Stop. Sit. Surrogate.

From Egg To Embryo: Truths, Myths, And Modern Fertility

• Kenedi & Ellen Smith • Season 5 • Episode 27

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Want a clear, unvarnished guide to IVF that blends science, empathy, and practical advice? Lisa, an embryologist and lab director in Melbourne with over 15 years in the field, joins us to break down what truly shapes outcomes—from age and egg quality to lab standards, embryo grading, and the rise of AI in fertility care. No mystique, no scare tactics, just what works, what’s changing, and what still can’t be predicted.

We start with a step‑by‑step tour: stimulation, retrieval, fertilization via IVF or ICSI, blastocyst growth, and the decision points around fresh transfers, freezing, and PGT. Lisa explains how PGT prioritizes embryos by chromosome balance, why it can reduce miscarriage risk, and where it still falls short when mosaics appear. If you’ve ever wondered why a 4AA isn’t a guarantee or how a “CC” can still lead to a healthy birth, this conversation reframes grading as probability, not destiny.

Then we zoom out to the system that holds it all together: the lab. Not all IVF labs are equal. Culture media, incubators, quality control, and the experience of embryologists influence embryo viability more than most patients realize. Lisa shares how time‑lapse incubators and AI now analyze thousands of images to support consistent selection, and how robotics is beginning to automate ultra‑delicate procedures like ICSI—promising fewer variables and faster decisions. We also cover lifestyle levers that matter—smoking, alcohol, BMI, sleep, and stress—and why none of them outweigh the impact of age on egg quality.

If you’re deciding between fresh and frozen, weighing PGT, or trying to decode grading, this episode will help you ask smarter questions and make calmer choices. Follow Dr. Lisa Lee on Instagram for more lab‑side insights, and tap follow on our show to get future deep dives into surrogacy and fertility. If this helped you or someone you love, share it, leave a review, and tell us the biggest IVF myth you want gone for good.

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SPEAKER_02:

Welcome. We are a mother-daughter podcast about all things surrogacy. Together, we have brought eight beautiful babies into this world. And we would like to share through education and knowledge about surrogacy with those who want to educate themselves on the topic. This is Stop, Sit, Surrogate. Have you ever thought about growing your family but aren't sure what your options are? Or maybe you're someone who wants to help others experience the joy of parenthood? That's where Northwest Surrogacy Center comes in. Northwest Surrogacy Center is a full-service surrogacy agency that guides intended parents and surrogates through every step of the journey with compassion, transparency, and personalized care. From matching to legal support into emotional wellness, they make what can feel overwhelming feel deeply human and supported. Whether you're considering surrogacy to grow your family, or you're ready to become a surrogate yourself, the Northwest Surrogacy Center is there to walk society every step of the way. Visit Northwest SurrogacyCenter.com. That's nwsurrogacycenter.com to learn more and take the first step towards something truly life-changing. Northwest Surrogacy Center. Love makes families. Surrogacy makes babies. Hi everybody. Welcome back to Stopsit Surrogate. We are welcomed today by an amazing embryologist who I found on Instagram and was like so fascinated, and you're so nice to have reached back out. So thank you.

SPEAKER_03:

Would you like to introduce yourself? Well, thank you so much for having me. My name is Lisa. Um I'm an embryologist and I work in Melbourne all the way in Australia. So very far away from where Kennedy is. In fact, it's the morning for me right now and it's like late afternoon for it's tomorrow for you. Oh my god.

SPEAKER_02:

So weird. How's the future?

SPEAKER_03:

It's awesome. It's great. Great day. You know, it's looking everything's looking really good. It's good. Good. All right. So a little bit about myself and my work journey. I've been in the fertility industry probably uh say f 15, 15 plus years, maybe almost coming up.

SPEAKER_02:

Look like you could be in the industry for 15 plus years.

unknown:

Thank you.

SPEAKER_02:

You're welcome.

SPEAKER_03:

Um, so I I basically went straight into um embryology uh after graduating from uni. Um so I did reproduction as a major. I was in uh I did biomedical sciences. Um and I guess at that time um IVF was becoming a little bit more um talked about, like it's not doesn't have that. I think, well, I I would I'm sure you would remember like 20 odd years ago, there's a slight shame that comes with doing IVF, like not many people talk about it. Um so when I was doing uni, people were talking about it, so it became an option as a career. So I first did an honors degree um under Professor David Gardner. You may recognize the name because his name is the name of the Gartner Grading System for scoring embryologists. So, you know, when you talk about embryologists grading, like embryo grading, um, his system is the most widely used in the world. Um, so I did an honors year under him, fell in love with embryology. I thought it was fascinating that something so small, eggs and sperm, can come together and form a baby. Um so yeah, so then I got a job, I got myself a trainee job in Hong Kong, that's where I started training. Um and a couple years in, I was like, oh, I f I feel like I need to know a little bit more about the science of how everything works. Um, so I went to I went back to Melbourne in Australia and I did a PhD under David Um Gardner himself. So that was a couple years in. Um finished my PhD. Um that was tough, but I got through it. Flash your heart. Um and then and then I started working as an embryologist. So I held a couple of different roles. Um, obviously, did all my training, got qualified as an embryologist. I worked as a clinical research embryologist as well. So I ran a couple of clinical research trials. So there was a little bit of science and embryology involved, which was really cool. Um, and then I would manage a lab, so I was a lab manager of a really large clinic for the last six plus years. Um, and I've recently just moved on um to collaborate with uh two medical doctors, um, and they've started a brand new clinic, like a small boutique, brand new clinic in Australia. Um, and I'm running the lab there. So that's my journey so far. And it's it's been it's been awesome. And because of the fact that I'm now running the lab the way I want it to run, um, and it and I asked my doctors, hey, is it okay if I put a couple of clips on social media? Um, and it took off. It took off um in a couple of months, and I guess everybody was really interested in it, you know, to see how it works. Obviously, it's a lot of um controversy. Um, you know, don't you love it though? Gosh. Do you like it? No, I mean at the beginning, I uh maybe I guess I I'm in a little bubble where where where everyone accepts IVF for what it is, you know. I don't yeah, like you know, I work with people that obviously works in IVF. My friends are uh you know pretty accepting of my job, otherwise they won't be friends with me.

SPEAKER_02:

Right, right.

SPEAKER_03:

So I guess you know it was a bit confronting initially to receive a lot of comments about why I'm doing what I'm doing. Um at the end of the day, I'm really here for the patients who are going through it. Um there is so much with IVF, it's impossible to explain to a patient that what they're going through has happened before. Right, it's not new what they're going through. Um, so I try to share these stories on Instagram because at least if it happens and they see it there, yeah, it they can relate, I suppose.

SPEAKER_02:

Feel less alone, yeah.

SPEAKER_03:

Yeah, it's really hard if because because there's there are a lot of um you know negative results that happens or like unexpected turn of events in IVF. Yeah, and and then you try and tell them after, oh, actually it happens in five percent, and then they're like, Oh, you're just making it up, like and and I'm like, no, not really.

SPEAKER_02:

Right. Well, like, and like you say, right? Like, this is still science, like it's gotten, we were talking a little bit before this, and I had mentioned that my mom they threw her, they would never do that now, right? Because science has come such a far away, but it's it's still science, it's not perfect. So yeah, it is you still you still have a slight gamble, but it's it's it's a better your odds are better, right? Than they are not.

SPEAKER_03:

So much better, so much better. It's it's increased significantly. It's obviously not perfect. Everyone wants to just do IVF once and have the family that's what a dream. Oh I believe one day in the future it's gonna improve to a point where you know everything's much better, but that takes time, money, and research.

SPEAKER_02:

So you said research. So I'm a little curious. I kind of want to back up a bit. So you said that you were doing research beforehand, like research on embryo. What what what is that? Like what what are you researching with the embryos?

SPEAKER_03:

Um, well, it could be anything, but the few projects that I collaborated with. Um the first one um that was just recently published, actually, um, was the inclusion of antioxidants in the culture media. So the solution where the embryo grow. So we've um the research team has included like specific antioxidants into it to try and help the embryos grow better. Oh so that was part of research. So in order to, you know, that was like from 10 years worth of work where it started by you know adding it in in mice, right? Because you gotta have basis, you can't just have an idea and then do it on human embryos or so wrong. So they started all that groundwork in mice, they proved that conceptually it it does translate to better embryo outcomes, like in terms of grading and gene expression, etc. etc. And then they eventually move into um human trials, um, where patients will voluntarily sign up for it. Um, and then in order, the gold standard of most research is something called a randomized controlled trial, um, RCTs, where a patient will sign up to the trial, they don't know whether they get the antioxidants or not, so it's completely blinded, like there's no bias to it.

SPEAKER_00:

Right.

SPEAKER_03:

Um you look at the results and you compare it and see if it actually works. So that was one of um the research projects I was involved in.

SPEAKER_02:

That's so cool. Okay, now I'm so whenever we have people on that like are smarter than me, I call myself a civilian because I'm like the civilian. No, you're so smart. So, what in the world is a gene expression?

SPEAKER_03:

Um, I like to describe it as um a series of instructions, really. Okay, and so so we we've got DNA, that's the set of instructions inside the embryo. Um, and the embryo has to read the instructions and then carry it out. So gene expression is basically carrying out the set of instructions.

SPEAKER_02:

So that's oh oh my gosh, I feel smarter now. Thank you. Um, and I have to backtrack because you kind of just flew over the fact that you learned from one of the greats, right? Yeah, yeah, like no big deal, like no big deal at all. Um, so you literally work, did you like literally work with him?

SPEAKER_03:

Yeah, yeah. David Gardner was my was my PhD professor. He's an amazing man. Um I've worked with him closely for maybe 10 10 plus years. Um that's a huge honor.

SPEAKER_02:

That's very cool.

SPEAKER_03:

It is, it is, yeah, yeah.

SPEAKER_02:

That I I just we had to touch on that because you were just saying it like it was it was nothing.

SPEAKER_03:

Oh if if many um patients know about him, you know, in in the IVF world, yeah. Every doctor, every scientist um knows of his name. Um, but you know, um I'm assuming most of our listeners will be patients, so yes, yes, a patient of some type, yes, yeah, yeah.

SPEAKER_02:

Um okay, so in in kind of like a nutshell, could you if for someone who's like completely new to IVF, could you like give a quick overview of the process from like start to finish?

SPEAKER_03:

Yeah. Um so a really quick overview. Um, I would say you are obviously trying to get pregnant um with IVF. So um to do that, to maximize the chances, you would try and rather than um getting that one egg that ovulates that comes through every month, you would take hormonal injections, okay, take a series of injections over a couple of days to try and recruit um every single follicle that grows inside the ovaries. Um, with each follicle, hopefully there'll be an egg inside it. Um, and then as a result, the patient will then have an egg collection surgery where the doctor will collect as many eggs as they can, hands it over to the IVF lab, where they will then fertilize all the eggs with sperm from the partner, um, and then we'll grow the embryos out for a couple of days. Um, depending on the treatment, um, we will we may either transfer the embryo, the best embryo, just one usually, we'll put it back and hopefully the patient gets pregnant. Any extra embryos will be frozen. Um, there are additional testing that can be done for the embryos. So if that's something that the patient and the doctor has discussed, we will um test the embryos first before freezing them.

SPEAKER_02:

So when it comes to testing, sorry, when it comes to testing, are you the one doing the testing?

SPEAKER_03:

That's me. That is you. That is me. That is the embryologist in the lab. So um testing um usually refers to um PGT, pre-implantation genetic testing, um, where a small amount of cells is taken from the embryo, um, and then those cells are sent off for genetic analysis. We determine if the embryo is carrying the right amount of DNA.

SPEAKER_00:

Okay.

SPEAKER_03:

And then we can tell the doctor which embryo is better, and then we try and prioritize the embryo to put back, and that way we maximize the chances of pregnancy.

SPEAKER_02:

Okay, so for PGT, because so me being a surrogate, you know, all of the embryos that I've had transferred into me had PGT testing, and never in my life did I ask what it is, because I'm just like, sure, yeah, okay, that's normal. So you just said that it's like you're making sure that it has like all the DNA. Is there like specific markers that would be off?

SPEAKER_03:

Um, specific chromosomes. So so most of the time it's because um the older the women, the the women are, the higher the chances um of the eggs not having the right amount of DNA. Right. Okay. So so even though we we may make five embryos, um they maybe only four of them, uh sorry, maybe only one of them is genetically normal. And you can't you can't tell the difference. They all look like beautiful, perfect, perfectly suitable embryos.

SPEAKER_00:

Okay.

SPEAKER_03:

Um, but maybe only one of them is genetically normal. If you don't test these embryos, you will end up putting one after one after one in maybe four months before you get pregnant, and you won't know why. Um TGT is a way of sort of um changing the order in which the embryos are are put back in, um, because we know that that particular one is normal. Um and correct. So it will also reduce the chances of miscarriage if the DNA isn't balanced, then it will it will it may implant and then cause a miscarriage, which is obviously not great for the patient um or so good.

SPEAKER_02:

Okay, and then because we're talking about PGT, I'm also curious about, and now I haven't been around for a while for this. Um the one that starts with an N the N I N I P T nip nip no nip testing, yeah.

SPEAKER_03:

After you get pregnant.

SPEAKER_02:

That's so that's after you can't do that before.

SPEAKER_03:

No, you can't do it before. That's okay.

SPEAKER_02:

So the PGT is before and the nipped is after.

unknown:

Yes.

SPEAKER_03:

Okay, okay, then never mind. Um I do want to add though, um what I do find interesting is uh I believe um I may be wrong, I believe in the US PGT is used widely. So a lot of clinics do it, a lot of clinics recommend it routinely for all patients. Yes. Um in Australia, the practice is a little bit different. Um, I would say it's usually only recommended to women who are like 37 and older. Of course, it's doctor-dependent and it's also patient-dependent. So if you're a 30-year-old and you've had recurrent miscarriages, then yes, we would recommend that. But we don't, I don't like PGT is not used as widely in Australia compared to the US.

SPEAKER_02:

So it's not like a standard thing, because like here it's very rare for it to not have the PGT testing done.

SPEAKER_03:

Right, yeah, it's not standard in Australia. Um, and there are reasons for that. Um, eight, it's ridiculously expensive. I don't know. I don't know how much it costs in the US, but in Australia it costs, I would say maybe eight hundred dollars Australian per embryo tested. Oh, per embryo. Per embryo. So how much would that be?

SPEAKER_02:

I mean, I don't know that probably close. I feel like probab close-ish. I feel like Australia is kind of close with our with our money when it comes to countries.

SPEAKER_03:

Um so it's it's a lot of money per because it's per embryo tested. Um, and it there is a small chance that the embryo may be damaged during the process. Because if you I don't know if you remember the video you watch, but it does look a little bit brutal. You take you literally, we're literally taking cells from the embryo.

SPEAKER_02:

It looks like you're ripping it.

SPEAKER_03:

Yeah, yeah, it's not it doesn't usually it's it's not great. Um, I promise if done properly, it is very safe.

SPEAKER_00:

Okay.

SPEAKER_03:

Um, but there's always a risk, right? Every time we're touching something so tiny, so tiny, yeah. There is a risk that something bad may happen. Yeah. Um and there's always you can do the test and it can have an ambiguous result. So it's not always happy days with PGT.

SPEAKER_00:

Right.

SPEAKER_03:

Um in Australia, we don't recommend it for all patients. Um, but I do know it's it's widely recommended in US.

SPEAKER_02:

It is. It I didn't know that it wasn't in Australia, so look at that.

SPEAKER_03:

And it's actually illegal in um some conservative countries to get the PGT testing, correct. Yeah, yeah. Really? Some Asian countries and some European countries where it's actually illegal to do this sort of testing.

SPEAKER_02:

Um wow. I mean, I guess that doesn't shock me to hear, I mean, a little bit, but not super much, because I know like in Canada, I don't know how it is in Australia, but like in Canada, you can't find out if it's a boy or a girl. Like you're not allowed to okay, same. Okay, oh wow, you asked, what are we doing? Okay, so you can't find out in Australia either. Yeah, interesting. Okay, I guess it makes sense. I guess.

SPEAKER_03:

Every way is a little bit different. I think there's there's pros and cons to the different ways the system is done.

SPEAKER_02:

So yeah, well, uh pros and cons. Like, what are some misconceptions about IVF? Do you think?

SPEAKER_03:

Ooh, I mean, like I feel like a lot of people think it's a guarantee. Or maybe not so much anymore, but there are maybe the younger generation.

SPEAKER_02:

So I think I think it's more like, yeah, I would say it's like uh like a more of a guaranteed uh like mindset, like oh okay, IVF, like at some point, even if I have three failed transfers, it's gonna work type thing.

SPEAKER_03:

Yeah, and unfortunately there will be patients where it won't work for them, right? Um so so yeah, I I would say maybe that's a number one thing, but with education, I do feel like a lot of people now understand that age is a big factor. Um and then I guess the second misconception, let me think. Um I I don't know. I'm I'm so yeah, what what would you say with IVF?

SPEAKER_02:

You know, I don't know if it's a misconception rather than like the way that people have talked negatively about it in the sense of like, oh, IVF is it's well, I've heard IVF is the easy way, and I'm like, uh, that's complete BS is so not true. It's beyond beyond the truth. Um and uh the other one is like playing God, right? Like you're you're picking which one's the best, which one's the prettiest, which one's gonna have blue eyes, which one, like all these kind of things, right? Like a designer baby. And I'm like, I don't think IVF is like that.

SPEAKER_03:

I'm just glad to get an embryo for a patient. Literally, like we're not picking anything here, we're just trying to get them pregnant.

SPEAKER_02:

Yeah, exactly. Just a healthy embryo. We don't care what color eyes, what color hair, we don't care. Yeah, yeah. But those are the ones that I've heard, and I'm like, maybe we should read a book. Thinking about becoming a surrogate, it's a life-changing decision, and you deserve expert guidance every step of the way. That's where Serene Surrogacy Partners comes in. Serene Surrogacy Partners is a reputable, experienced surrogacy agency dedicated to supporting women like you, with thorough screening, legal protection, and comprehensive medical and emotional care. As a surrogate, you'll be matched with intended parents who align with your values, and you'll have a dedicated case manager throughout the journey. Compensation is fair and transparent, and your health and well-being always come first. If you've ever considered surrogacy, start by getting the facts. Visit Serene SurrogacyPartners.com to learn more or apply confidentially. That's SerenesurrogacyPartners.com. So, what's the difference between a fresh versus a frozen embryo transfer?

SPEAKER_03:

Yes. So after an IVF cycle, so you've just had the egg collection surgery, um, then you've created a you know, luckily, if you're lucky, you create a bunch of embryos. Um you can actually transfer one immediately, usually five days after egg collection. Um, and that is called a fresh embryo transfer. So it means the egg.

SPEAKER_02:

Five days. Sorry, so you can wait five days. So when the egg so when the egg is retrieved, does it immediately go into the next room? And that's where you put like the sperm to meet the egg?

SPEAKER_03:

Yes. So the on the day the egg is retrieved, so the day that the patient goes through surgery, yeah, um, on that day itself, we will fertilize the egg with sperm.

SPEAKER_00:

Okay.

SPEAKER_03:

That's day zero. And then the next day is day one, and then day two, day three, day four. So on day five, um, we can try and see which one's the best embryo, and then we can put and select the and put the back, uh, put the best embryo back. That is called a fresh embryo transfer. So it means that the embryo has never been frozen. It's you know, literally just five days after a collection and we put it back. Um and any other embryos, we don't want it to go to waste. You've gone through two weeks of injections to create these embryos so we can freeze them. And then if the fresh one didn't work in the next menstrual cycle, we will then warm the embryo up and put it back, and that's called a frozen embryo transfer.

SPEAKER_02:

Okay, so uh a couple questions. So blastocysts, are those is that happening uh before they're being frozen? Like, are we waiting for that?

SPEAKER_03:

Yeah, so blastocyst is a stage in the embryo growth. So really, it we we you can call it an embryo every single day. So on day one it's an embryo, and day two, it's an embryo, day three, but we do have specific terminology for each day. Okay, so blastocyst is a day five or a day six embryo.

SPEAKER_02:

Okay, and that's when you would freeze it, uh yes, yeah.

SPEAKER_03:

That's when we would either do um genetic testing, so it's the procedure is actually called embryo biopsy, where we're taking a little bit of cells out, um, or we can freeze. So there's a blastocyst stage.

SPEAKER_02:

Wow, okay, and now I have a personal question because we're on this. What's a zygote?

SPEAKER_03:

A zygote is oh, you're testing me now, but it's a it's a it's a very early stage embryo. So a zygote, I believe. Oh, I feel like I need to fetch so sorry.

SPEAKER_02:

While you're looking that up, I'll give a little background. It's because I was recently on a journey and my IM needed to get some zygotes to do this procedure that she's trying to do, and um I, for the life of me, could not figure out what a zygote was.

SPEAKER_03:

So it's a fertilized egg.

SPEAKER_02:

Okay.

SPEAKER_03:

So if you imagine um we've just collected eggs from the patient, yes, and on the same day we've put sperm into the egg, yeah. Um either through IVF or or Ixy, where we inject one sperm into each egg. About 16 to 18 hours later, we will see signs of fertilization. So once we've confirmed that, that is now called a zygote. Wow, okay, so that's quick. Well, 16, 18 hours. Yeah, well, like quick-ish. Yeah. So it's still a one-cell embryo and it hasn't technically divided into two cells yet. It's still one cell, but we can see signs of fertilization. So we can see both mom's DNA and dad's DNA inside it. That early.

SPEAKER_02:

That's so cool. Um, and back to thank you for explaining that. So, but um, back to fresh and frozen. You know, there's always been this debate that I hear among the community, like, fresh is better to do a transfer, or I don't know. Have you heard of that? Have you heard that? Is there like truly one side?

SPEAKER_03:

No, there's so many nuances to it, and this there's so many of these debates. So it's not just fresh and fresh versus frozen, there's day three versus day five, right? There's ixy, anything you can think of, it's it's out there. There isn't a one-sided argument to it, it really depends on the patient's history. Okay, I'll give you an example. Um, let's say uh the patient is a 30-year-old who created um 10 embryos, okay. And then she may take five to eight months to go through the 10 embryos before she finds the the one with the correct amount of chromosomes in it. Um it's better for her in that respect to perhaps have done the PGT, like the genetic testing, freeze all the embryos, figure out which ones are the ones with the highest potential, and put it back.

SPEAKER_00:

Right.

SPEAKER_03:

On the flip side, you may have, for example, a 41-year-old patient who's got a low AMH and only creates two eggs every cycle. Okay. Um and there's nothing to select for. She only gets one embryo per cycle. So maybe you should just put it back. Right. However, however, maybe that patient has had miscarriage after miscarriage after miscarriage and doesn't want to go through that heartache anymore. Then she maybe she will choose to test that embryo, freeze it, and only transfer it when it's when it's genetically normal. So it really depends on the patient.

SPEAKER_00:

Yeah.

SPEAKER_03:

And it really depends on what they're going through. And the doctor will discuss all those different options with them and decide what's best.

SPEAKER_02:

I cannot pronounce this word. So we're gonna see. Can you explain? I'm gonna give you the abbreviation, the ICSI. I'm not even gonna attempt. In you know what I'll attempt. Intracytoplasmic sperm injection. Great job! Great job. Oh my gosh, I'm so smart. Okay, there you go. Is that what you were talking about? Ixy. Ixy. Oh, you're calling it Ixie.

SPEAKER_03:

I thought it was we call it, we call it Ixie. Okay. Um fertilization for the egg. So um there's two main methods to fertilize the egg. The first one is to process the sperm and mix a whole bunch of sperm with the egg.

SPEAKER_02:

Yeah, but would they like fight and like swim in the dish, right?

SPEAKER_03:

Let the swimmers do its own job, find the eggs and fertilize it. So that's more natural way. That's called IVF actually. Just in vitro fertilization, just call IVF.

SPEAKER_01:

Perfect.

SPEAKER_03:

Second method, and I would say most people have seen like the video on TV where you see one needle piercing the egg, that is Ixy. Okay, it's it's ICSE stands for intracytoplasmic, which means a needle going in inside the cytoplasm um injection. So we select the embryologists, we'll select one single sperm and then we will inject it into the egg directly.

SPEAKER_02:

Why?

SPEAKER_03:

Um mostly for male factor related infertility issues. So, for example, male patients have a really low sperm count, or perhaps their swimmers are not swimming very well. Okay, they need a little bit more.

SPEAKER_02:

help getting inside the egg that's when it is really helpful um because naturally the eggs the spoon is not gonna find its own way into into the into the egg right oh look at that i love learning that from the other side because being a woman in surrogacy i just always am like egg egg egg but that's that makes a lot of sense that's actually pretty cool i think we kind of went over this but what factors have the biggest impact on IVF success rates well yeah like well is that is that even like a true question yeah it is but there's there's so many uh I mean the first one that comes to mind is actually just age um oh age of the women yeah um and that's a really hard one to share because you can't change anything about that yeah and you know sometimes like it's it's easy to say just have kids younger but you might not be ready you may not have found the right partner you may not be in the right of life so right and not everybody has the money to go freeze their eggs that's that's a whole different can of worms that we have um yeah it's just yeah so but age unfortunately has the single biggest impact. So is age because now my understanding of that is because the older that the woman is right the the less viable the egg is like it's just not healthy is my understanding like strong.

SPEAKER_03:

Yeah yeah so we're born um with all the eggs we've ever had yeah um since birth so we're we're carrying eggs that we've ever had the minute a woman's born um and as you go through puberty that's when the the ovaries start kicking in and every month um a bunch of follicles will start growing and the most dominant follicle will release one egg each month. So that's the menstrual cycle and that's the ovulation that comes in every single month. But as we age the the mechanisms for sort of doing all that don't work as well. So the eggs that are then released tend to have an unbalanced amount of chromosomes in it DNA. Okay. Which means that even if you try and fertilize that embryo it will either not grow or it may grow and not implant or it may implant and miscarry. So okay the older the women typically above the fertility just starts declining from age 22 to 24 and it's a slow decline. I'm sorry did you just say 22 to 24 that's unfortunately the way nature works there's a slow decline from it peaks at about very young 20s there's a slow decline up until age 30 between 30 to 35 there's a slightly steeper decline between 35 to 40 there's another bigger drop and then from 40 onwards it is a pretty steep decline. So the success rates for IBF does drop significantly per age group that is a my mind is blown right now.

SPEAKER_02:

I was not expecting you to say anything I just turned 30 and I'm like uh oh okay we gotta go oh my that's crazy any of the listeners to feel stressed out about it um you know you can't turn back the clock on on no for sure and it's healthy to most most women these days tend to have their babies you know in their 30s you know a lot of women tend to have babies in their 30s you know you're establishing careers and and things like that so there's no I was just mind blown to hear you say 22 to 24. That's really really young that's really young.

SPEAKER_03:

The bodies work um but there are obviously um people do get pregnant naturally in their 40s like that that's not doesn't happen um but just don't ever be the one that's that will think that it's a guarantee if in the for like that's that's definitely the I don't want people to take away from this podcast thinking that yeah like don't wait like yeah like if you have a choice you're not gonna be the unicorn not like I'm just gonna like put it bluntly like just like you know yeah we don't want to chance being a unicorn like yeah um so you mentioned follicles and I mean I watch all of the the the med shows um you know like race anatomy and everything and I'm just like I just like nod my head along but since you're here I'm gonna ask you so if you have a lot of follicules is that good does that mean anything like if you if you if you're able to amp up your follicles does that really mean anything for retrieving more eggs yes so typically the higher your AMH so AMH is anti-malaria hormone it's typically one of the first few blood tests that doctors may recommend for their patients it's a good and bad test because it shows your ovarian reserve so it does tell you how likely you are to retrieve eggs in an IVF cycle but what it doesn't tell you is the quality of the eggs right so in the IVF lab we actually often say we would rather one good egg than 10 bad eggs. Okay that's fair we we need the one good egg but like it's not it doesn't mean much if we're gonna have many many follicles if they produce bad quality eggs.

SPEAKER_02:

Right.

SPEAKER_03:

And can the AMH tell you if it you it can't tell you if it's gonna be good quality right you is there a test that will tell you that before no there's not not yet not yet unfortunately and I I don't think there will be one um to be honest just because the way the eggs grow it's impossible to test for it until you actually level okay well that's very interesting yeah that is a a good and bad I guess yeah the AMH test is still a very important test because if you have a low AMH um then it's a de it's a good sign to to try and do something about it because it declines with age so if you have a low AMH at a young age you may want to freeze some aches because you will ah we just went through those numbers 22 24 30 like they're going they're going down okay and actually I I actually wanted to share I did I do actually have a lot of conversations with patients and they often say but I'm so healthy I've I've you know right I've I didn't I've exercised my whole life I don't smoke drink I don't do recreational drugs why is this happening to me so I I actually do want to share that it's unexplained right it can happen to the healthiest of person um so yeah it's just infertility is just something shitty that happens to random people yeah right exactly because there's no yeah so because I know that that was like also a misconception of this IVF world right it's like oh well you know if you do drugs or if you drink or things like that then yeah sure like that'll have an impact on your fertility and then there are so many healthy people that have never touched anything like that and they have fertility struggles so again science is just real interesting it's just real interesting um well speaking of that though is there um do lifestyle factors like diet stress like actually play the the impact on IVF outcomes yes it does yes it does um probably not as uh big of a factor as age um but it absolutely does um so I think it's uh so for example smoking okay no no like we tell our patients to quit both the male and the female should quit yeah males males males the husband all types of all types of smoking not just cigarettes like all types of recreational everything oh everything okay okay yeah just checking how our advice is to just just quit it if to try and maximize the outcomes um so research has shown that it's it's got lots of negative flinks I mean one can always count it and say hey but so and so has has changed smoke for 10 years and then still got pregnant naturally that's always going to happen but research shows that if you smoke a lot be it the male or the female it's going to have a low it's gonna lower your chances of pregnancy with or without IVF.

SPEAKER_02:

Interesting and the same goes for recreational drugs a lot of this haven't been tested yeah as extensively as smoking um you know it's quite difficult to try and recruit a people who's gonna say hey I am doing XYZ drugs right right right yeah or study we don't do that what are you talking about we're healthy people we don't we don't do anything like that does drinking affect it as well like the same it does um for patients going through RVF we definitely don't recommend drinking especially the women um and then men we typically recommend like you know no more than two to four standard drinks a week which is nothing um yeah um and yeah so it does affect everything does affect even sleep stress right and stress right that one's a big one because that takes over your whole nervous system that I know yeah a lot of things does affect diet does as well um so the higher the BMI um the not so good the results of the embryos right um obviously with a higher BMI there are more um obstetric risk to carrying a pregnancy um so we definitely try and recommend um controlling that if we can but a lot for a lot of patients it's it's very difficult to try and lose weight right like it's yeah it's not like you snap your fingers and you you get it done like it's a whole lifestyle and for a lot of people it's it's very restrictive. Yes and when it comes to diet does it matter if you eat organic like I hear that you know every now and then like oh you gotta eat as healthy as you can just greens all day long and it's like well I mean you need some protein the the um standard recommendation is actually the Meditarian diet so not necessarily organic or um vegetarian it's actually a balanced diet so yes you know there's meat there's there's veggies um healthy nuts and oils in it um I'm not a dietitian so I can't comment sure no you're good i i'm not a dietitian i have friends that are but i eat Mediterranean that's just because I have a lot of stomach problems but you're just supposed to eat Mediterranean diet anyways to be a healthy person. I put quotes around that but that's the diet we all should be eating supposedly we'll be right back but first I want to take a quick moment to talk about something close to my heart helping families grow through surrogacy. If you've ever thought about becoming a surrogate or if you're an intended parent ready to start your journey Paying It Forward Surrogacy is here to guide you every step of the way. At Paying It Forward Surrogacy you're not just a number you're supported celebrated and connected with real people who've walked this path before whether you're just starting to explore or ready to take the next step they'll make sure you feel informed empowered and cared for from day one. Visit paying itforward surrogacy dot com to learn more. That's payingitforward surrogacy dot com because every journey to parenthood deserves heart honesty and the right support. Now let's get back to the episode there's just so many things that affect the chances of pregnancy and I I often if I do have a chance to speak to patient I'm like you know do everything you can but if it's going to stress you out trying to follow a Meditarian diet then that's probably not a good thing either like right yeah don't do something that's gonna add stress yeah interesting when you said when you get to talk to a patient do you not get to talk to them that much are you like the little are you are you like the Wizard of Oz like are you just like behind the curtain?

SPEAKER_03:

Yeah so as an embryologist we actually don't um connect with the patients until they are actually having their collection surgery um and their embryos are growing inside the lab. So we really only so the doctors and the nurses see the patient for like for like you know the the first two months leading up to the IV process. We only see them in the six to seven days when when their actual embryos are inside the lab. Oh so that's and give them their results have a chat um occasionally I do speak to patients outside of their cycle but but often we're like sort of hidden behind behind the scenes no one sees us we're always just like inside the lab because no one's always but it's always the people that you don't see that do the most important work.

SPEAKER_02:

You guys are just busy you just gotta like hide like you just don't you don't want the fame I get it yeah so I don't get to tell the patients that often but it's it's lovely when I when I do and they all mean so much to me you know like I don't know if they know that oh that's so sweet. Well I mean you're working on their I call them beans I mean I call my bean a bean but you know like you're working on their little beans you're working on their little babies like it's you would need you would need a certain type of heart to be in this field because again like we talked about in like that that reel that I saw that you did I'm like I know you weren't but it looks aggressive like you know it like looks like it's being pulled which blows my mind that you're not actually damaging like the future human that it's going to turn out to be like you're not taking a finger off like I know that sounds weird but when you take some cells away it's just it's shocking.

SPEAKER_03:

So the first time I went into IVF I'm just like this is what we're doing we're sticking a giant needle into an egg and it's fine but yes it's amazing like hats off to whoever invented that that scientist actually I I think I met him in person like 20 years ago that was very cool.

SPEAKER_02:

Oh my god yeah Japanese guy professor how cool you've just met everyone I'm older than um so okay so I know that I'm pretty sure I know I know this answer but I know a lot of people always ask it and that is well the question I have here but it's like can you explain implantation failure and what causes it and I I'm gonna let you answer it but I feel like I know your answer.

SPEAKER_03:

What do you what do you think I think your answer well I think your answer would be we don't know what causes it like it's right we don't know yeah yeah if the if the embryos haven't been tested yeah um then I would say the the single biggest factor is actually just chromosomal abnormalities inside the embryos okay right but we know that even with PGT normal embryos even if I put one back in it may not always take right but it's it's never a guarantee right I mean we can lie it could be anything it could be the uterine environment for whatever reason wasn't playing ball that month um it could be it it could be anything it could be stress it could be yeah right yeah there's like a whole button you just never you'll just you just won't know you just don't know and I think that hurts a lot of patients a lot of patients go down the rabbit hole of trying to understand why they go through so many types of testing out there you know immunology testing um like back to back to microbiome testing um oh my gosh yeah it's gotta be heartbreaking I mean you go through you go through all of these injections you go through all of this planning you go through all this money you go through all this hope and then when it doesn't take it like feels like your heart's ripped out like it's that's a lot yeah if only there were answers because I know every right if there were answers then there would never be failures.

SPEAKER_02:

Correct yeah yeah I think um there are some research coming out that does show that um it it it could actually be genetic um mutations variations that that patients have um that you know causes whatever reason um but there's so many different variations out there um that it's quite difficult to sort of narrow down yeah it's very interesting and then um just so fascinating I could literally sit here and talk to you for like days this is like I'm amazed um okay are there emerging technologies in IVF testing or embryo selection we should be watching so many really there is quite a lot um and I think it's because tech is really catching up on on on the whole IVF feel um so in my new lab uh we've actually started incorporating AI artificial intelligence in the assessment of embryos so so when we grow the embryos we actually put it inside a time lapse incubator what that means is that there's a camera inside the incubator and every 10 minutes it takes a photo of the embryo at different focal planes.

SPEAKER_03:

So over the course of five days with a picture taken every 10 minutes at like you know all these different focal planes you've got thousands and thousands of photos right yeah yeah so when time lapse first came about like the embryologist would literally scroll through the photos and try and make some sense of it and try and decide like use that information to try and decide whether or not this embryo is better than the other embryo but now we've got AI so AI can now do it in like seconds like you press a button and then it just scans through all of those images and try and correlate that and find the best embryo for selection. So amazing wow that saves somebody a lot of time I mean it's still sort of um like I use it in parallel with like the traditional embryo grading system um mostly because it's it's quite a new technology and I you know you don't I don't want to trust it 100%.

SPEAKER_00:

Right.

SPEAKER_02:

So I sort of use it at the same time to sort of help assist or make sure it it aligns with my decision in which I'm sure in time it's going to become yeah the technology standard correct yeah right wow so that's that's that's like that's that one yeah AI is now being used in stimulation protocols like picking the best one for the patients they're using AI in like analyzing genetics um inside the embryo it's used in so many ways it's amazing kind of creepy but also fun they're even using it in like ultrasound scanning you know like determining determining exercises like it's it's use in so many ways now and I think in the next five to ten years it's it's gonna really become the gold standard wow that's crazy I never thought I honestly I really thought AI was chat GPT I'm like yes this is my whole life like literally chat GPT is my whole life like I'm there 247 and so like I I find that fascinating that AI is really like super helpful and can like do all these amazing things.

SPEAKER_03:

So that's that's definitely I would say already um in a lot of labs already used in many ways and it's only going to be more um and the second emerging technologies I would share is actually robotics. So there's a lab in Mexico that's already pioneering and creating babies from robotic machines that does all the actual work so that the Xy procedure that we were just talking about where a scientist would sit behind a microscope and control a needle going into the egg right the robot that can be done by robots now.

SPEAKER_02:

So wow that's pretty cool that's because you must need I wasn't even thinking you must need a really sturdy hand to do that right like I quit coffee when I first started training. Did you say you drink coffee?

SPEAKER_03:

I quit coffee oh you quit I'm like you needed it I I had to quit coffee because I was just shaking and I I just like you know I mean I was a trainee right I was nervous like I had a like watching over my shoulder like trying to make sure I'm not doing the right thing so yeah I mean it it comes with time and practice and just experience like now now I can I can inject and I can chat at the same time like it's it comes so naturally to me. When you've done it for a while yeah just like muscle memory at that point yeah just muscle memory but at the beginning I I was just like how does anyone do this?

SPEAKER_02:

Right yeah well it's such a delicate procedure that yeah oh that's so crazy. Um I have two questions left are we good on time? Yeah yeah we're good on time yeah okay okay I'm just making sure um okay can you just kind of graze over grading because you always hear like oh like I'm probably gonna say them wrong like what is it like double A or like 4A or something right and like you want like AA or A B or am I right?

SPEAKER_03:

Yep correct okay so I guess yeah I can go over it quickly. So the grading system for Blastoise so we're talking about five or day six embryos okay and that's what you're grading. That's what your grade is going off of correct that's what we're grading. And like I said the most common grading system is the Garner grading system. So he invented the the 4AA or like the 5AA that's the system essentially it runs off a number followed by two letters. So um the number runs from one to six if you imagine one is like like a golf ball a tiny little golf ball and six is like a massive basketball. So it's something to do with six all right um and the larger it is the more advanced it is which is good which is good yeah okay but it's important to think about which day you're grading so I'll get into it in a little bit but um and then this the next two letters grades um the inner cell mass which becomes the future baby okay so it's ball of cells inside the embryo that ball of cells becomes a baby the second letter grades the trafectatum cells which becomes the future placenta oh so you need both to be a good quality because you can't have a baby without a placenta and you can't if you have a placenta and no baby that's that's not gonna be it that's not gonna work so you need ideally the best sort of gradings on a day five embryo is typically around a 4AA or a 5AA embryo okay those are those are top notch those are top notch that's like best of its class okay um if you let the day five embryo continue growing so it's growing continuously a 4AA should become a 5AA and then it should become a 6AA right because it's always you're never looking at it it it's it's not stationary unless you freeze it. So if you let it continue growing it's just gonna keep keep going all the way yeah the thing about grading though is that a CC embryo can still become a healthy baby. Okay right so I tend to tell my patients grading is a is very it's kind of like a beauty contest um is how a lot of people describe it it doesn't really it like we know that the chances of an AA embryo is much higher than a CC embryo sure but a C C embryo still has a chance and I will always like transfer it if that's the only embryo that the patient has. Yep. Okay and I and I think yeah I try not to dwell on it um if if there's discussion about the grading then we will share that you know it's not gonna be as high as we think it's gonna be the chances of you being pregnant but if it takes happy days right if it if it works great like that's awesome right and if it doesn't then we we do it all over again and we and we try for try to get a better grade so that's that's the grading system in a in a nutshell and for any patients that are listening please don't compare your embryo grading with someone else's embryo grading because why every single lab is different.

SPEAKER_02:

Okay embryo grading is really subjective like you see oh oh my god like so oh oh my god it's so subjective really oh yes there's so many studies on there so studies have shown that what someone may call an AA another lab or a b b or a b a or a it can be anything it's so variable um that's interesting so well because I'm shocked to hear that because the the guy that you worked with right and the guy that created this he he clearly they're going off of his system so how is it so different?

SPEAKER_03:

It's just because the cells are so variable like these cells inside the embryo it's it's all based off like a picture um it's just really difficult and there's so many variation between and then especially for those embryos that's sort of in between a grade like someone may call it this and then someone may call it that um and that's that's how technology like AI can be really useful because AI is just going to do the same thing every single time. A really fun fact they've actually shown that the same embryologist so the same person if you give them the same picture at different times they may score it differently really correct and that's how subjective it is so not only is there subjectiveness between labs even the same person can score it differently they've even associated hangry like before coffee after coffee and they will change the the grading system um there's even things like patient medical history so for example if they know the patient has been through 10 cycles of IVF and this is all they've got then they may be a little bit more lenient with the grading you know so this I yeah never compare your own embryo grading with with anybody else's um I'd say have that discussion with your doctor and your team what are my chances of success is there a chance if there's a chance I would say go for it okay perfect and then no I think that's

SPEAKER_02:

Like a fantastic explanation. I am gonna throw a little curveball in there, and I'm gonna ask you to explain a mosaic. Oh, I know. I the amount of times I get asked, because I've had a couple girls on the podcast and they've transferred mosaics, and and you know, some worked out and some didn't. Uh for the life of me, I still can't explain a mosaic.

SPEAKER_03:

Um, so mosaic is a result that comes from PGT tested embryos, so embryos that we've sent for genetic testing, and the results will come back as either normal, abnormal, and mosaic is in between, right? Okay. So the way I would explain mosaicism is I think we can all imagine how an embryo grows. You've gone from one cell, it divides into two cells, each of those cells divides into two, so then you've got four cells. Four cells become eight cells, eight cells become six cells, right? If you imagine when it's going from eight cells to sixteen, one of those eight cells has a little error in reading the instructions. Oh and it's done something wrong. All of a sudden, out of 16 cells, so you've gone from eight to sixteen, two out of the 16 now has that error, right? Okay, and when you go from 16 to 32 cells, now oh I've got to do my math, but now four of those cells out of 32 cells has that error. And it keeps multiplying, and it keeps multiplying. Okay. So this really depends at what point did that error happen. You you don't you don't you don't know. It could have happened at the two cell stage, which means half of the embryo has that error, or it could have happened much later and only a tiny amount of those cells have that error. Right. When we do genetic testing, we've got the a whole embryo, it's it contains about, I would say, anywhere between 100 to 200, maybe even 300 cells.

SPEAKER_02:

Okay.

SPEAKER_03:

We are taking a small amount of cells, around five cells. That location where we take that cells could be the difference. Because if I happen to take those cells and three out of five of them has that error, then I have a mosaic result because I took five cells, three has an error, two doesn't, and I've now got an in-between result.

SPEAKER_02:

Interesting. So if you took it from the other side, right? Like because you're not gonna know where this is, but if you took it from the other side and there were no errors, then you're not even gonna know that there are errors.

SPEAKER_03:

So it's so now it's now reported as normal, right? But actually there are some errors in there and we we didn't know.

SPEAKER_02:

Very, very interesting. So the errors, does that mean that it's like there's like problems with DNA? Like, is that what the errors are?

SPEAKER_03:

Most commonly it's the number of chromosomes are wrong. Um so the most famous would be um trisomy 21, or otherwise known as Down syndrome. That's that's a that's one that a lot of people know about. Um, but it's plus or minus chromosomes. Um, and it all has to do with the DNA replication and the the sorting out process during the division of cells.

SPEAKER_02:

Okay, I'm gonna ask one more question because you said Down syndrome. So would a mosaic if if I got an embryo graded and it's then you know it comes back mosaic, do I now have the conversation of this this could possibly be Down syndrome? Or is that not that high on the list?

SPEAKER_03:

Um so a mosaic embryo usually it's classified as like a like a high-level mosaicism or low level. So if, for example, if one out of the five cells is mosaic, then that's low level. Okay. But if three out of five, then maybe that's higher. And it it depends on the type of errors that the test has picked up. So it won't probably won't necessarily be um trisony 21 or Down syndrome. Okay, um, that will be like a complete the whole embryo has has an extra set of trisomy number 21. Okay. Uh so yeah, it probably wouldn't really be that. Like that.

SPEAKER_02:

Okay. Yeah. And different low. Oh, sorry, you said low and high. So you want you want the low mosaic. Low mosaic is better than high mosaic.

SPEAKER_03:

Yeah, but again, it like like you said, if I've taken the cells from a different spot, my result may be different. You know, right. That's the that's the controversy that comes with PGT. Like there are researchers and scientists and doctors out there who don't believe in PGT, um, because there is a limitation of the test, right? Because the amount of cells we take isn't reflective of the whole embryo. Um and that's what the PIP is for, right? Yes, so the NIP does so, even if you've done PGT and you get pregnant, we would still recommend a NIP test to make sure everything's working fine.

SPEAKER_02:

Right. Wow. This is you're you're fascinating. You're absolutely fascinating. Um, I was gonna ask my next question, but you answered it because it was how do you see genetic testing and AI shaping IVF for the next five to ten years? But you said this, you said AI is gonna take over, it's gonna be standard. Um I'm just enjoying this. No, this is amazing. I I really appreciate it. Thank you so much. This is phenomenal. I literally want to come to Melbourne and have tea with you now and do all the things. Um say it again.

SPEAKER_03:

I said make that trip.

SPEAKER_02:

I know, my gosh, I need to. I would love to. It's on my bucket list. Um, you know, I'm not even gonna ask that question because we really went over it. But so is there anything else that you want to say about IVF, about embryos, about anything like that that maybe has a misconception or just like a PSA for people?

SPEAKER_03:

Um I think as an embryologist, my my priority is is the IVF lab. And I actually do want to share that that there are a lot of different types of labs out there, IVF lab. So every single lab is different. It could come down to the brand of incubators, the type of culture media where they grow the embryos, are it's really variable between IVF labs all around the world. Um, and my point of saying that is that the quality of your IVF lab does affect the quality of your embryos. So that's sort of why I actually started my own Instagram account because I really want to share like what I believe is a good quality lab. Okay. Um, so I'm not trying to shut down or the labs are bad, like purely because there's been so many changes in the last 40 plus years, and it's really difficult to sort of continuously keep up with the what is the gold standard, right? So it's always a continuously improving process in an IVF lab. Um, but I do, yeah, I I think I I really do want to stress that there are your IVF lab, the quality of it is really important. So your quality control, how your lab is designed, the experience of the embryologists, and these are all coming from like published like research papers. Like I'm not just it's just not a fee, it's not like a feeling that I just like have.

SPEAKER_02:

Sure, sure, sure. But when you say quality, I'm you know, civilian over here, how do I know what quality is?

SPEAKER_03:

Yeah, I think that's that's the hardest part. Like people on Instagram like text me and they'll say, Hey, how am I supposed to know if the lab that I'm going to is a good lab or not? And I'm like, I actually don't know how to respond to that question because if you're not in the industry, right, like you wouldn't know what's good. Yeah, you wouldn't know what what to look out for. Um, the thing that I actually point most patients to is to actually look at the success rates of their clinic and have a look and compare it to other clinics. Um, success rates is a good indicator. Of course, it's not the whole story because every clinic may treat a different cohort of patients. So, for example, if you have one specific clinic that turns away 40-year-olds, then they're always going to have like amazing success rates, right? Because they're only treating young patients. This is a really dramatic example, but um, but I I do think in general, clinics with a high success rate are reflective of clinics who try and do their best to maximize it for their patients.

unknown:

Okay.

SPEAKER_02:

No, and that's a that's a great way to look at that. And also, people could just follow you. And how where do they follow you? What's your account?

SPEAKER_03:

Yeah, yeah, they could, yeah. Please come and follow me on my Instagram account. What what is it? So that way people can look it up. It's Dr. Lisa Lee, so um underscore IVF. Okay.

SPEAKER_02:

Oh, it'll be in the show notes, so don't worry about it, people. You can just go there and we'll find her. But um, you have been fascinating and I seriously appreciate it. Thank you for talking to me in the morning. My sun is going down, as you can see over here. Your sun is going up.

SPEAKER_03:

Yeah, yeah, she's getting a little broader. Actually, it looks like a really nice day, so I might go for a walk.

SPEAKER_02:

Oh, I love that. Well, oh my gosh. I I've I seriously, I thank you so much. I would love to have you back and talk about more things if you're willing.

SPEAKER_03:

Yeah. We should, we should, yeah. Let me know if um, you know, anybody who watches this have any questions and we can dig dig a little bit more into it.

SPEAKER_02:

Yeah, absolutely. Amazing. Thank you so much, Lisa. Thank you. All right, well, have a uh have a beautiful day. I was gonna say have a great evening, have a beautiful day. Have a great evening. Thank you. I will. And we'll talk soon. Thank you. Bye. Thank you. Bye. Holy cow, that was so phenomenal. Thank you so much, Lisa. That was I'm like, that was just amazing. Just thank you. Um, I hope that everybody was able to get some questions answered, uh, some extra education there. And if there's any questions that I didn't ask Lisa or things that you guys would like to know, please send them over. And Lisa has agreed to come back and we can talk some more. Um, if there's a specific topic that you want us to go into, she's happy to do that as well. So send any conversations that you would like us to have my way. And if you have any questions or stories that you would like to share, please feel free to reach out on Instagram at stop periodsit period surrogate or at my email at stop periodsitperiod surrogate at gmail.com. And this has been another episode of Stop Sit Surrogate. Thanks for listening. Bye guys. Before we wrap up, we want to give a huge thank you to our sponsors, Northwest Surrogacy Center, New York Surrogacy Center, Paying It Forward Surrogacy, and Serene Surrogacy Partners. Their continued support helps us share real stories, educate our community, and connect families through the incredible journey of surrogacy. Thanks so much for tuning in to Stops It Surrogate, where every story matters and every journey is worth sharing. We'll see you next time.

SPEAKER_01:

If you enjoyed this podcast, be sure to give us a like and subscribe. Also, check out the link to our YouTube channel in the description. And be sure to also check out our children's book, My Mom Has Super Powers, sold on Amazon and Etsy.