen binding protein. And IT is the combination of testosterone from the light cells and abp from the catti cells that is necessary for spermatic. Genesis is necessary for those spatialized to become what will eventually be healthy, mature, firm that have really nice shaped oval heads, have a middle region chock block through ma contra, and can generate a fast whipp in motion of the taye to swim.

From the survey s are .

up the rejoining to the survey s and from the survey to the egg to fertilize the egg. So it's really a basic set of chemical players that are involved here. And so basic, in fact, that if you were to disrupt any one of these chemical players, either the loony zing home on the effort, the testosterone for the light cells, or enter in binding protein, you would observe pretty market disruption in permanent genes or the elimination of sperm entirely will get into a few deficits and sperm development and sperm number and sperm functional little bit later.

But just keep in mind where I should say maybe sit back and just appreciate that the exact same players generate from the hypotheses almas, which causes lung zing hormones, and follow stimulated hormones released from the patatras, which travels to the go at which, in this cases, the testa, which triggers the release of test astern from light cells, which triggers the action of the supporting cells, are totally cells which make energy and binding protein, to also, on an android binding protein, combine and create a chemical and actually a structural menu in which those little supreme medium des can go from the walls, from literally the walls of the tubes of the semi force two bills can mature into healthy, well developed sperm, and can hop into those ducks, those little tubes, and then head off to the epidemic. They will reside, the epidemic, the tissue nearby, the testicle surrounding one portion of the testicle, and then eventually fuse with the vast difference, can combine with, or be contained with, rather the seminal fluid ID, and then can be ejaculated, either you, we throw into the female, or then they can swim very quickly, productively. The distance for them anyway, from los Angeles, december csco, over the course of a very short period of time, and fertilized the egg so that the process is permeated genesis.

The maturation of sperm, which is ongoing throughout the life span from poverty, honored. And in doing so, we talked about some of the hormonal elements coming from the hypotheses and coming from the petitti and within the tests themselves, the lady cells, which produce a tosta on the story cells, which are the support cells that allow spermatic genesis to occur. With that in mind, next i'd like to think about what's actually contained in the ejaculated in terms of numbers of sperm and what's really being selected for in terms of the experiment that actually successfully fertilizes the egg, and what sorts of elements coming to play in dictating whether not fertilization will or won't to occur and the major themes that we're going to discuss, our frequency of ejaculation.

But really, that's just kind of a proxy for talking about maximizing sperm concentration and quality of sperm arriving at the egg, right? Because remember, violation in the menstrual cycle really about creating the opportunity for fertilization OK. And we are also going to talk about how the vaginal duct, the vagina and the menu around the services and some other elements within the female herself contribute to and support the sperm in their journey to the egg and in the likelihood that they will fertilize the egg.

So really what we need to talk about first is sperm quality. And we should also probably talk about ejaculates quality because as odd as that theme might seem, really the ejaculates quality, which has a number of different parameters, including the number of mature firm that are not so mature that they're swiming slower, are dead but also qualities firm that have friends, is one tail. It's not entirely uncommon to sea sperm with two tales, right, because they just didn't form properly or sperm that are not moving very much um in fact, spam motility is scored along a scale of zero, one, two or three three bring the best fast ford progressive a zero is not moving at all um one they are actually called twitchers, right?

Twitchers are sperm that are just twitch in place but don't undergo forward progression. Two with somewhere in between one and three, not surprisingly, different clinics, different ob js, different eolians sts, will throw out different numbers. But in general, IT is hoped that more than fifty percent of the firm should be motl in somewhere, or others are not scoring a zero, but a one or two earth, ideally a three.

The concentration of sperm, of course, if it's higher within the ejaculates, you know the total number of sperm per little leader of ejaculate, if that's higher than there's a higher probability that one of those sperm will fertilize the egg. One thing I didn't mention before when discussing the production of eggs and ovl tion, and I probably should have so I will now, is that most often only one over gives rise to an emulating egg, right IT IT happens. But it's somewhat rare for to two mature eggs won from each other to be deployed during a single abul tion.

Ah there's a name for that when IT occurs in both are fertilized is called fernand al twins um if a single egg that of course comes from a single over is fertilizing the egg splits and that something that happens further along the process of fertilization and differentiation of the embro, well then what you get are identical twins. Um there are other instances that are um quite uncommon in which you can get for internal twins through other circumstances. But in general, that's the wait works.

But essentially what happens is one egg from one over. That's the most common, accurate. The sperm once ejaculate into the vagina, inal duck are going to pass through the services and then are going to swim m toward the egg.

The egg could be at varying locations along the female reproductive access. Now this is actually a very important thing and actually gets right down to um the safety of both the potentially developing embryo in the mother. There is something to refer to as a topic pregNancy, and that's when the pregNancy actually occurs within the philopena tubes.

So the precise location in which fertilization between the sperm in the egg occurs can vary somewhat, but ideally the feriz egg implants into the enter medium where the enemy trial lining of the uterus and develops there as opposition within the floppy tubes, which is so called actos c pregNancy. Now, where they permit egm exactly can vary, as I mentioned before, but in general, the faster swiming sperm and the more far along the bilateral sectory the egg are, the higher the probability of a successful fertilization because of the proximity to the implantation zone of the uterus. So basically, it's all a probabilities game. It's a probabilities game related to the number of sperm cells that encounter the egg and where the egg is in terms of its observatory cycle and also its position where IT is in the obligatory cycle.

the.

Sperm parameters, I should say the semon parameters and evicted parameters that most clinicians want to see if you were to give a sperm sample would be somewhere in access of fifteen million sperm per million leader of ejaculate. Now there's a lot of discussion nowadays seems to be a very popular news theme to talk about diminishing sperm counts.

You know, the idea that one hundred years ago, or maybe even thirty five years ago, the typical mail jacket contained one hundred million sperm per mil leader, and nowadays it's down to fifteen to twenty or fifty. And indeed, sperm counts do seem to be declining, and the exact reasons for that are not clear. Now confess some a little bit reluctant to talk about this because there have been a lot of back and forth discussions about the safety of em s of electro magnetic fields. It's not exactly what we're talking about here, but there are some excEllent data contained many analysts and reviews that I will provide links to and that will talk about in more detail in a minute. That corporate the advent of smart phones in a particular caring of smart phones in the pocket with diminishing sperm counts, although there are certain to be other factors that can explain diminishing sperm counts as well.

Um doctor shana swan uh for instance, is beautiful work describing how the sallets um and the B P S and so called and the disruptions might be disrupting some of the menu of the seminar first tube eels that this would be reductiones in testosterone one end or disruptions to the sir toy cells and energy ine binding protein brought about by underground structure such as daleys contained in pesticides and contained on printed receipts and things that sort they're awesome data that that is negatively impacting um sperm counts. How much so is still debate. There are also quite good data pointing the fact that both the heat related and the non heat related impact of smart phones and laptops contained on the the lap are impacting from counting in a negative way.

Again, there is going to be tremendous variation in the concentration of sperm from one individual to the next IT will vary according to age. And a number of other factories that will talk about a little bit later. But in general, if somebody is wishing to conceive, then clinicians like to see a ejaculate volume of more than two Miller leaders.

So jet late volume can be anywhere from one point five to five million leaders. And that will strongly be determined by how frequent ejaculation is occurring. There's a lot that goes into evaluating quality of ejaculate in sperm, but basically these huge variations that are observed of anywhere from fifteen million sperm premier leader or in some males who are not producing sperm for whatever reason.

We talk about those reasons in a little bit. The as lowest five million um sperm premiere leader all the way up to hundred or may be one two hundred million sperm premiere leader. Huge variation, the cause of which is not always clear but is certainly determined in part by the frequency of event lation.

So because there are so many variables impacting why one male versus another male or even the same mall across the life span might have variations in his, uh, concentration of sperm within the ejaculates. Let's talk for a second about frequency of event lation as IT relates to the goal of fertility per sick because that's really what today is episode is all about. So what i'd like to talk about next is how people can increase the probability of a successful fertilization, focusing both on the components from the male side and from the female side.

And i'm mainly going to couch this discussion in the context of the so called natural method of sexual intercourse and ejaculation in vivo right within the female, but I will also touch on some parallel themes as IT relate to in vitro feriz ation and intrauterine insemination. okay. So the idea here is that we want the maximum number of high quality firm that is rapidly for motors, firm that are of the correct mortal logy that is shaped, that's going to require a lot of meter conry and the mdr region, a well shaped head.

So it's gonna an ov shaped head. The tail is gone to be a single tail, not multiple tails. These aren't to be at the twitter type of of or in motor type of sperm that are either twitching in place aren't moving forward.

All of those components are going to be essential for increasing the probability of fertilization. But of course, there's the female side of IT too, which is that violation occurs on just one day during the metro avila ory cycle. And that egg will be available for vertical zone for approximately twenty four hours.

Now keep in mind that the sperm can survive within the vagina inal duck and within the area, around the services and within the uterus and a along the female reproductive track for anywhere from three to five. Or it's even been described up to seven days, but generally it's going to be about three to five days. Now most women can figure out the day of their ovulation by counting the total number of days of their typical cycle.

This is where it's really useful to have a cycle that of more less regular duration or rather of more less regular life. So as we talked about earlier, if somebody is cycle is twenty one days or twenty five days and it's twenty one or twenty five days consistently or even thirty days consistently, that's going to be a far Better scenario to favor feroza. Then if it's twenty days one month and then twenty one days the next month, but then suddenly, you know, thirty days and then sudden thirty five days, those varying durations of the observatory cycle make IT very hard, obviously, to time and understand when ovulation is going to occur.

So regular duration of tory cycles are the ideal circumstance. There are the ideal circumstance because even though the eggs only available for fertilization for a few days, the sperm can survive for some period of time, which leads to the issue of how often should couples be having intercourse. And here, referring specifically to intercourse with ejaculation, how often should couples be having intercourse around the time of violation, if the specific goal is successful, fertilization of the egg and the creation of a baby? Okay, this is leaving aside all issues, which of course, are interesting issues related to how often people are having intercourse when they not.

There's event lation every time they have intercourse or not for sake of pleasure or sake of their bonding and pleasure or for sake of any number of other potential goals of infer course here i'm only referred to inter course as IT relates to the goal of fertilization of the egg o so knowing what we know about spermatic genesis, in the fact that ejaculate is going to contain a certain concentration of sperm, but that within that ejaculate, some of the sperm will be older and less healthy and some will be optimistic, mature and some might even be a little bit immature. Although there's a tendency for the image res firm to not have yet exited the seven inforce two bills s gone into the epidemics and vast difference. But given that the educate contains sperm of varying ages and therefore varying quality, and given that with each successive event lation in a short period of time, there is going to be a decrease in the concentration of sperm per mille ader of Simon of adjacent, we can make some good arguments as to how often couples should have intercourse with ejaculation around the time of violation of the goal is to fertilized if ovulation occurs on for insane day fourteen of a cycle.

Here we're using the kind of standard average of twenty eight days the cycle. But for some people with thirty days cycle, you know, that could be a day fifteen or with a shorter cycle b day a twelve, for instance. But given a twenty eight day average cycle, let's say ogula's occurs on day thirteen or on day fourteen and typically would occur on day fourteen of a twenty eight day cycle.

Given how long sperm can survive inside of the woman, you might think that the optimal strategy would be to have as much intercourse with the jet lation in the three or four days leading up to ogula's hope that those permits were as far as they possibly can, and we will encounter the egg just as soon as possible after IT obviates IT. Turns out that's not the optimal strategy. The optimal strategy is really to maximize the concentration of healthy sperm within each adjacent to really center that around the day of violation.

So what this involves generally with the typical recommendation is, is to abstain from intercourse with ejaculation about two or three days out from violation, and then on the day prior to emulation and on the day of violation, to essentially introduced as much semon and ejaculate into the reproductive pathway of the female as possible. 对， now that's the general recommendation that the O B G I S. And the urologist I spoke to gave, but you will also hear a different strategy.

It's only slightly different, but the different strategy involves trying to maximize the concentration of healthy sperm with an each jaculation with the understanding that with each subsequent ejaculation over about a twenty four hour period, that there is going to be a dramatic reduction in the concentration of spring. What that means is that if a couple, for instance, where to have intercourse with ejaculation many times on the day prior to emulation, yes, that will introduce a lot of sperm into the reproductive pathway, the female. But what IT means is that on the day of violation, if they would have intercourse, the number of high quality firm that will be available to the egg will be greatly diminished.

And if none of the sperm that were introduced in the day prior manager fertilize that egg well, essentially chances are off that there will be feriz ation or they are greatly diminished. Rather, if they're having intercourse with event lation once or twice on the day prior to violation and then a maximum number of times with event lation on the day of population, that itself can maximize the probability of realization. So which tragedy is optimal? Should couples have as much intercourse with ejaculation on the day prior to violation and on the day of ovulation? Or should they have intercourse on the day prior to violation, but not so frequently that IT diminishes the concentration of sperm and then allows for intercourse with the maximum number of event lations on the day of violation? You really hear at both ways.

And what this really boils down to is, Frankly, that nobody knows. And the reason nobody knows is that there's tremendous variation among males in terms of the absolute concentration of sperm per mille ader of ejaculate and the amount of sperm familiar of ejaculate within a given time frame. But what everyone agrees on is that a period of absence ranging from forty eight to seventy two hours prior to an event lation increases the concentration of high qualities permit within that first event lation occur after the absence period.

okay. So again, to relate if one's goals to fertilize the you want to take into consideration that. Most often there is going to be a dramatic decline in the concentration of sperm per ju late anytime.

Those event lations are occurring within a short period of time, said within twelve to twenty four hours of one another. Now all of this, of course, also relates to the female biology and the extent to which the woman can precisely identify the day and timing of her abul tion. Some women feel as if, and indeed are very accurate, estimating their time of violation to within a couple of hours.

Or some women even report being able to feel their actual violation, whether not they are feeling the violation itself. The deployment of the egor not isn't clear. I certainly would know, never produced eggs nor of I abul ted.

I am certain ly not going to contest the idea that women um can do that. I mean that makes sense that some people have a very keen so called interactive awareness and awareness of the sensory events within their body. And well, of course, the overs are not thought of as an organ that we want to be able to sense what's going on in there in terms of feel.

There are sensory endings within the over. And so the notion that one could literally sense changes within their over, including the development of the egg, is not outside the bounds of reason, and in fact, could likely be the case. Now that said, there are a number of different ways that women will track their violation.

One is the temperature methods so they will actually measure interaction al temperature. Um they're looking for changes in template that are consistent around the time of violation. We're going to have an expert guest on an og Y N who can tell us a lot more about the details and nuances of the temperature method.

You'll see a lot of information about this online, but there's a lot of misunderstanding about IT as well. Other women will use apps that take into account either the temperature information, if the acquiring temperature information that'll be entered into the APP, as well as marking the onset of monsters tion, the onset of bleeding, therefore, the start of the obligatory cycle. Because of course, as we mention, really that Marks a day one of their cycle.

And then again and again, you can see how regularity of cycle duration or relative regularity of cycle duration really favors this whole process of being able to predict win one obviates. Unfortunately, if the goal is feriz ation, there are some margins for error that are introduced by the fact that the sperm can survive within the female reproductive track for some period of days, thereby reducing the need for absolute certainty about the time of violation and so on. In fact, it's pretty well known that around the time of violation, a couple of things happen earlier. We talk about one thing, which is there's an increase in label just prior to violation.

This relates to in part and increase in some of the androgen, things like D, H, ga, but also to stores one and some related androgen that can increase libido both in males and females and changes to the reproductive pathway, the female, in particular, a change in the PH, that is, the relative acidity versus basic nature of the mucosal lining near the service, and also vagon inal secretions such that around the time of violation, the entire mill u of the vagina and the servex and the locations in which feriz ation can occur, and certainly in which the sperm swimming towards the opportunity for fertilization is shifted to support sperm mortality and health. In other words, one of the best environments for sperm to survive is going to be within the female reproductive pathway itself. And as long as we're talking about vaginal secretions and mucus, it's important to point out that a number of commercially available lubricants can actually be detrimental for sperm health, even if they don't contain spermatic IDE.

So this is something you'll want to discuss with your O B G Y N, or certainly if you're male, you could also discuss this with your error gist and your partner O B G Y N. A lot of the commercially available lover can contain chemicals that while they may favorably change the consistency or the 我 city of the vaginal pathway for purposes of inner course， certainly may not be the most favorable for maintaining the health of this firm in the mortality this firm. So again, here we're talking about intercourse only in the context of trying to maximized fertilization.

And I should mention that there are certainly workings that are more conducive to the sperm environment, but it's something that you're really wants to talk your O B G Y N about or at least read up about if your interest isn't trying to fertilized and developed in embro. So we covered the optimal strategies for how often couples should have intercourse with ejaculate around the time of obvious tion in order to maximize the probability that successful fertilization and ultimately the pregNancy will occur. What we haven't covered, however, is how long couples should apply that method over time in order to achieve successful fertilization and pregNancy.

Now of course, if a couple decides that they want to conceive and they apply that method or any other method, for instance, and they achieve feriz, ation and a successful pregNancy the very first month that they try well, then there's no other work to do, at least until that child is born, and if, and only if they decide they want to have more children. However, many couples find that they do not conceive in the first month of trying, even when they apply the optical methods, and even if their age and every other factor related to equality and sperm quality is optimized. Now I think it's the rare instance in which equality and sperm quality are optimized.

In fact, the word optimal and optimization and optimized is a little bit misleading in general, because no one really knows what that is. But of course, there is an ideal, there is a perfect standard to which everyone would like to achieve. But of course, we all enter the picture with genetic variables, environmental variables and so forth, many which will talk about because you can, in fact, adjust them in the direction that you would like to improve permanent quality.

But most people simply will not succeed in achieving a successful fertilization the first month that they try. Now there is a truth that govern how many tries IT ought to take in order to achieve successful fertilization and ultimately, pregNancy. And it's very age dependent and in particular is dependent on the age of the mother because the age and quality of the egg, well, it's not the only factor, is certainly one of the most determining factors and whether not successful feriz ation occurs.

And as women age, the quality of the eggs tends to diminish over time, largely due to changes in the meta contro function and the spindle that pulls the chromosomes apart, although there could be other factors involved as well. Now, before continuing any further, I just want to acknowledge that this whole language around egg quality and sperm equality is not the greatest language because it's entirely subjective. And yet the word quality in these instances is really there to explain a broad variety of factors that can, in fact, be measured, things like the number of policles that are deployed each month in a woman's violation, or the number of mobile sperm, the number of morphological that is correctly shaped sperm in the mail and so forth.

So when we talk about equality or sperm quality, we're really referred to in a malem of different features related to the different aspects of violation leading to successful feriz ation, where the different aspects of spur m related to whether not they can arrive and deliver their DNA contents and so forth. So I will use the words egg quality and sperm quality just as general themes because that's what a lot of the clinicians use. But I do understand it's a little bit of a loaded term in both instances, and IT doesn't relate to any one specific parameter, percy.

So getting back to this issue of how long couple should try according to the age of the female and perhaps also the age of the male, well, most of the data that have been collected relate to the age of the females I mentioned before. And what we're about to discuss is within the scientific literature described as what's called for conditional body, which is the amount of time over which a given couple needs to attempt to conceive, of course, by having intercourse with adjacent tion around the time of violation. IT assumes that all the other things are being done correctly.

And what we know is that there's a strong age dependent effect that largely rests on the age of the egg, that is, of the female. And what we know is that for females thirty years old or Younger, if they have intercourse with event lation around the time of violation on the day before in on the day of violation, and there could be other intercourse with adjacent tion round that time as well, on average, that will result in a successful fertilization and pregNancy about twenty percent of the time on the first month of attempting the first education cycle. Now, if feriz ation in pregNancy occurs, great, they'll be at least to nine months lag until they decide whether not they want to try and conceive again.

However, most couples, even if the woman is thirty years old or Younger, will not successfully conceive on that first attempt. And that's because the probability is not one hundred percent, it's twenty percent. So eighty percent of the time, they simply will not conceive, which means that they hopefully will try again the very next month.

And if they successfully conceive, great. And if they don't, then they ought to try again the next month, the next month and so forth. Now, the typical advice that an og .

Y N would give you .

is that for a woman thirty years or Younger, and leaving aside the age of the father, but still assuming that eg quality and sperm quality are sufficiently high to achieve realization that the couple should, or if the woman's trying to have kids alone, the woman should attempt to conceive over the period of six months. why? If you think about IT, there's a twenty percent chance in the first month and it's unsuccessful.

Well, then on the second month, they'll also be a twenty percent chance. On the third month, also a twenty percent chance. What i'm describing here is what obviously is independent probabilities.

That is, if you were to flip coin and the probability of getting heads is fifty percent, the probability of getting tails as fifty percent. Of course, you don't expect that the previous flip had anything to do with the result that you'll get on the subsequent flip. That's what independent probabilities are. However, when IT comes to for constables, we are really talking about something which is called cumulative pregNancy rate, which is not really independent probabilities.

Now why would that be? Why would I be that if you did not successfully conceive in the first month of trying that by simply trying again and again and again, the probability of conceiving would increase? Well, the reason for that is that this whole business of utilization is not just about what's happening with the egg, is also about what's happening with the sperm.

So there are a number of different events related to the biology of the egg of biology of this firm, which you are now very familiar with from everything i've talked about up until now. And there are a bunch of chance events, for instance, that the sperm won't actually arrive at the egg time or that the egg won't arrive at the sperm time because, of course, it's a by directional migration of those two sell types or that for whatever reason, fertilization won't occur. So we're really talking about when we talk about the cumulative pregNancy rate over time is the fact that there are multiple probabilities at work. And yes, those are somewhat independent in the sense that the biology of the sperm doesn't really strictly depend on the biology of the egg, at least not until they meet, and but the .

likelihood pregNancy .

depends on those independent probabilities, which makes this a cumulative pregNancy rate. Now, if any of that is confusing, what IT basically means is that for the egg in this firm to meet into, fertilize a number of different events that Carry some intentionality, right? This firm was told the egg, and so far the eg, we doesn't have A A personality and there at least not yet, but IT a quoting what wants to be for lazy IT IT is in principle receptive to feriz ation.

Well, in order for that to happen, they're going to be some events related to chance that could limit the ability for that to happen. And they're be other events, dict by the biology of those who cell types that are driving that event to happen, that advising the event to yes happen. And so what we're talking about when we tell about cumulated of pregNancy rate is how much of the biology of the woman is cued towards fertilization to be likely to occur.

okay. So to make this very simple, all we need to know is that for women thirty years old or Younger, because the probability of getting pregnant on any one attempt to conceive is twenty percent, well, then if that doesn't occur the first time, then you should simply repeat that at least five and probably six times before deciding to go to an O B G N and conclude that there's something going on either with the egg or of course, I could be with the sperm. But in general, that's why O B G Y S, i'll tell their female patients.

Look, if you're setting out to conceive, try for about five or six months, and if you're not successful, come back and see me. Now, for women who are age thirty one to thirty three, the probability of conceiving in the first months drops through about eighteen percent. So women in that age range and their partners should certainly try and conceive naturally over a period of six or seven months.

And then for women who are age thirty four to thirty seven, the probability of conceiving in that first month of of trying, and certainly every month thereafter, is about eleven percent. So when the age of the woman starts extending out to about thirty four or thirty five years old, then the typical advice of the O B G Y N is going to be to attempt to conceive over a period of about nine months to a year before deciding to take some sort of medical intervention. And then, of course, as the age of the woman increases, so too does the quality of the eggs go down.

Now that's not true for every woman. There are many women who, in their late thirties and forties and even really fifties, have successfully conceived healthy children, although the probability of that, the likelihood of IT drops substantially. So for instance, for women who are age thirty eight to thirty nine, the probability of a successful conception by natural conception, intercourse with a jaculation going to be about five percent, right? So it's really dropped to a quarter of what IT was when that woman was thirty.

Again, these are averages only. What does that mean? Well, that means that if you are age thirty eight or older, chances are that you should probably go to your O B G Y N right at the outset of your desire to conceive and ask what you can do to improve eg quality.

Otherwise, if you were to extend the math out, right, we know that if you're age thirty or Younger, twenty percent chance in anyone given month, that means about four to six months of trying what you can simply multiple that times four or five for someone in their late thirties or early forties. And so what you really talking about a several years of trying, and of course, what's happening during those several years, the woman is getting older. And as a consequence, the quality of the eggs is declining even further.

So if you are, you know, thirty five, thirty six years old, IT might not be entirely unreasonable to talk your O B G Y and right at the outset of desire to conceive. But you could also just take the approach of trying to conceive naturally for about a year, a year and a half before deciding to do that, keeping in mind that all the while you can't stop time. So biological time in aging is going to occur in the backroads. But hopefully this description of cumulative pregNancy rate makes sense. again.

The ideas that while it's true that every single month there is an independent chance of the woman getting pregnant, and that chance is dropping from about twenty percent at age thirty over time to about really one to three percent for women forty or older, there is also this notion of cumulative probability, which involves multiple biological events in both the egg in this firm that have to converge in time and space in order for successful feroza to occur as long as well. On this topic, I think it's only fair to address the issue of miscarriage. And miss carriages can arise from a variety of sources.

They can arise from genetic effects that can arise from issues in the menu of the uti st. They can arise from issues with a spirit for that matter, right? We really don't want to put all the weight and all the responsibility on the egg.

This is always an egg firm dynamic. And when I say extreme dynamic, now hopefully that calls to mind the huge library of information that we've been covering up until now about a criminal al segregation and the coming together of these different cell types and their genetic information. Any number of different steps within the process of fertilization leading up to pregNancy can lead to miss carriage.

However, the probability of miscarriage greatly increases as a function of the age of the egg. And the basic numbers on this are that for women who are thirty five years or older, about twenty five percent of successful feriz ation lead to miscarriages. Now, when those misCarries occur during pregNancy can be highly variable.

Sometimes it's within the first prime master, sometimes IT could be later, but the probabilities is about twenty five percent. That probability increases greatly over time, such that by the time women are in their early forty, so forty or older, the probability of miscarriage after a successful feriz ation is going to be about fifty percent. And this could be due to a number of factors, as I mentioned before.

But one common reason is that there can be chromosomal abNormalities, and that could be related typically to the segregation of the egg when half of the chromosomes in that egg removed, taking IT from deploy to haploid, if you recall, is that little polar body, which is the removal of the chromosomes, is ejected from the egg g. That will eventually evolve. And sometimes not all the chromosomes that they were supposed to be ejected in that polar body are ejected, and as a consequence, their multiple chromosomes, or duplications of chromosomes, things like tries to mies, sometimes too many chromosomes, move away.

And they are actually removal of entire chromosomes, meaning both friends, so that you have chromosome eal delicious. And in that case, typically fertilization won't to occur. But the orange cities in which fertilization will occur so women will get a positive pregNancy test for periods will stop and they the couple will think that they are advancing along uh, the steps to a successful pregNancy and then there will be, sadly, a miscarriage many, many times.

Those misCarries are the consequence of the fact that when there are extra chromosomes there, or there are too few chromosomes present, that embryo genesis can simply not progress in a healthy way. There are some instances in which all of the crime somes and all the crime oe arrangements are privately Normal and miscarriages can still occur. I'm going to do a future episode about pregNancy and embro ic development where we will get into this more deeply.

But just understand that the frequency of misCarries increases dramatically after about age thirty four and then continues to increase dramatically, uh, extending well out until the forties. Now very important consideration in terms of understanding and predicting fertility and vindictive, this word that describes the probability of getting pregnant on a given try and over time, is trying to address how quoting, quote, fertile a woman is, and importantly, how quoting, quote, fertile a mail is, will talk about male side in a moment. But when trying to address how fertile a woman is, of course, age is going to be one of the major factors, but just one factor we already talk about how age determines the likelihood of a successful pregNancy if the intercourse and ejaculation is being Carried out at the correct times and with viable sperm capable of feriz ing eggs.

And then, of course, is the issue of equality. But in general, most women would like to know how fertile they are as a function of their age. And I actually think this is one of the most important topics in this whole space around fertility that isn't often discussed, or at least isn't often discussed until women are in their late thirties or forties, when often times they will look back and wish that either they had frozen their eggs or they head frozen, fertilized embro, which is a whole thing unto itself.

Let me talk about that when we have episode on visual feriz ation in more depth. But there is a fairly straightforward way or set of ways that women can determine their basic level of fertility, leaving aside a lot of the detailed issues about the quality of eggs and so forth. One thing that you already learned is that there's this volt, there's this reserve that we call the ovarian reserve and that each month a certain number of folk les leave that reserve.

And there's the opportunity, based on the violation of a single leg, to fertilize that egg and for the woman to get pregnant. One thing that we know for sure is that the size of the population that released from that volt each month has a very strong positive correlation with the size of the reserve in the volt itself. okay.

So the way to think about this perhaps is that the wall is like a bank account has a certain amount money, in this case, eggs in IT. And you could imagine if someone's reasonably logical that if they have more money in their bank account, they are going to withdraw a larger amount each month. Then if they have a small amount each month, if the idea is to make that.

Volt, that bank of eggs available to them over the longest period of time. And indeed, biology is pretty smart. IT doesn't deploy or release you know half the followers in one month and then just slowly trickle out the remainder followers. No, that's not how works.

What you find is that, of course, in Younger women, so saying in their late teens, twenties and thirties, the ovarian reserve in the volt is going to have more eggs in IT, and the number of followers and eggs that leave at all each months going to be quite high. So one way to evaluate how the fertile you are, again, just one way is to go to your ob, jan, and say that you would like to know how many followers you have in a given month. And of course, they will look at them on both sides, in both others.

And for instance, if a woman has you know just two or three followers that are out each month, well then the assumption again is just an assumption. But the assumption that's pretty good because there is a positive correlation that generally crs is that that a van reserve that the number of eggs in the volt is fairly low compared to someone who say has twenty folk, les are thirty four aces each month. okay? And that's the typical trend.

Again, these are averages and is very important to not get attached to any one number here. Again, these are averages. So for instance, there are women who only deploy five followers and eggs each month from out of their are very involved, but who find themselves to be very fertile.

And there could be a number of different factors to explain that other women will have twenty or thirty eggs and folk les that leave that volt, the ovarian reserve each month, and they will have a harder time getting pregnant, any number of different reasons. But in general, the more eggs and policles that leave the volt each month, the higher number of eggs that are still in reserve, meaning the greater amount of time over which a given woman could still attempt to have successful fertilization. Now, this small collection of followers and eggs that are released each month actually has a name that are called the anchor followers.

These are small followers. They tend to be about two to nine millimeters across. The way these are analyzed are measured is women will go into the ob G Y in office. And by ultrasound, typically there are some local anesthesia, but it's not often a general anesthetic by local anesthesia. Sometimes, no, they will essentially count the number of followers that are present in each side on over on the left and the over on the right, and give women some sense of how many people SHE has. And typically, this has done over series of months to determine how many eggs are leaving the ovarian reserve each month, and therefore how many eggs SHE is likely to still have in the over in reserve.

Now there's a non invasive way to do this as well, although typically in an O B G I N will do both what I just described with ultrasound, and measure something called A M H, which is anti malaria hormones, which is a hormone that is released by the android follow population, the population of policles, and eggs that leave the over in reserve each month. So one is a blood draw measure of a hormones amh, the other is a structural imaging measure of the anti folk les directly. Again, the typical trend is for the number of anti folk les to decline over time.

So one might expect for instant that a woman in her twenty years or thirties might have twenty, thirty, maybe even forty antil followers that are exciting the reserve each month. And again, that's the total across both overs. Again, these are just averages.

These are going many distributions. That will be people with far fewer. There will be people with far more. But that over time, regardless of where women starts out from one decade to the next half, decade in decade and so on, that the number of animal followers decline in the amount of, or the levels of amh will also decline.

So what does this all mean? What this means is that if you are a woman who is in her twice or thirties or forties, whatever your age, if you are interested in conceiving in the future, it's very likely a good idea to go to your O B G Y N and get either your amh levels measured or your local count measured. And to do that several time times in a given period, and I don't mean a mental P D, I mean given period of time across several months to determine what is the average number of followers, what's your average amh level, thereby giving you some window into how many eggs you are likely to still have in your varian reserve.

I cannot tell you how many women that i've spoken to in how many O B G Y ens. More importantly, because they speak to many more women about this than I ever have, ever will wish that they had done this earlier, right? They think, oh, well, I mean, my twenty, i'm likely to have a tone of folk les, or they got pregnant once before.

And so they're not so concerned about the number of followers or their amh levels. But over and over again, I was told in researching for this episode that the earlier and more frequent that women do this procedure of measuring amh and measuring their follow account, the higher the probability that they will eventually have a successful fertilization and pregnant y when they seek to do so. Now, the mirror image of all this, of course, is the sperm.

And you know, there's a kind of common misconception out there that you know the sperm, you only need one, and indeed, you only need one, but actually you need many, and it's only one that's able to successfully fertilize the egg. So this whole concept of you only need one is both dismissive of the sperm, but more importantly, dismissive of the biology of the sperm. In the egg kit only takes one successful sperm and one successful egg.

But that sort of like telling a woman, hey, you only need one egg, right? You need one egg of sufficient quality in the right time in place, and you need one sperm of sufficient quality in the right time and place in order to get successful fertilization and hopefully pregNancy. But you need a lot of sperm in order to get a high probability that that one sperm will be able to successfully fertilize the egg.

So we have the image of sperm is kind of these the dumb Operators that just to swim mindlessly towards anything i'm and if they bump into an egg and they fertilize the egg, and that's really not the way IT works. As I talked about earlier, the sperm with its head, its mid region, its tail chock a block with medical re in the middle gian, is really an active motor cell that indeed will just swim forward if it's a healthy forward progressive sperm. But in many meals out there, just simply do not have any knowledge of how many qualities sperm that they happen to have.

Now, given the fact that sperm analysis is relatively inexpensive and also the fact that freezing sperm is relatively inexpensive, think IT stands to reason that most men should at least get some window into the numbering quality of their sperm. Now it's a fair assumption to say that someone is in their late teens, early twenty years, there were thirties, that they probably have high quality spring. But again, as with the egg and the importance of measuring A, M, H and four count across time, men should really evaluate the quality and number of their sperm.

And we talked to a little bit earlier about some of the parameters that europe gist and O B G Y S like to see when evaluating sperm. right? There is a minimum number concentration of sperm that they like to see if a couple is going to use ibf and metro feriz ation.

And typically, that's going to be about fifteen to twenty million per mills of sperm or Simon. And typically, they want to see somewhere between two and five new leaders of Simon um overall in a given ejaculation after a seventy two to forty eight hour absence period because of course the more accusations, the smaller the volume of the ejaculate in a short period time. But after forty eight to seventy two hours, you more or less maximize the volume of ejaculate.

And then, of course, they want to see fifty, but typically sixty percent or more of motor sperm in order to get ibf. But IT more is Better. And of course, there is an enormous ranges I mentioned before. Some miles will have anywhere from ten to twenty million sperm prime leader of a jacket. And some men will have hundred to two hundred million. Okay, but just because they have one hundred to two hundred million doesn't mean that all of those burma of high quality and comfort lize ex, sometimes the more than half will be twitchers and some will be in motile and so on.

And so for so it's very straight forward what I believe most people should do and what the urologist I spoke to in advance of this episode I had said to do, which is to simply do, as per manali sis, refrain from event lation for forty eight to seventy two hours, give a sperm sample, have that sperm sample analyzed, the cost of the sperm analysis is not typically that much. okay? And considering that conception and healthy conception and fertilization is an expensive process, if you have to go the in virtual feriz ation route, IT stands to reason that the cost is pretty well justified. You also have the option to free sperm over time. There is evidence that the age of the father and therefore the age of the sperm, can dictate whether or not there's a higher instance .

of problematic .

pregNancy or developmental outcomes, including autism. That is true. You've probably heard that if the father is forty years or older, the incidents of autism is increase in significantly. That is true, although the overall probability of having autistic offspring, if somebody, if the father, that is, is forty years or older is still quite a bit lower, then you would imagine as not as if the probability suddenly skyrockets. Okay, so that we will have an episode on autism and genetic and um influences on autism and other aspects of the autism spectrum.

But the point is this, I believe in the urologist I sort to who are interested in fertility and male health and sexual health suggest that men get their sperm analyzed at least once every five years and certainly if they're going to want to conceive children in the distant future, that they consider freezing their sperm, because that too is fairly cost in order to freeze sperm at a Younger age. And of course, if you can freeze, use sperm from the time in which you were Younger, why wouldn't you? right? I mean, you can still up to go for natural pregnant y later if that's what you want to do.

But having that in reserve is um generally a good idea. And I discuss some of the parameters that that are looking for and perhaps most importantly. There is the possibility of an underlying issue whereby, for instance, there is very little sperm in an ejaculate. As I mentioned earlier, the seminal fluid in the acute ate could have zero permanent, but the volume of ejaculates could appear completely Normal.

So just because your ejaculate volume is uh Normal to you or is in that range of you know two to five million ads, well then that doesn't necessary mean that there are any sperm there or that they're very few sperm there and the few spare that are there or the many sperm there are there are functionally moti. So get this analyze is really worth doing. And again, it's not something enough to do every year and something that you want to do probably every five years, at least until the point where you've conceived as many children as you ever want to conceive.

So the basic take away here is that if you're a woman to get your eg count, your annual follow count, that is, and therefore your reserve of eggs indirectly measured, and of course, also get your amh levels measured. And if you're a mail to have a supermini sis and to do that relatively early, in fact, another incentive for doing that early is that you have a comparison point so that, for instance, if you are in your early twenty years and you're not thinking about having kids at all or you're thinking that you might someday have kids, but it's a really someday, someday far off in the future. Well, it's wonderful to have a reference point from which to compare your biology in your early twenty years to your biology in your midst, late thirties or forties, when you might happen to be interested in conceiving.

And if that doesn't provide incentive enough, I should mention, and this is important to point out, and then I think both males and females are not aware of, is that one in five couples that have issues with fertility, the issue ends up falling on the biology that is the quality of the sperm or a lack of number of sperm. So you I think there's a misconception that when fertilize an issue is always an issue with the eggs um and this age dependent a decline in the egg quality. Again, the best language we have available to us at the moment.

This age dependent decline in equality is often to blame, but not always one in five couples that have chAllenges conceiving. Turns out this can be in issue with the sperm. And of course, there are number different sperm alyse that shows all the other parameters of experiment Normal.

Now, for instance, you can get A D N. A fragmentation analysis, can see whether not the DNA of this burma somehow disrupted. Neurologists these days are excEllent at figuring out, for instance, of a male has lots and lots of sperm. Everything would grape at the shape of the head of the sperm isn't quite right.

If it's not over enough and it's too rounded, that could be a genetic effect under which conditions there is zero probability of the male ever naturally conceiving, right? Regardless of who the female partners believe or not, the meals can have a torn of sperm, but if they Carry a certain genetic effect, those firm will be incapable of depositing these twenty three chromosomes into the egg. However, there are ways in which that sperm can be coasts or forced to fertilize the egg, deposit its gene contents by in virtual feriz ation and the implantation into the female.

So again, lots of reasons to have a egg reserve analysis by ultrasound in an image for females, and lots of reasons for males to have a spr analysis. And of course, typically with superman, aly sis and A A very reserve analysis will be a horton analysis. And i'm a very strong believer in people getting in insight that is a window into the hormonal composition, not just when they encounter problems, but starting at a pretty early age.

You'd if it's only done once every five years or so, having a reference point to your twenty years and to your thirties and mid thirties for when you felt a certain way. Maybe as in the case for many people, I know they actually feel Better in their forties than they did in their twenty years because they're doing a lot of things to support their health that is possible. But in many cases, people start feeling not as well or their fertility seems to be dropping off for any number of different parameters that we've discuss today were related to vital longevity seem to be dropping off over time, and they want to get a insight into what could be the issue.

And hormones are sometimes, not always, but sometimes involved in those underlying issues. And there is nothing as valuable as having a reference point from a time in which things were going well to evaluate the, for instance, the levels of hormones, not just test astern, but also as rogen and protesters on and so forth. So you need a comparison point in order to determine what really needs to be changed. So all of this is a strong push for people to use your insurance. If you're able to put IT on insurance, often times people are.

And if not to try and find a reasonable or reasonably prised way to do a firm and egalite sis and to ideally do hormone analysis as well, it's really going to set you up for the maximum probability of being able to conceive children when you want to, and also to avoid bunch of other health related issues that are involved, hormones and reproductive health, and in general, to support your mental health and physical health. So i've been talking about a bunch of things to do. There are a couple of things to be mindful of to actively avoid if your goal is to be and remain fertile.

And that's regardless of whether or not you want to could save different in the future or not. Now in the context of this discussion, the same things that we have hurt to be true for other aspects of our health turn out to also be true. So let's just start with the basics.

Everybody should be getting approximately sixty eight hours of sleep every night. There should be quality sleep. Optimizing your sleep is fundamental to balancing your hormones. Now, balancing your hormones is of a catch phrase for all things related to proper hormone regulation.

Sleep is the fundamental layer, mental health, physical health and performance of all kinds, and believe in not fertility when people are not sleeping well or enough stress harmons, in particular court, is all shift to peaking later in the day. And those elevated quarters, all levels later in the day, cause a bunch of different problems in both males and females, many which impact for tilly. So controlling courters all starts with controlling your sleep, but also impacts to stop one and estrogen levels.

So of course, the proper ratio of testosterone, estrogen will vary from males to females. But in order to get those right or as right as they can be without other interventions, you want to make sure you're getting enough quality sleep. How much sleep? Most people need about sixty eight hours of sleep per night, waking up once, maybe twice per night.

In the mild the night, going back to sleep is not such a bc deal, but hours of solid sleep would be ideal. Some people need a little bit less than in order to function in five hours. Some people need a little bit more developing teenagers and babies and kids need a lot more.

People who are sick or recovering from injury need a lot more. We've done multiple episodes on sleep. We have a tool kit for sleep available free at huberman lab dot com. You go there, you don't even have to sign up for the newsletter, although you can if you want to go to tool kit for sleep under the menu and you'll be able to download data, you can even just viewed on the screen if you don't want to download IT as lots of tools we've done in episode perfect your sleep that has a lot of tools that all time stamped for. You've done a master your sleep episodes, a lots of tools to get your sleeps, get your sleep right.

If you are wishing to conceive and or to simply have healthy biology to be fertile or otherwise this fundamental, now there are other things to not do, and those again, fall into the somewhat obvious categories. I think a lot of people are aware of just how striking, in effect, these certain behaviors that you want to avoid can have in diminishing your fertility for both males and females. So let's talk about those.

The first one is smoking. When we talk about smoking here, we're going about smoking nickey and we're talking about smoking cannabis. And indeed, there are strong data. And I will put a reference to one of the Better, larger analysis of these data. They're strong data showing that cannabis reduces fertility.

Now I can already hear the streams from the back, although they're probably purely drown out streams from the back of people saying they smoke cannabis and they had no trouble conceiving. Certainly, there will be exceptions, but whether not your male or female, smoking cannabis is a bad idea. If you want to conceive a healthy child, can you still conceive a healthy child while smoking cannabis? Probably certain people can.

Many people will greatly decreased the probability of a healthy fertilization and pregnant y by smoking cannabis. They are excEllent data to support that as well. Nickey, both smoked or raped, is going to disrupt the process of fertilization and can disrupt gnant cy dramatically.

Okay, so just avoided altogether. How does this happen when IT turns out that smoking increases what are called reactive oxygen species? This greatly disrupts the quality of the egg, the level of the spinal in my country and a number of other features. And in the sperm turns out that smoking doesn't necessarily disrupt the sperm directly, although I can cause DNA fragmentation, which can cause all sorts of abNormalities, can prevent feriz ation, can lead to birth defects in the offspring.

But more importantly, IT increases what are called reactive oxygen species in the seminal fluid, in the semen that contained this firm, this very, under Normal circumstances, under healthy circumstances, beautifully orchestrated chemistry of fluid that allows us firm to thrive in their trajectory and attempt to fertilize the agen lead to a healthy pregNancy. So if you are smoker and you want to conserve, the best advice I can give you to quit smoking. And yes, that includes cannabis as well.

Now I am not somebody who believes that cannabis across the board is not useful. There are medical applications and other applications. I talk about that an episode all about cannabis for health and disease.

And notice health was there too. So you cannabis smokers don't come after me with, I guess, whatever IT is with bones and pipes or whatever IT is that you want or with vapor. The point is that while I can be beneficial for certain populations, it's certainly bad for others.

And if you're trying to conceive IT is bad for fertility and for a healthy pregNancy, okay, now that smoking and waiting, by the way, okay, vapor is included there. Now the next category of don't relates to alcohol. Everyone has heard that drinking during pregNancy is a bad idea.

You may have heard, and some people have talked about the fact that there are cultures in which they allow, if you will, or even condone. Sadly, one or two drinks while pregnant provided its just champion or something of that sort. That is a terrible idea.

I didn't episode all about alcohol, both its potential health effects of which there turn out to be zero. And yes, that includes red wine. IT is far Better to not drink at all.

And if you're going to drink the limit, if you're a healthy adult who who is not trying to conceive, not pregnant and you don't have issues with alcohol, m is probably two drinks per week total. That's like two drinks per week total. And that's the level that you really should consider if you're a drinker, if you're somebody who's trying to conceive.

However, for a woman who becomes pregnant, the total number of drinks that you should allow yourself per week while pregnant and breast feeding is indeed zero. There is absolutely no evidence that one can go and could get away with drinking during pregNancy. And people say, well, I had a perfectly healthy child, but you, of course, you don't know what the health of that child would have been had you not drank at all. Now i'm not here with any generally strong stance against alcohol.

I, myself and h somebody has a drink every once in a while although I don't consider myself somebody who has a strong procul vary for alcohol and of course at this moment i'm not trying to conceive children and certainly not pregnant so that's safe for me um but Frankly haven't had a drink in a very long time and so I don't miss IT and that's me but I do realize that a lot of people enjoy alcohol and so it's that two drink's per week limit that really sets the upper limit and threshold beyond which you start running into issues with sellar remur. You start running into issues of oxide stress, greatly increased cancer risk, in particular breast cancer risk, all that covered in the alcohol ever so that we did. You can find a huberman and lab up, calm and time stamped if you want to navigate a specific topics.

And so for find out all about the data supporting the statements that are making so on and so forth. Now if you're somebody who is seeking to conceive or are you fall into this category that some couples described themselves as, we're not trying, but we're not not trying. They're not using birth control that kind of letting chance run its course.

Well, then you should definitely be aware of the data showing that even just one belt, one belt of so called binge drinking, which is five to six drinks in a given night or half day in a twelve hour period, one about of five to six strings, if you a woman or you a man, greatly increases both the likelihood of mutations in the embro that would result from a fertilization, and at the same time, for reasons that should be obvious to you, based on all the biology of, talked about a greatly reduced probability of fertilization. Now that absolutely doesn't not mean that you should use the injection of five or six drinks as a method of birth control. That is not what i'm saying here.

What i'm saying is, is that if you go out on a given night and you have five or six drinks and you happen to become pregnant, the probability that that pregNancy will be disrupted in some way is greatly increased. What the exact consequences are, no one can tell you, but also, if you're somebody who is interested in conceiving a child, well, then you absolutely should abstain from interesting drinks more than one or two during the time in which you're trying to conceive an ideally, that would be zero, and you certainly would want to avoid drinking multiple drinks per night. And so this idea of going out and having, you know, three or four drinks or four or five drinks in a given night at a time in which you're also trying to conceive children, the biology tells us, the epidemiology tells us that this is just a terrible idea.

It's going to reduce the likely od of fertility and successful pregNancy. And if there is a successful pregNancy, the word succeed needs to be in quotes. I am going to think every parent, every species, for that matter, wants to increase the probability of having healthy offspring.

And so to my mind anyway, and to the O B G Y N S and the neurologist that are focused on fertility that I spoke to, will say, try as hard as you can to avoid these so called bin drinking episodes. And again, these episodes are one night of consuming five to six drinks. Now, another important thing to remember in this context is that the negative effects of consuming five or six strings in a given night extend over many weeks following the congestion of that alcohol.

If you're a male, what that means is that going to impact the quality of your sperm and greatly decreased the likely od of successful fertilization and or healthy pregNancy over the period of the entire perimeter genesis window, which is, as we talked about before, sixty to ninety days, right, sixty to generate this firm and then in some additional time for the sperm would be transport to the point where they could be ejaculated. If you are a woman and you have five or six strings on a given night, well then you are going to disrupt the quality, not of just the egg that eventually obviate, but indeed the entire pool of policles that leaves the ov very involved in reserve and from which the one eg will be selected. In other words, you are reducing the quality of all of the eggs that you happen to deploy that month.

Now some of you who were really following the biology earlier might say, well, what if I have those five or six strings during the time in which i'm monstrat, in which there is bleeding present, and therefore I haven't yet ogula's? Oh, but if you remember the biology we talked about earlier, specifically, there is a subset of policles and eggs that leave that ovarian reserve quite a bit before that one egg is selected for inoculates. And of course, there are all the different hormonal cascades in the general menu of the over, which are important and are being regulated by different hormones.

And yes, indeed, the regulation of those hormones is strongly impacted by alcohol through a number of different paths. Through the regulation of the neurotransmitter gaba up in the brain, it's actually lot of gaba, gaba receptors in the hypothesis, the very region from which can add rope and releasing hormones. Our old friend from couple hours ago in this discussion to disrupt h circuit, you can disrupt atua tory function with alcohol again and again.

What we're seeing is that consuming more than one or two drinks per week of alcohol is really detrimental to the entire process of fertility and the entire process of healthy pregNancy. And that's true from both the male side in the sperm and is true from the female side and the egg. So my simple advice on this is, if you are wishing to have a healthy fertilization and pregNancy, the best thing to do would be avoid alcohol together.

And if you're going to drink to really limit that drinking to one or two drinks per week maximum. So those are the major, don't really avoid excessive stress. And I should mention, excessive stress is not just best avoided by getting enough quality sleep at night, although that is the primary way, there are other ways to avoid stress.

We've one entire episodes about this, and we have a tool kit late to reducing stress with very simple, zero cost tools. Again, you can find all that human man love out com, as you mention, if you want to find any episode or topic or timestamp, that website is keyword search available, so you can just go to give lab that com. Putting into the search function, stress tools and a bunch of different links will pop up related to those topics, likewise with sleep, likewise with any number of different topics you might be interested in.

So get enough quality sleep and thereby reduce stress and also directly buffer stress with real time tools to buffer stress i've talked about um in the episodes that you can access and there are ways to greatly reduce your overall level of stress to limit any quarters all that's released early in the day, which is when you want court is over least and not have IT late in the day and so on and so forth. So reduce your stress. And as I just told you, by all means, do not drink more than two drinks per week and zero is Better than two.

If anyone tells you all, there's know all this respire ual in red wine. And that's good for us. The data simply tell us that there there is not enough, is very troll and red wine to really have any positive health benefit.

The data around is very true, and health benefits itself is under question. Nowadays, zero alcohol is Better than any alcohol. Two drinks per week is the limit.

Also limit or eliminate or avoid nickey, and ideally kind of a smoking and vapor at the time in which you are trying to get pregnant. And certainly, if you are pregnant, avoided all of the things as best you can that I just describe a moment ago. Now there a couple other don't that are really important.

One of the most important ones relates to st or sexually transmitted infections. Everyone who's sexually active should get an S T I check. In fact, if you go to a fertility clinic, or you go for sperm aly sis, or you go for egg alysa, almost always they will do N S T I check.

Even if you happen to be in an enormous relationship, even if you happen to be not sexually active in, you're somebody who is seeking to use ibf with the sperm donor, something in that sort. Why would they do that? why? Why are so much concerned about is IT about avoiding giving birth to a child that has um something like a herbart's infection or something or HIV?

Well, certainly that's one reason, but that's a down the line reason because at the time when someone to goes into the clinic for one of these sperm egon alysa, I mean, that's well in advance of any pregNancy, right? The reason is there are a number of st. S, in particular kilometers, a for which IT greatly increases the probability of miscarriage.

So committee is one of those very insidious and encysted S. S. Because a lot of people, both males and females, don't even realize that they have climate a and then they can Carry climate e at the time in which they can ceive.

And then that can lead act, topic, pregnant es and or miscarriages. So by all means, get an S T I E check. If you are somebody who is seeking to conceive children or evaluating your fertility generally.

Media can also have the damaging effects on the epidemic and on the very few other aspects of male reproductive health. In the future, we will do an episode all about sexual health. This is not the time for that, but get an S, T, I check if your goal is to conceive a healthy child.

Now the other thing that can have a very negative impact on fertility and healthy pregNancy is a viral infection. Now, for instance, if a male has had a severe viral illness, and this could be any number of different viral illness nesses from flu to cold there any number of different viruses? Take your favorite virus in the previous seventy to ninety days, that can greatly diminish the number and or quality of sperm.

Okay, so that's really important. This is also important if you're going to go in and do as per manali. Sis, and you had a viral infection in the previous of one ty to ninety days, then you need to be aware of that, because I could greatly impact the parameters of that permanently.

Sis, likewise, for women, if you pat a serious viral infection in the previous thirty days, does that mean you should not try and conceive? Not necessarily, but you should talk your ob jn about that. There are data showing that viral infection, in particular, of influenza, in the mother in the first trimester pregNancy, has some correlation, is not one hundred percent, but some correlation with negative mental health outcomes of the offspring sometime later, including schizophrenia.

A this is some of the work that was done a caltech a number of years ago and other laboratories as well. Those data are still being built up over time. Again, it's not one for one, it's not caught.

So if you did get an influence or cold or other kind of viral infection during the first trimester or any trimester pregNancy, I don't want to cause alarm, but you should talk your O B G Y N about this. The goal, of course, is to avoid viral illness at any time when you're trying to conceive or have healthy pregNancy. But of course, sometimes people get ill and the children can turn out to be perfectly Normal and fine, but this is something that you want to avoid and IT will impact your egon.

Aly sis, and IT will impact sperm. Aly sis, and one thing I found really surprising and researching this episode was that one in twenty five men Carry a copy of a mutation for clic fibrosis. Now some, you are probably ly familiar, or sister fibrosis as a condition that can cause issues with the longs, the accumulation of fluid in the lungs or other tissues, specific fibrosis, in order to express that way of accumulation of flooding the lungs, you really need two copies, or you need two mute copies, or you need two copies of the cyclic fibrosis gene.

One in twenty five men will Carry just one copy, and therefore we will not have any symptoms of sister fibrosis. But those one in twenty five men will have defects in the architecture of the vast difference the ducks through which the ejaculates needs to pass in order to eventually be ejaculate out of the throw. And so what that means is that these men can have what appears to be Normal season in volume, but that they won't have Normal numbers of sperm.

And that's not because of a deficit in making the sperm. The test is, can function, just find the brain and the Peter communicating with the text is just fine. But that literally the passage way by which the sperm arrived within the seminal fluid eventually ejaculated, is disrupted by the cystic fibrosis.

Lucy, if somebody has just want to copy the system by bois gene, and they're all, and this is the issue, the vast difference either can be repaired by a europe gist, whose expert in the surgical repair vast difference, or sperm can be extracted from the testicle directly, which might sound like a painful procedure. But I believe now is in talking with serious experts on this, turns out that he can be done with minimum of discomfort. And certainly, if the goal is to have a healthy child, you're going to need those sperm.

所以 you going to want to get them one way or the other， regardless of the discomfort. Now, before getting into some of the things that you can do in the positive sense to increase your futility, we do need to touch on just a few other things that you want to avoid in order to avoid diminishing your fertility. And this mainly relates to males, but I will also be relevant to females and of course when I say also relected females are referring to the fact that if it's a woman in a man who are trying to conceive um then SHE of course is going to be interested in her red quality, but also the sperm quality.

And of course there are women who are conceiving by way of sperm donor through I V F I U I or otherwise. But in any case, the need to understand and maximize the quality, both the egg and the sperm is paramo. So in order for men to maximize the quality of their sperm, as I mention earlier, does not seem to be a big difference whether or not they use boxes or brief s or whether not they go, go command, do they don't wear any boxes, a brief of any kind? However, IT is important to keep the testicle les cool enough.

They need to be about two degrees cooler than the rest of the body. And there are number of different ways do that. As I mention before, avoid going in hot tubs during the period in which you're trying to conceive children.

You should also avoid going in sonus during the period in which you are trying to concede children. And if you do go on the sona, you can bring an ice pack there you can put in on the testicles in order to offset the heat of the sona and keep the testicles cool while in the sona. The other thing that you will definitely want to do is avoid putting a laptop or any other hot device directly on here lap.

There are a number of different devices that you can put on your lap. You you could put books or a box or there these devices, they are designed to dispel the heat from the laptop. I would say if you're trying to conceive, just keep the laptop off of your lap. Just put IT on a table or standing desk or whatever, just keep IT off of your lap.

Also there are some really interesting data showing that the amount of time that men spent sitting regardless of White enough, they sit with their ankle on their opposite knee or with knees spread the classic man spread stance or um or any other cut of seated stance, is going to increase the temperature of the scrotum for reasons that are somewhat obvious. If you think about the architecture of all this, I think both men, women, if you put enough not to, yeah, that would increase the temperature, obviously avoided um c heaters and cars are otherwise. But reducing the total amount of time that you spend seated is really important if you want to keep the temperature mild, you of the scrotum optimal for sperm quality and fertilization.

And as I mentioned earlier, it's going to be important to make sure that your legs are not really big to the point where they are creating a hotter than is healthy environment for the scroll of and testicles. So a hotter than Normal environment for the testicles can be caused by legs that are very large, appropriate, that are very large due to obesity or due to those opposites being too moscow. So by all means, don't skip like day, but be aware that if you're somebody who's trying to conceive, you want to do whatever you can to reduce the temperature of the scrotum, or at least not let you get too hot for too long.

And so um I can think of all sorts of reasons now that men are going to come up with to um do the man spread stance of their knees really far apart even further if they have large legs. It's not a discussion we want to have here, and that's not really what today's discussion is about. really.

The principle is what's most important, which is to keep the temperature of the scrotton anta asco s lower than the rest of your body. There is a direct blood flow from the body to the testicle that provides blood flow, is designed in a way that that blood pathway should be outside the body and as far away from the body as possible in order to get the temperature mill you of the strom anta cco correct for healthy sperm quality. Now, a topic that is sure to be a bit controversial, but I really shouldn't be because the data, at least to me, are very clear, is this issue of phone use and sperm quality.

Now this can open up a whole array of issues related to things like EMS. And you've got people out there have no ideas about five g and all of this stuff. That is not what this discussion is about.

The discussion about to have with you relates to the fact that the electronic magnetic fields and the heat related effects of smart phones can indeed have a detrimental effect on sperm quality, and yes, indeed on testosterone on levels as well. I'm going to refer you to a paper. We will link IT in the shown out captions.

The title this paper is effects of mobile phone usage on sperm quality, no time dependent relationship on usage, a systematic review and updated meta analysis. This is a paper that came out in twenty twenty one and talks about the fact that phones amid a radio frequency electro magnetic waves, which are called R F radio frequency E, M W election waves at a low level between eighty and two twenty two hundred mega hurts that can be absorb by the human body. We know this.

okay? This is not controversial and have potential adverse effects on brain heart integrant system in reproductive function that has been established. Keep in mind, there is basically no controversy that radio frequency waves and em s can have a negative impact on biological tissues.

The question is, how intense are those radio frequency waves and EMS? And how detrimental are those on those biological tissues? Okay, it's a matter of degrees, but there is very low controversy as to whether not they have an effect on biological tissues.

And i'm aware of absolutely zero data showing that they can have a positive effect on biological tissues. Since what we're mainly talking about now are smart phones, we want to separate out the heat effects of smart phones from the M S. Late to the fact that they wifi smart phones or they're using cellular towers and wifi one of the other accommodation OK.

So there are no different things in the phone that could be detrimental. We need to separate those out. why? Well, because you might have heard that Carrying your phone in your pocket can reduce your testosterone levels and sperm count.

And guess what? That is true. The data contained within this men analyses and other men analyses clearly point out that you can produce sperm count. And maybe testosterone levels significantly, but certainly sperm count and motility significantly. IT reduces sperm quality.

So should you avoid putting your phone in your pocket? You certainly your front pocket, I would suggest yes, right? If you are somebody who are seeking to conceive, right, i'm not somebody who is going to stop using my smart t phone.

I don't expect anyone's going to stop using a smart phone. The question is, should you Carry in your front pocket if you're mail? I think to be on the safe side, the answer is probably avoid doing that too much of the time.

I don't do IT at all. Then people say, well, what if I turn off the wifi or I turn off the cellular access, then is is still a problem? Well, it's a problem due to the heat related effects. And then people say, well, I don't actually feel the heat of the phone doesn't get that warm.

But the temperature effects of the phone IT turns out are enough, even under conditions in which people don't report IT to be uncomfortably warm, that I can change the temperature meu of the testa in ways that can demon sperm quality. How much and how that relates to fertility and healthy pregNancy, not clear. But since we're talking about things to avoid, if your goal is to have a healthy fertilization and pregNancy, well then by all means, just don't Carry IT in your front pocket.

Then people say, well, what about back pocket or what about backpack is very clear that avoiding being too close to the phone is probably Better for your sperm quality than putting the phone very close to your testicles or anywhere else on your body. But it's also the reality that most people are going to Carry a phone notes, right? Is just the reality.

I think all I think the current estimates discussing this paper that ninety percent of the human population has a smart phone, ninety percent, which is incredible. The adult population, of course, although a lot of kids have them as well. So this paper goes on to detail a number of different studies and outcomes from studies, but based what they find.

And here i'm perthes ing, is that, uh, the data indicate that sperm quality declines when people start using a mobile phone. So from the point they start using a mobile phone, regardless of the usage time, this is important you to be thought that he was four hours a day or more of holding your phone or having that phone close to your body was going to dima sperm quality IT. Turns out that it's not related to use a time that even the title of the paper, it's just the fact that people are using mobile phones, is reducing sperm count and quality.

That's the reality, is IT entirely responsible for all the reductions in sperm quality and maybe even the reductions into stores on levels that we are observing from decade to decade going forward. I doubt that the case is IT likely to be one of the major players. I've got my bet on the fact that IT is based on the data that i've observed.

And so if any of you would like to process the data, this, meaning sis, they are quite good to study, looked at eighteen studies that include forty, two hundred and eighty samples. They were able to separate out the radio frequency versus the heat effects. And they were able to eliminate this time of usage variable that previously we thought if you were exposed to a lot of cell phone contact, that that was far worse than if you were supose to a little bit.

Turns out if you're supposed to any at all, you're going to diminish sperm quality. What does that mean? Does I mean that no matter what you do, if you own A A smart phone that you're going to diminish erm quality? I think the short answer is yes, but that you can mitigate IT.

What might you do well keeping your phone away from your growing as far from you're growing as possible if you're a male who's wishing to conceive and maybe even a male who's wishing to maximize to stop strom levels because IT does appear that radio frequency waves and the heat from the phone. So both of those factors independently and together, of course, can disrupt the living cells of the tests. And the production of test astro and inter testicular test astros is important for sperm production.

The exact biological variables leading to all these changes is into exactly clear. But if you're like me, say, okay, probably not a problem for most males to Carry their phone, but probably best do not Carry in the front pocket, maybe even avoid Carry in the back pocket as well. Again, in the future, we will have an epsom all about blue tooth.

We will talk about various aspects of emf. It's a super interesting uh, dataset and it's a dataset which there's a tonto controversy. Um it's uh, really interesting, however, and they're more and more quality data coming out all the time.

And I think going forward, we are going to see that indeed, there are some negative effects of smart refund related to both the radio frequency transmission and the fact that they generate heat. And in general, heat is not good for biological tissues. So any discussion about heat and sperm and how heat is detrimental to sperm has to raise this issue of whether or not cold is good for the testicle. okay.

Well, now there is a lot of data starting to come out about the positive effects, the positive biological effects of deliberate cold exposure on different aspects of brain biology, such as the release of dopamine and eupeptic an, and on the biology body, to some extent, meta lisp, but more so, the impact on Brown fat stores, which are good for us, so called Brown fat or magennis there a lot related to deliberate cold exposure. And we've done entire episode on deliberate cold exposure. Again, you can find that a huberman lab dot com, we did a guest episode with an expert on the use of cold for health and performance with my college crag heller from stanford department of biology.

We also have a tool kit on how to apply deliberate cold exposure for health for both females and females for sports performance, cogent performance, mood, sleep at at a you can find all that, again, huberman lab I com, totally the zero cost. It's going to the man. You will go to newsletter and scroll down and you'll fine those.

When thinking about sperm quality, we want to remember that excessive heat is bad. Now does that mean that deliberate cold good? Well, IT turns out that one of the major causes of lowered sperm count and overall reduce perm quality that's quite common, is the presence of what's called the very cell.

Very cell is going the very cosey ins of the veins that interval the testicle. And what IT essentially does is IT means that blood will pool in the testicular region. IT can't circulate back to the body quickly enough, and therefore the temperature of that environment increases.

There are some other things that variables do which can be obstructive at the physical levels and not just temperature related. It's pretty clear that using deliberate cold exposure can be healthy for the sperm because of the ways not that called directly supports to stop or sperm quality, but rather because cold reduces heat. Okay, so you will find an available online.

I think they're actually called, forgive me, but that's they're called I didn't name them called snowballs. These are um uh there like jail pack a cold briefs that um you can buy and and men will wear for some period of time. I I don't think you wear them all day.

Wear them for some period of time. Lot of people are now using cold showers and ice bars, and circulating cold bars are going to a cold ocean or lake for any number of the different reasons I talked about earlier. I myself start every day with either a one to three minute cold shower or won to three minute um the emersion up to my neck in a cold bath and cold water, circular water or a cold shower.

I do that mainly for the psychological facts related to the long lasting increases in toping and epanchin. But there are other data starting to come out showing that the that sort of approach or similar approaches can increase this ostern levels and maybe even sperm counts can reduce quarters all late in the evening if the cold exposure is on early in the day. So and so what's a lot of interesting data coming out in really good journals that are peer reviewed and so on? In humans, I should mention the studies are done in humans to support the use of deliberate cold exposure.

But if you're going to use deliberate cold exposure to improve sperm quality, can IT work? Yes, indeed. IT can work either indirectly by increasing testosterone or directly by improving sperm quality.

But both of those effects are likely to be indirect by virtue of reducing the temperature of the testicle overall, not because there's any sort of magic effect of cold on the testicle. Now I have to imagine that a number of you, in particular the females, listening to this, they are going to say, is deliberate cold exposure. And for that matter, is deliberate heat exposure likes on our hot tub, good or bad, for the over, for ex, on, for fertility.

Now there are fewer data to look to, unfortunately. But what we do know is that deliberate cold exposure, done in the way that I just described, one to three minutes a day, ideally early in the day, through cold shower, merge up to the neck, doesn't to be a nice bath, could be cold circulating water, or even non circulating cold water. And people say, well, how cold? I should have mention that before.

How cold there is? No way I can tell you exactly how cold the, because for some people, sixty degrees find and height will be exceedingly called. For other people, forty degrees is going to be more appropriate.

How cold should you make IT? If you're going to embrace these practices, you want to, according to the literature, what you want to do is make IT uncomfortably cold such that you really want to get out but safe, right? You don't want to go to thirty degree water um immediately. You can actually have a heart attack and die if you do that. So you want to progress gradually into the cold so you don't want to shock your system too much.

Although IT is the address nal and evoked by that, that quickening or shortening or elimination of the breath for a short period of time, when you get into uncomfortable ly cold water that correlate with, or is actually the reflection of, would be more accurate to say, the release of a general and then doped and so forth, which has been very well documented. So uncomfortable ly called, but safe to stay in. And I cannot tell you an exact number that is uncomfortable ly cold but safe for you.

It's going to differ. A person, my person, you want to figure that out, just like I can tell you how much weight that you should squat in order to. Achieve some effective resistance training for the legs. It's going to differ depending on um your strength and your prior experience and so for so easy to IT be safe but IT does appear that both for men for reasons I talked about a few minutes ago and for women that deliberate cold exposure can be beneficial for fertility and for hormone production but in particular females in terms of regulating cortisol and for hormone production now you might say, okay, getting into cold is stressful.

How can that be helpful for regulating stress? Well, turns out when you get into the cold, you get a big surgeon, a journal in and then dopamine, which is very long lasting, provided that's done in the early part of the day. So I would say not too close to sleep.

Then what you do is you restrict your maximum court is all released to APP earlier in the day that buffers reduces that is the likelihood that you would have excessive amounts of court is all later in the day, which not only can disrupt sleep but is correlated with a number of other um hormonal effects that are not good for us and therefore not good for fertility. So here what i'm describing are positive yet indirect effects of a cold on hormonal levels, both in males and in females. So for men we talked about increased to stores.

One improve the sperm quality that was indirect, right? You're reducing the temperature of the testicle, but it's not that cold itself is positively impacting those things. Does that make sense? He is bad. Therefore, reducing good.

Likewise, with females delivered cold exposure can be good for the overall fertility process, not because cold is good for the over, or being cold is good for the over, or for luti zing, hormonal or for follow stimulating hormone or anything else like that, but rather that using delivered cold exposure as a way to restrict stress in a deliberate way to a particular time of day increases. The release of court is all then and indirectly reduces the amount of court is all that's released at other times along the twenty four hour cycle OK. So these are positive yet interactive facts.

So if you are a woman who really um is interested in expLoring deliberate cold exposure, who enjoys IT or is already doing IT and you're wishing to conceive great, explore IT, do IT safely of course but explore and continue to do IT. However, if you're somebody who hates the code and I want to go anywhere near IT, there's no reason thing that you absolutely need IT provided that you're stress your sleep in other factors are all being Carried out properly. The next things that will talk about in terms of positive things or things that we can do in order to maximized fertility for both females and males are the things that you also generally hear about elsewhere.

Red, along with sleep, and avoiding alcohol and avoiding nickey and avoiding canvas, avoiding excessive heat for the testicle, avoiding excessive stress, is that you want to try to get enough exercise. right? Why would exercise of anything to do with if this will exercise? And that is both the combination of resistance training and cardio ashlar exercise is going to improve the health of the market.

Contrary in particular, cardiff asked lar exercise, and I realized that for your fitness experts out there, anytime someone says cardio people roll their eyes, like, what is that? There's endless training. There's interval training, there's hit training, there's sprinters, all sorts of different things. Some of those overlaps, some of them are separate. Indeed, that's the case.

But we can use a general rule of thun here, which is that for most people, getting anywhere from thirty and ideally forty five to sixty minutes of exercise per day for six days per week, maybe even seven, but most people like to take a day off or need to take a complete day off each week. Six or seven days per week is going to be good for metal. Oral health and function is also gonna act.

All the other things like quality, sleep, mood, reducing stress and so on. And so far so exercise we can handle pretty quickly um by just saying everyone should be doing IT. Now what people are pregnant, they might have to, of course, change the amount of exercise or the type of exercise they're doing. They're varying opinions on that, but certain ly, the type of exercise and the amount can vary when people are pregnant.

But if you're seeking to conceive, getting enough exercise is good because good for the mea cony, the da contra are present in the midst region of the sperm, and critical for chromosome segregation and the spinal and other aspects of the formation of a healthy egg obel tion and feriz ation in the female. One thing that I know a lot of people are interested in is so called intermit and fasting or time restricted feeding. I mean, let's be fair, everybody is restricted in their feeding time because hopefull.

Everybody is sleeping at some point in the twenty four hour cycle, and nobody's eating while they are sleeping. That said, many people are employing a so called eight hour feeding window, or a ten hour feeding window or twelve hour feeding window. And indeed, there are some data to support the idea that there can be a good thing for a number of different biological and health parameters.

However, also a lot of data, especially recently, pointed the fact that your overall number of calories and the quality of your food sources is going to be the most important variable, and some people simply find that time restricted feeding interment fasting, as is also called, is just a convenient way to ensure that your total intake of calories is not excessive for what you need. Now with all that said, there is evidence that i've covered in a solo episode and will soon have an expert guest on showing that time restricted feeding can have certain positive outcomes for various aspects of organ seller and tissue health. This is somewhat controversial, but there is growing evidence that by researching your feeding window to, say, eight hours or ten hours or twelve hours, that IT is Better than if you were to eat over a longer period of each twenty four hour cycle.

Again, the data are still in coming. The reason we want to talk about time restrict to feeding in terminate fasting is that a lot of people do use IT because they find IT easier to not eat at certain periods of they're twenty four hour cycle than to restrict calories. But again, keep in mind you have to restrict calories if your goal is to maintain or lose weight, right?

Discussion that we've covered in that episode on internet fasting and in the episode with doctorate norton and that we will cover in other episodes in the future. So refer to those episodes that human woman lab ed a com, if you would like to learn more about international fasting per sue for sake of this conversation. A number of people are probably asking if I restrict my feeding to a certain window each twenty four hours, because that's what's convenient or because i'm excited about the potential positive effects of intervention.

Is that going to disrupt the likelihood of fertility and thereby a healthy pregNancy? And the short answer to that is, if you are a female and you are having regular menstrual cycles, that is a fairly consistent duration. So maybe it's twenty one days, maybe thirty five or anywhere in between, but it's fairly consistent from month to month. And you are following intervention, fasting time, started feeding well, then chances are pretty good that it's not disrupting your fertility and likelihood of fertilization and a healthy pregnant y of course, during pregNancy, you need to talk to your doctor and make sure that you're eating in a way that supported both of you and of the developing feet is that's extremely important. I am not aware of data expLoring in a regimented way time stricter feeding during pragyan.

Cy, okay, so please please please if your pregnant do not jump on a time stricter feeding, so called international fasting that talk to your O B G Y N, talk to your your doctor, talk to multiple doctors for that matter um before doing anything like that because of course you're now eating for two or if you have twins and their year eating for three, very important. If however, you're not yet pregnant and you want to be further, get pregnant or simply maintain a full potential and biology you're following in fasting, it's going to be the regular of those periods and regulatory of cycle length that will tell you whether or not that's a good idea or not. Keeping in mind, of course, that if your total number of calories is too low, your periods will cease.

That's a well known effect. But of course, stress can also induce the sation of monsters tion. And there are other factories that can induce ation adminstration as well. Some of them start with changes in the brain, literally in hypo thema. Some occurred the patuit ary.

Many of life staff actors can do that, but most typically, it's going to be excessive choric restriction or it's going to be a coLoring deficit brought on by access physical activity. So even know someone's eating a lot if they're not eating enough to offset their physical activity or they are not eating enough of, in particular, fats, you know, the essential fatty acid and protein, but also carbo hydrates. Well, then monsters tion concedes.

And of course, if administration is seizing, chances are almost a certainty that you're not getting regular obviates. Now in terms of males and whether not interact, fasting is going to disrupt from a genesis and testosterone production. Uh, there there is essentially no data we can look to, but we can look to the general logic around the relationship between body fat, testosterone and spermatic genesis.

In this was something that was covered in a discussion I had on optimization of hormonal health for males, that I had a doctor called gilet, who is a medical doctor in obesity specialists, getting find that episode, you rein love out com if you want to learn all about hormonal opposition in males. And essentially the story is as follows. If a male is excessively overweight, he's Carrying too much body fat, in particular not too much muscle, although that can issue you, but too much body fat is typically the issue, so you know, more than say twenty percent body fat.

Well then losing body fat is going to be the primary goal for maximizing test astre one sperm health and spermatic genesis. If, however, a males already lean well, then actually increasing calories will increase the astro. So it's a bit of a of a complicated story, although not so complicated that none of us can understand IT.

Basically, if you're overweight, you should focus on losing weight in order to maximum ze super quality and health. If you are very lean, well, then restricting your calories to the point where you are starting to lose weight or you're dropping even more body fat is unlikely to increase your testosterone further. I doesn't necessarily mean it's bad or that you shouldn't try and go, for instance, from fifteen percent to ten percent body found nothing in that that's bad and that will reduce your testosterone one.

But in general, you're already very lean. So you know ten percent body fat, five percent body fat and you start restarting calories further, your testosterone levels will drop. So in the context of interment fasting, it's really not an issue of whether or not you you're feeding window is eight hours or twelve hours.

It's really issue of whether not you're getting enough calories to offset the physical demands and activities of your life or not. You're on a main style to maintain your weight. And of course, you have to put all that in the context of whether not you're overweight or lean to begin with.

The simple thing to take away from this is if you're male, who's using, because you like, IT internet fasting, social timer of feeding, and you're following an eight hour or maybe even a one meal per day type approach. Although I don't really recommend that for a number reasons. We could talk about separately if you're eating over the course of eight or ten or twelve hours, hours per day because that's what works for you and you are interesting enough calories to maintain your weight if you're already lean.

Or you are interesting fewer calories than you are burning in order to lose weight because you are already overweight and you want to lose body fat, you're probably optimizing for all the things that you need to do in order to improve firm quality and testosterone levels. Now also in that episode that I did with doctor called let on optimizing hormones for males, we talked about to slash n replacement therapies. Not a topic I want to get into in any detail right now, but I will say this.

Remember earlier when we were talking about spermatic genesis, in the fact that in order first firm to be generated consistently every month, ongoing from the time of poverty until essentially the time that a man dies, you need two things. You need to stop production from the light cells of the, and you need spermatic genesis to be supported by that energy binding protein coming from the support cells from the cr toy cells. So you need to to astern, and you need energy and binding protein, and you need the light itself.

And the socially sells active when men take exogenous meaning from outside the body to stop her on other by cream or by patch, by pellets, or more typically, by injection. The most typical rt approach now is is testosterone pipino, which is biologically identical to the kind of distal you would make well because of negative feedback loops, which you also learned about earlier, the testicles s themselves shut down their own testosterone production. Why would that be? okay.

So you're taking test ostrom in by stranger, by patch or um any other method. So the circulating test stone in the amount that arrives at the testicle is going to be of the clinically appropriate, not super physiological, but it'll be somewhere in the healthy references range. May be a little bit higher nowy.

Some people are going a little bit higher. We're not thinking about full blown quoting or antioch c steerage ID use. Keeping in mind, of course, that as genes there is a story, but won't think about stories.

We really like performance and enhancing drugs. So super physiological doses we're talking about within physiological or or near physiological rangers. So someone's in taking their testosterone in from an outside exogamous source. The levels of circulating ist astre one will be sufficiently high that the patuit ory will register that and will stop making, utilizing hormones and generally follow stimulating hormones as well. And as a consequence, spermatic genesis is vastly reduced or eliminated.

In other words, for men who are on T, R, T or who are taking to from an external source, the new number of firms that they're going to make is going to be dramatically reduced. There are things that they can do to offset that, like taking H C G, human coryon ic. And at open, just kind of a mimic for uti zing, hormones stimulate the testes to continue to make testosterone, and some men will also, or instead IT, take F, S, H to stimulate the security cells.

Is the support of matter spermatogenesis, excuse me, or both, or some combination. And some people take clumping climate. There are any number of different ways of on bypass or offset the sperm reducing effects of taking exogenous to.

This is a conversation that was covered in a fair amount of detail, that episode with doctor julep. But just keep in mind that if you are taking testosterone from an exogenous source, your sperm counts will dramatically be reduced unless you do something to offset IT. So if you are wishing to conceive, you need to think about whether not you're going to offset the test, also some replacement therapy or whether not you going to come off IT entirely.

So you'll need to talk to a european st and chonodemaire that um and again, a number of these different themes in ways to go about tapering off T R T were covered in that episode a doctor college let. So if you're on T R T here, you're considering taking in in your interesting in having children, not just now, but at any point you really want to take these things into consideration. Now I do want to point out that for the number of you out there who are taking supplements, some of which we've talked about on this podcast, i've talked about an other podcast such as tongue.

Ali turns out that there are lot of men and women taking tongue to reduce sexy mom binding global lion levels, to increase testosterone and extradition, in some cases label and so forth. Those approaches mean supplement based approaches to increase testosterone or free testosterone, or some related hormones are not going to shut down your own in dodger's to stop ROM production and reduce the number of sperm that you make. Or this, as far as we know, disrupt violation in any kind of way, provided that the dosages are within Normal ranges.

Again, supplementation to support your hormones should not disrupt evolution or spermatogenesis or testoon production. Quite the opposite, you should enhance IT. What I just described around tt is taking exogenous testosterone at that itself as an entirely different beast. Now with all of that said, there are some supplements out there that include test astro as a ingredient that's been snuck in to various formulas that include blends and things that sort you want to be aware of that. And we did an episode about how to develop a rational guide to supplementation.

A highly recommend listen to the episode again, its time stamp available free at you, woman lab down, calm in all formats because IT talks about which supplements are likely to be clean, quote, quote, to contain the things that you expect them to contain. There's more, more evidence coming out that a lot of supplements, including some, for instance, supplements that contain testicle uh, or the extra acts of testicles, can contain test astro. Whether or not that can shut down your own in gaudi inst to astern production isn't clear.

No one's really explore that in detail. But based on everything we just talk about, A T R T, it's sense a reason that I might either reduce IT or shut IT down. It's just never been explored yet. So by all means, make sure that you know what you're taking if you're taking supplements. But again, the major point here is that for both females and males, taking supplements to support healthy hormone production, including things like tonga, ali is not the same as taking hormones or bioidentical hormones, which indeed can shut down your own inorganic production of harmons and thereby reduce both equality and the chance of realization and healthy pregNancy, and sperm quality and the chance of realization and healthy pregNancy.

Anytime there's a discussion about fertility and pregNancy, there seems to also be a parallel discussion about sex determination, that is, what factors can influence whether or not the child is born, is male or female, that is, whether not IT has double x chromosomes, one x chromosome one from mom, one x chromosome from dad, because the egg was fertilized by a sperm that had an x sex chromosome one that twenty three criticism, or whether not the offspring is male, whether has the x crime zone for mom, because it's always going to be the x crisis in that egg and a White chrome zone from the sperm that fertilized that particular egg. Now, of course, there are instances out there of people that have X X Y crime zs or X Y Y crimsons. But the vast majority of people out there are going to have either an X X chromosome.

So we call that a female carrio type, right? This is different than genotype and finot pe. But I female Carrier type would be xx, or a male Carrier type would would be X, Y OK. Now despite the fact that IT is the egg in the sperm in the chromosomes that they Carry that are going to determine the chromosomes, there's a lot of lower and discussion about the factors that can buy us which sperm will fertilize the egg and thereby whether or not you're gonna in xx female or an X, Y male chrome zone, and therefore offspring. Now, not only is the lower around this whole issue of sex determination rather prominent, but IT is also somewhat unusual, and perhaps even interesting.

So for instance, aristotle himself proposed that if a man is thinking about himself and his own pleasure more than his partner and her pleasure at the point of ejaculation, then the offspring ing will be male. Aristotle also asserted that if a man is thinking more about his partner and her pleasure at the point in which he ejaculate, well, then the offspring would be female. Of course, we have zero reason to believe that there is any truth to arist theory. There are no data to support that. In fact, i'm not even sure how you would run that experiment because you can't really look at people's thoughts.

You'd have to rely on honest self report and um even if people were to faithfully report what they were thinking about, uh, at the moment of event lation, this would evolve of course bringing people into the laboratory and somehow um measuring or analyzing their thoughts or gathering their thoughts during the sexual intercourse at the point of evacuation and figuring out which biological sex was the offspring at at a just near impossible and probably not the most important experiment to invest our time doing none the less. There continues to be a lot of lower about what determines sex of the offspring. Most notably, there's a lot of lower and discussion in rumor about the idea that particular sexual positions at the point of evacuation during intercourse can somehow bias the likelihood that a pregNancy will be either resulting in male or female offspring.

Again, there are zero data to support this. And yet this whole notion of sex determination is a really interesting one that people seem to be somewhat obsessed by. So much so that, again, if you go online, or if you were to talk to people in the sort of, let's call, IT holistic or peripheral health spaces related to fertility, there is discussion about, okay, well, you take this sexy position at the point of evacuation to get a boy, and you take that sexual position at the point of evacuation.

To get a girl or you do um you do this in the early part of the day or the later part of the day again, offer which there is zero data to support any kind of systematic relationship between what I just discussed in the biological sex of the offspring. That said, there are now emerging methods that people are using in order to separate out the sperm that will indeed give rise to a male offspring versus a female offspring. Now this, of course, is done in the context of in vitro fertilization.

We haven't talked too much about in virtual realization but in virtual feriz ation involves, as the name suggests, taking an egg and taking a sperm, pairing them in a dish. This can be done a number of different ways um but just a briefly described the ibf procedure. Ibf involves administering supra, meaning greater than Normal supra physiological levels, vocal stimulating hormone and uti zing hormone during the folicur phase of a woman cycle.

What that causes is the maturation of not just one egg that would be emulated, but multiple followers and eggs, and then emulation itself is suppressed also through the administration of exogamous hormones. And then the ultra sound guidance. And O B G. Van goes in and collects the mature eggs, and folk les puts them in a dish, and then sperm, or delivered to that dish. Those could either be sperm that were frozen previously or more typically or ideally IT would be perm collected that day that are washed to the a very straight forward procedure and then those sperm either are allowed to compete for those eggs and fertilized those eggs and allow them to advance to um very early embro stage before those embryo s are frozen and eventually implanted into a woman in order to have them be Carried to full term ideally.

Or there's a procedure in .

which specific experience selected because they have the best morpho, gy motility and so forth and in a process called xc I C si, in which the sperm themselves are literally forced to fertilize that particular egg. Now under those conditions, typically a couple or a woman, as she's doing this on her own with a sperm donor, will get multiple fertilize embro, okay, that are Carry to a mul mult cellular stage so that it's clear that they could grow into a child if they were implanted into a viable host. Sometimes the surge IT, sometimes the woman who wants the child herself.

And under those conditions, IT is possible to look at the genetic makeup, including the Carrier type of those early nant embryos, in which case people really can select the sex of their offspring, that is, they will have some embryos that are xx, some embryo s that are xy. It's very likely also that they will have some embryos that have carrio types or genotypes, which are not ideal in that they would potentially lead to a miscarriage or some other genetic effect. And so typically people do not select to implant those embro if they have the option to implant embryos that are of either xx or xy carrio type and the Normal chromosome mal um arrangements and for obvious reasons.

So the the whole point here is that sex selection is possible, but only using in virtual fertilization. The other thing that is becoming clear to us in more recent years is that sex election is actually possible at the level of the sperm even prior to fertilization. This is an emerging data set, and this is largely happening in clinics outside of the united states. But there are some clinics that have figured out methods in which they can take a sperm sample, and they can spin that sperm sample in a center fuge at a rate that separates out this firm into water called different fractions.

So for those of you done a little bit of biology with future, when you spin any kind of substance that includes multiple things in IT of different weights, when you spend them, that things have different weights segregate out into different fractions along the depth of the tube, and then you can take out one fraction or the next, simply with a little pie pet. You take out the top for action, the middle of action and so forth. And what these clinics have figured out is that if they spin the sperm sample at the correct spin rate, that the sperm that will give rise to mail off spring and the stream that will give rise to female off spring segregate out into different fractions, allowing them to take each of those fractions separately and to apply them to eggs if it's a virtual fertilization and give rise very reliably, certainly much more than chance to either male or female embrace.

They also, of course, can choose to do this outside the context of eventual feriz ation. So some people are now opting to have their sperm samples spun out in this way, separate out the sperm that give rise to male or female off spring, and then to only use the fraction that they are interested in, right? So if they want a boy, they use one fraction.

If they want a girl, theyll use different fraction, and then to use those fractions in the context of what's called I U I, or introduce an examination, which is, as the name suggests, rather than having the man deliver the educate with his penis, in this form with his penis, they have a device. The devices are now commercially sold, believe and not. They're all over the counter and on the internet.

So people even do this at home. And so what you're doing is they'll take the this burman and they'll do I U I in order to bias the probability that they're going to a male or a female offspring. Again, this is something that's now emerging. Um it's not common place most of the time.

People simply roll the dice as as IT were um by having other um intercourse and just hoping for or not caring if they they get a male or female offspring um or in the instance survive of selecting male or female spring, sometimes largely on the basis of the chromosomal arrangements. So of course um some people might prefer to have one or the other biological sexes they're offspring. But of course the healthy chromos mal arrangements are going to be param out for getting a healthy child in.

As I mention before, unhealthy chromosomal arrangements or abNormal chromosomal arrangements often lead to miss carriage or end or birth defects. So selecting for healthy chromosomal arrangements is always param out. But some people are selecting for biological sex, and indeed some couples who can conceive naturally are opting for I, U.

I, in order to be able to select biological sex because of this ability to spin out the sperm samples to different fractions and select the male or female sperm, that is, the sperm that would give rise to male or female offspring so this is a rapidly emerging theme believe IT or not who knew um and of course he has nothing to do with aristotle assertions about what people are thinking about at the point of evacuation nor does that have anything to do with body position at the point of evacuation but I do find IT rather interesting that um even in this day in age, people seem to be continually pursuing new and different ways to understand why one sperr another sperm happens to fertilized the egg and when that information is not available, because Frankly, is not available yet, we don't know why a sperm containing A Y chrome or sperm containing x chromosome one is more likely to feriz an egg. There are some ideas, for instance, that older fathers tend to have more daughters as opposed to sons. But when you really look at the data, it's pretty mixed.

So if you've heard that before, um has a particularly nickname that I am not going to describe on the podcast you can look at up online. But um if any of you are aware of any other kind of ideas or law, no matter how ridiculous or crazy, please put them in the comments section on youtube. I would be very curious to learn about h those mostly out of um uh interesting curiosity.

But look sometimes these outrageous stories such as uh notions of body position and what how they influence biological sex, even though they turn out not to be true, turn out to be interesting for other reasons. And in fact, next we're going to talk about how body position during sexual intercourse can in fact influence fertility and pregNancy. So another common theme around fertility and pregNancy that you will hear about is that for couples that are trying to get pregnant, that during intercourse, they should do whatever is that works for them.

But then after the man ejaculate, that the woman should try and position her ankles above her head, or somehow otherwise till her pElvis back, in order to increase the rate and or probability that the sperm swim tored the egg as opposed to the other direction. Now I talked to a couple of different O, B G, Y, N S and europe gist that are focused on fertility about this topic and IT turns out you get pretty mixed answers as to whether not there's any validity to this idea that the woman's body position after the man ejaculates inside of her can somehow influence the probability of pregNancy. One group of experts told me that there is no reason for a woman to need to continue to lie down, elevate the angles, or in any way tilt to her pElvis back in order to increase the probability of successful ization.

The other group suggested that, indeed, there is a strong reason to believe that tilting the pElvis back, maybe even keeping the angles elevated, and having women lie on her back for about fifteen minutes, with the pelf positioned at about twenty degrees back, is ideal for optimizing fertilization. I mean, they were really specific about the recommendations. So I find this interesting that within the a cohort of extremely well trained mds, O B G Y N S and urology, fertility dogs and O B G S, you see a split has nothing to do with whether or not the the physician was male or female or where they are training or the institution.

None of that, but just seemed to be a sort of even split between the two. Now granted, IT wasn't the largest sample size that I could have obtained. And yet I do find interesting that there is this this split in the opinion about this one group, the group that said, no public position doesn't really matter, don't worry about it's not going to influence of the rates of fertility, argue that the sperm swim very quickly and that if they are released near the survey, they're going to swim very quickly toward the egg in order to fertilize that regardless of pelvic position.

The other group said, well, yes, sperm swim quickly and even if they're released right at the entry to the servex, that the spam still have a long distance to go again. If you were to scale this um according to the size of the servers, size of a human body, the entire human body, what you'd scale IT to is the distance between los Angeles and and france ago. And that needs to undergo that basically within twenty four hours or so, although as we mentioned earlier.

Sperm can survive quite a while inside of the woman's body, maybe three or five days at least. So in both cases, they acknowledges along distance. But on the one hand, you have a group of experts that are saying this term more less know what to do, and you're going to do IT regardless of the position of the woman after evacuation inside her. And the other group saying, no, we wanted do everything we can to bias the likelihood that the sperm will fertilize the egg OK.

Well, setting aside the basic argument that tilting back at the pElvis and lying stationary also for about fifteen minutes after sexual intercourse and evacuation is not a inexpensive, uh you know, endeavor, although IT requires a little bit of time and IT forces people to remain motionless or or close to motionless and they're not up up around and moving about aside from that is a relatively low investment. So one argument is, well, if I could bias the likelihood of fertilization at all and people want to get pregny, wouldn't they do that? Okay, that's a reasonable argument, but doesn't really point to the mechanism.

The arguments that point to a potential mechanism are that, if you recall, what we were talking about when we have about supreme quality, sperm quality involves a bunch of different measures like concentration sperm. Premiere leaders seem in morpho gy of those firm how many afford motel IT? Turns out that in any one jacuzzi, the total number of forward mobile and yet fast forward motl sperm that are also of the highest quality morpho gy is actually quite low.

And so the idea here is that you want to get as many sperm of the highest quality swimming toward the egg, because those sperm stand the highest probability of fertilizing that egg in. In fact, this relates to some of the discussion we are having earlier about behavioral dues, and don't for sake of increasing the probability of fertilization. And the one that is most important here is cannabis IT turns out that the data on cannabis really do support the idea that some of you may have heard from um parents and teachers I don't know.

I did hear this from parents and teachers that um cannabis can disrupt the swimming styles of sperm in in ways that are not supportive of feriz ation that I can turn more of the sperm into twitchers although when I learned about this I was not informed of the word twitchers. What I was told is that if you use cannabis that the sperm don't know which direction to go, that they're confused um almost implying that the sperm themselves are are high on cannabis well that certainly not the argument that are making here but IT does seem to be the case that people who use cannabis even once the sperm that are generated during that particular months or two months during which or after which they use cannabis have less forward motility and possibly altered morphology as well. Okay, I want to be very clear.

I did not say that if you use cannabis once, you are forever disrupting the motility and more follow to you your sperm. I did not say that. What I said is that if you use cannabis once, then the sperm that are generated in the sixty days after that cannabis use are going to have a higher incidence of disrupted motility and perhaps more pology as well OK remember, sperm continually generated every sixty days or so.

And so if you use cannabis once, you are not forever disrupting your sperm. But if you are using cannabis and then you are looking to conceive in the next sixty days, you are going to be reducing, we think, significantly. So the number of quality ford motor sperm.

So the simple takeaway from this is avoid cannabis use, although if you are going to use cannabis, and again, there are medical uses of cannabis and beneficial uses of cannabis for certain populations that can be bad for other populations. We talk about that in the huberman lab podcast, all about cannabis. But if you're going to use cannabis, you should try to stain from cannabis in the two months prior to the attempt to fertilize and get pregnant.

Now i'm not aware of any data on how cannabis used by the woman can influence the likelihood of fertilization and pregNancy. And I want to touch this whole discussion around cannabis under the umbrella of something that came up in the episode that I did on cannabis, which is that for about half of people out there, mail and female, okay, so here we're not distinguishing by biological sex. About half of people who use cannabis reported as an afford gia IT makes them want to have sexual intercourse more than if they don't use canvas.

And for the other half, IT actually is the opposite effect by way of an influence on a hormone called proactive, which suppresses the dooming system, the text on in the estrogens system. And so this old idea that cannabis and affordable a seems to be true for about half of the human population and not for the other half of human population. So I mentioned that because I know a number of people use cannabis as an afford to jack, they like to use cannabis before intercourse.

IT was actually very surprising to me to discover when I researched that cannabis is episode, that approximately twenty fifteen, one five percent of women who are pregnant continued to use cannabis during pregNancy. And that's a very alarming statistic. And everything we know is that the use of cannabis during pregNancy is detrimental to the health, in particular the brain development of the fears.

So that's a real concern. I hardly recommend women obtained from cannabis used during pregNancy. Um talk to your obi about IT if you're using IT all or considering using IT all. So based on what I told you earlier about the fact that cannabis use is not good for equality and the fact that kind of us use can disrupt the mortality of sperm and therefore is not good for sperm quality and IT can disrupt the patterns of swiming sperm in ways that reduce the likelihood fertility.

I think the tako message is clear, which is that whether not um you want to be a cannas user or not, if you are going to try and conceive and certainly while you're pregnant, you're going to want to avoid the use of cannabis and that is smoke cannabis and vapid cannabis and during pregNancy, the consumption of cannabis, even an edible form and tincture form, is also going to be to developing for us. But of course, we started this conversation in the context of body position, in particularly the point of evacuation in determining the sex of the offspring and or the likelihood of getting a successful fertilization and pregNancy. And I think that given that the tilting back of the pElvis, so again, this is elevating the puvis by about twenty degrees, I don't think that has to be exact exact, but about twenty degrees for about fifteen minutes post to jaculation inside of the the woman or I suppose if people are using I U I intrauterine insemination, since that seems to be the consensus among those experts that believe that pvt tit backward can be beneficial for increasing the probability of realization.

And given that IT involves no cost, but a little bit of time, seems to me that if you want to get pregnant, that that would be the right thing to do. And as far as I know, there is no information, nor was I able to obtain any recommendations from experts about what the ideal body position of the mail is after accusation, if the goal is to increase the probability of fertilization and pregnant. Y, so we've been talking about behavioral interventions, some dues and some donors that people can do to increase their flight lite, and the likelihood that any fertilized egg will be Carried to term successfully and soon will also talk about things that people can take to improve their fertility.

Now keep in mind that this entire discussion is about fertility. But also remember, as we discussed the beginning of the episode, trying to increase your fertility is one of the best ways to think about trying to create and maintain opt more physical health. So for people they are trying to conceive, and for people who are not trying to conceive, optimize, zing your fertility status when not your male or female.

It's one of the best ways to target those approaches. And there are now a lot of data supporting the idea that accused uncle of all things can be very beneficial for improving both female and male fertility. And should a woman get pregnant for improving the quality of outcomes, that is the likelihood that there will be a successful pregNancy that is Carried to term, not premature, and so on and so forth.

Now for some of you out there, you might think, oh, of course, archives unctions archibong cres been known to work for thousands of years, and it's not surprising that I would assist with fertility and pregNancy. For many of you out there, however, probably thinking active puncture that seems, and like france, science. But what I can assure you is that there are now quite a few clinical trials funded by government agencies like the national institutes of health showing that archibong care is a very effective treatment for a number of different things, including fertility and pregNancy, but for hormones status, for stress relief, but even for chronic illnesses of different kinds, including auto mune illnesses.

So this is no longer considered fringe science. In fact, one of the best laboratories in the world working on this is a laboratory out of harvard medical school run by a guy named truth mom. And lab has really been expLoring, in a mechanistic way, how the different stimulation sites that are used in archibong crores of where the needles are inserted, tap into neural pathways that link the different organs of the body. So for instance, theyve found that stimulation of a particular site on the lower limb can reduce inflation tion dramatically throughout the body by way of neural pathways that originate in the lower lime and extended areas such as the kidney in the pancreas.

So all these tico ancient maps of the human body, as late to archive uncle, are now being parsed at the level of mechanism, which I think is wonderful, because is not only is showing us that so much of what has been proportion and reported in the landscape of active puncture actually has an underlying mechanistic basis, and with additional mechanistic understanding, of course, always arrive new and Better practices that the idea to evolve these fields of architectural, to evolve the fields of mechanistic understanding of our biology and health. And so the issue of whether not archibong ccr can assist in getting pregnant and in turning a child to term, and for that child to be healthy are really starting to emerge in a major way. And rather than go into all those data in detail, what I can tell you is that there are clinical trials and data supporting the fact that female fertility itself can be supported by archibong CER through several mechanisms, one of which is the balancing.

And I realized that to a somewhat tRicky term, and i'll d to find IT Better in a moment, the balancing of ormonds across the obituary, slashing store cycle, including regulating levels of F, S, H, so that they're not too high nor too low. And restricting the face age to the filler phase of the of dementia cycle, as well as using active punctual to improve things like blood flow and the health of the over itself and other aspects of the female reproductive access. So active puncture can Operate at the chemical level impacting hormones, IT can act at the mechanical level impacting the different tissues through which the egg has to pass, and so on and so forth.

Likewise, on the male side, active puncture has been shown to improve seen and volume quality of sperm, sperm tilted at seta, and in large part through changes in the neural pathways that innovate the very tissues and vascular input to the scrotum and testicles, because, as we learned earlier, temperature regulation of the scrotum and testicles is so vital for getting healthy spam and increasing sperm quality. In addition, there are good data to support the idea that archibong cure can increase levels of test astern, free test astro and the sorts of hormones that are going to support healthy hormone production and sperm production in males. And this is distinct from applying testosterone from an exogenous source, right? So when we're talking about archived uncle in increasing levels of testosterone, are talking about increasing levels of endogenous testosterone.

So those lady cells can support the sir tolly cells, and the circuit y cells can make that android and rebinding protein. And you get in enhanced spermatic genesis, you can find evidence for all of these different features, both changes to the chemical million, that is, the hormones, and changes the mechanical meu, including, for instance, improvement of the pathways leading from the semi I force tube eels to the epidemics, to the vast difference, basically clearing out the plum bing so that more quality ejaculate can be delivered, which, of course, is going to increase the probability of fertile ation. So when you hear that across, unctuous can improve the likelihood of pregNancy.

That's an accurate statement for which there are now increasing amounts of mechanistic data, if you want to learn more about how archives uncle can be used to contribute to improve realization and pregNancy, there are number of different excEllent reviews on this, both as IT relates to females and as IT relates to males. One of the best papers that I happen to like is one that will provide a link to in the references entitled archibong cca and urban medicine for female fertility and overview of systematic review. So I A review of reviews.

This was published recently in twenty twenty one. We will provide a link to that. And um there is also going to be a link to a review that relates to archibong cure for male fertility and hormonal augmentation.

I should just mention briefly that if you're going to look at scientific papers, one thing that you want to consider is also looking at the references that they reference. And of course, papers tend the reference of tony references in particularly reviews. So what you want to do is look for the references that are showing up most often in the introduction.

Those references often are going to be the most prominent recent reviews or the most important findings in recent years. That's not always the case, but that's often the case if you read the first couple of paragraphs. So these papers and these are openly available as full, full text, by the way, online, if you go to these links, you'll be able to access the best papers, the most relevant papers, in the context of archives unco supporting female and act puncture supporting male fertility and hormones status.

Now we'd like to discuss things that men and women can take in order to maximize their fertility. And again and again, when we're talking about fertility, we're talking about people who want to conceive and have children, but also we're talking about a basic measure of overall health status. So if you're somebody who does not want to conceive children, I still encourage you to think about whether or not you would want to do certain things or not, do certain things in order to maximize your fertility as a means to maximizes your vitality in longchamp, because that's really what maxims ing fertility is about for a lot of people.

That said, I know a lot of people would like to conceive children, perhaps not right away, but in the future. And what i'm about to describe are some tools and interventions, that is, things that one can take in order to improve their hormones status, but also, in particular, the quality of their eggs and the quality of their sperm in the short and long term. The first on the list of things that people can take in order to improve equality or spring quality is l carney.

L county is present in various foods, in particular in red meat. But again, it's going to be very hard to get sufficient levels of our carneta to improve equality and sperm court unless you're going to take IT in supplement form. The typical recommendation based on p reviewed studies that have shown significant improvements in egg quality, that is, chromosomal arrangements, that is, the likelihood of fertility or pregnant y rather the likelihood of sperm being forward fast.

Swimmer opposed to twitchers are a motile and having proper mortal logy. All those measures has been demonstrated to be significantly improved by the congestion of al carney. How much al carney? Well, that depends on how you're obtaining the al nor team if you're obtaining in capsule form, one to three grams per day of capsule form alkan tine is what's been suggested to improve equality and sperm quality.

Now one to three grams per day can be taken all at once or spread out throughout the twenty four hour cycle. IT can be taken with or without food does not seem to matter, and when taken for a period of thirty to sixty days does seem to significant. Improve all the parameters that have been discussed for equality and sperm quality.

Now the mechanism for that effect is pretty clear. l. Carnet is involved in the processing of lipids fat in terms of medico function.

And as we talked about before, medication are vital for the organization and action of the spinal that pulls apart the chromosomes, taking that cell within the female from deploy to half loyd, which is essential. You really want just the twenty three individual promotion al strands. You don't want criminal repeats.

Also involved in the actual fusion of the egg as IT exists, the over and enters the oval tion cycle. Meta country are also important, as we talked about before, for the ford mortality of burn because the enrichment of meta country and that ID region just behind the head, because the whipping flag lation of of the tale, allowing for forward movement as well as other aspects of cellular morphology. So IT makes a lot of sense to why altering and supplementation would be beneficial.

Al, it's one to three grams per day over a period, about thirty to sixty months. If you're hoping to conceive in the upcoming months, recommend taking IT for at least thirty days prior to that. Um of course, based on the data we talk about before the cumulative probability for accountability, IT said there's no reason to not continue to try for pregnant y before taking our current.

But l courtine is going to improve I can sperm quality. And so you might actually or take the stance that even if you don't have any problem getting pregnant, wouldn't you want to maximize the quality of the egg that gets fertilized and the quality of this firm that fertilizes that egg that's additional rationed for taking out carneta? One important note, if you are going to take our current tine in oral form and capsule form, IT can crease something called T M O.

T M O can cause differences of the arrest. You don't want T M O levels to go too high. One way to offset the increases in tmo caused by oil o carnet is to take six hundred milligrams of garlic per day, I suppose good, he clothes of garlic that would work just as well because garlic contains something called alison, which can offset the increase in TM.

L but six hundred milligram capable of garlic are going to be, or garlic extract rather is going to be the most probably cost effective and um simplest way to do this. And also they aren't going to create that garlic smell. Some people like the smell of garlic.

Some people don't. So if you're going to take oral carney, I suggest also taking six hundred milligrams a day of garlic extract and you can do that at any time throughout the day. Doesn't have to be with the alternative.

The next item on the list of compounds that have been shown to improve equality and sperm quality, and quite robustly, so is co n zi q ten. Co n zim q ten is something that you can actually measure levels up in your blood. Most physicians will say that they want to see your levels of coe's.

I'm q tend to be somewhere between point five and two. Point five is going to on the units. Most people I realized are not going to run off and get their coco o ten measured.

It's not included the most standard blood tests. But if you were to measure coco ton, that's the range that you want to look for. That said, many people up to supplement with coke yo ten, and you'll find that many fertility dogs, O B G S and eulogists that are trying to assist their male patients with fertility will suggest coq ten.

Because, again, IT supports the health of metal contra metal contro, so vital to so many aspects of the formation and fertilization of the egg and sperm, that, of course, fertilizes the egg, the coin sine q ten dosages that are most often suggested, and that you'll observe in the p reviewed research literature on humans, I should add, is one hundred to four hundred milligrams per day. And the coin's am q tn is taken generally with a meal, and ideally a meal that contains fat. And there's even some idea that taking coins, i'm q ten with your dinner, assuming that dinner includes some fat, you don't have to add additional fat is going to be more advantages than taking coin's.

I'm q ten early in the day, although that's probably a detail that's getting a little too far down in the weeks. So again, one hundred to four hundred milligrams of cosm q per day, whether or not you a man or a woman for improving the likelihood of fertility by way of improving egg firm quality. And again, if you're somebody who just doesn't have any problem getting pregnant reviews already producing many sphere of quality mythology, this is another case in which you could take a step back and to say, well, why wouldn't I want to further optimize the quality of the egg, the sperm? Because the quality of the egg and the sperm ultimately are going to determine, not just whether not you have a successful pregNancy, but are going to determine, admittedly dly, in ways that will forever remain cypher to you.

But none of less are going to be important in determining the qualities of the brain tissue and body tissue of your offspring. The third item on the list of compounds, which are commonly suggested or prescribed by fertility dox nowaday for men and women wishing. Conceive and or optimized their fertility as a basis for general vitality and health is in oit. All ince at all has many uses. So you'll hear about the use of an ospital for reducing anxiety, improving mood or even for the treatment of depression.

We talked about an ospital and previous episodes of this podcast um for instance, I talk about in oslo all and in particular taking nine hundred milligrams of milo and ospital prior to sleep which is something that I do along with the other supplements that I take and recommend for sleep such as magnesium three and eight APP genin and seeing if you're curious about those, you can see our newsletter on sleep or a perfect or sleep episode or the master sleeve episode talks about a behavioral and implementation based tools for improving sleep but milano at all is not just suggested for or prescribed for people that are wishing to get pregnant and for general health, but my own hospital is often recommended for people that want to improve ean sperm quality because of the way that you can positively impact insulin sensitivity. Insulin sensitivity might sound like a bad thing to people out there, but IT turns out that you want to be insulin sensitive. The last thing you want is to be insulin insensitive.

In lin, insensitivity is associated with type two diabetes, with obesity. And even for people who are not chAllenge with obesity, you want yourselves to be inside in sensitive. You don't want a lot of insulin floating around in your system with yours cells unable to use that instance.

That's really what insulin in sensitivities about. Milo in official, at dosages of one to five grams per day, pretty high one to five grams per day, keeping in mind that a thousand milligrams one gram has been suggested to improve equality and sperm quality. Now, one point of I went, take caution, but of note is that mile also can reducing.

This idea can be a slight sensitive, which is why some folks, including myself, take almost a gram, nine hundred million grams prior to sleep. If you've going to take five grams of my own hospital, you would want to restrict that to the late evening or second half of your day. And I don't suggest starting that high.

I would start with one or two grams and then working your way up, seeing what you can tolerate um in terms of the level of anton's ID and drawing that IT produces wonder five grams per day of mile in arcata is what suggested for both men and women wishing to improve egg health and burn health. But for women it's also often suggested to include also okay, so that to take my own official, but to also take d caro in oslo, al d. Caro and ospital has elements in IT that can be both pro and anti androgens.

Androgens are things like testosterone and related molecules. There are a number different causes of infertility and disruption to equality. Age being the most significant factor. But another significant, very common factor, even among Young women who are fertile, is having too many androgen.

And as IT relates to something called policy ovarian syndrome, and we'll do an entire episode about menopause and pcs in a number of other things that relate to fertility because it's an entire and very interesting other discussion that we need to have. But the recommendation is that women take one to five grams of mile hospital, but also decayed in hospital because of the ways that I can baLance androgen in offset some of the negative effects of policy stic ovarian sync me. Or even for women who do not have policy stic ovarian sync me because of the ways that d kiro an oscitation can baLance androgen in ways that are beneficial.

The dosages of deka o and ospital that are recommended tend to be one twenty fifth to one fifth of the mile hospital, though. So you have to get out your calculator. Remember, a thousand milligrams equals one gram, so figure out if you're taking one gram of my on hospital per day or two grams, you're going to want to convert that to milligram.

So let's say you taking two grams of my own hospital per day, that's two thousand milligrams. And you d wanted divide that by twenty five and that's many milligrams of the cairo in hospital, or you would want to take as well. Or you could go with the lower endows individed by forty and take that number of milligrams of d an ospital along with the and ospital.

Again, I will be taking IT later in the day is going to be good. And it's not clear at all. They take IT with food or without food makes any difference whatsoever.

So I would suggest you do either keep in mind as discussing these recommendations, I may all them prescriptions, but one of these are prescription drugs. And of course, you should always discuss any supplements that you're planning to take or stop taking, for that matter, with your physician. I don't say that to protect me.

I say that to protect, you know, anytime you're going to add or change something in your overall health regime and you want to discuss that with your trusted health care professional, typically, I would hope, aboard certified empty. The fourth item in the list of commonly suggested supplements for men and women wishing to optimize egg and spend quality, respectively, is omega three fatty acid. And now here we're talking about something that could be obtained from food and can be obtained from fit.

If you're consuming uh, fatty ocean fish, things like, uh, sardines and chose salmon with the skin, chances are you're going to get some quality omega trees. Omega's ries are also available in plant based sources and also available in creel for that matter. Um but most people find IT difficult to reach the threshold required for optimizing mental health and physical health that is the threshold of the E P, A essential fatty assets.

And so for that matter, i've suggested before in this podcast and many fertility dogs will suggest that their patients take omega three fatty assets and supplement form IT could be taken in liquid form, in capsule form. But enough of those that you're getting at least one gram per day of the E P A form mego three, okay. So at least one gram per day and as high as two or even three grammes per day of the E P A forms, you'll need to look at the packaging because often times you will say high potency omega trees.

You'll say you know fifteen hundred milligrams of omega trees, but that's not fifty hundred milligrams of the E P. A form. You look on the back of label and you'll say each serving contains seven hundred and fifty milligrams of epa.

You want to get above that one gram dosage per day and as highs grams per day of the epa. The most cost effective way to do that is going to be liquid form megas. But that's a little bit inconvenient for many people. Some people don't like the taste. That's why they rely on the captain former megas. And of course, there are compounds that can impact fatlings status, quality of eggs, quality of sperm, not by adJusting my to contra or insulin sensitivity, or creating a general meu of support for the egg in the sperm production and function, such as the compounds that I just listed off to, but rather compounds that influence the hormones involved in the generation of sperm, in the generation of the eggs involved in the adulatory cycle, in this permanent ency cycle. That is, now these are going to come in different forms.

And I want to just emphasize that the supplements that do this, that adjust hormones in these ways that can be beneficial are distinct from hormonal therapy or bioidentical hormones OK distinct from hormonal therapy or biodensity hormones because we discussed earlier, when you take a hormone like test stores, or even estrogen, for that matter, from an exogenous and outside source, you are going to disrupt feedback pathways inside of your body and you're going to ut down your own in dodger's production. The supply something about to describe do not do that, and yet can adjust levels of harmonies in more subtle ways that could be beneficial for the improper of maxims ing fertility for males and for females. The first of which, on this list i'd like to discuss, has been discuss in previous podcast as well, which is a substance called tongue ali.

Tongue ali also goes by other names, but when taken at four hundred milligrams per date, sometimes separated two dosages, typically taken as once a day, early in the day, because I could could be a little bit stimulating, although not his I D provoke, I ve never heard of that can be a little bit stimulating. But foreign milligrams a day of tonga ally has been shown to increase free test astern by way of reducing something called sex hormone binding globulin. It's also been shown to increase uti zing hormone, the net effect of which has been described as a subbed but significant increase in label and some of the other parameters res associated with increased androgen like free test after on in males and females.

So a number of people out there are taking tonga ally in this way. Four hundred milligrams per day researcher to the early part of the day, with or without food. People always asked, do you need to cycle tongue ali? I'm not aware of any need to cycle toner ali.

In fact, IT tends to work Better minute. The effects on lebel and some other hormone profiles tends to increase over time. Again, tongue ali is an option is certainly none of these things are requirements.

Um we're simply listing off options. But many people, both males and females, seem to benefit from an light tinga ali even if they're not seeking to conceive. There's no reason think that tongue ali directly improves egerton accept in males the increase in androgen created by tongue a ally supplementation and can indeed lead to improve spermatic genesis.

So there is a growing amount of data in the researcher. Larger on tonga, many people find IT beneficial. And so it's something that both men and women wishing to conceive and or optimized their fertility, just as a general health parameter, might want to explore.

The other supplement that's been shown to improve both equality and sperm quality, and there are, I referred to a number of different parameters, related equality and prime quality, as well as to increase libido fairly substantially is a substance called shiloh shiloh h spelled S H I L A G I T C log is actually a uh compound that used in iowa tic medicine. But there are some really good research studies expLoring the supplementation. Michelle gy, at about two hundred and fifty milligrams twice per day.

And this has been looked at a males. And in females, IT does seem to significantly increase two hormones. One is testosterone and the other is following stimulating hormones.

And for that reason, slog is often considered atoning that people use both as an affordable act uh, to increase libido as well as to increase fertility. Now one note of caution, if you're a woman and you're considering taking sheep in order to increase the doctor n nl stimulating hm. And keep in mind that the obligatory cycle is this very.

Regulated cycle in which you want low but elevated levels of fall to stimulating hormone early in the fully cured phase that IT peaks right before abusing tion, and then low levels of follow stimulating hormone in the second half of your cycle. For that reason, using geology chronically around the entire course of your avatar cycle could be a little bit risky and i'd recommend that you talk your O B G Y N um prior to doing that. If doing that at all for males, it's a little bit less of an issue because as I mentioned earlier, sperr constantly being and the presence of f sage is going to increase primates genesis.

Now Chloe is not F S H itself. Eo gy stimulates the release of epsau and IT stimulates the release of testoon. So again, there's no reason to think that I would shut down your indolence. Inst tester on our effaced production, although there are limited amount of data that really explore that in detail.

Many people using logy in order to increase their testosterone, ea age, their libido and various aspects of sperm health that again, the dosages of sheep are about two hundred fifty milligrams two times per day. One issue with eloge is that often comes as I as a tar, which is little hard to measure out the dosages. Yes, a tar.

It's this um kind of think gumming substance that you're supose to dissolve in water and the recommendations are you take a little beat and dissolve in water. IT is available capable form where the ability to control the dosage is a little bit uh is made a little bit easier. But of course, as with any supplement, I recommend starting with the lowest possible dosage.

So want to start with a small very small bed of sheedy and dissolved in water taken once per day, and then increase the dosage as needed in order to obtain the effects that you want. Things like shea gy start to um bring us into the realm of what can only be described as a little bit unwieldy right here. We're saying you can't really control the dosage and now you're talking about hormones that need to be tightly regulated, at least for females across the ovarian cycle.

For males, yes, IT has been shown to increase the toast stern and ea age improves spermatogenesis erm count pretty significantly. No reason to think that you couldn't do that chronically. Rachelle gy, and yet I do.

I acknowledge that sheepy, as this black car substance is, contains a lot of different things that, in fact, IT comes from a mineral pitch. What is that is, IT comes from the literally the dirt and plants that have been compressed by rocks in the hima. As so pretty esoteric c stuff really comes down to IT.

But the biological effects of sheets in both males and females seem to be related to the fact that IT is highly enriched, called for vic acid, involve the acid, is involved in a lot of different cellar processes. Not the least of which, at least in this context, is the transport of molecules across cell membranes and for hormones to have the effect they need to cross cell membranes on the outside, in the inside of the cell. So maybe that's how it's having its a fact again, the mechanisms of exactly how she's increases to stop on an epsau and thereby libido equality and sperm quality aren't entirely clear.

But for um the more adventures of you out there who want to experiment, michele logy, whether not you're trying to conceive or or not, um IT might be something to consider. But of course do talk to your physician. The next compound that I wanted discuss is zinc.

And then this discussion mainly pertains to males, although I um of course you point out that female e should get the recommended daily allowance of sink each day. Males on the other hand seem to benefit from having additionally high levels of sink intake now that can be obtained through foods. You know you're often here oh you know isters are in Richard and zank and and twisters are in afd.

Ja, I don't know who's doing the marketing for oysters, but it's it's really uh, terrific. I think that seems so persisted in um and maybe it's true um they are waters are in riches sink. What does zinc do for fertility? Well in males we know based on a really nice set of studies that zinc dosages that are pretty high of about hundred and twenty milgram taken twice per day that's quite a lot with meals can significantly increase testosterone and di hydro testosterone.

And this, Polly shouldn't come as a surprise. As IT turns out, the sink is highly enriched in human testes, and in the testes of other animals, including fish and other mammals, was actually in one thousand and twenty one that IT was observed in fish, that zinc levels skyrocket in the testy of fish during the breeding season. So sink is correlated with increases in breeding.

But you never know which direction that correlation is running. Turns out that sink, in both animals, clean fish, other mamas and in human, strongly impacts the energetic functions in the tests, including the function of androgen binding protein. So IT seems that high levels of zinc can increase per matic genesis and testosterone levels very significantly.

This was exploited in a really nice study that i'll provide a reference to. Its an older study. I really like IT.

It's called effect of zinc administration on plasma sts tosta one died is tosta one and sperm count. This is but just one study among a many. Now this dates back to one thousand nine hundred eighty one. But there have been a study subsequently the point to the fact that supplementation was ink at those high levels can really be a helpful in terms of increasing sperm count to stop and even testicular size of all things. So one important point about taking zink this hundred and twenty milligrams of zinc to two times daily um definitely needs to be done with meals.

If you've ever taken zink on an empty stomach, even if you just take or thirty milligrams of thing, you can feel very nauseous not well for a few hours so make sure that you're taking sink with full meals. So this would mean that you're taking um in at least two full meals per day. Um I should also mention that zk supplementation did not appear to impact the anatta in releasing hormones or production.

So that seems to be a fairly targeted effect on the test astro and related pathways in males. As far as I know, there have not been systematic exploration of the effects of high levels of zinc ministration on females. I would hope that those studies would soon be done.

But meanwhile, if you're in a male and you're interested in improving sperm quality and your testosterone levels overall, for whatever reason, zink likely is a good candidate that pretty much summarizes the compounds that men and women should take in order to maximize equality, sperm quality and fertility. And then, of course, if we start to enter the landscape of other things that men and women can take in order to improve utility, and those other things, generally, our prescription drugs. And so I just want to mention what a few of those are.

But of course, these are things that you would absolutely have to obtain prescriptions for from your md. And your md would, without question, would want to take blood test prior to prescribing these things. So for instance, if men have been taking exogamous testosterone through the use of animal x steroids, like performance in ancon drugs, or even testosterone one replacement there, their endogenous disaster's levels are going to be very low.

And this firm counts are going to be very low, unless for instinct, they are prescribe bed in taking something like H G human corona gena rope, which myrick elation would stimulate the testes to produce to stop one. And through some indirect pathways, uh, rescue supermac genesis, although not to the same degree as if people are not taking exception sources of disasters, some men, even if they've never touched T R, T or exogenous testosterone of any kind, will be prescribed to take hcg because of its ability to stimulate the testes to produce more test astern in sperms. They're just taking H C G alone.

Other men will take or will be prescribed rather F S, H in order to stimulate manager cities or H C G and F S or column, which can regulate all sorts of things in the both test stern and estrogen related pathways at the level of brain and patti and go out tests. Likewise, for women, if they're low in fa sage, they might be prescribed F A. If they are low in luizi hormone, they might be prescribed ed cg.

If the low testosterone, they might even be prescribed stock one. And if they're just strown is too high and they're dealing with pcs, they might be prescribed ed anti androgen and androgen blockers and on and on and on. There are so many different hormones that can impact the different aspects of the obligatory in this permanent genocide cycle that the O B G Y N S and the europe gist focus on male fertility.

Nowaday really have an excEllent handle on which levers and button and threads to pull in, push and so forth, in order to set in motion a proper avilla tory cycle and a proper super manager iis cycle. You know, everything we talked about up until now in the early phase of this episode, especially about how the brain commands the parritch and the Peterie ory commands the gone ads and then the go ads. The over year or the testis send feedback signals to the Peterie ory to influence the patch.

All of that incredible orchestra, that dance is so tightly regulated in a way that really provides the O B G I S. And the fertility dox concerned with male fertility exceptional tools to, for instance, figure out if a man is not producing any sperm, but his deston levels are well within Normal range. Well then there are some very clear sets of explorations and potential treatments, some of which are mechanical, making sure the epidemic is and vast differences are clear, allowing the sperm venture the exactly the ejaculation to enter the return.

obviously um to enter the female as well .

as for a woman who's not evolving to adjust your levels of face or maybe even to apply active punching conjunction with supplementation and various prescription hormone on therapies to adjust fertility and ogula's and the probability of successful pregNancy. So there's a vast landscape of prescription drugs and surgical interventions of varying degrees of invasiveness. And some are, for instance, our page procedures.

Some require general and seure, IT said, are in order to maximize male and female fertility. What i've tried to do today is to provide you with a deep dive understanding of the bilateral menstrual cycle. We talked about the brain, the patuit, tary, the over, the flop, an tubes. In fact, the whole female productive access as IT relates to fertility and reproduction. I also described the male reproductive access as IT relates to the brain, the paternity, the go add the testes and the various ducks, the pathways out of the tests that allow the sperm to be enriching the semon, and then the semon and the ejaculate to exit through the urethra. I did all that is a way to frame the various tools and interventions that can really assist in increasing futility, equality and sperm quality.

So when we discuss my to continue in the context of the development of an egg, where the development of spirits ability to swim quickly forward now IT should make sense to why give an intervention, whether or not it's l carneta or whether or not it's exercise, or whether or not getting enough sleep and limiting stress, while that should matter, and why, in fact, mechanistically those interventions can work, because indeed there are many interventions that we can all do and use to support our fertility. And again, as a more general theme today, I really wanted to a teach you about the human reproductive access. I do find the biology of the avila ory and mentor cycle and permanent encies to be absolutely fascinating to me.

And again, if you're somebody who's interested in conceiving or if you've already conceived children and even if you don't want more children, this is really the aspect of our biology that allowed us to be here. It's the aspect of our biology that determine whether or not we are male, female. It's the aspect of our biology that determined so so much.

And yet I think that most of us generally are not taught this in school or at least not at the debt that we discuss IT today. So hopefully, that information was of itself interesting and perhaps useful as well. And I do think that even if people are not wishing to conceive more children, that the information related to fertility and optimizing egan firm health is a value in the sense that optimizing egan firm health can be used as a proxy for optimizing our body and brain health generally, in other words.

And here I admittedly dly taking words out of the mouse of the various wonderful doctors, the ob g. Yins and urologist, that helped inform me in anticipation of this episode. What is good for the woman is good for the egg and for fertility and pregNancy.

And what's good for the man is good for the quality and production of sperm and for fertility and pregNancy. Put differently, whether not we are male or female, the things that we can do to optimize our are the exact same things that we should all be doing to optimize our vitality. In our lunch gevalia, I realized today's episode was so much the deep dive and fairly brought as well that I ended up being fairly long and extensive.

And yet we still have not touched on any of the important things that I know a number of people want to know about. So for instance, menopause, Andrew pause, pcs and other themes related to hormones and reproductive function in biology. And I promise that we will have episodes, both solo episodes and episodes, with expert guests in the future to cover all those topics in detail.

Meanwhile, the information discuss in today's episode should serve as a basic foundation for those discussions going forward. And hopefully, we're of interest you in their own right. If you're learning from under enjoying this podcast, please subscribe our youtube channel that's a terrific zero cost way to support us. In addition, please subscribe to the podcast on spotify and apple.

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