One consultation can replace so much fear with clarity.
– Dr. Bana Kashani
Fertility can feel overwhelming, especially when you’re navigating unfamiliar terms like IVF, egg freezing, genetic testing, and even artificial intelligence in the lab. For many individuals and couples, the desire to build a family is deeply personal, yet the path forward can feel confusing, emotional, and filled with unanswered questions. That’s exactly why conversations that make fertility care simple, clear, and hopeful are so important.
In this interview, Stacey Chillemi sits down with double board-certified fertility specialist Dr. Bana Kashani, who practices in Orange County, California. Drawing on years of experience in reproductive endocrinology and infertility, Dr. Kashani breaks down fertility basics, IVF, egg freezing, genetic testing, and how AI is showing up in the fertility space… all through a lens of compassion and personalized care.
Thank you so much for joining us! Our readers would love to get to know you a bit better. Can you tell us a bit about your backstory?
Thank you so much for having me. I’m a fertility specialist based in Orange County, California, and I’m double board-certified in Obstetrics and Gynecology as well as Reproductive Endocrinology and Infertility. My passion really developed during my training, when I saw some couples struggle deeply to conceive while others who didn’t even want children became pregnant easily, and it felt like the world wasn’t always fair. That question of “What can I do to help balance this, even a little?” led me into reproductive endocrinology, and eventually to building a personalized practice in the community where I grew up. Infertility isn’t just a medical issue—it’s emotional and relational—so my goal has always been to create a space where patients feel truly heard, not like a number, and to walk with them step by step toward the possibility of a child.
Many people feel a lot of shame and fear even booking that first fertility visit. How do you approach that first consultation?
I know that simply making the first appointment can feel huge, especially when there’s still a taboo around struggling to get pregnant or carry a pregnancy. In that first consult, I want people to feel they can exhale, tell their story, and not be judged or rushed, which is why I set aside a full hour for new patients. I listen carefully, ask focused questions, and then outline a plan that fits their situation instead of overwhelming them with unnecessary tests. I truly believe knowledge is power—the more you understand your body, the less fear controls the process—so I want them to leave feeling the journey may be hard, but they are not alone and there is a clear, compassionate path forward.
For someone just starting, how do you explain fertility basics like egg quality, sperm health, and ovulation in simple terms?
I like to break it down into four simple pillars: male factor, uterine factor, tubal factor, and ovarian factor. The male factor is all about sperm—how many there are, how well they move, and how normal they look—and a straightforward semen analysis answers that, which is critical since at least a third of couples have something contributing on the sperm side. For women, we look at the uterus itself, your “baby room”, to be sure there are no fibroids, polyps, or scar tissue crowding the space, then we look at the fallopian tubes, which are like hallways where egg and sperm must meet. Finally, we focus on the ovaries and egg quality, which is closely tied to age; eggs are usually healthiest in the 20s, start to show more changes in the 30s, and become more often abnormal in the 40s, which drives miscarriage and chromosome issues, so understanding your cycle pattern and whether you ovulate regularly becomes a key piece of the puzzle.
When should someone see a fertility specialist instead of just “waiting and trying”?
There are some simple timelines I like to use as a starting point. If you’re under 35 and have been having regular unprotected intercourse for a full year without conceiving, it’s time to be evaluated, because most couples in that age range who will get pregnant do so within that first year. If you’re 35 or older, I recommend coming in after six months of trying, so we don’t lose valuable time when age is such an important factor. Beyond that, there are situations where you shouldn’t wait at all—very irregular periods, known polycystic ovary syndrome, a partner with a history of chemotherapy or testicular surgery, or significant endometriosis and pelvic pain—because those are clear signs you may need help right away, rather than hoping things will fix themselves.
Which early tests really matter, and which tend to be overhyped?
The semen analysis is one of the most important and most underused early tests. Many men feel fine and assume everything is normal, but only a microscope can tell us about count, movement, and shape, and the good news is that sperm regenerate roughly every 72 days, so there is often room to improve things if we find an issue. For women, I focus on ovarian reserve testing: an ultrasound to count small follicles, those little black “chocolate chips” in the ovary that represent egg quantity, and a blood test called AMH to give a sense of egg numbers and reproductive timeline, even though it doesn’t predict a specific month’s pregnancy chance. On the other hand, broad immunologic panels and extensive blood clotting workups are often overused early on and can add anxiety and cost without changing the plan, so I prefer to start with semen analysis, ultrasound, AMH, and confirming ovulation, and then only expand when the clinical picture suggests we should.
Can you walk us through IVF in plain language, the steps, timeline, and what patients usually experience?
Each month, your ovaries have a group of eggs ready to grow, say around 15, but in a natural cycle, your body chooses one to ovulate and lets the others quietly disappear. IVF is about not wasting those extra eggs: we use medication to help many of them grow at once, then retrieve them before they naturally die off. You get your period, start small daily injections under the skin for about ten nights, and come in for ultrasounds and blood work so we can track how your follicles are developing; when they’re ready, we schedule a short egg retrieval under light sedation, done vaginally with no incisions, and most people rest that day and are back to usual activities the next. The stimulation and retrieval phase usually takes less than two weeks, and then in the lab, the eggs are fertilized, embryos grow for five to seven days, and we can decide whether to test them for chromosomal issues and either transfer an embryo soon after or freeze them to transfer in a later cycle, even several years later.
Fertility treatment can be such an emotional roller coaster. How do you keep IVF patients grounded, supported, and feeling truly cared for?
I never underestimate how emotional this process is; hormones, injections, past losses, and future hopes all become amplified. One way I support patients is by being very present: I personally perform their ultrasounds, and after each visit, we sit together to review results and next steps, instead of them piecing information together from staff messages or internet searches. That consistent face-to-face connection helps them feel seen and lets us correct misinformation they may have picked up. I also encourage supportive tools like meditation, yoga, acupuncture, and a thoughtful support network so that medically we’re doing all we can, and emotionally they feel held by both science and compassion throughout the journey.
Who is egg freezing really for, and what’s the best age window to consider it?
Egg freezing can benefit many women, but timing makes a real difference. If we keep it simple, doing it before 35 is ideal because about 70–80% of eggs in that age range are good quality, so each egg has a better chance of leading to a healthy pregnancy later. Women over 35 can absolutely still freeze eggs, as in the case of a 39-year-old egg freezing patient, but we talk honestly about likely needing more eggs and sometimes more than one cycle to reach the same level of reassurance. I especially encourage women in their late 20s and early 30s who are in long training paths, demanding careers, or still looking for the right partner to at least get their fertility numbers checked, because there’s no crystal ball for how life or fertility will unfold, and one month of commitment to egg freezing can give your future self valuable options.
How many eggs should someone aim to freeze for a realistic chance at a future live birth?
This is one of the most common questions I hear. Earlier guidance suggested women under 35 aim to freeze around 15 mature eggs for a good chance at one live birth, and women around 40 aim for closer to 30 or more, because age changes the chromosomes inside the eggs. Newer data breaks it down into a per-egg chance: for women 35 and under, each mature frozen egg carries about a 13% chance of leading to one live birth, while for a 40-year-old, each egg has about a 4% chance. Practically, that means a younger woman might feel comfortable freezing 10–15 eggs, while a woman closer to 40 may need 20–25 or more, and it explains why younger women often complete this in one cycle, while older women sometimes need two or three cycles.
For single women and couples, what practical medical, emotional, and financial tips do you share around egg freezing?
I always start by acknowledging the financial reality, because it’s a real and often frustrating part of this journey. It doesn’t feel fair that infertility and fertility preservation aren’t universally covered like many other medical conditions, but the landscape is changing: more states are mandating coverage, more employers are adding fertility benefits, and for those without coverage, there are grants, fertility-specific loans, and low-interest credit options that allow costs to be spread out. Medically and emotionally, I encourage people to see egg freezing as giving a future version of themselves more options; you may never need those eggs because things go smoothly later, which is wonderful, but if you do need them, you will likely be very grateful you acted when you could. Whether single or partnered, it’s about understanding your numbers, your timeline, and your values, then making a thoughtful decision that honors both your present life and your future hopes.
Can you clear up some misconceptions around PGT and the fear of “designer babies”?
PGT, or pre-implantation genetic testing, sounds more intimidating than it is. When an embryo reaches the blastocyst stage, it has an inner group of cells that will become the baby and an outer group that becomes the placenta; during PGT, we take a tiny sample of 5–10 cells from that outer layer and send them for chromosomal analysis. It’s a powerful screening tool but not a 100% guarantee, yet when an embryo tests chromosomally normal, the chance that the baby will be healthy from that standpoint is about 98%, which is deeply reassuring for people who have endured miscarriages from chromosome problems. A more targeted form, PGT-M, helps identify embryos affected by specific single-gene diseases in couples who both carry a mutation, allowing us to avoid transferring embryos with severe conditions, but what we cannot and do not do is build “designer babies” with custom hair, eye color, or height; the goal is to spare families devastating diseases, not to engineer cosmetic traits.
Where is AI already showing up in fertility labs, and what excites you most about it?
One of the most exciting uses of AI in the lab is the embryoscope, an incubator system with a built-in camera that takes time-lapse images of each embryo as it develops from one cell to two, four, eight, and beyond over five to seven days. Instead of constantly moving embryos in and out of the incubator to check under a microscope, embryologists can watch a continuous movie of development and use that information to better understand which embryos are progressing well, while keeping them in a stable environment. AI is also starting to assist with techniques like ICSI and improving tracking systems through RFID labels on dishes, adding safety and reducing the chance of mix-ups. On the clinical side, some algorithms are emerging to help interpret ultrasounds and suggest retrieval timing; I see them as promising, especially where there are fewer fertility specialists, but still as tools that should enhance, not replace, experienced human judgment.
With AI in the mix, what should patients ask about privacy, data use, and validation of these tools?
Patients absolutely deserve clear information about how their data is used. If a clinic is partnering with an AI company on the clinical side, it often means patient data—such as ovarian reserve numbers, medication doses, and responses—may be analyzed to build or refine algorithms, and in those situations, you should be told and given the choice to participate or not. In the lab, tools like the embryoscope are usually used internally, with data staying within the clinic to help monitor and select embryos, but policies can vary. I always encourage people to ask whether their clinic works with any outside AI companies, how their information is stored and protected, and whether these tools are supportive aids or primary decision-makers, so they can feel confident their privacy is respected and technology is being used thoughtfully.
Is there a patient story that especially shaped your journey as a fertility specialist?
Many stories have stayed with me, but one young woman in her early 30s stands out. She conceived naturally, seemed to have a healthy pregnancy, and then suddenly went into preterm labor around five months and lost her baby, which was profoundly traumatic. Because of heavy bleeding, she needed a procedure that damaged her uterus, and she was later found to have a shortened cervix, so even after surgeries to remove scar tissue and support the cervix, her uterus never fully returned to how it was. Despite suggestions to give up carrying and rely only on a surrogate, she spent two to three years going through IVF, procedures, and multiple attempts; she ultimately carried one baby herself and then welcomed a second child through a gestational carrier, and today she has two healthy children. Her resilience is a powerful reminder of how deeply meaningful this journey is and how honored I am to walk beside patients through it.
If someone wants to explore IVF or just check in on their fertility, what one-week action plan do you suggest?
In one week, you can gain a remarkable amount of clarity. Start by scheduling an appointment with a fertility specialist and getting foundational tests: an ultrasound to look at your ovaries and count follicles, an AMH blood test to assess egg quantity, and a semen analysis if you have a partner. It’s also helpful to check thyroid function, vitamin D, and basic blood counts, since all of these can influence ovulation and overall reproductive health. At the same time, begin simple lifestyle upgrades—start a prenatal vitamin, cut down on highly processed foods, add antioxidant-rich fruits like blueberries and pomegranates, reduce alcohol and excessive caffeine, and become more mindful of environmental exposures such as plastics and certain cookware—so that by the end of the week you not only have real data but have also taken concrete steps to support your fertility and well-being.
Are there any persistent myths about fertility and IVF you wish you could erase, and what’s one key question patients should ask their clinic before starting?
One myth I would gladly erase is the idea that IVF causes autism. The best data we have, including large registry studies from places where IVF is widely used, do not show IVF itself as the cause of higher autism rates; what stands out more is advanced paternal age—the age of the male partner—so it isn’t accurate to place the blame on the IVF process alone. Another misleading belief is that it’s easy to get pregnant after 40 and that IVF with your own eggs will automatically work, when in reality, national IVF success rates using your own eggs at age 42 are only about 5–10%, which is much lower than many people assume from celebrity stories. One key question I encourage patients to ask is, “Given my age and my specific situation, what do you estimate my chances of success are here?” and to pair public clinic data with an honest, individualized conversation so expectations are based on their real scenario.
From everything we’ve discussed, what key lessons do you most want readers to remember?
The first is that age truly matters; life moves quickly, and it’s easy to keep pushing family-building into “later” until you suddenly find yourself in your late 30s or 40s with fewer options using your own eggs. I don’t say that to scare anyone, but to encourage proactive thinking—checking in on your fertility earlier can profoundly change the choices available to you. The second lesson is that your daily decisions add up: what you eat, how you manage stress, and what you’re exposed to environmentally all influence egg and sperm quality, as well as your long-term health as a parent. Finally, I want people to let go of shame around asking questions; you don’t need to be ready for treatment to seek a consultation, because simply knowing whether your tubes are open, your sperm count is adequate, or your ovarian reserve is appropriate can replace fear with a plan.
Can you share a bit about the services you provide in your practice?
In my practice, I offer a wide range of fertility services tailored to each person or couple. That includes fertility preservation like egg and embryo freezing, both electively and for patients preparing for treatments such as chemotherapy that could harm fertility, as well as support for those struggling to conceive through options like ovulation induction, intrauterine insemination, and IVF with pre-implantation genetic testing when appropriate. I also care for people experiencing recurrent pregnancy loss, working to understand and address the underlying causes, and I perform uterine surgeries to correct issues such as fibroids, adhesions, or congenital malformations that interfere with pregnancy. Through South Coast Fertility Specialists, we also provide infertility assessments, ovarian reserve assessment, and care for conditions like PCOS, endometriosis, abnormal uterine bleeding, uterine fibroids, uterine polyps and adhesions, and more, always with a strong focus on personalized, concierge-style care so each patient feels genuinely seen and supported.
How can our readers further follow your work online?
I’m based in Orange County, California, and you can find me through South Coast Fertility Specialists at southcoastfertility.com, which shares more about our clinic and services. For those who are not local, we offer virtual consultations, including Zoom, so we can connect, review your situation, and discuss next steps, no matter where you live.
I also have a personal website at banakashanimd.com, where you can learn more about my background and approach. On social media, I’m active on Instagram as @dr.banakashani and Facebook, where I share educational content and insights related to fertility and reproductive health.
Thank you so much for sharing such clear, compassionate guidance today. I know our readers will feel more hopeful and informed after hearing your perspective.
Thank you, Stacey. It’s been a real pleasure talking with you, and I’m grateful for the chance to support your audience on their journeys toward building the families they dream of.
