🎧 Episode 14: IVF Success, Fertility After 40 & Whole-Body Health with Dr. Aimee
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Introduction
In this episode of the WOVA Circle Fertility Podcast, we explore what patients often wish they knew before starting IVF, from understanding expectations and outcomes to navigating the emotional and physical realities of treatment.
Dr. Aimee Eyvazzadeh, a Harvard-trained reproductive endocrinologist and host of The Egg Whisperer Show, shares her perspective on how fertility care is evolving and where patients can feel more informed and supported. She walks through common misconceptions about IVF, what truly impacts success rates, and how to approach fertility with both clarity and compassion.
You’ll gain a deeper understanding of the factors that influence IVF outcomes, including age, egg and sperm quality, and uterine health. We also explore the emotional side of the journey - how to manage expectations, avoid unnecessary stressors, and focus on what actually makes a meaningful difference.
Whether you’re preparing for IVF, in the middle of treatment, or exploring your options, this episode offers grounded, practical guidance to help you feel more informed and supported in your decisions.
What You’ll Learn in This Episode
What IVF can and cannot do, and common myths patients often believe
Why age remains the most important factor in fertility outcomes
How to set realistic expectations and avoid unnecessary disappointment during IVF
The IVF “funnel” and why fewer embryos than expected can still be a positive outcome
Key factors that impact success beyond age, including sperm health and uterine environment
What patients tend to overfocus on (diet extremes, cutting coffee, avoiding exercise) and what actually matters more
The role of emotional support and why building a fertility “team” early can make a difference
How to approach lifestyle changes in a sustainable, evidence-based way
Insights into how fertility care is evolving, including the role of technology and AI
⏱ Listen time: 40 minutes
🎧 Format: Video & Audio
📍 Best for: Individuals and couples considering or undergoing IVF, those wanting to better understand fertility treatment, and anyone looking for a more informed, balanced approach to reproductive health
👉 Explore Personalized Support with WOVA Health
👉 Learn More About Gabie’s Story
Podcast Transcript
Introduction
Gabie: Hi everyone, I'm Gabie, founder of WOVA Health and your host. Today I am very grateful to be joined by Dr. Aimee, a Harvard-trained reproductive endocrinologist and one of the most well-known fertility specialists in the United States.
She's also the host of The Egg Whisperer Show, where she brings together experts, doctors, researchers, and specialists across fertility, nutrition, lifestyle, environmental health, reproductive medicine, and overall wellness.
What stands out about her approach is that she doesn't look at fertility purely through a medical lens. She believes in a whole-body approach — recognizing that biology, lifestyle, emotional health, and environment all play a role in fertility outcomes.
Dr. Aimee, welcome.
Dr. Aimee: Thank you for having me. I love talking to you — it's so nice to see you again.
Personal Connection And Intro To Dr. Aimee's Work
Gabie: I first came across your work while I was struggling to conceive. My first IVF cycle had failed, and I was in the middle of a second IVF cycle. I was doing a lot of research, speaking with different doctors across the world, and that's when I found your podcast.
What immediately stood out to me was how different your conversations were. You weren't only speaking with traditional reproductive endocrinologists — you were also bringing in functional medicine doctors, nutrition experts, and specialists in lifestyle and environmental health.
I also learned later that you have a Master of Public Health, which really explains your systems-level thinking around fertility, nutrition, and environment.
I reached out to you, and that consultation call was honestly one of the most meaningful experiences I had during my fertility journey. You played a big role in my third IVF cycle, and I often tell people you are one of the most impactful doctors I've met. So thank you for the work you do.
Dr. Aimee: Thank you. I really appreciate that. I love what I do. And honestly, seeing you now as a mother — it's one of the most rewarding parts of my work.
Gabie: Thank you. Time really does fly — my child is already three.
Early Inspiration And Career Beginnings
Gabie: Can you share a bit about your story? What inspired you to go into reproductive endocrinology and infertility?
Dr. Aimee: I always wanted to be an OB-GYN since I was about three years old. My father was an OB-GYN, and my grandfather was also an OB-GYN. So I grew up surrounded by medicine.
But the moment it became very personal was when I was around 12 years old. My mom started experiencing multiple miscarriages. She is a very strong woman and doesn't easily show emotion, but I would hear her crying at night. That had a deep impact on me.
I asked my dad what kind of doctor helps with miscarriages and fertility issues, and he told me about reproductive endocrinology and infertility. From that moment on, I knew that was what I wanted to do.
I spent summers in Boston working at the recurrent miscarriage center at Harvard, doing research and publishing papers. Even before medical school was finished, I knew exactly what I wanted my career to be.
What drives me now is helping people feel less overwhelmed. Fertility medicine can feel very complex, but when you break it down into clear steps, it becomes more manageable. At its core, patients don't just need procedures or tests — they need understanding, clarity, and support.
How Dr. Aimee's Perspective Has Evolved
Gabie: Has your thinking changed since you started your career? What is different between early Dr. Aimee and the Dr. Aimee today?
Dr. Aimee: My core approach has not changed. I've always focused on identifying root causes, making an accurate diagnosis, and optimizing everything we can before starting treatment.
But what has changed significantly is my perspective on age.
When I started my practice at 32, I was trained — like most fertility doctors — to believe that outcomes after 40 were very limited. Now, at 50, I look at a 40-year-old and think: you're young. We can absolutely work with this.
Over time, my patient population has shifted significantly. I now see many patients over 42, and even women in their mid-to-late 40s pursuing fertility treatment. I performed an egg retrieval on a 49-year-old patient this morning.
Some people question this, but I always say the same thing: if the chance is not zero, patients deserve the opportunity — so long as they understand the realistic outcomes.
We also now have more tools than ever in fertility medicine. There are treatments and approaches that simply did not exist 10 years ago. It is a very exciting time in reproductive endocrinology.
What To Know Before Starting IVF
Gabie: What do you wish more patients understood before starting IVF?
Dr. Aimee: I think the most important thing is understanding both what IVF can do — and what it cannot do.
Patients should go into IVF with a clear understanding of their diagnosis, their age-related expectations, and their individual fertility profile.
One of the biggest misconceptions is that IVF improves egg quality or guarantees success. That is not true. What IVF actually does is allow us to retrieve multiple eggs in a cycle, which gives us more chances to create embryos.
Another misconception is around genetic testing of embryos. Even when embryos are tested, it does not guarantee a live birth or a healthy baby. It reduces risk, but it is not absolute.
I use a four-step process I call the DIET method: Diagnosis, IVF preparation, Embryo creation, and Transfer with endometrial testing. Understanding each stage before you begin helps reduce emotional distress later in the process.
The Emotional Side Of IVF
Gabie: From an emotional perspective, what part of IVF do people underestimate the most?
Dr. Aimee: The emotional impact of the outcomes.
Even when patients are well prepared intellectually, the emotional experience can still feel very different. For example, a patient may start with 10 follicles and end up with 2 embryos. Medically, that can still be a very good result — but emotionally, it often feels like loss.
I share what I call the IVF pyramid with patients — it visually maps what happens at each stage, from follicles to mature eggs to fertilized eggs to blastocysts to genetically tested embryos to a baby. It helps people understand the natural attrition and set more realistic expectations.
This is also why I strongly encourage patients to seek support early, not only after things become difficult. Working with a fertility therapist from the beginning can make a significant difference. Even when IVF is successful, many patients still describe the process as emotionally intense or even traumatic.
What Actually Impacts IVF Success
Gabie: What do you feel is most impactful when it comes to IVF success and having a healthy baby?
Dr. Aimee: The most important factor is age. Age at the time of egg retrieval has the greatest influence on egg quality and embryo quality.
Beyond that, overall health plays an important role — mental health, sleep, nutrition, movement, stress levels, and relationships all contribute to the environment your body is in.
We also look closely at sperm health, uterine health, inflammation, and conditions such as endometriosis or adenomyosis. But if we are talking about the single strongest driver, it is still age.
This is why I tell patients: if you're 32, partnered, and want two kids, freeze embryos now. Your age at the time you're creating embryos is the most important variable you can control.
Where Patients Tend To Overfocus
Gabie: Are there things you see patients overfocus on that don't actually make a meaningful difference?
Dr. Aimee: Yes, absolutely. One of the most common things I see is patients making extreme lifestyle changes that are not evidence-based.
For example, completely eliminating coffee, cutting out entire food groups like gluten or dairy without medical indication, or stopping exercise because they believe it causes inflammation.
A lot of this comes from wanting control during a process that feels uncertain. But these extreme restrictions usually don't improve fertility outcomes — and can sometimes increase stress, which is counterproductive.
I encourage patients to focus instead on sustainable habits: movement, strength training, balanced nutrition, good sleep, and emotional wellbeing. Fertility is not about perfection. It's about creating the strongest possible foundation while still living your life.
Whole-Body Health And Fertility Care
Gabie: Where do you see whole-body health fitting into fertility care today?
Dr. Aimee: Everyone in the field acknowledges that it matters, but I don't think it gets talked about enough in practice. Doctors often assume patients already know how to support their health, without actually guiding them. That gap is significant.
In my practice, I prescribe GLP-1 medications to about 25% of my patients. Medications like Zepbound can be very effective at reducing inflammation and helping patients regain a healthier baseline.
What I also hear frequently is that patients gain anywhere from 10 to 40 pounds during their fertility journey — from the medications, the stress, the stopping of exercise. That impacts self-esteem, energy, and overall wellbeing. This is exactly why programs like WOVA matter. They fill the gap between clinical care and the day-to-day reality of the fertility journey.
Gabie: How do you help patients prioritize without adding more pressure?
Dr. Aimee: I start with what is most accessible and easiest to change first, and I lead by example.
I don't go to the gym — I genuinely dislike it. But I keep weights next to my desk, I do squats in the hallway between patients, and I jog around the office to get my steps in. The point is: movement does not have to be formal or perfect. It just has to happen.
When patients tell me they can't exercise because of back pain, I ask them if moving their arms hurts. When the answer is no, we start there. Fertility optimization is not about doing everything perfectly. It is about removing the excuses and finding what works for your life.
When IVF Doesn't Work
Gabie: What about situations where IVF doesn't work? What are the most common explanations?
Dr. Aimee: The majority of the time — approximately 80% — IVF failure comes down to egg quality.
Egg quality is influenced by three main factors: age, genetics, and environment.
Age is the most well understood. An embryo created from an egg at age 25 is almost always chromosomally normal. An embryo created from an egg at age 45 has roughly a 2% chance of being chromosomally normal.
Genetics also play a role. Some people are born with genes that affect egg viability, independent of age.
Environment is the third factor — and one that deserves far more attention. Exposure to toxins, air pollution, secondhand smoke, and plastics all impact egg quality, sometimes from before birth. We are finding microplastics in follicular fluid. The long-term impact of that on fertility is something we are only beginning to understand.
Gabie: How do you differentiate between an egg quality issue and a sperm quality issue?
Dr. Aimee: Biologically, eggs carry significantly more genetic material than sperm, and the quality of that genetic material is far more sensitive to age.
That said, sperm absolutely matters. Elevated DNA fragmentation in sperm can affect embryo quality. And paternal age matters more than most people realize — men over 50 have a meaningfully higher risk of chromosomal abnormalities in embryos.
This is why I encourage men to consider freezing sperm by age 25, just as I encourage women to at least consider egg freezing around the same age. We are already seeing the downstream effects of delayed parenthood, and I believe the next one to two generations will face serious fertility challenges if we don't address this now.
What We Don't Yet Know About Implantation
Gabie: What do you think we still don't fully understand about implantation?
Dr. Aimee: There is still a lot we don't know about the immune interaction between an embryo and the uterus.
We have made progress in areas like the uterine microbiome, receptivity testing, and identifying silent endometriosis. Companies like Preg, Igenomics, and others are developing useful tools in this space.
But the genetic compatibility between an embryo and a uterus — why some embryos implant and others don't, even when everything looks normal — is still not well understood. If we could better identify incompatibilities at that level and find ways to address them, it would be a significant step forward in improving IVF outcomes.
Being Open To Emerging Models In Fertility Care
Gabie: You were one of the first specialists to get behind WOVA and want to be part of the network. What makes you open to emerging models in fertility care?
Dr. Aimee: I think about what problem a company is actually trying to solve. Is it a real gap? Is there something better already doing the same thing? What is the financial and time cost to the patient, and what is the genuine benefit?
I'm also very aware that some companies present themselves as mission-driven but are ultimately monetizing patient data. That's something I take seriously.
For companies I do support, it comes down to one thing: will this actually help my patients? If the answer is yes, I want to learn about it and offer it as soon as possible. I have Google alerts set for everything fertility-related, and I actively seek out companies doing interesting work in this space.
AI In Fertility: Promising Or Overhyped?
Gabie: What makes you most excited about AI in fertility care?
Dr. Aimee: AI makes me more efficient, which means I can reach and serve more patients.
In my practice, I use AI to transcribe and summarize every patient interaction. Before AI, I would spend an hour typing detailed notes after every appointment. Now that time goes back into patient care.
I send every patient a written summary of our conversation, with links to relevant research articles, so they leave with clarity even if they were nervous and forgot things we discussed. AI has made that kind of information reinforcement much more scalable.
From a lab standpoint, I also think we'll see more AI-driven efficiencies in the IVF lab — and we're really just at the beginning of that.
Gabie: Where do you think it's overhyped?
Dr. Aimee: The area where I think it's most overhyped right now is embryo selection. For a couple of years we've been told that AI can identify the best embryo to transfer and meaningfully improve pregnancy rates. I don't yet see that as a reality — but I'm hopeful that day will come.
There are also some interesting early applications in sperm selection and egg quality grading. There's a company called Violet that uses AI to assess egg quality and give patients a sense of how viable their frozen eggs may be in the future — which is a real gap in how egg freezing is currently communicated to patients.
Dr. Aimee's Upcoming Book
Gabie: Can you share a bit about your book? I pre-ordered a copy and cannot wait to read it.
Dr. Aimee: The book is called Know What to Ask, How to Test, and Give Yourself Every Chance at Getting Pregnant. The goal is simple: I want people to have a no-regret plan.
I've been blogging since 2008 and have written over 2,000 articles. But the book is different — it's a chance to bring everything together in a way that helps someone understand how I think about fertility, step by step.
I also introduce what I call the TUSHY method — Tubes, Uterus, Sperm, Hormones, and Genetics — which I want every OB-GYN to know. These are the basic checks that should be part of routine preventive care, long before someone even starts trying to conceive.
Reading the book is, in some ways, like seeing me without seeing me. It's the education I give patients every day, now accessible to everyone.
What Gives Dr. Aimee The Most Hope
Gabie: What gives you the most hope in fertility medicine right now?
Dr. Aimee: Honestly? That people are still showing up and choosing to have babies.
With everything going on in the world — wars, political uncertainty, environmental concerns — you might think people would give up on the idea of bringing children into this world. But they haven't. People still want to build families. That gives me enormous hope.
And those children — born to parents who fought so hard to have them — I believe they're going to change the world.
If You Could Change One Thing
Gabie: If you could change one thing about fertility care, what would it be?
Dr. Aimee: It should be free for everybody.
So many people don't have children simply because of the financial strain. That breaks my heart. If I could do one thing, it would be to make sure that anyone who wants to build a family has access to the care they need — regardless of what's in their bank account.
Closing
Gabie: Dr. Aimee, thank you so much. Your knowledge, your warmth, and your honesty make such a difference — not just in the exam room but for everyone who listens, reads, or follows your work. We are so lucky to have you in this space.
Dr. Aimee: Thank you. This is exactly why I do what I do.
This transcript has been lightly edited for clarity and readability.
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