The IVF Math Nobody Warns You About, From Lo Bosworth’s Own Doctor

Lo Bosworth has gone through the most fertility wise. Three egg retrievals, an endometriosis diagnosis, surgery, and one frozen embryo transfer to get her daughter. But this episode of Tell Me I’m a Good Mom is the most granular she’s gotten about it, and she brought the right person to do it with.

Dr. Sheeva Talebian is a reproductive endocrinologist and the Director of Third-Party Reproduction at CCRM Fertility New York. She’s also been Bossworth’s doctor since 2020, which means she was there for all of it—the low AMH at 33, the cycles that didn’t go as planned, the endo surgery, and the retrieval at 38 that ended up being her best one. Basically, she’s the one responsible for Bosworth’s daughter.

In the episode, the two chat about what IVF actually looks like step by step, the egg and embryo math that most people aren’t prepared for, what supplements and lifestyle changes seem to actually move the needle on egg quality, and how to evaluate whether the fertility clinic you’re at is actually any good. 

IVF Facts and Fiction: Guide to IVF with Lo Bosworth’s Doctor

If you’re navigating any part of this, there’s sure to be some good tidbits here for you. 

IVF, explained simply and without panic

Every month, your ovaries have a pool of immature eggs just sitting there. In a normal cycle, your brain releases FSH, which travels to your ovaries and tells one egg to develop and ovulate; just one. The rest go unused, not because your body picked the best one, but essentially at random. “I wish the body was smart enough to know that that was actually the good egg that was going to be the one that had a healthy chromosomal backbone, but it’s not,”  Dr. Talebian says.

IVF changes that equation. The injections (FSH and LH) stimulate all of those follicles to grow at once over about 10 to 12 days. Then a trigger shot brings the eggs to the edge of ovulation. They’re retrieved just before they’d release, and from there the path splits; either freeze them as-is, or fertilize and start making embryos.

The numbers

This is where a lot of people get blindsided. You might retrieve 14 eggs and feel like you’re set, but the math shrinks fast. Dr. Talebian breaks down what you’re actually working with. For a 30-year-old with no fertility history, you’d ideally want eight to 10 frozen eggs for roughly a 70 percent shot at one live birth. By 35, closer to 15. Late 30s, around 20. At 40 and beyond, well over 20 eggs just to try for one pregnancy.

And that’s before chromosomal screening narrows the pool further. Bosworth describes watching her numbers drop cycle after cycle, how a promising retrieval count can end up with almost nothing viable. “Sometimes nothing,” Dr. Talebian says. “Sometimes nothing, sometimes nothing.” It happens more than people expect, and there’s currently no test precise enough to predict exactly how your eggs will perform ahead of time.

Why Bosworth’s doctor pumped the brakes before her transfer 

Bosworth had a low AMH at 33, which is a potential red flag for endometriosis (which Dr. Talebian now watches carefully in younger patients who aren’t getting pregnant or responding as expected). Instead of moving straight to a frozen embryo transfer, she flagged the possibility of an underlying issue first. They confirmed endometriosis and did an excision surgery before any transfer attempt.

If you’re failing chromosomally normal embryo transfers, something else is going on. Dr. Talebian recommends asking your doctor what testing hasn’t been done, and if you’re not getting a real answer, get a second opinion.

What Bosworth actually did differently before her best retrieval

Bosworth’s third retrieval, at 38, produced better results than either of her cycles at 33 and 35. She spent a year prepping: acupuncture, NAD+ injections, glutathione, cutting back on alcohol, and overhauling her diet and sleep.

Dr. Talebian has started recommending NAD+ to women over 35 who aren’t responding well, which started after noticing a pattern in patients who had outlier cycles with improved embryo quality. “I had a couple patients who were over 38, done some cycles, and each of them had an outlier cycle of just improved embryo quality and higher chromosomally correct embryos, and I was like, what did you do? And they had both done NAD,” she notes. The research is still early, but she considers it low-risk and worth trying. CoQ10, glutathione, and acupuncture all came up as well.

Basically, reducing inflammation through food, sleep, and lifestyle seems to matter more than Western-trained fertility doctors have historically let on.

Lab quality matters more than you think

Not all fertility clinics are running the same operation behind the scenes. “Your doctor is important, but honestly more important than your doctor is the quality of that lab,” Dr. Talebian says. The embryologists doing the fertilizing, freezing, and thawing are where outcomes diverge most from clinic to clinic.

The CDC and SART websites publish outcome data, but it takes some digging—live birth rate per embryo transfer is the number worth focusing on. How long a clinic has been operating matters too.

On stress and IVF

Look, everyone doing IVF is stressed. That’s just the reality of it. But Dr. Talebian reveals that stress alone won’t sink your cycle, which is totally reassuring, because there’s no way around it. Her advice? If you’re going through a genuinely traumatic period and have the flexibility to wait, wait. But normal stress? You don’t have to micromanage it. Sleep, eat well, hydrate, lean on your support system, and don’t stress about being stressed.

To hear all of Dr. Talebian’s insights, listen to the latest episode of Tell Me I’m A Good Mom wherever you get your podcasts.

Read More

• Your Kid’s Emotions Are Triggering You—Here’s Why That’s Not Your Fault
• Menopause Fact vs. Fiction: Why You Suddenly Don’t Feel Like Yourself
• A Parenting Checklist for Raising Confident Kids, Not Just Obedient Ones