The Truth About Fertility That No One Talks About | Lisa Falco (#18)

Episode Summary

Lisa Falco, a data scientist and leading voice in women’s health technology, joins me to explore the fascinating phases of reproductive health. This episode dives deep into the phases of reproductive health, exploring fertility, pregnancy, and life after birth. Lisa Falco shares insights on how factors like age, stress, and mental health impact conception, as well as the realities behind miscarriage statistics and pregnancy complications.

We also tackle widespread fertility myths—such as whether like whether timing, position, diet, caffein, alcohol or prolonged use of birth control can impact fertility—and examine how modern technology is reshaping our understanding of reproductive health. From surprising data to practical advice, this conversation is packed with eye-opening insights for anyone curious about the science of the female body.

Meet Lisa Falco

A pioneer in FemTech with 20 years of experience in data science and health technology. Former Director of Data Science at Ava, a Swiss startup specializing in fertility tracking, Lisa is the author of Go Figure! The Astonishing Science of the Female Body and a TEDx speaker, where she discusses how technology can empower women and enhance understanding of individual health. Her career focuses on using technology to bridge gaps in knowledge about the female body.

Transcript

E19. Lisa Falco interview

Mike: [00:00:00] Hey everyone, welcome back to the channel. My guest today is Lisa Falco, data scientist, digital health expert, and leading figure in women’s health technology with 20 years of experience in the femtech space. Lisa holds a PhD in biomedical imaging and is the former director of data science at Ava, a Swiss startup that developed a groundbreaking device to help women conceive faster by analyzing physiological data from their menstrual cycles.

 She’s also the author of Go Figure, the Astonishing Science of the Female Body, and a TEDx speaker on how modern technology can enhance our understanding of individual health and fertility.

So what does the data say about the most effective way to conceive. Does stress and mental health influence fertility, and is there such a thing as knowing too much? Could awareness of declining egg counts or the increased risk of miscarriage with age create stress that actually works against conception?

In this [00:01:00] episode, Lisa and I explore the phases of reproductive health, from getting pregnant to navigating pregnancy and life after birth. We discuss how factors such as age, stress, and lifestyle changes impact fertility, the shocking reality of miscarriage statistics, as well as the remarkable transformation of the body and the brain during pregnancy.

We also tackle a series of common myths about conception, like whether lying with your feet in the air after sex increased your chances of conceiving, whether time and position during sex can actually influence a baby’s gender.

Some of the answers actually may surprise you.

 That’s it for part one of my episode with Lisa Falco, but be sure we are not done. Come back tomorrow for part two, as there is still much more to unpack. Stay tuned.

 I’m Mike Connors and this is How It Ticks. Let’s pick up right where we left off with Lisa Falco.

Lisa, thank you very much for [00:02:00] joining the show. How are you doing?

Lisa: Thank you for having me. I’m doing really well.

Mike: You have, been quite successful creating a device, which very much looks at data to, indicate when someone’s ovulation cycle, is ready to help people conceive. What have you learned from that when it comes to conception going through this journey?

Lisa: Hmm. That’s a very good question. I think the thing that struck me the most when we were developing this device and really talking to women that were trying to get pregnant is that women know so little about their own bodies. They don’t really know, you know.

When you can get pregnant, how to get pregnant and really how the menstrual cycle works and that there’s this really huge, uh, knowledge gap. I think also we spend like the first, first 10, 15 years of [00:03:00] our, um, of our sexually active lives. We spend trying very hard not to get pregnant and being completely terrified that whenever we make a small mistake, we’re going to get pregnant.

immediately. And then suddenly, when you try to get pregnant, you realize it’s actually not. that easy, then it’s not that you’re going to get pregnant just by someone looking at you, which you basically think for, you know, earlier, um, in your sexual active lives. And I think that’s really an eyeopening for many women.

And also What comes up when women try to get pregnant is that very often women have been taking a hormonal contraception for many, many years, and often that has covered some kind of underlying issue that they have with their menstrual cycle. Maybe they had PCOS, that’s polycystic ovary [00:04:00] syndrome, or they had endometriosis or some other condition that the contraceptive has been covering.

And when they stop, when they stopped taking the contraception, they don’t get the Their perfect menstrual cycles immediately. But then all those, um, um, disturbances on the menstrual cycle come up and that’s when they get issues getting pregnant. Um, and I mean, from a technology, uh, point of view, what we were trying to do was really to try to have the women figuring out.

When in their menstrual cycle, whether ovulating because we learn in school, you’re going to have a 28 day cycle and you’re going to ovulate on day 14, but these are averages and very few people are actually average. It’s always a distribution. So they can be quite large spread on when you’re actually ovulating in your [00:05:00] menstrual cycle, and it’s only by knowing your own personal data that you can nail it and get it really right.

Mike: What is the spread, of course there’s gonna be some outliers, but if 28 days is the average, what is the healthy range from long to short.

Lisa: It’s actually quite large and experts are not entirely, um, you know, they don’t have the same opinion on what exactly the right moment is.

We, we were talking to so many experts, but they say between 21 and 35 days

Mike: of, uh, big,

Lisa: of the length of the menstrual cycle. And then normally what is most consistent in a cycle are, uh, is the second part that is called the luteal phase. And this, they say it’s normally 14 days, so you would actually count back from Uh, you know, from the end of your cycle and back 14 days.

But even that, that can [00:06:00] vary. Maybe it’s 10 days, maybe it’s 16 or 17 days.

Mike: If you don’t have something collecting your data and giving you information, if you were just really in tune with your body, how well do you think you were able to track your own cycle?

Lisa: Actually very well, but to be honest, for, uh, for me, uh, personally, I was not so in tuned with my body when I started developing this technology.

But by using the technology I learned when I was ovulating. And then once I knew that I started seeing all the signs and then there, uh, you can see how your cervical mucus, uh, is, uh, It’s changing, for example, over the cycle and it has a very special consistency, um, when you’re ovulating and when you’re more fertile and you can also, many women have something that’s called a mittelschmerz.[00:07:00]

It’s a, it’s a German word, but it’s, um, it’s the same word in English. It’s that you have pain, that kind of pain around the ovaries when you’re ovulating. So that’s, um, that’s a sign is kind of a small. Inflammatory events when you’re ovulating and many women can actually feel this as well. And also if you’re generally in balance or in tune with your body, you can, you can feel that you’re, um, you’re happier, you’re hornier, uh, when you’re actually fertile.

I mean, that’s, uh, that’s how evolution works. That’s why, why we get pregnant in the first place. That’s because we, we want to have intercourse.

Mike: Then how does the device work that you’ve developed? Um, I’m guessing it doesn’t measure the cervical mucus. Um, what does it actually do to be able [00:08:00] to be so accurate?

Lisa: So what’s interesting over the master cycle is that you have all the hormones that are fluctuating over the cycle. And once you, uh, ovulate, you start producing a hormone called progesterone. And this is driving a lot of parameters. So it’s changing your temperature. It’s changing your heartbeat. You actually, your heart starts beating faster in the second part of the menstrual cycle.

Uh, your breathing rate also changes and even more, uh, parameters as well. And all these things, all those things, those changes you can measure. So you can actually, uh, so we use sensors on the outside of your body to measure these parameters. And then you can see, okay, this is when your, uh, your heart rate and your temperature normally goes up.

And then you can use statistics to [00:09:00] predict when it’s going to happen next time. And something that also happens that’s quite interesting, just around our relation is that. Your temperature sometimes dip a little bit just before and also we could see so you if there’s one moment in the cycle where temperature dips and heart rate goes up because heart rate starts going up slightly.

before the ovulation. So that is kind of the particular moment when, when you are the most fertile. But, uh, it’s just a lot of statistics around it, but it’s personal statistics. It’s not statistics on all women, it’s statistics on you

Mike: and so the entire cycle is longer. Does that also mean that the ovulation cycle also is very variable for different women?

Lisa: I mean, it follows the cycle. Yes. And then if you are [00:10:00] if you are young or this below 35, um, then if you have regular cycles, that means that very likely you’re also ovulating regularly, like every cycle. That’s, that’s the most common thing. If you really have always, if you have 29 or 30 days or whatever it is you’re having, and you’re always having the same length.

then you can be pretty sure that you’re ovulating every cycle. And they say a regular cycle is, can deviate up to five days from the shortest to the longest cycle. But if it deviates more than that, then it’s considered being irregular. And then you might not be ovulating every cycle.

Mike: If you can be quite sure when you’re ovulating, can you use this? as contraception for when you’re not ovulating to have sex unprotected? [00:11:00]

Lisa: Absolutely. Um, but of course you have to be quite careful. It’s actually, it’s a very well known method in many countries. It’s called family planning, natural family planning, uh, method.

And then what you do is really that you track your cervical mucus because you’re actually fertile five to six days after up to ovulation because the sperm can live so long. So there’s this period before you ovulate where, where your mucus is very favorable for sperm to live in. So in this very good environment, it can live for five days.

So if you have intercourse five days before ovulation, you might still get pregnant. So it doesn’t have to happen on the exact day. So that is what is a bit tricky. Like when does your fertile window really start? And then the end can be a bit easier [00:12:00] because if you have all the signs when you’re ovulating, or if you just use the thermometer and see that your temperature goes up, then you know, okay, now I have ovulated and it’s been more than 24 hours since I ovulated.

And then you have basically no chance of getting pregnant. It’s just, you just have to be really careful. Right. And, um, and use some kind of other protection because one thing that I personally have against this family planning method is that you say, okay, that’s don’t have sex then. And it’s basically when you’re the most horny, that’s when you’re not supposed to , but you can use other protection or, I don’t know, do other things, but.

Mike: So, so what is the most effective way to conceive then? Is it just volume of sex that would be the most effective method?

Lisa: Yes, , but it’s not you. You don’t have to have sex three times a day. Actually, they recommend when [00:13:00] you try to get pregnant that you have sex, uh, at least every two days when you’re

Mm-hmm. That is the recommendation, and that should be largely enough. That’s the man also has a part to play in this, and he needs time to, uh, regenerate. Mm,

Mike: mm-hmm . I wanted to ask you a bit about age and fertility, I’m aware at least that, yeah, once you get to that 30, there’s that decline of, chances of success.

But I wanted to sort of understand a little bit more of the detail. Can you explain to me what the difference in fertility success rates is approximately between say 30, 35 and 40 years old?

Lisa: Especially within that, it’s, it’s really, it’s not like a cliff you go over and suddenly it’s gone. It’s really like more a continuous degradation of your fertility.

Um, but the numbers that I have is, Like when [00:14:00] you’re, uh, when you’re 25, you have about 25 percent chance of getting pregnant every menstrual cycle, if you’re trying. And if you’re 40, that chance is down to 8%.

Mike: And that’s also an average.

Lisa: Yeah, that’s just an average. So it’s of course different for everyone. And I mean, you will always see pregnant women in their forties because 8 percent is still, you know, It’s still can give you a pregnant, get you pregnant, but it’s just, it’s just harder and it takes longer. And very often you actually end up, um, getting assistance with IVF, uh, to get pregnant in your forties.

So sometimes we can get a skewed picture of how easy it is and everyone will still have a friend said, Oh, I got pregnant at 40 and 8 percent is not nothing. But it’s [00:15:00] still not that high, so it is advisable. One of the main factors why women have problem getting pregnant is that they’re old.

Mike: And that 8%, that’s the right, so that is per ovulation cycle when the woman is actively trying to conceive.

Lisa: Yes.

Mike: How, how does, as far as you know, chemically, how does the stress affect fertility? Because I wonder, do you think there are downsides in having so much knowledge about fertility? You know, could the knowledge of a declining egg count and increased risks because you’re getting older actually negatively impact your ability to conceive?

Lisa: Well, it has to be quite a lot of stress to to negatively impact the fertility, to be honest. So all external factors influence. Your fertility in the sense that the impact your, um, your [00:16:00] menstrual cycle because your menstrual cycle is, is conducted from your brain. So from a part called the hypothalamus and, and whenever you are too stressed, often in combination, the worst thing is having too much stress and too little fat on your body because fat produces some, uh, a hormone called leptin and leptin.

is necessary for the menstrual cycle to work. And then that combination with too little leptin and too much cortisol. Cortisol is a stress hormone. So this combination kind of shuts down the menstrual cycle in the brain. And that leads to something called hypothalamic amenorrhea. And that means that your menstrual cycle basically stops or become irregular.

So this is quite common among women that are [00:17:00] elite athletes or, um, or, you know, sports that are, you know, it’s good to be low weight or have too much muscle mass compared to, to fat, because they say to actually have a functioning menstrual cycle, you need to have at least. Uh, 22 percent fats on your body and then if you then to have too much stress on top of this, this is just too many things that are, um, disturbing the balance.

But if you have regular menstrual cycles, Stress or your mental state should not really influence.

What it does influence is maybe your desire to, uh, to have intercourse.

Mike: What about other physical or lifestyle, um, activities? Are there any particular things women should consider when trying to conceive which could benefit them?[00:18:00]

Lisa: Well, I mean, generally it’s good to have, you know, a rather balanced lifestyle and eat healthy, make sure you get enough nutrients. Of course. I think if you eat, if you kind of have a normal way of life, then it’s fine. But if you only eat crappy food or you get drunk every night, that is. That is of course not recommended, but you also don’t need to be, you know, overly cautious.

What you do need to do, which is super important is that you need to take, um, um, in French, I said fully a folic acid. You need to take that as a supplement. That’s quite important when you try to get pregnant. Um, but that is the only thing from apart from this. Generally having a reasonable, um, reasonable lifestyle.

many try to sell you that you have, [00:19:00] yeah, that you have to be, uh, do this or that, but we have been pregnant for, you know, that’s since we existed it’s more of those extreme things. Um, and also you should not, you know, in terms of weight, you know, A little bit overweight is also not a problem if you still have regular cycles, but if you, you really go into the obesity spectra, that will also disturb your menstrual cycle.

So the menstrual cycle is somehow always a sign that if you’re healthy enough to, to have, yeah, to be, to become pregnant.

Mike: What was the name of that, um, supplement you mentioned?

Lisa: Um, God, I, uh, it’s acid folic.

Mike: Folic acid, that’s it, yeah.

Lisa: Yeah, folic acid.

Mike: What does that do?

Lisa: Um, [00:20:00] it’s important for actually when it doesn’t necessarily help you become pregnant, but it’s really important that when you get pregnant, that, uh, that the feet is developed properly and doesn’t get, um, uh, problems with the development of the back and the spine.

So that is why it’s really recommended, uh, to take this supplement early on.

Mike: I now have a, in preparation for this conversation, I listed down a list of, um, pregnancy. Myths conception myths I should say and I wanted to go through with you now each of them Some of them were in my head already other ones the internet helped They kept coming up time and time again, and I thought oh, I’ve got just the right person to ask this to Okay, first question.

You can control your baby’s sex with either timing diet or sexual position

Lisa: I mean the, the reasoning behind, uh, [00:21:00] that statement is quite interesting and it comes from the idea, especially then yeah, with timing, that it comes from the idea that they’ve seen that male sperm, like sperm that will become a male baby.

Swim faster, whereas the ones that have, uh, you know, the female sperm is living longer and being more robust. And then there, there is like this idea that if you have intercourse closer to ovulation, You would get more male babies. And if it’s a further from a relation, you would get more female babies. Um, but there is however, I mean, that’s the reasoning behind it.

And the reasoning, I mean, I get it, but the statistically, this has never been proven, uh, that this is the case and that you actually can do that. Uh, we’re talking about [00:22:00] maybe they seen, you know, maybe that would be 51 percent chance versus 49, you know, nothing significant. whatsoever. It’s going to be what it is.

Mike: Is there a way to identify the sex of the baby based on like, so essentially do, does sperm have a gender or a sex? Or is that really just looking, well, if you look at the studies, then if you measure the speed of the sperm, the fast ones are more likely to be male, but there’s nothing about the sperm, which indicate whether it could be a male or female.

Lisa: That’s a very good question. Yes. Yes. I mean, it has to be, I mean, half of it, one has Y chromosome and one have an X chromosome, but I don’t think you can see it in the microscope. Maybe if you do some other analysis of it, but then I guess you destroy it at the same time.

Mike: Interesting. Okay. Um, caffeine intake reduces the chance of conception.

Lisa: [00:23:00] No, no, I mean, within reasonable amounts, I mean, I don’t know how many liters you want to drink. That’s probably not good for you, but normal coffee consumption, no.

Mike: What about alcohol? I know that’s generally a bad thing, but in moderation, how does that impact conception?

Lisa: Um, no, no moderation, no. I mean, I think many drunk girls get pregnant all the time.

Mike: Valid point.

Lisa: I mean, in the, before you know you’re pregnant, you know, that you’re not, that the fetus is not really hooked up to your, um, to your vascular system either. So I’m not saying if you want to get pregnant, it’s probably a good idea to not drink, uh, too much and everything in, in extreme, but you should also not completely stress out if you realize, Oh, I got pregnant a week ago.

And [00:24:00] I had, you know, I had some wine, glass of wine. You don’t need to stress about it because the, if something goes wrong anyway, the pregnancy will not really happen. It will detach, but it’s not really a part connected to your blood. in the beginning that that takes a few weeks. So, uh, it’s nothing to be, you know, obsessive about, but the moment, you know, you’re pregnant, you should of course start, stop drinking immediately.

Mike: Okay. So I guess that goes for a lot of the dietary and health things to protect the baby, for example, um, raw fish. Once you know, you’re pregnant, you should stop and leading up to it. It doesn’t have the same impact.

Lisa: Yeah.

Mike: Okay. Next one. Certain sexual positions can increase chance of conceiving.

Lisa: Um, Um, I know I researched this from a book [00:25:00] Also like things to do after Uh, you’ve had sex trying to really like tilt up the pelvis. That

was my next one. Yeah, okay sorry for taking it from you, but No, no it what it’s it’s timing. It’s timing that matters and then Because if you disturb sperms get into an environment where the mucus is favorable They’re going to feel very well in that mucous and swim in whatever direction they have to, to get there.

Mike: Okay, so total time spent with your legs up in the air is not going to increase, you’re not allowing extra time for the sperm to figure his way around.

Lisa: No, I specifically looked at this one for my book and tried to study if it would have an impact because a lot of my friends told me. Um, I did this and I got pregnant, but that’s just anecdotal.

[00:26:00] There’s, uh, there’s no statistics.

Mike: There, there are a lot of, um, mothers out there who they look at you and they go, it’s going to be a girl. I feel like mothers in mother’s intuition. I don’t know. Is that a, is that, is that a myth or is that something that’s a bit of science behind as well?

Lisa: Hmm. Yeah, no, I don’t see how how that should be possible. It would be possible. I mean, what’s really interesting is that when you get pregnant, it’s a fetus that like the, um, you have the placenta inside your body, right? And the placenta is, is actually not an organ. It’s an organ, but it’s not the organ of the mother.

It’s an organ of the fetus of the, of the baby. So it’s a way, the placenta is a way for the fetus to control the body. Um, of the mother. So it creates all the [00:27:00] hormones that are needed to transform the body of the mother so that the fetus can get all the nutrients it needs. And it’s those hormones that is changing everything in the body.

In, um, in the body, body of the mother, like, uh, how, how we, we put on more and more fat, for example, you can see very clearly, we get much bigger. The breasts are growing, um, the cardiovascular system, uh, is changing. The blood flow, uh, is changing. The brain is also getting remodeled. because of these hormones.

So it’s really changed transforming, um, a woman to a mother, if you like, um, through the hormones that the placenta is, um, it’s execrating in the in the body. And then [00:28:00] thinking that a male fetus would somehow send out hormones differently to control the body. Um, I have not seen anything that that would be the case because the hormones that are being executed is it’s progesterone, it’s estrogen, it’s relaxin, some, some, um, CRH, some other hormones as well.

Um, but it’s not really linked to. The sex of the baby.

Mike: Were there any other myths that you researched during your book where maybe the findings were actually surprising?

Lisa: Oh yeah, yeah. I mean, if you, I like this, this one very much and that is that we’re actually having parts of our babies live in us forever. [00:29:00] Uh, you say that if you’ve been pregnant, you will actually have parts of your baby in you forever. Uh, and you could actually find traces of our baby’s, uh, DNA and our baby cells in our bloodstream and in our, uh, brain after it’s called, um, micro shimerism.

And, and for example, Oh, Oh, wait a minute. I have to go back on my other statement there that you can’t tell anything because if it’s a boy or a girl, but if, because if a mother have had male babies, you can actually find cells with traces of, um, you know, the Y chromosome inside, uh, yeah, find traces of this inside her body.

So we do keep parts of our babies in us forever. I think that’s, that’s a really fascinating fact about,

Mike: I feel like women would like to hear that. That’s something [00:30:00] nice to hear as a mother. Yeah.

Lisa: Yeah, it is. It is. If, if you want it. Yeah. Every mother is different and we all react differently. So it could also be a terrifying thought for some, I assume.

Mike: Could be.

Lisa: For many, I’m sure it’s a nice thought.

Mike: Is it true, that your chances of success for a second or third child are higher than the first one? Yeah. Almost like the logic would be something along the lines of your body’s been through it before and therefore knows what it’s doing and the chances of success are greater.

So any truth to that?

Lisa: No, no, not really. I mean, of course, if you have proven that you can get pregnant. I mean, that means that you’re not infertile, that you don’t have a fertility issues. And maybe you have sorted out a few of the fertility issues that you might be having in the [00:31:00] beginning. If you had, um, irregular cycles, if you were getting off your contraception and it took time for your body to, to readjust.

And then, um, then of course, if you can get pregnant once, there’s nothing to say that you shouldn’t be able to get pregnant twice. So from that perspective, I think your chances are higher to get a second baby, but there are no, uh, guarantees a secondary infertility is also very common because at the same time, you’re also older, you have a different lifestyle, so it also depends what kind of lifestyle you had in the part, how much you saw your partner.

In the past, and then how much you see him, um, after you get pregnant. So, you know, that can be [00:32:00] either, Oh, maybe you had sex all the time before, and then suddenly the babies are overwhelming you, and then you don’t get to have sex again, or if it’s the other way around, maybe you’re always traveling before you have babies.

So you rarely met and had sex at the right moment. And then after you have babies, you’re together all the time. And that makes it easier. Um, It’s nothing really about your body. I think it’s just statistics.

Mike: Okay, I’m going to add that to another myth busted that the body doesn’t have some sort of memory from a previous experience, therefore sort of knows what it’s doing.

Lisa: Um, that is true. Once you Once you are, are pregnant, once you give birth, so it’s much easier to give birth the second time, um, than the first, because you’re kind of, uh, I mean, the, all the, the, the joints loosens up the, the, the cervix has gone [00:33:00] through, uh, the cervix, that’s the opening of your uterus, it’s gone through the transformation.

Once I’m getting a baby out. So, um, all those cases that you hear when women are giving birth on the side of the road, on the way to the hospital, that’s never where the first baby. And that’s, that’s, that’s more, um, the more babies you have, the faster it will go. And, um, the pain is probably the same, but it’s not lasting so long.

Mike: Does that, does a pregnancy change the shape of your bones? Like I understand if muscles stretch, skin stretches, but like can your hips physically open to a point where they are more open after than before?

Lisa: I mean, normally they should go back. So it’s not the bones themselves. it’s like the joints that are getting more stretched.

And you also, I mean, during the pregnancy, you get those additional [00:34:00] hormones that are being released by the placenta and the roles of some of those hormones is really to loosen up the joints, uh, to, to make that transformation possible. That’s also why most women get bigger feet. By every pregnancy because, uh, well, of course the bones are not growing, but you know, the joints are kind of stretching in the mouth and then, uh, you’re losing the joints and you also have more pressure because you become heavier and then they kind of become more flattened out.

Mike: Interesting.

Lisa: Yeah,

Mike: I want to talk a bit more now about going through going through pregnancy, we’ve been successful. We are pregnant. I wanted to start with physical health. How important is physical exercise during pregnancy? I would understand that exercise is good for pregnancy.

However, [00:35:00] as some exercises more beneficial than others in terms of cardiovascular, uh, keeping the muscles strong, do your research cover anything like this?

Lisa: I haven’t been looking so much at that. And I think on this, this topic, it’s so individual because we all react so differently to all those hormonal changes and there are huge changes to our cardiovascular system.

So generally the recommendation, but this, I know more, uh, because I’ve gone through. You know, several pregnancies myself, rather than from the research point of view, I mean, it’s generally recommended to stay active and to move a lot and to, you also want to avoid getting blood clots. And for that exercise and movement is important because the risk of blood clots do go up, uh, during pregnancy.[00:36:00]

Um, but then also some, some women needs to go into bed rest because there are some complication. They can’t move, um, because the risk, uh, the risk of preterm birth. So it’s so individual. I think the best thing is to go on As you usually did as long as you as you can, and as long as you feel well and just listen to your body.

and feel what is right for you and maybe discuss with your doctor because now we’re really going to the, you know, the medical domain. There’s always, uh, yeah, I’m not qualified to give medical advice.

Mike: As you get older and it is more difficult to conceive, does the risk of complication also increase?

Lisa: Yes. Yes. A lot. Um, that’s also one of the reasons why they think, [00:37:00] um, In the, in the, in the U. S. they’ve seen a lot that the age goes up, but, uh, also, it has other reasons as well, but, uh, maternal mortality has gone up quite a lot in, um, in the U. S. since the 80s.

So in Europe, the risk of dying in a pregnancy is very, very low. I mean, um, it’s, I can’t remember exactly the numbers now on top of my head, but it’s, it’s very, very low. And it was the same in the. Until the eighties and, and then suddenly in the U S this has gone up. So now it’s like two or three times as likely that a woman dies during pregnancy as it was in, uh, in the eighties.

One of the tired things are of [00:38:00] course the decline in healthcare, but this one of the benefactors is, is age. So everything becomes a bit more. dangerous. Also, I think it’s a lot linked to the cardiovascular system. Um, the risk of preeclampsia. It’s a condition that you also, if you have high blood pressure, you have high risk of preeclampsia and also it drives the blood pressure to go up.

So it’s everything linked to, um, yeah, to these aspects. So you should have kids when you’re young.

Mike: Have kids when you’re young. And I suppose that also means the risk of the baby being healthy also decreases as well. Do you know much about the statistics around miscarriages as you get older?

Lisa: Um, well, they do get much more. More common when you, [00:39:00] um, when you get older, I don’t have the exact numbers, but the risk of miscarriage increases after 35 and even more after 40. For sure. And it’s also like the quality of the, of the eggs that goes down a lot. That’s also why the reason, the reason why we’re less for, uh, fertile, uh, at 40, than at 25 is the quality of the eggs.

So, um,

Mike: So it’s not the egg count. It’s the quality of the eggs that’s left.

Lisa: Yeah, exactly. That is the problem. So at 40 you might still have regular cycles and still ovulate, but the quality of these eggs is going down. So either you don’t get pregnant, At all that it that means that the fertilized egg has not been attached [00:40:00] to the uterine lining.

The uterine lining is like the wall inside the uterus, but, uh, but even though if you might have a lower quality egg, it might get attached to to the uterine lining and start to grow. But there might be some chromosome changes or some quality that is not good and that will then cause the body to reject the pregnancy later on.

And that is the reason behind miscarriage. So ideally, you know, you would never, you wouldn’t even notice that you’re pregnant, that it’s kind of rejects. Um, the egg already before the time where you would have had your next menstruation anyway, and that’s where actually most miscarriages happens, or it will notice it later that things are not right.

And then it would expel, um, you know, get rid of that, that pregnancy. [00:41:00]

Mike: And that’s really to do with age. There isn’t anything you can do in terms of ensuring you have a healthy diet ultimately it’s the quality of the eggs, um, which is the most likely impact of a baby’s health.

Lisa: Yes. Yes, that is. I mean, of course, if you really have a bad diet and you’re really exposed to toxins, um, you know, that’s if you’re working in a lab with dangerous chemicals, you should be very careful, of course, um, And they’re also, I mean, I was looking a lot into toxins and how it influence us, et cetera.

And it depends very much where you are in the world. Um, so there are much more. Dangerous places in terms of toxins in the US, for example, or, or in parts of Asia, but in Europe, we’re [00:42:00] not that exposed to this. So, you know, all these advice and also when you hear all those influence, you hear a lot of podcasters, American podcasters that talks a lot about toxins.

Um, it’s also because they have less regulation on this since then what we have, um, because there are a lot of, they, there have been a lot of bad chemicals in the past, but they have been regulated away. And one thing that was really big when, when I was pregnant was this, uh, um, BPA in plastics

that can be harmful and that can really mess with your fertility and it can mess with the baby’s development, uh, et cetera, but this have all been banned now. Um, so, you know, it’s good to take the usual You know, don’t try to avoid getting [00:43:00] my microplastics into your system.

Mike: That was my question. When you say toxins, you’re predominantly talking about microplastics, which are a huge talking point at the moment, especially like you said, American podcasts.

It’s like, it makes you paranoid based on the kind of conversations they have. And it is interesting that you say that there is a big difference between what is what the people in the U S are exposed to compared to Europe. So BPA is one. Are there any others which Are worth thinking about when going through pregnancy

Lisa: here in Europe. I did not see so much. I mean, I did research this. I, they don’t really stuck to my mind to be honest, because since they felt a bit irrelevant for our, for our ecosystem here. And I think, especially in Switzerland, we have. Great water. Uh, we have great products, um, in the [00:44:00] supermarkets. You can never say it’s never gonna happen, but compared to, to, to genetics, compared to age, these are really minor, minor things.

Mike: Is it true, and I’ve also heard this through people and not research, that if you’ve gone through A miscarriage, the likelihood of the following baby being healthy is higher?

Lisa: Hmm, maybe, I don’t know, it could be just a purely statistical issue. I mean, you have, you have 20 to 30 percent of risk of miscarriage, uh, in any pregnancy.

Mike: In any pregnancy, regardless of age, that’s even if you’re 20.

Lisa: Yes, but remember, this is very early. I mean, most pregnancies, most miscarriages happen before you even know you’re pregnant.

You would just notice as, uh, maybe a heavier menstruation, [00:45:00] maybe a period was late a week and, and it would get, uh, before you actually have any pregnancy symptoms before you noticed something was different. So, um, so it’s a statistical thing that you still have a higher chance of not having a miscarriage and having a miscarriage.

So maybe that’s just, um, You know, it’s most women I know have gone through at least one early miscarriage and they all happen before, uh, I mean, there, there are other things, but most. Also happens, most happens very early and then the other largest portion is happening before the week 12. That’s why they often don’t recommend you to talk about your pregnancy before you’re three months in.[00:46:00]

Mike: At what stage of the pregnancy does medical intervention have to happen for a miscarriage? For example, need to go to a doctor to actually remove the fetus? Yes.

Lisa: Yeah, I don’t know exactly that date. Often you would still go to a doctor, but you could probably remove, you can mostly remove it by taking a pill. normally if you just bleed it out, I think it’s also probably around week 12 or so, because then it’s still so small that it would just bleed out, but sometimes you can get what is called, um, called a mist. It’s called a missed abortion. I mean, it’s not when we say, uh, I had a missed abortion myself. So I got a bit shocked when it said in my fire that I had an abortion.

I did not have an abortion. I had a fetus that [00:47:00] didn’t develop. So it died, but it was not exposed. So, uh, it was, uh, quite early in the pregnancy in week eight. So, uh, then I went, I got the first ultrasound, which is quite common in Switzerland. And then there was no heartbeat. And if there’s no heartbeat in week eight, um, something is wrong.

And then you get, then I got the control a week later, and then it was clear that was never going to become anything, but it didn’t expel. So I was still pregnant, but. but the fetus was dead. And then you get pills to, to expose it and it’s kind of abortion pills actually. So you can just take this pill and then you, you bleed out.

That’s, um, I think that’s, that’s the most common thing. And then it is [00:48:00] if, if, you know, if you, if you’ve gone a lot further than you need more medical intervention,

Mike: she must be pretty confronting for a woman to need to do this, especially if you’re doing it alone.

Lisa: Yeah, it’s, uh, it’s not ideal, but it’s, um, I think what helps a lot is really understanding.

I think how common this is. Um, and of course there’s a lot of expectations. I think if you really want to get pregnant, you have so many hopes, you get all those hopes and dreams. They, they, they get crushed. Um, and die, but, um, yeah, it’s, it’s a part of life.

Mike: I guess there’s also the, the expectation versus reality effect of social media as well.

People don’t tend to post their unsuccessful, pregnancies. They post their successful ones. So the illusion is that everyone else is being successful. [00:49:00] I do feel like there is at least. Maybe also just because I’m getting older and the people in my life are at that age too, but it does seem to be more openly talked about.

Do you find over the last say 10 years that these kind of conversations are more and more public and people are getting more informed?

Lisa: It’s a, it’s a good question. I do, yes, I do feel that generally people talk much more about, about women’s health in general, that it’s much more, it’s more talked about, um, menstruation, I guess also miscarriages. I think a lot of those conversations still happening, but maybe between women, you know, not out in the open.

So the shift is maybe that it’s become more, more open. I mean, when I had, um, my, my kids, they are, you know, it was 16 years ago. I knew that basically all of my friends have [00:50:00] had at least one, if you had, if they had more than two kids or two kids or more, they have basically all gone through at least one miscarriage.

So it was really, really common.

Mike: Now through all of this, um, from trying to conceive to the end of pregnancy, from your personal and professional perspective, what role can a man play here to make things as easy as possible besides just being a good partner?

Lisa: Um, besides being I mean, that part is really, really important.

I think that is not to be under underestimated how important that is. And I think really respecting that you change so So much as a woman, I briefly touched on that point before, but I think it could be worth [00:51:00] mentioning again, you know, that the brain changes during pregnancy because, um, both estrogen and progesterone levels that you, you know, they fluctuate and they influence your mood, uh, during the menstrual cycle.

But during a pregnancy, those levels are more than a hundred times higher. And what happens is that something, some structures in your brain are basically growing, for example, the amygdala, which is kind of your, your fight and flight response and your, your, your stress response is happening a lot in the amygdala.

It gets really, it grows, it becomes much more active. So you do become more, more anxious. And it also, you know, remodel other parts of the brain that is more into caring and nursing. So I think it’s really important to [00:52:00] understand that you, most women, it’s always on average,, but that most women go through a transformation.

And then often I feel that we’re asked to still be the same person as we were before, because that’s a person you hooked up with. person, you know, you, yeah, that you love, but she is going to go through transformation and, and really not putting pressure that you have to be the person you were before, because it’s not, and it also can be a big.

grief, I think for the woman to have. Sometimes you can be happy about that. You become a new person, of course, and that can be amazing. And I think there’s mostly amazing and something we should be grateful for, but it can also be a grief to let go of the person you were before. And that you don’t really accept accepted maybe, but also show yourself [00:53:00] some, I mean, you as a woman should get this, give yourself some slack that you’re actually, you know, yes, I am more anxious.

Yes. It sucks. I used to be big, cool, fearless, whatever, and now I’m afraid of. of everything. Um,

Mike: I think every woman that I’ve spoken to who now has a, I said, he’s had a baby in the last two or three years. I’ve also the same thing. I thought I’d be a really cool, relaxed mom. And that is not the case.

Lisa: I mean, I, yeah, I had the biggest transformation ever.

Um, I, I, I’m still a free skier, but I did some really extreme things and I was scared of nothing before my pregnancy. The last thing I did before getting pregnant was like to be caught in an avalanche and then I got pregnant. And then when I went out the first time with my baby in the streets, I just [00:54:00] started crying because I was terrified a person would snap my baby out of the wagon.

I had to. I got a panic attack and we needed to go home. You know, just. It’s such a huge transformation, it will calm down a little bit and you get used to it, but you’re just not the same anymore. And it’s biology, it’s really your brain that has gone through this. And sometimes it feels like we’re judging women on this.

that we say that is less good or that we try to put women in a box because of this. And that is not what I want, you know, people to do, but we should also see it as a huge. It’s a huge value for evolution. There’s a reason why we become like that because women who are like this, their offspring had higher chances of survival.[00:55:00]

So that’s why this, this, uh, behavior has been, been passed on and has spread is because it’s what’s best for everyone.

Mike: I also was thinking. I wanted to ask you about sort of post pregnancy, when you have all this crazy stimulation because of all the different hormones going on, and I know that post natal depression is quite common, is that the outcome Of essentially your hormones, not going, not regulating back down to their normal rates from before pregnancy or something along those lines.

Lisa: Um, yes. Well, it’s kind of, it’s actually that they all go away. As I said, you know, in the menstrual cycle. Uh, you probably heard about PMS when, uh, you get really anxious and depressed. And that is when the hormones fall back from, you know, it’s, it’s progesterone and estrogen that is quite [00:56:00] high during the second part of the menstrual cycle.

And, and those hormones make you feel so progesterone makes you feel calm and relaxed and estrogen makes you feel happy. And it’s because it actually stimulates the production of serotonin, which is a happiness hormone. So all these hormones have a very positive effect on us. Then at the end of the menstrual cycle, they suddenly drop like they’re gone and it can be very rough to, um, to adapt to the new low levels.

of the hormones. And that’s when you get PMS and you get sad. Then, as I told you before, during pregnancy, the hormones are a hundred times higher. So that means that during the pregnancy, you have been maybe very relaxed due to all the nice prednisone. You’ve been super happy. [00:57:00] And you also, you know, this pregnancy glow that many women have when, when they’re pregnant, it’s all due to estrogen.

So many women do feel great, uh, during the pregnancy and all these hormones are produced by the placenta. And during pregnancy, when you give birth, the baby comes out and then the placenta goes out. So it’s like a huge drop in the hormone levels. It’s like you’ve been on, on some kind of happiness drug.

It is going up, take it up. And then you just, bam, it’s gone. And that’s why, I mean, 80 percent of all women get baby blues. It’s almost unavoidable, but that’s baby blues. And that is that you got, you know, you start crying. You’re really, you know, you get super emotional. You also don’t have this. You know, [00:58:00] these hormones to kind of balance you out anymore.

Um, so baby blues, basically everyone gets or 80%. Um, then, then if you have this baby blues and you additionally have a lot of stress, if you don’t have enough support, if you get scared of the situation, for example, if you have twins, um, it’s much harder. If you don’t have support from family, if you don’t have support for your partner, then.

Then this additional stress is really. It’s really mortal cocktail. Also, the fact that you won’t be sleeping anymore.

So it’s a really, really dangerous cocktail of things that risks to put you into Uh, postpartum depression. And, uh, and that is something that lasts much [00:59:00] longer. So baby blues, no reason to be scared about it’s really, really normal, but when it lasts for weeks and you can’t get up on your feet, that is probably why.

And then it’s probably postpartum depression, and that is very, very hard to get out of on your own. You really need a lot of help. You need help to, you know, um, if you don’t sleep, you’re not going to get out of it and when you have too, too much stress, you need to figure out how to, to deal with it.

It’s a really, really big problem. difficult time in, uh, in, uh, in a woman’s life, if she does not have the adequate support. And even if she does have the adequate support. And then also, I think there’s a lot of, of guilt. Um, many people think that you would automatically love your baby. When [01:00:00] it comes out,

but you don’t know your baby, you have never seen this thing before.

And it’s kind of really abstract what it is that is coming out of you and, and a bond and love is something that grows. They say you don’t, uh, there’s a saying, and it’s very true is that you don’t care for your baby because you love it. You love your baby because you care for it. Love is also a hormonal reaction that gets triggered by being physically close to your baby.

So the more time you spend taking care, nursing your baby, holding your baby, the more you will love it. And that is also true for fathers or for, you know, foster parents or grandparents. So, so love is a chemical [01:01:00] reaction. That is triggered by proximity like skin to skin

Mike: interesting

Lisa: and to know that so you should not feel guilty that you don’t love this little creature that you’ve never seen before that you have no relationship with um,

Mike: so that bond will really then grow with time

Lisa: yeah, exactly and it grows by you taking care of it.

Mike: Now, Lisa, we are just about out of time, but I wanted to ask you, is there anything in your book that you’ve come across that you’ve studied that we haven’t talked about today, which you think is really important for people looking to, or recently have conceived?

Lisa: I think he mentioned maybe the most crucial parts around, you know, myths and stigma and some kind of reality check. Then my book has [01:02:00] So many facts about everything, both concerning pregnancy, of course, I think it’s also interesting, like all the weights we put on. What is it really? Where does it come from?

Where, where does it go? And it also tells much more about all the details, um, that is happening, uh, in the brain, um, and more, I mean, it goes through everything. It goes through, um, all the bodily reactions that you have due to the hormones, both within the menstrual cycle, but also in pregnancy, and then what happens afterwards in perimenopause and menopause, it also explains what happens.

It’s in puberty, both how, how the hormones are triggering all the bodily changes and also how it shapes the brain, uh, in a way that is kind of different. And, um, it has [01:03:00] a lot of, lot of, lot of facts that are, um, many of them are really fun. You know, it covers everything from how they discovered, um, how sperm swim to, and all this kind of fun facts to, to maybe the more important biological parts.

Mike: And I’ll be sure to link the book in the show notes of the podcast.

 Lisa, if people want to know more about you or get in contact with you, how should they find you?

Lisa: Um, the easiest I would say that’s LinkedIn or my website, lisafalco. com.

Mike: Amazing. Well, thank you very much for your time for this very informative conversation.

My wife’s going to be very proud of me for having this conversation.

Lisa: Yeah, I hope so. Hope you learned something.

Mike: Indeed. Bye bye. Bye.

Lisa: Bye. Bye. Bye.