Transcript: EP 274 – Time’s Not Up: Infertility & IVF with Dr. Shahin Ghadir

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Dr. Taz: Hi everyone, and welcome to Super Women Wellness, I’m Dr. Taz. I’ve made it my mission throughout my career in integrative medicine to support women in restoring their health, using a blend of eastern medical wisdom with modern science. In this show, I will guide you through different practices to find your power type and fully embody the healthiest and most passionate version of you. I’m here for you and I can’t wait to get started. This is a Soulfire Production.

Dr. Taz: Welcome back everyone. Welcome back to another episode of Superwoman Wellness where I am determined to bring you back to your super-powered self. Today’s topic is something that I sit with so many women in our clinics about, and really try to help them understand their overall health, how to have a baby, what fertility means to them and oftentimes that journey leads down the path of needing a fertility expert.

Dr. Taz: There’s so much confusion in the field. There’s so many different thoughts. There’s even ovarian PRP, believe it or not. So we are going to break it all down today with Dr. Shahin Ghadir. He’s a compassionate and caring physician who has dedicated his career to helping people overcome their reproductive challenges. And we know how heartbreaking that can be. He really wants to help people have the family of their dreams for both traditional families and the LGBTQ community. He is currently positioned as a top physician for egg freezing sought out by women all over the world for his highly coveted procedures. He’s a founding partner of the Southern California Reproductive Center, and he’s a double board certified position in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. He’s been voted as one of the top doctors in the USA by LA magazines national poll, and Super Doctors of Southern California, along with all kinds of academic merits as well. Welcome to the show and thank you for joining us.

Dr. Shahin Ghadir.: Thank you so much. Thank you. Thank you, my pleasure.

Dr. Taz: Well this fertility journey, this is not a joke, right? This is something..

Dr. Shahin Ghadir.: No.

Dr. Taz: I had a big stamp on my charts. I didn’t have to do infertility treatments, but I had my first child at 34, my second one at 36, but all over my charts, it was AMA, AMA, advanced maternal age. So, I think women walk into this journey already feeling a little less than, no matter what the outcome is. And I have story after story of patients who’ve seen specialists and the worst one I’ve got to share was, “Well, you have no eggs”. She was 20 something. “You have no eggs. And I don’t even think a surrogate would work. So you might as well get a dog”. And this woman is just in my office crying hysterically. So we don’t want that experience for people. Tell me how you landed in the fertility world, what you’re seeing and kind of your general thoughts about what’s happening out there right now?

Dr. Shahin Ghadir.: Well, I was a resident in Obstetrics and Gynecology, and I was lucky enough to do a great rotation in a subspecialty of OBGYN called Reproductive Medicine. And I just fell in love. I realized very quickly that it not only gave that compassionate connection that you can have to an obstetrical patient, but it was a lot more. A lot more than that, meaning that I got to connect at a level that I really wanted to connect to people. For many areas of medicine, it’s just not for me. The lack of connection to patients treating them for a cough or a sore throat is not what I was looking for in medicine. I was in my undergraduate degree in UCLA in psychology and I really needed that human connection. So the field of fertility really allowed me to have that human connection to patients.

Dr. Shahin Ghadir.: And at the same time, it was just rapidly advancing, scientifically advanced. A lot of things involved with it that fit my personality really well. I’m always a believer that you need to find something in life that fits your personality, not just something you like, because it may not fit with your personality. So that was the key. And I started the fellowship program almost 20 years ago and I’ve been working for a little bit less than that. It gave me a really deep understanding and appreciation for life and for family and being given that gift of what I can do for people was huge, really, really, really, really huge. And to be really honest, I really appreciated that. And I really wanted to go out of my way to make sure that my clinic is at the top of their game. And so am I, and that’s what we’ve done over the last almost two decades.

Dr. Taz: That’s amazing. So talk to us about what you’re seeing in your clinic and what are women telling you? What’s their journey like and infertility in general? I have some theories as to what’s happening, but I’m so curious, kind of what you think as to what’s going on.

Dr. Shahin Ghadir.: The simplest theory out there, and it’s the truth, is that women are waiting until an older age to have their families. Everyone, wherever I go, when I ask the question, “When did your parents have you?”, the majority of people, their parents have them in their early twenties, when people are at the peak of their fertility, have not started that decline of 26, 27, 28 years of age. And as you can see in your story, people that also are these rapid decliners that even start earlier than that declining, that we’re not even aware of why. So that is, I think the number one thing and it was going to happen sooner or later. Women are as driven, as successful, as academic, as professional as men. And they are out in the workforce just like everyone else. But unfortunately it keeps them away from something that is on a time crunch, as you could say.

Dr. Taz: Not fair. Certainly not fair. So that brings IVF into the picture, right? Talk to us a little bit about IVF. Why does it work? Who’s the right candidate and what sort of your little twist on it? I know that you’ve perfected it and have a particular technique, bring that into the picture as well.

Dr. Shahin Ghadir.: So many of our patients are doing some aspect of IVF or IUI. So whether you’re freezing your eggs and you take the eggs out and they just get frozen there before they’re fertilized. So without the F of IVF, it’s basically the freezing of the egg, or once we have the eggs and then we’re fertilizing, it is the manner of treating a fertility patient that gives you the highest level of success, which in our clinic has hit months as high as like 84 to 86%. It is the most advanced ability to screen an embryo to make sure that your future child is as healthy as possible, weeding out genetic abnormalities, such as down syndrome or other things like that. And allowing you to preserve fertility in the future by keeping leftover embryos sitting there for you. So, you get the highest level of science, the deepest amounts of screening and all of this coming together to preserve you on the timeline that you want to be on, not what your body is telling you.

Dr. Taz: And then how long, when you do that, when we freeze eggs and do those things, how long do you have? What’s the age at which a woman needs to be, “Okay, got stuff sitting in the freezer back there, it’s time to take it out”. How long?

Dr. Shahin Ghadir.: That’s a really great question. And then the answer is kind of up to you. The American Society of Reproductive Medicine used to say 55. Now I’ve heard it’s gotten a little bit younger. However, I’ve had patients that were 48 years old and at excellent health and carried, then I had patients that were 45 years old and had diabetes, high blood pressure, obesity, that had to move on to having a surrogate carry those pregnancies for them. So I like to tell people, as long as you are very healthy and you are willing to take the risks of advanced maternal age while being pregnant, we can help you get pregnant.

Dr. Taz: Okay. Gotcha. And with IVF, are there things that women should be aware of? What are some of the common misconceptions out there that you hear as people are coming to your clinic?

Dr. Shahin Ghadir.: Really good question, because many smart women out there have these major preconceptions that if they do fertility treatment they’re going to get cancer in the future. Complete myth. The fertility medications have never been linked to any kind of cancer at all. We do not take all of your eggs out. So if you still want to get pregnant the natural way and try the natural way, you’re welcome to. We only take a cohort, a group of eggs that were going to die off that month. In the process of ovulation, there’s always about 1000 to 1500 eggs that die off in that process. We are trying to recoup and take those eggs and take a big chunk of them if we can. So we usually can get anywhere, 20, 30 eggs you’ve done really, really, really well. You are not going to go into an earlier menopause either. By us taking out a handful of eggs that were going to die off that month anyways, you are not going to run out of eggs and go into an earlier menopause.

Dr. Shahin Ghadir.: Also, timeline. Some people call me like, “I know this is going to take one year”, I’m like, “No, it’s not”. You can freeze your eggs and be done basically in about a 12 to 14 day process.

Dr. Taz: Really?

Dr. Shahin Ghadir.: And you, yes. That’s exactly how it is. And you can do IVF basically, and then go through the same procedure to get the eggs out. Then we have to give the embryos a week to grow. And then we wait for genetic testing results, which take another week, and then we can prepare the body within a month and put the embryo back. So basically a two month process is the fastest that can go.

Dr. Taz: Is there a cutoff at which you no longer harvest eggs? You no longer withdraw eggs? What’s sort of the cutoff there?

Dr. Shahin Ghadir.: There’s no cut off. I have had a 48 year old patient tell me that she’s willing to try. And I said, “If you are willing to try, I am happy to support you through this entire process. If you are aware that your chance of success, even if we are able to retrieve an egg, is under 1% and you agree to that, then I’m here to help you”. Some clinics have a cut off though, they don’t talk to you if you’re over 42.

Dr. Taz: Right.

Dr. Shahin Ghadir.: And I think that’s really sad because some of those patients that are 43 actually have gotten pregnant in our clinic. And some of them are 44 and 45 as well. Now, after that age, if they’re not getting pregnant, we have other options like egg donation and a lot of other things to help these patients. So we don’t really have a cookie cutter policy of closing people and leaving them out without treatment.

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Dr. Taz: So this brings me to the question I’ve been dying to ask. I’ve been hearing about ovarian PRP, there’s some doctors talking a lot about that, that we can regenerate our ovaries and maybe that sort of equalizes the race of fertility between men and women. What do you think of that?

Dr. Shahin Ghadir.: So we have had patients that have done it. I don’t encourage it because there is absolutely no literature out there in the real scientific world. So let’s talk about PRP. PRP is when they take aspects that are in your blood. They mix with different chemicals that are rejuvenating and then inject that into your ovary. There’s no research out there that has shown that this is beneficial right now. And I have had patients that did it, despite me giving them that data. And sadly, we saw no benefit from it.

Dr. Taz: I see research. Is there anything new in the research world of how we can equalize the biological clock of women and men, or there’s nothing new? Got nothing?

Dr. Shahin Ghadir.: There’s nothing. The female human being was made very different than the male human being. They’re on different timelines. They are on different levels and everything is totally different. Women got maybe a downside of the fertility world, but they have benefits from many other things. This is the way that human nature was made, unfortunately.

Dr. Taz: I didn’t have fertility issues, but if I had come in at 24, 25, hadn’t met the person I wanted to be with yet, didn’t look like a prospect, whatever, or let’s say older, what if I’d come in at 34, 35 and it was in that scenario.

Dr. Shahin Ghadir.: So I’m glad you changed it because I was sadly going to say, no one comes to me at 24, 25. Actually, to be very honest, the people that do come to me at that age are people that unfortunately have cancer or have already lost one ovary because of a cyst or torsion or something. And they’re like, “Wow, what if it happens to me again on the other ovary”. And then that becomes a disaster.

Dr. Taz: Right. Okay. So let’s make it older, 34 or 35.

Dr. Shahin Ghadir.: I tell everyone, if at the age of 30, you don’t have a ring on your finger and you’re not talking about the baby coming next year, you need to freeze your eggs or your embryos. One or the other. 30, because I see a lot of 31 year olds that come in and I see already a significant decline in fertility. And I don’t want that. I have had patients that are coming to me at 28, 29, 30.

Dr. Taz: My gosh, that seems so early. When you think about our careers.

Dr. Shahin Ghadir.: I know, I know.

Dr. Taz: There’s so many women that don’t… We’re not meeting people, whatever.. I’m not going to get into all that, but anyhow, that’s great… For everybody out there listening, I hope you heard that because I think many women I meet artificially believe that everything’s going to work out and we can control this. Just like we controlled our careers and we controlled our education and we controlled everything else. And sometimes it’s just not the way it is. All right. I do want to talk about PCOS. And I do want to talk about endometriosis. I do think those are the two sort of most underdiagnosed hormonal conditions for a lot of women. What are you seeing in the fertility world? What would you want women watching to really be aware of? That was a big part of my story by the way of why I’m even in kind of the integrative and holistic world. Cause I had to kind of find out about it in a backdoor way. So what would you tell women who might have PCOS and endometriosis about fertility?

Dr. Shahin Ghadir.: So PCOS patients who have polycystic ovary syndrome generally have a lower quality of egg. There is a lot of male hormone in the body and the male hormone affects the eggs in a negative way. So not only does it affect you to have very irregular cycles as one of the number one symptoms, it affects the egg quality as well. Endometriosis as well, when the lining of the uterus grows outside of the uterine cavity in places that are not desirable, it has been shown also to affect the egg quality in a negative way. For those two subgroups of patients, I would highly encourage that they freeze their eggs as soon as possible.

Dr. Taz: Any age?

Dr. Shahin Ghadir.: The sooner the better because the sooner you do egg freezing the better the quality of your eggs.

Dr. Taz: And can you improve your egg quality in your opinion? We’ve had some different..

Dr. Shahin Ghadir.: No, I think you’re born with your eggs and they are the eggs that you’re going to have. Now, can you improve your health so the decline slows down? Yes.

Dr. Taz: Gotcha. What are the three factors you’ve seen really slow that decline? Maybe. I don’t know if you might not be..

Dr. Shahin Ghadir.: The use of coenzyme Q10 is the only one that I know that medically has proven to slow down the decline.

Dr. Taz: OK. Gotcha. Okay. Let’s break IVF down just a little bit. Because many places offer IVF, even here in Atlanta where I live, we have different clinics, right. But patients come out having different experiences from each of those clinics. Let’s say we have somebody who’s listening today and decides, “I’m going to go freeze my eggs” or “I’m going to go ahead and move forward with IVF”. Can you help them with maybe a guide? How do they pick? What do they look for? What are some things that work? There are some women that have done eight, none, 10 rounds of this stuff.

Dr. Shahin Ghadir.: Yeah. But that’s a bad doctor because if you haven’t guided your patients after that many cycles and it’s not working and it’s not going in the right direction. Then you’re just out for it for yourself and you’re not doing the right thing.

Dr. Taz: OK. So help women with that because I feel like they don’t know good from bad, to do this or do that. Help them with that just a little bit.

Dr. Shahin Ghadir.: I love making an overall plan from the get go. And I like to stick to it as best as we can, because if you don’t have an overall plan, you’re just kind of dangling in the air. And I think it’s really unfair to women to not know, “Oh my God, am I doing another cycle? Am I done?”. I think it’s good to try to stick to an overall plan that guides people in the right direction from the get go. But people… It’s different because I know in my clinic, if someone hasn’t done well in three cycles, the chances of doing well is going to be reduced. Most people do really well in one cycle in my clinic.

Dr. Taz: Really?

Dr. Shahin Ghadir.: I know there are other clinics, there’s people that get pregnant on the seventh cycle because the clinic quality is not that good. So they keep having to do more and more cycles.

Dr. Taz: Define clinic quality?

Dr. Shahin Ghadir.: I think that it’s very important. Our lab is renowned in the country as being one of the number one of top 10 labs that exist. You need to have an excellent IVF lab, usually a small, tiny office with one doctor that has the best IVF lab. We have our IVF labs open to doctors in the community. So make sure that you like your doctor and that’s a good doctor that you really bond with. And also that they’re using an excellent laboratory.

Dr. Taz: Wow. So the lab of it, many women don’t think to ask about it.

Dr. Shahin Ghadir.: No they don’t, because patients don’t know anything about the lab. Asking for success rates and asking for published data that’s on the Society for Assisted Reproductive Technology success rates, they’re unfortunately lagging a few years, but it’s the best that’s out there.

Dr. Taz: It’s fascinating. Anything new in the infertility world in terms of research or developments or technology or procedures?

Dr. Shahin Ghadir.: We’ve been at a little lull for a while because success rates have gotten so high. I think everyone’s just tweaking what we have out there. That’s making things better and better, but not really, sadly.

Dr. Taz: And then for me, I’m always sort of connecting the dots on hormones and what’s happening and I’ve seen a hormone shift in women, for sure. I’ve seen an increase in the androgens..

Dr. Shahin Ghadir.: Oh yeah. I think trying to keep yourself as clean, your diet as clean, your mental states as stable and as happy all of these things begin to affect the overall female body and the male bodies to be honest.

Dr. Taz: I love that. And well, we didn’t talk about it, so do you see men in your place?

Dr. Shahin Ghadir.: So sadly if a male has no sperm, poor sperm, low sperm, it’s the woman that still has to undergo the treatment in order for us to help them both together.

Dr. Taz: But you diagnose..

Dr. Shahin Ghadir.: We can, yes. We always check the male, always checking the male alongside the female.

Dr. Taz: And are you in alignment with what everyone’s saying with a decrease in male fertility across the board? Is that something you’re seeing more of or not really?

Dr. Shahin Ghadir.: I probably am seeing that as well. Sadly.

Dr. Taz: Any thoughts on that?

Dr. Shahin Ghadir.: I think our environment is not so clean. I think there’s too many chemicals. There’s too much of everything out there that is not allowing us to do, in terms of that better.

Dr. Taz: Yeah. Too bad. All right. Well this is enlightening any last words?

Dr. Shahin Ghadir.: Thank you. Thank you. It was great questions. I hope I wasn’t talking too fast. I sometimes get excited and do that, but I really appreciate all the excellent questions and I appreciate being on your podcast. Thank you so much for having me.

Dr. Taz: Of course. Now, if someone wants to reach out to you or connect with you, what’s the best way for them to do that?

Dr. Shahin Ghadir.: Instagram and Facebook, it’s Dr. Shahin Ghadir, D, R, S, H, A, H, I, N, G, H, A, D, I, R. And I do have my own podcast called The Fertile Life as well.

Dr. Taz: I love it. All right. Well, thanks again.

Dr. Shahin Ghadir.: Thank you. Thank you so much.

Dr. Taz: You’re welcome.

Dr. Shahin Ghadir.: Really appreciate it.

Dr. Taz: You are welcome. For everybody else, thanks for watching and listening to this episode of the podcast. Remember you can rate and review it and share it with your friends. I’ll see you guys next time.