Ep 163 C-Section Scar and Fertility: Should Isthmocele Be Treated?

What if inflammation is quietly affecting your fertility? What if the key to improving egg quality and hormonal balance isn't just medical treatment, but the everyday choices you make? And what if understanding your body earlier could change your entire fertility journey?  In this episode of Brave & Curious, Dr. Lora Shahine welcomes fertility specialist Dr. Natalie Crawford to explore how inflammation influences reproductive health and what women can do to support fertility from the inside out. Dr. Natalie Crawford is the author of The Fertility Formula, and she is here to share how her own experience with infertility and pregnancy loss shaped her passion for empowering patients with science-based fertility education.  Together, she and Dr. Shahine discuss the growing role of chronic inflammation, insulin resistance, environmental exposures, and lifestyle factors in fertility challenges. Dr. Crawford explains why fertility medicine often reacts too late in the process and why understanding hormones, ovarian reserve, and reproductive health earlier can help people advocate for themselves and make informed decisions. In this episode you'll hear: [2:32] Dr. Natalie Crawford's fertility journey [7:00] Chronic inflammation and fertility [20:59] Insulin resistance impacts hormones, ovulation, & egg quality [26:34] The connection between stress, cortisol, and fertility outcomes [28:09] Sleep is an important fertility-supporting habit [32:41] Strength training to improve hormone health [41:23] Nutrition basics that work [48:25] Dr. Crawford's framework: Educate, Advocate, Optimize [54:26] Connecting with Natalie Resources mentioned:  nataliecrawfordmd.com As A Woman Podcast @nataliecrawfordmd Instagram | TikTok | LinkedIn | YouTube   Ep 157 Why Sleep is the Most Powerful Habit You Can't Ignore with Dr. Meredith Broderick Dr. Shahine's Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode! This episode was produced by Audiotocracy Podcast Production.

Are progesterone shots really necessary for a frozen embryo transfer? Why would your doctor recommend intramuscular injections over suppositories or other less painful options? And could the type of progesterone you use actually affect implantation, miscarriage risk, or live birth rates? In this episode of Brave & Curious, Dr. Lora Shahine explains the science behind progesterone support in frozen embryo transfer (FET) cycles, especially why intramuscular (IM) progesterone is often recommended in certain programmed cycle protocols.  Dr. Shahine explains how progesterone supports implantation and early pregnancy, the key differences between programmed or medicated and natural or ovulatory FET protocols, and why not all progesterone options perform the same way.  Listeners will learn how IM progesterone compares to other forms and when IM progesterone may meaningfully improve FET success. You'll get some practical guidance on how to talk with your doctor about choosing the right progesterone protocol for your body and your treatment plan.  In this episode you'll hear: [1:11] Progesterone shot fears [2:30] Why progesterone matters [4:22] Why supplement in treatment [5:22] Programmed vs. ovulatory FET [7:31] Progesterone options explained [11:07] Landmark 2021 trial set up [13:08] Results: live birth miscarriage [15:14] Next steps   Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode! This episode was produced by Audiotocracy Podcast Production.  

Are ovulation predictor kits enough to time intercourse? Can an app really tell you when you're fertile? And what if your body has been giving you the answers all along?  In this episode of Brave & Curious, Dr. Lora Shahine is talking to fertility awareness pioneer Dr.  Are ovulation predictor kits enough to time intercourse? Can an app really tell you when you're fertile? And what if your body has been giving you the answers all along?  In this episode of Brave & Curious, Dr. Lora Shahine is talking to fertility awareness pioneer Toni Weschler, author of Taking Charge of Your Fertility, and her niece, software engineer, Sabrina Nowicki. These three women explore how women can confidently track ovulation, understand cervical fluid, and take charge of their reproductive health with both education and technology. Toni Weschler shares the powerful origin story behind her decades of paper charting and why she once resisted fertility apps altogether. She believed that a thermometer, a pen, and knowledge of your own body were enough.  Sabrina explains how that philosophy evolved into Cyclisity, an educational cycle tracking app designed as the perfect companion to the book. Unlike predictive period apps that rely on algorithms and "average" 28-day cycles, Cyclisity follows the sympto-thermal method exactly as taught in Toni's work. It will finally make sense why basal body temperature confirms ovulation but doesn't predict it, how cervical fluid signals approaching fertility, why ovulation predictor kits can miss critical timing, and how improper app use can delay fertility diagnosis or lead to unintended pregnancy.  This conversation is a masterclass in reproductive education and body literacy while blending science, privacy, and modern technology. In this episode you'll hear: [0:39] Meet the guests: Author Toni Weschler and Sabrina Nowicki [2:36] Why track your cycle? [4:03] Understanding ovulation and health [6:49] Sabrina's personal journey [10:29] Toni's period story [13:10] The push for technology [14:52] Early software resistance [18:35] The perfect team forms [22:03] Creating Cyclisity [27:07] Using book and app together [31:41] Temperature vs cervical fluid [32:53] Checking cervical fluid Resources mentioned:  cyclisity.com tcoyf.com @cyclisity on IG @cyclisityapp on TikTok @wanderingsabrina on IG | on TikTok Ep 50 Over 25 Years of Taking Charge of Your Fertility with Author Toni Weschler Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode!  

Did you have a C-section and now notice spotting that won't quit? Are you dealing with pelvic pain, confusing symptoms, or trouble getting pregnant, and wondering if they're connected? Has anyone ever mentioned the word isthmocele to you… or is this the first time you're hearing it? In this episode of Brave & Curious, Dr. Lora Shahine explains a condition many patients are never warned about after a C-section: an isthmocele. She tells us what an isthmocele is, how it can form in a prior C-section scar, and why it can sometimes lead to unexpected bleeding, pain, or fertility challenges.  You'll learn the five key symptoms that may signal an isthmocele, how this condition can affect fertility and future pregnancy plans, and the pros and cons of monitoring versus treating. Dr. Shahine also talks us through when surgical repair may be helpful, and the exact questions to ask your doctor so you can advocate for informed, personalized care.  If you've had a C-section and feel like something isn't quite right, this episode offers knowledge, reassurance, and a clear path forward. In this episode you'll hear: [0:46] Understanding C-section scars: Isthnocele [2:21] What is an isthmocele? [3:24] How common? [4:18] Getting diagnosed [6:06] Symptoms [7:36] Treatment options [9:21] Observation vs. surgical management [14:01] Important questions to ask your doctor [14:57] Conclusion & final thoughts Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books Join the Learn at Pinnacle app to earn FREE CE Credit for listening to this episode

How do you make an embryo stick? Is there anything you can do to improve embryo transfer success? And how do you know which advice is science-backed versus fertility folklore?  In this special solo Q&A episode of Brave & Curious, Dr. Lora Shahine answers the questions patients ask most often when preparing for an embryo transfer. What really matters during an IVF embryo transfer? Using real questions from Instagram, YouTube, and her own practice, she walks listeners through fresh vs. frozen embryo transfer, what happens on transfer day, whether you need a full bladder, lying down afterward, Valium use, pineapple cores, French fries, genetic testing, ERA testing, and how uterine lining preparation actually works. Listeners will come away with a clearer understanding of embryo transfer success rates, frozen embryo transfer protocols, and implantation timing, and get their real questions answered. In this episode you'll hear: [1:27] What should I expect on transfer day? [8:00] What happens post-transfer? [9:35] Funny myths: pineapple cores & McDonalds french fries [13:46] Fresh vs. frozen transfer myths [20:18] Pre-transfer testing and ERA [24:37] Natural vs. medicated transfer protocols [28:30] Conclusion & final thoughts Links and Resources: Embryo Transfer: What to Expect on YouTube Does the Embryo Fall Out: Embryo Transfer Tips on YouTube Fresh vs. Frozen Transfers: Pros and Cons on YouTue Studies Mentioned: Randomized Controlled Trial for FET Protocols: PMID: 38944045 Retrospective analysis Perinatal Outcomes with FET protocols PMID:33926401 Randomized Controlled Trial for ERA before FET PMID: 36472596 Randomized Controlled Trial Bedrest after embryo transfer: PMID:31520259 Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books Join the Learn at Pinnacle app ⁠to earn FREE CE Credit for listening to this episode!

Are you starting to think about fertility testing? Have you been trying to conceive and wondering which tests actually matter? Or are you overwhelmed by conflicting advice  and unsure where to begin?  In this episode of Brave & Curious, Dr. Lora Shahine breaks down fertility testing with clarity, compassion, and evidence. Now you can move forward feeling informed instead of intimidated. Dr. Shahine covers the basics of fertility testing including the essentials of a thorough health history. She also explains how menstrual cycles, ovulation patterns, pain, PCOS, endometriosis, lifestyle factors, and mental health all shape a fertility workup.  This episode empowers couples with realistic expectations, evidence-based guidance, and the confidence to advocate for personalized fertility care, because understanding your options is the first step to feeling as ready as you can for what comes next. In this episode you'll hear: [1:36] Key fertility tests for women: AMH, FSH, estradiol, ultrasound, and HSG [3:42]] The full work up: lifestyle, medical history, menstrual cycles, and past pregnancies  [7:54] Ovarian reserve and AMH explained [13:19] Fertility tests for men: semen analysis and hormone evaluation [16:13] Preconception testing including genetic carrier screening [21:48] When to see a fertility specialist and what to ask your doctor after testing   Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Can you really get pregnant after menopause? Why do celebrities seem to defy biology when it comes to age and fertility? And just because pregnancy is possible at later ages, is it actually safe?  In this episode of Brave & Curious, Dr. Lora Shahine explores the questions so many people are quietly asking as they navigate fertility, aging, and family-building decisions. Dr. Shahine breaks down what the science actually says about age and fertility, including why it becomes harder to conceive with age, how eggs and sperm age differently, and what role options like IVF, egg freezing, and donor eggs play.  She also reviews headline-making cases of pregnancy at advanced reproductive age and explains why these headlines, while eye-catching, don't always tell the full medical story. She explains how clinicians think about risk, safety, and counseling for pregnancy later in life. This episode offers evidence-based clarity, compassionate context, and practical guidance to help you make informed decisions. At any age. In this episode you'll hear: [1:22] What record-breaking pregnancies really tell us [3:00] Understanding age & fertility [7:19] Health risks of pregnancy at 40s, 50s, and beyond [9:28] Men's reproductive age & health of pregnancy  [10:21] Ethical considerations for older parents [11:27] Updated ASRM recommendations [13:35] Final thoughts   Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Could your DNA explain why one-size-fits-all nutrition advice doesn't always work? Why do some people thrive on certain diets while others struggle, even when they're "doing everything right"? What if your genetics could help guide smarter nutrition choices before pregnancy, during pregnancy, and across your entire lifespan?  In this episode of Brave & Curious, Dr. Lora Shahine explores how genetics, nutrition, and reproductive health are deeply intertwined. She is joined by Dr. Steven Zeisel, a physician-scientist whose groundbreaking research helped redefine choline as an essential nutrient.  Their discussion traces how decades of work in biochemistry, genetics, and medicine led to the concept of precision nutrition. Dr. Zeisel explains how nutrients like choline, folate, methylfolate, betaine, and vitamin B12 interact with our genes. And he explains why common genetic variants can change how much of these nutrients our bodies actually need.  They also touch on why pregnancy, estrogen, fertility, and even sperm health are profoundly influenced by these metabolic pathways, and why traditional nutrition guidelines may miss the mark for many people. Listeners will learn how emerging genetic tests can help identify individual "roadblocks" in metabolism. This episode is a powerful reminder that when it comes to nutrition, personalized science matters. In this episode you'll hear: [0:48]Why one-size-fits-all nutrition advice doesn't work [2:19] Choline goes from non-essential to critical [8:16] The surprising role of estrogen [10:11] What can genetics influence? [15:33] Precision nutrition testing and what it can reveal [28:06] Challenges and acceptance in nutritional science [33:29] Genetic testing for personalized nutrition [45:56] What does all this research mean? Resources mentioned:  genate.com @TheGenateTest on Facebook   Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books Disclaimer: This episode is sponsored by SNP Therapeutics. All opinions and thoughts expressed are our own and were not influenced by the sponsor.

Have you had a C-section and now you're wondering if it could affect future conception? Are you planning one and feeling unsure how it may influence your reproductive health?  In this episode of Brave & Curious, Dr. Lora Shahine goes beyond headlines and reviews a landmark study to better understand how C-sections may impact future fertility, miscarriage rates, and pregnancy complications.  This episode will arm you with three essential questions to ask your provider and help you make informed decisions and have empowered conversations, all grounded in clarity, not fear. In this episode you'll hear: [0:50] Overview of C-section impact study [1:08] Fertility after C-section [7:59] Pregnancy risks after C-section [18:36] Benefits of a C-Section [19:45] FAQ [21:14] Advocating for your care [22:51] Final thoughts Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Are you exhausted but still can't sleep through the night? Do you wake up feeling unrefreshed, foggy, or wired-tired no matter how early you go to bed? Could your sleep habits—or an undiagnosed sleep disorder—be quietly impacting your hormones, mental health, fertility, and long-term wellbeing?  In this episode of Brave & Curious, Dr. Lora Shahine and her guest, Dr. Meredith Broderick, invite you to rethink everything you've been told about sleep and why "pushing through" exhaustion is not a badge of honor.  Dr. Broderick shares how her own experience with sleep deprivation led her into sleep medicine, why sleep disorders are vastly underdiagnosed in women, and how poor sleep is linked to conditions like depression, migraines, cardiovascular disease, metabolic dysfunction, and infertility.  Together, they explain the difference between true sleep and sedation, why sleeping pills and alcohol disrupt restorative sleep, and how sleep apnea and chronic insomnia show up differently in women. You'll learn when to ask for a sleep study, common red flags you shouldn't ignore (like morning headaches and daytime fatigue), and practical, evidence-based steps to start improving your sleep—without shame, perfection, or fear. In this episode you'll hear: [1:23] Sleep is a non-negotiable pillar of health [5:10] Recognizing sleep disorders [12:59] The science behind sleep [14:19] Sleep & reproductive health [19:04] Practical sleep solutions [27:52] Understanding mid-night awakenings [29:21] Cultural variations in sleep patterns [31:23] Sleep trackers [33:20] Key reasons to consider a sleep study [36:50] Conclusion & final thoughts Resources mentioned:  soundsleepguru.com @sleepdoctormer on Instagram Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books