Taco Bout Fertility Tuesday

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Progesterone-in-oil shots, also known as PIO shots, are one of the most feared and hated parts of IVF. They are uncomfortable, intimidating, and often leave patients wondering: “Do I really need this, or is my fertility doctor just being cruel?”

In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explains why progesterone matters for implantation, how estrogen and progesterone work together to prepare the uterine lining, and why the type of embryo transfer cycle changes everything.

The key question is not simply whether progesterone shots are better than vaginal progesterone. The real question is whether your body is making progesterone on its own.

Dr. Amols breaks down the difference between ovulatory or modified natural frozen embryo transfers and programmed frozen embryo transfers. In an ovulatory cycle, the body forms a corpus luteum and produces progesterone naturally. In a programmed cycle, there is no ovulation, no corpus luteum, and therefore no natural progesterone production — meaning all progesterone support must come from medication.

This episode also reviews the research comparing daily progesterone-in-oil shots, vaginal progesterone alone, and combination protocols using vaginal progesterone plus intermittent PIO injections. The data shows why vaginal progesterone alone may not be enough in programmed frozen embryo transfer cycles and why many clinics still rely on PIO for reliable progesterone support.

Dr. Amols also discusses progesterone blood levels, why levels can be hard to interpret with vaginal progesterone, why clinics may differ in their protocols, and how some patients may be candidates for fewer injections or modified natural cycles.

If you are preparing for an embryo transfer, taking progesterone, or wondering why your clinic recommends PIO shots, this episode will help you understand the science behind the shot — and hopefully hate your doctor a little less.

The bottom line: fertility doctors are not sadists. Progesterone-in-oil may be a literal pain in the butt, but in some embryo transfer cycles, it has an important purpose.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

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Can your embryo fall out after an embryo transfer? Do you really need bed rest after IVF? Can walking, peeing, coughing, laughing, going up stairs, having stress, or riding home in the car ruin your chances?

In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols breaks down one of the most common fears patients have after embryo transfer: whether one wrong move can prevent implantation.

We discuss where the bed rest myth came from, why the uterus is not an open space where an embryo can simply “fall out,” and what the evidence actually says about bed rest after embryo transfer. Dr. Amols also explains why normal movement is okay, why peeing after transfer is not a problem, and why patients should not spend the two-week wait blaming themselves for every sneeze, step, or bump in the car.

This episode also covers the difference between fresh and frozen embryo transfers, why activity restrictions after a fresh transfer may be more about enlarged ovaries than the embryo itself, whether retroverted uteruses change the equation, and why clinic instructions can vary.

And yes, we also talk about McDonald’s French fries after embryo transfer — because no IVF superstition is safe on this podcast.

If you are preparing for an embryo transfer, recovering from one, or stuck in the two-week wait replaying everything you did, this episode will help separate fear from fact.

In this episode, we cover:

•  Can an embryo fall out after embryo transfer? 
•  Does bed rest improve IVF success? 
•  Is it okay to pee after embryo transfer? 
•  Can walking, coughing, sneezing, laughing, or stairs hurt implantation? 
•  Fresh vs frozen embryo transfer activity restrictions 
•  Retroverted uterus and embryo transfer positioning 
•  Sex after embryo transfer 
•  Stress during the two-week wait 
•  McDonald’s French fries and IVF superstitions 
•  Why patients should stop blaming themselves after transfer 

The takeaway: after embryo transfer, take care of yourself — but you do not need to treat yourself like a porcelain doll. Rest if you want to rest, not because your embryo needs you perfectly still.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

Fertility advice can be wrong even when the person giving it meant well. In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explores how reassurance, incomplete evaluations, and well-intentioned attempts to “save money” can sometimes delay the fertility care patients actually need.

This episode looks at the emotional stress patients feel when they realize they may have lost time, the difference between bad intentions and bad outcomes, and why advice like “just keep trying,” “your labs are normal,” or “at least you can get pregnant” can sometimes miss the bigger picture.

Dr. Amols also discusses when OB/GYNs can appropriately help with fertility concerns, when referral to a fertility specialist matters, and why good advice should include a reason, a timeline, a next step, and a point where the plan changes.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

A semen analysis is one of the most important fertility tests, but for many patients, it is also one of the most awkward. In this episode, Dr. Mark Amols walks through what to expect at a semen analysis appointment, how to prepare, what happens during collection, and why this test gives fertility clinics such valuable information.

In this episode of Taco Bout Fertility Tuesday, Dr. Amols explains why semen analysis is not a masculinity test, but simply a lab test that helps guide fertility treatment. He covers abstinence timing, at-home versus in-office collection, what to do if part of the sample is missed, why timing matters, and what the lab is looking for when evaluating sperm count, motility, morphology, volume, and total motile sperm count.

He also discusses why one abnormal semen analysis does not automatically mean infertility, when repeat testing may be needed, how testosterone can affect sperm production, and what the next steps may be if the results are abnormal.

Whether you are preparing for your first semen analysis or supporting a partner through fertility testing, this episode helps make the process less intimidating, less confusing, and maybe just a little less awkward.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

Fertility misinformation on Instagram and social media can make patients feel like their doctor missed something important. In this episode, Dr. Mark Amols breaks down fertility fear-mongering, IVF myths, unnecessary fertility testing, and how scary medical advice can turn real concerns into panic.

In this episode of Taco Bout Fertility Tuesday, Dr. Amols explains how patients can tell the difference between helpful fertility education and fear-based marketing. He discusses common examples involving “normal” fertility test results, genetic carrier screening, donor sperm, PGT-A, Down syndrome risk, failed embryo transfers, immune testing, endometriosis, low AMH, fibroids, uterine polyps, sperm DNA fragmentation, and second opinions. The goal is to help fertility patients ask better questions without being scared into unnecessary testing or treatment.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

PCOS has officially been renamed PMOS, or Polyendocrine Metabolic Ovarian Syndrome — but does the new name actually change the way patients are diagnosed and treated?

In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explains why polycystic ovary syndrome was always a misleading name, how PCOS got its name from the historic Stein-Leventhal description, and why the “cysts” in PCOS are usually follicles rather than true ovarian cysts. He breaks down why the new name, PMOS, better reflects the real condition: a lifelong endocrine and metabolic disorder involving insulin resistance, androgen excess, ovulatory dysfunction, diabetes risk, cholesterol, blood pressure, endometrial cancer risk, sleep apnea, fertility, and long-term health.

Dr. Amols also discusses whether this name change is a true medical breakthrough or simply a rebranding of PCOS. While the diagnostic criteria have not dramatically changed, the hope is that the new name will push the medical community to stop treating PCOS as only a fertility problem and start managing it as a full-body metabolic disorder.

If you have PCOS, PMOS, irregular periods, insulin resistance, elevated testosterone, acne, hirsutism, difficulty losing weight, or fertility concerns, this episode explains what the name change means — and what better care should actually look like.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

AMH is one of the most misunderstood fertility blood tests. Many patients hear that their AMH is low and immediately worry that they cannot get pregnant, that their eggs are bad, or that menopause is right around the corner. But AMH does not tell the whole fertility story.

In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explains what AMH really measures and what it does not. AMH is a marker of ovarian reserve and helps predict how many eggs someone may make during fertility treatment, especially IVF stimulation. But it does not directly predict whether someone can get pregnant naturally, whether their eggs are genetically normal, or whether the next egg they ovulate can become a baby.

Using simple analogies like a basketball player’s vertical jump, egg contests, and ovarian reserve as a “toolbox test,” this episode breaks down the difference between egg quantity and egg quality, why low AMH does not mean infertility, why high AMH does not guarantee pregnancy, and how AMH may give some clues about ovarian aging and menopause timing.

If you or someone you know has been told they have a low AMH, this episode will help explain why AMH is important information — but not a fertility verdict.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols breaks down new research on male obesity and fertility and explains why a man’s weight may matter more in IVF than many people realize. This study looked at donor egg ICSI cycles and found that male obesity was associated with delayed early embryo development, lower inner cell mass quality, and a higher miscarriage rate, even though fertilization, blastocyst development, implantation, and clinical pregnancy rates were fairly similar across groups. 

Dr. Amols explains what this means in plain English for patients and clinicians, why a normal semen analysis does not always tell the whole story, how sperm health may affect embryo development after fertilization, and why fertility should be viewed as a couple’s issue, not just a female issue. If you want to understand the connection between male BMI, sperm quality, IVF outcomes, embryo development, and miscarriage risk, this episode breaks it down in a way that is clear, practical, and evidence-based. 

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

Many patients assume that if they have gotten pregnant naturally before, IVF should be simple. But IVF and natural conception are not the same process.

In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explains why IVF is incredibly powerful, but still cannot perfectly duplicate every hidden filter, timing system, and biological checkpoint that happens inside the body. From sperm selection and fertilization to fallopian tube transport, embryo transfer timing, uterine receptivity, egg recruitment, and embryo grading, IVF can reveal parts of reproduction that nature usually keeps hidden.

This episode explores why someone may have children naturally but still struggle with fertilization, embryo development, or implantation during IVF. It also explains why a failed IVF cycle does not mean failure — it may provide valuable clues that help guide the next step.

IVF is not worse than nature. Nature is not better than IVF. They are different routes toward the same goal. And sometimes in fertility, the route matters.

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

Send us Fan Mail

Why can two embryos both be genetically normal, both be labeled AA, and even be tested by the same genetics company… yet still have very different chances of leading to pregnancy?

In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols breaks down one of the biggest misunderstandings in IVF: the idea that “normal” means “equal.” He explains what PGT-A really tells us, why embryo grading is useful but limited, and how two embryos with the same label can still have very different biologic potential. He also dives into why IVF lab quality matters so much — from culture conditions and air handling to biopsy skill, freezing, thawing, and transfer technique.

If you have ever wondered why one euploid embryo works while another does not, or why some clinics may have better outcomes than others, this episode helps make sense of it all in a clear, patient-friendly way. 

Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols.

If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen.

Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes.

Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.