What Causes Miscarriage? A Fertility Doctor's Full Breakdown

What Causes Miscarriage? A Fertility Doctor's Full Breakdown

Pregnancy loss affects 15–25% of clinically recognized pregnancies, yet so many people are left without answers — or without hope. In this solo episode, Dr. Sasha Hakman breaks down everything you need to know about miscarriage and recurrent pregnancy loss: the five major causes, how each one is diagnosed, what treatment actually looks like, and which lifestyle factors are (and aren't) worth worrying about. If you've experienced a loss and are searching for answers, this episode is for you — and remember, it is not your fault. In this episode, we cover: * Why miscarriage is so common, and how the definition of "recurrent pregnancy loss" has evolved to include biochemical losses * Bucket 1 — Genetic/Chromosomal causes: why random chromosomal errors (like trisomy 16 and Turner syndrome) account for up to 75% of losses, the U-shaped age-risk curve, and when to test for balanced translocations via karyotype * Bucket 2 — Anatomic causes: uterine septums, scar tissue (Asherman syndrome), fibroids, polyps, adenomyosis, and how they're diagnosed via saline infusion sonogram or HSG * Bucket 3 — Immune/Autoimmune causes: antiphospholipid syndrome (APS), the antibodies involved, and why diagnostic criteria may lag behind clinical reality * Bucket 4 — Endocrine causes: thyroid dysfunction, high prolactin, insulin resistance/diabetes, PCOS, and luteal phase defects * The "5th bucket": unexplained pregnancy loss — and additional testing some REs order beyond ASRM guidelines (clotting disorders, chronic endometritis, vaginal microbiome) * Treatment options by diagnosis, including PGT-SR, Lovenox + baby aspirin for APS, metformin, and surgical correction of uterine abnormalities * Modifiable risk factors: smoking, alcohol, caffeine (the real data), weight/GLP-1 agonists, sleep, sedentary behavior, and why stress is often unfairly blamed * The encouraging stats: a 70% live birth rate in the pregnancy following a loss, and how high-touch prenatal care can improve outcomes Follow Dr. Sasha!  TikTok: @sashahakmanmd  Instagram: @sashahakmanmd @tryingpod  YouTube: @sashahakmanmd Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter for updates, Q&A answers and more! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every week. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Thank you to our sponsors!  Head to cozyearth.com [https://cozyearth.com] and use my code DRSASHA for an exclusive 20% off. Use code DRSASHA at carawayhome.com [https://carawayhome.com] for 10% off Subscribe, rate, and review if this episode helped you — and share it with someone who needs to hear it. New episodes drop every Wednesday. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Fertility After 40: Real Stats, Real Options, Real Talk

In this solo episode, Dr. Sasha dives into one of the most requested topics on the podcast: trying to conceive and being pregnant after 40. She cuts through the noise of misleading celebrity headlines and online misinformation to give you a clear, honest, and compassionate look at the biology, statistics, and real options available to you. In This Episode, You'll Learn: * Why more women are having babies in their 40s than ever before — and why that's a good thing * The biology of egg aging: how quantity and quality decline, and what's actually happening at the cellular level (mitochondrial dysfunction, meiosis errors, chromosomal abnormalities) * What your AMH level means after 40, and why high ovarian reserve can be a game-changer * Natural fertility rates by age and when ASRM guidelines say to seek immediate care * IVF success rates broken down by age: from 43% live birth rate under 35, all the way down to 3% over 42 Follow Dr. Sasha!  TikTok: @sashahakmanmd  Instagram: @sashahakmanmd @tryingpod  YouTube: @sashahakmanmd Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter for updates, Q&A answers and more! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every week. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Thank you to our sponsors!  Save 20% Off Honeylove by going to honeylove.com/DRSASHA [honeylove.com/DRSASHA]! #honeylovepod For a limited time, try OneSkin with 15% off using code DRSASHA at oneskin.co/DRSASHA [oneskin.co/DRSASHA]. Head to AirDoctorPro.com [AirDoctorPro.com] and use promo code DRSASHA to get $250 off select AirDoctor air purifiers, including the 3500, 4000, and 5500 models New episodes of Trying with Dr. Sasha Hakman drop weekly. If this episode resonated with you, leave a review and share it with someone who needs a doctor they can trust in their corner. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

The IVF Test That Could Finally Explain Your Failed Transfers with Jeremy Grushcow of Juniper Genomics

If you've ever gone through a failed embryo transfer and wondered why , this episode is for you. Dr. Sasha sits down with Jeremy Grushcow, co-founder and CEO of Juniper Genomics, to break down a groundbreaking advancement in IVF: whole genome and transcriptome embryo testing. Jeremy holds a PhD in molecular genetics and cell biology from the University of Chicago, along with a law degree, and has published research in DNA repair, cancer, gene therapy, bioethics, and patent law. He's building the technology that could change the odds for IVF patients everywhere. In this episode, we cover: * What whole genome sequencing actually is — and why IVF has lagged behind every other field of clinical medicine in adopting it * The brilliant "books on a shelf" analogy that finally makes PGT-A vs. whole genome sequencing click * Why failed embryo transfers are not your fault, your doctor's fault, or your lab's fault — and what the embryo's genetics have to do with it * What the transcriptome tells us that the genome alone can't * The difference between PGT-A, PGT-M, and Juniper's PGT-G testing * How Juniper looks at both the embryo and the parents' DNA to identify where variants are coming from (egg or sperm?) * The 6,000+ known genetic diseases — and why 10–15% of embryos being transferred today carry a detectable single-gene disorder that standard carrier screening missed * Why "reduced viability variants" matter and how they impact IVF success rates * The emotional and financial cost of failed transfers — and how more information can reduce both * Pricing breakdown: what Juniper's PGT-A and PGT-G costs, how to make it more affordable, and how it stacks up against the cost of a failed transfer cycle * Why patient autonomy in the US and Canada is driving better IVF outcomes globally Follow Dr Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingwithdrhakman YouTube: @sashahakmanmd Resources & Links: Juniper Genomics website: junipergenomics.com [http://junipergenomics.com] Instagram: ⁠@junipergenomics⁠ [https://www.instagram.com/junipergenomics] Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter [https://sashahakmanmd.com/newsletter] to receive updates, answers to Q&A and more !If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com [https://sashahakmanmd.com] to learn more! If this episode helped you, the best thing you can do is subscribe, rate, review, and share it with a friend. So many women deserve this information, help get it to them. Episodes drop every Wednesday. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

The Truth About Women's Health, Medical Misinformation, and Advocating for Yourself

What does it actually mean to try as a woman, as a patient, as a person navigating a healthcare system that wasn't built with you in mind? In this first solo episode of the newly rebranded Trying with Dr. Sasha Hakman, Dr. Sasha shares why she changed the name, what this podcast is really about, and who it's for. She opens up about the conversation that sparked the rebrand, the reality of practicing medicine in a field driven by IVF incentives, and why she started a podcast in the first place. She also shares a personal update (18 weeks pregnant with baby #3!) and answers one of the most frequently asked questions from her community: how do you know if you can actually trust your doctor? In This Episode, You'll Learn: * Why Dr. Sasha rebranded from Trying to Conceive to Trying with Dr. Sasha Hakman * What a Reproductive Endocrinologist actually specializes in beyond IVF * How to know if your doctor's IVF recommendation is truly evidence-based or financially motivated * The green flags to look for when choosing a fertility doctor or clinic * How to read online reviews and pregnancy success rates without being misled * What actually makes an exceptional doctor Follow Dr. Sasha!  TikTok: @sashahakmanmd  Instagram: @sashahakmanmd @tryingpod  YouTube: @sashahakmanmd Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter for updates, Q&A answers and more! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every week. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Thank you to our sponsors! head to http://www.bioptimizers.com/DRSASHA [http://www.bioptimizers.com/DRSASHA] and use my exclusive code DRSASHA to get 15% off any order Use our exclusive link to save 20% off Honeylove at honeylove.com/DRSASHA [honeylove.com/DRSASHA] Go to ogee.com/DRSASHA [ogee.com/DRSASHA] and use code DRSASHA for 20% off. New episodes of Trying with Dr. Sasha Hakman drop weekly. If this episode resonated with you, leave a review and share it with someone who needs a doctor they can trust in their corner. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]

Your Doctor Is Wrong About Exercise: What a Doctor of Physical Therapy Wants You to Know

Are you being told to stop exercising while trying to conceive or going through IVF? You're not alone and according to today's guest, you're also likely being given advice that isn't backed by science. In this episode, Dr. Shannon joins us for a conversation that is equal parts empowering and eye-opening. As both a physical therapist and a patient who exercised throughout her own fertility journey, she brings a rare dual perspective to the table. She and host Dr. Sasha take on the pervasive fear around exercise during fertility treatment, break down why the "rest and raise your legs" mentality is outdated (and potentially harmful), and share a practical, research-backed framework for building and maintaining muscle at every stage of the journey. Whether you're in the thick of fertility treatments, newly pregnant, postpartum, or just trying to understand your body better, this episode is packed with actionable guidance and a refreshing dose of truth. In This Episode, You'll Learn: * Why most doctors tell patients to stop exercising during IVF — and why there's no evidence behind it * How months of exercise restriction can harm your long-term recovery and postpartum body * The REPS Framework: the four principles that actually build muscle while TTC or pregnant * What "training to failure" really means — and why it's safe even during fertility treatment * Why you need to train near failure just to maintain the muscle you already have * How to choose exercises that actually target the right muscles (and why combo moves fall short) * Protein targets for TTC and pregnancy, and how to realistically hit them * When HIIT is okay to keep during TTC — and when it may be hurting your chances * How to safely return to exercise postpartum without setting yourself back * One simple trick to improve your form without a personal trainer Follow Dr. Shannon@dr.shannon.dpt @evlofitness  Follow Dr Sasha!TikTok: @sashahakmanmdInstagram: @sashahakmanmd @tryingtoconceivepodYouTube: @tryingtoconceivepod Resources Mentioned: Evlo App (Dr. Shannon's fitness app) — Use code DRSASHA for 6 weeks free (first 2-week trial + 1 month at $0) American College of Obstetricians and Gynecologists (ACOG) — exercise contraindications list available on their website Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter [sashahakmanmd.com/newsletter%20]to receive updates, answers to Q&A and more!If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every 2 weeks. If you're interested in becoming a patient go to sashahakmanmd.com [sashahakmanmd.com] to learn more! New episodes of Trying to Conceive with Dr. Sasha Hakman drop weekly. If this episode resonated with you, leave a review and share it with someone on their fertility journey. Learn more about your ad choices. Visit megaphone.fm/adchoices [https://megaphone.fm/adchoices]