In this episode of The Care Circle powered by Motherhood Hospitals, host Sahiba speaks with Dr. Anupama Ashok, Fertility Specialist at Motherhood Fertility & IVF, Hebbal, Bangalore. With nearly two decades of experience, Dr. Anupama breaks down how modern lifestyles, sleep patterns, stress levels and everyday choices quietly influence fertility for both men and women.
Together, they explore what really happens during a first fertility consultation, how age impacts egg quality and quantity, practical lifestyle habits that improve fertility, the science behind male infertility and the increasing challenges around repeated pregnancy loss.
The episode also deep dives into fertility preservation, emotional wellbeing during treatments and clears common myths through the popular Myth versus Facts segment. This conversation empowers couples with clarity, early awareness, real life examples and the reassurance that science and hope can work hand in hand.
Key Takeaways:
Here are the key points you shouldn’t miss from this episode:
- Fertility is influenced by lifestyle, sleep patterns, stress, nutrition, weight and routines.
- Even healthy-looking couples may have subtle hormonal or metabolic imbalances.
- A first consultation is mainly a conversation to understand history and concerns before tests.
- Starting early increases options and improves success rates across treatments.
- Egg quantity and quality decline with age, especially after 35.
- Secondary infertility is common and often related to tubal issues or lifestyle changes.
- Underweight women take five to six times longer to conceive as compared to overweight women
because hormonal reserves and nutritional stores are inadequate. - Lifestyle shifts like balanced nutrition, sleep hygiene, regular exercise and cutting down screens
support both egg and sperm health. - Male infertility accounts for almost 40 per cent of all cases and is rising due to lifestyle, stress,
environmental toxins and steroid-based gym supplements. - Repeated pregnancy loss requires thorough genetic, hormonal and immunological evaluation.
- IVF is not unnatural as it only helps eggs and sperm meet outside the body.
- Women can preserve fertility through egg freezing if they plan to delay pregnancy.
- Emotional support is essential because feelings of sadness, frustration or guilt during treatment are normal.
- The right guidance, along with awareness, helps most couples achieve successful outcomes.
Dr. Anupama Ashok
Senior Fertility Specialist, Motherhood Fertility & IVF, Hebbal, Bangalore
0:05 – Intro: Modern lifestyle & fertility
0:59 – Guest intro: Dr Anupama Ashok
1:09 – Why healthy couples may still struggle
1:41 – How sleep, stress & routine impact hormones
2:35 – What actually happens in a first fertility consultation
3:24 – Creating personalised fertility plans (TI, IUI, IVF)
3:52 – Delaying parenthood & age-related fertility decline
4:55 – Secondary infertility explained
6:04 – Key lifestyle changes to support fertility
7:19 – Underweight vs overweight and conception
8:10 – Male infertility: major causes today
10:28 – Repeated pregnancy losses & real case example
12:21 – Myth vs Fact: common fertility misconceptions
14:01 – Emotional well-being during fertility treatment
14:56 – Egg freezing: when and why to consider it
15:18 – Fertility summarised in one sentence
15:49 – Outro: guidance & consultation info
Sahiba (0:05): Hello and welcome back to the care circle, a podcast series where we talk openly about women’s health, couples health and everything in between.
Today we are talking to all the modern couples out there who are juggling work, travel, social lives and big dreams and also thinking about starting a family. How do your lifestyle choices, stress, sleep and everyday habits really affect your chances of having a baby?
And what role can science play in making this journey a little easier, a little less scarier and a lot more hopeful? Joining me is Dr. Anupama Ashok, Fertility Specialist at Motherhood Fertility & IVF, Hebbal, Bangalore. With nearly two decades of experience, she has helped countless couples navigate this journey with care, clarity and confidence.
Welcome Dr. Anupama.
Dr. Anupama (0:59): Thank you Sahiba.I am so excited to be here. Talking openly about starting a family can take away a lot of stress and I am thrilled we are having this conversation today.
Sahiba (1:09): Let’s start with a question many modern couples wonder about when they are thinking of starting a family or actively trying. We are healthy, exercising, eating well, so why isn’t it happening yet?
Dr. Anupama (1:21): That’s very common. Modern life with long work hours, late nights, screens, stress, processed food, quietly affects the hormones. Even couples who appear healthy may have subtle imbalances. To understand that fertility is like an orchestra, if one instrument is off, the whole harmony is affected.
Sahiba (1:41): So, doctor, it’s not just about diet and exercise, it’s also lifestyle, sleep and stress, right doctor?
Dr. Anupama (1:47): Exactly. Sleep deprivation, stress and irregular routines increase cortisol, which is a chemical and which interferes with reproductive hormones.
Simple lifestyle adjustments can make a big difference.
Sahiba (2:01): That’s quite reassuring to know doctor. If any of our listeners feel uncertain about their fertility journey, Motherhood Fertility and IVF is here to guide you personally.
You can call us at 08067 230 or email at info@motherhoodivf.com to start your consultation. The earlier, the better.
So, doctor, for someone feeling anxious about the first consultation due to fears of judgement or intimidation, can you take us through what really happens when someone walks into your clinic?
Dr. Anupama (2:35): Sure, Sahiba. It’s mostly a conversation. We take a detailed history as regards how many years they’ve been married for, since how many years they’ve been trying to conceive, what are their lifestyle and what is her menstrual cycle pattern and has she had any medical disorders before? Was she operated for anything? Is there a family history of early menopause or is there a family history of infertility? All of this will help us make a decision about what else is to be done for that couple. Then we run certain basic blood tests, semen analysis and a scan. This is all to check and see if everything is functioning properly.
Sahiba (3:14): So, doctor, the consultation is more about understanding the unique journey and helping couples get a clear sense of the right approach for them, rather than just running tests.
Dr. Anupama (3:24): Exactly. Based on that, we create a personalised plan.
It could be just ovulation tracking and timed intercourse or ovulation induction and ovulation tracking or advanced treatments like IUI or IVF. Every plan is unique and tailor-made. The goal is clarity and direction.
Sahiba (3:43): That reassurance itself must help couples feel less anxious.
Dr. Anupama (3:47): Absolutely. Knowledge is empowering.
Understanding your body gives couple control and hope.
Sahiba (3:52): So, doctor, we often hear from young couples that we are focussing on our careers, travelling, financial stability. We’ll think about kids later.
How does this approach affect fertility and what should people keep in mind when balancing life goals with biological timelines?
Dr. Anupama (4:08): It’s fine to delay, but fertility does gradually decline after 30, especially after 35. What everybody should understand is every woman across race, religion, continent is born with 2 million eggs. When the girl attends her menarche between 11 to 13 years of age, half the reserve comes down. Thereafter, every month the reserves are going down more after 30, even more after 35.
Also important to understand is at 35 years of age, she’s producing a 35-year-old egg. So not only is the quantity going down, the quality also is going down. So planning ahead, thorough assessment and or even fertility preservation like egg freezing gives flexibility and options without pressure.
Sahiba (4:55): That’s some really great information we got from you, doctor. So it’s really about understanding your body and knowing your options, not feeling forced to make life-changing decisions immediately. And let’s also talk about couples who already have one child, doctor. Secondary infertility is something many don’t anticipate.
Some assume that having a second baby will be easy, but that’s not always the case.
Right doctor?
Dr. Anupama (5:21): Yes. Secondary infertility is quite common. It can be caused by age, lifestyle changes, medical conditions or tuberculosis. What you have to understand is, irrespective of the outcome of the first pregnancy, whether it resulted in a miscarriage or voluntary termination of pregnancy or a caesarean or a normal delivery, there are chances that the tubes are affected or blocked.
But you have to understand that most of these challenges can be treated successfully today.
Sahiba (5:49): Understood, doctor. Many people focus only on medical treatments, but lifestyle changes are equally important. For our listeners, could you give some practical advice, things they can start doing that really improve fertility for both men and women?
Dr. Anupama (6:04): Yes. The most important thing about all of this, about changing the lifestyle is a balanced diet where trans fats are cut down, carbohydrates are kept to a bare minimum and there is a lot of protein inculcated, there is a lot of coloured fruit and vegetables inculcated like pomegranate, tomato, peppers, broccoli. This will increase the antioxidants which will help the egg health and the sperm health.
And of course, seeds which will add on to omega-3 fat acids and whole grains, nuts. It’s important to maintain a healthy BMI, while overweight people take double the time to conceive and malnourished people take 5 to 6 times more time to conceive. Exercises, brisk walking for about 30 to 45 minutes a day, sleep 7-8 hours a day, avoiding late night screens because you have to understand that sleeping at between 9.30 to 11 p.m. is very important.That’s when a chemical called melatonin is secreted and when that is disrupted because of lack of sleep during that time, there could be problems with fertility. And of course, stress management should be dealt with meditation, journaling or timing nature, completely avoid smoking, excessive alcohol and environmental toxins.
Sahiba (7:19): So, doctor, I am quite intrigued to know, you mentioned overweight people have issues in conceiving, but underweight people have issues 5 to 6 times more as compared to overweight people.
Dr. Anupama (7:30): Yeah, underweight people take 5 to 6 times more time to conceive than overweight people. That’s because we need adequate muscle mass, adequate proteins, fat and estrogens. All the hormonal disturbances are more in underweight. So, being underweight can impact both men and women. There are hormonal imbalances there, ovulatory dysfunction, nutritional deficiency and also there is energy deficiencies.
All of this can cause impaired reproductive function.
Sahiba (8:00): Understood, doctor. So, doctor, now that we spoke about factors affecting women’s fertility, can you also throw some light on male infertility?
Dr. Anupama (8:10): So, 40% of the time infertility is due to the male factors. Nowadays, we see a rise in male infertility cases and the average age group of men coming in for fertility treatment is usually between 31 to 35 years. The most common issues are the poor motility, normal morphology, hormonal imbalance, varicose yield and low sperm count in that order.
The male infertility is more in urban areas, could be due to the environmental toxins and the lifestyle and lack of sleep, stress and smoking alcohol.
Gym practises and supplements that they use is also contributing to male infertility especially if they are using steroids which will suppress the male hormones leading on to fertility issues and the modern diets like too much of trans fat, too much of carbohydrate in the diet, inculcating less amount of fruit and vegetables is also adding on to the fertility issues.
I would tell 6 out of 10 men have a lot of mental stress which might be contributing to the fertility issues. Substance use like alcohol, smoking, vaping, recreational drugs have also a major impact. 20% of the men with normal semen analysis still have fertility issues, this could be unexplained or it could be due to the female factors.
Lifestyle diseases like diabetes, hypertension, obesity is causing a rise of male fertility
by leaps and bounds and many men do not come voluntarily for help and for treatment nowadays, I would put it at just as 10% but hopefully the percentage will increase next. Technology related causes like laptop radiation, mobile heat exposure, impact sperm quality
are definitely yes.
A brief case history, we had a male trainer who was taking a lot of protein supplement and steroids and he came with a semen analysis report showing almost zero sperm count. We counselled him and asked him to stop all those drugs, repeated the semen analysis after 3 to 4 months which showed improvement by leaps and bounds and the couple conceived naturally without any intervention one year later.
Sahiba (10:28): So doctor, recently there has been some growing conversations around repeated pregnancy losses. Could you please tell us how it impacts the fertility journey of the couples?
Dr. Anupama (10:37): So sometimes a couple comes and approaches us with the history of previous abortions. Any couple with more than 3 abortions, miscarriages is termed as a repeated pregnancy loss. So we have to evaluate the couple. Most of the times early miscarriages are because of genetic factors or there can be some blood clotting problems like antiphospholipid, antibody testing and all should be done. Sometimes it is immunological factors and once we are certain what the cause is, then we take them forward accordingly.
I had a couple who had come with 8 repeated abortions with no cause ascertained at all. So they were all early miscarriages, all 8 of them were early miscarriages. She didn’t reach the heartbeat stage at all. So everything, all the miscarriages were happening at 6 to 7 weeks before the heartbeat was documented. We have done exhaustive tests on them, the genetic, the carrier type, whole exome sequencing, immunological, antiphospholipid, everything. We couldn’t ascertain the cause. So we told them let’s go ahead and take a chance and do a pre-implantation genetic testing if it will help.
The first cycle when we did our IVF, we got a good number of eggs, good fertilisation but none of the embryos grew till day 5. Second IVF, only one embryo we got day 5. Third IVF, we got one embryo. So these two embryos on day 5, we did a biopsy. One came out as chromosomally normal, we put that into her uterus and put her on all supporting medications like progesterone and low molecular weight heparin, all that, whatever was, you know, whatever I thought would help her. Luckily she conceived, went on to deliver a healthy baby girl. I think the baby girl is almost 5 to 6 years.
Sahiba (12:21): Now it’s time for our favourite segment, myth versus fact. Are you ready doctor?
Dr. Anupama (12:25): Yeah, sure Sahiba.
Sahiba (12:26): So the first myth is infertility is mostly a woman’s problem.
Dr. Anupama (12:31): So 40% of the causes for infertility is because of the problem in the woman, 40% of the times it’s because the problem is in the man, 20% of the time it cannot be explained. That we term it as unexplained infertility.
Sahiba (12:46): Second one, myth or fact, IVF is unnatural.
Dr. Anupama (12:49): So IVF just helps the sperm and egg meet outside the body. There’s nothing unnatural about it. Remember, we are not manufacturing sperms and eggs in the lab. We’re just using whatever is there.
Sahiba (13:01): Next one, stress alone causes infertility.
Dr. Anupama (13:05): Stress matters, but it’s rarely the only cause. There are other accompanying factors like hormonal disturbances, which will add more to the cause of infertility.
Sahiba (13:14): Next one, once you have had a baby, second conception is easy.
Dr. Anupama (13:19): Now the fact is secondary infertility is very common. Like I’ve already told, it’s mainly because of the tubal factors.
Sahiba (13:25): And the last one is doctor, after 35, it’s impossible to conceive.
Dr. Anupama (13:29): Fertility declines after 35, but pregnancy is still possible. The oldest woman who’s conceived with me is a 46 year old woman. She came asking for help. So I’ve counselled her that the egg quantity and quality is compromised at 46, but luckily she had very good lifestyle. She was a runner herself. We could get good number of eggs with IVF, but she needed four IVFs to get one chromosomally normal embryo. We did a PGT on her, conceived and she delivered a healthy baby boy.
Sahiba (14:01): Thank you doctor for clearing all the myths for our listeners. So doctor, after understanding the science of IVF, what advice do you give couples about managing the emotional ups and downs like sadness, frustration or guilt during the treatment?
Dr. Anupama (14:15): This is deeply personal. Those emotions are normal. We encourage couple to acknowledge them, seek professional support if needed, talk openly, set boundaries and celebrate small events and be kind to themselves.
Sahiba (14:29): And when it comes to age doctor, why does fertility decline? And what can couples do to stay informed and prepared without feeling pressured?
Dr. Anupama (14:37): Like I’ve already spoken about this Sahiba, every woman is born with a finite number of eggs, which decline over time and egg quality also decreases with age. Early assessment, focussing on health, running timelines, considering fertility preservation are key strategies. Staying positive and informed is essential.
Sahiba (14:56): What about our younger listeners doctor who aren’t ready for kids yet? How does fertility preservation like egg freezing actually work and when should someone consider it?
Dr. Anupama (15:07): So fertility preservation involves retrieving eggs when a woman’s egg quality is still good and freezing them for future use. It’s ideal for women who wish to delay pregnancy but want to keep their options open.
Sahiba (15:18): So doctor Anupama, if you had to sum up fertility in one sentence, what would it be?
Dr. Anupama (15:24): So Sahiba, this is science guided by hope, not luck. The right guidance and with right awareness, most challenges can be addressed successfully.
Sahiba (15:33): Beautiful. That really captures the balance between lifestyle, medical science and optimism. Doctor Anupama, thank you for sharing your knowledge with such a warm and relatable way.
Dr. Anupama (15:43): Thank you for having me. Talking openly about fertility makes the journey less intimidating for couples. Thank you.
Sahiba (15:49): To our listeners, remember, fertility is about understanding your body, making informed choices and staying hopeful. If you’re curious or concerned, reach out to Motherhood Fertility and IVF for a personalised consultation today. Call us at 08067238900 or email us at info at the rate motherhoodivf.com. Until next time, take care, stay informed and keep your care circle close.
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