In this episode, Dr. Mistry and Donna Lee are joined by Dr. Kaylen Silverberg of Texas Fertility Center to discuss the ins and outs of starting fertility treatment. Many patients begin their fertility journey with a simple question: "Why haven't I gotten pregnant yet?" Although gynecologists and urologists are often the first physicians to hear these concerns, a fertility specialist like those at Texas Fertility Center have years of experience with the complex and sometimes difficult process of becoming pregnant. Tune in to learn what factors can impact fertility, how to tell when you're ovulating, and when to ask for help if you don't become pregnant. If you or someone you love has had difficulty conceiving or may be interested in fertility treatments, you don't want to miss this episode!
Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 3 (00:13):
Hello and welcome to the Armor Men's Health Show.
This is Dr. Mystery , yourhost, board certified
urologist, men's health expert.
Glad host of this show, broughtto you by N A U Urology
specialist. The practice that Istarted in 2007 to take care of
the men here in Austin, Texas,central Texas area. Joined as
always by my wonderful co-hostpartner in crime, Donna Lee.
(00:35):
That's right . I'm
Speaker 4 (00:36):
A board certified co-host, and happy to be
Speaker 3 (00:38):
Here. Donna, you're in charge of , uh, building a
lot of our business. Mm-hmm .
business has beengood. So
Speaker 4 (00:42):
Good. So good and busy. I'm tired.
Speaker 3 (00:44):
Yeah . There's very few fields of urology that
better illustrate our approachto medicine better than taking
care of men who are trying tohave babies. That's
Speaker 4 (00:53):
Right. All sorts of men trying to have babies.
Speaker 3 (00:55):
And there's a common like myth that like, you know,
men can have babies all the wayuntil they're 75 and there's no
problem, and yada, yada, yada.
Mm-hmm . . Butthere are so many things that
affect man's fertility, and wetalk about a lot of that on the
show.
Speaker 4 (01:06):
That's right. And that is one of your favorite
topics in the world.
Speaker 3 (01:08):
Now what happens is these men don't come to me
thinking they're having troublehaving a baby. No.
Speaker 4 (01:12):
They're blaming it on their wives.
Speaker 3 (01:13):
They are blaming it on their power . Wive ,
. And for years. Years, I thinkthat, or, you know, I think
this classically andculturally, it is the woman's
problem . It's the woman'sproblem, right? Mm-hmm .
, I mean, if thecouple can't get pregnant, the
woman needs to go getevaluated. One of our best
partners in this city, and whenit comes to helping families
develop and have kids is Dr.
Kaylin Silverberg with TexasFertility Center. We're so glad
(01:35):
to have you here as our guest.
Thank you so much, Kaylinn . Oh
Speaker 5 (01:38):
God . Thanks for having me.
Speaker 3 (01:39):
There's some reason that I'd like you so much. I'm
just gonna put my finger on it.
. Now , now, if I'mthinking to myself now , you
had to go to medical school,right? Correct.
Speaker 5 (01:49):
. And I just
, I had to, I didn't have a
choice.
Speaker 3 (01:51):
I just don't remember. What, what medical
school did you go to? Baylor.
Speaker 4 (01:55):
Oh.
Speaker 1 (01:56):
Oh ,
Speaker 3 (01:56):
Jesus. Oh, no wonder. That's right . Help us
. Just the, just the, just thepure genius. The what? A setup
. Wow . The , the insight, thegood looks. I mean, I knew you
were a Baylor man, right?
Speaker 4 (02:06):
. Geez . Is
that why you get a little, when
you see Dr. Silverberg,
Speaker 3 (02:10):
I do have blue erection . I do, I do have
Speaker 4 (02:12):
A little man , it's anion .
Speaker 3 (02:13):
I do have a man erection, production .
So, Dr . Silverberg ,
Speaker 5 (02:16):
I could , could have gone my entire life without
knowing that , thatwould've been great.
Speaker 3 (02:20):
So it's not small by design .
Speaker 4 (02:22):
So,
Speaker 3 (02:23):
You know what I know about men? They know absolutely
nothing about women. .
I mean, I don't know what mywife wants to eat. I don't know
what to get her for her for herbirthday. I mean, I don't, I
don't know anything, and Icertainly don't know about her,
like girly parts right now. I'ma doctor, so I'm just being
funny . You,
Speaker 4 (02:39):
You just said girly
Speaker 3 (02:39):
Parts, girly parts.
Speaker 4 (02:41):
Apparently Baylor School of Medicine right there,
apparent ,
Speaker 3 (02:43):
Apparently, apparently, apparently she
bleeds every month and doesn'tdie. And all I want hear is
nothing about it. That's right.
Okay . Now all of a sudden,when somebody's trying to have
babies, everybody knowseverything about everything
cycles and this and that, theother, so I , I thought maybe
we could use this opportunityto teach some of our listeners
about like, what is going on inthe woman when it comes to
making a baby? Because just soyou know, you may not know
(03:05):
about the guys because you takecare of women all the time, but
the guy's always kind of ready.
Yeah . Right. Yeah. I'm alwaysready. . So, so
Speaker 5 (03:10):
Tell me about , so I tell my patients all the time,
you know, I mean, you're, womenare, first of all, they're born
with all the eggs are evergonna have ever, and this is
under the heading of life's notfair, right? Yes. So guys, I
tell my patients all the time,you know what, you know, this
guy that you brought in here,you know, he is making sperm
all day, every
Speaker 3 (03:25):
Day right now. And when hes
Speaker 5 (03:26):
Not making
Speaker 3 (03:27):
M watching him ,
Speaker 5 (03:27):
He's thinking
Speaker 3 (03:28):
About making sperm.
While , while we're watchinghim, he's making sperm.
Speaker 5 (03:31):
He's That's exactly right. And you mind his own
business. You lady
Speaker 3 (03:33):
We're born with all that you're gonna give us.
That's right.
Speaker 5 (03:35):
So in fact, 20 weeks before women are even
delivered, you know, they'vegot all the eggs they're ever
gonna have . They have 15 to 20million eggs by the time
they're delivered, 20 weekslater, it's down to six to 7
million. By the time they gothrough puberty, it's down to
300,000 to 500,000. And by thetime they're 40, they have
10,000 eggs left or less. Andthis is unfortunately not to
save the best for last kind ofgame. So as women age and the
(03:59):
quantity of their eggsdecreases, the quality of those
eggs that are remainingdecreases as well. And that's
why it's hard to get pregnantas they get older.
Speaker 3 (04:06):
And so, you know, when we're in seventh grade and
the boys go to one class andthe girls go to the other
class, the boys don't get tohear that the reason that a
woman has a period every monthis because the uterus is
preparing itself forimplantation of an egg. And if
you are a normal woman who'snormally ovulating, then about,
what, about 10 to 14 days afteryour period ends, you get
another egg that drops in thechute . That's
Speaker 5 (04:27):
Exactly right.
Speaker 3 (04:28):
And, and that's your primary prime time to get
pregnant mid cycle . And so youwant that sperm and that timing
of, of , of sex if you'retrying to get pregnant to be
right about that time. And somepeople do the opposite, right?
Right. Like for natural familyplanning. Mm-hmm.
, sometimes people know theyhave to avoid those days to not
get pregnant. But just likepulling out is not a great
(04:48):
strategy for pregnancyprevention. Timing may not be
the best way to do this .
Speaker 5 (04:52):
No, I mean, you know what we, you know , we jokingly
tell our patients that , youknow, couples who are trying to
time intercourse, what we callthem is parents.
Speaker 3 (04:58):
Right . ,
Speaker 5 (04:59):
You know , because I mean, they're trying their best
to say, oh, I'm not gonna havesex mid-cycle. But you don't
know exactly when mid cycle is.
And this is biology, right?
It's not physics, you know,physics, you type on a keyboard
a million times and a milliontimes, the exact same letters
are gonna appear on yourmonitor. Biology, every cycle
is
Speaker 3 (05:12):
Different. Every cycle is different. And so when
, when a woman is havingirregular periods mm-hmm .
, and , and Ithink they know what that
means, men may not know. Right.
If , if their cycle's not thesame number of days in between,
right? What , what does thatmean in terms of their
fertility potential?
Speaker 5 (05:26):
Well , it decreases it, right? So some women, first
of all, women have tounderstand that this is just
another myth. Again, this is,you know, in the popular
magazines, popular press on theinternet everywhere that, you
know, women ovulate on day 14and they have 28 day cycles.
That's garbage. Just doesn'thappen. Women can biology. So
there's fluctuation from cycleto cycle. The one cycle, a
perfectly normal woman mayovulate on day 14, one cycle.
(05:47):
She may ovulate on day 16, onecycle. She may ovulate on day
11 or 12. That's all fine. Butwhat has to happen is there's
two cycles that are going on.
There's the egg cycle or theovarian cycle, and then there's
the uterine cycle. So forexample, in the ovarian cycle,
when she has a period, she'sgot tiny little follicles in
her ovaries. Over the course ofthe next eight to 10 to 12
days, through this reallycomplicated endocrinologic
(06:08):
game, one follicle becomesdominant. Okay? So it wins the
game against all the otherfollicles. And the reward for
that is, is that at ovulation,that follicle gets to open up
the egg , gets to play, youknow, come out and play with
the sperm and all the folliclesthat lost the game die a fiery,
horrible death. And they overnever hurt from again,
, but the uterine cycleWow , that's surprising is also
happening. So as that follicleis getting bigger and bigger
(06:29):
and bigger, it's making moreand more estrogen, which is
causing the uterine lining toget thicker, to make a bed for
the baby , so to speak. Thoseare the two cycles. But , and
Speaker 3 (06:36):
They have to sync
Speaker 5 (06:37):
Up. They've gotta be sync . You're exactly right.
Speaker 3 (06:38):
If , if they don't sync up, then you can have
problems now. So a couplethat's trying to get pregnant,
there are some tools that theycan use. Mm-hmm .
, a lot of women use apps nowto measure their basal body
temperature to kind of do theircycle. Right . And then there
are sticks that you can buyfrom the pharmacy to pee on.
Mm-hmm. . Whwhich one of these do you think
is works the best? Is mostreliable?
Speaker 5 (06:58):
Yeah, no question.
Stop taking your temperature.
Okay. Okay. I mean, take thatthermometer, put it in the
medicine cabinet. You use itwhen you're sick. All right .
To predict ovulation, you go tothe store and you buy an
ovulation prediction kit.
Speaker 3 (07:07):
And so this is something you buy over the
counter . And what is itmeasuring? What does it ,
Speaker 5 (07:11):
It's measuring the secretion in production of a
hormone called lh, which isluteinizing hormone. Not to
make your eyes roll back inyour head, but that's the
hormonal trigger that causesthe egg to come outta the
Speaker 3 (07:21):
Ovary. And so when you're peeing on this stick and
this thing turns blue or red orwhatever it's gonna do, or
Speaker 5 (07:25):
You get a smiley face, you get get
Speaker 3 (07:26):
Smiley face . That's nice. So sweet . So don't pee
on your phone. That app ispromise . No , that's wrong .
That's the wrong one. That'sthe wrong app. Okay. Right . So
get this sticky on it. Andthen, then do you have to go
home and have sex right now?
Speaker 5 (07:38):
No. No, not, this just tells you when you can, if
you want six , you can if youwant to. But what this is
really telling you is, is thatwe know that 95% of women are
gonna ovulate within 24 hoursof either that color change or
that smiley face. Okay. So theycan time intercourse around
that. But what we tell them is,I want them to have sex every
other day. And I say to them,I'm the doctor. The guy sitting
(07:59):
next to you has a differentagenda, right? , he's
going to have sex 12 times aday. I want you to have sex
every other day. And the reasonis he's gotta replenish his
sperm count.
Speaker 3 (08:06):
And this is where you and I differ. Okay. So you
tell 'em every other day. Right. And I tell 'em 12 times a
day. And that's why they'reconfusing. That's
Speaker 5 (08:13):
Why they Yeah . But see, this is why they love you
and they don't like to come seeme .
Speaker 3 (08:16):
Right . Because I'm a believer that the more
soldiers on the field, right ,the more likely you're to
attack. Totally . But , but youthink you need to replenish.
And I'm telling you man, notall of us need to replenish.
Okay,
Speaker 5 (08:25):
Fine. You know , it's , I'm gonna try and keep
it non-personal, but just ingeneral. Oh no . You know, if
we're gonna talk about it ingeneral, the typical
guy, you know, if a guy threetimes within a 24 hour period.
Yeah . The third has basicallyno, well, I don't know .
Speaker 3 (08:38):
Gotcha . . I
don't know . . I think
, I think it's worth a try.
, you're just trying tomake , I think it's worth try
across the country. But youknow what's very interesting,
and you and I have talked aboutthis quite a bit, the journey
to try to get pregnant can bevery emotionally draining.
Speaker 5 (08:51):
For me it is . I know. I don't know about the
Speaker 3 (08:53):
Patients
Speaker 5 (08:53):
, oh my God,
I go home every exhausted,
Speaker 3 (08:55):
Tired. For those of you out there that are trying
to get pregnant, recognize thatit's a very emotionally trying
process. Even so many peoplethink that, well, fine, I'll
just do I V F I mean, that'snot a finish line. No . That's
a new, that's a new race. Yes.
So if you're trying to getpregnant in real serious, use
the sticks. Use the tools atyour disposal time your
intercourse properly. Reduceyour stress. Have a good diet.
(09:18):
These are such important thingsfor people to remember.
Speaker 5 (09:20):
Yeah. And talk to your doctors. You know what I
mean? We're not the enemy here.
We're trying to help. Austin isloaded with really talented,
really good OBGYNs. Go talk toyour OBGYN and say, Hey look,
I'm trying to get pregnant. Imay not have told you that. I'm
kind of embarrassed. You reallyneed to know. We've been trying
now for, you know, we stoppedusing pills or stopped using I
u d or you know, no plan orwhatever. We haven't done
anything in three or four yearsand nothing is happening. You
(09:40):
know, if a woman has been, if acouple's been trying for 12
months and that woman is under35 and she's not pregnant,
there's a problem. That'sright. Mm-hmm . .
And if she's over 35 and she'sbeen trying for six months,
Speaker 3 (09:51):
Then there's a problem. And
Speaker 5 (09:51):
She's not pregnant, she needs to go see somebody.
Speaker 3 (09:53):
Well, thank you so much for helping our listeners
learn about , um, you know, thefairer sex . Is that
what you call 'em ? Sure. Idon't know . I'm gonna get a
lot of mail about this one.
Mm-hmm. . So atleast we explained why women
are bleeding right . When toget pregnant. And the fact that
you have to have sex 12 times aday. ,
Speaker 5 (10:10):
When you order us .
Speaker 3 (10:10):
Thank you for joining us and we're gonna
continue this. Donna, how dopeople get a hold of us?
Speaker 4 (10:13):
You can call us during the week at 5 1 2 2 3 8
0 7 6 2 armor men's health.com.
And I started my new only fanspage where I pee on my phone
and I get a smiley face.
Speaker 6 (10:23):
. Wow.
. I'm subscribing tothat one. Is
Speaker 5 (10:29):
That live or is that
Speaker 4 (10:31):
It's recorded. It's the
Speaker 3 (10:33):
Office. This is Dr .
Mystery , your host. I'm aboard certified urologist. I ,
uh, specialize in men'sfertility and cancer
treatments, everythingurologic. We have a holistic
practice, which , uh, soundsweird when you're a surgeon. I
always thought that I'm joinedby my co-host Donna Lee. That's
right.
Speaker 4 (10:48):
I'm super impressed though that you are a holistic
surgeon. People
Speaker 3 (10:51):
Don't even know what that means. They don't, they
think
Speaker 4 (10:52):
That
Speaker 3 (10:52):
It sounds good though . They think that I just
like to cut and that's wherethey would be, correct? That is
correct. I do love cutting.
Right.
Speaker 4 (10:57):
But before the cutting, we have supplements
and nutrition
Speaker 3 (11:00):
And pelvic floor,
Speaker 4 (11:01):
Physical therapy,
Speaker 3 (11:02):
And then cutting.
Speaker 4 (11:03):
And then the cutting and then
Speaker 3 (11:04):
Cutting. This show is brought to you by the
urology practice. I started in2007 N a u Urology specialist.
We are joined again by one ofour great partners, Dr. Kaylin
Silverberg from Texas FertilityCenter. Thank you so much for
joining us, Kaylyn .
Speaker 5 (11:16):
Thanks for having me. Happy to be here. You
Speaker 3 (11:18):
Know what's nice is sometimes on this show I have
graduates of the University ofTexas at Southwestern Medical
School, . And then wehave to use small words,
,
Speaker 5 (11:26):
Small
Speaker 3 (11:27):
Sense , and speak very slowly. Right. .
'cause as they know it's thesecond best medical school in
Texas. Oh boy. But those of usfrom Baylor, we're allowed to
use a more sophisticatedlanguage. Absolutely.
Speaker 5 (11:38):
Bigger
Speaker 3 (11:38):
Words and that's, and bigger words. That's nice.
So let's talk about yum Yumsand Dinglings. Um ,
when it comes to, when it comesto the fertility journey that
many couples go through, onceagain, I must reiterate, men
have no idea what is going on.
Right . The women come in withreams of books and chapters of
things and the guy looks like adeer in the headlights. I don't
(11:58):
want to come see you, Dr .
Misery . My wife said I had tocome see you. Right . And I'm
gonna fix my fertility. Youknow, on the men's side, I just
wanted to mention that so manyof our patients come in not
healthy, they're overweight,they're not sleeping well,
they're stressed at work.
Explain to them very simply,when you're stressed, your body
doesn't want you to have ababy. Uh , understand that
anthropologically. Mm-hmm.
. You need to behealthy and happy to be able to
(12:20):
get pregnant when you're even aman. Now, do you think that's
the same for women? Yeah,
Speaker 5 (12:23):
I do. I think that's the same. I mean, you know,
people ask me all the time,well, what about my stress
level? And I say, well , youknow, there's no stress scale.
I can't say to you, you're 68.7on a stress scale and I need
you to be below 63.2 .
It doesn't work that way. Imean, there is no stress scale.
And then realistically, Godforbid, there's people right
now in the Ukraine who aregetting pregnant while their
homes are getting rocketed.
Mm-hmm . . Right. So, I mean, that's like real
stress. Yes . But having saidthat, we really want
(12:45):
everybody's stress level to beas low as
Speaker 3 (12:47):
Possible. And so, you know, what we use in our
practice to help assess stressis sleep quality. So we use
this thing called the whoopbracelet that we, we have
patients get that like trackstheir sleep. And I think I've
seen that just by tracking it.
They have better sleep. Where
Speaker 5 (13:00):
Do I get this thing?
I need this.
Speaker 3 (13:02):
I mean, it's online . It's , it's awesome. And so I
think that managing sleep,managing stress is gonna be so
important to help improvepeople's fertility if getting
pregnant naturally didn't work.
So we've talked about under 35,if your wife is under 35 and
you've been trying for 12months of unprotected sex,
please pee on a stick. Do theright things that we talked
about in our last segment. Andthen over , uh, six months if
(13:24):
you're over 35. Right . 'causethere are more problems.
Mm-hmm.. Now whenyou see them, what does your
evaluation usually entail?
Well,
Speaker 5 (13:30):
So we do a basic evaluation. We do, you know, a
history and a physical, that'sthe first thing we do. We do an
ultrasound of vaginalultrasound to look at the
uterus, look at the ovaries. Wewanna make sure that the
ovaries still have eggs inthem. So we can actually see
these little black circleswithin the ovary. We're looking
for the fallopian tubes, hopingwe don't find them because if
you can see a fallopian tubewith ultrasound, it's too big ,
badly damaged. We look at theuterus to make sure that the
(13:52):
uterus , uh, is normal size.
Make sure there are no fibroidtumors. We look at the lining
of the uterus to make surethere are no polyps. Uh , we
try and look and see to makesure there's no scarring in the
cavity. We'll get an x-ray ofthe uterus in the fallopian
tubes to make sure the uterinecavity is normal and the tubes
are open. We'll get a semenanalysis on the guy, which is
really the first thing that wedo to make sure that we've got
sperm to work with. And then wetalk to them about whether we
(14:12):
need to go further. You know,we'll evaluate their blood on
the third day of their cycle toevaluate ovarian reserve to
find out how many eggs a womanhas left.
Speaker 3 (14:20):
What is that called ? That's called the a M h .
Speaker 5 (14:22):
Well, a M H is one of the tests that we do, but we
used usually a combination ofestradiol, F s H and a m H .
Speaker 3 (14:29):
So, you know, interestingly enough, I have so
many couples that come to me.
They say these words. My wife'sob gyn has already checked her
out and said she's fine. Sure.
Whenever I hear that, I'malways so confused. Right .
'cause I'm certain that thatchecking out means something
different to every OB gen outthere . Absolutely. And so when
we're talking about a fertilityevaluation, if you've gone too
(14:49):
long, do you think they need togo, like make sure their OBGYN
is doing certain things? Yeah,I mean,
Speaker 5 (14:54):
I think there's, there's some certain basic
things that need to be done.
Most of the OBGYNs in Austin dothose routinely and they really
do a good job. So by the timepatients get to us, a lot of
the basics have been done. Butlemme give you some examples.
You know, we do carrierscreening, so we're looking at,
we use a company that tests for289 different genetic disorders
that can cause problems withbabies. Okay. A lot of the
(15:16):
OBGYNs look for four or 11disorders. And so it's just a
more extensive process when wedo an H S G to look at the
uterine cavity and look at thefallopian tubes. We're not just
making sure that tubes areopen, we're, we're really
seriously looking at the cavityvery critically to make sure
that the uterus is normal
Speaker 3 (15:31):
And able to host that egg when it drops down
there. Yeah ,
Speaker 5 (15:34):
Exactly. Right. Able to hold , you know , to hold an
embryo. Um, we look at a semenanalysis a little bit
differently. Absolutely. Okay.
So, you know, I think thatthere are, there are major
differences between OB gens andreproductive endocrinologists,
but for the overwhelmingmajority of patients, start
with your OB gyn because, youknow, we got great docs here
who know what they're doing.
Speaker 3 (15:49):
And the further out you are from a major
metropolitan city, I feel likethe level of the kind of
evaluation kind of goes down.
And I think that if you're, andthis is my personal opinion, I
think that if your OB gyn doesnot do babies, if they don't,
if they don't do ob Yeah . Ifthey only do gynecology, that
the evaluation that they'regonna do is , you know, may not
be of the same degree of likeintensity. Yeah. It may not be.
(16:10):
And so if somebody's gonna dothat next step, sometimes
you'll use medication so thatthey can ovulate mm-hmm .
and drop an egg.
Sometimes you'll give themmedication where they make
multiple eggs mm-hmm .
. And then thenext step, which a lot of
couples go to is tointrauterine insemination.
Right . Maybe you could justdescribe what that process
looks like.
Speaker 5 (16:26):
Yeah. So I, intrauterine insemination, or I
u i is really simple and reallystraightforward. What we do is
when the woman's getting readyto ovulate, in other words, the
day after she has a smiley faceor a color change on her
ovulation prediction kit, onlyGod , her partner brings us a
sperm specimen. We wash it, wespin it down, we separate the
good sperm from the debris andthe dead stuff. And then we
painlessly put a littlecatheter through the cervix
(16:48):
into the uterus, put thespecimen inside, takes 15
seconds, they lay , it'spainless. They lay still for 10
minutes, read a magazine and goback to work a
Speaker 3 (16:55):
K a the Turkey baster . Yeah.
Speaker 5 (16:56):
I hate that term, but Yeah, that's right.
Speaker 3 (16:58):
Why ? That's the only part of Thanksgiving I get
to do. So . Yeah . Right . I'mpretty happy with the Turkey.
Right . So we don't like theterm Turkey baer because that
kind of dehumanizes kind ofwhat is a process that
sometimes people feel is veryartificial uhhuh , but in fact
it's not that artificial. WhatI say to people is it reduces
the amount, the , the distance,the sperm have to swim from
like, you know, six inches toone inch . And so , um, that
(17:19):
process generally doesn't costthat much money. Right. Even if
you're paying out of pocket.
Right. Are we talking about inthe hundreds or the thousands ?
Speaker 5 (17:25):
Oh yeah . No, no, no , no, no. 300, $400, something
like that. I mean, it's, it'sinexpensive, but realistically
the analogy is , you know, youranalogy is a good one. But the
analogy is if you want to gofrom New York to Paris doing I
u I starts you off really inLondon. Okay. So it really
significantly shortens thatjourney for a sperm that it has
to undergo to be able to get tothe egg and fertilize it .
Speaker 3 (17:43):
I'm not sure your analogy was much better than
mine. I failed
Speaker 4 (17:45):
In geography. Will you explain that to me?
Speaker 3 (17:47):
Know I'm saying, I don't know hard . I think my
analogy was just as good .
Speaker 5 (17:50):
Fine.
Speaker 3 (17:51):
God . The difference between him and me is that I
graduated later and Baylor'seducation really got a little
bit better . So then ifwe move on, but ,
Speaker 4 (17:59):
But still what was said was girly parts and Turkey
ba
Speaker 3 (18:02):
In vitro fertilization , uh, like and
Speaker 5 (18:04):
Ling Lings and Dingdong, something like that .
Speaker 3 (18:06):
It's called yum Yums and dinglings are fine when it
comes to in vitrofertilization. Now we're
talking about something bothmore expensive, more invasive
Right. And more involved. Maybebriefly you could just describe
kind of what that process lookslike
Speaker 5 (18:18):
For the woman. We stimulate her ovaries with
really powerful injectablefertility drugs. So she'll take
anywhere from one to five shotsa day to try and get these eggs
to develop. She'll do that forabout 10 to 14 days. During
that period of time, we see herin the office about every three
days for a vaginal ultrasoundand a blood estrogen level
because we want to titrate herdose of medicine. We don't
wanna give her so much that shegets really sick. It's not
Speaker 3 (18:40):
The same for everybody
Speaker 5 (18:41):
On the other. Yeah.
And on the other hand, we don'twanna give her so little that
she only ends up making one ortwo eggs. When her eggs are
mature, we give her a triggershot. 36 hours later we take
her to the operating room. Shegets IV sedation with , uh,
from one of theanesthesiologists. And then
while she's on a beach in theCaribbean drinking margaritas,
we do an ultrasound. We pass aneedle through the top of the
vagina into the ovaries and getthe eggs out. Her partner at
the same time is giving us asperm specimen, just the old
(19:04):
fashioned way. We wash it, wespin it down again, isolate the
good sperm five hours after weget the eggs out. And by the
way, getting the eggs out takeseight minutes, five hours after
we get the eggs out, we lookunder a high power microscope
and we can pick up a singlesperm with a microscopic needle
and actually inject that spermdirectly into the egg. Now
Speaker 3 (19:21):
Not everybody has to have that. Sometimes we do a ,
a winner takes all . We put theeggs in the spur in the same
Petri dish, and then we put onsome, some really motivational
rocky music and see who went .
Mm-hmm . . That'sright . Very well see what
happens. That process , uh, canbe more expensive and more
involved. It certainly involvesa lot more commitment. It can
be biologically kind of moretrying on the woman. Sure. But
, uh, despite all of that, wehave an incredible resource
(19:44):
here with Texas FertilityCenter. You're doing an amazing
job with very good numbers andamazing lab, wonderful staff. I
cannot speak more highly ofwhat you and your staff do,
Kaylyn .
Speaker 5 (19:52):
Well, thanks. We got an unbelievably committed team
and we have, you know, ourlaboratories Ovation fertility,
and they're just absolutelyphenomenal. And I know they
love working with you 'causeyou do a lot of sperm retrieval
procedures for a lot of ourpatients. Um, and, you know, so
guys who really have no chanceat all of getting pregnant
without your intervention, yougive them the same chance for
pregnancy as guys who walk inwith a completely normal sperm
(20:13):
count. Well, we look
Speaker 3 (20:14):
Forward to continuing to work with you.
How , how do people get aholdof you? What's your website?
Speaker 5 (20:17):
Our website is tx fertility.com
Speaker 3 (20:20):
And if you , uh, wanna learn about I V f, your,
your webinars that you do everymonth are absolutely
spectacular. And I wouldencourage, thank you , all of
you that are just trying tolearn about this fertility
journey to go to that websiteand do it. And that'll be on
our social media page.
Speaker 5 (20:35):
Yeah. The website's just killer . I mean, it's
really fantastic.
Speaker 3 (20:38):
Donna, how do people get ahold of us? That's
Speaker 4 (20:39):
Right. You can call us during the week at 5 1 2 2 3
8 0 7 6 2 our website's, armormen's health.com. Listen to our
podcast wherever you listen tofree podcasts. Thank you Dr.
Silverberg.
Speaker 5 (20:49):
Thank you so much for having me.
Speaker 2 (20:51):
The Armor Men's Health Show will be right back
to submit a question for Dr.
Mystery . Visit armor men'shealth.com.
Speaker 2 (00:07):
Welcome to the Armor Men's Health Show with Dr.
Mystery and Donna Lee.
Speaker 3 (00:13):
Hello and welcome to the Armor Men's Health Show.
This is Dr. Mystery , yourhost, board certified
urologist, men's health expert.
Glad host of this show, broughtto you by N A U Urology
specialist. The practice that Istarted in 2007 to take care of
the men here in Austin, Texas,central Texas area. Joined as
always by my wonderful co-hostpartner in crime, Donna Lee.
(00:35):
That's right . I'm
Speaker 4 (00:36):
A board certified co-host, and happy to be
Speaker 3 (00:38):
Here. Donna, you're in charge of , uh, building a
lot of our business. Mm-hmm .
Speaker 4 (00:42):
Good. So good and busy. I'm tired.
Speaker 3 (00:44):
Yeah . There's very few fields of urology that
better illustrate our approachto medicine better than taking
care of men who are trying tohave babies. That's
Speaker 4 (00:53):
Right. All sorts of men trying to have babies.
Speaker 3 (00:55):
And there's a common like myth that like, you know,
men can have babies all the wayuntil they're 75 and there's no
problem, and yada, yada, yada.
Mm-hmm .
affect man's fertility, and wetalk about a lot of that on the
show.
Speaker 4 (01:06):
That's right. And that is one of your favorite
topics in the world.
Speaker 3 (01:08):
Now what happens is these men don't come to me
thinking they're having troublehaving a baby. No.
Speaker 4 (01:12):
They're blaming it on their wives.
Speaker 3 (01:13):
They are blaming it on their power . Wive ,
. And for years. Years, I thinkthat, or, you know, I think
this classically andculturally, it is the woman's
problem . It's the woman'sproblem, right? Mm-hmm .
woman needs to go getevaluated. One of our best
partners in this city, and whenit comes to helping families
develop and have kids is Dr.
Kaylin Silverberg with TexasFertility Center. We're so glad
(01:35):
to have you here as our guest.
Thank you so much, Kaylinn . Oh
Speaker 5 (01:38):
God . Thanks for having me.
Speaker 3 (01:39):
There's some reason that I'd like you so much. I'm
just gonna put my finger on it.
had to go to medical school,right? Correct.
Speaker 5 (01:49):
choice.
Speaker 3 (01:51):
I just don't remember. What, what medical
school did you go to? Baylor.
Speaker 4 (01:55):
Oh.
Speaker 1 (01:56):
Oh ,
Speaker 3 (01:56):
Jesus. Oh, no wonder. That's right . Help us
. Just the, just the, just thepure genius. The what? A setup
. Wow . The , the insight, thegood looks. I mean, I knew you
were a Baylor man, right?
Speaker 4 (02:06):
you see Dr. Silverberg,
Speaker 3 (02:10):
I do have blue erection . I do, I do have
Speaker 4 (02:12):
A little man , it's anion .
Speaker 3 (02:13):
I do have a man erection, production
So, Dr . Silverberg ,
Speaker 5 (02:16):
I could , could have gone my entire life without
knowing that
Speaker 3 (02:20):
So it's not small by design
Speaker 4 (02:22):
So,
Speaker 3 (02:23):
You know what I know about men? They know absolutely
nothing about women.
I mean, I don't know what mywife wants to eat. I don't know
what to get her for her for herbirthday. I mean, I don't, I
don't know anything, and Icertainly don't know about her,
like girly parts right now. I'ma doctor, so I'm just being
funny . You,
Speaker 4 (02:39):
You just said girly
Speaker 3 (02:39):
Parts, girly parts.
Speaker 4 (02:41):
Apparently Baylor School of Medicine right there,
apparent ,
Speaker 3 (02:43):
Apparently, apparently, apparently she
bleeds every month and doesn'tdie. And all I want hear is
nothing about it. That's right.
Okay . Now all of a sudden,when somebody's trying to have
babies, everybody knowseverything about everything
cycles and this and that, theother, so I , I thought maybe
we could use this opportunityto teach some of our listeners
about like, what is going on inthe woman when it comes to
making a baby? Because just soyou know, you may not know
(03:05):
about the guys because you takecare of women all the time, but
the guy's always kind of ready.
Yeah . Right. Yeah. I'm alwaysready.
Speaker 5 (03:10):
Tell me about , so I tell my patients all the time,
you know, I mean, you're, womenare, first of all, they're born
with all the eggs are evergonna have ever, and this is
under the heading of life's notfair, right? Yes. So guys, I
tell my patients all the time,you know what, you know, this
guy that you brought in here,you know, he is making sperm
all day, every
Speaker 3 (03:25):
Day right now. And when hes
Speaker 5 (03:26):
Not making
Speaker 3 (03:27):
M watching him ,
Speaker 5 (03:27):
He's thinking
Speaker 3 (03:28):
About making sperm.
While , while we're watchinghim, he's making sperm.
Speaker 5 (03:31):
He's That's exactly right. And you mind his own
business. You lady
Speaker 3 (03:33):
We're born with all that you're gonna give us.
That's right.
Speaker 5 (03:35):
So in fact, 20 weeks before women are even
delivered, you know, they'vegot all the eggs they're ever
gonna have . They have 15 to 20million eggs by the time
they're delivered, 20 weekslater, it's down to six to 7
million. By the time they gothrough puberty, it's down to
300,000 to 500,000. And by thetime they're 40, they have
10,000 eggs left or less. Andthis is unfortunately not to
save the best for last kind ofgame. So as women age and the
(03:59):
quantity of their eggsdecreases, the quality of those
eggs that are remainingdecreases as well. And that's
why it's hard to get pregnantas they get older.
Speaker 3 (04:06):
And so, you know, when we're in seventh grade and
the boys go to one class andthe girls go to the other
class, the boys don't get tohear that the reason that a
woman has a period every monthis because the uterus is
preparing itself forimplantation of an egg. And if
you are a normal woman who'snormally ovulating, then about,
what, about 10 to 14 days afteryour period ends, you get
another egg that drops in thechute . That's
Speaker 5 (04:27):
Exactly right.
Speaker 3 (04:28):
And, and that's your primary prime time to get
pregnant mid cycle . And so youwant that sperm and that timing
of, of , of sex if you'retrying to get pregnant to be
right about that time. And somepeople do the opposite, right?
Right. Like for natural familyplanning. Mm-hmm.
, sometimes people know theyhave to avoid those days to not
get pregnant. But just likepulling out is not a great
(04:48):
strategy for pregnancyprevention. Timing may not be
the best way to do this .
Speaker 5 (04:52):
No, I mean, you know what we, you know , we jokingly
tell our patients that , youknow, couples who are trying to
time intercourse, what we callthem is parents
Speaker 3 (04:58):
Right .
Speaker 5 (04:59):
You know , because I mean, they're trying their best
to say, oh, I'm not gonna havesex mid-cycle. But you don't
know exactly when mid cycle is.
And this is biology, right?
It's not physics, you know,physics, you type on a keyboard
a million times and a milliontimes, the exact same letters
are gonna appear on yourmonitor. Biology, every cycle
is
Speaker 3 (05:12):
Different. Every cycle is different. And so when
, when a woman is havingirregular periods mm-hmm .
means, men may not know. Right.
If , if their cycle's not thesame number of days in between,
right? What , what does thatmean in terms of their
fertility potential?
Speaker 5 (05:26):
Well , it decreases it, right? So some women, first
of all, women have tounderstand that this is just
another myth. Again, this is,you know, in the popular
magazines, popular press on theinternet everywhere that, you
know, women ovulate on day 14and they have 28 day cycles.
That's garbage. Just doesn'thappen. Women can biology. So
there's fluctuation from cycleto cycle. The one cycle, a
perfectly normal woman mayovulate on day 14, one cycle.
(05:47):
She may ovulate on day 16, onecycle. She may ovulate on day
11 or 12. That's all fine. Butwhat has to happen is there's
two cycles that are going on.
There's the egg cycle or theovarian cycle, and then there's
the uterine cycle. So forexample, in the ovarian cycle,
when she has a period, she'sgot tiny little follicles in
her ovaries. Over the course ofthe next eight to 10 to 12
days, through this reallycomplicated endocrinologic
(06:08):
game, one follicle becomesdominant. Okay? So it wins the
game against all the otherfollicles. And the reward for
that is, is that at ovulation,that follicle gets to open up
the egg , gets to play, youknow, come out and play with
the sperm and all the folliclesthat lost the game die a fiery,
horrible death. And they overnever hurt from again,
happening. So as that follicleis getting bigger and bigger
(06:29):
and bigger, it's making moreand more estrogen, which is
causing the uterine lining toget thicker, to make a bed for
the baby , so to speak. Thoseare the two cycles. But , and
Speaker 3 (06:36):
They have to sync
Speaker 5 (06:37):
Up. They've gotta be sync . You're exactly right.
Speaker 3 (06:38):
If , if they don't sync up, then you can have
problems now. So a couplethat's trying to get pregnant,
there are some tools that theycan use. Mm-hmm .
, a lot of women use apps nowto measure their basal body
temperature to kind of do theircycle. Right . And then there
are sticks that you can buyfrom the pharmacy to pee on.
Mm-hmm.
is works the best? Is mostreliable?
Speaker 5 (06:58):
Yeah, no question.
Stop taking your temperature.
Okay. Okay. I mean, take thatthermometer, put it in the
medicine cabinet. You use itwhen you're sick. All right .
To predict ovulation, you go tothe store and you buy an
ovulation prediction kit.
Speaker 3 (07:07):
And so this is something you buy over the
counter . And what is itmeasuring? What does it ,
Speaker 5 (07:11):
It's measuring the secretion in production of a
hormone called lh, which isluteinizing hormone. Not to
make your eyes roll back inyour head, but that's the
hormonal trigger that causesthe egg to come outta the
Speaker 3 (07:21):
Ovary. And so when you're peeing on this stick and
this thing turns blue or red orwhatever it's gonna do, or
Speaker 5 (07:25):
You get a smiley face, you get get
Speaker 3 (07:26):
Smiley face . That's nice. So sweet . So don't pee
on your phone. That app ispromise . No , that's wrong .
That's the wrong one. That'sthe wrong app. Okay. Right . So
get this sticky on it. Andthen, then do you have to go
home and have sex right now?
Speaker 5 (07:38):
No. No, not, this just tells you when you can, if
you want six , you can if youwant to. But what this is
really telling you is, is thatwe know that 95% of women are
gonna ovulate within 24 hoursof either that color change or
that smiley face. Okay. So theycan time intercourse around
that. But what we tell them is,I want them to have sex every
other day. And I say to them,I'm the doctor. The guy sitting
(07:59):
next to you has a differentagenda, right?
going to have sex 12 times aday. I want you to have sex
every other day. And the reasonis he's gotta replenish his
sperm count.
Speaker 3 (08:06):
And this is where you and I differ. Okay. So you
tell 'em every other day. Right. And I tell 'em 12 times a
day. And that's why they'reconfusing. That's
Speaker 5 (08:13):
Why they Yeah . But see, this is why they love you
and they don't like to come seeme .
Speaker 3 (08:16):
Right . Because I'm a believer that the more
soldiers on the field, right ,the more likely you're to
attack. Totally . But , but youthink you need to replenish.
And I'm telling you man, notall of us need to replenish.
Okay,
Speaker 5 (08:25):
Fine. You know , it's , I'm gonna try and keep
it non-personal, but just ingeneral. Oh no . You know, if
we're gonna talk about it ingeneral,
guy, you know, if a guy threetimes within a 24 hour period.
Yeah . The third has basicallyno, well, I don't know .
Speaker 3 (08:38):
Gotcha .
, I think it's worth a try.
across the country. But youknow what's very interesting,
and you and I have talked aboutthis quite a bit, the journey
to try to get pregnant can bevery emotionally draining.
Speaker 5 (08:51):
For me it is . I know. I don't know about the
Speaker 3 (08:53):
Patients
Speaker 5 (08:53):
Speaker 3 (08:55):
Tired. For those of you out there that are trying
to get pregnant, recognize thatit's a very emotionally trying
process. Even so many peoplethink that, well, fine, I'll
just do I V F I mean, that'snot a finish line. No . That's
a new, that's a new race. Yes.
So if you're trying to getpregnant in real serious, use
the sticks. Use the tools atyour disposal time your
intercourse properly. Reduceyour stress. Have a good diet.
(09:18):
These are such important thingsfor people to remember.
Speaker 5 (09:20):
Yeah. And talk to your doctors. You know what I
mean? We're not the enemy here.
We're trying to help. Austin isloaded with really talented,
really good OBGYNs. Go talk toyour OBGYN and say, Hey look,
I'm trying to get pregnant. Imay not have told you that. I'm
kind of embarrassed. You reallyneed to know. We've been trying
now for, you know, we stoppedusing pills or stopped using I
u d or you know, no plan orwhatever. We haven't done
anything in three or four yearsand nothing is happening. You
(09:40):
know, if a woman has been, if acouple's been trying for 12
months and that woman is under35 and she's not pregnant,
there's a problem. That'sright. Mm-hmm .
And if she's over 35 and she'sbeen trying for six months,
Speaker 3 (09:51):
Then there's a problem. And
Speaker 5 (09:51):
She's not pregnant, she needs to go see somebody.
Speaker 3 (09:53):
Well, thank you so much for helping our listeners
learn about , um, you know, thefairer sex
what you call 'em ? Sure. Idon't know . I'm gonna get a
lot of mail about this one.
Mm-hmm.
are bleeding right . When toget pregnant. And the fact that
you have to have sex 12 times aday.
Speaker 5 (10:10):
When you order us .
Speaker 3 (10:10):
Thank you for joining us and we're gonna
continue this. Donna, how dopeople get a hold of us?
Speaker 4 (10:13):
You can call us during the week at 5 1 2 2 3 8
0 7 6 2 armor men's health.com.
And I started my new only fanspage where I pee on my phone
and I get a smiley face.
Speaker 6 (10:23):
Speaker 5 (10:29):
That live or is that
Speaker 4 (10:31):
It's recorded. It's the
Speaker 3 (10:33):
Office. This is Dr .
Mystery , your host. I'm aboard certified urologist. I ,
uh, specialize in men'sfertility and cancer
treatments, everythingurologic. We have a holistic
practice, which , uh, soundsweird when you're a surgeon. I
always thought that I'm joinedby my co-host Donna Lee. That's
right.
Speaker 4 (10:48):
I'm super impressed though that you are a holistic
surgeon. People
Speaker 3 (10:51):
Don't even know what that means. They don't, they
think
Speaker 4 (10:52):
That
Speaker 3 (10:52):
It sounds good though . They think that I just
like to cut and that's wherethey would be, correct? That is
correct. I do love cutting.
Right.
Speaker 4 (10:57):
But before the cutting, we have supplements
and nutrition
Speaker 3 (11:00):
And pelvic floor,
Speaker 4 (11:01):
Physical therapy,
Speaker 3 (11:02):
And then cutting.
Speaker 4 (11:03):
And then the cutting and then
Speaker 3 (11:04):
Cutting. This show is brought to you by the
urology practice. I started in2007 N a u Urology specialist.
We are joined again by one ofour great partners, Dr. Kaylin
Silverberg from Texas FertilityCenter. Thank you so much for
joining us, Kaylyn .
Speaker 5 (11:16):
Thanks for having me. Happy to be here. You
Speaker 3 (11:18):
Know what's nice is sometimes on this show I have
graduates of the University ofTexas at Southwestern Medical
School,
Speaker 5 (11:26):
Small
Speaker 3 (11:27):
Sense , and speak very slowly. Right.
'cause as they know it's thesecond best medical school in
Texas. Oh boy. But those of usfrom Baylor, we're allowed to
use a more sophisticatedlanguage. Absolutely.
Speaker 5 (11:38):
Bigger
Speaker 3 (11:38):
Words and that's, and bigger words. That's nice.
So let's talk about yum Yumsand Dinglings
when it comes to, when it comesto the fertility journey that
many couples go through, onceagain, I must reiterate, men
have no idea what is going on.
Right . The women come in withreams of books and chapters of
things and the guy looks like adeer in the headlights. I don't
(11:58):
want to come see you, Dr .
Misery . My wife said I had tocome see you. Right . And I'm
gonna fix my fertility. Youknow, on the men's side, I just
wanted to mention that so manyof our patients come in not
healthy, they're overweight,they're not sleeping well,
they're stressed at work.
Explain to them very simply,when you're stressed, your body
doesn't want you to have ababy. Uh , understand that
anthropologically. Mm-hmm.
(12:20):
get pregnant when you're even aman. Now, do you think that's
the same for women? Yeah,
Speaker 5 (12:23):
I do. I think that's the same. I mean, you know,
people ask me all the time,well, what about my stress
level? And I say, well , youknow, there's no stress scale.
I can't say to you, you're 68.7on a stress scale and I need
you to be below 63.2
It doesn't work that way. Imean, there is no stress scale.
And then realistically, Godforbid, there's people right
now in the Ukraine who aregetting pregnant while their
homes are getting rocketed.
Mm-hmm .
stress. Yes . But having saidthat, we really want
(12:45):
everybody's stress level to beas low as
Speaker 3 (12:47):
Possible. And so, you know, what we use in our
practice to help assess stressis sleep quality. So we use
this thing called the whoopbracelet that we, we have
patients get that like trackstheir sleep. And I think I've
seen that just by tracking it.
They have better sleep. Where
Speaker 5 (13:00):
Do I get this thing?
I need this.
Speaker 3 (13:02):
I mean, it's online . It's , it's awesome. And so I
think that managing sleep,managing stress is gonna be so
important to help improvepeople's fertility if getting
pregnant naturally didn't work.
So we've talked about under 35,if your wife is under 35 and
you've been trying for 12months of unprotected sex,
please pee on a stick. Do theright things that we talked
about in our last segment. Andthen over , uh, six months if
(13:24):
you're over 35. Right . 'causethere are more problems.
Mm-hmm.
evaluation usually entail?
Well,
Speaker 5 (13:30):
So we do a basic evaluation. We do, you know, a
history and a physical, that'sthe first thing we do. We do an
ultrasound of vaginalultrasound to look at the
uterus, look at the ovaries. Wewanna make sure that the
ovaries still have eggs inthem. So we can actually see
these little black circleswithin the ovary. We're looking
for the fallopian tubes, hopingwe don't find them because if
you can see a fallopian tubewith ultrasound, it's too big ,
badly damaged. We look at theuterus to make sure that the
(13:52):
uterus , uh, is normal size.
Make sure there are no fibroidtumors. We look at the lining
of the uterus to make surethere are no polyps. Uh , we
try and look and see to makesure there's no scarring in the
cavity. We'll get an x-ray ofthe uterus in the fallopian
tubes to make sure the uterinecavity is normal and the tubes
are open. We'll get a semenanalysis on the guy, which is
really the first thing that wedo to make sure that we've got
sperm to work with. And then wetalk to them about whether we
(14:12):
need to go further. You know,we'll evaluate their blood on
the third day of their cycle toevaluate ovarian reserve to
find out how many eggs a womanhas left.
Speaker 3 (14:20):
What is that called ? That's called the a M h .
Speaker 5 (14:22):
Well, a M H is one of the tests that we do, but we
used usually a combination ofestradiol, F s H and a m H .
Speaker 3 (14:29):
So, you know, interestingly enough, I have so
many couples that come to me.
They say these words. My wife'sob gyn has already checked her
out and said she's fine. Sure.
Whenever I hear that, I'malways so confused. Right .
'cause I'm certain that thatchecking out means something
different to every OB gen outthere . Absolutely. And so when
we're talking about a fertilityevaluation, if you've gone too
(14:49):
long, do you think they need togo, like make sure their OBGYN
is doing certain things? Yeah,I mean,
Speaker 5 (14:54):
I think there's, there's some certain basic
things that need to be done.
Most of the OBGYNs in Austin dothose routinely and they really
do a good job. So by the timepatients get to us, a lot of
the basics have been done. Butlemme give you some examples.
You know, we do carrierscreening, so we're looking at,
we use a company that tests for289 different genetic disorders
that can cause problems withbabies. Okay. A lot of the
(15:16):
OBGYNs look for four or 11disorders. And so it's just a
more extensive process when wedo an H S G to look at the
uterine cavity and look at thefallopian tubes. We're not just
making sure that tubes areopen, we're, we're really
seriously looking at the cavityvery critically to make sure
that the uterus is normal
Speaker 3 (15:31):
And able to host that egg when it drops down
there. Yeah ,
Speaker 5 (15:34):
Exactly. Right. Able to hold , you know , to hold an
embryo. Um, we look at a semenanalysis a little bit
differently. Absolutely. Okay.
So, you know, I think thatthere are, there are major
differences between OB gens andreproductive endocrinologists,
but for the overwhelmingmajority of patients, start
with your OB gyn because, youknow, we got great docs here
who know what they're doing.
Speaker 3 (15:49):
And the further out you are from a major
metropolitan city, I feel likethe level of the kind of
evaluation kind of goes down.
And I think that if you're, andthis is my personal opinion, I
think that if your OB gyn doesnot do babies, if they don't,
if they don't do ob Yeah . Ifthey only do gynecology, that
the evaluation that they'regonna do is , you know, may not
be of the same degree of likeintensity. Yeah. It may not be.
(16:10):
And so if somebody's gonna dothat next step, sometimes
you'll use medication so thatthey can ovulate mm-hmm .
Sometimes you'll give themmedication where they make
multiple eggs mm-hmm .
couples go to is tointrauterine insemination.
Right . Maybe you could justdescribe what that process
looks like.
Speaker 5 (16:26):
Yeah. So I, intrauterine insemination, or I
u i is really simple and reallystraightforward. What we do is
when the woman's getting readyto ovulate, in other words, the
day after she has a smiley faceor a color change on her
ovulation prediction kit, onlyGod , her partner brings us a
sperm specimen. We wash it, wespin it down, we separate the
good sperm from the debris andthe dead stuff. And then we
painlessly put a littlecatheter through the cervix
(16:48):
into the uterus, put thespecimen inside, takes 15
seconds, they lay , it'spainless. They lay still for 10
minutes, read a magazine and goback to work a
Speaker 3 (16:55):
K a the Turkey baster . Yeah.
Speaker 5 (16:56):
I hate that term, but Yeah, that's right.
Speaker 3 (16:58):
Why ? That's the only part of Thanksgiving I get
to do. So . Yeah . Right . I'mpretty happy with the Turkey.
Right . So we don't like theterm Turkey baer because that
kind of dehumanizes kind ofwhat is a process that
sometimes people feel is veryartificial uhhuh , but in fact
it's not that artificial. WhatI say to people is it reduces
the amount, the , the distance,the sperm have to swim from
like, you know, six inches toone inch . And so , um, that
(17:19):
process generally doesn't costthat much money. Right. Even if
you're paying out of pocket.
Right. Are we talking about inthe hundreds or the thousands ?
Speaker 5 (17:25):
Oh yeah . No, no, no , no, no. 300, $400, something
like that. I mean, it's, it'sinexpensive, but realistically
the analogy is , you know, youranalogy is a good one. But the
analogy is if you want to gofrom New York to Paris doing I
u I starts you off really inLondon. Okay. So it really
significantly shortens thatjourney for a sperm that it has
to undergo to be able to get tothe egg and fertilize it .
Speaker 3 (17:43):
I'm not sure your analogy was much better than
mine. I failed
Speaker 4 (17:45):
In geography. Will you explain that to me?
Speaker 3 (17:47):
Know I'm saying, I don't know hard . I think my
analogy was just as good .
Speaker 5 (17:50):
Fine.
Speaker 3 (17:51):
God . The difference between him and me is that I
graduated later and Baylor'seducation really got a little
bit better
Speaker 4 (17:59):
But still what was said was girly parts and Turkey
ba
Speaker 3 (18:02):
In vitro fertilization , uh, like and
Speaker 5 (18:04):
Ling Lings and Dingdong, something like that .
Speaker 3 (18:06):
It's called yum Yums and dinglings are fine when it
comes to in vitrofertilization. Now we're
talking about something bothmore expensive, more invasive
Right. And more involved. Maybebriefly you could just describe
kind of what that process lookslike
Speaker 5 (18:18):
For the woman. We stimulate her ovaries with
really powerful injectablefertility drugs. So she'll take
anywhere from one to five shotsa day to try and get these eggs
to develop. She'll do that forabout 10 to 14 days. During
that period of time, we see herin the office about every three
days for a vaginal ultrasoundand a blood estrogen level
because we want to titrate herdose of medicine. We don't
wanna give her so much that shegets really sick. It's not
Speaker 3 (18:40):
The same for everybody
Speaker 5 (18:41):
On the other. Yeah.
And on the other hand, we don'twanna give her so little that
she only ends up making one ortwo eggs. When her eggs are
mature, we give her a triggershot. 36 hours later we take
her to the operating room. Shegets IV sedation with , uh,
from one of theanesthesiologists. And then
while she's on a beach in theCaribbean drinking margaritas,
we do an ultrasound. We pass aneedle through the top of the
vagina into the ovaries and getthe eggs out. Her partner at
the same time is giving us asperm specimen, just the old
(19:04):
fashioned way. We wash it, wespin it down again, isolate the
good sperm five hours after weget the eggs out. And by the
way, getting the eggs out takeseight minutes, five hours after
we get the eggs out, we lookunder a high power microscope
and we can pick up a singlesperm with a microscopic needle
and actually inject that spermdirectly into the egg. Now
Speaker 3 (19:21):
Not everybody has to have that. Sometimes we do a ,
a winner takes all . We put theeggs in the spur in the same
Petri dish, and then we put onsome, some really motivational
rocky music and see who went .
Mm-hmm .
happens. That process , uh, canbe more expensive and more
involved. It certainly involvesa lot more commitment. It can
be biologically kind of moretrying on the woman. Sure. But
, uh, despite all of that, wehave an incredible resource
(19:44):
here with Texas FertilityCenter. You're doing an amazing
job with very good numbers andamazing lab, wonderful staff. I
cannot speak more highly ofwhat you and your staff do,
Kaylyn .
Speaker 5 (19:52):
Well, thanks. We got an unbelievably committed team
and we have, you know, ourlaboratories Ovation fertility,
and they're just absolutelyphenomenal. And I know they
love working with you 'causeyou do a lot of sperm retrieval
procedures for a lot of ourpatients. Um, and, you know, so
guys who really have no chanceat all of getting pregnant
without your intervention, yougive them the same chance for
pregnancy as guys who walk inwith a completely normal sperm
(20:13):
count. Well, we look
Speaker 3 (20:14):
Forward to continuing to work with you.
How , how do people get aholdof you? What's your website?
Speaker 5 (20:17):
Our website is tx fertility.com
Speaker 3 (20:20):
And if you , uh, wanna learn about I V f, your,
your webinars that you do everymonth are absolutely
spectacular. And I wouldencourage, thank you , all of
you that are just trying tolearn about this fertility
journey to go to that websiteand do it. And that'll be on
our social media page.
Speaker 5 (20:35):
Yeah. The website's just killer . I mean, it's
really fantastic.
Speaker 3 (20:38):
Donna, how do people get ahold of us? That's
Speaker 4 (20:39):
Right. You can call us during the week at 5 1 2 2 3
8 0 7 6 2 our website's, armormen's health.com. Listen to our
podcast wherever you listen tofree podcasts. Thank you Dr.
Silverberg.
Speaker 5 (20:49):
Thank you so much for having me.
Speaker 2 (20:51):
The Armor Men's Health Show will be right back
to submit a question for Dr.
Mystery . Visit armor men'shealth.com.
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