Noor: Super excited to have Dr. Amber Cooper on the show today. And, I would love to just start with, you sharing a little bit about, you have this super incredible background, not only as a fertility physician with so much experience, but also on the genetic side. So you wanted to start with just giving the audience a quick background on who you are and you know, why you, why you chose this field and this amazing profession.

Dr. Cooper: Yeah. I absolutely thank you for having me. Most importantly, so I'm excited to be here. Um, yes, I am a board certified reproductive endocrinologist, so I feel like taking care of patients is the heart of what I do. Uh, but I'm also a, a nerd when it comes to science and have done a lot of research over the years and run clinical trials.

I have a master's degree that I pursued years ago and clinical research with a sort of a focus in genetics, and that's where I entered the genetics realm. Spent some time back in the day at Washington University. Training and on, uh, faculty for a while. But when I did my master's, I worked with really experts in genetics.

They did a lot of cancer genetics back then, right? And they were interested in reproductive genetics. So I was able to do some incredible research that led me down a genetics path. And, you know, I very much became passionate about over the years and how we use genetics or genomics and sort of, you know, how genes interact with each other and the environment.

I love that term. With the world that I see every day, right? How do I help preserve fertility? How do I help predict fertility pools? How do I help couples build families and healthy families, right? And so how do we bring all these worlds together? So where I sit now at Kind Body as I'm one of the chief medical officers, and I oversee both genomics and laboratory sciences.

So sort of, you know, the alignment of our IVF labs. That's awesome.

Noor: So can you start with just the super basics? You know, someone who, you know, doesn't know anything about fertility, doesn't know anything about reproductive endocrinology, can you just give them like the, you know, one minute crash course on, you know, what is IVF?

Like, what is the process? Mm-hmm. And, you know, how does it work?

Dr. Cooper: Yeah. So IVF in vitro fertilization, right? Putting egg and sperm together in a dish. That's really the classic definition of IVF. We use it to really imply, you know, females taking injections to retrieve eggs and access eggs. And sometimes we freeze those eggs and we say that's an egg freezing cycle.

We're not doing fertilization, you know, in the dish.

Noor: Mm-hmm.

Dr. Cooper: Um, but we use that term very broadly now and I think that, you know, if you really say how do we define IVF, it's really. Giving a woman, um, gonadotropins, FSH and lh, you know, often purified or recombinant gonadotropins and subcuticular injections to stimulate the ovaries.

Over on average, about a 10 to 12 day period with monitoring, with vaginal ultrasounds and blood draws until the follicles or cystic structures in the ovaries. Reach a large enough size. We give a trigger shot as everybody knows it as, yeah. And we go in about 35, 36 hours later, and through a transvaginal ultrasound with a needle, we just pass through the vaginal sidewall into the ovary, aspirate the follicles, and they go and test tubes.

We hand them to our embryologist. They're looking on these high powered microscopes saying one egg, two eggs, three eggs. So they talk to us. Within about three to five hours afterwards, they put eggs and sperm together and we come back about 16 to 18 hours later to see what fertilizes those embryos develop generally over the next 5, 6, 7 days to a blast assist stage, which I always say is kind of like a globe at a 150 to 200 cell globe.

Sometimes we'll just freeze that embryo. Sometimes we'll do a fresh embryo transfer. Sometimes we biopsy the edge of that embryo to do genetic testing. So that's really, I would say the one minute version of IVF.

Noor: Amazing. And can you talk a little bit about, um, how birth control works and basically birth controls interaction with IVF?

I think that's also something that people are really confused about. They're like, well, why did I go on birth control while trying to, so

Dr. Cooper: can you explain that you're percent correct? Women all the time are. I wanna have a baby. Why would I go on birth control? I always say, what is a birth control pill?

It's really, you know Yeah. A pill that has synthetic estrogen and synthetic progesterone. Mm-hmm. And yes, as they work, they suppress the brain, which in turn suppresses ovulation and it works as birth control. In the world of IVF, we're actually using it to quiet the noise of the brain when quiet, the no noise of the ovaries, and often I always say synchronize the resting follicles.

So we generally use it for a very short period of time to really help women get medicines, get everything ready, and then stop it. Then really move into what we call sort of a baseline monitoring appointment, and we wanna keep the ovaries resting. If we keep 'em resting, it's a better time to stimulate the ovaries.

We might get, you know, maybe more eggs or have an opportunity for a fresh transfer, though in reality, it's really important to send the message that we can start IVF at any point in time. I have cancer patients that come to me say it's a new breast cancer diagnosis, and a woman needs to freeze her eggs before chemo or radiation, and she happens to walk in on day 12 of her cycle.

You can still start stimulation that day. So it's important for patients to understand. It could be early in the cycle, middle of your cycle, or late in your cycle. Now, later we might not be able to do a fresh embryo transfer, but we think there are multiple waves of follicles every month.

Noor: Could you, um, just sort of debunk that misconception around egg retrievals accelerating menopause?

Why is that mechanically just not what's going on here?

Dr. Cooper: Going back to the, the wave analogy. Right? Right. Those waves are coming in and out regardless of what we retrieve. So if it's a month that there's 15 or so little follicles there mm-hmm. They're all coming in, but only one rose and ovulates and the rest die off.

The difference is in IVF, we're trying to get them all to grow and grab them all at once, but we're gonna lose that wave regardless. Yeah. You're not going in to get a thousand out at once. We're just riding the wave that we can at that time.

Noor: So, so that's basically the key misconception in a, you know, natural cycle.

You're only ovulating one egg, but you actually have another 10, 15, 20 depending, that are just resting that get wasted. They die anyways. And those are the ones that are captured. Um, during an egg treatable. That's amazing. So, can you talk more about ovaries, more about eggs? Just, you know, what, what happens?

Why does egg quality decline? Yeah, I'd love to hear about it.

Dr. Cooper: Well, first of all, we're still waiting for the magic bullet, right? Yeah. I always say, I get asked about supplements all the time. Every single day I get asked about supplements and diet and the environment, and then I always start with, I wish we knew all the answers, right?

Mm-hmm. We don't. And, you know, age is still the biggest age of the egg is the biggest driver of egg quality in IVF success. We do not have, you know, regeneration of eggs every month or every day. Right. And we, we don't have the stem cells like testicles do. I would say men make sperm every day of their life.

Mm-hmm. And so when a man provides a semen sample for IVF. That sperm and that ejaculate is only about, you know, 75 to 90 days old. That's why men in father pregnancies in much, much older age groups than women can. Mm-hmm. We, we are born with that finite pool and our eggs are the age we are, and I say this to women all the time, it doesn't matter if the woman.

Is in the best shape of her life and looks 20 years younger. Her eggs are still the age she is right now. Hopefully good health practices might reduce inflammation and might help a little bit, and that's where you get into the environment. But age is so important. If you predict IVF success based on age, it's generally pretty consistent.

You get to about 35, 36, it starts to turn down and it generally hits zero. Somewhere early to mid forties, right? Mm-hmm. You know, have I done IVF in a 44, 45, 46, 40 7-year-old? I mean, success rates are so close to zero. At that age, the women that tend to find a euploid or as close to genetically normal as we think, uh, embryo tend to have to have dozens and dozens and dozens of eggs to test, and that's pretty rare.

So to go back to really your question on, you know, really a quality I'd put age first, hands down. You know, I think that, um, in general we look at a lot of things in the environment. You know, in fact been involved in a lot of different research studies looking on, um, you know, in all aspects of the environment.

One of the biggest ones we looked at and published on years ago was Take doing a secondary analysis of the NHANES study. Which is really testing women's blood and urine for all these endocrine disrupting chemicals, right? Exposures to phthalate as pesticides, dioxins, PCBs. And you know, what we know is that some of these things potentially may accelerate menopause and there might be anything from a utero exposure to when we're creating our egg pools to how we lose them over time.

Some of it's out of our control. You know, some of these things are in the water and the soil and they're really hard to fight. Now, maybe there are other things we can do, like try to reduce our exposure to plastic. I always try to find actionable things. Maybe don't microwave in plastic or know do you touch receipts less, or these are all the things that are out there.

Those are like ate exposure, but

Noor: mm-hmm.

Dr. Cooper: But, you know, I, I always say actionable items are the most important, right? The less we eat out of a box a can, less preservatives we're exposed to maybe the less inflammation we have. Right? And if you can reduce inflammation, more antioxidants, more of our good fats are Omega-3 fats.

You know, I think probably the Mediterranean diet has more, more of data than other diets out there. But you know, I have women that'll come in with lists of 30, 40 supplements long, and I, I start to worry about interaction of supplements. They're not regulated by the FDA. You have to be very careful about things.

There are co-factors in cellular aging that are hot topics. Coq 10, NAD, various antioxidants, you know, are involved in some of these things, but I wish there was a magic bullet. I've been using a lot of these for decades and if I thought one was, I'd put everybody on it.

Noor: Yeah, definitely. Um, do you wanna switch gears and talk a little bit about, um, genetics?

Yeah. What excites you about, uh, whole genome sequencing of embryos?

Dr. Cooper: Hmm. You know, what really excites me about whole genome sequencing for embryos is it's like this present. I get to open right with all this information inside and or a thousand piece puzzle that I wanna put together. You know, when I sit down, it's.

Way bigger than that. But I use that analogy if I sit down and build a puzzle. But there's so much information we don't understand. Right. And so much of the why and the how and the, the progress towards building families and healthy live births, there's so much information we need to make that better.

You know, I feel like. I'm one of those people that loves to read a book. And if I start a book, I almost can't go to bed at night 'cause I'm reading a book. Right. And I think about genetics sometimes as a tease because somebody handed me a book and I read five pages in the middle of the book. Right. But I didn't know the rest of the book.

You want more information. You know, I'm a big believer that knowledge is power.

Noor: Mm-hmm.

Dr. Cooper: Uh, the more we understand genetics, the better off we are. You know, I, I look at genetic testing of embryos. The evolution of how much we've been, we still look at a minuscule, often less than 1% of the genome. Right. And we make clinical decisions on that.

It's still a lot of info, but it's nothing compared to how much information is there.

Noor: Mm-hmm.

Dr. Cooper: And you know. Genetics are complicated. Right. So you and I have what, 99.8 0.9% similar DNA. Right. Well, what makes us unique and what little single changes in the library of letters and our DNA make us unique and how is our DNA packaged in a very small amount is actually making proteins.

Mm-hmm. It's regulatory. So what does it even mean? So I, you know, I believe we are, if you look at progress since the Human Genome Project and where we sit, we're right at this tip of the iceberg and we're about to, I think, unleash kind of a lot of information, which I think is pretty cool. It scares some people.

Genetics for some reason, scares people. Mm-hmm. And I think, you know, I, we have to understand how to talk about it. Providers, dare I even say providers, if we didn't train. And even my generation, I, I was lucky enough to do an extra master's degree extra training and really live in this space. When I trained, even in medical school.

I mean, we learned the basic structure of DNA. That's it. We didn't know anything then. Mm-hmm. So we're right there and we, you know, we look at all this information now, you know. It's fantastic because how many times I think I've done it with patients four or five times today already.

Noor: Mm-hmm.

Dr. Cooper: Had to try to say, why do I think your genetically tested embryo either didn't implant or miscarry?

Noor: Mm-hmm.

Dr. Cooper: I have to explain that, you know, we tested a minuscule amount of the DNA and there's so much we don't understand still, and it's still probably the embryo. You know, how many women or couples. Tended parents think it didn't work. It's gotta be the uterus, it's gotta be the environment new. Probably 90% of the time it's still the embryo.

Right? And so we tend to blame. That's why we need more information to help quiet down this assumption that it's suddenly my immune system, it's my, my uterus, my lining didn't develop well. We gotta do something in the uterus. I'm not saying those don't exist in a small percentage of patients. I think a large percentage, it's still the embryo.

Yeah. Now, sure. Little bit Pandora's box, we open it up, we get more information, we have to know what to do with it.

Noor: Mm-hmm.

Dr. Cooper: And we're gonna find things that we question their clinical significance.

Noor: Mm-hmm.

Dr. Cooper: Um, so we have to be careful. We have to do it strategically, but we need not only more information on why infertility exists.

We need more information on success of embryo implantation, and we definitely need more information to help. What is it we want? Healthy pregnancies, healthy live births, right?

Noor: Mm-hmm.

Dr. Cooper: So that's how I look at it.

Noor: Okay. And then could you talk a little bit about, um, what are the types of families and patients that you think would benefit more from this whole genome data?

Dr. Cooper: Yeah. You know, I see. Genetic testing of embryos is really evolving in that it's an option to me for any patient who walks in the door. Right. Um, who might benefit more readily. Mm-hmm. Or more openly to it. Mm-hmm. Are patients that are of advanced maternal or reproductive ages Right. Both for men and women, um, you know.

Couples who have had recurrent pregnancy loss is a big one.

Noor: Mm-hmm.

Dr. Cooper: Uh, couples who've had recurrent implantation failure with previous, even PGT tested embryos, they might wanna look at a larger platform. Right. Even especially when we transfer a PGT tested embryo and we have a later loss, we're still wondering what's going on.

So they may benefit from more expanded testing in the future, but then we go down a whole path. Of other things that we're looking at in genetics, and I always say there's, there's sort of two families that we look at. We look at the spontaneous things that happen in the embryo after egg and sperm join, and those cells start dividing what errors happen that really are related to failed implantation or miscarriage or no sort of an impacted live birth, right?

Noor: Mm-hmm.

Dr. Cooper: Um, then there's the other stuff with single gene issues, right? And those may be related to. Recessive or dominant conditions, right, or X-linked disorders or cancer genetics, or other things that become more and more important the more we learn about these things, right?

Noor: Yeah. And could you explain, um, you know, what the difference is between PGTA?

So chromosome testing versus whole genome? Yeah, because sometimes people think, you know, genetics, uh, I got one test, it tells me everything. And can you kind of just, um, yeah, explain what the, what the differences are between those two.

Dr. Cooper: I, I actually think it's a message we need to send loudly and broadly.

I mean, even just the term genetic testing means so many different things. Yeah. And you know, patients come to me and said, oh, I, I already had my genetics tested, and they might have meant. I had genetic carrier screening. They may have just had their blood drawn and tested for say, four or 500 silent mutations.

You know, they're looking for recessive things they may carry just so when agans burn come together, we won't have an infected child. That's different, right? They're, they're doing testing on themselves for inherited things. They may not even understand that the term genetic testing is very broad, and when we just talk about an embryo, you know, if we have an embryo that's 150 or 200 cells like a globe, we're biopsying say 4, 5, 6 cells off the edge of that embryo.

We're testing what's gonna be the placenta. Not even the baby now.

Noor: Mm-hmm.

Dr. Cooper: To the time they should be the same. But on rare occasions they are.

Noor: Mm-hmm.

Dr. Cooper: And you know, just testing a few cells is a minuscule amount of DNA. Right. Back in the day we couldn't do that. And so technologies have gotten better and so it's evolved to, okay, let's extract the DNA and you have to amplify it 'cause it's still not enough to test and.

So the standard technologies right now that we use around the world that are more commonly used when we say PGT pre-implantation genetic testing dash A for aneuploidy or spontaneous changes that happen as cells divide. Or unbalanced amount of DNA is an easier way to look at it. You know, they generally are extracting the DNA from a handful of cells, amplifying it and doing targeted sequencing.

You know, sometimes looking at single letter switches.

Noor: Mm-hmm.

Dr. Cooper: Types of technologies out there and looking at a tiny, tiny amount of DNA. That's the standard genetic testing when people refer to, hey. I genetically tested my embryos. Right. You know, one of my passions is really to change the narrative.

Noor: Mm-hmm.

Dr. Cooper: You know, I don't like to use the word normal and abnormal. Mm-hmm. I think EGTA as it stands right now in what's used commonly simply a screening test, looking at a tiny amount of DNA mm-hmm. To try to rank which embryos. Are better to choose first, right? Because the ones that are more apt to implant or have a healthy live birth or less apt to miscarry, right?

Mm-hmm. Patients sometimes though now we get into these things called mosaic embryos, right? This gray area in between that they think still feels abnormal, and sometimes I have to explain, there might be one or two little percentage points different from what you think is a eulo formal embryo and a mosaic embryo.

So now they're really confused. No, no, this was, this one feels abnormal, but this one's normal. I, that's the hard part when we use these words right, with testing, that's why we need more knowledge.

Noor: Yeah, yeah, definitely. So kind of, it seems like the quick summary is sort of, PGT is looking at chromosomes.

Chromosomes. You can kind of think of them as, you know, chapters in a book. And if you're missing a entire chapter, like chapter one or chapter two, chromosome one or chromosome two, that's not likely to be compatible with life because you don't really have enough information, enough data to, you know, make that, um, that pregnancy viable.

And, um, unfortunately, PGTA is limited and that it doesn't actually look at all the different letters. So each of those chromosomes, each of those chapters has, uh, you know, hundreds of pages, thousands of, of letters, and those letters are not actually looked at with PGTA. And that's the difference between PGTA, uh, or chromosome testing versus holds genome holds.

Genome was actually looking at. Every single letter and telling you, not just, are you missing, uh, a chapter or do you have an extra chapter, but what is that? Let's actually typo check every single letter and see if that's associated with cancer or birth defects or autism, neurodevelopmental disorders, everything that's sort of currently known based on, you know, the thousands of, uh, people that have been sequenced and all the work that's sort of been done since the Human Genome Project.

Yep, absolutely. So could you talk a little bit about egg freezing? When is the right time to freeze your eggs?

Dr. Cooper: Right. Yeah. So, you know, I think we are seeing, particularly across the US and, and, and even in many places around the world, an increase in egg freezing cycles or fertility preservation, right?

Yeah. What we're saying is that women are choosing to freeze eggs before they want to be pregnant. Right? And that might be six months or a year before, and it might be 10 years before. They want to carry a pregnancy or build their family, right?

Noor: Mm-hmm.

Dr. Cooper: Um, what, you know, we look at and where we struggle is how much of an insurance policy is that?

Right? You have to be careful in counseling women and you would you prefer them to freeze eggs when they're gonna get a good number at one time? In a perfect world, right?

Noor: Mm-hmm.

Dr. Cooper: You have a younger patient, let's make her under 35 in a perfect world, because that cut off a lot in this field. Yeah. We make her under 35.

You know, we generally need, you know, at minimum, probably six to 10 eggs. Mature eggs frozen to have at least a 50 to 60% chance of even one live birth. People hear that and they're like, wait, not every egg makes a baby? And the answer is no. We are actually incredibly inefficient producers. I, when I give talks, I have these slides, sometimes I have all these mammals and I stick the human in the middle.

I'm like, we are one of the worst. Right? Mm-hmm. When it comes to, you know, efficient producer, she had a cat or a dog, they have sex once and they have a litter, we.

You know, we generally have to think about, it's a complicated process when you have an egg. If it's frozen, it has to survive the thaw. It has to fertilize. It has to develop to that 150, 200 cell, you know, stage. It has to be genetically normal enough to implant. It has to implant, it has to be an ongoing pregnancy.

That's a lot of hurdles. Yeah. So, you know, that's why numbers matter. And you know, the more mature eggs you have frozen at a younger age, the more of an insurance policy that may be. Mm-hmm. Some women may never use their eggs. Right. They might freeze eggs at 32, decide to build their family at 35, still have a pretty reasonable egg pool, get pregnant a couple times, and they never use those eggs.

Hmm. Others and I use, I say this a lot, it's. Not always that you're freezing eggs for your first pregnancy. Sometimes you're freezing for baby number two or three because a lot more women pursue careers. The average age at first, you know, live birth as well as even marriage has gone up tremendously over the years.

Right? And so it might be that might instead of age 30 for first life birth, or even in the twenties, it's getting up into the mid thirties. Maybe they still get pregnant with the first go round, but it's, they want two or three children and it becomes harder in the late thirties or early forties. So it's important.

And I always say it's where do you wanna be in five years, 10 years, 20 years? Right? How do, what does your family look like? And it's important. To really ask patients that.

Noor: So maybe if you're, if you're a third year old woman, and if you're a 30 5-year-old woman, how many eggs would you, would you say to freeze Per, per baby?

I know that's always the million dollar question. What's, what do you, what do you counsel these days in terms of how many, how many eggs?

Dr. Cooper: Yeah. You know, I think there are a few studies out there that actually try and suggest this, and it's a really complicated, do we have really data to, to back this number and this recommendation.

There's some egg freezing calculators out there. I know, you know, spring fertility has one on the west coast and there's, there's a few that exist out there. Yeah, and it's, it, they're interesting because they're based on a few studies of women that have used their eggs. It's an incredibly important thing.

A lot of women have frozen eggs, but a much smaller percentage of actually used them. So IV F's been around over 40 years, but we've only been successfully freezing eggs. For the last 10 to 15 years, it was a little bit experimental before that. So it's newer technologies. Yeah, newer freezing technologies.

So I, I think it's really important for women to know that like we counsel with the best information we have now, and so in a perfect world Sure. Most studies suggest it'd be best if you could freeze it. 33 and under, definitely under 35 if we can. Does that mean I would tell a woman who comes to see me at 37 38, not to freeze her eggs, but I would tell her she probably needs at least twice as many frozen as a 30-year-old.

Right? If not three times as many. Because remember what I said earlier is like pregnancy rates. Go down with age chromosomal abnormalities, go up with age. Yeah. So you have to freeze more and more. And so, you know, I think, you know, if I had a 30-year-old and I said, you know, at least six to 10 to have a 50 to 60% chance of one live birth, how do those numbers feel to you?

Right? Mm-hmm. You might say, oh, I don't like that. So now I want 15 to 20 to get me a little higher for at least one life. I have a small chance at a second one with that, right? Yeah. Oh, so I might want 25 to 30 because I might want three kids, you know? And, but even that, there's no guarantees, right?

Because sometimes in this world of IVF and we quote IVF success rates, it's predominantly in couples with infertility, right?

Noor: Which is different than the egg freezing population.

Dr. Cooper: Yeah. Very different. And so I think it's just important to understand what data we use is still pretty limited. We're building on it, I think with every year, but it's still limited.

Yeah. Mm-hmm.

Noor: So would you, uh, advise someone to freeze eggs or embryos? Um, but how do

Dr. Cooper: you, how do you kind of help people make that decision? Yeah, yeah. It's a great question. I think if someone is in a relationship. Or really has pretty high confidence of the egg and sperm source, right? Mm-hmm. It's probably slightly better to freeze embryos because if you think about it, they've made it past a lot of hurdles, right?

Mm-hmm. You know, fertilization, embryo development, and especially if you can test them too, you get a little more confidence. You have an embryo that's 150 to 200 cells, it survives the thaw. Generally 99% of the time. An egg is a single large cell. Mm-hmm.

Noor: That's

Dr. Cooper: why egg freezing came later than embryo freezing because it was much more fragile in the freeze ball process and we had to change the freezing techniques to make it more successful.

Vitrification or rapid freezing is what we do now. Mm-hmm. And you know that even at the best technologies we have. Survival in the thaw might only hover around 88, 90%. So it's not that 99%. So we will lose some eggs still at

Noor: the thaw.

Dr. Cooper: Mm-hmm.

Noor: Because they're smaller than the, than those embryos. Yep, yep. Um, and could you talk a little bit about, um, at what age you recommend, um, egg donors or at what point that kind of shifts the probability of a live

Dr. Cooper: birth test?

Donation, you know, has been increasing tremendously too. I mean, uh, I, you know. I would say 15 to 18% of patients I see are using donor sperm, donor egg donor embryos, or surrogates.

Noor: Mm-hmm.

Dr. Cooper: We call all this third party reproduction in a sense.

Noor: Mm-hmm.

Dr. Cooper: Um, most of the time, egg donation is what we call de-identified.

I try not to use the word anonymous anymore in today's world. Right. Mm-hmm. Facial recognition and genetics, it's hard to keep things anonymous. Um, you know, there are occasionally what we call directed donors. He uses a sister or a cousin, you know, or a friend, but most use a de-identified egg donor. There are frozen egg banks now, so we can use donated eggs that are either fresh or frozen.

And with egg freezing success, we're seeing frozen egg banks increasing their numbers as well. Most of the time egg donors are really 32 and under, you know, going back to statistics where we think quality is best or we need a lower quantity to achieve a live birth. And you know, we, when do we use egg donors?

Well, generally it's when success rates really start to fall. So many women in their forties right, are, have a higher likelihood of needing an egg.

Noor: Yeah. Yeah. That's super interesting topic. What are you excited about in terms of the future of IVF and how, how the field is gonna change with new technologies like, you know, whole genome and, you know, other things that are coming down the pipe.

Dr. Cooper: I, I love what I do in this field because of how fast technology is changing. How much we're learning and how quickly we adjust. So what are we doing in all areas of medicine right now? We're trying to shift from a reactive nature to a proactive nature, right? Mm-hmm. Isn't it better to prevent cardiovascular disease than get a bypass, you know, at age 60?

Noor: Mm-hmm.

Dr. Cooper: And we're looking at that in all aspects of health, right? In aging, right? And so this is where we sit in the medical field. This is where we sit in the IVF world because only we're pretty young, right? Mm-hmm. Just over four decades, and you look at the rapid acceleration of the ability to test the embryos, which are microscopic, right?

We used to need several cells and now we learn a lot in a single cell even, right? We're moving fast, and that's really cool. We wanna make sure that we're building healthy families, and that's what we're trying to do.

Noor: Yeah. Awesome. Uh, so great to chat with you and, um, yeah, hope us inspire some more people to become, uh, you know, Arias like you.

I mean, you have the coolest job ever. You get to help all these families have healthy babies. I'm sure you have a drawer full of, you know, thank you cards and baby photos from all the people who, um, you know, they, they owe their, their favorites and um, their family too. So thanks so much for taking the time and, uh, chatting with us about everything from fertility to genetics, to eggs and uh, um, over equality was amazing.

Thanks much for your time.

Dr. Cooper: Thank you for having me. And thank you for all you're doing in the field too.