Welcome to the Brilliant Fertility Podcast. I'm your host, Dr. Katie Rose, and this podcast exists to help illuminate the path ahead of you. With expert interviews, clinical pearls, and real client success stories, my intention is to bring you hope for what's possible on this journey, and to give you tools and resources to navigate the ups and downs on the road before you. If you find this podcast helpful, don't forget to subscribe on your favorite listening platform. And I have a big request. If you have a minute, can you leave us a five-star review? And let us know what did you learn, what did you come away with? Did you leave with that spark of hope? This helps more people like you find the podcast. My mission is to support as many humans as possible on their path to become parents. And by you sharing and subscribing, you're part of that mission too. And I'm so grateful for you for being here. And I am seeing increasingly more and more women over 40. The average age of women uh who have been trying to conceive in my practice over the last 13 years has been about 37, 38. And over the past two years, I'm seeing that creep up into like 39, 40, which is really interesting. And, you know, just no good, bad about it. It's like that's neutral for me, but it also means we need to be talking more about what a 40-year-old body needs for support. I think there's so much mixed messaging around fertility over 40 in the social media world and influencer world. On one hand, we'll see people who are like talking about fertility falling off a cliff at 35, and that you need to be having babies as young as possible. And on the other hand, you might see these posts about, you know, effortlessly conceiving at 47 years old. And the reality is there's so much nuance. Everything really needs to be tailored to the individual. And I feel particularly called to the subject today because I just turned 40. And, you know, on one hand, it's like, yeah, it's a big milestone birthday that I think should be celebrated. Like 40 years in the world is an accomplishment. It is a privilege to age, to have these years under my belt. And I'm putting myself in the shoes of my patients, my clients who are wanting to conceive and thinking about like if I were in that place now, how would I be approaching this? Now, just from a totally personal lens, like I already uh prioritize my hormone health in a way that I didn't know how to 15 years ago. And so I can personally say without a shadow of a doubt that I am more fertile today than I was at 25 years old. I don't say that lightly. And I mean, in some ways, like, well, I wasn't getting a period at 25 years old, or it was every six months non-ovulatory. So it's like, well, duh, I am definitely more fertile now than I was then. But we also have to look at, you know, what other factors come into play at this stage of life? I know people are worried about their mitochondrial health and having quote unquote bad eggs because they're reproductive endocrinologists have told them that they're just too old. But what about the benefits of having all these years of wisdom? What about how amazing it is that you have learned so much about regulating your nervous system? Like, I know for me, like just as a complete side story, but I promise it relates back just before I set up to record today. This little corner that I'm recording in is actually like a clean-ish looking corner of my younger son's bedroom. And so I opened the door to his room and I closed it. And behind the door, like drawn in pen on the closet door, is this big line with, you know, it's a big, big vertical line all the way from about halfway up the closet door down to the floor with a vertical or a horizontal line saying in written phonetically, definitely not spelled correctly, written measurements, like measure with like a M-E-Z-Z-U-R. It's hilarious. And I can see that and actually think, oh my gosh, that's so funny. Like my kid was clearly trying to like measure his height on this door, written in pen on this like fairly freshly painted closet door. And 15 years ago, me 25 years old, who had not acknowledged trauma, who had not learned how to release the perfectionism that was a culping mechanism, would have freaked out when she saw that. There was like this teeny moment of like, oh come on. Um but then like looking at the spelling of it, just like this is hilarious. Like, look what he's look what he's after. And we'll have talk about drawing on walls and furniture. But I can thoroughly enjoy these moments. And I credit that to having more years of wisdom, having more opportunity to do deeper healing work that goes beyond the physical. So, yes, there are certain things over 40 that we need to prioritize physically more than we may need to may have needed to focus on that when someone is 25 or 30. And if you are trying to conceive at 40 years old or older, then we have to get real in there sooner rather than later when it comes to the mental, emotional, and spiritual aspects of this journey. So when we're looking at the physical pieces, the mitochondrial health, inflammation, and oxidative stress are three areas that we really have to zero in on differently. At 25 years old, our mitochondria are usually more robust at that point. Maybe not for everyone. Maybe if they've had significant environmental exposures or mold exposure, we have to work on that in that age group as well. But as a general rule, over 40, those are the areas physically that we need to give more attention to. And we also have to look at this as not just, it's not just an age issue. We have to look at the whole picture. What other symptoms does a person have? What have what have their periods been looking like? Are they ovulating regularly? And sometimes, uh, you know, for the couples I have who have partnered later in life and they uh are just now trying for the first time at 40 to 42 years old, maybe it truly is just an age game that we are um wanting to optimize their mitochondrial function and reduce oxidative stress. But maybe there's been a whole lifetime of history that points us in the direction of PCOS or endometriosis. Like those conditions don't just disappear because someone is 40. Like we still have to take that into account. And I think it can be really frustrating when a patient ends up at one of the larger, more like corporate-owned fertility centers that just rushes to the, well, you're 40, so you should probably just start thinking about donor eggs because this is going to be an age issue. And they they don't even look at the whole person. And people have been reporting to me that they're just feeling like they're on a conveyor belt, they're getting these cookie cutter treatments, and very quickly being referred to donor egg without ever having taken some time to consider what this individual body needs. So, from the nutrition angle, with my over 40 population, uh, we can't mess around as much as we could when we were 25. Like, we can't get away with skipping meals. We can't get away with just eating plain oatmeal for breakfast and then being like good for the day. Like that is just not gonna cut it. We really need to dial in nutrition in a way that is so nourishing, so nutrient dense in your vitamins, your minerals, your protein, your healthy fats, your rich rainbow of colors, and not in this restrictive way that you have to avoid everything that is fun in the food world, but rather looking at it as like, okay, what do my cells need to be vibrantly healthy? That little egg, that sperm that creates this embryo, we want them to have a juiced up level of nutrients, and that really does start with food. We cannot out-supplement a shitty diet. And while most of my patients are coming to me eating okay, they're not like eating fast food every single meal, but a lot of them are undernourished, and a lot of them are, I would say most of them are not getting enough protein. Refer back to a few episodes ago on like how much protein do I really need? And they're certainly not getting enough color. I think it's it's one of the pitfalls of like being a career woman and having not a lot of disposable time. That uh when you're meal prepping, it's hard to get that variety in of all the rainbow of colors, but it truly is so important because each of those colors is going to have a different set of antioxidants that will help fuel your body and uh reduce oxidative stress. So I would advise, and I've done this on and off for myself over the years, of like just having a little chart on your refrigerator or background on your phone app that just reminds you to get your rainbow of colors in every single week. Make it a fun game of shopping the produce aisle and seeing if you can get all those colors in and then looking through recipes. I have used apps on and off that I can like plug in the specific ingredients that I want to try to create recipes around, and it will send me those recipes, which is just makes it so much easier than trying to get creative on days that I've had, you know, a full, you know, 10 to 12 clients back to back type of day. So I know that that's an area where people can get really stuck. Um, we have several different sets of recipes within the Brilliant Fertility program. So if you're a client and you're feeling stuck and you're like, hold on, wait, I have access to these, just remember that you can go into the nutrition module and you can pull up those recipes to get some inspiration on getting more color into your diet. And all of the recipes that we have in the Brilliant Fertility program are automatically 20 grams plus protein per recipe and high in iron and color as well. So that's one area to really walk in and like what do you need in order to get three balanced meals per day with healthy fats, 20 to 30 grams of protein per meal, fiber that often comes along with getting more color in your diet. But sometimes we have to look at what do we need to bolster that with in terms of beans, whole grains, supplementation, because not um everyone is getting that fiber easily. I aim for about 30 grams per day. And sometimes that does mean supplementing with psilium or chia or flax and looking at, you know, which what are the days, what are the pitfalls in a typical busy day that would prevent someone from getting enough fiber? And how can we work around that? One easy way to just get some extra fiber in your diet is opening up a can of beans, rinsing it off, and adding beans to a salad. That makes it, you know, 30 seconds or less of uh getting extra fiber in your diet. And if you're aiming for black beans or kidney beans, then you're also getting some extra color in because those beans have more antioxidants in the skin that gives them that dark rich color. The other area that physically we can focus on over 40 is supplementation. But again, you cannot out-supplement a shitty diet. We can only target what we can target in an individual. And we do have good evidence for CoQ10, Nacetylcysteine, alpha lipoic acid, maybe some emerging evidence for NAD. That doesn't mean you have to take all of these things, and it doesn't mean you have to take them forever. And it is really important to discuss with your provider what set of mitochondrial supporting nutrients is going to make the most sense for you as an individual. Uh, if you were to test, there's a test called the metalloomics from Genova that I don't do for everyone because these functional medicine type tests are often not covered by insurance, usually not covered by insurance. They tend to run in around the four to five hundred dollar range. And um, that being said, if you just have no idea what or how to supplement and you have the resources, it's a really interesting test that looks at these parameters of mitochondrial health, oxidative stress, inflammation, toxin exposure. Um, it's just fascinating. I've I've done this test on myself and it surprised me because you know, we assume like, oh, with mitochondrial health, like everyone needs CoQ10. Well, my CoQ10 levels actually looked pretty good, but alpha lipoic acid and vitamin B2 were in the toilet. And I wouldn't have known that if I hadn't seen it on the test, I wouldn't have known to supplement differently. So I do think it can be a really interesting tool. And especially when we want to be minimalist with our supplements and be really targeted with our supplements, which is my goal. I don't want people on 17 different things for months or years at a time that gets really overwhelming. It's it can be challenging for the gut in terms of absorption. Um, it's it's not pretty on the wallet either. You know, you can get to a place when you're literally on$500 a month of supplements. That's wild. So I like to be targeted. I like to, you know, have a supplement stack that is like four to seven things max, if possible. And we still get great results with that. I've I've lived the days when people wheeled in their roly backpack of supplements and lined up, no joke, 32 things along my desk and my exam table and like overflowing onto the chair, like and going through each one with someone, like having a complete dedicated appointment just to supplements. It shouldn't have to be that way. Most people do not need to be on that level of supplements, even if you are 44 years old. We can be targeted about this. The other thing that I want to address from the physical standpoint is that we can't mess around when it comes to sleep. Again, 40 is not 25. You cannot be pulling all-nighters. And in fact, you really shouldn't even be staying up past like 11 o'clock at night because we want your circadian rhythm to be in a very healthy place. There's there's relationship between the hormones that we produce when we are awake versus asleep. There's so much repair that happens when we are asleep. There are studies showing that when we get less than six hours of sleep, it increases insulin resistance, which we know has an impact on egg quality. Now I know that we're also getting into the time zone in life where perimenopausal insomnia can creep in. So we have to be really mindful of how we move through this time to support the nervous system and the different phases of the cycle in order to optimize sleep. So I'm always asking my patients how they're sleeping, what time they're going to bed, what time they're waking up, are they waking up refreshed? Are they waking up during the middle of the night? And what's causing them to wake up? Are they getting a hop flosh? Do they need to pee four times? Are they hungry? Does it just feel random and then their brain won't shut off? Like how we sleep, what's causing us to wake in the night, the time that we are waking, all of this matters and can help tell the story of what your body needs. And locking in that circadian rhythm is so impactful. I just caught up with a new patient yesterday who we've only had a couple of sessions together, but one of her biggest complaints was that her sleep was really impacted over the last few years of trying to get pregnant and going through multiple losses. And we haven't really done that much yet. We're still waiting for some tests to come back. So we've really just started gently opening up the conversation around past traumas and how she can support her nervous system in stressful situations. And really, like we've we've just taken a very gentle, minimalist approach using EFT tapping and journaling. And she's already sleeping so much better, and her eyes looked so much brighter, and her face looked so much brighter. It was like the energy was just such a palpable shift, and it was beautiful to see. And it was also such a clear indicator that we're on the right path. And that's a big question that can come up for people at any point in the fertility journey. But how do you know you're on the right path? Like, how do you know that something is working when you haven't gotten pregnant yet? Or in this couple's case, I've actually advised while we're waiting for test results to come back to intentionally not try to get pregnant. Like take one to two cycles of pause while we collect this information and can get really targeted with our treatment plan. But in the meantime, we have some things to work on. So we can we can already see these shifts starting to take place. And and part of that for her was optimizing her sleep. But then it's like, then we start getting into the other layers, right? Because all this is connected. We can't forget that. I think with how IVF clinics, how many Western providers approach this, is like they are just so zoned in on the physical, and even within the physical, what is the ovarian function and what is the uterus? Anatomically able to carry a pregnancy. And if the AMH is low, if things aren't responding, then you know they they really don't have any other solution other than egg donor, which I am totally not opposed to. But in this scenario, and I've seen this just multiple times with this patient's not sleeping, um, she has some significant physical responses to stressful situations, uh, which makes me wonder like, can she even absorb her nutrients given how her body is responding to stress? And so we have to look, well, how is the mental and emotional affecting the physical? How was the replaying the traumas or the stressful events of the day affecting sleep for this person? And for so many people who struggle with sleep. If we know that sleep is that important to our hormone health and to our tissue repair and to getting inflammation down, then what is it that we need to do to make sure someone is sleeping well? And this branches us into the mental and emotional part pretty beautifully. I mean, obviously, to me at least, fertility is an emotional topic. And it in and of itself can be the biggest stressor that someone is currently experiencing. But then you just add the rest of life. And so many people who are in this phase of you know, late 30s to early 40s are, you know, places in their career where career has been a priority for a long time. And maybe it's been a significant stressor that they've just adapted to and don't even relate to it as being a stressor anymore. But then you layer in trying to get pregnant and things not working the way that you expected them to or hoped for. And then we have even more layers of stress. And we have this societal idea that we have to stay positive, we have to just be happy, we have to minimize the stress so that we can have a body that is receptive to pregnancy. And even like the little zone of spirituality teachings that focus on manifestation, and you know, you have to be the frequency that you want. And it's like, well, if you don't actually know how to validate and feel and process your emotions, then reaching a place where you genuinely feel hopeful and positive and even certain that this is meant for you, that motherhood is meant for you, it's nearly impossible to have a genuine sense of that if you have not also fully walked through emotional processing. And that's part of where like our sleep tells that story, our dreams tell that story. You'll be walking around all day being like, I'm fine, it's all good, it's all gonna work out. But your nervous system is like, fuck you. I'm angry. I am so pissed off that this hasn't worked yet. I am so mad that that person, two cubicles over, goes out and parties five nights a week, and now she's gloating about how she got pregnant on the first try. Like this, like that's BS. I'm mad. And you know, there's that part of your brain that's like, yeah, but you're not supposed to be mad because you're not supposed to feel stressed, because you're supposed to be positive that your your body is baby ready. It's like, I am sorry to say it doesn't work that way. We have to have the resourcing to feel the feelings, to alchemize the feelings, to be able to see this as an opportunity to prepare for parenthood now. And if you aren't in a place to hold space for your own big emotions, what is gonna happen when you are 44 years old and you have a toddler who has their big emotions and you are never allowed to have yours? I will warn you, it's not pretty. So maybe this means going to therapy and ideally working with a therapist who is trained in fertility and uh the grief that can come with life not looking the way that you had hoped, specifically around fertility. Maybe this means joining a support group that has facilitators who are well trained in holding space and emotional regulation and processing work. Not maybe some of the Facebook groups that I have been a part of over the years that are um they can be really interesting. I know some of you have told me about your experiences in online support groups that are not uh being overseen by a professional facilitator, uh, in which it's just kind of, you know, everyone's flying by the seat of their pants and sharing their stories, and uh it can get it can get real spirally real fast in there. So I would be very discerning about stepping into spaces, whether in person or online, that uh feel further dysregulating. You know, at the end of the day, our body just needs to feel safe to conceive. And we do need those physical resources. We do want to support our mitochondria and ensure that you're ovulating and decrease inflammation and regulate blood sugar and sleep really well and learn to process emotions, and we have to have a safe space to do that, and no one can tell you what a safe space is. In fact, it's it's a little red flag for me when I enter an offering or a space, and someone just says, this is a safe space. And it's like, well, how are you facilitating that? What does that mean? That means there need to be agreements, there need to be frameworks, there needs to be integrity, and my goodness, we are living in a world right now where there is a lot of trauma, violence, information being shared without context, and that doesn't feel safe. So maybe the pause that I'm inviting you to today for all of you listeners, but especially those of you who are over 40 and really feeling the pressure and the crunch and all of the societal expectations and judgment and other people's opinions, like just pausing in this moment and asking yourself, what do I need to feel safe? What do I need to feel safe to explore processing my emotions? What do I need to feel safe in letting go of some of these old beliefs that don't serve me? What do I need to feel safe in stating my need to get three balanced meals per day? What is the framework required for that? What do I need to feel safe to connect to my spirit baby and learn from them? I know we'd have even scratched the surface of spiritual fertility in today's episode, but that's such a strong element of my practice to such the degree that I would argue that I am as much working for your future children and their spirits as I am for you, maybe even more so. And that may sound wild, but that just feels so true for me when I connect to my source, the wisdom of my ancestors, the wisdom of these spirits who, for whatever crazy reason, want to come in right now with the world the way it is, because they're helpers and they're visionaries, and they are true bundles of joy who want to be a part of creating a better world. And we've got to clean up a lot of our human BS for them to do that. So I invite you to look at what your physical, mental, emotional, spiritual body needs to feel safe, what it needs to thrive at 40 plus years old. I know these stories can um often come through uh at being preachy, but I think just you know, returning to stories of people who have conceived at over 40 and had healthy, thriving pregnancies, healthy babies. What did that look like for them? And no, it's not going to be exactly the same for you, but can you choose to take inspiration from that? Can you choose to see that as okay, if it can happen for them, it can happen for me, and shut out all of the noise of the people who might judge you for being too old, or on the flip side be asking, why haven't you done it yet? Like it's no one else's business. But if it is the calling of your heart and your soul to be a parent, to be a mother, then tune out all that noise. Find time to go within, find your support team. This is not the time to DIY, not from this place of time scarcity, but rather like, why would we do it any other way? Like, if we want to center the child and center mothers and center a family unit in a way that is deeply supportive to creating a much more beautiful world, why would we try to do this alone? Or with the overuse of AI. That is for a completely different rant, but I do want to just put it out there that AI is not my preferred form of support for people on complex and nuanced fertility journeys. So if you even took one little thing away from this episode today, I want you to jot that down somewhere, voice note it to yourself to come back to and explore that ping that you felt as um as you listened. And if you're in that 40 and over age range, just please know age is just a number. If you are still ovulating, if you are still having cycles, there is always a chance. And there's so many tools and resources to explore. And when you can find someone who can really key those in with you, it can make the journey a lot easier. All right, I'm sending you so much love, so much vitality. Hope you can find some beauty in the world today. I'm gonna go outside and enjoy the beautiful weather that we're having here in Arizona and go enjoy some plants and fresh air. And I hope that you can find a way to find some joy and some beauty and some fresh air today as well.