Your Fertility After 40: Myths, Misunderstandings, and Realities with Dr. Shahin Ghadir
Navigating fertility in midlife is complicated — and too often, women are left sifting through myths, fear-based headlines, and outdated statistics. This week, I’m joined by Dr. Shahin Ghadir, one of the leading fertility specialists in the country, for a clear, unfiltered look at what’s actually possible after 40.
We get into the real numbers, the current science, and the emotional weight of making decisions about your reproductive future at this stage of life. From egg freezing and embryo quality to donor options, hormones, and the truths the media gets wrong, Dr. Ghadir breaks down what every midlife woman deserves to know — without shame, stigma, or sugarcoating.
If you’ve ever wondered whether you still have options, what your odds really are, or how to make empowered decisions about your body, this conversation will give you clarity, context, and the information you should have been handed years ago.
Knowledge is power — and this episode puts it back in your hands.
Transcript
Better to have one egg frozen than no egg. I had a patient once who was able to have one egg come out of her and that was her beautiful baby.
Roxy Manning:That's so nice.
Dr. Shahin Ghadir:She tells me, I know my chance of success is less than 1%, but I'm willing to try.
Roxy Manning:People should really take their health into their own hands and make that move and go to the doctor. Are there things that they can do to increase their chances of fertility?
Dr. Shahin Ghadir:You want to make sure that you're taking your prenatal, you're taking your omega 3s, the DHA, you're taking your methylated folates.
Roxy Manning:Is that like a vitamin or a supplement that you could continue to take after you've had your baby? You know, it's really emotionally taxing at some point. How does she protect her mental and emotional health?
Dr. Shahin Ghadir:If you have no emotional support from your doctor, then you are in the wrong place. My team gives so much love and are so compassionate and caring to my patients.
Decades from now, people in their 20s, it's going to be a part of a normal part of being a female. Finish college, freeze your eggs, move on.
Roxy Manning:It's a graduation gift to give yourself.
Dr. Shahin Ghadir:Huh?
Roxy Manning:Okay, real talk. When it comes to fertility in midlife, there is so much confusion out there. From social media myths to to outdated advice.
It can feel like no one's telling women the truth about their options or the urgency until it's too late. That ends today.
My guest is Dr. Shaheen Ghadir, a world renowned fertility specialist, founding partner of Southern California Reproductive center, and someone who has helped thousands of women, celebrities included, navigate the most personal, high stakes decisions of their lives. We're talking freezing eggs, kids getting pregnant in your 40s, hormone truth bombs, and the emotional weight of wanting a baby.
When time feels stacked against you.
Whether you're child free by choice, thinking about solo motherhood, or trying to beat the clock with science on your side, this episode is required listening. So let's get into it. Well, welcome to the iconic midlife. How are you doing today?
Dr. Shahin Ghadir:I'm doing really well and I'm excited to be here. Oh, good.
Roxy Manning:I'm so excited to talk to you because as you can imagine, fertility is such a big issue for midlife women.
And once you hit 40, I feel like, you know, the things start going through your head if maybe you've wanted to have children but you haven't gotten there yet or you haven't met the right person, or you're just trying to figure out, like how to do it sort of on your Own. So I wanted to get, you know, your take on what fertility after 40 looks like.
Um, and, you know, just to kind of start things off, you know, I feel like there are so many, like, myths and, you know, half truths and things that kind of fly around that, you know, people really want to get clear on.
So just to start it out, like for a woman, let's say she's 40 or 40 plus, how likely is a woman at that stage in life going to be to get pregnant naturally?
Dr. Shahin Ghadir:This is an incredibly important topic. Women over the age of 40 are now a large population of pregnancies. Women are no longer having that many kids in their 20s.
We know some women are starting in their 30s, but they're also starting a lot of their careers in their 30s. So it's complicated. Many, many women walking into my office are very interested in having children in their 40s.
And the chance of having a healthy pregnancy after the age of 40 falls to be under 10%. When a woman is 20 years old, it has been known that 90% of her eggs are good and 10% are bad.
That statistic reverses by the time you're 40, where 90% of your eggs are bad and only 10% are good. So making pregnancy very, very challenging for some people.
Now we always hear of that woman that got pregnant at 46 or 47, and you know, in her family, her grandmother had the baby at 49. But those are really, really rare cases.
And that's why we're here, to make sure that people think ahead, do everything they can, and know all of their challenges and choices that are going to be made to make this an easier transition.
Roxy Manning:What do you think?
Because I've heard, you know, different numbers, but generally speaking, I've heard the number 35, like 35 years old is sort of the tipping point is between, you know, like being, having an easier time of getting pregnant naturally versus after. What do you think about that?
Dr. Shahin Ghadir:So 35 changes. Lots of definitions put some people into the advanced maternal age category, but it is not a light switch.
There are some people, we do know that statistics and studies have shown that from the age of 26 to 28, that's when women start to have a decline in fertility. I have had patients of mine that came in at 31, 32, 33 and had an incredibly difficult time getting pregnant.
And then I have had 45 year old women come in and it was easy. So when you say 35, I think it's an average when some women begin to have difficulties, but everyone is on Their own timeline.
And that's what I can't stress enough is that the importance of doing testing annually, discussing these things with your doctor, knowing where you stand, so there's not a big surprise hitting you at the wrong time.
Roxy Manning:That's also a good point. It's very individual, in other words. So, like, people should really take their health into their own hands and make that move and go to the doctor.
Dr. Shahin Ghadir:And get these things tested 100%.
Roxy Manning:So what is. What is the woman asking for when she, let's say she's going into her OB GYN and she's thinking about having a baby.
And are there certain tests that she should be asking for from her doctor?
Dr. Shahin Ghadir:Absolutely.
So some of the most important, telling your doctor, I am interested in fertility, even If I'm not 100% sure when, and I'd love to do a fertility assessment. The fertility assessment should include a blood test called amh, anti mullerian hormone. The AMH hormone is released from the eggs in the body.
So the more eggs you have, the more AMH will be on your blood test. The less eggs you have, the less AMH will be on your blood test. So that is a very, very important process.
And also doing an ultrasound that looks at the ovary by looking, it's very. I try to explain this to patients in this way. When you look at someone's face and they have a lot of wrinkles, you can tell that person is older.
When you look at someone's face and they have flawless skin, you're like, that person is very young.
When I look at the ovary on ultrasound and it has a lot of these little bubbles called antral follicles, I know that that ovary is healthy and has a great reserve of eggs inside of it.
When I look at an ovary on ultrasound and it has very few of these little bubbles on it, it tells me that that ovary has had a decline in its fertility and its egg reserve. So those are the two biggest things. One is looking at the ovary to see how youthful it looks, and one is the AMH level.
There are also some blood tests that are done on day two or three of the period that are called FSH and estradiol and lh. These are all things that kind of give me more information.
There's also some hormones like thyroid and prolactin that are indirectly related with fertility but still important. So all of these things are assessed whenever someone comes in as a consult. And most of them, I can say obese check.
So your gynecologist should be able to check some of these things. Not every single OB GYN is excellent at understanding and comprehending and being able to give a patient some of the results of what it really means.
Roxy Manning:So it's hard for them to kind of like relay it onto the patient.
Dr. Shahin Ghadir:They don't do this every day. They're not fertility specialists.
So that's why I tell people, if you have an opportunity of discussing all your options and doing this assessment with the fertility doctor, it's going to be much, much better than doing it with your ob gyn.
Roxy Manning:Yeah, absolutely. So, you know, I think there's also a lot of confusion between the terminology. Right. So we hear ivf, iui, we hear egg freezing, embryo freezing.
So can you walk us through that as it relates to kind of a midlife woman? Let's say she's like 40 plus. Is there, like, are there certain directions?
Dr. Shahin Ghadir:Generally speaking, egg freezing is reserved for someone who does not have a partner or can make the decision on what to use to fertilize, like, sperm in the future. So if you're waiting for the right partner or trying to figure out what sperm to use, that's when you use. That's when you freeze just your eggs.
Because once you put a sperm into an egg, then it's called an embryo, and there's no taking that sperm back out.
So if you are 40 years old and you have not conceived, you're thinking there's a small chance you will, or you may want to, or you may change your mind. That's a perfect person to freeze their eggs if they're single. We have had many, many, many women freeze their eggs after the age of 40.
Some have done incredibly well. Sadly, not every single person who freezes their eggs over the age of 40 has a robust outcome. But we have had many people do very well. I have this.
This theory in my head that it's better to have one egg frozen than no egg. Because I had a patient once who was able to have one egg come out of her, and that was her beautiful baby.
The embryo, on the other hand, is better for partners. So if you.
If there's a male and a female in the relationship, you then put the sperm with the egg and then make an embryo, because the embryo, as it grows, is able to have genetic testing on it done, and we will know if it's genetically normal or not. You cannot do that on an egg. You cannot check the health of the egg alone because it damages the egg.
But an Embryo goes from one cell to two cells to four cells 8, 16 and continues. By the time it's been growing for five to seven days in our lab, it's between 150 and 300 cells.
And we have the capability from taking a couple of these cells and sending them off for genetic testing, freezing the embryo, and a week later we get genetic testing results which let us know if the embryo is healthy or not.
Roxy Manning:So is, do we have a higher rate of, like, birth defects and things like that after, you know, 40 and above?
Dr. Shahin Ghadir:We do.
Roxy Manning:Okay.
Dr. Shahin Ghadir:We 100% have more chromosomal defects because women are born with all of the eggs that they have in their body the day they're born. And those eggs have been there now for 40 plus years.
So during that time, some of these eggs begin to have what we call sticky chromosomes, chromosomes that stick together. That's why, for example, women that are over 35 have a higher risk of down syndrome. Down syndrome is an embryo that has an extra chromosome 21.
Because when the female egg has been there for a while, maybe two of the 21s stuck together, and then the male partner gave a 21. So now we have three chromosome 21s, which is down syndrome, and obviously not a perfectly normal pregnancy.
Roxy Manning:Okay. So that's kind of how the birth defect comes into play.
Dr. Shahin Ghadir:It also happens with sperm. So studies have shown that men that are over the age of 40 have a higher risk of chromosomal problems and other defects as well.
Roxy Manning:Okay. So it is reliant on the sperm as well. I mean, it's really important to test both.
Dr. Shahin Ghadir:Absolutely, absolutely. It is very important to know that the issues with egg are equally as important as sperm.
And the reasons why people aren't getting pregnant are equal, male and female.
Roxy Manning:Okay, that's really good to know. Yeah.
Dr. Shahin Ghadir:So we usually say 40% of the issue comes from the egg. 40% comes from the sperm.
And sadly, even to this day, we have about 20% of pregnancies that we that are infertility issues that are unexplained, and we just don't know why.
Roxy Manning:Wow, that's interesting. So even now, I mean, you couldn't say with maybe 100% every single time.
This is why, you know, like, this pregnancy didn't come to fruition or why it wasn't successful because it could be a whole. And within that fertility, like, infertility range, is that just, you know, could it be environmental?
Could it be like, health within, you know, one of the two people? Is this just like a mix of different factors?
Dr. Shahin Ghadir:You just. There's many things we can figure out these days. But as much as our science had advanced, it's still not 100% with figuring things out.
100% why a pregnancy doesn't implant 100% if it's the egg or the sperm. Those are the things that we, we kind of just don't know.
Roxy Manning:And what is. Because there's also, I feel like some confusion between IVF and iui.
Dr. Shahin Ghadir:Yes.
Roxy Manning:So I know some people start out doing maybe IUI and then they move to ivf.
Dr. Shahin Ghadir:Yeah.
Roxy Manning:Tell us a little bit about that.
Dr. Shahin Ghadir:In the past, a lot of patients, I've been doing this for 20 years now and we used to do a lot of iuis intrauterine insemination or what, or artificial insemination or what someone, the layperson may call the turkey baster. When you take the sperm and wash it up and then you just inject it up into the uterus.
Unfortunately, other than cleaning up the sperm and getting the sperm up into the uterus, it really doesn't do anything else.
Roxy Manning:Okay.
Dr. Shahin Ghadir:It doesn't affect the egg in any way. So for a 40 year old woman to do an IUI, it's really not that beneficial unless it's purely because of sperm.
And we know that getting the sperm up into the uterus is going to give us a better outcome. That's when an IUI is beneficial for an older woman. In vitro fertilization, or ivf, where the word in vitro means outside of the body fertilization.
So it means that the egg and the sperm go into a petri dish and that is where they're fertilized. That is what's called ivf.
Roxy Manning:Okay.
Dr. Shahin Ghadir:And the benefits of IVF is that we can take multiple eggs out of the female. As long as there's an egg reserve and she responds to our medicine, we may be able to get 5, 10, 20, 30 eggs out of a woman even over the age of 40.
And that's how we have like 30 options of making an embryo.
We're also able to pick the best looking sperm under the microscope and then inject that sperm directly into the egg and then help with fertilization. So also increase fertilization rates. Then we're able to observe the growth of the embryo and make decisions on which one we're growing the nicest.
And then finally doing the biopsy for genetic screening which tells us which embryo is genetically healthy and normal versus not. So once we get multiple healthy embryos back, the major benefit for us is that we can also preserve them.
So if you make suddenly four embryos at the age of 40, guess what? You have four chances of having four kids. But with IUI, it all happens internally. You can't genetically test an embryo.
You cannot preserve any of the embryos or eggs, and you have no control over gender, and you have no control about the timing. It just has to happen. So there's a lot of benefits for IVF that we have available that IUI does not offer at all.
Now, the downside is that IUI is not that expensive because it's not that involved, but its success rates are extremely low. And then IVF is much more involved, much more costly, but much higher pregnancy rates.
Roxy Manning:Yeah. What are the pregnancy rates of an IVF for, like, women over 40, do you think?
Dr. Shahin Ghadir:It really, really depends. It's very difficult to answer that question.
The way that I like to answer the question is that I don't know what, when I'm talking to someone, what your pregnancy rate is, but I can tell you if we are able to create one genetically normal embryo, that one genetically normal embryo, with my own personal statistic, is 84% for implantation.
Roxy Manning:So the pregnancy will come to 84%, will come to fruition?
Dr. Shahin Ghadir:Yes.
Roxy Manning:Okay, that's high. I mean, that's.
Dr. Shahin Ghadir:I've worked very hard to get it this high.
Roxy Manning:You're like, they don't pay me the big bucks for nothing. That's funny.
Dr. Shahin Ghadir:Yeah.
Roxy Manning:No, that's great. You know, it's funny. I was actually with some girlfriends this past weekend, and a couple of them have done IVF past 40 to get pregnant.
And because they were taking the medications along with it for their IVF journey, they're now afraid to take HRTs as they're entering into perimenopause and menopause. Now, do you think that that is a fair assessment, or are they two separate things that they, you know, should be treated differently?
Dr. Shahin Ghadir:Completely. Two separate things that need to be treated separately. One has nothing to do with the other.
There are no studies that have ever correlated or said that if you've done ivf, you have a higher chance of cancers. Never in the history of me doing this over 20 years, we've never had those studies. So if people are thinking, wow, I've already done all that.
I've already given all these hormones. It's not accurate what they're thinking.
And the doses of HRT that people get, people don't understand that the dose of HRT is almost one tenth of a birth control pill.
Their whole life, they were happy to take a birth control pill, but now that their own Hormones are going down, and the HRT pill is one tenth a birth control pill. They're suddenly scared. Now, I'm not advocating that everyone going into perimenopause or menopause should be on it.
That's a bigger discussion with your doctor to see what your risk factors are. The timing of when you start is important. If it's you stop and you go into menopause for five years, then go on it.
It's very different than if you're not quite. And you go on it. During the perimenopause, the statistics of what's safe and not is very different.
And that's a deep discussion and an important one with your gynecologist.
Roxy Manning:Yeah, that's a good point. And also the birth control pill, that's synthetic hormones. That's not even bioidentical hormones.
Dr. Shahin Ghadir:It's true, but not all HRT is always bioidentical as well. So it's a big discussion point there.
Roxy Manning:And I think it's interesting, too, because we look around, especially in Hollywood and Los Angeles, and, you know, we see a lot of celebrities, let's say, that are like 50, 53, who are having babies, you know, well into their 50s, you know, but they're not really saying, you know, how they're doing it. And I think it kind of leads people, right, to kind of second guess.
They're like, okay, if I see this person in the public eye at 55 getting pregnant, maybe I can do it too, you know, and they don't really get. So tell me your take on that. What are your thoughts on that?
Dr. Shahin Ghadir:So there has, to the best of my knowledge, there is absolutely zero data that says that a woman who is 50 or above can get pregnant on her own with IVF unless you froze your eggs at an age where your egg was functional. So if you froze your eggs at the age, you know, when people do, like in their 30s or early 30s or 20s, then you can do great.
You could have also frozen your eggs in your early 40s and just been very lucky. And good eggs still. And you can get pregnant, but if you didn't freeze your eggs, then those are pregnancies with egg donors.
So those are when you go and say, listen, my own eggs are not doing it. I really want to have a kid. I at this point, what I need to do is I need to use an egg of someone in their 20s, which is an egg donor.
But no one, no one is really raising their hands and saying, I used an egg donor. Now we do. I've Done thousands of egg donor cases. I really don't know. I don't think that people are just running around announcing that.
Roxy Manning:Right, right. It's almost like there's like shame or. I don't know if it's embarrassment or just not. What do you think it is?
Dr. Shahin Ghadir:What I can tell you is over the last 20 years, the People's openness to the fact that they have done IVF has changed significantly. Like, it went from like nine, no one would talk about it to now. Everyone's like, oh, I froze my eggs. Oh, I'm doing ivf. And it's like a cool thing.
It's like, you're smart, you're resourceful, you know what you're doing in this world.
But the idea of something incredibly personal like your egg didn't work and now you had to use an egg donor, I don't think it's something that is as easily talked about. I'm not sure if something that personal needs to be talked about now.
I'm sure there are some people that feel very comfortable talking about it, and I'm sure there are many that do not. But I like to respect people's opinions on and their comfort level about what they want to disclose and not about their lives.
Roxy Manning:Yeah, that's a good point. I mean, we have to give people privacy 100%. Right. Would you say that there's like an upper limit to egg freezing, age wise?
Dr. Shahin Ghadir:That's a really wonderful question. I have patients of mine that have come in and told me I need to freeze my egg or else I'll never be able to live with myself.
I don't care if I just get one egg. I just need to know that I did what I could do. So for the rest of my life I could live with myself and know that I did what I could.
So I respect that. I think everyone is very different. I think that, you know, there are people. I've had patients that were 44, 45 and froze eggs and it worked.
But then I've had patients that was like 46 and froze and then it never worked. And then again, it gets difficult to even make eggs at that point and retrieve the eggs. So it's hard to give an age.
I can tell you that there are some clinics that won't even say hello to you after a certain age, and usually that's 42. Some clinics even 40. But I don't do that.
If, if someone I have told patients I have a 48 year old who makes 10, 15 eggs every time we do an Egg retrieval. And I told her, as long as you know that your chance of success is extremely low, I am here to hold your hands through this.
And she knows, she tells me, I know my chance of success is less than 1%, but I'm willing to try. And not everyone has that financial ability, that physical ability, that mental and emotional capability. So I think it's very individualized.
And that's one way that I really try to practice medicine, is that it's not cookie cutter. We don't close our doors on the statistics. Patients, every single patient is their own story and own timeline and own protocol and.
And everything has to be done for that person.
Roxy Manning:What would you say to a woman talking about the financial sort of aspect? Because it can get pricey, you know, the farther you go into it.
What would you say to somebody that was maybe not as, you know, financially, you know, solid as someone else, but is really, you know, wanting to have a child and is struggling with fertility?
Dr. Shahin Ghadir:As a parent of four who's been through a lot, myself, and doing this for over 20 years, I think the chapter of your life that introduces children and changes your own entire world for the rest of your life is a very important one. I am 100% aware that it is the biggest challenge financially for those that don't have coverage for this.
But at the same time, I think it's one of the inmost, the biggest investments of your life into the. One of the most important chapters of your life, if that's important to you. So I'm a little biased because I've seen how it's changed people's lives.
But then again, it has to do with the person. I have patients that are like, yeah, I'll have a kid, but I'm not willing to spend that much money. So maybe just try and see what happens.
If I don't get pregnant, I'm fine. And then there are people that. That is their entire livelihood and future depending on it. And then I'd say, then do what you need to do.
There are loans, there are scholarships, there are grants, there are programs. There's lots of different options in this day and age to do.
But sadly, the financial aspect of this whole process is probably one of the most challenging aspects of it.
Roxy Manning:And for something that's so, you know, like, if that is your goal in life to be a parent, it can become all consuming.
You know, you want this baby so bad, and you're on this IVF journey of maybe it's not successful the first time, and you're trying and Trying and trying. It can kind of, you know, there can be like a mental, sort of an emotional toll that it takes.
What would you say to a woman like that who's maybe been trying for, you know, a bit IVF and, you know, it's really emotionally taxing at some point, how does she protect her mental and emotional health?
Dr. Shahin Ghadir:So I think your support system and for an infertility patient is one of the most important things to address.
You need to have a support system, whether it's a spouse, whether it's a friend, whether it's a relative, or whether you talk about it to no one and it's your therapist. But you need to have some kind of support system during this process. Everyone's different than what they look for, for support.
Some people can bring all that support internally and give it to themselves. I can't. I'm not that kind of person. And I thrive from communication and discussion and feedback from important people that I look up to in my life.
But I do think that it is. It can become a struggle. The other thing is that I really, really think that the clinic you're going to and the doctor who's treating you is key.
If you have no emotional support from your doctor or his team, then you are in the wrong place. My team gives so much love and are so compassionate and caring to my patients. Sometimes I get jealous because they're giving them. I'm just kidding.
I am so proud of the fact that when people graduate or are leaving my office, they tell me, your team just was incredible and there for me. And that is really important. I think it's incredibly, incredibly important to have a team that is, you are a part of.
You feel listened to, you feel heard, and that cares about you. And if you're not in a place like that, you need to find a new place. Yeah.
Roxy Manning:And how does. Let's say a woman's in a place that isn't great for her? Like, what is the best way, particularly a midlife woman, you know, how.
What is the best way for her to find that? Right? Dr.
Dr. Shahin Ghadir:Listen, I say, like, reading reviews is important, but every single healthcare provider or professional out there who has reviews about them, people here and there are writing crazy things. You have no idea who they are and what they're talking about, but you can get an overall gist of reviews. I think you also talk to people.
You ask your doctors for referrals, but you're the ultimate decision maker. I have patients these days that tell me you're my fourth fertility doctor. I'm Interviewing. They want to understand. They want to have a choice.
And I think that is so smart. Not every. I am not the right doctor for every single patient.
And people are understanding that they need to find the doctor that they believe in, the doctor that meshes with them. And I think that's an important process in this, the whole thing.
I do think, though, doing your search online, looking at their social media, looking at their website, looking at their, you know, Instagram videos, and when they're talking, do you like their messaging? Do you like how they talk? Do you like the things they're talking about? I think you start to get a feel for some people.
You know, I think it's a nice way to understand.
And if the person is, like, missing from the world, when you Google and can't find anything or anything that's of any, maybe that's not the right doctor for you, again, because there's nothing about them there.
Roxy Manning:Yeah, there's no, like, social media whatsoever or, like, no online presence.
Dr. Shahin Ghadir:I think in this day and age, you know, I'm not really good at taking my phone and taking a selfie every time I walk into a restaurant or market, but I put enough out there that is meaningful, and I believe that is important to give a message to everyone every day. A little post, a little this, a little that. And I've gotten.
I suddenly walked onto an airplane, and someone's like, you're the guy I listen to every morning. Or my waitress at a restaurant was like, I listened to you. And these are things that, like, make that moment for me.
You know, I went to a restaurant recently, and this guy came and said, you're not my doctor, but you helped my wife and I get pregnant. We followed every single thing you said, but we don't live that close to your clinic. And it was the hope you gave people.
And so I think you have to have some kind of bond. The bottom line, I'm trying to say, is that you need to have some kind of bond with your doctor and their team.
Roxy Manning:Yes. And it's good to put those touch points out there, like you're saying, so people can connect.
Dr. Shahin Ghadir:Absolutely. Absolutely.
You know, I have to tell you, I am invited on many lovely podcasts just like this, and people really trust the podcast that they listen to. Hosts and hostesses that bring people on with that are trusted and are good at what they do.
So that's, you know, that's a way to look at this as well. If you don't know how to find. Maybe there are people that know how to find.
Roxy Manning:Good point. Yeah, that's true. I mean, it is. And you are building a community and an audience that, like, you're saying it really trusts you.
So it's so important, you know what you put out there. And also, I was just thinking, you know, with women over 40, they. The egg quality discussion comes up quite a bit.
So for a woman in midlife, after 40, is it more important to have egg quality or egg quantity quality?
Dr. Shahin Ghadir:So women after the age of 40, no matter what quantity, is going to go down. Once in a blue moon. You have a woman over 40 who still makes lots and lots of eggs and. But no one cares about lots of lots of eggs.
We care about healthy eggs that are going to make healthy embryos. So I rather get three eggs. And I recently had a patient who was around 40, and she had only made three eggs, but guess what?
She made one of those eggs. Two of them fertilized. One of them grow beautifully the whole week. The other one did it. The one that grew was eligible to get a biopsy.
And we froze it. And a week later, I called her and said, you made a genetically healthy normal embryo.
And I put it back in her a month later, and she is like 15 weeks pregnant now, so. And she only started with three eggs. Wow.
Roxy Manning:Wow. Yeah, that was. That was meant to be, that one.
Dr. Shahin Ghadir:It was meant to be. It's meant to be. Yes.
Roxy Manning:Coming in hot, you know, very hot.
Dr. Shahin Ghadir:Right.
Roxy Manning:And that's great. She's almost through her first trimester.
Dr. Shahin Ghadir:Oh, she. No, she's halfway through her second. Yeah.
Roxy Manning:Okay. For the women at home, let's say they're like, kind. They're maybe they're in their 30s or leading up to 40.
Are there things that they can do to increase their chances of fertility?
Dr. Shahin Ghadir:I think always having a healthier lifestyle is going to be good for you in every aspect of your health, including your fertility. So if you're overweight, that can make a challenge for fertility.
With that being said, I know many people that are very overweight and got pregnant like that. But generally speaking, weight is very important. You want to make sure that your ovulation pattern is very regular.
You want to make sure that you're taking your prenatal, you're taking your omega 3s, the DHA, you're taking your methylated folates, you're taking your CoQ10, which is an antioxidant that slows down the aging of your eggs.
Because women that have taken 600 milligrams of CoQ10, the strongest antioxidants available actually show that they're slowing down the aging of their eggs. So instead of the eggs going down like this, it'll go down. It'll still go down. It will not stop it, but maybe a little slower.
So those are important things.
I think eating a healthy diet that is not full of preservatives and chemicals, which is basically, in my eyes, like a Mediterranean diet that has fresh foods and fresh vegetables and fresh fruits and things that are full of vitamins and are natural, is very, very important.
Keeping yourself well hydrated, exercising, and at the same time, just having a good life balance on rest and everything else that you're doing is very, very important. It's so easily said, very difficult. But you gotta do the best you can do.
Roxy Manning:Absolutely.
And because we're in midlife and the hormones are going, you know, up and down and all around and crazy, is it possible for the women that are on hrt, can they also try to, you know, try for pregnancy at that point?
Dr. Shahin Ghadir:Not once you're on hrt. So HRT is going to stabilize your hormones, and you're not going to be then ovulating like you normally and naturally do.
But once you've made it to hrt, then that's not going to be the time when you want to be trying. It's before that.
Roxy Manning:Okay, it's before that. Could they do like an egg donor at that point?
Dr. Shahin Ghadir:Yes, you could. So that's a very good question. Thank you for asking that, Roxy.
You can be menopausal and completely done with your period, or some people have premature ovarian failure where their periods stop really young. Anything under the age of 41 is premature.
So you can have no periods, and we can still get you pregnant with the use of an egg donor, where we use the egg of the young woman, the sperm of your choice, make an embryo, and we can prepare the lining of your uterus, even if you haven't had a period in 10 years, 20 years. But we're not going to be doing that in a woman over the age of 55. Okay.
So the American Society of Reproductive Medicine does not Recommend for anyone 55 and older to carry a pregnancy. I want to be very honest here. I get very, very concerned when my patient is in their late 40s or early 50s and still wants to carry.
I have had patients that I make sure they have to go through a list this big of clearances, double checks, knowledge, just every counseling that I can get them to understand everything involved. And if they still pass all their clearances, and are in excellent health and aware of all the risks. That's a different story. Then we can talk.
But after the age of 55. No. So it's a. And it's not right for everyone. Not everyone who is 52 wants to carry a pregnancy.
Roxy Manning:That's true. So is it because once you're that age, just what's happening in the body?
I mean, just muscular bones like all of those things, or is it just not safe because it actually could threaten the mother's life?
Dr. Shahin Ghadir:All of the above. So not every single 52 year old woman is in the best of health. So that's. It could be your. It could be a lot of things.
But what has been proven after the age of 35 is higher rates of gestational diabetes, higher rates of high blood pressure in pregnancy, which is called preeclampsia, and higher rates to an extent on preterm delivery and labor. So those are kind of proven things. With all of that being said, I have had patients in their late 40s and early 50s still do incredibly well.
Roxy Manning:Wow, that's so interesting. Okay, so you don't need the period you could still carry?
Dr. Shahin Ghadir:Yes, yes. Okay.
Roxy Manning:But it's not recommended in your mid, late.
Dr. Shahin Ghadir:Let's put it this way. It concerns me, okay. My patient's health is my number one priority. It concerns me. What if something goes wrong?
Roxy Manning:Yeah, no, it's a viable concern, of course, like, absolutely.
Dr. Shahin Ghadir:But I've had some patients that are. Have been in incredible health, I mean, incredible healthier than my younger patients and have done incredibly well carrying pregnancies.
So again, everyone is individual, everyone's their own story. Everyone is treated individually with what's best for them.
Roxy Manning:You know, for my story personally, I got pregnant at 38 naturally, and then I had my child at 39.
And I keep hearing these statistics where they're saying the later you've gotten pregnant and delivered a child, maybe the less risk of health issues down the line you might have as far as like cancer and things like that. Is that true?
Dr. Shahin Ghadir:No.
Roxy Manning:Is there in sort of any correlation with that?
Dr. Shahin Ghadir:Okay, well, the only correlation that I can think of is that your reproductive health is potentially better than a woman who no longer could get pregnant and 34 and pass. So your reproductive health, the fact that you got pregnant later and delivered is great, but it doesn't tell you anything.
I think about other things. Never seen any data at all that correlates with that.
Roxy Manning:Okay, so there's no. The reproductive is just totally separate. It doesn't really have a bearing on the, the holistic health picture.
Dr. Shahin Ghadir:Not really.
Roxy Manning:Okay. Okay, that's good to know. And you know, we all took prenatal vitamins, you know, when we were pregnant. Doctor always says to take them, so we did.
Is that like a vitamin or a supplement that you could continue to take after you've had your baby?
Dr. Shahin Ghadir:So half the patients that come into my clinic, Roxy, are coming for egg freezing. I tell. I just.
If you are a reproductive aged woman, you are welcome to take prenatals because I personally think that it is the best multivitamin available for a female body in the reproductive years. Now, once you hit like menopausal age, there are different supplements that needed that a prenatal may not be the best for.
But a woman between 20 and 45, I can't think of a better vitamin for them than a prenatal vitamin instead of a multivitamin.
Roxy Manning:Okay. Oh, that's good to know. So it doesn't. The iron, the higher iron and the folates and stuff like that. That can only mean good things, right? Okay.
Dr. Shahin Ghadir:Only good things.
Roxy Manning:Only good things. Okay, that's good to know.
So what would you say to a woman who's coming into your clinic panicking, like, she's like, I'm 40 years old or 42 and I don't have a partner and I really want to have a baby. What do. Like what are you telling her? What is, what does this appointment look like?
Dr. Shahin Ghadir:So the first thing we do is calm down and go over all of the options that we have available. Get an excellent history on the patient to know where they're coming from, health wise. And if everything is looking good, then we evaluate.
Then I call back and go over all the results and explain, your fertility is good, your levels are low, your levels are high, and then what the options are. So if a 42 year old comes in like that, I would say you have two choices. One is you freeze your eggs until you meet Mr. Right.
The other is like, many women have done that. Go for having the baby alone and be a use sperm donation and do it. Many, many, many women have done that in my office.
And many have told me, I looked for Mr. Right. I didn't find him. I can do this myself and I want this bad enough that I don't want to wait any longer.
Roxy Manning:I forgot to ask you for the menopausal woman that still wants to carry, let's say she's late 40s, if she had previously frozen her own egg, is that something you could try to implant? If it's if she's in menopause.
Dr. Shahin Ghadir:Yes, absolutely. So the whole purpose of freezing your egg is that later on in life, you don't have to use the egg of someone else.
So instead of going to the egg donor, guess what? We go and get your own eggs out of the freezer.
Roxy Manning:Okay. So it's viable as long as it was, like a healthy egg that you harvested. And.
Dr. Shahin Ghadir:Yeah. I have a friend that I grew up with. I've known her since I was 8 years old. And when she wasn't married, we talked.
I told you, you got to freeze your eggs. She did three cycles of egg freezing, and at 51, she had her baby with her husband that she finally met and loved.
And a surrogate carried it for them, and they have a beautiful, beautiful, beautiful baby because she thought well ahead and did every single thing that she needed to do to have her baby.
Roxy Manning:Oh, my gosh, that's amazing. And did they use his sperm?
Dr. Shahin Ghadir:Yes, of course. They used her husband's sperm.
Roxy Manning:Wow.
Dr. Shahin Ghadir:So biologically, the child is their child. And the only thing is that she just didn't feel comfortable carrying and she had it carried by a surrogate. Oh, wow.
Roxy Manning:That's a great. That's a great story. You love when you hear things like.
Dr. Shahin Ghadir:That'S a good one. And I adore this person. I've known her since I was in the third grade. So it's been a bit.
Roxy Manning:Yeah, exactly. You're like, I know this girl.
Dr. Shahin Ghadir:It's very few people that you could say you've known for, you know, over 45 years.
Roxy Manning:Totally. On the flip side of that, let's say a woman tries IVF and all the things, and it doesn't work. Do you.
What kind of advice do you give her at that point if she's, you.
Dr. Shahin Ghadir:Know, so if it doesn't work, I mean, we have to see why. Like, if she has very few eggs and it's not working, you may say to someone, I don't know if it's worthwhile to do this again.
There's many different ways of looking at that. And at that point, I think it's important to say, listen, do you try again, or do you now try to do this with someone else? Egg and egg donor?
Or do you adopt? Or maybe you didn't want to. You know, this is. You're fine without a kid. I think there's. That's when you have some deep discussions.
Roxy Manning:And is that something that you handle at your clinic? Like all those different.
Dr. Shahin Ghadir:Not the adoption. I have resources to send them to for Adoption, but we don't handle that in our clinic.
But the egg donation process, we can guide them and help them through that entire process.
Roxy Manning:And what if this. Okay. What if there's another woman, another potential patient, she's 45, she hasn't frozen her eggs yet. What would you tell her at that point?
Dr. Shahin Ghadir:For a 45 year old, I'd say it's gonna be very difficult to do this with your own egg. Freezing an egg at the age of 45 and having success from it is very, very unlikely. But has happened. But I think that's it at 45.
But you have to understand, it's not like an 80% chance of success doing that. There's a very, very low chance that it works. I think it's a very individual, deep discussion at that point to see if this is right for you or not.
Roxy Manning:Okay. And then the 50 year old woman that's coming in, she needs to go.
Dr. Shahin Ghadir:To an egg donor.
Roxy Manning:Okay. So just go get the egg donor, get the sperm if it's.
Dr. Shahin Ghadir:And then probably discuss even surrogacy at that time.
Roxy Manning:Okay. Yeah. Because it might not be safe to do the pregnancy on her own.
Dr. Shahin Ghadir:It may not. Okay.
Roxy Manning:Okay. So there's a lot of factors, but.
Dr. Shahin Ghadir:If you notice, Roxy, this thing changes really quickly in about a 15 to 20 year, which like goes like that.
From the time you're 30, when you've got, you know, you should be freezing your eggs to 35, advanced maternal age to 40, declines in this 45 may not even happen. 50, forget like that is a huge, very, very. If two decades that go like that with major changes in what's available and what's not.
Roxy Manning:Yeah, no, you're absolutely right. I mean, what would you say to those gals who are like 30?
Dr. Shahin Ghadir:Even I have this. I say it again and again and again.
Anyone who follows me on social media, if you have not had kids or not frozen your eggs and you've turned 30, you need to freeze your eggs if you have 30. 30 is a good age. Now I have people that come into 32. I'm still proud of them.
But the earlier, the better quality eggs and the more eggs you're going to get.
Roxy Manning:Okay, and is there a peak age when the eggs are just like the best they could ever be in your.
Dr. Shahin Ghadir:20S is when the eggs are the best they could be.
Roxy Manning:Okay, so that's even like the ideal time, right, to do the egg freezing?
Dr. Shahin Ghadir:It is a perfect time. However, every year I probably have 1 handful to 2 handfuls maximum of people that are like hey, I'm in my 20s, let me do this.
It's getting a little better. It's getting a little bit better. I think decades from now, people under 20, that's going to be a part of a normal part of being a female.
Finish college, freeze your eggs, move on.
Roxy Manning:Yeah, yeah, I know. It's a good thing. It's a good college graduation gift to give yourself, huh?
Dr. Shahin Ghadir:Very. So if any grandmas are listening right now and their grandkid is about to graduate, it's the best gift you can ever give them.
Roxy Manning:Yeah. And then there's not that rush and the freaking out.
Dr. Shahin Ghadir:There's not the pressure. There's just not that pressure that's put onto women. You can work on your career, work on finding Mr. Right. All the things you need to do.
Roxy Manning:Well, I would even think in your 20 year career.
So seeing the change, you know, like the, about women wanting to have babies later because we are working on our careers and everything else, that's the number.
Dr. Shahin Ghadir:One reason why women aren't getting pregnant as easily is because of their careers and waiting longer. And they should have the right to do that. They should have to. They should be able to have a child on their own timeline.
And that's what freezing your eggs allows you to do.
Roxy Manning:And has being a father yourself, has that shaped you as a fertility doctor? Has it, you know, changed you? How do you think that that sort of plays into everything.
Dr. Shahin Ghadir:So I think understanding the meaning of having your own children is something is very impossible to explain to someone who doesn't. It's been one of the most beautiful gifts that I've ever been given in life.
One of the hardest jobs I've ever been given in life too, because it's really not easy, but one of the biggest joys in life too. And I feel so incredibly grateful for having the opportunity to have one of the best professions that I ever could have dreamt of in my life.
Roxy Manning:Yeah, I know it is. I mean, you probably see the happiest of the happiest, you know, it's, it's.
Dr. Shahin Ghadir:I do.
Roxy Manning:When you get to tell people the.
Dr. Shahin Ghadir:Great news, you know, oh my God, it's such. I get.
The other day I got a picture sent to me on my phone phone of this chubby little baby, brand new, just held up at the hospital and the operating room. And I was like, I love this. I just never get. It never gets old. Never gets old. It never gets old.
Roxy Manning:If you do have to tell people, like not so great news, do you, do you personalize that or does it stay at the office?
Dr. Shahin Ghadir:It does affect me. So one of the reasons I went into this area of medicine is because I didn't do well. I saw my personality like I was.
When I was going through, like, the areas of cancer and people that were really sick and dying, it really affected me in a very negative way. That's why I decided to go into obstetrics and gynecology. You know, I thought it's like just a more pleasant area of medicine.
And once I was doing my residency delivering babies, I realized, I love this, but that's a very demanding lifestyle from the delivery. And then I saw fertility was. You get to bond with people, and I'm a people person, and it meant a lot to me. So I'm able to bond with people.
I get to treat them for long periods of time. It's not like you just go in once in a year for your annual checkup or a cough or a cold, and you leave.
So I kind of found my calling in an area that I felt very, very comfortable. But the bad news part of it is difficult, very. And it kind of affects me. You know, I'm one of those people that it's like, just not.
I've had partners that I worked with. I don't think it fazed them for one second telling someone bad news.
But it does get to me a lot, especially since I get to know people and I get to learn a little bit about their life, and their story becomes very human. It becomes a very real human chapter.
Roxy Manning:Right. And it's like that deep, like, almost primal goal in life, to have a child. I mean, there are some people that don't. Some people don't.
Dr. Shahin Ghadir:So I love that you said that, because in the beginning of my career, I used to think, wow, they're so weird that I want to have kids. And then I realize that is one of the smartest people I know. Someone who understands that being a parent is not for them.
It is the smartest decision ever. It is the biggest job ever. And if you're not 100% ready for it, it can be, in my opinion, the biggest mistake ever.
So I look up to people that can say, I just realized parenting and having kids is not for me. And I don't think they're weird at all. I think they're very smart now.
Roxy Manning:Yeah, very smart. They know their strengths and their limits.
Dr. Shahin Ghadir:And they know what they want and they know what they don't. And sometimes they want it to be all about them. Sometimes they want it to be all about Giving to others.
And sometimes it just, it's very important to be able to understand that.
Roxy Manning:Yes. And to not cave into societal pressures and expectations. Right, exactly. You have to.
Do you, you know, so what advice would you give your 25 year old self?
Dr. Shahin Ghadir:My 25 year old self and to a female 25 year old of myself would be, be very, very proactive. Learn exactly what your options are. Keep track of your options and don't let them pass by and be like, oh, I should have and I didn't. You can't.
You're only given one life. You got to make the best of it. Make the smartest decisions, discuss, consult, and make the best decision so you never have to regret your future.
Roxy Manning:Yeah, that's a good point. I'm sure you see a lot of regret too, in your practice.
Dr. Shahin Ghadir:Oh, all the time. People like, I don't know why I didn't freeze my eggs or I don't know why I hear that all the time.
Roxy Manning:Yeah. And you got to just move forward at that point, you know?
Dr. Shahin Ghadir:Yeah.
Roxy Manning:And how are you living iconically right now?
Dr. Shahin Ghadir:Oh, gosh, that's a hard one. I try to live for myself and this is one thing that I think is really important. I just like, I don't love societal norms.
I love to do what makes me happy, what makes my family happy, and kind of be the truest authentic human being. That makes me happy.
Roxy Manning:That's true. I think authenticity plays such a big part in that. You know, it's, it's, it's how we should live. You know, we should be true to ourselves.
You know, it's true.
Dr. Shahin Ghadir:Very.
Roxy Manning:Oh, my gosh. Well, thank you so much for coming on. You gave so much great information.
Dr. Shahin Ghadir:Thank you, thank you.
Roxy Manning:And please let everybody know where they can find you.
Dr. Shahin Ghadir:So my website is Dr. Gadir D R G H-A--I-R dot com. So it's DrGedir dot com. My social media handle is Dr. Shaheen Gadir. One word. Dr. Shaheen Gadir. We're on Instagram, Facebook, Tik Tok.
I have a podcast as well called the Fertile Life. It's on Spotify and you can find it very easily. And I'm at HRC Fertility in Beverly Hills.
And next week we are moving into our brand new office in the heart of Beverly Hills. And it's again. And the website for HRC Fertility is having babies dot com.
Roxy Manning:Oh, that's so great. Oh, well, that'll be exciting. New office.
Dr. Shahin Ghadir:Very, very exciting. State of the art IVF lab It's amazing.
Roxy Manning:Wow. That's amazing. Well, best of luck with all of that. That sounds so good and thank you so much.
Dr. Shahin Ghadir:My pleasure. Thank you very much.
Roxy Manning:Whether you're on a fertility journey, thinking about starting one, or just needed to hear the real deal behind all the headlines, this episode was about one thing. Informed choice. Dr. Dr. Ghadir, thank you for giving us clarity, compassion, and the facts that too many women don't get until it's late in the game.
If this conversation opened your eyes or made you feel less alone, share it with a friend. Tap, follow, leave a review and let us know your biggest takeaway.
All of Dr. Goodear's info is linked in the show notes if you're ready to explore your options. Because midlife doesn't mean you're out of time. It means you get to decide what's next. See you next time. And stay iconic.
