In this episode of the Egg Whisperer Show, I have the pleasure of welcoming Dr. Abby Eblen, Dr. Carrie Bedient, and Dr. Susan Hudson: board-certified reproductive endocrinologists, co-hosts of the “Fertility Docs Uncensored” podcast, and authors of the new book, “The IVF Blueprint.” As clinicians and, in some cases, IVF patients themselves, they bring a wealth of experience and empathy to our conversation about the emotional and practical aspects of fertility treatment.
Together, we dive into the motivations behind writing “The IVF Blueprint,” the importance of patient education, and the ever-evolving landscape of IVF care. We discuss our shared mission to demystify the IVF process, provide evidence-based guidance, and empower patients to advocate for themselves. We also explore the emotional journey of infertility, the significance of transparency in the lab, and what the future holds for fertility care.
In this episode, we cover:
- The inspiration and collaborative process behind “The IVF Blueprint”
- Common sources of overwhelm for IVF patients and strategies to manage them
- The importance of patient education and anticipatory guidance throughout the IVF journey
- Evidence-based recommendations for supplements and lifestyle during fertility treatment
- What really happens in the IVF lab and why transparency matters
- Trends in IVF access, family planning, and genetic testing
- How patients can advocate for themselves and find support during fertility care
Resources:
Fertility Docs Uncensored Podcast & Book
Dr. Carrie Bedient at Fertility Center of Las Vegas
Dr. Susan Hudson at Texas Fertility Center
Dr. Abby Eblen at Nashville Fertility
Find Dr. Aimee’s Fertility Essentials & Supplements
Full Transcript:
Dr. Aimee: Today, I have the pleasure of talking with Dr. Abby Eblen, Dr. Carrie Bedient, and Dr. Susan Hudson. Together, they are The Fertility Docs, board-certified reproductive endocrinologists, podcast hosts of Fertility Docs Uncensored, and authors of their new book, The IVF Blueprint. Two of the fertility docs are IVF moms themselves, and all three run thriving clinics across the country. They bring clarity, warmth, and evidence-based guidance to one of the most emotional journeys many families face.
I’m so excited to learn more about your book, so let’s jump right in. You have a popular podcast and work together often. How did the book come about, and how did you draw from your experiences as doctors and patients in creating it?
Dr. Abby Eblen: We had decided when we started the podcast, we made some goals about things that we really wanted to do, so that was one of the things on the list. I don’t know, the time was just right and we started working on it. The reason we did it was because we get so many questions on our podcast about IVF. Patients only have about 30 minutes during their consult with their doctor. While we go through a lot of that, and I’m sure you do too, a lot of times, patients don’t do IVF for several months, and they don’t have a way to remind themselves about what we talked about. The idea behind the book was to make it a handbook so that when somebody goes through IVF, they’ll be able to reference what they’re doing at each step and be able to get more information.
Dr. Aimee: That’s great. Early in the book, you talk about how overwhelming IVF can feel. From your perspective, what’s the root of that overwhelm? How can both patients and doctors make the process more manageable?
Dr. Susan Hudson: I think really there is power in knowledge. Most of the time when people are overwhelmed, it’s because they’re scared and it’s because they just don’t understand what’s going on. I remember when I was going through my own IVF journey and the times I cried, which I cried just like everybody else does during their IVF journey, is when things didn’t match up. It was like why are we doing this, why did something change, things weren’t going according to what I in my brain had as the plan. It’s the same slide that everybody else goes down.
We wanted to help give a good solid reference of why your doctor may do different things. There’s no one way to do IVF. There’s no one couple that’s exactly like another couple. What we intended with this book was to show a variety of ways and reasonings behind what we find is important, and to be able to use that in your personal journey.
Dr. Aimee: So much of what we do as doctors is helping patients understand what to expect at each stage. How do you approach that, giving patients enough information to feel prepared without creating extra stress?
Dr. Carrie Bedient: So much of what patient anxiety focuses on is the uncertainty of what will or won’t happen. There are two parts to this. One part is giving them the information they need for right now, because while yes, at the very first visit, we could tell them everything about the IVF retrieval cycle, the uterine preparation, the transfer cycle, and all the lab work, it doesn’t make sense to do that at that point. It’s figuring out how do we get a bite-size piece of information that’s very relevant to what the patient is going through right now and present it?
The other part of it is the anticipatory guidance, because we all know some of the pain points that patients have. You know that when you get 20 eggs out and you only get one, two, three … however many embryos at the end of it, that patient is going to freak out about that if they’re not prepared for it. As a result, you tell somebody at the time of their retrieval, before, during, after, “You have 20 eggs. You will not have 20 embryos. This is normal, this is expected, this is what we want. You want to see that natural selection in process because you don’t want to transfer all the ones that are never going to make it.” A lot of it is that real anticipatory guidance, how to help people deal with some of the uncertainty in the big ways that will send them into one of those tailspins.
Dr. Aimee: Yes. As human beings, we always want 100%. That’s ingrained in us from such an early age. An A+ isn’t getting one embryo out of 20, one out of 20 feels like failure.
If you reframe it, it makes the patients feel less afraid and scared and worried. No matter what we say, though, sometimes they still feel overwhelmed. It’s good that we’re hand-holding our patients.
You dedicate space to lifestyle and supplements, and I’m sure you get so many questions about that. It’s one of the first questions I get asked after a transfer is, “What should I eat? What should I do?” In your experience, what advice has been the most helpful, and what should patients look for when choosing supplements?
Dr. Abby Eblen: I think we would all agree that prenatal vitamins are important, so prenatal vitamins. I personally ask them to take extra folic acid because it’s one of those things you can’t get too much of, you can only get too little. Then also Vitamin D. I think over the years in checking Vitamin D levels, most of us know that most of our patients have really low Vitamin D levels. That’s one of the ones I think they really need to take. Then it depends on where they’re at. Sometimes age-related, so CoQ10 is another good supplement. I think it depends on the patient.
In terms of what to look for, there’s different ways that you can look at supplements, and you want to make sure that they have what they say they have in them. There are some different certifications. USP is one, and I know NatureMade Vitamins have that certification that an outside source has looked at those vitamins to make sure that they have the right components in it. I think the quality of your vitamins is also important as well.
Dr. Susan Hudson: In addition to USP, the other designation is NSF, and those are designations to show that a third party has proven that what you expect to be in your vitamins is truly what’s in there and at the appropriate dosages. A lot of people don’t realize that vitamins and supplements aren’t regulated by the FDA, the Food and Drug Administration, so you have to take these folks at their word. Unfortunately, there is some pretty good data to say that a lot of these companies are lying to consumers. I would rather you take something than nothing, but sometimes you are getting what you pay for. Sometimes paying a little bit more for those vitamins that have those designations are going to help you get all of the vitamins, nutrients, antioxidants that we’re searching for to improve your chances of success.
Dr. Abby Eblen: Sometimes, too, with gummy vitamins, even though I think they’re much easier to take and they taste better, sometimes they don’t have a lot of actual vitamin there, it’s more the gelatin component. I really recommend that patients actually take pills rather than gummies, if they can.
Dr. Carrie Bedient: We found that when we were writing the supplement chapter of the book that, number one, we had to divide it three ways, and number two, it was like writing a term paper. You figure all doctors are professional students. Holy cow, I was back in some of my senior-level writing classes trying to figure out how to cite this and make sure I have the correct number of sources and that everything is pulled together in a succinct and easily understandable way. I think all three of us went through that process, particularly with that chapter because it required so much data diving.
Dr. Aimee: The other supplement I would add that I find helpful, and I imagine you do too, is something that boosts NAD levels in cells, something like OvaNAD or something similar. I’ve been recommending that for a while now.
What is your lifestyle recommendation around activity when you’re doing an egg retrieval? I get that question a lot, activity after an embryo transfer.
Dr. Susan Hudson: I think a good guideline is life in moderation. We don’t want you going off the deep end one way or the other. When you’re very close to your egg retrieval, we’re going to want to start reducing that exercise and those types of things, but through most of your fertility journey, a good balanced diet, something like a Mediterranean style diet is a good place to start, doing moderate exercise, getting your body moving. Going through pregnancy is one of the hardest things your body is going to go through in your lifetime, so we want you to be in as good of shape as you possibly can, but we also don’t want you in a very aggressive way of losing weight if we’re actively trying to get you pregnant.
Now, if we’re preparing for something and you’re losing the pounds, that’s great, but that’s not the best thing during an egg retrieval.
Dr. Aimee: Yes. Be gentle with yourself. That’s not the time to worry about your weight.
I love that the book also takes patients behind the scenes into the lab, from egg retrieval to embryo development to genetic testing. Why is transparency so important about the lab, and what do patients need to know about the scientific and lab side of IVF?
Dr. Carrie Bedient: It’s so important to have transparency in and throughout the IVF cycle, especially in the lab component because the patients are never going to directly see that. We’re walking in and out of the lab all day in our booties, in our hairnets, with our lab coats on, going through the swipe keycard doors, so we know everything that goes on there. But they don’t, and it’s very nerve-wracking because they don’t know what we’re doing with their eggs, sperm, and embryos. They don’t necessarily realize that there is computer matching going on to make sure the names are the same, there’s always a second, if not third person who is cross-checking their names. It’s not just you checking in at the front. You get your bracelet and then it’s checked in the pre-op area, in the OR, by the embryology lab, there’s a dual set of checks that happen in the lab, then when they come into the room, and then when they go back into the lab. Every time they take out your embryos from their incubator, there is cross-checking that is happening.
Knowing a lot of that is really important. Knowing that there is a ton of quality control that occurs in the lab, they are constantly looking at the pH, the temperature, the air quality parameters, the oxygen levels, CO2 levels, nitrogen levels. That’s all being monitored constantly. We always joke that fertility docs are compulsive. Embryologists are way more compulsive than we are, and thank goodness. When you combine the compulsiveness of most people who work in a fertility clinic, it ends up being a very safe environment.
Like we talked about before, there will always be decreases in numbers along the way. There is a funnel effect. The number of eggs you get is not going to be the number of embryos you get. That’s good. You don’t want it to be that way, because even in a really healthy 35-year-old, 40% of the eggs coming out are going to be abnormal. That’s expected. You don’t want to put those embryos back. Being able to understand that yes, these numbers are going to go down, no, not every embryo is going to make a baby is very helpful so that they understand the realities of the world that we work in, what science and biology can do and what they can’t.
Dr. Aimee: Yes. You explained that so well.
Dr. Abby Eblen: I think it’s also important that they know about the procedure itself. I think the average person when they come in and you start talking about an egg retrieval, they don’t have a concept for how we do it, it just doesn’t make sense to them. Particularly based on the models most of us have in our office of the uterus, it just doesn’t make sense. We try to discuss that in the book and explain that in detail. We also tried to explain who is going to be back there with you, who you’re going to meet, kind of walk them through the whole process.
If you don’t know what’s going to happen, that’s when you have a whole lot more anxiety. I think by letting them know the type of people they’re going to meet and what each person’s role is, that also helps to reduce their stress and anxiety about the procedure.
Dr. Aimee: Yes. I tell patients you might feel like a car at a pit stop at a NASCAR race, everyone’s putting on the monitor, getting your blood pressure, putting your legs up, telling you to scoot down.
Dr. Abby Eblen: That’s absolutely correct. Yes.
Dr. Aimee: Then the older I get, the funnier I think I am, so I tell the patient at the end, “clap twice and touch your nose,” because it almost feels like we’re playing Simon Says in the OR at times.
IVF has changed a lot, and more people are turning to it for different family building reasons. What kind of trends or changes are you seeing in how patients approach IVF today?
Dr. Susan Hudson: I think one of the most exciting things is with people getting more and more access to IVF through their insurance, through their employers and things like that. When they come in to talk to me about having a baby, I can talk to them about their family goals. I don’t have to just focus on the here and now, I can plan their treatment based on what their true hopes and dreams are. I think that’s one of the most exciting things is that you come in to see me, you’re 34 years old, and you tell me you want to have three children. That’s a very different conversation than if you’re 34 years old and you say it’s one and done. It makes me feel good that I’m able to look at the future and not just solve the immediate problem, but lay the groundwork so we’re going to have success in the future.
Dr. Aimee: We’re hope and dream dealers. We’re all very empathetic people talking to one another today. What would you say to someone who is not getting that? I think everyone should get that conversation with their doctor, but you and I both know that’s not happening. How can a patient who, let’s say, doesn’t have a choice with where she can go because she’s limited by where she lives, how would you recommend that she advocate for herself if she’s not getting that kind of conversation with her doctor?
Dr. Abby Eblen: I think she should probably make a list of questions. Sometimes I think when people get in front of their doctor, they kind of freeze up and they don’t know what to ask. I think it’s helpful to come up with questions. I think it’s important to talk to friends who have been through it to get some sense for what their experience was, that way they can compare and contrast. Sometimes I think patients see things that we do and they feel like that’s not what other physicians would do. Then when they see, almost like the egg conversation where not every egg is going to make an embryo, when they see that this is the way the flow is in the clinic, I think they better understand I’m coming in and I’m going to maybe not see the doctor, I’m going to have my ultrasound, I’m going to have my blood drawn, then I’m going to leave.
I think just talking to other people to get a sense for what they should expect, but if they’re not getting that, I think it’s important for them to bring it up with their doctor or with their nurse so that they do get the experience they hope for.
Dr. Susan Hudson: I think it’s also important to know that although your physician, nurses, medical assistants, and administrative staff are all part of your family building team, it’s important that if you need to go outside of that realm to get the support you need, that’s okay. If you need to seek a mental health professional or you need to join a support group, or you need to just start writing in a diary to get some of those emotions out of you in a safe place, those are all very good things to do.
Not every physician and patient are going to be a perfect personality match. If you live in a place where there’s lots of doctors to choose from, then sometimes you can pick your physician based on that. But as you mentioned, that’s not always a possibility because of geography. Most fertility doctors are in major metropolitan areas and, quite frankly, most people in the United States actually don’t live in those areas, they have to travel to get the care that they need. Going through some of these other avenues can build a bridge for what may be missing.
Dr. Aimee: Yes. True story, I had a patient once who told me to stop being so happy and stop being so positive with her. I said I just can’t change how much I believe that this is going to work for you. I just can’t change that. She was angry. She transformed, obviously, once she reached her goals, but that was very funny. We still laugh about it together. I still tease her about how she said that literally. It was a dead serious conversation. It wasn’t like, “Can you stop being so happy?” It was like, “We need to talk. You’re just too happy of a person for me.” So, I understand what you’re saying when sometimes it could be a mismatch between the doctor and the patient.
Dr. Susan Hudson: The other thing to keep in mind is when you’re going through infertility, you are going through a grieving process. No one grows up thinking, “I want to do IVF, that’s how I want to have my baby.” You really are going through a grieving process. Sometimes as you’re doing that, you end up having some anger that goes towards those who are trying to help you. We understand that, but I think it’s also very insightful to recognize that hey, I am going through this grieving process.
I have a medical condition called Celiac, where essentially I’m one of those people who really can’t eat gluten. I remember when I first got diagnosed, it was very isolating. I came home from work one day and I was angry. My husband turned to me and he’s like, “Why are you angry at me?” I’m like, “I’m not angry at you. I’m angry at everything.” That was one of the most wonderful moments of my life because I didn’t even realize it until that moment.
Dr. Aimee: Where do you see the future of IVF and fertility care headed, if you were to make some predictions?
Dr. Carrie Bedient: I think that it’s going to expand to people who otherwise would never consider having families, would never be able to have families. For example, we’ve already seen an explosion of care being able to be given to LGBTQIA+ patients. Whether they have a partner of the same sex, of a different sex, someone who has transitioned, whatever it may be, we’re expanding more and more our ability to get good care to those patients, to get them what they need, and to do it in an inclusive environment where they don’t feel like they’re the odd person out.
I think the other area that’s going to continue to transform is the genetic testing that’s being done. Where we started with just PGT-A, being able to see if you have 46 chromosomes, no more and no less, male and female, and then PGT-M with single gene mutations like Tay-Sachs, cystic fibrosis, and sickle cell anemia. Now it’s expanding further out, so you have the structural mutations for people who carry translocations. You have PGT-P for people who carry these polygenic traits that are not a real easy to identify one gene and therefore you have a problem and therefore we avoid that embryo. We look more at the folks who have maybe a handful of embryos, for those who are fortunate enough for that. Say you have a nasty family history of diabetes, these embryos are more prone to that, so maybe we don’t transfer those first, maybe we transfer these other ones first, and help to shape some of those discussions going forward so that some of the big known problems we can avoid from the beginning rather than having to scramble into treatment, which depends a lot on what’s your insurance, what’s your access, what’s your health literacy level. I think that’s going to continue to rapidly evolve. It’s already rapidly evolving, but I think it’s going to continue to just be a rollercoaster that goes a hundred miles an hour at improving those capabilities.
Dr. Aimee: I’m glad you brought up PGT-P, because I think a lot of patients aren’t offered it. I feel like you can’t give informed consent about genetic screening of your embryos unless you know what all of your options are. So many patients are told about just standard PGT-A. I’m one of the only doctors in Northern California that offers PGT-P. The fact that you brought it up is huge, including in your book, which is really helpful so patients can then advocate for it. If they aren’t able to get it at the clinic that they’re going to, then they can find another option. Once your embryos are biopsied, I get patients who come to me and say, “I want to do PGT-P on my previously biopsied embryos,” and I don’t want to do double biopsies just for PGT-P, ideally. Thank you for bringing that up and bringing awareness to that.
When you think about the book reaching both patients and doctors, what is the key message you hope each group takes away?
Dr. Abby Eblen: For doctors, we want them to know that we want to put this information out to help them. We don’t want them to feel that we’re trying to supersede what they’re telling the patient. We make a couple of points in the book to say there’s more than one way to do this. If your doctor does something different than what we’ve mentioned, just ask your doctor. I’m sure they have a good reason for that. We really want it to be helpful for physicians. Actually, for family members as well. Instead of a patient having to go to a family member and explain all the details of IVF, they can just say look at this chapter to read about this.
For patients, the same. We just want patients to be able at any stage in their journey, whether they’re starting out thinking about doing IVF, whether they’re right in the middle of it, or after they’ve already finished and they’re still thinking about their FET, their frozen embryo transfer, we want them to be able to jump around in the book without having to read the whole book. It really is something that will be a reference for them when they come in for each of their visits, or afterward, after IVF is even over with.
Dr. Susan Hudson: We very intentionally thought of both physicians and patients when we wrote this book, to make sure that it was going to be more of a help than a hindrance. None of us wanted to go to our national meeting and somebody throw our book at us. We also recognize that there is a lot of noise out there. Just because it’s loud does not mean that the information is accurate. We wanted to give good, strong, reliable information to those who are seeking it.
Dr. Aimee: Can you please tell us where people can find you if they would like to work with you?
Dr. Carrie Bedient: I’m Dr. Carrie Bedient, and I’m the one in fabulous Las Vegas, at The Fertility Center of Las Vegas. Our website, we do a lot of remote telemedicine consults, we see patients from all over the world. If anyone wants to find my little component of that world, that’s where you find me.
Dr. Abby Eblen: I’m in Nashville, Tennessee. I’m not on Broadway, that’s the place when people come to Nashville where they mostly want to go, but I’m not very far from there. We are always accepting new patients. Certainly, you can go onto our website and we would love to see you.
Dr. Susan Hudson: I am at Texas Fertility Center. I actually have two locations. One is in New Braunfels, Texas, which is right in between San Antonio and Austin. My other location is in Corpus Christi, Texas, which is on the Texas coast. I also do a lot of telemedicine and see patients from all over.
Dr. Aimee: Love it. Where can listeners find your book? Carrie, were you going to add something?
Dr. Carrie Bedient: I was going to add for the podcast, The Fertility Docs Uncensored, you can go to FertilityDocsUncensored.com. That website will give you information on locating the podcast, which you can find at all the normal podcast locales, such as Apple Podcasts, Spotify, all those usual places. That website will also give you links directly to the book, which you can either go through to find there or you can look at Amazon, Barnes and Noble, Bookshop.org, any of the places that you would normally go to buy books. We’re on the Target website as well. We’re all over the place, so if you just type in “The IVF Blueprint book” you should be able to find it one way or the other.
Dr. Susan Hudson: The book is available in hardback, audiobook, and ebook.
Dr. Aimee: Excellent. Is there anything else that you would like to add today?
Dr. Carrie Bedient: More than anything, we hope patients take hope out of this, that they can understand this, that this journey is possible, that they will make it through to the end, and that there is a huge team of people on their side rooting for them. Not just their own family and their own clinic, but the IVF world in general is full of very good cheerleaders. We all have that experience of being out in the world and somebody figures out what we do, and they say, “Oh, I’m in the midst of my IVF cycle,” or, “I had two babies from retrievals,” or what have you. It’s pretty much always a cheerleading type of response of I’m so happy for you, I’m so glad that happened, I’m sorry you’re going through a struggle right now. There is hope and there is support for everybody. We hope more than anything that people take that away from our book and the technical information that we’re trying to provide in a bite-size fashion.
Dr. Aimee: I always wanted to be a cheerleader. True story. Every year in high school, I tried out. I never made the cheer team. I’m making up for that. The only thing I don’t wear is a tiny little skirt, but I feel like I’m waving pom-poms every single day.
Thank you so much, Dr. Abby Eblen, Dr. Carrie Bedient, and Dr. Susan Hudson, for sharing your insights today. I can’t wait for our listeners to read The IVF Blueprint. It truly is such an incredible resource for anyone navigating IVF, or your friends and family members, they should get a copy, too, so that they know what you’re going through.
If you enjoyed this episode, make sure to subscribe to The Egg Whisperer Show on YouTube, Spotify, or Apple Podcasts so you never miss a conversation like this. Thank you all for joining. Keep sparkling. Keep asking questions and learning because, remember, the more you know, the better it will go.
