What really happens to your eggs once they leave the operating room? And how much does the embryology lab actually impact IVF success?

In this episode, Dr. Sasha Hakman sits down with Shaun Reed, an experienced embryologist from Utah Fertility Center, to break down one of the most misunderstood parts of the fertility journey: the IVF lab. From egg retrieval to embryo transfer, Shaun walks through what happens behind the scenes, why it matters, and what patients should actually care about.

You’ll learn what a day in the life of an embryologist looks like, how labs protect eggs and embryos through strict quality control, and why temperature and pH are critical at every step. Shaun explains how eggs are identified and handled, and the debate around when to strip eggs during the IVF process.

We also dive into conventional insemination vs ICSI, why most clinics now use ICSI, and how embryologists manually select sperm under a microscope. Shaun shares insights on sperm processing technologies like Zymot, incubation methods including time lapse systems, and what truly impacts embryo development.

A major focus of this episode is embryo grading. Shaun explains why grades like AA vs BB are more subjective than patients think, and why even lower graded embryos can still lead to successful pregnancies. We also discuss zero PN embryos and why many still result in normal, healthy outcomes.

Finally, we explore the future of IVF, including AI in embryo selection, PGT biopsy, and popular lab add ons. Shaun shares what is worth it, what is not, and why the embryology lab may be one of the most important factors in IVF success.

This episode is essential for anyone going through IVF, considering egg freezing, or wanting a deeper understanding of what happens to their eggs and embryos behind the scenes.

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Follow Shaun Reed on Instagram: @shaun.ology

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Could your PCOS diagnosis actually be something else?

In this episode of the Trying to Conceive Podcast, Dr. Sasha Hakman breaks down polycystic ovary syndrome (PCOS), one of the most common and misunderstood hormonal conditions affecting fertility. She also shares her personal experience of believing she had PCOS for years before discovering through expanded genetic testing that she actually had non-classical congenital adrenal hyperplasia (NCCAH), a condition that can closely mimic PCOS but requires different treatment.

Dr. Hakman explains what PCOS really is, why it has nothing to do with ovarian cysts, and how it is properly diagnosed using the Rotterdam criteria. She also walks through the essential lab work needed to rule out other hormonal conditions, including thyroid disorders, elevated prolactin, adrenal disorders, and testosterone producing tumors. You will also learn why testing 17-hydroxyprogesterone is a critical step that is often missed.

The episode explores how insulin resistance and elevated androgens drive many PCOS symptoms such as irregular periods, infertility, acne, and unwanted hair growth. Dr. Hakman also discusses the long term health risks associated with PCOS, including type 2 diabetes, metabolic syndrome, cardiovascular disease, and endometrial cancer.

Finally, she covers evidence based treatment strategies, from lifestyle changes like nutrition and resistance training to medications and fertility treatments such as Letrozole.

Whether you have been diagnosed with PCOS, suspect you might have it, or want to better understand hormonal and metabolic health, this episode provides a clear and practical guide to navigating this complex condition.

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How do you know if the prenatal vitamin you're taking actually contains what it claims? And why do some supplements promise everything but deliver almost nothing?

In this episode, Dr. Sasha Hakman sits down with Sam Diamond, co-founder of Bird & Be to pull back the curtain on the supplement industry. From sourcing ingredients to third party testing, manufacturing challenges, and regulatory differences between the US and Canada, this conversation reveals what most brands don't want you to know.

Sam Diamond shares her personal journey navigating PCOS and pregnancy loss, and how working with fertility naturopaths opened her eyes to the power of integrative care. That experience led her to co-create a line of supplements built on evidence, transparency, and real clinical input from reproductive endocrinologists and naturopathic doctors.

We discuss why not all prenatals are created equal, the truth about folic acid versus methylated folate, how to spot misleading labels like proprietary blends, and why elemental dosing matters more than you think. Sam also explains the science behind inositol for PCOS and insulin resistance, the 40 to 1 ratio that actually works, and why combining it with medications like Metformin or Letrozole may improve outcomes.

You'll learn what third party testing really means, how heavy metals end up in supplements, why some ingredients like choline are nearly impossible to dose correctly in a capsule, and what certifications like Clean Label and NSF actually verify. We also talk about why Canada's pre-market licensing system offers stronger consumer protection than the FDA's supplement regulations, and how that impacts product quality and safety.

If you've ever wondered whether your prenatal is safe, effective, or worth the money, this episode will give you the tools to evaluate any supplement with confidence. Sam breaks down what to look for on a label, what red flags to avoid, and why the best prenatal is always the one you'll actually take.

This is essential listening for anyone trying to conceive, currently pregnant, or simply wanting to make informed decisions about reproductive health.

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Follow Bird & Be Co at https://birdandbe.com/ and on Instagram @birdbeco

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If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every 2 weeks.

If you're interested in becoming a patient go to sashahakmanmd.com to learn more!

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How many follicles are too many for an IUI? When should you move on to IVF? And is IUI ever a waste of time?

In this episode, Dr. Sasha Hakman sits down with Dr. Blake Evans, a reproductive endocrinologist and researcher whose groundbreaking studies on ovarian stimulation and IUI have changed the way fertility specialists counsel patients every day.

Dr. Evans breaks down his widely cited research on follicle count, multiples risk, and pregnancy rates across different age groups. He explains why singleton pregnancy rates stay the same whether you have one, two, three, or even five follicles, and why the only thing that increases with more follicles is the risk of multiples, especially in women under 38.

We discuss the real risks of twin and triplet pregnancies, including preterm delivery, NICU stays, maternal complications, and the financial burden that can far exceed the cost of IVF itself. Dr. Evans also shares his second major study showing that patients can still conceive after multiple IUI cycles, with cumulative pregnancy rates reaching over 70% by cycle eight, though he emphasizes this does not mean it is the most efficient or cost effective path.

This conversation is packed with practical takeaways for both patients and providers navigating unexplained infertility, insurance limitations, and the decision between continuing IUI or moving to IVF. Dr. Evans also shares candid insights on the Femeseed device, fresh transfers in IVF, and how geography and insurance coverage shape treatment decisions.

If you are trying to decide how many IUI cycles to do, whether to cancel a cycle due to too many follicles, or if IVF is worth the investment, this episode will give you the data and clarity you need to move forward with confidence.

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Follow Dr. Blake Evans on Instagram: @dr.blakeevans

Follow me!

TikTok: @sashahakmanmd

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If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every 2 weeks.

If you're interested in becoming a patient go to sashahakmanmd.com to learn more!

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I finally share something I know so many of you have been waiting for.

My embryo transfer failed.

In this episode, I walk you through what happened, what I felt as both a fertility doctor and a patient, and the real reasons embryo transfers sometimes do not work even when everything looks perfect.

We talk about the science behind failed implantation, what recurrent implantation failure actually means, and at what point you should start asking deeper questions about your IVF journey.

One of the biggest misconceptions is that a chromosomally normal embryo should always work. The reality is more nuanced. Even strong embryos may not implant due to embryo competency, metabolic health, uterine factors, or variables we still do not fully understand.

I explain the most common causes of failed embryo transfer including chromosomal abnormalities, embryo quality beyond genetics, uterine environment, inflammation, endometriosis, and metabolic health. We also discuss what testing is useful, what testing is controversial, and when additional investigation makes sense.

If you have experienced one or two failed transfers, this episode is meant to ground you in data and help you avoid spiraling. If you are facing recurrent implantation failure, I break down what that diagnosis means and what next steps may look like.

I also share my personal protocol, what I am changing for the next transfer, and how I am thinking about resilience in this process.

Fertility is one of the few areas in life where doing the same thing again can lead to a different outcome. That does not make it easy, but it does mean there is still reason for hope.

If you are preparing for an embryo transfer, navigating IVF, or coping with a failed cycle, this episode will help you understand the science, the decisions, and the emotional reality behind what happens next.

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Topics covered:

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If this resonated with you, please subscribe, leave a review, and share with someone navigating their own fertility journey.

Follow me!

TikTok: @sashahakmanmd

Instagram: @sashahakmanmd @tryingtoconceivepod

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Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter to receive updates, answers to Q&A and more!

If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every week.

If you're interested in becoming a patient go to sashahakmanmd.com to learn more!

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What if your fertility struggles are not just bad luck?

In this episode, I sit down with Dr Natalie Crawford to unpack one of the most overlooked drivers of infertility… chronic inflammation.

We talk about why so many women are told to “just try for 12 months” before testing, why sperm counts have dropped dramatically over the last 50 years, and how inflammation quietly interferes with ovulation, egg quality, sperm health, implantation and even IVF outcomes  .

Dr Crawford shares her personal story of experiencing multiple pregnancy losses while training as a fertility specialist and how digging into the research on inflammation changed everything for her. From discovering a short luteal phase to eventually being diagnosed with celiac disease, she explains how lifestyle changes and reducing inflammatory burden impacted her own fertility journey  .

If you are doing everything “right” but still not getting pregnant, this episode will give you a deeper understanding of what may be happening at the cellular level and how to proactively support your reproductive health.

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We cover:

• How chronic inflammation disrupts the brain to ovary communication pathway

• The connection between stress, cortisol and insulin resistance

• Why egg quality is not only about age

• How skeletal muscle improves insulin sensitivity and fertility

• Why sleep is foundational for hormone balance

• The gut microbiome, estrogen metabolism and intestinal permeability

• Red meat, ultra processed foods and IVF outcomes

• Environmental toxins and endocrine disruptors in daily life

• What to optimize 90 days before IVF

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Fertility is not just about biology. It is a health marker.

And you deserve to understand how your daily choices add up.

If you found this helpful, make sure to subscribe, leave a review, and share with someone who is trying to conceive.

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Gestational surrogacy can be one of the most powerful—and misunderstood—paths to building a family. In this episode of Trying to Conceive, Dr. Sasha Hakman sits down with her partner and colleague, Dr. Shahin Ghadir, a double board-certified reproductive endocrinologist with nearly 20 years of experience in third-party reproduction.

Together, they break down the essentials of gestational surrogacy, including key definitions, who typically needs a surrogate, how the matching and screening process works, and why legal protections are critical. Dr. Ghadir shares insights into embryo transfer protocols, timelines, costs, and why California is one of the safest places in the world to pursue surrogacy.

They also explore the emotional and ethical realities intended parents often don’t anticipate—from boundaries with gestational carriers to single vs. double embryo transfer—and share real-world stories from clinical practice. This episode offers expert guidance and clarity for anyone considering surrogacy or wanting to better understand the process.

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In this solo Q&A episode, Dr. Sasha Hakman answers your most common and complex fertility questions with clarity and nuance. She breaks down topics like chronic endometritis and transfer timing, reasons for low egg maturity and fertilization rates, day 7 PGT-normal embryos, and what “normal” HCG rises really look like. Dr. Hakman also shares guidance on natural vs. programmed FETs, exercising during IVF and transfers, protocols for low AMH and diminished ovarian reserve, vaginal microbiome testing, and when to pursue fertility evaluation—even after having children. This episode is packed with practical insights to help you make informed, confident decisions throughout your fertility journey.

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Trying with Dr. Sasha Hakman is a women's health podcast hosted by a reproductive endocrinologist, covering everything from fertility and IVF to perimenopause, endometriosis, and hormonal health, all in plain, evidence-based language. No jargon, no shame, just the answers you've been searching for.

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Should you delay IVF or egg freezing to improve egg quality—or could waiting actually hurt your chances? In this episode of Trying to Conceive, Dr. Sasha Hakman is joined by renowned reproductive endocrinologist Dr. Philip Romanski to break down what the science really says about timing fertility treatment. They explore ovarian reserve testing, egg quality myths, lifestyle and supplement considerations, and groundbreaking research showing that short delays in IVF—even for women with diminished ovarian reserve—do not negatively impact pregnancy outcomes. This episode offers practical, evidence-based guidance to help patients make confident, informed decisions about when to start treatment and how to optimize results.

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