Trying to Conceive with Dr. Sasha Hakman

If you've ever gone through a failed embryo transfer and wondered why , this episode is for you. Dr. Sasha sits down with Jeremy Grushcow, co-founder and CEO of Juniper Genomics, to break down a groundbreaking advancement in IVF: whole genome and transcriptome embryo testing. Jeremy holds a PhD in molecular genetics and cell biology from the University of Chicago, along with a law degree, and has published research in DNA repair, cancer, gene therapy, bioethics, and patent law. He's building the technology that could change the odds for IVF patients everywhere. In this episode, we cover: What whole genome sequencing (PPG) actually is — and why IVF has lagged behind every other field of clinical medicine in adopting it The brilliant "books on a shelf" analogy that finally makes PGT-A vs. whole genome sequencing click Why failed embryo transfers are not your fault, your doctor's fault, or your lab's fault — and what the embryo's genetics have to do with it What the transcriptome tells us that the genome alone can't The difference between PGT-A, PGT-M, and Juniper's PPG testing How Juniper looks at both the embryo and the parents' DNA to identify where variants are coming from (egg or sperm?) The 6,000+ known genetic diseases — and why 10–15% of embryos being transferred today carry a detectable single-gene disorder that standard carrier screening missed Why "reduced viability variants" matter and how they impact IVF success rates The emotional and financial cost of failed transfers — and how more information can reduce both Pricing breakdown: what PPG costs, how to make it more affordable, and how it stacks up against the cost of a failed transfer cycle Why patient autonomy in the US and Canada is driving better IVF outcomes globally Follow Dr Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingwithdrhakman YouTube: @sashahakmanmd Resources & Links: Juniper Genomics website: junipergenomics.com Instagram: ⁠@junipergenomics⁠ 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 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! If this episode helped you, the best thing you can do is subscribe, rate, review, and share it with a friend. So many women deserve this information, help get it to them. Episodes drop every Wednesday. Learn more about your ad choices. Visit megaphone.fm/adchoices

Are you being told to stop exercising while trying to conceive or going through IVF? You're not alone and according to today's guest, you're also likely being given advice that isn't backed by science. In this episode, Dr. Shannon joins us for a conversation that is equal parts empowering and eye-opening. As both a physical therapist and a patient who exercised throughout her own fertility journey, she brings a rare dual perspective to the table. She and host Dr. Sasha take on the pervasive fear around exercise during fertility treatment, break down why the "rest and raise your legs" mentality is outdated (and potentially harmful), and share a practical, research-backed framework for building and maintaining muscle at every stage of the journey. Whether you're in the thick of fertility treatments, newly pregnant, postpartum, or just trying to understand your body better, this episode is packed with actionable guidance and a refreshing dose of truth. In This Episode, You'll Learn: Why most doctors tell patients to stop exercising during IVF — and why there's no evidence behind it How months of exercise restriction can harm your long-term recovery and postpartum body The REPS Framework: the four principles that actually build muscle while TTC or pregnant What "training to failure" really means — and why it's safe even during fertility treatment Why you need to train near failure just to maintain the muscle you already have How to choose exercises that actually target the right muscles (and why combo moves fall short) Protein targets for TTC and pregnancy, and how to realistically hit them When HIIT is okay to keep during TTC — and when it may be hurting your chances How to safely return to exercise postpartum without setting yourself back One simple trick to improve your form without a personal trainer Follow Dr. Shannon@dr.shannon.dpt @evlofitness Follow Dr Sasha!TikTok: @sashahakmanmdInstagram: @sashahakmanmd @tryingtoconceivepodYouTube: @tryingtoconceivepod Resources Mentioned: Evlo App (Dr. Shannon's fitness app) — Use code DRSASHA for 6 weeks free (first 2-week trial + 1 month at $0) American College of Obstetricians and Gynecologists (ACOG) — exercise contraindications list available on their website 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 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! New episodes of Trying to Conceive with Dr. Sasha Hakman drop weekly. If this episode resonated with you, leave a review and share it with someone on their fertility journey. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this solo episode, Dr. Sasha goes deep on one of her most-requested topics: endocrine disrupting chemicals (EDCs). What they are, where they're hiding, how they affect your hormones and fertility, and exactly what you can do about it. As a reproductive endocrinologist and infertility specialist, she brings both clinical expertise and personal practice to this conversation. This episode is grounded in evidence-based research, including a 136-page scientific statement from the Endocrine Society, and is designed to inform, not alarm. In This Episode, You'll Learn: What the endocrine system is and why hormones are the body's "keys and locks" The definition of EDCs and why exposure is considered a global public health crisis Why even tiny exposures can have outsized health impacts (it's not always dose-dependent) The major classes of EDCs to know: BPA/bisphenols, phthalates, PFAS (forever chemicals), parabens, glyphosate, heavy metals, and triclosan and where each one hides The 4 mechanisms EDCs use to disrupt your hormones - including epigenetic modification that can be passed down through generations Why in utero exposure is the most critical window, and what effects have been linked to fetal EDC exposure (including hypospadias, cryptorchidism, diminished egg reserve, and premature ovarian insufficiency) How EDC exposure impacts puberty, fertility, and the TTC window specifically - including the finding that phthalate metabolites were detected in the follicular fluid of 99% of women undergoing egg retrieval The link between EDC exposure and sperm count decline (down 50% in 50 years, per Dr. Shanna Swan's research) Health risks in adulthood: endometriosis, PCOS/PEMOS, diminished ovarian reserve, thyroid dysfunction, breast cancer, prostate cancer, and more The Tier 1 vs. Tier 2 framework for prioritizing what to eliminate first Why "BPA-free" is a marketing gimmick and what to look for instead Why "unscented" ≠ fragrance-free - and what that means for your products Why fragrance is banned entirely in IVF embryology labs (and what that tells us) A study showing BPA urinary levels drop significantly after just 3 days of cutting out heated plastic Follow Dr Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingtoconceivepodYouTube: @tryingtoconceivepod 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 2 weeks. Thank you to our sponsors! Head to AirDoctorPro.com and use promo code DRSASHA to get $250 off select AirDoctor air purifiers. Head to cozyearth.com and use my code DRSASHA for an exclusive 20% discount. New episodes of Trying to Conceive with Dr. Sasha Hakman drop weekly. If this episode resonated with you, leave a review and share it with someone on their fertility journey. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Sasha Hakman is finally joined by her husband, Dr. Eryk Hakman. In this honest, funny, and surprisingly emotional episode, Sasha and Eryk sit down together for the first time to share the full story: how they met on labor and delivery, why Eryk almost didn't commit, and what it has really been like to navigate three rounds of IVF as a couple, including a failed embryo transfer that hit them both harder than either expected. Eryk opens up about feeling powerless in a process driven by his wife's expertise, what grief looked like from the partner's side, and what finally convinced him to say yes to baby number three. They wrap it all up with a fertility quiz that is equal parts educational and hilarious. In This Episode, You'll Learn: How Sasha and Eryk met during residency, why Eryk ghosted her, and the ultimatum that changed everything Why Sasha froze embryos early in their relationship and how it led to their first son, Remy What IVF felt like from Eryk's perspective as the non-REI doctor in the relationship The male side of fertility treatment: the semen collection experience, lifestyle changes, and feeling like a passenger How they conceived Rocky naturally after Sasha ovulated on her own for the first time post-IVF Why Eryk initially said they were done after two kids and what changed his mind Their decision to pursue gender selection for family balancing and what that process looked like The emotional weight of their failed embryo transfer: the biochemical pregnancy, the grief, and the delayed reaction Why Sasha chose a programmed cycle with progesterone in oil for the second transfer despite the pain and the disagreement it caused How two doctors with completely different approaches to data and uncertainty navigate fertility decisions together Eryk's fertility quiz results and the one lie Sasha told him about his own sperm Follow Dr Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingtoconceivepod YouTube: @tryingtoconceivepod 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 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Thank you to our sponsors: Go to aquatrue.com and use code DRSASHA for 20% off Go to bioptimizers.com and use code DRSASHA for 15% off Go to oneskin.co and use code DRSASHA for 15% off Learn more about your ad choices. Visit megaphone.fm/adchoices

Today, I’m breaking down one of the most misunderstood topics in women’s health: hormonal contraceptives. With so much misinformation online, it’s easy to feel confused or even scared about your options. As a reproductive endocrinologist, I want to give you the science-based facts so you can make informed decisions about your body and your future fertility. I walk you through the different types of hormonal birth control, including the pill, patch, ring, IUD, Depo shot, and implant. I explain how they actually work in your body, the real risks versus exaggerated claims you might see online, and the benefits that often get overlooked. We also dive into some of the biggest questions I get from patients and my community: Does birth control cause infertility? What happens when you stop the pill? Is there a link to cancer or blood clots? Can it affect your mood, gut health, or brain? Which option is best if you plan to conceive in the future? I also share my personal experience with birth control, how different formulations can affect you differently, and why there is no one-size-fits-all solution. Whether you’re currently on birth control, considering starting it, or planning to stop soon to try to conceive, this episode will give you clarity and confidence in your choices. Remember, knowledge is power when it comes to your reproductive health. Follow Dr Sasha!TikTok: @sashahakmanmdInstagram: @sashahakmanmd @tryingtoconceivepodYouTube: @tryingtoconceivepod 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 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices

I see this all the time. You’re doing everything right, your tests look “normal,” and yet… you’re still not getting pregnant. What if something is being missed? In this episode, I’m breaking down one of the most underdiagnosed and misunderstood conditions in fertility: endometriosis. I walk you through what endometriosis actually is, how it impacts your body, and more importantly, how it can affect your ability to conceive. From inflammation and egg quality to blocked tubes and implantation issues, this condition can interfere with fertility in ways most people don’t even realize. We also talk about why symptoms don’t always match severity. Some women have severe pain and no fertility issues, while others have zero symptoms and struggle to conceive. This is what makes endometriosis so difficult to diagnose and why so many cases go unnoticed. I dive into how we evaluate for endometriosis today, including updated guidelines that no longer require surgery for diagnosis, as well as newer testing options and imaging limitations. Then we get into the big questions: When should you suspect endometriosis? Should you consider surgery or avoid it? Does removing endometriosis actually improve fertility? When is it time to move to IUI or IVF? I also break down real clinical scenarios so you can understand how treatment decisions are made based on age, symptoms, ovarian reserve, and fertility goals. If you’ve been told you have “unexplained infertility,” or you suspect something deeper is going on, this episode will give you clarity on what might be happening and what your next steps could look like. Endometriosis is complex, but understanding it can completely change your fertility journey. _____ Follow Dr Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingtoconceivepod YouTube: @tryingtoconceivepod 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! Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices

Are you wasting money on fertility supplements that don’t actually help you get pregnant? In this solo episode, I break down the truth about fertility supplements, what is worth taking when you are trying to conceive, and what may be overhyped or unnecessary. There is so much conflicting information online, especially around prenatal vitamins, folic acid, and trending supplements, so I wanted to walk through this in a clear and evidence-based way. I share what I recommend starting with before pregnancy, including prenatal vitamins and key nutrients that support fertility and early fetal development. I also explain the controversy around folic acid vs methylfolate and MTHFR, and why this topic is often misunderstood. From there, I get into the most popular fertility supplements for egg quality and sperm quality, including CoQ10, omega-3s, vitamin D, melatonin, and antioxidants. I also talk through how age impacts egg quality, when supplements may actually make a difference, and why they should always be used alongside proper medical care and lifestyle support. I also touch on PCOS and why inositol can be a helpful supplement for improving insulin resistance and supporting ovulation in certain cases. If you are trying to conceive, preparing for pregnancy, navigating infertility, or doing IVF, this episode will help you better understand which fertility supplements may actually support your goals and which ones may not be worth your time or money. Follow along for more conversations on fertility, TTC, egg quality, PCOS, hormone health, prenatal nutrition, and pregnancy preparation. _____Follow Dr Sasha!TikTok: @sashahakmanmdInstagram: @sashahakmanmd @tryingtoconceivepodYouTube: @tryingtoconceivepodWant 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 2 weeks.If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Learn more about your ad choices. Visit megaphone.fm/adchoices

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. _____ Follow Shaun Reed on Instagram: @shaun.ology Follow Dr Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingtoconceivepod YouTube: @tryingtoconceivepod 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 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Learn more about your ad choices. Visit megaphone.fm/adchoices

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. _____ Follow Bird & Be Co at https://birdandbe.com/ and on Instagram @birdbeco Follow Dr Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingtoconceivepod YouTube: @tryingtoconceivepod 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 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Learn more about your ad choices. Visit megaphone.fm/adchoices

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. _____ Topics covered: Why embryo transfers fail Causes of implantation failure Chromosomal normal embryos that still do not work Recurrent implantation failure explained Uterine testing and controversial tests Metabolic health and IVF success Protocol changes after a failed transfer How to move forward after disappointment _____ 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 YouTube: @tryingtoconceivepod 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! Learn more about your ad choices. Visit megaphone.fm/adchoices

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. Learn more about your ad choices. Visit megaphone.fm/adchoices

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. Learn more about your ad choices. Visit megaphone.fm/adchoices

I’m excited to share my latest solo episode on maximizing natural fertility. In this episode, I cover how to understand your fertile window, the best ovulation-tracking methods, and what really matters for timing intercourse. I break down lifestyle strategies proven to support fertility—from nutrition and resistance training to essential supplements like folic acid and CoQ10. I also address environmental toxins, practical everyday swaps, and the importance of sleep, stress management, and mindful substance use. This episode gives you evidence-based, actionable steps to support your fertility and know when it’s time to seek professional guidance. Listen now to feel informed and empowered. Learn more about your ad choices. Visit megaphone.fm/adchoices