Many women are starting families later in life, and for some, that means turning to IVF. But what’s fact, what’s myth, and what really matters when you’re navigating fertility in your late 30s or 40s?

In this episode, Dr Renee White speaks with Dr Kellie Tathem, a Fertility Specialist, Gynaecologist and Obstetrician at Queensland Fertility Group. Kellie has a special interest in endometriosis, pelvic pain and fertility care. She’s passionate about making sure women have clear information and the space to make informed choices.

You’ll hear about:

• The biggest fertility myths women face in their 30s and 40s
• When to consider IVF and how long to try naturally first
• Egg freezing, donor eggs and embryo donation explained
• How age affects fertility, pregnancy and birth outcomes
• What lifestyle factors really make a difference for egg and sperm health

This episode is here to give you evidence-based answers and support if you’re thinking about IVF, considering egg freezing, or planning pregnancy later in life.

Resources & Links

📲 Connect with Renee on Instagram: @fillyourcup_

🌐 Learn more about Dr Renee White and explore Fill Your Cup Doula services

🍪 Treat yourself with our Chocolate + Goji lactation cookies

Connect with Dr Kellie Tathem

Queensland Fertility Group: https://www.qfg.com.au

Akoya Health (coming soon): Search Akoya Health Brisbane

Resources mentioned in this episode

• IVF Australia – reliable information on egg freezing, IVF processes, and costs: https://www.ivf.com.au
• Medicare – information on rebates for medically indicated egg freezing and fertility treatments: https://www.servicesaustralia.gov.au/medicare

🎧 If this conversation helped you feel more informed, pass it on to another mum navigating her fertility journey. And make sure you’re subscribed so you’ll always catch the next episode.

The Science of Motherhood is proudly presented by Fill Your Cup, Australia’s first doula village.

Disclaimer: The information on this podcast presented by Fill Your Cup is not a substitute for independent professional advice.

Nothing contained in this podcast is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.

[00:00:30] Dr Renee White: Hello and welcome to episode 194 of The Science of Motherhood. I'm your host, Dr. Renee White. Thank you so much for joining me today. We have got a special guest. We are gonna be talking about [00:00:45] IVF and having a baby as an older mama and I have to say.

[00:01:22] Dr Renee White: And so there seems to be a, a bit more of an awareness piece with that. And we [00:01:30] have a number of families that we support, as I said, in this demographic, whether it be for birth doula support, or postpartum support. Typically with postpartum, I think, I think recovery is something that they are [00:01:45] consciously aware of.

[00:02:39] Dr Renee White: If this is something that you might be interested in, please feel free to jump over to our website, [00:02:45] I fill your cup.com. The link is also in the show notes, and you can have a look at our services, our birth doula, and postpartum doula services. We have doulas all across the country. Let me rattle them all off.

[00:03:43] Dr Renee White: A doula is definitely for you, so please [00:03:45] feel free to reach out and, um, organise a, just organise a chat, see if it's for you. Okay. Let's dive into today's episode. We have got the wonderful Dr. Kellie Tathem. She is [00:04:00] a fertility specialist at Queensland Fertility Group. She's a gynecologist, she's also an obstetrician in Brisbane. But she's got a, like a real keen interest in endo and pelvic pain and obviously fertility [00:04:15] treatments and maternity care.

[00:04:40] Dr Renee White: So in today's episode, we are gonna be looking at, I [00:04:45] guess the following things. You know, o the overarching topic is doing IVF and having a baby as an old, older mum. We walk through of course, because it would be remiss of us not to hear on the signs of motherhood, the [00:05:00] biggest myths that women encounter in this particular area.

[00:05:34] Dr Renee White: How long should you be trying, um, naturally before you kind of think about that IVF journey? We talk about the realities of pregnancy success rates, [00:05:45] and I guess, you know, what are the risks, what are the things that you need to prepare for? Also, we talk about, you know, lifestyle, like supplements, acupuncture, what are the types of things that improve your egg quality?

[00:06:24] Dr Renee White: Hello and welcome to the podcast, Dr. Kellie. How are you?

[00:06:33] Dr Renee White: Oh yes. We were just talking offline how gorgeous it's in Queensland and how frosty here is in, uh, a lovely Hobart, but that's okay.

[00:06:51] Dr Renee White: oh my goodness.

[00:06:54] Dr Renee White: Stop it. I think, uh, we're, I mean, we are recording. I, [00:07:00] I went for a run the other day and it was three o'clock. Three o'clock. It was three degrees down at Lake.

[00:07:05] Dr Renee White: So, yeah, little bit different, but that's okay. We can work with that. Thanks so much for coming on today. We are obviously gonna be [00:07:15] talking about IVF and having a baby as an older mum. People would've heard that from our intro. But before we dive into that, did you wanna just give us a little like, snapshot of you and you know, where you're [00:07:30] at and I guess, you know, obviously you help a lot of older mums through the IVF process.

[00:07:56] Dr Kellie Tathem: I see young girls with pelvic pain and we discuss [00:08:00] endometriosis and, you know, medical treatments and surgery and when that might be appropriate. I often then see the same women back when they're pregnant. I get to deliver their beautiful babies, and then I continue getting to see them. So it's the job where I often never have to [00:08:15] say goodbye, which is wonderful.

[00:08:40] Dr Kellie Tathem: I love that women can now choose lots of different things about their reproductive [00:08:45] health and I do feel like I spend a lot of time educating women, but that bit gives me pleasure. That's the bit that I don't want to go fast because I think it's really important for everyone to really understand. So yeah, so I'm a generalist fertility obstetrician, [00:09:00] um, and gynecologist and I think I've got one of the best jobs in the world.

[00:09:08] Dr Kellie Tathem: Yeah.

[00:09:15] Dr Kellie Tathem: Yes.

[00:09:24] Dr Kellie Tathem: It's so good. And it is what everyone should aim for. We know that continuity [00:09:30] of care models absolutely give better outcomes both for mums and babies, mental and physical health. And that's what we should all be aiming for. In my business model, we also have midwives as well, because I can't be there for every [00:09:45] bit.

[00:09:54] Dr Renee White: Yeah.

[00:10:07] Dr Kellie Tathem: But I did move away from that model for me, because it didn't feel right coming in at the last [00:10:15] minute, seeing terror in women's eyes that they'd never met me before, and them just having to trust the process.

[00:10:22] Dr Kellie Tathem: And I think I had my own little bit of trauma associated with being the trauma maker in those situations. So, [00:10:30] you know, my patients still undergo emergency caesars and some vacuums and some forceps and those sorts of things. But I see less sheer terror because we have that beautiful relationship where they know, okay, we're just gonna do it and it's gonna be fine and there's already that inherent [00:10:45] trust.

[00:10:45] Dr Kellie Tathem: And I am completely convinced that continuity is best. However we get that. It's just unfortunate that we can't give that to every person.

[00:10:55] Dr Kellie Tathem: Yeah.

[00:10:57] Dr Kellie Tathem: Yeah.

[00:11:06] Dr Kellie Tathem: Yeah.

[00:11:10] Dr Kellie Tathem: I love it,

[00:11:20] Dr Kellie Tathem: Yeah. I love, I love bursting the bubbles. Yeah. Bring it.

[00:11:57] Dr Kellie Tathem: Yes. Yes.

[00:12:03] Dr Kellie Tathem: Look, I think, uh, I think. Thankfully more women are coming in proactively, which is great. And often we are talking about what are the pros and cons? What is the reality [00:12:15] of what we're trying to achieve?

[00:12:35] Dr Kellie Tathem: But I do, you know, some people will come in at 43 and say, look, I'd like to freeze my eggs, and one of my first questions is, what are your goals? [00:12:45] When do you know that you wanna have a child? Do you have a current partner? If so, why not now? Let's talk about the risks of being an older mum and how long we can delay things for, what was your intended family [00:13:00] size?

[00:13:36] Dr Kellie Tathem: So I think that, yeah, social media does, or some women unfortunately do, does paint very unrealistic expectations. But I am [00:13:45] finding that that is changing for every one woman that I have that I'm counseling at 43, about why are we waiting, what are we doing here? On the other hand, I, I think I'm having some really educated women who are in their late [00:14:00] twenties, early thirties saying, Hey, look, I've heard about this.

[00:14:25] Dr Kellie Tathem: We need to keep educating, but I think now it's about making it [00:14:30] accessible to women as well. I think education really has to start probably in high school, you know, we all actually had had the discussions about how it will be easy to conceive and we're all gonna have a teenage pregnancy. If we had sex once,

[00:14:48] Dr Kellie Tathem: Well, my 15-year-old, funnily enough, and she'll kill me if she ever listens to this podcast, but she came home and asked if she could really get pregnant in a swimming pool, swimming with other people [00:15:00] in the pool. And I said, pardon, sorry, pardon me.

[00:15:03] Dr Kellie Tathem: And whether it was her interpretation of what the teacher had said, or whether that was legit what was said, it took me back to, hang on, there is still a fear. Like we are, we are giving [00:15:15] education. I feel like we are giving education still from a fear-based model.

[00:15:20] Dr Kellie Tathem: You know, you're gonna get pregnant, you're definitely gonna get chlamydia, you're gonna do this, let's talk about it. And you know, our whole lives are spent to try not to get pregnant. Mm-hmm. [00:15:30] Um, and they, because we expect that it's gonna happen so quickly.

[00:15:33] Dr Kellie Tathem: Yeah. And so I think that we still need to be talking in schools about endometriosis and painful periods, but on the flip side, saying yeah in the same instance, please do not delay your fertility [00:15:45] until age, you know, 40 At this point, you need to be thinking what your plan is a bit earlier than that.

[00:16:05] Dr Renee White: yeah. What is the cost for,

[00:16:09] Dr Renee White: Yeah.

[00:16:34] Dr Kellie Tathem: If you are older with less eggs, you may actually need to do three or four cycles of egg freezing. Mm-hmm. Medicare will chip in if there is a medical indication for [00:16:45] egg-freeze. So if you've got endometriosis or if you've got a reason, you know, if you have a low egg count and therefore you are more likely to be infertile and it's not classed as a social reason.

[00:16:58] Dr Kellie Tathem: Or an elective reason, [00:17:00] which I could talk all day about how that is.

[00:17:04] Dr Kellie Tathem: An incorrect way of labeling that. Then if you've got a medical reason, then you would get a Medicare rebate as well, which may make it cheaper.

[00:17:13] Dr Kellie Tathem: So more three to [00:17:15] $5,000 per cycle for most people. Mm-hmm. And then you've got storage fees, which for most companies are gonna be about $500 a year ongoing to continue to store your eggs or embryos, which you create. So it is a really expensive thing. [00:17:30] However, from a cost effectiveness point of view. There've been studies that show that if we embark on egg freezing below the age of 32 mm-hmm it is more cost effective and you're more likely to achieve having your own [00:17:45] biological child than if you come back at 39 and do IVF.

[00:17:50] Dr Kellie Tathem: So yeah,

[00:17:58] Dr Kellie Tathem: Yes.

[00:18:01] Dr Kellie Tathem: Yeah.

[00:18:24] Dr Kellie Tathem: Yeah, so donor egg, if I start with donor, obviously we can have [00:18:30] donor sperm and we can have donor eggs, and we could also have donor embryos. And I would say that the easiest thing to acquire is donor sperm.

[00:18:41] Dr Kellie Tathem: Because for men that, that means the physical [00:18:45] act of masturbation and catching it in a cup and storing it For women, the actual collection, if you're doing an egg collection, that involves someone, uh, going through a full, like an IVF process.

[00:19:16] Dr Kellie Tathem: And women then also run the risks of IVF in terms of, you know, if we get lots of eggs, there's a 1% risk in Australia of ovarian hyperstimulation syndrome. So there it is a lot more involved for the woman and a bit, and a lot more [00:19:30] risky to become an egg donor. And for that reason we have less egg donors especially, anonymous egg donors in Australia, because we cannot pay donors. It has to be altruistic in Australia. Mm-hmm. [00:19:45] And so to go through that process for someone that you don't know, I mean, what a wonderful gift that is. But it is rarer to do that with sperm donors, a lot of our donors are actually from overseas because of the, you know, the [00:20:00] necessary tightening up of the rules.

[00:20:26] Dr Kellie Tathem: So it, it is an ever changing and ever expanding [00:20:30] area. And there is a lot of red tape as, as you mentioned, rightfully so, but it, it is a big deal to have an egg donor and a lot of women will find an egg donor either through a friend or a sister. Or I had a [00:20:45] mother's group, uh, mum donate to one of her other mother's group, which was absolutely incredible.

[00:20:50] Dr Kellie Tathem: So usually egg donors are known egg donors. They know what their friends have gone through. They've made that decision that that's what they want to do. And a lot of people actually find [00:21:00] egg donors through social media groups and online. And so there's your egg donors, there's sperm donors, and then we have embryo donation now.

[00:21:38] Dr Kellie Tathem: We can use them for research. And what that means typically is that we might try, [00:21:45] for example, biopsy techniques or new thawing techniques to check survival of embryos, or you can choose to donate to a fa another family. And so I would say that embryo donors come up more commonly [00:22:00] than egg donors.

[00:22:02] Dr Kellie Tathem: Because they're already creators as a byproduct of other people making families.

[00:22:17] Dr Kellie Tathem: Yes.

[00:22:23] Dr Kellie Tathem: yeah yeah,

[00:22:36] Dr Kellie Tathem: Yeah. No, I think lots of us at 15 would've made the wrong decision then.

[00:22:50] Dr Kellie Tathem: Yes,

[00:22:58] Dr Kellie Tathem: They are very scarce.

[00:23:00] Dr Kellie Tathem: They're very, very scarce. And so that's,

[00:23:04] Dr Kellie Tathem: You do not get paid for sperm donation in Australia overseas. You can, and that's why many Australian companies, the majority of the sperm donors [00:23:15] are actually sourced from overseas.

[00:23:19] Dr Kellie Tathem: Correct. Absolutely.

[00:23:21] Dr Kellie Tathem: Yes.

[00:23:22] Dr Kellie Tathem: Yeah, yeah, yeah.

[00:23:23] Dr Kellie Tathem: Yes, because college students can get paid for doing that.

[00:23:28] Dr Kellie Tathem: Whereas in Australia, [00:23:30] again, you are not paid. It is completely altruistic. And the ethics of that, uh, obviously, you know, that's a, that's a huge conversation there.

[00:23:39] Dr Kellie Tathem: It is pandora's Box and so, you know, there are plenty of older mums who [00:23:45] I have gone through many, many IVF cycles that we're not getting anywhere. And then we come to talking about, okay, well I, you know, we need to really think about what the definition of a family is. And for, you know, more and more [00:24:00] people, more and more people are accepting that, okay, well my goal here is to have a family, and if I'm a single woman and I'm 43 and I'm not making embryos out of a donor sperm and my own eggs, then I [00:24:15] actually am accepting to choose an embryo donor because my definition of family is who I choose to be with.

[00:24:25] Dr Renee White: Yeah, yeah,

[00:24:26] Dr Renee White: absolutely.

[00:24:30] Dr Renee White: Wow.

[00:24:31] Dr Renee White: and I, and I would imagine, because you know, you're blowing my mind at the moment, I would imagine. That, you know, there's a lot of counseling around this, like the psychology, this is not [00:24:45] just like turn up and it all happens, like what goes on behind the scenes, you know?

[00:24:54] Dr Kellie Tathem: Yes.

[00:24:56] Dr Kellie Tathem: Yeah, so generally if I see someone for, for an [00:25:00] initial, initial consultation and we are talking about, you know, we, we obviously have to do a workup. If you are really after the age of 45, the chances of having a live birth from your own IVF cycle, own eggs is very minimal.

[00:25:35] Dr Kellie Tathem: Yeah. And so when that is happening, we have the discussion about, you know, that that really where you, you may have a miracle, but you may require many, many, many, many cycles to get [00:25:45] there. And that it is almost futile and this is where we need to talk about, you know, donor embryos or donor eggs. That process then really gets handed over to our incredible donor team and our donor counselors.

[00:26:17] Dr Kellie Tathem: They do genetic carrier screening, lots and lots of questions to do that. They have to be talked through the implications and, uh, do they want to be linked in with a family that wants to know anything about them? Mm-hmm. [00:26:30] They need to know that the legal implications might mean that, that the future child will be able to come and find them later on.

[00:26:53] Dr Renee White: Yeah.

[00:27:22] Dr Renee White: Yeah.

[00:27:35] Dr Renee White: Mm-hmm. Mm-hmm. Okay that's great. Cause yeah, I would imagine that that would be somewhat of a minefield, as you say, like the laws are constantly [00:27:45] evolving and so even, even, is it almost like retrospective?

[00:27:57] Dr Kellie Tathem: It can

[00:27:59] Dr Kellie Tathem: Yeah. Correct.

[00:27:59] Dr Kellie Tathem: And we have seen [00:28:00] that. Yeah, we have seen that. Yeah. Okay.

[00:28:05] Dr Kellie Tathem: Pardon me? What are the current laws these days with?

[00:28:13] Dr Renee White: That's okay.

[00:28:23] Dr Renee White: Yeah.

[00:28:44] Dr Renee White: [00:28:45] I can imagine. I wanna shift gears, so

[00:28:48] Dr Renee White: You know, let's, let's fast forward and say, you know, it's a successful kind of IVF. Kind of program and you know, mama gets pregnant.

[00:28:58] Dr Renee White: When we are [00:29:00] looking at like older mums and can I, can I just say I'm 40, right?

[00:29:05] Dr Renee White: I have no plan to have another child. Yep. But why do we keep calling older mums geriatric pregnancies?

[00:29:15] Dr Renee White: petition tally for that to just be put in the bin.

[00:29:21] Dr Renee White: Oh.

[00:29:32] Dr Renee White: Yeah okay.

[00:29:33] Dr Renee White: Right.

[00:29:38] Dr Renee White: Oh my god. Okay.

[00:29:45] Dr Renee White: Advanced maternal. Okay. I think,

[00:29:49] Dr Renee White: It is much kinder, I think. I think I would be okay with that.

[00:29:53] Dr Renee White: I'd be okay with that.

[00:30:01] Dr Renee White: Okay.

[00:30:04] Dr Renee White: Okay.

[00:30:14] Dr Renee White: What

[00:30:16] Dr Renee White: Oh my God.

[00:30:22] Dr Renee White: really?

[00:30:25] Dr Renee White: Yes. I felt like a spring chicken at 35.

[00:30:28] Dr Renee White: I just, hold on a minute. I was, [00:30:30] I gave birth when I was 33, so

[00:30:33] Dr Renee White: Oh my God. I was two years off.

[00:30:38] Dr Renee White: Yeah.

[00:31:04] Dr Renee White: Yeah.

[00:31:08] Dr Renee White: Yeah.

[00:31:28] Dr Kellie Tathem: So a woman that is [00:31:30] coming for her third pregnancy at 39, who's otherwise had completely normal pregnancies bothers me less than the first time mum at 40.

[00:31:40] Dr Kellie Tathem: Cause we know that first time mums are higher risk for things like blood pressure and [00:31:45] diabetes and those sorts of things, which are exacerbated by if it's your first time mm-hmm.

[00:31:51] Dr Renee White: That's interesting. I didn't know that.

[00:32:15] Dr Kellie Tathem: We are born with those eggs, they're hanging with us really for the 40 years until we actually conceive. And so the DNA in those eggs becomes a little more fragile. And when they meet with the sperm or just before they meet with the sperm and they're splitting their chromosomes, we become a [00:32:30] little bit more inaccurate at doing that.

[00:32:48] Dr Kellie Tathem: The uterus, usually works pretty darn good. However, by the age of 40, there is about a 50% chance that you'll require a ceaser in labor. Mm-hmm. Because the ute, the cervix won't open [00:33:00] properly.

[00:33:00] Dr Kellie Tathem: Or as we expect. And there's a higher chance of getting prolapse as well after if you're a first time mum and having your baby in your older years.

[00:33:08] Dr Kellie Tathem: And that's because the tissues don't bounce back as well.

[00:33:13] Dr Kellie Tathem: As if you are 14

[00:33:15] Dr Kellie Tathem: the collagen and connective tissue. So there's, you know, I know I'm sounding all doom and gloom and there are plenty of women at age 40 who have the most beautiful low risk pregnancies and beautiful deliveries and those sorts of things.

[00:33:38] Dr Renee White: Yeah.

[00:33:42] Dr Renee White: and we're having babies older, aren't we? [00:33:45] I, I dunno what the median age.

[00:34:03] Dr Kellie Tathem: So we are at an all time low in terms of birth rate. And if we keep going in this direction, we are going to end up with not enough to replace the population. So we need about 2.1 births per [00:34:15] woman in Australia to maintain the population, we're at 1.5. And so that is a bit of a, that is a massive crisis coming for, for, from an for Australia and it's multifaceted.

[00:34:38] Dr Renee White: No.

[00:34:53] Dr Kellie Tathem: Mm-hmm. You know, people are pushing at that little bit later. We need to be able to encourage [00:35:00] women during training to take that time out. To potentially come back part-time. We need accessibility to childcare services and part-time jobs and work from home. We need to even up the gender pay gap [00:35:15] because if the guys are earning more, then you know, then the women are losing out because they're the ones at home.

[00:35:23] Dr Kellie Tathem: They never get to even that up. So there's a whole heap of reasons why people delay, but we are in a fertility crisis. Mm-hmm. We are [00:35:30] not going to replace our population. And that is terrible from a humankind point of view.

[00:35:35] Dr Kellie Tathem: But also from an economic point of view, because if we're not replacing population, we're gonna have a population full of aged people who don't contribute to the economy and no [00:35:45] one to look after them and no one to pay taxes to pay to look after them.

[00:35:49] Dr Kellie Tathem: All a bit depressing. Unless,

[00:35:51] Dr Kellie Tathem: unless we have increased immigration.

[00:36:01] Dr Kellie Tathem: Absolutely.

[00:36:07] Dr Kellie Tathem: Correct.

[00:36:24] Dr Kellie Tathem: yeah.

[00:36:45] Dr Renee White: So people do this, like, millions of people do this every day.

[00:36:50] Dr Renee White: And then he was like, this is the role of a mother. And everyone was like. Oh, you know.

[00:36:55] Dr Renee White: You know, you just like,

[00:37:00] Dr Renee White: A hundred percent.

[00:37:01] Dr Renee White: Yeah. So I feel like

[00:37:07] Dr Renee White: No, we don't,

[00:37:26] Dr Kellie Tathem: She's still there at, at five months. I can't do this on my own [00:37:30] and I, I've gotta go back to work. How do I do this? Mm-hmm. It's, it's incredible the amount we do. And in the past we, someone just used to stay at home and look after the kids.

[00:37:40] Dr Kellie Tathem: And it's amazing, this beautiful freedom that we have as women. But there is, I go back to Ita [00:37:45] Buttrose about who said, well, women can have it all but probably just not all at once.

[00:37:50] Dr Kellie Tathem: And when we try to do that, we are burning the, you know, you're burning the candle at both ends, you know, and that's, you know, some people thrive in that. I'm probably, I am one of those until [00:38:00] I crash and burn.

[00:38:14] Dr Renee White: I, I, I would [00:38:15] say it's impossible. Like it's

[00:38:17] Dr Renee White: I mean, yeah. It's, it's, it's, it's not impossible, but like someone is going to break. At the end of the day.

[00:38:24] Dr Renee White: You know, like,

[00:38:26] Dr Renee White: You know?

[00:38:26] Dr Renee White: It, it might not be your career that's being [00:38:30] sacrificed, but your mental health would probably go down the toilet.

[00:38:34] Dr Renee White: Yeah.

[00:38:36] Dr Renee White: Absolutely.

[00:39:02] Dr Renee White: Yeah.

[00:39:07] Dr Renee White: Absolutely.

[00:39:09] Dr Renee White: Yes.

[00:39:11] Dr Renee White: So good.

[00:39:14] Dr Renee White: So good. [00:39:15]

[00:39:36] Dr Renee White: so what is it? Is it bubs and beers?,

[00:39:39] Dr Renee White: bubs and beers.

[00:39:40] Dr Renee White: all across Australia. It's so, so good.

[00:39:46] Dr Renee White: Yeah, absolutely.

[00:39:48] Dr Renee White: they realise how much they can miss out on in that first year also

[00:40:20] Dr Renee White: Yeah.

[00:40:42] Dr Kellie Tathem: Mm-hmm. Versus take it outta your super. I mean, at [00:40:45] least we've got that option, but it's still not as good a option as, I guess it would be really nice if society could maybe chip in and value that.

[00:40:56] Dr Kellie Tathem: yeah,

[00:40:57] Dr Kellie Tathem: I dunno how to fund that, by the way. [00:41:00]

[00:41:00] Dr Kellie Tathem: I'm not a politician. That's not,

[00:41:03] Dr Kellie Tathem: Yes, correct. Not our problem. But in an ideal world,

[00:41:10] Dr Kellie Tathem: no correct.

[00:41:14] Dr Kellie Tathem: [00:41:15] Correct.

[00:41:17] Dr Kellie Tathem: But I do look back, I, you know, the baby bonus, you remember the baby bonus when that came out, we did see an increase in fertility rate.

[00:41:45] Dr Kellie Tathem: Many people are choosing to remain childless or there are many people who do a round of IVF that have frozen embryos that they say, no, we are stopping at one.

[00:41:54] Dr Kellie Tathem: Cause we can't afford to have a second child. And that is, that is something as a [00:42:00] society, we really need to promote.

[00:42:03] Dr Kellie Tathem: But I don't have the money.

[00:42:05] Dr Kellie Tathem: Promote that. But in a perfect world we would do that.

[00:42:11] Dr Kellie Tathem: Rather than pay for six cycles of IVF when these people are 39. [00:42:15] It is, it is a more cost effective, long term strategy.

[00:42:20] Dr Kellie Tathem: Yeah. I can see that.

[00:42:41] Dr Kellie Tathem: Yeah.

[00:42:53] Dr Kellie Tathem: Yeah. Yeah.

[00:43:01] Dr Kellie Tathem: No. So the, the issue with aging is twofold. One is egg quantity. Mm-hmm. So as we get older that that cohort of eggs where we start with 400,000 eggs, [00:43:15] generally when we are born, irrespective of if we're having periods on the pill, pregnant, breastfeeding, irrespective of what is happening, there is a constant march through the ovary of using those eggs.

[00:43:46] Dr Kellie Tathem: And in terms of quality, there's no way to turn back the age of DNA. Mm-hmm. So we do know that the quality of an egg may be, may change a little bit over the three months before an egg [00:44:00] collection.

[00:44:01] Dr Kellie Tathem: And so generally I say to women, if we're going to embark on IVF or egg freeze, really for the three months before you need to be in your best shape.

[00:44:34] Dr Kellie Tathem: Have been shown in mice models, but not translated to human studies to be effective. Mm-hmm. So those sorts of things that people take are, and usually antioxidant based, like [00:44:45] nicotinamide, you know, coq 10, DHEA can occasionally give you one or two more eggs that might mature in a cycle. So those sorts of things, they're not gonna do any harm generally.

[00:45:05] Dr Renee White: Yeah.

[00:45:16] Dr Kellie Tathem: Get enough sleep, do some regular exercise, you know, try and be in the healthy weight range, those sorts of things because there is no unfortunate magic pill. Mm-hmm. Which sucks.

[00:45:26] Dr Kellie Tathem: it sucks.

[00:45:27] Dr Kellie Tathem: Because men make new sperm every 76 days. [00:45:30]

[00:45:32] Dr Kellie Tathem: yeah,

[00:45:35] Dr Kellie Tathem: No,

[00:45:38] Dr Kellie Tathem: Yeah.

[00:45:42] Dr Kellie Tathem: So, so the blokes, we do know that [00:45:45] increasingly we, we have some evidence that advanced paternal age, so we know that as men hit their mid forties, there is a reduction in quality of the sperm and the DNA they carry.

[00:46:15] Dr Kellie Tathem: How many sperm do you have? Can they swim? And what do they look like? Because most sperm, in fact, don't look normal. They don't have one head and one tail. They might have two or three heads and one tail or half a tail. And the normal, [00:46:30] correct. That's the majority amount of sperm. So we know we need 20 million, 20 million per mil of sperm to fertilize one egg.

[00:46:39] Dr Kellie Tathem: Now superiority right there. Anyway, we need that many sperm because most of them are actually [00:46:45] abnormal. So if you get a normal semen test, I say it because everyone's pretty proud when they get a normal test.

[00:46:52] Dr Kellie Tathem: And I say, look, that's fine. However, this is not a test of function.

[00:46:57] Dr Kellie Tathem: So, your sperm needs to not [00:47:00] only look normal and be there in normal amounts, but it has to be able to bind firstly, find the egg, bind to the egg, drill a hole in the egg and pop its DNA in there and the DNA that it carries actually has to be of good quality and there is actually no way to measure that [00:47:15] at the moment, aside from in an IVF cycle when you put the egg and sperm together.

[00:47:19] Dr Kellie Tathem: and see what they do. And so what's really important for the male? Is not smoking or vaping. That is the most, that, that is the most detrimental thing that you [00:47:30] can do. We know that prolonged heat exposure is a thing. No one really knows what, how, how much, how much is too much. But things like sitting your laptop on your lap every day, probably not a great thing.

[00:47:58] Dr Renee White: Yes.

[00:48:05] Dr Renee White: Yeah.

[00:48:19] Dr Kellie Tathem: Mm-hmm. So men that are obese will have a reduced quality and quantity of sperm, but there are lots of estrogens in say, BPAs, plastics, phthalates in the environment. [00:48:30] Mm-hmm. Pesticide, all of those sorts of things actually do have quite a significant effect on the quality of our sperm. Mm-hmm. And our sperm in Australia are pretty poor quality, to be honest with you.

[00:48:50] Dr Renee White: Wow.

[00:49:01] Dr Renee White: Okay

[00:49:17] Dr Kellie Tathem: All those things are really,

[00:49:21] Dr Kellie Tathem: Um, can be part of, but more so the DNA, the quality in the sperm as well and the, the reduction in sperm count

[00:49:28] Dr Kellie Tathem: now if you get [00:49:30] pregnant with a, and then this is the problem, people go, oh my gosh, my sperm don't look normal. Can I conceive? Will, I have a two-headed baby? It's not about that. It's just that if you have more abnormal looking sperm, probably the function of the sperm and the likelihood of falling pregnant [00:49:45] is going to be lower. Yeah.

[00:49:47] Dr Kellie Tathem: Yeah.

[00:49:51] Dr Kellie Tathem: It's probably not likely to work as well as a normal sperm. So yeah, if you have all, if you've got 0% normal appearing sperm

[00:49:59] Dr Kellie Tathem: The [00:50:00] chances of conceiving are gonna be extraordinarily low without IVF. Yeah.

[00:50:05] Dr Kellie Tathem: Yeah. But the things that the guys can do are largely lifestyle related rather than age related. I'm usually really pushing the lifestyle.

[00:50:14] Dr Kellie Tathem: And [00:50:15] antioxidants on the men.

[00:50:16] Dr Kellie Tathem: More so than the women where it is really about age. And that's why we are not getting men at 30 to freeze sperm to come back when they're 40.

[00:50:27] Dr Kellie Tathem: To have children. This is a women, [00:50:30] generally a women conversation.

[00:50:33] Dr Kellie Tathem: Yeah.

[00:50:38] Dr Kellie Tathem: Yeah. Yeah, it's really interesting. So, you know, I think for, for girls, I [00:50:45] always say, you know, I, I have some women turn up and I say, look, at the moment you are 30, you've got lots of eggs, you don't have endometriosis, you've got a good egg count.

[00:51:21] Dr Kellie Tathem: Mm-hmm. So that you can have those eggs in the freezer in case, and then you can move on being young and enjoying your life.

[00:51:27] Dr Kellie Tathem: And know that you've, that you've paid your insurance and you [00:51:30] move on and continue being young, right? Mm-hmm. Whereas at 34 of people are sort of going, oh, I haven't found the right person.

[00:51:55] Dr Kellie Tathem: So at the moment, you know, last year we did over 7,000 cycles of egg [00:52:00] freezing in Australia, which has more than doubled in the last five years. So more and more women are doing it. We, you know, depending on which database and which company you look at, about 10 or 11% of women are returning to use their eggs at the [00:52:15] moment.

[00:52:36] Dr Renee White: Yeah.

[00:52:52] Dr Renee White: Yeah.

[00:53:11] Dr Renee White: What's AMH? What is, what is that?

[00:53:19] Dr Renee White: Okay.

[00:53:41] Dr Renee White: Yeah.

[00:53:56] Dr Kellie Tathem: You know, it's looking good kind of thing. Mm-hmm. You, there are [00:54:00] some companies that offer AMH testing online, but I would say that, it shouldn't be looked at in isolation, because if you have a normal AMH for age, but your age is now 36 and you've got terrible endometriosis, then you should be considering [00:54:15] doing an egg freeze.

[00:54:17] Dr Kellie Tathem: Even more so than the person that's 24. You know? It it, I mean, it's just one marker.

[00:54:23] Dr Kellie Tathem: It's one piece of a, of a large counseling puzzle.

[00:54:27] Dr Kellie Tathem: Yeah.

[00:54:28] Dr Kellie Tathem: Yeah. Yeah. Yeah. [00:54:30]

[00:54:33] Dr Kellie Tathem: absolutely.

[00:54:41] Dr Kellie Tathem: Correct.

[00:54:46] Dr Kellie Tathem: yes.

[00:54:54] Dr Kellie Tathem: Yeah.

[00:54:58] Dr Kellie Tathem: Correct.

[00:54:59] Dr Kellie Tathem: so it's [00:55:00] nothing without knowing what your family history is.

[00:55:03] Dr Kellie Tathem: Your personal history, what's been going on in the last three months. Mm-hmm. Yeah. Correct. So, you know, AMH is, it's useful for starting a discussion.

[00:55:12] Dr Kellie Tathem: But in isolation it [00:55:15] is not enough to really be putting off your discussion mm-hmm. With a fertility doctor about whether or not on a personal basis, you should be freezing your eggs or not.

[00:55:25] Dr Kellie Tathem: yeah makes sense,

[00:55:43] Dr Kellie Tathem: What we do when we freeze [00:55:45] eggs is we are selling insurance. Mm-hmm. We really are. It's just a really, it, it's really a very emotionally charged expensive insurance. Mm-hmm. And we hope that we will never have to use it. And the women that do it at [00:56:00] 32, that store 20 eggs. Hopefully they will never have to use those eggs that are there.

[00:56:16] Dr Renee White: Yeah.

[00:56:21] Dr Renee White: Yeah.

[00:56:24] Dr Renee White: Agreed.

[00:56:25] Dr Renee White: This has been absolutely fascinating. Kellie, thank you so much.

[00:56:29] Dr Renee White: We are gonna [00:56:30] dive into our rapid fire now just to wrap up. Alright. Are you ready?

[00:56:36] Dr Renee White: Everyone panics. Everyone's like, oh my God. Yes. Okay. First question. What is your top tip for mums?

[00:56:47] Dr Renee White: Yeah. Let's do want to be mums.

[00:57:12] Dr Renee White: Yeah.

[00:57:25] Dr Renee White: Mm-hmm. Good advice.

[00:57:27] Dr Renee White: Do you have like a [00:57:30] go-to resource for, you know, mums to be, it can be a book, a workshop. Some people even said a poem or a quote, but yeah anything for, for that,

[00:57:59] Dr Kellie Tathem: [00:58:00] For new mums, I have done a lot, a lot of reflection on this in my own journey 15 years ago, and I think we are doing a way better job compared to what we did in the past for new mums, I think find your tribe, find a mother's group, say yes, [00:58:15] that your best supporters will be your other mums in your mother's group. That was the most valuable experience for me.

[00:58:33] Dr Renee White: Yeah.

[00:58:41] Dr Renee White: Absolutely.

[00:58:42] Dr Renee White: I was having this discussion with someone the other day, and we were [00:58:45] talking about the fact that, you know, particularly for first time mums who are perhaps introverts.

[00:59:00] Dr Kellie Tathem: Yeah.

[00:59:08] Dr Kellie Tathem: Yeah.

[00:59:14] Dr Kellie Tathem: Yep.[00:59:15]

[00:59:17] Dr Kellie Tathem: exact same age.

[00:59:33] Dr Kellie Tathem: Sleep. Correct. Yeah, we,

[00:59:39] Dr Kellie Tathem: Is anyone else awake four hour?

[00:59:45] Dr Kellie Tathem: Yeah. Because you, you forget that stuff. And I think when you're in a mother's group and you've got a four month old and you have suppressed the memories of the last four month period, uh, with your previous

[00:59:56] Dr Kellie Tathem: And you're thinking, oh my gosh, what is going on? My baby is [01:00:00] not doing the right things. And someone pipes up. Oh yeah. Remember there's a sleep regression. Oh yeah, yeah. Or my kid now has a tooth. Oh yeah. Teeth are coming. That's right. This is normal having someone in the exact same month as you and there's that solidarity and you're [01:00:15] not alone and gee, it's helpful.

[01:00:35] Dr Kellie Tathem: And that's fine and she probably found, found her own tribe.

[01:00:38] Dr Kellie Tathem: But there, there was a solid five of us that really found our tribe and it was wonderful.

[01:00:44] Dr Kellie Tathem: It was so [01:00:45] good. And do you know, I got away for the first two years without people knowing that I was an obstetrician.

[01:00:53] Dr Kellie Tathem: Well, I was a training obstetrician in fairness. But no one

[01:00:58] Dr Kellie Tathem: actually knew because, [01:01:00] and I think that that said. Lots about the group. We didn't care what you were because we were

[01:01:06] Dr Kellie Tathem: Right?

[01:01:07] Dr Kellie Tathem: So I think when we introduced ourselves, I said, I work in the healthcare system and no one really cared. Mm-hmm. And then the [01:01:15] conversation just carried on.

[01:01:24] Dr Kellie Tathem: No. Because I think we all just knew each other by our kids' names anyway.

[01:01:29] Dr Kellie Tathem: Like I'm [01:01:30] pretty sure I was Molly's mum.

[01:01:36] Dr Kellie Tathem: Yeah, I know, right? So

[01:01:38] Dr Kellie Tathem: I really, I, I look back on that experience and I think it breaks down barriers. We're all there as [01:01:45] equals. We are all there just learning how to be mums and to do motherhood. And that is really important, that solidarity is really important.

[01:02:01] Dr Renee White: absolutely.

[01:02:14] Dr Kellie Tathem: [01:02:15] They are a tight group. I love it. I love that.

[01:02:19] Dr Kellie Tathem: Yeah, yeah, yeah. It's next level. It's great. So that's, yeah. Postnatal supports get a mother's group.

[01:02:35] Dr Kellie Tathem: Yeah.

[01:02:39] Dr Kellie Tathem: Oh, so many things. There's a process to go to sleep. Always.

[01:02:46] Dr Kellie Tathem: Isn't it just the guys go, come going to bed and they're snoring in five seconds? Mm. I'm going to bed and it requires a shower. Cleaning my teeth, getting in bed, putting on lip balm, putting on lavender hand cream.

[01:03:18] Dr Renee White: I, I can, can you share what you are reading at the moment in the Kindle sphere? Like, what's your jam? Are you a romcom? Are you a fiction, nonfiction?

[01:03:41] Dr Renee White: Me too.

[01:03:53] Dr Renee White: Oh, wow. well.

[01:03:56] Dr Renee White: You know,

[01:04:00] Dr Renee White: Fascinating.

[01:04:01] Dr Renee White: I might have to like find this book. Yeah. I'm a, I'm a Kindle convert. I used to be hard books only and then someone had to send like a rush version of, um, a book for me to review for a podcast. Yeah. And I was like, [01:04:15] ah, I'm pretty sure I've got this kindle from like, years ago that I tried to do. Yes. And I was like, uh, it doesn't feel right.

[01:04:24] Dr Kellie Tathem: Oh, it's the best. The biggest barrier, the biggest barrier to reading for me is going [01:04:30] and choosing another book. And in fact, I would say that post having babies. Exercise and reading left my life for probably five years.

[01:04:39] Dr Kellie Tathem: And when I, yeah, and when I had a bit of a, an internal [01:04:45] crisis about I get no time to myself, what is going on? Those were the two things I Yeah. Found that I really needed to reclaim

[01:04:58] Dr Kellie Tathem: So that is actually another [01:05:00] thing I say to people down the track is, you know, Kindle really brought me back to, that is my escape. And I'm getting that escape, whether it's at 3:00 AM or 9:00 PM Yeah.

[01:05:33] Dr Kellie Tathem: Was it French women don't get fat or something like that? Oh. Uh, French women. Something about that. That was the first book I ever read, but it was on my phone in the middle of the night, breastfeeding my youngest [01:05:45] daughter.

[01:05:45] Dr Kellie Tathem: And I think that's where I was like, I think I need to do this. Yeah. Because I'm spending a lot of time doing this.

[01:06:05] Dr Renee White: Yes.

[01:06:15] Dr Renee White: Yeah. Um, it's hard though because you don't know what you don't know.

[01:06:19] Dr Renee White: And correct. Then also like, I don't know about you, but I'd be like. Shut up. I'll work it out later. Like, I'm fine.

[01:06:35] Dr Renee White: Cause I think with, with reading and exercise, you, well, to a degree with exercise you can, but it's better if [01:06:45] you don't. You have to do those things by yourself. Yeah. You know what I mean? Yeah. Like I run, but I don't like running with people.

[01:06:59] Dr Kellie Tathem: [01:07:00] Yes, correct. Yeah.

[01:07:11] Dr Kellie Tathem: It is, I think they're the only two times apart from a really [01:07:15] deep sleep where my brain turns off, all of the tabs go off. Yes. And that is where actually I get rest. That is my restful place because there's so much going on in the, all of the other open tabs of motherhood and work and everything else [01:07:30] that unless I have that busy mindfulness, which is running or on a bike or you know, my heart rate's at 160 and I'm just focusing on being alive and breathing, or I'm completely distracted and being involved in a good book, [01:07:45] I'm thinking about all of the other things on the to-do list.

[01:08:01] Dr Renee White: Absolutely. Yeah. Agree.

[01:08:03] Dr Renee White: Kellie, it has been amazing to chat with you today. Thank you so much. So many like nuggets of wisdom.

[01:08:11] Dr Renee White: Like I'm just like brain explosion. [01:08:15] Uh, Julia, my virtual assistant is gonna be like furiously typing away and getting all these resources for the show notes. Cause I'll be like, oh my God, we need to include this, this, this and this. So

[01:08:25] Dr Renee White: Amazing. Thank you so much.

[01:08:30] Dr Renee White: Where can we find you if the listeners would like to contact you directly?

[01:09:02] Dr Renee White: Yes. All for it. Yeah. Alright, everyone, until next week.

[01:09:06] Dr Renee White: See you. If you loved this episode, please hit the subscribe button and leave a review. If you know someone out [01:09:15] there who would also love to listen to this episode, please hit the share button so they can benefit from it as well.