[00:00:00] Dr Renee White: Knowledge is power, and we are all about empowering the mamas of the world. In each episode, we will unravel and interpret the latest research and evidence-based practices for pregnancy, postpartum, and motherhood. [00:00:15] As mums and researchers ourselves, we have experienced firsthand the overwhelming complexity of information myths and those classic old wives tales. I'm Dr. Renee White, and this is The [00:00:30] Science of Motherhood.

[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.

[00:00:49] Dr Renee White: This is something where we get a number of inquiries from this particular demographic of women for our [00:01:00] doula services. I think they're just so heavily invested in it. Perhaps they have had a long journey with IVF and or they realise that, you know, [00:01:15] when we get a little bit older, things take a little bit longer to not bounce back, but bounce forward.

[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.

[00:01:46] Dr Renee White: I can tell you right now, I'm 40. If I decided to have another baby, I definitely would have been investing in a postpartum doula because you know, as a doula, we are just providing that [00:02:00] confidence that support those delicious meals every week. And the focus is really around building up. Physically stronger and mentally balanced you know, mamas. Who aren't [00:02:15] really, you know, second guessing their choices and it's, it's that kind of beautiful, uninterrupted support. We know continuity of care is the gold standard, and so having a doula to walk that journey with [00:02:30] you. Is just, it's beautiful. And you know, the ladies in the older age group seem to really resonate with doula support.

[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.

[00:02:59] Dr Renee White: I've gotta remember them [00:03:00] all. We're we're in, oh my goodness. We're in so many cities now. I'm so proud of our team. We are in Geelong, we are in Melbourne, we are in Brisbane, gold Coast, Perth, Sydney, [00:03:15] Newcastle and Hobart, that's where I am. I can't forget myself. That would be a bit of a crime, wouldn't it? So yes, if you are keen to learn more about our services, [00:03:30] if you are someone who is feeling a little bit overwhelmed or perhaps anxious about welcoming your new bubby into this world, and you want someone who's been there, done that, got the t-shirt.

[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.

[00:04:17] Dr Renee White: Kellie really, and you can tell this in the interview, like my goodness, she strongly believes in giving women and families the knowledge and time to make an informed choice about [00:04:30] their bodies and treatments offered. And, you know, like us really values that continuity of care model that you know, private models can provide for families.

[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.

[00:05:06] Dr Renee White: You know, how, how Kellie kind of tackles those things. Particularly, you know, we talk about the fact that we hear about [00:05:15] celebrity pregnancies and, you know, at 45 plus, and that sometimes can give a bit of false hope to the general, general folk. And so how do you, how do you have those [00:05:30] conversations with, with patients where we talk about, you know.

[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?

[00:05:58] Dr Renee White: And also [00:06:00] for the blokes as well, what's gonna improve their sperm quality because it's not just us ladies that need to be looking after our health. And it's just a really fantastic informed interview here with Kellie. [00:06:15] She's so, so great. I can't wait for you to listen to this one. So here is Dr. Kellie Tathem.

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

[00:06:28] Dr Kellie Tathem: I'm great. Thank you very much. It's a [00:06:30] lovely afternoon here in sunny Queensland.

[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.

[00:06:41] Dr Kellie Tathem: No problems. Well, we've cracked out our, uh, winter Woolies last weekend. [00:06:45] I think it hit 17 degrees and there were people at the A FL game wearing, wearing full beanie and scarves, so,

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

[00:06:52] Dr Kellie Tathem: You know, we really hit winter here in Queensland.

[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.

[00:07:04] Dr Kellie Tathem: Oh, no.

[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.

[00:07:34] Dr Kellie Tathem: I do. I do. So, uh, my name's Kellie Tatham. I'm a fertility specialist as well as obstetrician and gynecologist. I work in Brisbane. I work [00:07:45] with Queensland Fertility Group, and I have the best job in the world. I have continuity with my patients, which I absolutely love. My, I see young girls. I talk about egg freezing.

[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.

[00:08:16] Dr Kellie Tathem: And I often have people return with their three children in tow, and we are talking about their heavy periods and perimenopause. So I, I think I have the best job in the world, to be honest, and with [00:08:30] two beautiful daughters myself. I love that this population of girls coming through are more empowered with respect to their periods.

[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.

[00:09:03] Dr Renee White: Absolutely. And you touch on like that continuity of care element.

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

[00:09:08] Dr Renee White: That is something that I am so passionate about. I mean, we come at it from kind of a doula [00:09:15] angle.

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

[00:09:15] Dr Renee White: With, you know, pregnancy and birth and then postpartum. Like you just cannot beat that. Like you just cannot beat it. It's so, so good.

[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.

[00:09:45] Dr Kellie Tathem: Mm-hmm. But I think our model really encourages midwives and doctors to work together because we can't do our jobs equal. We can't do, we do different jobs.

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

[00:09:55] Dr Kellie Tathem: And you know, I wouldn't be able to see many people if I was doing [00:10:00] all of the things. But I also, you know, I worked publicly for a long time and I am extremely grateful because that's how we all train.

[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 Renee White: Yeah.

[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 Renee White: Yeah.

[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 Renee White: Yeah.

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

[00:10:56] Dr Renee White: Absolutely. Absolutely.

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

[00:10:58] Dr Renee White: So let's dive into [00:11:00] that kind of education piece as well cause that's something that we are really passionate about here at the science of motherhood.

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

[00:11:06] Dr Renee White: And we are loving, like myth busting here as well because there's,

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

[00:11:10] Dr Renee White: there's so much fluff on the internet, I call it. Like, I'm trying to be, like, that's my [00:11:15] Pollyanna personality of like, just lots of fluff, we're just gonna burst those bubbles.

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

[00:11:23] Dr Renee White: Um, I have to ask, so what is the biggest myth you hear from women [00:11:30] in like their late thirties, early forties about their fertility chances? And I guess how do you, how do you go about having those discussions with your patients, like during consultations? Like how does that go? [00:11:45] I, I think, you know, there's sometimes this whole like, oh, we see celebrities and they're like 45 and they're having twins, and there's this whole like other world out there.

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

[00:11:57] Dr Renee White: What are the types of things that you kind of are [00:12:00] having to kind of poke holes in during those consultations?

[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?

[00:12:16] Dr Kellie Tathem: What are we trying to achieve? What insurance are we trying to give ourselves? Mm-hmm. But I feel like the first con consultation is very much myth busting. It's finding out what, what do women know about egg freezing? Why are [00:12:30] they wanting to do it? And why not have their baby now if they're with that partner and those sorts of things.

[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?

[00:13:00] Dr Kellie Tathem: Mm-hmm. Because if we are talking about a 43-year-old with a partner for the last three years, and we're wanting to defer for another two years, but we're wanting to have four children. I need to be saying, you know, that's not gonna [00:13:15] happen. Unfortunately, that is not gonna happen, and it's really important that I don't take you on this journey with really unrealistic expectations because at 43, we're going to probably have trouble actually getting that one child, and we need to be looking at that now, not in two [00:13:30] years, because even creating a pregnancy and getting you there, we are talking about a risky pregnancy as well.

[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.

[00:14:04] Dr Kellie Tathem: I do wanna have babies. I know I definitely wanna have babies. I just haven't found Mr. Right, should I do it? So. I'm very thankful that, you know, there has been a big push on social media, about egg freezing. [00:14:15] Women are asking why, and I think that, I think that now it's probably more about the access, equitable access to egg freezing more than education.

[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,

[00:14:42] Dr Renee White: oh my god. I know they put the fear of [00:14:45] God in us and then it's kind of like actually.

[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.

[00:15:02] Dr Renee White: What?

[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.

[00:15:19] Dr Renee White: Yes.

[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 Renee White: Yeah.

[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.

[00:15:51] Dr Kellie Tathem: So I, I think there's that part with education. I think that we're slowly getting there and social media is becoming a little bit more balanced in [00:16:00] terms of the realities now that there's lots of egg freeze talk. But access is a really big thing. The costs,

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

[00:16:07] Dr Kellie Tathem: for social egg freezing are really high.

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

[00:16:10] Dr Kellie Tathem: So if, if there is a woman who has a really, it [00:16:15] can be anywhere from 5,000 to $10,000 for a cycle in most areas. Mm-hmm. There are some companies that will, uh, do cheaper promotional things. However, for most women, it will cost around five to 10,000 for one cycle of egg [00:16:30] freezing. Mm-hmm. And if you are young and you have lots of eggs, you may only need one cycle.

[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 Renee White: Yeah

[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 Renee White: Yeah.

[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.

[00:17:12] Dr Renee White: Yeah.

[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.

[00:17:49] Dr Renee White: Yeah. Right.

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

[00:17:52] Dr Renee White: I, I wanna talk about that. You've just said your own biological child. I, I'd love to talk about donor eggs.

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

[00:17:58] Dr Renee White: Because you think this is something that [00:18:00] doesn't get a lot of airplay as well.

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

[00:18:02] Dr Renee White: So I guess if you were discussing that with a patient, like walk us through like, what's the d Is it, what's the difference between, you know, natural conception, IVF using [00:18:15] donor eggs and also like realistic expectations around all of that? And is, is there, like, what's the red tape around donor eggs, if any?

[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 Renee White: Yep.

[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.

[00:18:56] Dr Kellie Tathem: So two weeks of injections going through an egg [00:19:00] retrieval, which might be done under local anesthetic or general anesthetic. Mm-hmm. And a couple of days recovery. And that's, that's to get anywhere between, and it depends on how many eggs the donor has, but you might get between two eggs or you might get 30 eggs depending on how [00:19:15] many you have.

[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.

[00:20:02] Dr Kellie Tathem: Um, now that we have donor conceived children, uh, there are laws now in place to protect donor conceived children and so there is a lot of counseling in place for both people becoming [00:20:15] gametes or egg or sperm donors and also embryo donors to what the rights of an unborn child are and when and if they can access their donor information and those sorts of things.

[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 Renee White: Wow.

[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.

[00:21:09] Dr Kellie Tathem: So because many couples will need IVF, so the amounts of [00:21:15] um, IVF increasing for many, many, many different reasons. One of those being starting families late. There are some, you would say fortunate couples who have their babies and will have some embryos that remain. And the options then when you [00:21:30] have stored embryos as to what you can do with those, we can either respectfully discard them on behalf of a patient or their family.

[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 Renee White: Really?

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

[00:22:09] Dr Renee White: Wow. I would not have said that cause I, I mean it's obviously just my own personal view, but I would've [00:22:15] been like, that's our child, you know?

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

[00:22:18] Dr Renee White: Like I would've, I dunno, it's a crazy, I think maybe's a crazy scientist in me going,

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

[00:22:23] Dr Renee White: I, I'm, I, since I was 15, like yes, but I apologise to all, not all the [00:22:30] boyfriends. Sounds like I've had many boyfriends, but I would always look at them and be like, am I prepared to mix my DNA with you?

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

[00:22:43] Dr Renee White: Yeah, of course. [00:22:45] But yeah, I'm just like, ah, okay. That's so interesting.

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

[00:22:51] Dr Renee White: that, so that, I don't know. That makes me think that egg donors alone are very scarce.

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

[00:22:59] Dr Renee White: Okay. [00:23:00]

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

[00:23:02] Dr Renee White: Do you get paid for sperm donation?

[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.

[00:23:16] Dr Renee White: Really? So they're shipping it over.

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

[00:23:21] Dr Renee White: Wow.

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

[00:23:22] Dr Renee White: Okay.

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

[00:23:23] Dr Renee White: Okay.

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

[00:23:27] Dr Renee White: Oh my goodness.

[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.

[00:23:38] Dr Renee White: Yeah that's Pandora's box, right 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.

[00:24:23] Dr Kellie Tathem: And it's not just biology.

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

[00:24:26] Dr Kellie Tathem: yeah,

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

[00:24:27] Dr Kellie Tathem: It's a, it's a really interesting concept. Yeah. [00:24:30]

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

[00:24:31] Dr Kellie Tathem: Yeah,

[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?

[00:24:51] Dr Renee White: Is there mandatory counseling that happens?

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

[00:24:54] Dr Renee White: How does that all work?

[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.

[00:25:14] Dr Kellie Tathem: Mm-hmm. [00:25:15] And depending on their egg count, you know, some women may still have a very high egg count for age, and I have twice this year done cycles on women above the age of 45. But unfortunately, despite plenty of eggs, we [00:25:30] don't, we are not creating normal, normal chromosome embryos that are going to create a pregnancy.

[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.

[00:25:58] Dr Kellie Tathem: So if you [00:26:00] are donating eggs, embryos, sperm, there is counseling before you go ahead with that. Mm-hmm. Um, there is genetic, genetic testing of donors. Uh, there's infectious disease testing of donors and most donors are wonderful and willing. They share [00:26:15] lots about their family history, their genetics.

[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.

[00:26:37] Dr Kellie Tathem: And so there's heavy counseling before the donors actually commit to that. And then on the receiving end, parents are offered a [00:26:45] number of counseling sessions as well, so that they're very clear on what the current laws are. And, and the difficulty is, is that things may change.

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

[00:26:53] Dr Kellie Tathem: Still over time and it's, it is an evolving space and that's what we're seeing with especially donor sperm and things at the [00:27:00] moment. So that, I would say that the counseling process is probably the most laborious and intense process. That is done behind the scenes outside of my office. And then I, I literally get told, [00:27:15] fantastic this family has been offered seven donor embryos, and away we go. Yeah. And I feel like that, that, that part to me, I get the easy bit.

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

[00:27:22] Dr Kellie Tathem: And we put the embryos in and work the woman up from that side of things. But there is, there's a lot of counseling that goes on and a lot [00:27:30] of counseling counseling that is then provided by the fertility companies and ongoing as required. 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?

[00:27:50] Dr Renee White: Like, you know, it could be today we're donating, this is what the law says, but in five years time it can change completely.

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

[00:27:57] Dr Renee White: everyone's

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

[00:27:59] Dr Renee White: Gonna be happy with that.

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

[00:28:02] Dr Renee White: What, what are the current laws these days?

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

[00:28:08] Dr Kellie Tathem: Oh, look, I'm, I can't, I'm not an expert in that. That's where I hand over to the donors.

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

[00:28:14] Dr Kellie Tathem: Um, that is [00:28:15] where I hand over to the donor team and I do say to the patients. I'm not gonna muddy the waters there. You are going to become the expert in this.

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

[00:28:24] Dr Kellie Tathem: Similar to families that need a surrogate. There are special, there are so many laws, not [00:28:30] so many laws, but there are a lot of ethics involved and a lot of counseling that is actually done behind the scenes outside of my office. And those parents need lots of legal counseling before they embark on those, those things as well. Yeah,

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

[00:28:47] Dr Kellie Tathem: Yeah.

[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 Kellie Tathem: Yep.

[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 Kellie Tathem: Yep.

[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?

[00:29:13] Dr Kellie Tathem: We don't, in [00:29:15] Australia, we don't

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

[00:29:18] Dr Kellie Tathem: That is, that is an American term.

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

[00:29:21] Dr Kellie Tathem: And we have never taken that up in Australia. We've never, that is, that is not an Australian term, but I feel like it's probably, [00:29:30] again through social media.

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

[00:29:32] Dr Kellie Tathem: Been exacerbated.

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

[00:29:34] Dr Kellie Tathem: But we, from a medical point of view, I've never written geriatric pregnancy.

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

[00:29:39] Dr Kellie Tathem: Part of our there we training and terminology, but we do say advanced maternal [00:29:45] age.

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

[00:29:47] Dr Kellie Tathem: which is kinder.

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

[00:29:52] Dr Kellie Tathem: Yes, I do.

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

[00:29:54] Dr Kellie Tathem: I still feel a little bit ick. I feel a bit ick writing that and so most people just write [00:30:00] AMA.

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

[00:30:01] Dr Kellie Tathem: We all know what that means, but we don't have to shove it in people's faces.

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

[00:30:05] Dr Kellie Tathem: Um, AMA advanced maternal age. Now the definition of that is more than or equal to age 35 at the time.

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

[00:30:14] Dr Kellie Tathem: [00:30:15] of delivery. Correct.

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

[00:30:17] Dr Kellie Tathem: So the older I get, the more I look at that and go, oh my God,

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

[00:30:23] Dr Kellie Tathem: It's too young.

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

[00:30:27] Dr Kellie Tathem: Correct. That's right.

[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 Kellie Tathem: Yes.

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

[00:30:35] Dr Kellie Tathem: Correct. And so look, it's all a continuum, right?

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

[00:30:39] Dr Kellie Tathem: Everything with age and the body, although I would say at 43 everything goes downhill fast, but that [00:30:45] feels like a cliff. However, however, you know with pregnancy and fertility really from age 35, we know that there are slight increase in risks each year past the age of [00:31:00] 35. So you don't all of a sudden be, become extremely high risk at 35.

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

[00:31:05] Dr Kellie Tathem: We know that 40 is different to 35 in terms of

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

[00:31:08] Dr Kellie Tathem: Risks of miscarriage and risks of blood pressure and diabetes and ceasers and those sorts of things, as well [00:31:15] as infertility and miscarriage. So there is a continuum. It's not just at 35 things exponentially increase and it is your, you are higher risk if it's your first pregnancy above the age of 35.

[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 Renee White: Gotcha.

[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.

[00:31:49] Dr Kellie Tathem: Um, as well. Yeah.

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

[00:31:52] Dr Kellie Tathem: So, yeah. Yeah. So the things past 35, I guess it, it can be more difficult to fall pregnant. The [00:32:00] risks of miscarriage at age 35 are about one in four by 38. That becomes one in three by 40, that's about one in two or up to 60%. And the reason for that is as women, we are born with 400,000 eggs.[00:32:15]

[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.

[00:32:31] Dr Kellie Tathem: So that miscarriage rate goes up the older we get, we may come into the pregnancy, you know, with a little bit more, a few more medical problems to begin with, like blood pressure, more likely to get diabetes and you're more likely that your [00:32:45] placenta is not gonna work as it should, and you get fetal distress in labor.

[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 Renee White: Gotcha.

[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 Renee White: Yeah.

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

[00:33:12] Dr Renee White: Yeah.

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

[00:33:14] Dr Renee White: collagen [00:33:15] connective tissues,

[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.

[00:33:28] Dr Kellie Tathem: But certainly [00:33:30] that's why we are seeing an increase that, that, that is partly then reflected in the increase amount of obstetric intervention.

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

[00:33:39] Dr Kellie Tathem: The, you know as women get older and they're,

[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.

[00:33:47] Dr Kellie Tathem: Absolutely, absolutely. So, and that's, you know, at the moment our birth rate in Australia is 1.5, meaning as though out of a thousand women, [00:34:00] uh, fif we would have 1500 live births per year.

[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.

[00:34:27] Dr Kellie Tathem: So women are waiting [00:34:30] longer, to conceive. And that is, that's gonna be because we're more educated. You know, no one is finding someone at 17 and being a housewife anymore.

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

[00:34:38] Dr Kellie Tathem: Or very few are doing that where we're, we're in this beautiful position where we can all have careers and those [00:34:45] sorts of things, but to be able to jump out of career training and career progression, to have the stability to then be able to take off ti take time off work.

[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.

[00:35:22] Dr Renee White: Yeah.

[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 Renee White: Yeah.

[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.

[00:35:48] Dr Renee White: Yeah.

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

[00:35:50] Dr Renee White: well,

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

[00:35:53] Dr Renee White: Yes. And, and like I, I mean. I would also like to add that, you know, I think we just need to [00:36:00] value mothers a bit more.

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

[00:36:02] Dr Renee White: And realise that that is a probably job and a half, you know?

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

[00:36:07] Dr Renee White: If, if we were to look at that, I, I saw a reel the other week and it was a guy who [00:36:15] was sitting there with essentially a job description of, you know, the role that a mother would actually do, and he was reading it out to candidates, um,

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

[00:36:24] Dr Renee White: To see if they would like to interview for the job. And every single one of them was like, [00:36:30] you've gotta be having a laugh. Like, you know, it was like, you're on 24 7, there's no annual leave, there's no sick leave, you're at the beck and call of your boss. You know, all those things. And everyone's like, and the, the guy was like, this is an [00:36:45] actual job.

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

[00:36:49] Dr Kellie Tathem: Absolutely.

[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 Kellie Tathem: Correct.

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

[00:36:56] Dr Kellie Tathem: correct. And then they have to go and also earn [00:37:00] money.

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

[00:37:01] Dr Kellie Tathem: Yeah.

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

[00:37:04] Dr Kellie Tathem: I know we no longer have the community right. So

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

[00:37:08] Dr Kellie Tathem: and this is what I say to women because I see a lot of single women who are choosing to choosing to access donor [00:37:15] sperm and be single mums. And, you know, I saw someone yesterday and she said, I didn't realise it was gonna be this hard, I don't know how, you know, I've got my mum that's moved in that was meant to be for four weeks.

[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.

[00:37:39] Dr Renee White: Yep.

[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.

[00:37:49] Dr Renee White: Yeah.

[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.

[00:38:01] Dr Kellie Tathem: I love to, I love being busy, but I'm gonna drop a ball occasionally because it is, you know, trying to have a career and do everything well and look after the kids and, and those sorts of things without significant external help is really difficult.

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

[00:38:16] Dr Kellie Tathem: impossible.

[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 Kellie Tathem: Yeah.

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

[00:38:25] Dr Kellie Tathem: yeah, that's right.

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

[00:38:26] Dr Kellie Tathem: Yeah.

[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.

[00:38:32] Dr Kellie Tathem: Yeah. And your relationship.

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

[00:38:34] Dr Kellie Tathem: And I think that it does put a strain on relationships as well.

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

[00:38:36] Dr Kellie Tathem: There's that constant push and pull of am I being a good mother? Am I being a good wife? Well, I am being a good employee. I, and I'm just trying to keep all the balls in [00:38:45] the air. Yeah. So I think you are right. We have to value mothers and I would say I'd extend that to we have to value parents. Mm. The role of parents. Because you know, there are some really forward thinking companies that are offering paternity leave for when the mums go back [00:39:00] to work, which allows women to go back to work.

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

[00:39:02] Dr Kellie Tathem: And recognises the fact that women are actually now sometimes the breadwinner.

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

[00:39:07] Dr Kellie Tathem: Which is amazing.

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

[00:39:09] Dr Kellie Tathem: And how many dads groups are there now?

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

[00:39:12] Dr Kellie Tathem: I love it. I love it.

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

[00:39:15] Dr Kellie Tathem: So when my first was born, so she's now 15, I was off for six months and then my husband was the full-time stay at home dad. He at least he didn't care, he rocked up to the mothers groups and he just did it [00:39:30] right. There were no dads groups. And now there are dads antenatal classes. There are dads groups. And it's

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

[00:39:38] Dr Kellie Tathem: get involved

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

[00:39:40] Dr Kellie Tathem: Um, I love it

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

[00:39:43] Dr Kellie Tathem: And most dads are really keen [00:39:45] to do that.

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

[00:39:47] Dr Kellie Tathem: Yeah. Making

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

[00:39:54] Dr Kellie Tathem: Yeah, absolutely. So I, I really think that we are getting there as a [00:40:00] society, but what I would like to see is access to egg freeze. Mm-hmm. I think that at the moment, you know, women are coming, they're using, well, they're really choosing, do I use this money to travel? Mm-hmm. Do I use [00:40:15] my super to access this to do it? And that's a bit of a double-edged sword.

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

[00:40:21] Dr Kellie Tathem: Already, because women we know are not gonna have as much super as men when we retire. And then that has that flow on effect later on in life. And I do feel quite [00:40:30] conflicted by that. But you know, if you're choosing now to freeze my eggs because I've got a low egg count and I'm not ready yet, and I don't have the finances to be a single mum right now.

[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.

[00:40:55] Dr Renee White: Yeah,

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

[00:40:56] Dr Renee White: yeah. Totally.

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

[00:41:00] Dr Renee White: Oh, no, that's,

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

[00:41:02] Dr Renee White: yeah, that's not our problem.

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

[00:41:05] Dr Renee White: I, I advocate for a whole lot of things and I'm like, I just don't know where we would get that money from but

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

[00:41:10] Dr Renee White: If it was a priority, I'm sure we could find it somewhere

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

[00:41:15] Dr Renee White: At PS government.

[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.

[00:41:24] Dr Kellie Tathem: I'm not, you know, I dunno whether we do incentive payments for people to have another baby [00:41:30] right now, but, you know, we are heading into a crisis. This is, we have to think about it long term as a country, about how we encourage people amongst an economic crisis where people can't afford housing, they can't afford to do all of this.[00:41:45]

[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.

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

[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.

[00:42:02] Dr Renee White: Absolutely.

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

[00:42:04] Dr Renee White: No.

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

[00:42:10] Dr Renee White: Yeah, absolutely.

[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.

[00:42:19] Dr Renee White: Yeah.

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

[00:42:22] Dr Renee White: I, I wanna ask you about, you know, external factors that can help with fertility. You know, there's a [00:42:30] lot of, I guess, chatter on social media about things like supplements and acupuncture and, you know, traditional Chinese medicine, all that kind of stuff.

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

[00:42:41] Dr Renee White: Is there any actual [00:42:45] science around any of this to help kind of aid, like say you were like a 40-year-old, you know, mum wanting to be type of thing.

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

[00:42:54] Dr Renee White: Is there anything that we know from science where we go okay. Yeah. That would kind of turn back the [00:43:00] clock for your fertility.

[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.

[00:43:26] Dr Kellie Tathem: Mm-hmm. Until we go through menopause, which AV average age in Australia [00:43:30] is age 51. So over time the amount of eggs that are present in an ovary are going to reduce. There is no way to get them back at this point. We don't know any way to preserve them or hold them where they are, aside from taking them outta the [00:43:45] ovaries and freezing them.

[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 Renee White: Mm-hmm.

[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.

[00:44:09] Dr Kellie Tathem: We need you preferably in a normal weight range. So you respond to the medications as we expect, [00:44:15] definitely no smoking or vaping, which, you know, uh, oxidize. It causes DNA damage and increases risk of miscarriage later on from a lifestyle factor point of view for women, there's not a lot otherwise really, that you can do to [00:44:30] change egg quality a lot of the things that people use.

[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.

[00:44:57] Dr Kellie Tathem: And so I say to women, you know what, you just for those three [00:45:00] months sure, throw the kitchen sink at it. Yeah. You need to know if you're spending the money that you're doing everything.

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

[00:45:06] Dr Kellie Tathem: But you can't take a tablet and turn back time. Mm-hmm. And if you're gonna be taking the tablet, you also need to know, give up the smoking vaping and do all the good [00:45:15] lifestyle things that you should be doing.

[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 Renee White: Yeah,

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

[00:45:26] Dr Renee White: Absolutely.

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

[00:45:30] Dr Renee White: So that was gonna be my next question, like,

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

[00:45:32] Dr Renee White: you know, we can't do anything about our eggs.

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

[00:45:35] Dr Renee White: but what are, what are the blokes doing? Like can they

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

[00:45:39] Dr Renee White: What's on their agenda of like, let's get you in tip top shape.

[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.

[00:45:56] Dr Kellie Tathem: And that can be associated with the increased miscarriage [00:46:00] risk in the woman as well. So aside from that though, the sperm are more, um, sensitive to lifestyle factors. So I always say to the guys, great, we need to do a sperm test to make sure there are sperm there. However, what we are looking at on a sperm test [00:46:15] really are three things.

[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 Renee White: Wow.

[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 Renee White: Okay.

[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 Renee White: Yeah.

[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 Renee White: Yeah,

[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.

[00:47:41] Dr Kellie Tathem: Mm-hmm. Everyone thinks of the cyclists, but we don't know how much time [00:47:45] wearing Lycra is bad and what's, you know, more and more people are living in apartments and have access to saunas. So I say don't put, do the saunas every day. And then the other thing is the car seat heaters are classic because lots of people drive around.

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

[00:47:59] Dr Kellie Tathem: Testies every [00:48:00] time they're in the car. So heat is a thing and I think it's, you know, reducing incidental heat exposure.

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

[00:48:06] Dr Kellie Tathem: But more and more our sperm are probably being exposed to lots of estrogens in the environment. So the classic one would be [00:48:15] the overweight males. So we have estrogen estrogens in our fat stores.

[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.

[00:48:41] Dr Kellie Tathem: And it's thought to be because of the environment we live in. [00:48:45] The more affluent a society is generally the lower the sperm quality because

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

[00:48:51] Dr Kellie Tathem: So you know, I say to the guys, you know, the beer that you drink on the weekend, well beer is one thing, but it's probably the can line with the BPA that's [00:49:00] doing the sperm more damage.

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

[00:49:01] Dr Kellie Tathem: so there's all of these environment environmental factors that the guys really need to be thinking about. And it's quite interesting the things that people come up with, you know, um, people are talking about, oh, my caffeine, my, this, my that. It's probably not the things they're seeing, it [00:49:15] is actually the plastics in the microwave.

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

[00:49:17] Dr Renee White: and that's what's contributing to like two or three headed sperm.

[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 Renee White: right

[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.

[00:49:46] Dr Renee White: Fascinating.

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

[00:49:48] Dr Renee White: So a two or three headed sperm could still infiltrate the egg.

[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 Renee White: Yeah.

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

[00:50:04] Dr Renee White: Wow.

[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 Renee White: Yeah.

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

[00:50:16] Dr Renee White: Yeah.

[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.

[00:50:26] Dr Renee White: Yeah.

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

[00:50:32] Dr Renee White: Yeah. Okay.

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

[00:50:33] Dr Renee White: That's fascinating. I never knew that. Oh my goodness.

[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.

[00:50:54] Dr Kellie Tathem: You know, we have options in with egg freezing. Certainly, you know, you could [00:51:00] choose to freeze now the younger you are and the healthier you are, and the more normal your egg count is, probably the less likely you are going to need to use frozen eggs later in life. Mm-hmm. However, if you're getting to [00:51:15] age 32 and you're not seeing a partner on the horizon, potentially, let's be talking about that.

[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 Renee White: Yeah.

[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.

[00:51:36] Dr Kellie Tathem: I'm not yet ready to embark on single motherhood. I'd like to give it another year at least. Then that's where we are sort of going, okay, well let's [00:51:45] freeze your eggs. Because for every year that goes by, we know that there's gonna be a significant reduction in chance of success. And the older we get, we know that you're more likely to come back and use those eggs.

[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.

[00:52:15] Dr Kellie Tathem: And so it really, when you're doing an egg freeze con con consultation, it's really important to discuss what does life look like. Is there a barrier now to, should we be conceiving now, if you've got a long-term partner and you're really thinking about maybe ha [00:52:30] having children in two years and you've got a low egg count, is there a bar? What are the barriers to doing that now?

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

[00:52:37] Dr Kellie Tathem: Or are we really going to be doing four rounds of trying to freeze exit embryos? Or should you just have children now? So that's a really important [00:52:45] conversation and thinking about how many children you're going to have, what are your expectations? So it's a really nuanced conversation. It has to be really personalised.

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

[00:52:53] Dr Kellie Tathem: And so lots of women have an AMH test online, and I, I, it's not a good [00:53:00] test in isolation, unfortunately. So it is one piece of a very large puzzle, and I think if you are 35 and you've got a normal AMH. It doesn't tell you anything because it doesn't.

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

[00:53:13] Dr Kellie Tathem: So AMH? Yeah. [00:53:15] AMH is, it's an acronym for Anti-Müllerian Hormone.

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

[00:53:19] Dr Kellie Tathem: So Müllerian, not malaria, as in the D, the Mosquito Mosquito.  Müllerian, or M-U-L-L-E-R-I-A-N. The  Müllerian duct [00:53:30] is actually the congenital version of where your reproductive organs come from. So Anti-Müllerian Hormone is a protein produced by the follicles in our eggs. Mm-hmm. So it's usually called the egg timer test.

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

[00:53:41] Dr Kellie Tathem: The more follicles you have, the higher your AMH will be. [00:53:45] So if you do an AMH and it's very, very low for age, then you may get referred in to have an egg freeze. If it's very, very high, you might actually be told, well, you don't need an egg freeze.

[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.

[00:54:16] Dr Renee White: Yeah.

[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 Renee White: Yeah.

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

[00:54:26] Dr Renee White: Yeah, absolutely.

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

[00:54:27] Dr Renee White: Totally agree.

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

[00:54:30] Dr Renee White: It reminds me of, um, like cholesterol testing, like

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

[00:54:34] Dr Renee White: Like there's, so like you get a, you get a number back, but it's like, yeah, but what does that mean? What's your age?

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

[00:54:41] Dr Renee White: What's your demographic like? All of those things I got, I got. [00:54:45] I got put down that

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

[00:54:46] Dr Renee White: Rabbit hole of someone just looking at the number going, yes. Oh, that's really high. You need to change your entire diet. And I'm like, do I like

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

[00:54:54] Dr Renee White: Are, are we like, let's actually look at the whole picture here because

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

[00:54:58] Dr Renee White: I eat very well and

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

[00:55:03] Dr Renee White: Yeah.

[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 Renee White: Yeah.

[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 Renee White: Yeah,

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

[00:55:26] Dr Kellie Tathem: and everyone is different. You know, I say to women, you know, everyone wants [00:55:30] different levels of insurance. When we are talking about car insurance or house insurance, there are gonna be people who will pay more money to have everything insured and others who do the bare minimum to get by because they think that they won't use that.

[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.

[00:56:05] Dr Kellie Tathem: And I say that to them, hopefully you're gonna pay $10,000 here. You won't think about it again. You're gonna feel psychologically better that you've done it. Mm-hmm. And you'll [00:56:15] never need to use this.

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

[00:56:16] Dr Kellie Tathem: What we are talking about is ensuring you, and that's why it's personal.

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

[00:56:21] Dr Kellie Tathem: And it needs a personalised discussion. Mm-hmm. Yeah.

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

[00:56:25] Dr Kellie Tathem: Yeah.

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

[00:56:28] Dr Kellie Tathem: Okay.

[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?

[00:56:34] Dr Kellie Tathem: I think so.

[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?

[00:56:43] Dr Kellie Tathem: My top [00:56:45] tip for want to be mums is be proactive.

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

[00:56:48] Dr Kellie Tathem: Yeah for want to be mums. If you've thought about having kids and you are, you are at your 30th birthday and the love of your life, whether male or female or [00:57:00] whatever has not arrived, do yourself a favor and come and have a discussion with a fertility specialist. Mm-hmm. And do it early and you will not regret it.

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

[00:57:12] Dr Kellie Tathem: And it may be that you walk away [00:57:15] feeling satisfied and you're putting that off for a couple of years. Or you might find out something about yourself and be forever thankful that you made that decision to rock in and have a discussion.

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

[00:57:26] Dr Kellie Tathem: Yeah.

[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,

[00:57:42] Dr Kellie Tathem: for new mums? Uh, so my, my [00:57:45] go-to, if you want to look at egg freezing, there is tons of information on the internet. Our IVF Australia resources I think are very sound. It talks you through the process, some of the costings, but I think your resource is a fertility specialist.

[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.

[00:58:24] Dr Kellie Tathem: Mm-hmm. And my youngest, my eldest is now 15 and I still catch up once a year with my [00:58:30] mother's group and we have a, a quite a special bond actually.

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

[00:58:33] Dr Kellie Tathem: So get yourself a mother's group, however that may look. Say yes. Get amongst it because they are lifesaving, I think.

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

[00:58:41] Dr Kellie Tathem: Yeah.

[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.

[00:58:51] Dr Renee White: Yeah. You know, there's sometimes this hesitation and I don't need any more friends. Like I've got, I've got [00:59:00] friends.

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

[00:59:01] Dr Renee White: And, and it's kind of like, without being like that, you know, person who throws unsolicited advice to new mums.

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

[00:59:08] Dr Renee White: But it's like, just go like, just go and see what it's like because

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

[00:59:15] Dr Renee White: They've got kids at the exact same age,

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

[00:59:18] Dr Renee White: I don't know about you, but about like, you know, 15 years ago, I'm not sure how you were communicating, but for me, eight years ago, like we had a WhatsApp group at three o'clock in the morning we're like, on there going, oh my [00:59:30] God, who else's baby just will not sleep?

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

[00:59:35] Dr Renee White: it wasn't about problem solving, it was just solidarity of like, okay, yeah.

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

[00:59:40] Dr Renee White: We're not the only ones who are like, rocking our babies to sleep. [00:59:45]

[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 Renee White: Yeah.

[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.

[01:00:18] Dr Kellie Tathem: Uh, I really, those mums got me through so much that it's messy. It's such a messy time and you all just know what you're going through all at the same time and you're not gonna get along. I think my mum's group started [01:00:30] with 12 in one of the community groups. Mm-hmm. And we all remember the one person that no one really got along with.

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

[01:00:38] Dr Renee White: Yeah.

[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 Renee White: Yeah.

[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.

[01:00:52] Dr Renee White: Really?

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

[01:00:57] Dr Renee White: I love this

[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

[01:01:05] Dr Renee White: That's so true.

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

[01:01:07] Dr Renee White: Yeah.

[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.

[01:01:16] Dr Renee White: And, and also like your brain is like mashed bananas at that stage. Like you just like, you're just like, I wouldn't even remember what someone said to me.

[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 Renee White: Yeah.

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

[01:01:31] Dr Renee White: Yeah. I, yeah. Itt you were Molly's mum. And then it was kind of like, what was her name again?

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

[01:01:38] Dr Renee White: that's so true.

[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.

[01:01:54] Dr Kellie Tathem: It doesn't matter who you are, what you do, we're all going through it and how do we help each other? [01:02:00] So yeah, I think

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

[01:02:02] Dr Kellie Tathem: I, I think Mothers Group is the best. And as I said to you, one of, one of my, one of my, our closest knit mothers group, one of them has become an egg donor to the other one. I just think that is so incredible.

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

[01:02:17] Dr Renee White: That's like dream team mothers group.

[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.

[01:02:27] Dr Renee White: Perfect. I love that. Our last [01:02:30] question, which we ask all of our guests, and we borrow this one from the lovely Brene Brown.

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

[01:02:36] Dr Renee White: What do you keep on your bedside table?

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

[01:02:44] Dr Renee White: Do you [01:02:45] mind sharing with us?

[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.

[01:02:57] Dr Kellie Tathem: Mm-hmm. Uh, setting my alarm. [01:03:00] Kindle. I have to read, irrespective if it's, if it's 3:00 AM and I'm coming home from a delivery, or I got in bed early at nine, I have to read before I go to bed. So big thing on my bedside table. Lip balm. Hand cream for all the hand washing. [01:03:15] Yes. Uh, and a Kindle. That's my escape.

[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?

[01:03:28] Dr Kellie Tathem: I'm, I'm [01:03:30] typically a fiction. Mm-hmm. I like things that are easy for my brain to go to sleep. Yes. And being on Kindle, I have to admit, I never know the name of the book I'm reading.

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

[01:03:42] Dr Kellie Tathem: I look at the front cover. Yes. And the one that [01:03:45] I'm currently reading is actually about mothers. It is actually about a mother's group and one of them murders her husband.

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

[01:03:55] Dr Kellie Tathem: I can't even tell you the name of it.

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

[01:03:56] Dr Kellie Tathem: it's a bit wild, but it's about a mother's [01:04:00] group.

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

[01:04:01] Dr Kellie Tathem: Yeah.

[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.

[01:04:21] Dr Renee White: And then I'm just like, forever Kindle done.

[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 Renee White: Yes, absolutely.

[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

[01:04:52] Dr Renee White: God so you're living rent free in my head, Kellie, this is exactly what happened to me as well.

[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.

[01:05:10] Dr Kellie Tathem: That is my mum escape. That is, I, I have to [01:05:15] carve that time out for myself because I lost so much of myself in the toddler years and I really, I just never had access to a book. I never had access to a book. And so Kindle for me has been life changing. I did read a, um, I read [01:05:30] what was the book about French women.

[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 Renee White: Wow.

[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.

[01:05:51] Dr Kellie Tathem: I need to start reading more. Um, but I really never got into it until my husband bought me a Kindle to go on a hike and I've, I've never gone back. But [01:06:00] that and exercise just feel like such guilty pleasures exercise.

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

[01:06:05] Dr Kellie Tathem: So to take away time from your family, but it's really important to keep that little bit of yourself. And I really wish someone had told me that before I went on [01:06:15] maternity leave.

[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 Kellie Tathem: Correct.

[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.

[01:06:25] Dr Kellie Tathem: I know. How am I gonna do that crazy person as if I have time to read a book? [01:06:30] Yeah. But it really is so, it's so important for self preservation. Yeah, it really is.

[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.

[01:06:52] Dr Renee White: I have one person that I run with and we both are the same personality in the sense I'm like, we do not talk to one another.

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

[01:07:00] Dr Renee White: Like we just, we just run next to each other and that's it. Yes. But yeah, I'm the same. I'm kind of like, yeah. Books for me are like, yep, I can just step away and slip into another reality.

[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.

[01:07:47] Dr Kellie Tathem: And it's such a, uh, I think mindfulness sitting still, mindfulness is for me as a busy person, much harder to tap out of. Mm-hmm. Then that active mindfulness. Yeah. Of running [01:08:00] or reading or something else.

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

[01:08:03] Dr Kellie Tathem: Yeah.

[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 Kellie Tathem: Great.

[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

[01:08:24] Dr Kellie Tathem: no problems.

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

[01:08:27] Dr Kellie Tathem: No worries. Thanks for the invitation. It's been a pleasure. [01:08:30]

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

[01:08:34] Dr Kellie Tathem: So I work at Queensland Fertility Group in Brisbane. We have a, a website. Our new business name is going to be Akoya Health, A-K-O-Y-A, [01:08:45] which is the finest Pearl. Oh. Um, so Akoya Health. But our, our website has been updated as we speak. Um, and we deliver at the Mater mothers, uh, hospital, uh, here in Brisbane. So Google us. I love my [01:09:00] job. Yep. It's great continuity.

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

[01:09:06] Dr Kellie Tathem: Thanks.

[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.

[01:09:22] Dr Renee White: You've just listened to another episode of The Science of Motherhood proudly presented by Fill Your Cup, [01:09:30] Australia's first doula village. Head to our website, I fill your cup.com to learn more about our birth and postpartum doula offerings, where every mother we pledge to be the steady hand that guides you back to yourself, ensuring you feel [01:09:45] nurtured, informed, and empowered, so you can fully embrace the joy of motherhood with confidence. Until next time, bye.