September 29, 2025 • 30 mins
On this episode of Cry it Out Loud! hosted by Chasing the Rainbows, we welcome Dr. Lora Shahine, a board-certified Reproductive Endocrinologist, OB/GYN, author, and host of the Brave & Curious Podcast. Dr. Shahine has dedicated her career to supporting families through fertility struggles, pregnancy loss, and women’s health.
In this powerful conversation, Dr. Shahine shares insights on:
Understanding fertility treatments and options for hopeful parents
Balancing health, wellness, and emotional care during fertility journeys
Why awareness and advocacy are critical for these traumatic losses
Whether you’re navigating fertility challenges, supporting a loved one, or seeking expert knowledge, this episode offers both hope and practical guidance.
Don’t miss Dr. Shahine’s free resource: Click here for her free IVF survival guide or her free PCOS eBook
For more information on Every Baby Loss Matters National Campaign for October Pregnancy & Infant Loss Awareness Month and beyond, visit BabyLossAwareness.org and join our mission at Chasing the Rainbows to support families nationwide.
Listen
Watch
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:12):
Crying Out Loud, a podcast by Chasing the Rainbows with your
host Bernice Quisenberry. Welcome to cry it out loud
podcast by chasing the rainbows where we shine light on the
realities around infertility, miscarriage, still birth and
(00:34):
infant loss while offering hope,healing and resources for
families everywhere who have experienced any type of baby
loss. Today we are have a truly
special guest doctor Laura Shaheen.
She's a board certified reproductive End chronologist,
OBGYN author, podcast host, and passionate advocate for
fertility, health, and Wellness.Doctor Shaheen has helped
(00:56):
countless families through fertility struggles, and she
continues to amplify conversations around fertility,
Women's Health, and baby loss. Her work brings both science and
compassion to families who need it most, and today we're honored
to have her share her expertise and her heart with us.
Thank you so much for being here.
Oh, yeah. And thank you so much for that
(01:17):
wonderful introduction. It's a real honor to be here.
You're doing such great work. Thank you.
Thank you so much, Laura. That means the world.
And you know, for you joining ustoday, your work in reproductive
end chronology and fertility hasalready touched so many lives.
And I know our listeners are eager to hear your insights.
So to begin, could you share a little bit about your journey?
(01:38):
What inspired you to specialize in fertility medicine and become
such a strong advocate for families facing loss and
infertility? Well, thanks.
Yes, it is definitely a long journey.
A lot of years studying and a lot of exams in medical school.
I really enjoyed a lot of different things, but I was very
drawn to Women's Health and I loved procedures and surgery.
(02:01):
So OBGYN is like the right residency for me.
I did that at UCSF in San Francisco.
I love delivering babies. I loved caring for women for
menopause and just like this breath of help in OBGYN, but I
really was drawn to reproductiveendocrinology and infertility.
I love the technology, I love the constant learning.
(02:22):
I loved helping people at such avulnerable time in their life.
And so in order to do that, it'sa three-year fellowship.
And I did that at Stanford University and was so fortunate
to start an amazing practice, Pacific Northwest Fertility in
Seattle in 2009. And I've been there ever since.
(02:42):
So a long journey, but really enjoyed it.
And you know, ironically enough,I was a fertility Dr. that could
not get pregnant. So I struggled with infertility
myself and did a lot of the tests and treatments that I help
patients with everyday. IUISIVF, multiple embryo
(03:04):
transfers. I'm very fortunate to have two
children, but it was definitely a journey and looking back on
how vulnerable I felt, how much shame I felt and sort of being a
success driven person that couldn't meet my goal.
I really wanted to help other people understand.
(03:28):
And so that's the drive towards education and being active on
social media, having my own Brave and Curious podcast,
writing my own books about infertility and miscarriage.
It it really comes from a passion to just help people
understand and feel less alone, just like what you are doing
(03:48):
here. Thank you so much, Laura, and
thank you for sharing all that, especially your, you know,
personal experience. And you know, that really does
shape you as a physician when you're not only treating, you
know, people that are living with infertility every day, but
then you're also facing your own.
I can't imagine. Yeah, it was very lots of
(04:12):
emotions, everything from anger,frustration, you know, I mean, I
really empathize with my patients that, like, are
struggling to get pregnant and they go to the grocery store and
every single person they see hasa big pregnant belly like it.
It just permeates every single thought and, you know, really
(04:35):
makes you doubt your purpose. It feels like it should just be
a given that we should just be able to get pregnant and have a
baby because we certainly are taught in health class, like how
easy it is to get pregnant. We have to really, you know,
focus on not getting pregnant before we're ready.
And contraception feels, you know, it works really, really
(04:57):
well. So that leads you to feel like
you're in complete control of your fertility.
So when you stop contracepting or you pivot to wanting to try
to conceive and it doesn't happen on your terms, you feel,
you know, gypped, angry, frustrated, like this is just
not the way it's supposed to be.In the movie, someone you know
comes home with a positive pregnancy test and the very next
(05:20):
scene in the movie is deliveringand having a cute baby in the
nursery. Like that's what we're shown.
And I think over my 20 year career in this field, finally
I'm seeing people talk about miscarriage and talk about
stillbirths and talk about IVFI Think that is one of the
(05:41):
benefits of social media. There's lots of pros and cons,
but just, you know, people sharing their stories help you
realize like wow, I'm not the only person that has faced this
and I I see that positive outcome of sharing.
Right, and you do, you find yourcommunity, you know, and social
media, like you're saying, you know, it can be hard and, and
triggering seeing pregnancy announcement after pregnancy
(06:02):
announcement when you're trying to conceive.
But then also finding the community of how we got
connected, you know, Laura on Instagram and you know, hearing
the voices and seeing the peoplewho have all, you know, been
through this and have experienced the same.
And, you know, just seeing validated and seen that is huge
when you're on this journey, especially when you're feeling
(06:24):
like a failure and you're feeling all that shape blame.
And yeah, absolutely. Exactly.
Yeah. So how you know how did you like
process and work through the shame and blame feelings you
know when you were on your own journey?
You know, probably not very well.
(06:47):
Medicine teaches us very much tocompartmentalize and just like
focus on what's in front of you and not really deal with all the
feelings. You know, because you have to go
from maybe in the ER like treating a gunshot wound to like
the next patient that you're seeing is just, you know, a
little baby with a rash or something.
(07:07):
Or, you know, in labor and delivery, you are delivering
this beautiful family. Everything goes well, the baby's
great, the mom's great. And then, you know, the next
patient that you go see is actually, you know, delivering a
still birth. And it's like a totally
different experience, right? So you learn to compartmentalize
in order to function and do whatyou need to do.
(07:29):
And so I feel like I tackled infertility like I did, you
know, studying for medical school or trying to get into a
fellowship at Stanford, just kind of like, you know, I, I can
do this and like knuckling it and not really processing the
feelings. And I, I do try to help my
(07:51):
patients, not only with the treatments that we're doing,
like, hey, these, this is what is open to you.
We can do IUI, we can do IVF, wecan do donor egg or surrogacy.
Like I talk about all these things, but I do try at every
visit to sort of at least check in on the emotional piece.
You know, are you still finding joy?
How's your relationship with your partner?
(08:12):
You know, how are things at work?
How are you sleeping? Because this trauma of feeling
gypped and feeling frustrated, it doesn't just go away when you
have a baby in your arms. Then you're processing, like not
sleeping and navigating, you know, balancing the rest of your
life with this new, you know, little baby.
(08:33):
And so I really would love for people to seek emotional support
and mental health resources as they're going through the
physical part of infertility andmiscarriage, because I feel like
it can often be forgotten. And I really, you know, it it,
it's hard because you don't havea lot of time in these visits.
(08:56):
But even if you can just ask thequestion, like, what are you
doing to support yourself? What did you do last weekend to
bring joy? You're like, Oh yeah, actually I
need to think about those things.
Yeah. And it is so important, you
know, sleep and all of those things, you know, when you're on
this journey, you know, the secondary and like work and your
partner and not going through any of the secondary losses that
(09:19):
are so affiliated with, you know, infertility and then
everything around it. And you're right talking about
that and working through it and processing it.
Absolutely. I know and I, you know, I almost
felt like when we on our journey, it was after pregnancy,
after loss, then I was finally able to process everything from
(09:43):
all the secondary infertility because you almost just keep
putting 1 foot in front of the other.
Just kind of like going through the motions and doing everything
that you can like, you know, in your control to try to keep
things moving or to get to the outcome.
You know that you're trying to, it's just, it's exhausting.
And then when it does catch up, it just like feels like a
freight train, like hit you in the face.
(10:04):
Absolutely, inertia is a powerful thing.
So if you are going from IUI to IUI or egg retrieval to egg
retrieval or embryo transfer to embryo transfer, it feels
comforting because you have likethe focus of like, you know,
making sure you have the medications and going from the
appointments and kind of gettingthat that follow up.
(10:26):
And sometimes one of the best things that I can do is just
really encourage people to pausefor a little bit.
I mean, I know that's hard because the age is important and
egg and sperm, you know, time isimportant, but sometimes, you
know, just sort of saying like it's a that the process can be a
little bit addictive almost. You just are focused on the
(10:49):
process and not the overall picture.
Like, oh gosh, like I actually took out a second mortgage to do
this third IVF cycle. And I haven't really thought
about, you know, big picture. You know, maybe I want to pivot
and actually think about a life of being child free or I want to
take a pause and look at adoption.
(11:11):
Or like you don't want to have patients go through just this,
you know, hamster wheel and thenhave no resources left to build
their family. Whether it's emotional
resources, you know, physical resources, financial resources.
But asking for that pause is really, really tough 'cause it
(11:32):
makes you think about the big picture and think about feelings
that you often don't want to. I know.
And you're right. So spawn on about the inertia
and just like going through the motions and then when you do and
it's like, yeah. Yeah, big stuff.
Big stuff, yeah. With like the technology and
(11:53):
things like that today, I mean, like you're saying like we're so
much more in tune with, I feel like from, you know, 20-30 years
ago with our health and things like we almost take more
proactive approach with it coming in educating ourselves
and you know, hopefully with reputable information and things
like that. But then the technology too has
(12:15):
become so much more advanced. And you know, what would you
say, you know, Laura, that you like, that you love about the
technology or or where things are?
Heading Oh my gosh, well doing this, you know, for decades, it
is so much fun to practice now as opposed to 15 or 20 years
(12:38):
ago. So, you know, it used to be the
success rates with an embryo transfer were in the single
digits. And even if you transferred
multiple embryos, we were just so excited if somebody got
pregnant and if they happen to get triplets, we're like, oops,
sorry, like, oh gosh, let's figure this out.
And now we can have as high as a6065% chance of live birth with
(13:04):
a single embryo transfer, depending on of course, so many
factors. But like if that embryo has been
screened for chromosome balance and age of the people that are
getting pregnant and you know, lots of other extenuating
things. But to wow, to be that high of a
success rate with a single embryo transfer and not having
(13:25):
anybody have to risk twins, triplets, and just how hard that
pregnancy can be on the person who's pregnant and the babies,
you know, that is a true joy. And, you know, even just
understanding and helping peoplego through the process with less
side effects. Like, you know, when I was a
fellow at Stanford, we were, youknow, routinely rounding on
(13:48):
people that had ovarian hyperstimulation syndrome,
really feeling bloated and nauseated and, you know, just
sick after an egg. People.
We were doing a lot of fresh embryo transfers.
So if you get pregnant when yourovaries haven't recovered fully
from like stimulation, the pregnancy hormone can make that
(14:09):
hyperstimulation syndrome go well into your first trimester.
So I rarely do fresh embryo transfers anymore.
They're almost always frozen embryo transfers so that you can
focus on a great outcome and a good number of embryos before
you're actually trying to get pregnant.
And so you're getting pregnant, you know, in a, you know,
(14:31):
recovered state as opposed to like right after you did this
stimulation. You know, those huge advances
have just made the process so much more successful and quite
honestly, so much easier on the people that are going through
IVF. Absolutely.
(14:51):
I know without all those side effects and because the first
trimester is hard enough and then to add that level is just I
can't. Yeah, yeah.
Wow. Now you know, what else have you
know, seen the progression and and where we're kind of headed
(15:11):
like, you know, what is what is the future of, you know, IVF or
you know. Any cuts?
Yeah. Yeah.
I think something that is reallybeen exciting about
understanding reproduction and genetics is the understanding
that the vast majority of miscarriages are related to the
(15:33):
embryo and the chromosome imbalance or genetic issues
within the embryo, that it's notthe person who is pregnant
fault. Like even the word miscarry is
just got to be changed. It should just be pregnancy not
continuing, you know, or, or embryo not, you know, going to
(15:56):
be a healthy baby. It shouldn't be the woman is
miss or messing up carrying the pregnancy.
And we know this from being ableto, you know, do genetic testing
on, you know, miscarriages and pregnancy tissue and realizing
that up to 60 to 80% of the timeit's a chromosome imbalance.
You know, half of the chromosomes come from our the
(16:18):
egg that we come from and half come from the sperm.
And if at fertilization there's an imbalance, there's too many
copies of #7 chromosome missing number, you know, 18.
You can have an an embryo develop and divide and turn into
a blastocyst and implant and even get to 6 to 8 weeks of
pregnancy, but the body will figure it out.
It'll stop developing. And then for people who are
(16:41):
still miscarrying and they do that testing and the chromosomes
are balanced, that doesn't automatically mean that there's
something wrong with that person.
There's incredible research going on, specifically at
Stanford right now, but you know, around the world doing
whole genome sequencing on miscarriages that are chromosome
balanced, looking for single gene mutations, like little tiny
(17:03):
mutations that you can't pick upon big chromosomes.
It's like a stack of Legos of genes that are leading to
miscarriage. So that doesn't help my patients
sitting in my office this week to sort of say, oh, let's see if
you've got a mutation on chromosome number six, that
could been the reason that this miscarried.
(17:23):
And maybe, you know, we can, youknow, check for that the next
time you make embryos, right? Like that information isn't
helping the patients who are trying to get pregnant right
now, but it will in the future. And even just the concept that
this research is being done and sharing that with people to say,
(17:45):
you know, we know that this is the case.
You know my book on miscarriage is called Not Broken and you
know an Approachable guide to miscarriage it is.
Your. Body is not broken and failing
you. I mean, of course there's things
we have to look for. Of course there's anatomic
issues that cause miscarriage. Of course, significant
(18:06):
hypothyroidism can cause miscarriage, but for the vast
majority of people, it's something within the embryo.
And just to be able to share that with people and help them
feel less of this shame and blame like you were talking
about earlier is, is just a gift.
And it's a wonderful way to be able to, to share with patients.
(18:29):
This is not your fault. And I do share with people, you
know, most people that are getting pregnant will go on to
have their baby or their family because so much is going, right.
The egg is ovulating, the egg and sperm like each other.
You know, implantation is happening.
And if it's really just that embryo, like the next time that
(18:50):
you try, no matter how scary it is, it's a brand new
opportunity. You know, it's a brand new egg,
a brand new sperm, a brand new embryo, brand new uterine
lining. As long as we're not missing
something that we can control and just to so be able, being
able to practice in a day and age where there's less shame,
(19:11):
there's more science backing up why most miscarriages happen and
treatment outcomes are more successful today than they've
ever been before. I think that is an incredible,
you know, thing to witness through my career.
That is, I know, and you know, one thing is like spiraling out
(19:34):
around not getting answers around what caused something
that is, you know, when you're processing, trying to heal, you
know, and and all the things andlike we're trying to work it out
and you know, it's all those uncertainties and to almost
isolate or no and get answers ishalf the half the battle when
you're going through this. Absolutely.
(19:54):
That feeling of being out of control is horrible, and that's
where a lot of the shame and blame comes from.
Like I've got to be doing something wrong if I can figure
out what it is. And then change that one
variable in the next pregnancy or the next time I try to
conceive, I'm not going to feel as bad.
(20:15):
But there is a that is temporarily comforting you, but
in the long term, it can really backfire.
It's like a spiral of, you know,trying to hang on to that
control, whether it's like you saw an Instagram post and it
says everybody should stop eating gluten in order to try to
get pregnant. OK.
(20:36):
There's some science that, of course, if you have celiac
disease that that is an inflammatory condition.
And if you can eliminate gluten,your immune system is going to
work better. And that really can decrease the
risk of miscarriage. Yes, that is true.
But for people without celiac disease, making them eliminate
pasta, which might be the most amazing comfort food and really
(21:00):
laser focusing in on that. If you accept that, and that is
what I'm going to change and then the next month you don't
get pregnant, guess who you blame?
Not the influencer that shared some study and twisted the, you
know, summary to make a point. You're going to blame yourself.
Like it must have been that salad dressing at the restaurant
and I forgot to ask if it had gluten in it.
(21:22):
That's why I didn't get pregnantor that's why I had another
miscarriage. Like you're just going to blame
yourself. So you have to get out of that
shame spiral and just realize there's things that you can
control and that you can't control and just really try to
be kind to yourself. Yes, yes.
And being gentle, I know. It's so interesting because we
can do that to others and you know that other peers that are
(21:45):
on the same journey as we are atthe same time.
And you know, we give them so much like kindness and
gentleness and grace and everything.
And then when it comes to ourselves, sometimes we can just
be the worst. Yeah, that is so true.
Sometimes we can be our own worst enemy.
Or I, I tell my patients, I'm like, it's really normal.
(22:05):
You are a huge target. Like it's easy to talk
negatively to yourself. Or again, it's comforting to be
like, oh, I did this wrong. Therefore I can change this and
I can take control back. And, you know, I just try to
really validate how normal that is.
Like it's a true coping mechanism, but just be aware of
how damaging it can be in the long run.
(22:27):
Absolutely, absolutely. And you know, talking about
things that what are some helpful things that someone who
is starting on this journey, youknow, they can do like secondary
things outside of coming to see NRE Dock, you know, and talking
about different options for them.
(22:47):
Like what are some things that you would recommend, Laura?
Absolutely. I think that it is really
important to be healthy overall,whether you're trying to get
pregnant or not, but thinking about lifestyle optimization is
really important, whether you'redoing fertility treatment or
not. Hopefully it'll help you be
(23:07):
healthier and your hormones workbetter so that you don't have to
end up seeing the reproductive endocrinologist because you're
pregnant. Or if you do get to that point
and you are having to use high technology like IVF, it's going
to have a higher success rate ifyou've already been working on
this with balance and with moderation.
So nutrition is important, exercise is important, sleep and
(23:31):
stress management. So there's no one perfect diet.
You know, if you look at my, I have a whole playlist on my
YouTube channel on like lifestyle optimization, you will
notice in every single video I'mlike, hey, I want to share with
you the one diet that's been associated with the highest
fertility is the Mediterranean diet.
But how to make sense? It's more fruits and vegetables,
(23:56):
animal protein is OK, but less red meat.
And it's kind of in balance likethat.
We know this like it kind of makes sense less processed
foods. But also realize that everything
in moderation. Like I tell people, if you can
do things 80% of the time that comes from like a Eastern
(24:16):
proverb, then 80% is perfection.So every once in a while, I
mean, have that ice cream, right?
Like alcohol, not good, not goodfor anything.
But Oh my gosh, a glass of champagne when you're
celebrating your girlfriend's birthday or a glass of wine you
got to an amazing restaurant. Enjoy that, you know, but you
(24:36):
know, not every single day and not, you know, a bottle when you
do partake. Like everything in moderation,
exercise very important. Like I see people really
struggle with, oh, well, I'm after ovulation and before I
know I have a positive pregnancy.
So I'm just going to lie in bed all day and like not do anything
to disrupt this implantation. That's not healthy, right?
(24:59):
Like moving your body, of course, you might want to modify
and, you know, do things that feel good to you and not
necessarily push yourself, but just to completely not exercise
like that's not good. And then also on the flip side,
you really don't want to be overstressing your body right now.
So I tell people like, this is not the time to train for a
(25:20):
marathon. You know, I can't tell you how
many of my patients are like, oh, I actually was going to do
a, you know, an Iron Man, you know, and I'm like, honestly,
like, I love that. But this is not the time to push
your body. If you push your body to
extremes or you're getting, you know, endorphin rushes and that
runner's high, that feels great,but that's also pushing out
stress hormones and that's goingto throw off the hormonal access
(25:43):
and throw off ovulation and things.
So, you know, again, everything in moderation and sleep, Oh my
gosh, sleep is I just cannot emphasize it enough.
It is something that you should absolutely prioritize.
I do have several videos on it on my YouTube channel, including
the importance of noticing if you snore.
(26:04):
If you snore, there's 90% chancethat you have at least mild or
significant sleep apnea. And that will, and that loss of
oxygen in the middle of the night will absolutely disrupt
your reproductive hormones and ovulation.
So you know, little things like that.
And then stress management, you cannot eliminate stress.
We live in a stressful world, but you can work really hard on
(26:26):
managing it. And what that means is finding
ways that can help your nervous system go from like, you know,
everything's on fire, fight or flight or freeze, running from a
bear to like a more neutral, kind of like whether it's
breathing, journaling, going fora walk in the woods, petting
your dog or cat, you know, whatever it is to kind of reset.
(26:50):
Working on that is really important because it's not like
you just automatically know how to do these things and and you
have to figure out what works sothat when you are in that
stressful fight or flight, you've got the tools at your,
you know, your fingertips. For you, you know, and, and then
(27:11):
you're ready, you can dive rightin and you know, or if you're
having panic attacks or whateverit kind of feels like for you,
you know, or just spiraling out like you're saying, fight or
flight and you know, how can youlike get grounded again?
And what can you do that you know works for you?
Yeah, exactly. Or yeah.
And I think also putting it intoperspective because so many
times it's like, you know, diet this, that and we sometimes,
(27:36):
especially when our end gamer goal is to get pregnant, we can
go to extremes and then like you're saying, blame ourselves
when things don't work then. But it's all about moderation
and making slow changes. So like processed, processed
foods, those kind of things likeif we started to eliminate,
didn't eat out as much, you know, and mainly on the
Mediterranean diet or whatever, that would look like, you know,
(27:58):
cutting like slowly decreasing red meat to those points and
stuff. But right, like food is fuel is
what we, you know, talk about a lot and like different support
groups and things like that and what it looks like because it's
true, you know, and like you're saying the moderation and that's
the key to all of. This, absolutely.
(28:19):
Yeah, Less like shame and blame around eating or exercise and
being kind to yourself. If your body is saying like, you
know, today is not the great dayto go for, you know that walk,
you know, just give yourself a little bit of grace.
Yes, and you know, my comfort food is ice cream, so like I'm
going right for that pint, you know, and then of course, you
(28:40):
know, you do you like it's hard not to in those moments, but you
know, allowing yourself to understand it's not like you
have to do this perfect all of the time.
Because also like when we're on a fertility journey, we're
tracking everything. So like we're always looking at
charts. We're always, you know, or, or
we might not be and, and you know, some choose not to do
those things, But for me, I'm like, I need to see this, this
(29:03):
and this. So I'm the same way with
everything else that's associated with it.
And then it does really creep with your mental health.
Yeah, yeah, exactly, exactly. No all, Laura, well, thank you
so much for getting on, for sharing your wisdom, for
everything that you're doing on social media.
You know, you put it in such a way that we find, you know,
(29:25):
connection with it. And I just, I can't thank you
enough for everything that you're putting out there.
And in a way, like I said, that is easy for us to manage or to
to look at and to understand, which is huge.
Well. Thank you.
I really appreciate that and I appreciate today, you know, you
are doing such wonderful things to support so many people and I
(29:47):
just really commend you for whatyou're doing.
Thank you so much, Laura. That means a lot coming from
you. And yeah, to have you on here
and to help our listeners. And, you know, we encourage our
listeners to find your information.
We'll put it in the podcast description.
So anyone listening, you can find those YouTube videos.
You can find Doctor Shaheen on Instagram anywhere that she is
(30:11):
so. And thank you so much again for
being here. Thank you.
Crying Out Loud, a podcast by Chasing the Rainbows with your
host Bernice Quisenberry. Welcome to cry it out loud
podcast by chasing the rainbows where we shine light on the
realities around infertility, miscarriage, still birth and
(00:34):
infant loss while offering hope,healing and resources for
families everywhere who have experienced any type of baby
loss. Today we are have a truly
special guest doctor Laura Shaheen.
She's a board certified reproductive End chronologist,
OBGYN author, podcast host, and passionate advocate for
fertility, health, and Wellness.Doctor Shaheen has helped
(00:56):
countless families through fertility struggles, and she
continues to amplify conversations around fertility,
Women's Health, and baby loss. Her work brings both science and
compassion to families who need it most, and today we're honored
to have her share her expertise and her heart with us.
Thank you so much for being here.
Oh, yeah. And thank you so much for that
(01:17):
wonderful introduction. It's a real honor to be here.
You're doing such great work. Thank you.
Thank you so much, Laura. That means the world.
And you know, for you joining ustoday, your work in reproductive
end chronology and fertility hasalready touched so many lives.
And I know our listeners are eager to hear your insights.
So to begin, could you share a little bit about your journey?
(01:38):
What inspired you to specialize in fertility medicine and become
such a strong advocate for families facing loss and
infertility? Well, thanks.
Yes, it is definitely a long journey.
A lot of years studying and a lot of exams in medical school.
I really enjoyed a lot of different things, but I was very
drawn to Women's Health and I loved procedures and surgery.
(02:01):
So OBGYN is like the right residency for me.
I did that at UCSF in San Francisco.
I love delivering babies. I loved caring for women for
menopause and just like this breath of help in OBGYN, but I
really was drawn to reproductiveendocrinology and infertility.
I love the technology, I love the constant learning.
(02:22):
I loved helping people at such avulnerable time in their life.
And so in order to do that, it'sa three-year fellowship.
And I did that at Stanford University and was so fortunate
to start an amazing practice, Pacific Northwest Fertility in
Seattle in 2009. And I've been there ever since.
(02:42):
So a long journey, but really enjoyed it.
And you know, ironically enough,I was a fertility Dr. that could
not get pregnant. So I struggled with infertility
myself and did a lot of the tests and treatments that I help
patients with everyday. IUISIVF, multiple embryo
(03:04):
transfers. I'm very fortunate to have two
children, but it was definitely a journey and looking back on
how vulnerable I felt, how much shame I felt and sort of being a
success driven person that couldn't meet my goal.
I really wanted to help other people understand.
(03:28):
And so that's the drive towards education and being active on
social media, having my own Brave and Curious podcast,
writing my own books about infertility and miscarriage.
It it really comes from a passion to just help people
understand and feel less alone, just like what you are doing
(03:48):
here. Thank you so much, Laura, and
thank you for sharing all that, especially your, you know,
personal experience. And you know, that really does
shape you as a physician when you're not only treating, you
know, people that are living with infertility every day, but
then you're also facing your own.
I can't imagine. Yeah, it was very lots of
(04:12):
emotions, everything from anger,frustration, you know, I mean, I
really empathize with my patients that, like, are
struggling to get pregnant and they go to the grocery store and
every single person they see hasa big pregnant belly like it.
It just permeates every single thought and, you know, really
(04:35):
makes you doubt your purpose. It feels like it should just be
a given that we should just be able to get pregnant and have a
baby because we certainly are taught in health class, like how
easy it is to get pregnant. We have to really, you know,
focus on not getting pregnant before we're ready.
And contraception feels, you know, it works really, really
(04:57):
well. So that leads you to feel like
you're in complete control of your fertility.
So when you stop contracepting or you pivot to wanting to try
to conceive and it doesn't happen on your terms, you feel,
you know, gypped, angry, frustrated, like this is just
not the way it's supposed to be.In the movie, someone you know
comes home with a positive pregnancy test and the very next
(05:20):
scene in the movie is deliveringand having a cute baby in the
nursery. Like that's what we're shown.
And I think over my 20 year career in this field, finally
I'm seeing people talk about miscarriage and talk about
stillbirths and talk about IVFI Think that is one of the
(05:41):
benefits of social media. There's lots of pros and cons,
but just, you know, people sharing their stories help you
realize like wow, I'm not the only person that has faced this
and I I see that positive outcome of sharing.
Right, and you do, you find yourcommunity, you know, and social
media, like you're saying, you know, it can be hard and, and
triggering seeing pregnancy announcement after pregnancy
(06:02):
announcement when you're trying to conceive.
But then also finding the community of how we got
connected, you know, Laura on Instagram and you know, hearing
the voices and seeing the peoplewho have all, you know, been
through this and have experienced the same.
And, you know, just seeing validated and seen that is huge
when you're on this journey, especially when you're feeling
(06:24):
like a failure and you're feeling all that shape blame.
And yeah, absolutely. Exactly.
Yeah. So how you know how did you like
process and work through the shame and blame feelings you
know when you were on your own journey?
You know, probably not very well.
(06:47):
Medicine teaches us very much tocompartmentalize and just like
focus on what's in front of you and not really deal with all the
feelings. You know, because you have to go
from maybe in the ER like treating a gunshot wound to like
the next patient that you're seeing is just, you know, a
little baby with a rash or something.
(07:07):
Or, you know, in labor and delivery, you are delivering
this beautiful family. Everything goes well, the baby's
great, the mom's great. And then, you know, the next
patient that you go see is actually, you know, delivering a
still birth. And it's like a totally
different experience, right? So you learn to compartmentalize
in order to function and do whatyou need to do.
(07:29):
And so I feel like I tackled infertility like I did, you
know, studying for medical school or trying to get into a
fellowship at Stanford, just kind of like, you know, I, I can
do this and like knuckling it and not really processing the
feelings. And I, I do try to help my
(07:51):
patients, not only with the treatments that we're doing,
like, hey, these, this is what is open to you.
We can do IUI, we can do IVF, wecan do donor egg or surrogacy.
Like I talk about all these things, but I do try at every
visit to sort of at least check in on the emotional piece.
You know, are you still finding joy?
How's your relationship with your partner?
(08:12):
You know, how are things at work?
How are you sleeping? Because this trauma of feeling
gypped and feeling frustrated, it doesn't just go away when you
have a baby in your arms. Then you're processing, like not
sleeping and navigating, you know, balancing the rest of your
life with this new, you know, little baby.
(08:33):
And so I really would love for people to seek emotional support
and mental health resources as they're going through the
physical part of infertility andmiscarriage, because I feel like
it can often be forgotten. And I really, you know, it it,
it's hard because you don't havea lot of time in these visits.
(08:56):
But even if you can just ask thequestion, like, what are you
doing to support yourself? What did you do last weekend to
bring joy? You're like, Oh yeah, actually I
need to think about those things.
Yeah. And it is so important, you
know, sleep and all of those things, you know, when you're on
this journey, you know, the secondary and like work and your
partner and not going through any of the secondary losses that
(09:19):
are so affiliated with, you know, infertility and then
everything around it. And you're right talking about
that and working through it and processing it.
Absolutely. I know and I, you know, I almost
felt like when we on our journey, it was after pregnancy,
after loss, then I was finally able to process everything from
(09:43):
all the secondary infertility because you almost just keep
putting 1 foot in front of the other.
Just kind of like going through the motions and doing everything
that you can like, you know, in your control to try to keep
things moving or to get to the outcome.
You know that you're trying to, it's just, it's exhausting.
And then when it does catch up, it just like feels like a
freight train, like hit you in the face.
(10:04):
Absolutely, inertia is a powerful thing.
So if you are going from IUI to IUI or egg retrieval to egg
retrieval or embryo transfer to embryo transfer, it feels
comforting because you have likethe focus of like, you know,
making sure you have the medications and going from the
appointments and kind of gettingthat that follow up.
(10:26):
And sometimes one of the best things that I can do is just
really encourage people to pausefor a little bit.
I mean, I know that's hard because the age is important and
egg and sperm, you know, time isimportant, but sometimes, you
know, just sort of saying like it's a that the process can be a
little bit addictive almost. You just are focused on the
(10:49):
process and not the overall picture.
Like, oh gosh, like I actually took out a second mortgage to do
this third IVF cycle. And I haven't really thought
about, you know, big picture. You know, maybe I want to pivot
and actually think about a life of being child free or I want to
take a pause and look at adoption.
(11:11):
Or like you don't want to have patients go through just this,
you know, hamster wheel and thenhave no resources left to build
their family. Whether it's emotional
resources, you know, physical resources, financial resources.
But asking for that pause is really, really tough 'cause it
(11:32):
makes you think about the big picture and think about feelings
that you often don't want to. I know.
And you're right. So spawn on about the inertia
and just like going through the motions and then when you do and
it's like, yeah. Yeah, big stuff.
Big stuff, yeah. With like the technology and
(11:53):
things like that today, I mean, like you're saying like we're so
much more in tune with, I feel like from, you know, 20-30 years
ago with our health and things like we almost take more
proactive approach with it coming in educating ourselves
and you know, hopefully with reputable information and things
like that. But then the technology too has
(12:15):
become so much more advanced. And you know, what would you
say, you know, Laura, that you like, that you love about the
technology or or where things are?
Heading Oh my gosh, well doing this, you know, for decades, it
is so much fun to practice now as opposed to 15 or 20 years
(12:38):
ago. So, you know, it used to be the
success rates with an embryo transfer were in the single
digits. And even if you transferred
multiple embryos, we were just so excited if somebody got
pregnant and if they happen to get triplets, we're like, oops,
sorry, like, oh gosh, let's figure this out.
And now we can have as high as a6065% chance of live birth with
(13:04):
a single embryo transfer, depending on of course, so many
factors. But like if that embryo has been
screened for chromosome balance and age of the people that are
getting pregnant and you know, lots of other extenuating
things. But to wow, to be that high of a
success rate with a single embryo transfer and not having
(13:25):
anybody have to risk twins, triplets, and just how hard that
pregnancy can be on the person who's pregnant and the babies,
you know, that is a true joy. And, you know, even just
understanding and helping peoplego through the process with less
side effects. Like, you know, when I was a
fellow at Stanford, we were, youknow, routinely rounding on
(13:48):
people that had ovarian hyperstimulation syndrome,
really feeling bloated and nauseated and, you know, just
sick after an egg. People.
We were doing a lot of fresh embryo transfers.
So if you get pregnant when yourovaries haven't recovered fully
from like stimulation, the pregnancy hormone can make that
(14:09):
hyperstimulation syndrome go well into your first trimester.
So I rarely do fresh embryo transfers anymore.
They're almost always frozen embryo transfers so that you can
focus on a great outcome and a good number of embryos before
you're actually trying to get pregnant.
And so you're getting pregnant, you know, in a, you know,
(14:31):
recovered state as opposed to like right after you did this
stimulation. You know, those huge advances
have just made the process so much more successful and quite
honestly, so much easier on the people that are going through
IVF. Absolutely.
(14:51):
I know without all those side effects and because the first
trimester is hard enough and then to add that level is just I
can't. Yeah, yeah.
Wow. Now you know, what else have you
know, seen the progression and and where we're kind of headed
(15:11):
like, you know, what is what is the future of, you know, IVF or
you know. Any cuts?
Yeah. Yeah.
I think something that is reallybeen exciting about
understanding reproduction and genetics is the understanding
that the vast majority of miscarriages are related to the
(15:33):
embryo and the chromosome imbalance or genetic issues
within the embryo, that it's notthe person who is pregnant
fault. Like even the word miscarry is
just got to be changed. It should just be pregnancy not
continuing, you know, or, or embryo not, you know, going to
(15:56):
be a healthy baby. It shouldn't be the woman is
miss or messing up carrying the pregnancy.
And we know this from being ableto, you know, do genetic testing
on, you know, miscarriages and pregnancy tissue and realizing
that up to 60 to 80% of the timeit's a chromosome imbalance.
You know, half of the chromosomes come from our the
(16:18):
egg that we come from and half come from the sperm.
And if at fertilization there's an imbalance, there's too many
copies of #7 chromosome missing number, you know, 18.
You can have an an embryo develop and divide and turn into
a blastocyst and implant and even get to 6 to 8 weeks of
pregnancy, but the body will figure it out.
It'll stop developing. And then for people who are
(16:41):
still miscarrying and they do that testing and the chromosomes
are balanced, that doesn't automatically mean that there's
something wrong with that person.
There's incredible research going on, specifically at
Stanford right now, but you know, around the world doing
whole genome sequencing on miscarriages that are chromosome
balanced, looking for single gene mutations, like little tiny
(17:03):
mutations that you can't pick upon big chromosomes.
It's like a stack of Legos of genes that are leading to
miscarriage. So that doesn't help my patients
sitting in my office this week to sort of say, oh, let's see if
you've got a mutation on chromosome number six, that
could been the reason that this miscarried.
(17:23):
And maybe, you know, we can, youknow, check for that the next
time you make embryos, right? Like that information isn't
helping the patients who are trying to get pregnant right
now, but it will in the future. And even just the concept that
this research is being done and sharing that with people to say,
(17:45):
you know, we know that this is the case.
You know my book on miscarriage is called Not Broken and you
know an Approachable guide to miscarriage it is.
Your. Body is not broken and failing
you. I mean, of course there's things
we have to look for. Of course there's anatomic
issues that cause miscarriage. Of course, significant
(18:06):
hypothyroidism can cause miscarriage, but for the vast
majority of people, it's something within the embryo.
And just to be able to share that with people and help them
feel less of this shame and blame like you were talking
about earlier is, is just a gift.
And it's a wonderful way to be able to, to share with patients.
(18:29):
This is not your fault. And I do share with people, you
know, most people that are getting pregnant will go on to
have their baby or their family because so much is going, right.
The egg is ovulating, the egg and sperm like each other.
You know, implantation is happening.
And if it's really just that embryo, like the next time that
(18:50):
you try, no matter how scary it is, it's a brand new
opportunity. You know, it's a brand new egg,
a brand new sperm, a brand new embryo, brand new uterine
lining. As long as we're not missing
something that we can control and just to so be able, being
able to practice in a day and age where there's less shame,
(19:11):
there's more science backing up why most miscarriages happen and
treatment outcomes are more successful today than they've
ever been before. I think that is an incredible,
you know, thing to witness through my career.
That is, I know, and you know, one thing is like spiraling out
(19:34):
around not getting answers around what caused something
that is, you know, when you're processing, trying to heal, you
know, and and all the things andlike we're trying to work it out
and you know, it's all those uncertainties and to almost
isolate or no and get answers ishalf the half the battle when
you're going through this. Absolutely.
(19:54):
That feeling of being out of control is horrible, and that's
where a lot of the shame and blame comes from.
Like I've got to be doing something wrong if I can figure
out what it is. And then change that one
variable in the next pregnancy or the next time I try to
conceive, I'm not going to feel as bad.
(20:15):
But there is a that is temporarily comforting you, but
in the long term, it can really backfire.
It's like a spiral of, you know,trying to hang on to that
control, whether it's like you saw an Instagram post and it
says everybody should stop eating gluten in order to try to
get pregnant. OK.
(20:36):
There's some science that, of course, if you have celiac
disease that that is an inflammatory condition.
And if you can eliminate gluten,your immune system is going to
work better. And that really can decrease the
risk of miscarriage. Yes, that is true.
But for people without celiac disease, making them eliminate
pasta, which might be the most amazing comfort food and really
(21:00):
laser focusing in on that. If you accept that, and that is
what I'm going to change and then the next month you don't
get pregnant, guess who you blame?
Not the influencer that shared some study and twisted the, you
know, summary to make a point. You're going to blame yourself.
Like it must have been that salad dressing at the restaurant
and I forgot to ask if it had gluten in it.
(21:22):
That's why I didn't get pregnantor that's why I had another
miscarriage. Like you're just going to blame
yourself. So you have to get out of that
shame spiral and just realize there's things that you can
control and that you can't control and just really try to
be kind to yourself. Yes, yes.
And being gentle, I know. It's so interesting because we
can do that to others and you know that other peers that are
(21:45):
on the same journey as we are atthe same time.
And you know, we give them so much like kindness and
gentleness and grace and everything.
And then when it comes to ourselves, sometimes we can just
be the worst. Yeah, that is so true.
Sometimes we can be our own worst enemy.
Or I, I tell my patients, I'm like, it's really normal.
(22:05):
You are a huge target. Like it's easy to talk
negatively to yourself. Or again, it's comforting to be
like, oh, I did this wrong. Therefore I can change this and
I can take control back. And, you know, I just try to
really validate how normal that is.
Like it's a true coping mechanism, but just be aware of
how damaging it can be in the long run.
(22:27):
Absolutely, absolutely. And you know, talking about
things that what are some helpful things that someone who
is starting on this journey, youknow, they can do like secondary
things outside of coming to see NRE Dock, you know, and talking
about different options for them.
(22:47):
Like what are some things that you would recommend, Laura?
Absolutely. I think that it is really
important to be healthy overall,whether you're trying to get
pregnant or not, but thinking about lifestyle optimization is
really important, whether you'redoing fertility treatment or
not. Hopefully it'll help you be
(23:07):
healthier and your hormones workbetter so that you don't have to
end up seeing the reproductive endocrinologist because you're
pregnant. Or if you do get to that point
and you are having to use high technology like IVF, it's going
to have a higher success rate ifyou've already been working on
this with balance and with moderation.
So nutrition is important, exercise is important, sleep and
(23:31):
stress management. So there's no one perfect diet.
You know, if you look at my, I have a whole playlist on my
YouTube channel on like lifestyle optimization, you will
notice in every single video I'mlike, hey, I want to share with
you the one diet that's been associated with the highest
fertility is the Mediterranean diet.
But how to make sense? It's more fruits and vegetables,
(23:56):
animal protein is OK, but less red meat.
And it's kind of in balance likethat.
We know this like it kind of makes sense less processed
foods. But also realize that everything
in moderation. Like I tell people, if you can
do things 80% of the time that comes from like a Eastern
(24:16):
proverb, then 80% is perfection.So every once in a while, I
mean, have that ice cream, right?
Like alcohol, not good, not goodfor anything.
But Oh my gosh, a glass of champagne when you're
celebrating your girlfriend's birthday or a glass of wine you
got to an amazing restaurant. Enjoy that, you know, but you
(24:36):
know, not every single day and not, you know, a bottle when you
do partake. Like everything in moderation,
exercise very important. Like I see people really
struggle with, oh, well, I'm after ovulation and before I
know I have a positive pregnancy.
So I'm just going to lie in bed all day and like not do anything
to disrupt this implantation. That's not healthy, right?
(24:59):
Like moving your body, of course, you might want to modify
and, you know, do things that feel good to you and not
necessarily push yourself, but just to completely not exercise
like that's not good. And then also on the flip side,
you really don't want to be overstressing your body right now.
So I tell people like, this is not the time to train for a
(25:20):
marathon. You know, I can't tell you how
many of my patients are like, oh, I actually was going to do
a, you know, an Iron Man, you know, and I'm like, honestly,
like, I love that. But this is not the time to push
your body. If you push your body to
extremes or you're getting, you know, endorphin rushes and that
runner's high, that feels great,but that's also pushing out
stress hormones and that's goingto throw off the hormonal access
(25:43):
and throw off ovulation and things.
So, you know, again, everything in moderation and sleep, Oh my
gosh, sleep is I just cannot emphasize it enough.
It is something that you should absolutely prioritize.
I do have several videos on it on my YouTube channel, including
the importance of noticing if you snore.
(26:04):
If you snore, there's 90% chancethat you have at least mild or
significant sleep apnea. And that will, and that loss of
oxygen in the middle of the night will absolutely disrupt
your reproductive hormones and ovulation.
So you know, little things like that.
And then stress management, you cannot eliminate stress.
We live in a stressful world, but you can work really hard on
(26:26):
managing it. And what that means is finding
ways that can help your nervous system go from like, you know,
everything's on fire, fight or flight or freeze, running from a
bear to like a more neutral, kind of like whether it's
breathing, journaling, going fora walk in the woods, petting
your dog or cat, you know, whatever it is to kind of reset.
(26:50):
Working on that is really important because it's not like
you just automatically know how to do these things and and you
have to figure out what works sothat when you are in that
stressful fight or flight, you've got the tools at your,
you know, your fingertips. For you, you know, and, and then
(27:11):
you're ready, you can dive rightin and you know, or if you're
having panic attacks or whateverit kind of feels like for you,
you know, or just spiraling out like you're saying, fight or
flight and you know, how can youlike get grounded again?
And what can you do that you know works for you?
Yeah, exactly. Or yeah.
And I think also putting it intoperspective because so many
times it's like, you know, diet this, that and we sometimes,
(27:36):
especially when our end gamer goal is to get pregnant, we can
go to extremes and then like you're saying, blame ourselves
when things don't work then. But it's all about moderation
and making slow changes. So like processed, processed
foods, those kind of things likeif we started to eliminate,
didn't eat out as much, you know, and mainly on the
Mediterranean diet or whatever, that would look like, you know,
(27:58):
cutting like slowly decreasing red meat to those points and
stuff. But right, like food is fuel is
what we, you know, talk about a lot and like different support
groups and things like that and what it looks like because it's
true, you know, and like you're saying the moderation and that's
the key to all of. This, absolutely.
(28:19):
Yeah, Less like shame and blame around eating or exercise and
being kind to yourself. If your body is saying like, you
know, today is not the great dayto go for, you know that walk,
you know, just give yourself a little bit of grace.
Yes, and you know, my comfort food is ice cream, so like I'm
going right for that pint, you know, and then of course, you
(28:40):
know, you do you like it's hard not to in those moments, but you
know, allowing yourself to understand it's not like you
have to do this perfect all of the time.
Because also like when we're on a fertility journey, we're
tracking everything. So like we're always looking at
charts. We're always, you know, or, or
we might not be and, and you know, some choose not to do
those things, But for me, I'm like, I need to see this, this
(29:03):
and this. So I'm the same way with
everything else that's associated with it.
And then it does really creep with your mental health.
Yeah, yeah, exactly, exactly. No all, Laura, well, thank you
so much for getting on, for sharing your wisdom, for
everything that you're doing on social media.
You know, you put it in such a way that we find, you know,
(29:25):
connection with it. And I just, I can't thank you
enough for everything that you're putting out there.
And in a way, like I said, that is easy for us to manage or to
to look at and to understand, which is huge.
Well. Thank you.
I really appreciate that and I appreciate today, you know, you
are doing such wonderful things to support so many people and I
(29:47):
just really commend you for whatyou're doing.
Thank you so much, Laura. That means a lot coming from
you. And yeah, to have you on here
and to help our listeners. And, you know, we encourage our
listeners to find your information.
We'll put it in the podcast description.
So anyone listening, you can find those YouTube videos.
You can find Doctor Shaheen on Instagram anywhere that she is
(30:11):
so. And thank you so much again for
being here. Thank you.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Joe Rogan Experience
The official podcast of comedian Joe Rogan.