Chapter 1: What is the biological clock and why is it misunderstood?
There is so much confusion, guilt, and so many myths around getting pregnant, especially if you're in your 30s and 40s. And it's so hard to know what actually matters. And that is why Dr. Lucky Seekon is here today. She's a board-certified reproductive endocrinologist and infertility specialist.
In her new book, The Lucky Egg, is one of the clearest, most grounded explanations of fertility that's out there. So whether you're trying to get pregnant now, you're thinking about your future options, or just trying to understand your body better, this conversation, I think, is really going to help you understand what's real, what's not, and what's worth paying attention to.
Before we start, though, if you haven't already, please take a moment, and wherever you're listening from right now, follow the podcast and leave a review. It helps us show more than you could know. Let's go ahead and get into it with Dr. Lucky. It's so good to see you. Thank you for having me. I wanted to ask you, what made you write The Lucky Egg?
I didn't really set out to write it. I feel like after years and years of conversations with patients, I just grew frustrated with the fact that there's such a huge fertility knowledge gap. And I'm a solution-oriented girly. I was like, this demanded to be written. In 2025, the most quoted book, the most popular fertility resource is not even written by a doctor.
And the focus is all about improving egg quality and supplements and what the woman can do. And I just feel like it's such an outdated narrative. We really need to be looking at fertility more holistically and actually listening to expert voices, people who are actually diagnosing and treating infertility.
Why do you think it's such an outdated narrative? Why in 2025 have we just gotten here?
I think it is running in the same vein of why women's health in general has been kind of often overlooked and ignored. Why did we start including women in clinical trials in the 90s, right? Even when you think about the lack of insurance coverage, even at the start of my career, infertility treatment was considered like a luxury. It was kind of put in the same box as plastic surgery.
oh, this is elective. And I'm like, not to get dramatic, but we're talking about the perpetuation of the human race. I mean, I don't think it's a debatable issue that it's not a medical problem when someone is unable to get pregnant when they want to be. And there are so many gynecologic and general health issues that tie into infertility.
So it's really something we need to be talking about more. And I love that the veil is being lifted and there's less stigma. But we still don't have good resources for people. And as a result, And I see it in a lot of my patients. Before they get to my door, they're looking for answers. They're hungry for solutions.
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Chapter 2: What is the difference between egg quantity and quality?
But it's a conversation.
Let's stay on the book for a second. What makes this one different from others? This really is a concise way to understand your fertility and how to get pregnant now. And I think that that is something that women really want. They want answers to these things without having to go to five doctors, 10 doctors and play a guessing game.
Absolutely. So I like to call this the fertility Bible. And when I sat down with my book agent and then eventually my editor, we had lofty aspirations. And they were like, I don't know if you're going to be able to do this. And I still don't even know how it's possible, but it is so comprehensive. Yeah. And it's really for anyone at any point in the journey.
What I hope to see in the future is that people are gifting this to their 20-something-year-old daughters to say, you know what? The last time you probably thought about the topic of reproduction was in health class in grade school. But now you're entering your 20s, and you're probably going to be fed a narrative of fear about the biological clock.
And I want you to actually know what the biological clock is so that you can kind of keep that in the back of your head and make informed decisions as you go through your life.
What was the moment that made fertility your calling?
There wasn't one singular moment. I think it was being raised in a household with a lot of women. I have two older sisters. My mom has always been a strong figure in our household, my grandmother as well. It was kind of a matriarchal family and household.
And I feel like I loved the field from the get-go because it was empowering to me that it can give women options that they otherwise don't have.
I think if you think about fertility and the lack of solutions that people had access to and also the shame that was surrounding the issue, I think it's just empowering to see how something that was invented, when you think about IVF, which is one of the most efficient and effective treatment options, it's not the only treatment option for infertility, But that only came about in the 70s.
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Chapter 3: When should women start thinking about their fertility?
So now we have different medications we can use. We've just learned so much along the way. Because guess what? Fertility issues are actually quite prevalent and people are willing to do anything that it takes.
And so even when things are kind of viewed as experimental or we're pushing the envelope, women will sign up and want to try because it's just innate that this is what they want for themselves. And so we've been able to push the science forward because we're constantly reevaluating, okay, did that work in the lab? What are we doing differently?
We're growing embryos out to day seven now from egg retrieval. We're able to do way more than we ever were before, and that's allowed it to be safer and more effective.
High profile people speaking out about it. And I think that that that shines a different light on things, whether whether whether we like it or not. You know, there is a there is a lot to say about people that are high profile speaking out. And I know Jennifer Aniston, for one, is one of those.
Has that helped shine a light on things so people are more open to these conversations and willing to talk about it?
Definitely. I think it's a double-edged sword when it comes to celebrities and headlines. On one hand, people will see Janet Jackson or other celebrities having kids in their 50s, and the whole story is not out there for the public consumption. And I think that's their own business. But when you only share part of the story, it can make people feel like, well, IVF and science has come a long way.
Anything is possible. And so that can lead to a lot of unrealistic expectations. But on the other hand, especially with the case of Jennifer Aniston, I think that she really helped a lot of people because she did not need to share something so vulnerable.
But so many people, when I posted about it on social media, they came out and said, you know what, thank you so much because IVF doesn't always result in success. And that's an uncomfortable truth that we have to talk about. Sometimes it takes several tries to get there and not everyone is guaranteed a successful outcome. And for someone with her profile to come out and say, I tried it.
And even with all my power, my access, my celebrity and resources, I couldn't overcome this problem. It really humanized her and it also made other people feel seen. Because let's be honest, we've all seen the posts of the baby with all the syringes and the needles from the IVF journey around that picture. And you're celebrating this wonderful moment where you've overcome this huge obstacle.
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Chapter 4: How do age and perimenopause affect reproductive health?
They don't have to be anywhere near ready to start trying. But I think they should have a clear understanding of what their biological clock actually means. What does it mean if your period is irregular? What does it mean if your period is really painful or debilitating or heavy? Because this could point to certain gynecologic issues like fibroids, PCOS, or endometriosis, to name a few examples.
that could one day predispose them to fertility issues, right? When I tell people they should see a doctor, it's after one year of trying if they're under 35. If they're 35 and older, don't wait longer than six months of trying or six cycles of trying. And if you're in your 40s, it's never too early to have a conversation even after three months of trying.
So go through that again if you're in your 20s.
If you're in your 20s and you're actively trying to get pregnant, it could take time, right? Because each ovulated egg is a long shot for everyone. And even though in your 20s you're told you're in your reproductive prime years, nobody has perfect eggs all of the time.
And sometimes you're going to ovulate an egg that's not healthy or maybe it's a healthy egg, but the window of timing was off, right? Because there's like a two to three day window where it's even high yield to try right before you ovulate. Not every egg is capable of fertilization.
Even when we do IVF and we try to inject sperm directly into each egg, we say maybe 70% to 80% of the time the egg will fertilize successfully. And only about half of fertilized eggs turn into an embryo, which takes about a week. At that point, that embryo should be implanting in the uterus. But we know even at that stage, lots of embryos might have typos or genetic errors.
And that might lead to it not implanting after all of that. Or it might implant for a little bit and then stop growing. That's the number one cause of miscarriage in the first trimester. And so in your 20s, even then, you have about 20% to 25% chance of an embryo that forms from your eggs having missing or extra DNA and leading to those types of issues.
So it might take several rounds of just randomly ovulating an egg. And I named my book The Lucky Egg because it really is a random ovulation. As much as we can talk about the science and the stats, there is some element of luck and serendipity. And this explains why, okay, as you age, right, your chance of ovulating an unhealthy egg increases.
At 35, we say, OK, now it's gone from maybe a quarter of embryos resulting from your eggs having these errors or typos to about a third. And at 37, 38, maybe 50%. And at 40, maybe two thirds are going to be in that bucket where it can be harder and take more ovulations to get there. And there can be higher risks of miscarriage. But everyone has a story of, well, my mom was 45 when she had me.
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Chapter 5: What lifestyle changes can genuinely impact fertility?
And I think there are some great things about that. But as a result, it has led to a lot of women, not all, pushing the boundaries of our reproductive system. Because while a lot of things are changing in society, the ability to ovulate that healthy egg, that shifting over time with our age, that hasn't evolved, that hasn't caught up yet.
So then let's define biological clock, because you brought that up. Can we define that? Because that hasn't changed if you're looking at that graph. Maybe the age they're coming to you has changed, but not necessarily how they're able to get pregnant in those later years. Yes. So how do you define biological clock?
So that's one of the biggest misconceptions. If you ask a layperson on the sidewalk, they're going to say, well, I'm losing eggs all the time, right? And so my egg count's dropping. That's actually not what I, as a fertility doctor, care the most about. So there's two separate components. We're born with all the eggs we're ever going to have, typically 1 to 2 million.
By the time we get into menopause, which as you know, the average age is 50, 51, you are falling below a critical threshold of about less than 1,000 eggs at that point. And so it's almost like your ovaries become resistant to the signal your brain is sending to the ovary to try to randomly select that egg to ovulate. And so you stop getting periods, you stop ovulating.
So most of the people who are coming to see me are somewhere between those two time points. And how many eggs they have is something I can actually assess in an individualized sense. I can do an ultrasound on them and I can get a count. And I'm not counting millions or hundreds of thousands of eggs. I'm counting a small subset which represent a small number that have trickled to the surface
And it's kind of like rationing. I always call it like the pantry in the ovaries is stockpiled. And you get that stockpile from the time you're born. You don't make new eggs and you can't repair or fix your eggs. And every month the pantry opens up and allows some to kind of escape to like the see-through kitchen cabinets. And that's what I see on an ultrasound.
So getting a count helps me because it kind of gives me a relative sense of what's in the stockpile. But ultimately what your body is doing is not dependent on numbers. You're releasing a signal from your brain and only getting one egg to mature and be released. So someone with a high egg count versus someone with a low egg count, They're on equal footing.
They're all ovulating only one egg at a time. Is that because it's egg quality that you're talking about now? Exactly. So I'm talking about egg quantity right now, which you can check your AMH level, which is a blood test, a hormone test.
What is AMH level?
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Chapter 6: What is the truth about supplements and their role in fertility?
But the most important thing is quality. And we have no direct test for quality in 2025. That is a massive blind spot. So many people come in and they're like, my doctor told me that I have the eggs of a 25-year-old and I'm 42. And I'm like, they must have been talking about you having a higher than expected egg count for your age.
So that's the quantity.
Exactly. But quality... is what I was referring to earlier, the ability to make an embryo from your eggs that has all of the DNA it's supposed to have, right, chromosomes, packages of DNA. And think about it like this. You have these proteins, they're called cohesins, and they bind the chromosomes together, and they keep everything organized.
When an egg and sperm come together, it goes through this process of genetic recombination. And when those proteins are breaking down because of normal aging, there's more disorganization and you can end up with embryos that have too much of those chromosomes or too few and those are not compatible with life. So either it won't implant or it will implant for a little bit and then miscarry.
Ovulation tests, are those helpful or is that what you're talking about when you talk about quality and quantity?
No. Ovulation is about understanding when you're in the game.
Okay.
When you ovulate, an egg only lasts for 12 to 24 hours. It's very fleeting. And when you have sex within minutes or when you have an insemination, right, if you're using donor sperm, sperm will get into the reproductive tract very quickly and it will sit there and wait and linger for up to three to five days.
So the ideal timing and why people are using ovulation predictor kits or why they're using a calendar to track their cycle and why they're coming to me from the get-go if they don't get a period or if their periods are really irregular and they have no idea when they're ovulating is that you ideally should know when to anticipate ovulation so you can aim to have sex in the two to three days leading up to that.
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Chapter 7: What mental health considerations should women keep in mind during their fertility journey?
We all know that that's not as effective as using birth control because we don't always get it right when we're tracking our cycle. And anyone who's had a period knows that you can have a period that's thrown off here or there.
Do you think, are the ovulation tests helpful in tracking? Is that helpful?
They can be. What you're basically doing is you're peeing on a stick. And it's picking up LH in the urine. LH is one of the signals I was talking about from the brain. You have follicle-stimulating hormone, which starts sending signals to the ovary to mature and ovulate an egg. And LH is the actual ovulation signal.
So as it detects that you have a mature egg that's ready to ovulate, it will send out a stronger signal. And that will very quickly end up in your urine. So when you start seeing that, if you start approaching mid-cycle, you're like, okay, I normally have a 28-day cycle. So maybe on day nine or day 10, I start peeing on these sticks. I want to see when that signal lights up.
And there's many different ways that that shows up depending on the brand you're using. But that gives you about a one to two-day window to say this is the key time to be trying.
Do you think women blame themselves too much if they're having problems with fertility?
Absolutely. And I think it's societal conditioning.
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Chapter 8: How does egg freezing work and who should consider it?
It's how we were raised. For me, you know, looking at my mom and all the women in my household, it's like that's what you see, and it's learned behavior. I think also it's kind of implied because we're carrying the pregnancy most of the time, right?
And in that case, it feels like everything in the arena of getting pregnant, trying to get pregnant, and trying to stay pregnant is to do with the woman's health and the woman's body. And thankfully, this narrative is starting to go away, and I think men are much more likely to get tested concurrently with their partners, and they understand the importance of
really optimizing their health as well. But that has been a thing for far too long. I think women really internalize it and think it's their fault, no matter what.
Yeah, I think that too. And I think that friends that I've had in the past, it was them for six months and then, oh, the guy would go get the test after she had gone through all these other things. Are you seeing that those tests run concurrently now? Like both are getting tested?
I mean, I insist upon it. If anyone ever gives me pushback, I re-educate them. And I talk to both partners about the fact that it's really 50-50. Isn't it crazy, though, that it's like shocking to people that it's 50-50 when it's the sperm and the egg?
Hello? It is. It is. And I would think if you go walk out in the street and you ask 20 people, they're going to say, oh, the woman's 80% and the guy's 20%.
But you know what part of it is? the fact that men always make new sperm for the rest of their life. So I think that that gives them an air of invincibility, but we know that male health habits, uncontrolled chronic medical conditions, all of that can play a role, not just in infertility, but also pregnancy complications that can arise in their partner.
Women are having kids later in a lot of cases. Perimenopause, we're talking about, I don't know if it's starting earlier or we're more aware of it earlier. How do those two coincide with each other? Because we know you can get pregnant when you're in perimenopause. Can you talk about those two and the overlap?
Absolutely. So let's start simple, right? Someone who isn't even coming to see me yet. Maybe they're not even actively trying to get pregnant, but their cycles are starting to become different. The natural evolution of how your cycle changes as you go through reproductive aging is
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