Fertility Q&A: IVF, Luteal Phase Defects, Embryo Testing, Exercise & More

In this solo Q&A episode of Trying with Dr. Sasha Hakman, Dr. Sasha answers listener questions across fertility, IVF, embryo transfer, hormone health, pregnancy, exercise, and reproductive genetics.

From adenomyosis treatment before embryo transfer and ways to support a short luteal phase to whole genome sequencing, balanced translocations, IVF in your 40s, male factor infertility, and exercise during treatment, Dr. Sasha breaks down what the evidence tells us, where the research is still limited, and why fertility care often needs to be highly individualized.

As always, this episode is for general education and is not personal medical advice.

In this episode, we cover:

➜ Adenomyosis, why it can affect implantation, and when Depo Lupron and letrozole may be considered before embryo transfer

➜ Using Inito to track FSH, LH, estrogen, and progesterone, confirm ovulation, and potentially identify a luteal phase defect

➜ Whole genome sequencing of embryos, polygenic risk scores, monogenic conditions, Juniper Genomics, Orchid, Nucleus, and the limitations of embryo genetic testing

➜ Persistent chronic endometritis after doxycycline, when additional antibiotics may be needed, and where EMMA/ALICE testing may have a role

➜ Resistance training, powerlifting, pelvic floor health, urinary incontinence, prolapse, and what researcher Margie Davenport's work suggests about exercise in pregnancy

➜ Balanced translocations, genetic counseling, untested embryos, embryo biopsy and re-freezing, and how maternal age can influence decisions around PGT

➜ Vaginal estrogen and the vaginal microbiome, Evvy testing, and using progesterone supplementation to support a short luteal phase

➜ Reproductive immunology after miscarriage or failed embryo transfer, plus when a rheumatologist or reproductive immunologist may be helpful