Episode 59: Dr Cindy M Duke
I can’t get pregnant. Now what?
In this episode, we cover:
🔹Your actual chances of getting pregnant each month
🔹Dr Cindy’s key tips for conceiving
🔹Why you shouldn’t have sex every day, even when ovulating
🔹Does having sex twice in one hour TRIPLE your chance of conceiving?
🔹Why you may be miscalculating your ovulation window
🔹What you cook with and store food in matters
🔹Being careful about cosmetic ingredients
🔹The importance of vitamin D
🔹Does fertility really drop off a cliff after age 35?
🔹What happens when you go to a doctor for fertility help
🔹Tests and options you may be offered
🔹The difference between IUI and IVF
🔹How long it takes for semen to form
🔹Getting COVID while pregnant
🔹Counseling vaccine-hesitant patients
🔹How has pandemic-life changed the infertility experience?
‘For some people, the pandemic brought a sense of urgency for family building’
Dr Cindy Duke - ‘America’s Only Dual Fertility Expert & Virologist’
Dr Cindy Duke knows how to improve your chances of getting pregnant.
Even if the idea of becoming a parent is a ‘one day’ goal, you’ll benefit from the knowledge in this episode. After all, even a healthy fertile woman has only around a one in five chance of conceiving each month.
By age 25, Dr Cindy told me, “your chance is about 22%.” By 35 that drops to around 10% and by 40 a dramatic plummet to 2% each month.
As the founding physician and director of the Nevada Fertility Institute in Las Vegas, Dr Cindy spends a lot of time helping patients become parents; with and without assisted reproductive technologies.
With everyone she meets, the initial conversations revolve around lifestyle factors and making adjustments that might help with achieving a pregnancy; increasing or decreasing bodyweight, getting enough sleep and coming off any fad diets - especially ones that cut out healthy fats.
“The truth is, our hormones are built on fat. In fact, estrogen, progesterone, testosterone - all of those key hormones that are important for reproduction actually are formed from cholesterol,” she told me.
From a fertility health perspective, what you prepare your food in could be just as important as the food itself. Dr Cindy makes her patients aware that “plastic shiny, non-stick coated pots” are ones to avoid because of potential endocrine disrupting compounds.
She prefers cast iron, stainless steel or enamel cookware instead.
“It’s not cooking once that's the problem. It's if you're using these things long-term… you could be systematically repeatedly exposing yourself to small doses of toxins, which our bodies don't usually know how to dispose of. And so it just stores them and sequesters them in our reproductive organs, our hormonal system, and that can disrupt a lot of our messaging.”
“We do need to be more conscientious about what we use, what we put on our bodies,” Dr Cindy told me
Products you put on your skin fall into the same category of vigilance.
“We’re definitely concerned about certain toxins - including hidden toxins - because not every cosmetic company is fully transparent about the ingredients,” she told me.
Phthalates and parabens are among the most concerning to Dr Cindy.
“We have more and more studies that show if someone would actually reduce their exposure to many of these chemicals, they can improve the overall response of their eggs and the quality of their eggs, and even their sperm.”
Watch/listen to episode 59 to hear about one of Dr Cindy’s patients who experienced shocking results after quitting certain cosmetic chemicals and products.
“Whether you're planning to reproduce right now or not, I think we do need to be more conscientious about what we use, what we put on our bodies. Recognize [that] anything that you rub onto your skin is likely being absorbed into your body and once it gets into your body, then your body would do what your body does, which is going to try to break it down. If it can't break it down, then it tries to sequester it somewhere.”
But Dr Cindy reminds those trying to conceive there’s no need to get obsessed about toxins, instead “just make it more of a daily conscientious habit,” she said.
With heterosexual couples “50% of the time, if they're struggling to conceive, it involves something going on with the sperm”
Along with lifestyle factors, nail your timing. You’ve probably seen movies where a woman is tracking her menstrual cycle to see when she ovulates (her most fertile window) in order to make the most of intercourse in the surrounding days.
Some people “think they need to have sex every hour, every couple of hours, every day around the time of ovulation,” Dr Cindy told me. “It's too often, too frequent. While the partner may be ejaculating, it's not enough sperm. So we talk more about spacing it out every other day.”
If you’re worried that’s too infrequent and you might miss the window, “ejaculated sperm can hang around in the reproductive tract for up to five days,” said Dr Cindy.
Watch/listen to episode 59 to hear about the ovulation calculation mistake you might be making. Plus, how medication and intrauterine insemination (IUI) can help achieve pregnancy.
There's the importance of getting a sperm test too. With heterosexual couples “50% of the time, if they're struggling to conceive, it involves something going on with the sperm.”
“The majority of people who conceive from fertility treatments are not conceiving from IVF,” Dr Cindy told me.
Then there’s in vitro fertilization (IVF).
“The majority of people who conceive from fertility treatments are not conceiving from IVF,” Dr Cindy told me.
This surprised me. The term IVF is so recognizable I had assumed its results were more widespread. But "it only counts for maybe five to 10% of our total patient population and treatment,” she said.
Its impact is significant though. Remember those women aged 40 with around a 2% chance of getting pregnant naturally?
“With [IUI] insemination, we'll probably be able to pull it up to six to 8% chance. With in vitro [IVF] at age 40, if we put in one or two fertilized eggs - we're talking about [a] chance of pregnancy [of] 40, 45%, even 50 plus percent.”
IVF could push the chance of pregnancy in a 40-year-old from around 2% to above 50%, according to Dr Cindy
Known to her fans and followers as ‘America’s Only Dual Fertility Expert & Virologist’ - I was keen to get Dr Cindy’s view of the pandemic’s effect on the infertility experience.
For some, it “brought a sense of urgency for family building,” she told me. For others, “we know that a number of relationships have ended.”
“At the peak, the height of the pandemic… many people opted to create their embryos and freeze them until they knew more.”
There were patients who “have historically had infertility and continue to struggle, but also were scared about the unknowns,” she said. Unknowns like; the potential risk of birth defects.
Now enough time has passed since the pandemic began, Dr Cindy is confident catching COVID-19 during pregnancy does not lead to birth defects. But the disease “can have some really bad and adverse effects” which is why she recommends her pregnant and trying-to-conceive patients get vaccinated.
“It protects you, it protects your baby,” she told me. “But if you ultimately chose to take the risk and not get the vaccine, then you should definitely make sure you're wearing your mask, washing your hands, minimizing your exposure, and make sure as many people around you as possible get vaccinated.“
Follow Dr Cindy on Instagram and Twitter.
See her website.
Common sense caution: Not personal or medical advice. You know the score - always talk to your own health provider about your concerns.👌
Thank you to the sponsors of this episode: GlycanAge. See my review of the biological age test with money off here.