Explore every episode of the podcast Trying with Dr. Sasha Hakman

How many follicles are too many for an IUI? When should you move on to IVF? And is IUI ever a waste of time?

In this episode, Dr. Sasha Hakman sits down with Dr. Blake Evans, a reproductive endocrinologist and researcher whose groundbreaking studies on ovarian stimulation and IUI have changed the way fertility specialists counsel patients every day.

Dr. Evans breaks down his widely cited research on follicle count, multiples risk, and pregnancy rates across different age groups. He explains why singleton pregnancy rates stay the same whether you have one, two, three, or even five follicles, and why the only thing that increases with more follicles is the risk of multiples, especially in women under 38.

We discuss the real risks of twin and triplet pregnancies, including preterm delivery, NICU stays, maternal complications, and the financial burden that can far exceed the cost of IVF itself. Dr. Evans also shares his second major study showing that patients can still conceive after multiple IUI cycles, with cumulative pregnancy rates reaching over 70% by cycle eight, though he emphasizes this does not mean it is the most efficient or cost effective path.

This conversation is packed with practical takeaways for both patients and providers navigating unexplained infertility, insurance limitations, and the decision between continuing IUI or moving to IVF. Dr. Evans also shares candid insights on the Femeseed device, fresh transfers in IVF, and how geography and insurance coverage shape treatment decisions.

If you are trying to decide how many IUI cycles to do, whether to cancel a cycle due to too many follicles, or if IVF is worth the investment, this episode will give you the data and clarity you need to move forward with confidence.

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Follow Dr. Blake Evans on Instagram: @dr.blakeevans

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If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every 2 weeks.

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I finally share something I know so many of you have been waiting for.

My embryo transfer failed.

In this episode, I walk you through what happened, what I felt as both a fertility doctor and a patient, and the real reasons embryo transfers sometimes do not work even when everything looks perfect.

We talk about the science behind failed implantation, what recurrent implantation failure actually means, and at what point you should start asking deeper questions about your IVF journey.

One of the biggest misconceptions is that a chromosomally normal embryo should always work. The reality is more nuanced. Even strong embryos may not implant due to embryo competency, metabolic health, uterine factors, or variables we still do not fully understand.

I explain the most common causes of failed embryo transfer including chromosomal abnormalities, embryo quality beyond genetics, uterine environment, inflammation, endometriosis, and metabolic health. We also discuss what testing is useful, what testing is controversial, and when additional investigation makes sense.

If you have experienced one or two failed transfers, this episode is meant to ground you in data and help you avoid spiraling. If you are facing recurrent implantation failure, I break down what that diagnosis means and what next steps may look like.

I also share my personal protocol, what I am changing for the next transfer, and how I am thinking about resilience in this process.

Fertility is one of the few areas in life where doing the same thing again can lead to a different outcome. That does not make it easy, but it does mean there is still reason for hope.

If you are preparing for an embryo transfer, navigating IVF, or coping with a failed cycle, this episode will help you understand the science, the decisions, and the emotional reality behind what happens next.

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Topics covered:

• Why embryo transfers fail
  

• Causes of implantation failure
  

• Chromosomal normal embryos that still do not work
  

• Recurrent implantation failure explained
  

• Uterine testing and controversial tests
  

• Metabolic health and IVF success
  

• Protocol changes after a failed transfer
  

• How to move forward after disappointment

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If this resonated with you, please subscribe, leave a review, and share with someone navigating their own fertility journey.

Follow me!

TikTok: @sashahakmanmd

Instagram: @sashahakmanmd @tryingtoconceivepod

YouTube: @tryingtoconceivepod

Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter to receive updates, answers to Q&A and more!

If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every week.

If you're interested in becoming a patient go to sashahakmanmd.com to learn more!

What if your fertility struggles are not just bad luck?

In this episode, I sit down with Dr Natalie Crawford to unpack one of the most overlooked drivers of infertility… chronic inflammation.

We talk about why so many women are told to “just try for 12 months” before testing, why sperm counts have dropped dramatically over the last 50 years, and how inflammation quietly interferes with ovulation, egg quality, sperm health, implantation and even IVF outcomes  .

Dr Crawford shares her personal story of experiencing multiple pregnancy losses while training as a fertility specialist and how digging into the research on inflammation changed everything for her. From discovering a short luteal phase to eventually being diagnosed with celiac disease, she explains how lifestyle changes and reducing inflammatory burden impacted her own fertility journey  .

If you are doing everything “right” but still not getting pregnant, this episode will give you a deeper understanding of what may be happening at the cellular level and how to proactively support your reproductive health.

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We cover:

• How chronic inflammation disrupts the brain to ovary communication pathway

• The connection between stress, cortisol and insulin resistance

• Why egg quality is not only about age

• How skeletal muscle improves insulin sensitivity and fertility

• Why sleep is foundational for hormone balance

• The gut microbiome, estrogen metabolism and intestinal permeability

• Red meat, ultra processed foods and IVF outcomes

• Environmental toxins and endocrine disruptors in daily life

• What to optimize 90 days before IVF

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Fertility is not just about biology. It is a health marker.

And you deserve to understand how your daily choices add up.

If you found this helpful, make sure to subscribe, leave a review, and share with someone who is trying to conceive.

Gestational surrogacy can be one of the most powerful—and misunderstood—paths to building a family. In this episode of Trying to Conceive, Dr. Sasha Hakman sits down with her partner and colleague, Dr. Shahin Ghadir, a double board-certified reproductive endocrinologist with nearly 20 years of experience in third-party reproduction.

Together, they break down the essentials of gestational surrogacy, including key definitions, who typically needs a surrogate, how the matching and screening process works, and why legal protections are critical. Dr. Ghadir shares insights into embryo transfer protocols, timelines, costs, and why California is one of the safest places in the world to pursue surrogacy.

They also explore the emotional and ethical realities intended parents often don’t anticipate—from boundaries with gestational carriers to single vs. double embryo transfer—and share real-world stories from clinical practice. This episode offers expert guidance and clarity for anyone considering surrogacy or wanting to better understand the process.

In this solo Q&A episode, Dr. Sasha Hakman answers your most common and complex fertility questions with clarity and nuance. She breaks down topics like chronic endometritis and transfer timing, reasons for low egg maturity and fertilization rates, day 7 PGT-normal embryos, and what “normal” HCG rises really look like. Dr. Hakman also shares guidance on natural vs. programmed FETs, exercising during IVF and transfers, protocols for low AMH and diminished ovarian reserve, vaginal microbiome testing, and when to pursue fertility evaluation—even after having children. This episode is packed with practical insights to help you make informed, confident decisions throughout your fertility journey.

Should you delay IVF or egg freezing to improve egg quality—or could waiting actually hurt your chances? In this episode of Trying to Conceive, Dr. Sasha Hakman is joined by renowned reproductive endocrinologist Dr. Philip Romanski to break down what the science really says about timing fertility treatment. They explore ovarian reserve testing, egg quality myths, lifestyle and supplement considerations, and groundbreaking research showing that short delays in IVF—even for women with diminished ovarian reserve—do not negatively impact pregnancy outcomes. This episode offers practical, evidence-based guidance to help patients make confident, informed decisions about when to start treatment and how to optimize results.

Our latest episode is here, and it’s one every fertility patient should hear. Dr. Sasha Hakman sits down with Certified Genetic Counselor Meaghan Doyle to break down the confusion around PGT-A, embryo grading, and what mosaic results really mean.

In this conversation, Meaghan explains the differences between euploid, aneuploid, and mosaic embryos, why so many early embryos show mosaicism, and how to think about transferring a mosaic when it’s your only option. They also discuss the limitations of PGT-A, when it’s helpful, and why results should always be interpreted within the full clinical picture.

If you’ve ever wondered whether PGT-A is worth it—or whether viable embryos are being discarded based on testing alone—this episode brings clarity, nuance, and evidence-based guidance.

Listen now to feel more informed and empowered on your fertility journey.

I’m excited to share my latest solo episode on maximizing natural fertility. In this episode, I cover how to understand your fertile window, the best ovulation-tracking methods, and what really matters for timing intercourse. I break down lifestyle strategies proven to support fertility—from nutrition and resistance training to essential supplements like folic acid and CoQ10. I also address environmental toxins, practical everyday swaps, and the importance of sleep, stress management, and mindful substance use. This episode gives you evidence-based, actionable steps to support your fertility and know when it’s time to seek professional guidance. Listen now to feel informed and empowered.

Artificial intelligence is revolutionizing reproductive medicine. In this episode, Dr. Sasha Hakman sits down with Dr. Eduardo Hariton—Harvard-trained OB-GYN, reproductive endocrinologist, and innovation leader at US Fertility—to explore how AI is transforming every stage of fertility care. From personalizing IVF medication protocols to improving embryo selection and patient communication, Dr. Hariton shares how technology is enhancing outcomes, increasing accessibility, and allowing doctors to focus on what truly matters: caring for patients on their path to parenthood.

Miscarriage affects one in four pregnancies, yet it’s still spoken about in whispers. In this episode, Dr. Sasha Hakman and Dr. Jessica Zucker confront the stigma head-on—discussing how social expectations, gender norms, and medical systems often fail grieving parents. Drawing from her bestselling book Normalize It, Dr. Zucker shares her insights on how to support loved ones through loss and why changing the language around miscarriage is key to collective healing.

For anyone tracking ovulation, this episode is a must-listen. Dr. Sasha Hakman and Dr. Pero from Inito dive into the real science behind fertility monitoring—how to know when you’re actually fertile, what hormonal patterns really matter, and why one-size-fits-all apps don’t cut it. Hear how Inito’s technology is redefining what it means to be informed and empowered while trying to conceive.

Get your Inito for $89 with the code TTCPODCAST

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Nearly half of infertility cases involve male factors, yet men are often left out of the conversation. Dr. Justin Houman joins Dr. Sasha Hakman to break down the myths and stigma around male fertility, from the basics of semen analysis to advanced treatment options. They explore how simple lifestyle changes, early testing, and proactive care can make a major difference in outcomes for couples.

In this solo episode, Dr. Sasha Hakman dives deep into one of the most frustrating diagnoses in reproductive medicine: unexplained infertility. She breaks down what it really means when everything looks “normal” on paper—but pregnancy still isn’t happening. From testing protocols to treatment options like IUI and IVF, this episode is your go-to guide for understanding how to navigate the unknown and how to move forward with confidence.

What if freezing your eggs didn’t have to come with a $15,000+ price tag? Enter Cofertility, the first platform to make egg freezing free when women donate half of their retrieved eggs to intended parents. Dr. Sasha Hakman sits down with co-founder and CEO Lauren Makler to talk about the ethics, logistics, and impact of this model—and how it’s reshaping fertility care for donors, parents, and future families.

In this episode, longevity leader and wellness entrepreneur Kayla Barnes joins Dr. Sasha Hakman to share her science-backed approach to fertility preservation. Kayla touches on how she decided to freeze eggs vs embryos and the tools she used that helped her recover faster than any patient Dr. Hakman has seen, Kayla breaks down the why, how, and what’s next in her journey to building a big family. Expect tips on testing, mindset, and why optimizing health before conception might be the most powerful investment of all.

Starting IVF can feel overwhelming. In this episode, Dr. Sasha Hakman simplifies the science and the steps so you know exactly what to expect. From understanding your menstrual cycle and ovarian reserve to exploring egg retrieval, embryo culture, and genetic testing, Dr. Sasha gives you the knowledge to feel informed and empowered throughout your fertility journey.

Dr. Sarah Oreck- psychiatrist, mother of three, and co-founder of Mavida Health- opens up about her experience with second trimester loss, IVF, and the emotional complexity of trying to conceive. With Dr. Sasha Hakman, she discusses how mental health is often overlooked in fertility treatment, the stigma around termination for medical reasons, and how her personal story helped shape the way she cares for others. This is an honest conversation about what it means to choose your path and how to survive when things don’t go as planned.

What happens when your lifestyle is optimized, your labs look great—and you still can’t get pregnant? Aggie Lal joins Dr. Sasha to unpack the emotions and realities behind “unexplained” infertility, how her partner’s sperm shifted the narrative, and why being a wellness influencer doesn’t guarantee an easy path to motherhood. This is the story behind the social media highlight reel.