Podbit · The Peter Attia Drive
The first IVF baby was born in 1978. Louise Brown is 48. We have no idea what IVF-conceived people look like at 60 or 70. There may be epigenetic effects from fertilization outside the fallopian tube that we simply cannot yet measure. For couples who can conceive naturally, Tomioka still recommends trying.
Where this was said
At 1:39:20 · chapter starts 1:32:29
Peter invites Tomioka to survey the technology horizon for women who want to use their own genetic material at advanced age. Mitochondrial replacement therapy, developed for mitochondrial disease and published in the New England Journal of Medicine by a Newcastle group, transfers nuclear material (pronuclei) into an enucleated donor egg to replace defective mitochondria — but the chromosomes, the actual source of age-related aneuploidy, remain the patient's own. [1] — Renato Tomioka "Mitochondrial replacement therapy swaps the cytoplasm around the nucleus but doesn't fix the chromosomes — the actual source of age-related…" 1:33:40 Tomioka bluntly labels clinics in North Cyprus and Greece selling this as 'egg rejuvenation' as misleading: 'It's a battery swap for the egg, but you're not changing the engine.' Ovarian cortex cryopreservation — freezing a slice of ovarian tissue in one's 30s and reimplanting it at 45 — is theoretically capable of postponing menopause by 10 to 15 years but lacks clinical data and is arguably inferior to standard hormone replacement therapy. [2] — Renato Tomioka "If pluripotent stem cells can be reliably converted into functional, chromosomally normal eggs, age becomes irrelevant to fertility. It has…" 1:36:30 The most transformative technology on the horizon is stem-cell-derived eggs: pluripotent stem cells converted into functional oocytes. It has been demonstrated in mice with normal offspring. Tomioka estimates clinical reality is about 10 years away, at which point age becomes largely irrelevant to fertility. He closes with a nuanced caution about IVF itself: Louise Brown, the first IVF baby, is only 48. Epigenetic effects of fertilization outside the fallopian tube remain uncharacterized, and selection bias makes epidemiological studies hard to interpret.
Mitochondrial replacement therapy swaps the cytoplasm around the nucleus but doesn't fix the chromosomes — the actual source of age-related infertility. Clinics in North Cyprus and Greece are marketing this as egg rejuvenation. It isn't. The engine is still old; you just changed the battery.
If pluripotent stem cells can be reliably converted into functional, chromosomally normal eggs, age becomes irrelevant to fertility. It has been done in mice with normal offspring. Larger animals are next. Renato Tomioka estimates 10 years to clinical reality — and when it arrives, egg freezing becomes obsolete.
Self-help fails because people are sold one universal cure by the hyper-responders who had a transformative result from it. The real problem is context: every method works for the right person at the right time, which is almost never you just because the author says so.
Spencer Greenberg was once so socially anxious his heart pounded just approaching a stranger. His therapist gave him homework: go to a bar alone, talk to 5 strangers. Starting with asking for the time, he worked up to asking men for hugs — and his anxiety fell dramatically in 6 months.
A person who flies regularly but obsessively checks weather forecasts before every flight is not doing exposure therapy — they're teaching their brain that flying is only safe with the ritual. Safety behaviors prevent the brain from ever learning that the feared thing is actually fine.
The worry-time technique assigns all worries to one scheduled slot (e.g. 5 PM). Every time a worry surfaces, you write it down and ban yourself from engaging with it until that time. When 5 PM arrives, most worries feel trivial and the act of batch-worrying exposes how little it actually accomplishes.
In a randomized study of 20 habit techniques, 'habit reflection' stood out: recall a past habit you successfully built, write down what helped you succeed, then apply those same strategies to your new habit. It works because it's self-adapting — it uses whatever worked for YOU.
The tiny habits technique — always having a minimal version of your habit you can do when life gets in the way — keeps the mental machinery of habit formation from breaking. Paradoxically, people given a tiny-habit fallback option were MORE successful at the full habit, not less.
Fears and worries act like playground bullies — they want to ambush you. But when you deliberately seek them out and choose the time of engagement, they lose their power. The volitional act of starting the fight on your own terms is one of CBT's most underappreciated insights.
Most downtime defaults are things you regret immediately after — phone scrolling, binge TV. 'Glad you did it' activities meet the same need for rest but leave you feeling like you spent your time well. The switch from a bad screen to a documentary, a book, or a walk costs almost no extra effort but compounds into identity over time.
You rarely control your first reactive thought. But you can train your second thought — the response to the trigger — by asking whether your initial reaction is the most helpful one and replacing it with something equally true but more constructive. Over time, that second thought becomes automatic.
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