Dr. Lucky Sekhon

Like, you know, that Kim Kardashian quote that went viral, which was like, people just don't want to work.

Like, that's what your brain's saying to your ovary when you give them letrozole.

It's saying, OK, you got to get up and work.

okay so pcos is broken telephone that is such a good way to describe it yes and so there are pills that can wake up your brain and say no we do have to ovulate okay and lifestyle changes too because anything you can do to counteract insulin resistance that's why weight loss can help people with pcos who are overweight because it can make the sig the noise that's preventing the signal from being received go away okay okay um that is fascinating

So there's really two buckets and I think we have to address this and talk about it.

Let's say you do the workup we talked about, like you do the imaging, uterus looks good, tubes look normal, sperm looks great, egg count, not that it really matters for your ability to get pregnant with one egg each month, but egg count looks good, you're able to ovulate, no tests for egg quality, remember.

Okay, well, why isn't it happening then?

Well, about 15, I'd say as little as 15% of cases of infertility are unexplained.

A lot of times there's actual endometriosis lurking in the background.

It's just like you just don't know about it.

Or it's egg quality, which there's no direct test for.

or a combination of just the inefficiency of all the different parts that have to come together.

So you don't find a target to treat.

Like if you find blocked tubes, then we do IVF.

We take the eggs out of the body, we take the sperm and the eggs, create embryos, and we bypass the blockage and we put an embryo at the top of the uterus.

And we go vaginally, so we're avoiding the blockage.

If there's a really low sperm count,

in extreme cases we could do ivf where we put one sperm into each egg and bypass that issue if there's a blockage in sperm getting into the reproductive tract we can do a minor procedure to extract sperm directly from the testes so there's a lot of like solves if you know what you're trying to solve for but if there's nothing that you can solve for you're you still need to rectify the inefficiency of human reproduction and there's two buckets of treatment okay

One is like gambling or like speed dating for the reproductive tract.

You're doing something to increase the odds just by a bit on the egg side and the sperm side.