Dr. Lora Shahine, 1101 Madison Street, Suite 1050, Seattle, WA (2026)

01/07/2026

Cycle Day 1: it sounds simple, but it’s one of the most confusing parts of fertility care.

What is Cycle Day 1?
Cycle Day 1 is the first day of full menstrual flow. This does not include spotting or light brown discharge. It means a true bleed that requires a pad or tampon.

Why is it confusing?
Many people spot for days before their period truly begins. Hormonal shifts, progesterone withdrawal, or even an early pregnancy loss can blur the lines. This is why “Is this Day 1?” is one of the most common questions I hear.

How to tell if it’s truly Day 1
• Bright red flow
• Needing menstrual protection
• Flow that continues or becomes heavier the next day
If you are unsure, it is always okay to ask. Clinics expect this question.

Why Cycle Day 1 matters for fertility treatment
Cycle Day 1 sets the timing for many important steps, including baseline ultrasounds and bloodwork, starting fertility medications, timing ovulation induction, IUI, or IVF, and coordinating treatment safely and accurately.

Bottom line
Cycle Day 1 is not just a date on the calendar. It is a key starting point for understanding your hormones and planning fertility treatment. When in doubt, ask. You are not doing it wrong.

01/06/2026

Millions of Californians just gained access to IVF under a new state law and this is a big deal for family building.

Starting January 1, 2026, many large employer health plans in California will be required to cover infertility diagnosis and treatment, including IVF. The law also updates the definition of infertility to include same s*x couples and single individuals, expanding access to care that was previously out of reach for many.

Why this matters
IVF can cost tens of thousands of dollars out of pocket. Insurance coverage can be the difference between pursuing treatment or giving up on the chance to build a family.

Important limitations to know
This law applies to many large group plans but does not cover self funded employer plans, Medi Cal, or some religious employer plans. Coverage may begin at plan renewal dates, so timing will vary.

If you are in California and considering fertility treatment, now is the time to check your benefits and talk with your HR team.

Progress like this matters. Access to fertility care should not depend on who you love, how you identify, or how much money you have.

Save this post and share with someone who needs to know.

Let me know in comments what you think about this announcement and follow me for me up to date fertility news

01/05/2026

Aspen photo dump
Not a ton of snow but plenty of family time and memories❤️

01/05/2026

What you’re seeing under the microscope matters more than most people realize.

This reel shows two very different s***m.

One has a normal shape and swims forward with purpose.
The other has an abnormal shape and irregular movement.

When an andrologist selects s***m for ICSI (intracytoplasmic s***m injection), they’re carefully evaluating several key features, not just whether s***m are present.

What we look for when choosing a s***m for ICSI:
• Motility: Forward, progressive movement rather than twitching or circling
• Morphology: A well-formed head, midpiece, and tail
• Head appearance: Smooth contour, appropriate size, no large vacuoles
• Overall integrity: Signs the s***m is structurally capable of fertilizing an egg

Even when a semen analysis shows low count or abnormal morphology, it’s often possible to find individual s***m with the characteristics needed for fertilization. This is one reason ICSI can be such a powerful tool in male factor infertility.

S***m quality is about far more than a single number on a lab report. It’s about function, structure, and careful selection at the cellular level.

If you’re navigating male factor infertility, know this: one healthy s***m can make all the difference.

01/02/2026

Male factor fertility matters—more than you may realize.

Up to 50% of couples experiencing infertility have a male factor component, either alone or combined with female factors. Infertility is not just a “women’s health” issue—it’s a shared medical condition that deserves shared evaluation.

A few key points every couple (and especially men) should know:

• Get the data. A semen analysis is a simple, noninvasive first step. It provides critical information about s***m count, movement, shape, and overall reproductive health. Assumptions—based on age, past pregnancies, or how “healthy” someone feels—are not reliable.

• Testosterone is not fertility-friendly. External testosterone (including injections, gels, pellets, or supplements marketed as “T-boosters”) can shut down s***m production by suppressing the signals from the brain to the te**es. I see this frequently—and it’s often reversible, but not always quickly.

• Lifestyle matters—for s***m too. S***m health is influenced by sleep, nutrition, exercise, stress, alcohol, ni****ne, cannabis, heat exposure, and environmental toxins. Optimizing these factors can meaningfully improve semen parameters and overall reproductive outcomes.

• Earlier evaluation = more options. Identifying male factor infertility early can guide treatment, reduce delays, and sometimes avoid unnecessary testing or procedures for a female partner.

Fertility care works best when both partners are evaluated, informed, and supported. If you’re trying to conceive and it’s taking longer than expected, a semen analysis is not just reasonable—it’s essential.

01/01/2026

The new year often brings hope, fresh starts, and big goals. If getting pregnant in 2026 is one of yours, this episode was created for you.

In Ep 156 of Brave & Curious with Dr. Lora Shahine, I walk through a practical, evidence-based fertility reset designed to help you prepare your body and mind for pregnancy.

We cover seven key areas that truly matter when trying to conceive: getting your health in check before pregnancy, knowing when to stop birth control, understanding and tracking your cycle, timing in*******se during the fertile window, nutrition that supports reproductive health, exercise and stress in a hormone-supportive way, and how to know when it is time to seek extra support.

This is not about perfection or pressure. It is about clarity, preparation, and using science to guide your next steps.

If you are setting intentions for the year ahead, I hope this episode helps you feel informed, empowered, and less overwhelmed.

Listen to Ep 156, The Fertility Reset for 2026, wherever you get your podcasts. Save this post to come back to as you plan your year and share it with someone who may need it too.

12/31/2025

What if fertility diagnoses were Stranger Things characters?

Infertility can feel isolating, confusing, and overwhelming.
Like Vecna, it feeds on silence and self-blame.
But when we name what’s happening, learn the science, and stop facing it alone, it loses power.

A few reminders I want you to take with you:
• A diagnosis is not your identity
• Pain is real—even when tests are normal
• Prior fertility doesn’t guarantee future ease
• Male factor matters
• Being misunderstood doesn’t mean you’re wrong

If this helped something click (even a little) save it.

If it made you feel seen, share it.

And if you’re in this season right now: you’re not broken, and you’re not alone.

12/31/2025

IVF does not use up all your eggs: Myth explained👇

This is one of the most common—and understandable—concerns I hear from patients. The idea of “using up” your egg supply can feel frightening, especially when fertility already feels uncertain.

Here’s what the biology actually shows.

You are born with approximately 1–2 million eggs.
By puberty, that number naturally declines to about 300,000–500,000.
Across your entire reproductive life, you will ovulate only 400–500 eggs.

Each month, hundreds to thousands of eggs begin to mature, but the vast majority are lost through a normal process called atresia. This happens every cycle, whether or not you pursue fertility treatment.

IVF does not deplete your egg supply.
Ovarian stimulation simply allows us to support and retrieve eggs that were already destined to be lost in that same month. It does not take eggs away from future cycles, cause early menopause, or “use up” all remaining eggs.

This worry is very real, and it deserves a clear, evidence-based explanation. IVF works within biology of the o***y, it does not override it.

If this myth has been weighing on you, know that you’re not alone and that accurate information can be empowering.

12/30/2025

“Infertility is no one’s fault.”

And yet so many people carry quiet shame—wondering what they did wrong, what they should’ve done differently, or whose body “failed.”

Let me be clear:
Infertility is a medical condition.
It is complex, multifactorial, and often unexplained.
It is not a personal failure, a punishment, or something you caused.

If this post made you feel seen, this message is for you.

Release the blame.

You deserve compassion—especially from yourself.

12/29/2025

This is a big step forward for equity in fertility care.

After years of advocacy and a landmark legal settlement, Aetna will now cover IVF and fertility treatments for same-s*x couples on the same terms as heteros*xual couples.
No more unequal barriers to building a family.

This change impacts millions of people nationwide and represents something we’ve been saying for a long time:
👉 Infertility care is medical care.
👉 Family building should not depend on s*xual orientation or relationship structure.

Coverage still varies by employer plan, and there may be important details around eligibility and reimbursement—so if you’re insured through Aetna, now is the time to review your benefits and ask questions.

Progress like this doesn’t happen quietly. It happens because patients, advocates, clinicians, and communities speak up.

Share this with someone who needs to see it.
And if you’re navigating fertility care as part of the LGBTQ+ community—you deserve support, access, and respect at every step.

12/28/2025

Best reason to cancel IVF cycle
💕

Hoping 2026 is YOUR year!

12/27/2025

“Is it PMS… or am I pregnant?”
If you’ve ever found yourself obsessively Googling that question during the two week wait, you’re not alone.

The two week wait between trying and knowing is an emotional rollercoaster
The symptoms? Confusing at best.

During the luteal phase (the time between ovulation and your expected period), progesterone is the dominant hormone. It’s the same hormone that supports early pregnancy and also causes PMS symptoms.
So what does that mean? You might feel bloated, moody, crampy, tired, have sore breasts or even some nausea—and have no idea whether it’s your period coming or a possible positive test ahead.

It’s like your body is giving mixed signals, and it’s frustrating when all you want is clarity—am I pregnant or not?

If you’re in the wait right now, I see you.
Be gentle with yourself.

Symptoms or no symptoms, you’re doing your best in the unknown.

Have you ever had confusing TWW symptoms that made you sure you were pregnant, only for your period to come? Or vice versa? Share below if you’re comfortable—it helps others feel less alone.

Curious about fertility? Comment here or DM me with ‘Fertility101’ (no spaces) for my free ebook with answers to 101 of the most common questions on fertility, ovulation, miscarriage, IUI, IVF, endometriosis, and PCOS. Be sure to follow for me to DM link to you.

Dr. Lora Shahine

01/07/2026

01/06/2026

01/05/2026

01/05/2026

01/02/2026

01/01/2026

12/31/2025

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12/30/2025

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12/27/2025

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