This week Maria and Roisin discuss how we can help you achieve your pregnancy goals in 2023
Fitness Fertility Podcast
Maria: Ultimately, what it comes down to with fertility is how long you have until you will be starting treatment.
How do you keep women motivated?
Efficiency in 2023
Find the full transcript of our show here: https://the-fitness-fertility-podcast.simplecast.com/episodes/ttc-2023
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Maria: Hi, I'm Maria.
Roisin: And I'm Roisin.
Maria: And welcome to the Fitness Fertility podcast. This podcast is all about how improving your physical fitness can help support you on your very own fertility journey. I'm a personal trainer who specializes in training women with fertility problems. I myself have PCOS and have had two beautiful boys, and I'm on a mission to help you do the same.
Roisin: Before we get into it, we will be discussing adult themes such as where do babies come from, pregnancy loss and bereavement. We may also be sweary from time to time. We are optimistic, lighthearted girls, but we know this is a really stressful time for some of our listeners. We respect that.
Maria: Happy New Year, everybody. I cannot believe that it is 2023, but here we are. In this week's show, we are discussing TTC 2023. So trying to conceive in 2023 and Roisin and I will be discussing everything you need to know when it comes to fitness for fertility.
Roisin: And we've made some bold New Year's resolutions this year, the boldest of which is……
Maria: Roisin and I are going to try and get as many women pregnant as is humanly possible in 2023.
Roisin: That's the goal.
Maria: That's the goal, people. We have high aspirations. We're on it. So TTC 2023, Roisin and I are here to get you pregnant. This is what we want to do. So our goal this year is to help as many of you as possible with your fitness and fertility training needs. So we're going to start off today by looking at where on earth you even begin when it comes to choosing a program to help support you. So often, they just don't know where to start. And so, this is what we're going to talk about today.
Roisin: And I think anyone that is on any social media would now recognise that 20,000 different diets that would have been recommended 20,000 different ways of exercising, do you know, it's actually really confusing. Just say that I've come to you for the first time. I'm absolutely new to the TTC journey, where would I start?
Maria: Ultimately, what it comes down to with fertility is how long you have until you will be starting treatment. And for me, the easiest way to look at this because the thing that normally determines that is whether or not you need to lose weight and how much weight you need to lose, because for a lot of people, that is the main barrier to starting treatment. And that is the thing that dictates how long it will be until you start treatment. The easiest way that I would put this is if you have let's say 12 pounds or more, so roughly five or six kg or more, realistically, you're going to be looking at round about 12 weeks, just roughly everybody's different one to two pounds a week, so half a kg to a kg a week. If it's more than that, you're going to be longer than three months out, I would honestly say, and that needs to be factored in. And the reason this is really important is if you are three months or more away from starting treatment, because you have more weight to lose, I would say you're going to need a different type of training to someone who is closer to fertility treatment. So that would be my starting point.
Roisin: We'll say that I am in the group that does not need to lose a huge amount of weight. What kind of training would you design for me?
Maria: If you're in a group that doesn't need to lose as much weight, that means you're closer to treatment. And if you're closer to treatment, we need to make sure your body is ready to have the first round of IVF or ICSI or whatever it is you're doing. And what ready means is your body isn't too stressed, your body is in a really fit and healthy state, but your adrenaline levels aren't too high, your cortisol levels aren't too high, that your body fat is an appropriate level for trying to conceive. So that's where you need to have knowledge of the requirements that are suitable for fertility. What the research now shows is that the maximum number of hours you want to be working out for fertility friendly training, you're looking at no more than four, maybe five a push hours a week. So most pieces of research would say, don't go any more than that. So four to five hours a week, don't go any more than that when you're training with fertility in mind. And then the other thing that research talks about is you don't want to be doing intense training when you are getting that close to fertility treatment. If you are in that kind of second group, like we're talking about them, these are two key factors that need to be taken into consideration because you're now getting close to treatment, which is amazing and it's really exciting, but that means you need to start preparing physically for that treatment to give yourself the best possible chance. You know, we always talk about just little nudges, but all of these are little nudges to help you be in the best possible shape for starting that treatment. And this is why you need to make sure that your trainer understands fertility because we don't want to be smashing you at that time. And we need to bear that in mind. The first group, the other group who need to perhaps lose more weight before they can have that 29 BMI, losing that weight is going to take longer. So therefore you are further out from treatment. And I wish it wasn't the case, but unfortunately it is true. But what that means is we can do a different type of training at the beginning to focus on the weight loss. And as you then get closer to the fertility treatment, we can then tailor that training to make it more fertility focused, but we would change the training that you're doing to basically merge you into that second group way of training to make sure that everything is nice and fertility focused. But to begin with, let's just burn the calories, let's burn the fat in a safe way, but we need to get that BMI down.
Roisin: It's all about the clock when it comes to fertility. We always say that, but also it's about knowing when to apply the pressure and when to relieve the pressure. So obviously you are providing more intense training packages for people that have more weight to lose, which makes sense. You want to get that off your body real quick, but also you want to make sure that you're tapering down the girls that are about to go through treatment. So you're not complicating an already quite complicated situation. Is there different exercises then if I'm part of first group or the second group, what kind of training would you recommend? Just top line.
Maria: In that group number one, the group that are further out from treatment and really need to lower that BMI, there are a couple of different options, but the two that I would explore and then I would see how the person responds is I would look at the higher intensity training if it was safe to do so. I say if it was safe to do so because it does depend on your history of training. Are you comfortable with training? I would look at the HIIT training because it is a short, sharp shock to the body. When you're further out from treatment, we can do the higher intensity training. And what that means is it would look like 20 seconds on and then maybe 20, 30, 40 seconds rest, depending on where you're at with your fitness. And you then repeat that and you maybe repeat that for again, 15, 20, 25 minutes on, off, on, off. You might do burpees, you might do squats, you might do the step ups, but you're working at a higher intensity level. And the idea is you're burning fat and it is a really good way to burn fat. The reason that we can do that in kind of group one, but I would not advise that in-group two, is because it does put the body under a lot of stress. So yes, it is good for burning fat and it's good for losing weight, but it does put your body under stress and we don't want to be doing that as much when you're closer to treatment. So that's one option that I would look at if you're kind of further out for treatment. The other option is, and we have talked about this before, but I would also look at weight training, resistance training, because like we've said before, it doesn't always look quite as dramatic in the gym, but it is a really good way to burn fat and it's a really good way to build muscle. And muscle will burn more calories than fat. Your base rate of burning calories will be higher, just sitting still, than if you have less muscle and more body fat. So it's a really, really good long-term investment and that's brilliant for people that are further out from treatment because you're building up, you're setting your body up to burn more calories for longer. So they are the two that I would go to. And then I would see how my client feels because if they hate HIIT training, I would switch it up because if you hate something, you're not going to do it. Consistency is key, Roisin isn't I laughing, but it is 100% true because if you hate it, you're not going to come back. Okay, you might bust it out for three weeks and then the novelty wears off and you're like, I'm done and we're back to square one. But I would start with those two. Start with HIIT training; see how you get on with it. Start with weight training if you prefer, see how you get on with it. And whichever one you enjoy the most and if your body's responding, I would stick with that because we need you to keep coming back. The other thing, I was just chatting to a lovely lady and what we were saying was, find a sport that you like, join a team. And I really mean this from the bottom of my heart, it ticks so many boxes. If you really like netball in school, go find your adult netball team. Why the heck not? Find a basketball team, try a completely new sport. I tried cricket, that was loads of fun. And what you can do is that then tops up your training in the week. So not only does it physically burn more calories, it gets you moving, it gets you off the sofa. It builds another community and you will find friends and you'll find support and it gets you out the house for a bit. For 2023, don't over complicate it but just find a sport you like and go and try it. Why not? You might fall in love with that sport and then you train twice a week, you train three times a week. That's amazing. So that would be my other piece of advice for the longevity. Do something you enjoy.
Roisin: If you have to lose a lot of weight, you've got to keep it easy in order to keep it consistent. It can't be all stick and no carrot. I always love the idea of sports because eventually the exercise becomes a secondary thing. You may feel shocking on the netball pitch for the first couple of games. Once you get fitter, then suddenly it's all about winning and the health and the weight loss is just beautiful side effects of your activity. There's nothing worse than being on a treadmill, trapped on a treadmill, just going nowhere.
Maria: I can't do it anymore. I can't stand it. And there are all some things you can do on a treadmill which we can maybe talk about another day but no, I agree with you. Unless you love treadmill work, some people do, you're not going to go back. I also just want to pick up on something else you said there about what we were saying at the very beginning is you go on Instagram at this time of year and you see all these trainers and they're all ripped and they're doing all these really complicated workouts. Honestly, that is not what real fitness is. Real fitness is doing the basics, enjoying it and just going back all the time. And there's one particular person on Instagram that I do follow and he's really good and he repeatedly says, and I completely agree, if people showed you what working out really was, you wouldn't have any followers on Instagram because it's just in the basics. It's doing the squats, it's doing the burpees. It does not need to be complicated. It's going out with your friends and playing a game of netball. That's what fitness is. But that doesn't sell on Instagram. So unless you're on the fitness fertility page, obviously, don't go on Instagram for fitness. Okay, that is my advice to you all.
Maria: Sorry to interrupt, but I know that you want a baby in 2023. I'm just here to let you know that I have a number of fantastic training plans designed to support you at whatever stage of your fertility journey you are at. So whether you need to lower your BMI, whether you need accountability support or whether you just want to throw everything you've got at making 2023 your year, then I am here to help. So head over to fitnessfertility.com training for fertility to find out more or booking for a free consultation at fitnessfertility.com forward slash free consultation to discuss your very own personal fertility needs.
Roisin: I'm assuming if I was part of group one, I may not be coming to you willingly. I may be coming to you because I've been sent away from a clinic. I could have a BMI over 30. So therefore I've tried dieting before I've tried exercising before it's not work. I'm not really coming to you because I want the pleasure of your company, Maria. I'm kind of been slightly dragged to it because if I want to have the baby, I have to lose the damn weight. And I don't know how to lose the damn weight because I've never been able to lose the damn weight. And how do you keep those women motivated?
Maria: I would say there's two things here. This is where accountability is massive. And to be honest with you, just building a relationship with your trainer, and I will be completely honest, you have to find a trainer that you got on with because of the accountability. Accountability just to be clear is where you basically have someone looking over your shoulder. You know, you've got someone week in, week out. Hey, are you working out today? When are you going to do your next workout? I noticed that you didn't do your workout on Tuesday. Let's work together so we can figure out when you're going to do it. And I'm going to check in with you afterwards. So accountability is someone who holds you accountable to what you have said you will do. And it's really important because just knowing that someone is going to check in, like quite often if I just message people and say, hey, how are you doing today? The reply I get is I'm working out. I'm going to do it tonight. You know, I'm coming. I'm going to do it. I'm going to do it. And just knowing that you've got someone looking over your shoulder, basically that's massively important, especially for people who do have more weight to lose because the novelty will probably wear off. So you need someone that's been looking over your shoulder saying, look, when are you going to do your next workout? And that's where; again, in all honesty, that relationship with your trainer is really important. When it comes to fertility, it's really important. You know, you need to be able to talk to your trainer about your period. You need to be able to talk to your trainer about ovulation. You need to be able to talk to your trainer about IVF.
I've just had a conversation with someone just in the last hour. They're currently going through stims for IVF at the minute and they were looking at when's the best time to train. So basically they're taking the stimulation medication so they can do an egg collection in the next week or so. Now, because I am a fertility personal trainer, what I could explain to her was the reason your fertility clinic have told you to be careful is because the thing they're worried about is ovarian torsion. There is only about a 1% chance of ovarian torsion. But what that is is where your ovaries get so stimulated, if you twist and jiggle them around, they can twist on themselves. And that's really, really dangerous. It's really important that you have a relationship with your trainer that you can talk to about those things. So relationship and accountability, to answer your question, are some of the key ways to help people that really don't want to be doing it.
Roisin: And accountability has been proven to work. It is the secret sauce between getting up and doing the exercises and hiding away. I think it's because you feel like there's a team involved. In a weird way, we can lie to ourselves, but it's very, very hard to lie to others. If you are a larger lady and you know that your treatment is going to be so far out, 2023 may not be a year that you will be able to conceive. So the plan really is to try and get them to that point as soon as humanly possible. So to really help them work through the stages of the weight loss in a controlled way and get them to that magical place where they need to start tapering and getting ready for treatment. And then you suddenly drop into that second group where they're just trying to put themselves in the very, very, very, the optimum place for treatment. So what does that look like?
Maria: You're coming into group two, or you've worked really hard and you've gone from group one into group two. In that group two session, what we're going to do is we're going to lower the intensity so that you're still maintaining fitness. You might need to lose a little bit of weight, but it's not such an extreme amount of weight. And we're going to lower the intensity and we're going to start to prepare your body more for fertility treatment that should then be on the horizon. So we're going to make sure that your body is in a good physical space for treatment, but we don't want your body to be overstressed because that has been shown again through research to do with the cortisol, which is your stress hormone, that has been shown to interfere with ovulation. So we're going to change your training like a nice little progression. We're going to lower the intensity. It might also be that we lower the number of hours you're working out per week. So like I said earlier, a lot of the research is now shown really you're looking at four, fourish hours maximum a week. And more than that has been shown to be detrimental to lots of different things really, but including trying to actually conceive. It might be that in that situation you still need the accountability support though, because we've talked before about, you know, you hit your goal. We were talking about this earlier. You hit your goal BMI and you're delighted with life. You know, for a solid week, you're like, boom, I am where I want to be. The jeans are looking good. The top's fitting in all the right places. So you treat yourself to a bagel. We've all been there people. I like a bagel with butter. I'm not going to lie.
Roisin: Celebrationary cake. I've done it every time.
Maria: We celebrate with the cake. We have the full fat latte. We love it. For the first week or so makes no difference whatsoever. So then you have another celebratory cake and then you know where I'm going with this. So the difficulty that we have from a psychological perspective is you've worked your ass off basically to get into this kind of, let's call it group two that we've been talking about. You celebrate, absolutely why not? But then the weight starts to come back on. And this is where the maintained accountability is super important. And again, the accountability support has to change. So it has to go from, okay, so we're not looking at dropping the weight now. We're looking at maintaining the weight. We might need to adjust your nutrition a little bit. We might not want to be in a calorie deficit, but we still want to keep the diet balanced. We still want to keep the nutrition balanced. So there might be a bit of an adjustment in terms of what you're eating as well. And like I said before, you're going to need to adjust the type of training that people are doing as well. So there are a few things that need to be adjusted when you move closer to actually starting fertility treatment. And they're really important adjustments to make because as we're always saying, it's little nudges, everything in the right direction to make that treatment to give it the best chances possible of being successful.
Roisin: We said this at the beginning of the show, but we know this is such a stressful time. And we recognize that we are advocating taking away crutches. We all have a thing. Mine's cake and wine.
Maria: Mm hmm. Followed by some cheese.
Maria: Hang on, you have cake and then cheese.
Roisin: And I have cake and then I have a cheese and wine board.
Maria: I didn't know people did both those things.
Roisin: They usually don't, Maria. They usually don't.
Maria: This is your niche.
Roisin: That idea of when you're stressed and when you're worried and anxious and concerned and someone wants to take away those things that make you feel better. So tough to say to someone, oh, we're going to do this for a year. It's daunting. The idea of having reasonable goal setting and accountability, someone in your corner that knows what they're doing. It's vital because you're going to need support. Near on impossible to do all of these things by yourself and no one should expect you to either. This is difficult stuff and it cannot be underestimated by how difficult it is.
Maria: A lot of people can stick to a diet or nutrition or a fitness plan for two to three weeks. Absolutely. Some people can stick to it for two to three months. Very few people can completely change their lifestyle for a long period of time. And that's where the accountability comes in because you need someone to help you. And the other thing that's really important because what we're talking about is changing your habits, which obviously is very topical at this time of year. It's very, very difficult to change your habits. And a lot of research has shown that actually it's nearly impossible to change habits that are hardwired into your brain. So what you need to do is kind of interrupt the flow of those habits. And again, this is where the accountability comes in, but it's also one of the things that I support clients with is we can set habits that we're going to work on. Now, our weekly check-in, we will talk about how have you got on with the habits today. So to give you an example, if you drive home a particular way and you always drive past McDonald's and you always stop in for a milkshake, you're not going to suddenly wake up on January 1st or the next Monday of the week and just not do that anymore. You might not do it for the first day. You might not do it for the second day, but when you're tired on Wednesday because you've had a difficult business meeting, you're going to stop at that McDonald's. So what you need to do is we would need to set you with a different habit and the habit might be I'm going to take a different road home if it's possible, or I'm going to put a podcast on that I'm listening to when I drive past McDonald's to try and distract me from the fact that I've driven past McDonald's. You need to put different habits in place or I'm going to have chewing gum in the car and I'm going to chew gum so that I'm not in the mood for the strawberry milkshake. Setting clients up with healthy habits and that is one of the things that I like to do. We keep it simple. Habits are in your brain. Your brain likes the nice food. It likes the fat. It likes the salt. It likes the sugar. Your brain doesn't like to be told no. So you have to try and distract your brain.
Roisin: You absolutely need those habit interrupters, don't you? Otherwise, not only does your brain like the sugar and the sweetness, it also likes the routine. The amount of times that I eat an absolute autopilot, I've finished it and I've completely forgotten that I've eaten it. In order to break habits, you have to be quite mindful about them and that takes energy. But new habits can be formed. We have this year to get you pregnant. We want you to use every single day small ways to improve your fitness, hopefully decrease your weight and get you closer to your goal.
Maria: And you know, it's a cliche, but we do want to try and keep you as, I hate the word, relaxed as possible. I know that being relaxed isn't going to get you pregnant, but especially when you get closer to fertility treatment, it's just all the little nudges. We don't want to be causing you stress through exercise. So yeah, if you can be in it for the long game, because if you lost a pound a week over a year, you know, you're looking at 50 odd pounds there. That's a significant chunk. It doesn't, those first couple of weeks with weight loss are really hard because you're like, I've lost a pound, big deal. It doesn't make any difference to my life. My genes don't feel any different. Nothing is different. No one can tell. That pound week on week on week on week on week, I always think, well, if someone said to you, Hey, listen, you'll wake up tomorrow and you'll be half a stone lighter. I'll take that. I'll be like, yeah, happy days. You know, if I need to lose weight, half a stone is a nice amount of weight that I would need to lose. If you can lose a pound a week, it's only seven weeks. So yeah, take the stress off; see it in the long game.
Roisin: I think there's something beautiful, just having a plan. For me, having a plan is, it's like a detox. I've got a beginning, I've got a middle and I've got an end and that's all I need. I just got to see the whole picture. Stress lives in the unknown. Can I ask you a question about cycle tracking? Do you train with people's cycles in both groups?
Maria: For anybody that has a regular cycle, because obviously with a lot of our listeners are not going to have a regular cycle, I would train to your cycle as much as you possibly can, because why not? It makes a difference. So if you have a regular cycle, it might be 28 days, it might be 32 days. If you have a spot before and after ovulation that I would definitely train to your cycle. And what this means is that you will have different energies at different phases in your cycle. And everybody is different, but kind of classically speaking, if you're in the phase before ovulation, a lot of people feel really good in this phase. This is a follicular phase and it's where you're growing those lovely follicles so that hopefully one of the lead follicles will release your egg and then hopefully it will meet a sperm that's looking for a nice egg to match up with. So in that follicular phase, a lot of people feel awesome. They will feel energetic, they will want to work out, they feel happy, they feel cheerful. That then leads up to ovulation, whatever day for you that might be. And again, for a lot of people around ovulation, you feel great. You have loads of ideas at work. You are happy to go and talk to loads of people. You're confident in your own skin. That couple of weeks is a really good time to train reasonably heavy, to do the high intensity workouts and to really kind of go for it. After ovulation, and for a lot of people you might then be in the two week wait as well, which is obviously really important for our fertility community. But after ovulation, the idea is that you work out in a less intense manner. There's a few reasons why, but the main reason is kind of your hormones at this point change. So your progesterone will start to rise and that will affect how you feel. So you want to train in a less intense manner. And the other reason for a lot of our fertility community is if you are in a two week wait, so this is the time between ovulation and hopefully when you don't get your period, this is the time where you may or may not be pregnant. And this is the time if you've had IVF, you know, people say kind of PUP-O, so pregnant until proved otherwise. A lot of people in this phase will act as though they are pregnant when it comes to their lifestyle. Because if you are, you want to do everything to maximise the potential success of that pregnancy. That's the luteal phase of your cycle. So it's the two week wait, but it's the luteal phase, your hormones change, you want to lower the intensity. It might be where you bring in more yoga, it might be where you spend longer on your cool down, it might be where you do kind of more mindful exercises. You can still train, but it's a slightly different type of training to the first half of your cycle. If you can adapt your training to your cycle, then that's a really positive, healthy thing to do. Because again, the thing is, you'll feel better because you're kind of matched up, you know, your training's matched to you and how you're feeling. You will leave the workout feeling better, you will come back for the next workout.
Roisin: Efficiency in 2023. We are all about getting this goal achieved. We're all about getting you pregnant. What if I am incredibly time poor, regardless of which group I'm in, I don't have time. What could you recommend?
Maria: I will talk about particular types of workouts that might suit you here. But the other thing I am going to say, just to be a bit wild and controversial, is can you do anything to change that? I know this sounds like I'm stating the obvious, but we quite often skip over this. If you are so time poor that you do not have time to work out, is there actually anything you can do to change that? And I know it sounds a bit, perhaps, presumptuous, but I think it is worth asking the question. Ultimately, your goal is to get pregnant. And that's your top priority. So there might be little adjustments you can make in your life. Is there anything you can actually drop? You might have to be a little bit selfish. So I think that's the first thing. Actually sit down and reflect. Can I find any more time in my day here? Is there anything I can drop? If you can't, and if you are still really full, the one thing I would say to avoid, if you can, is the resistance training. Just because resistance training is amazing, but it does just tend to take longer. Circuit training will be quicker, shorter bursts, 20 seconds on, 20 seconds off. Keeping the intensity lower if you are nearer to treatment, but you can still do the workout. You can still do the 20 seconds on, 20 seconds off. But resistance training, if we're being honest, does tend to take a longer gym session. Just because you have to have things like rests between sets.
Roisin: And then it is the other option. Get it up and out a bit earlier and just get it done. I prefer to exercise in an emptier stomach, personally. You can tick the box. You can get on with the rest of your day. Just set that alarm clock a bit earlier. So just to recap, because we want to keep everything real simple.
Maria: For your TTC journey in 2023, if you're in group one, which is where you've got a little bit more work to do to lower your BMI, and your main goal is to get that weight off, because we want to get your BMI into that nice healthy zone. This might be through HIIT training, which is safer at this point because you're further out from the actual fertility treatment. And also training with your cycle as much as you can. Look at when your follicular phase is, look at what an ovulation is, look at when your luteal phase is, if that's possible for you to do so. If you're then in group two, this is when you're going to be closer to treatment. You do need a different approach to training here. Your training needs to be supportive of fertility. So you're going to lessen the intensity. You're going to make sure you're doing less than four hours, well, four hours or less a week. And again, wherever possible training with your cycle. So knowing your follicular phase is, knowing what ovulation is, knowing your luteal phase is. And like we said before, that's just to try and make your training as efficient and as enjoyable as possible. Work with your body, not against it. Habits are really important. So you want to be building in healthy habits, but keep it really simple. Interrupt those habits and accountability is massively important, especially if you're on a journey that's going to be lasting that little bit longer. So have your accountability checking calls. You know, if you're with me, you can message me on the app and I'll message you back. But accountability and habits are also very, very important when trying to conceive in 2023.
Roisin: Make sure you eke out some time that you can dedicate to your exercise, but also to yourself. You know, do something fun. It's a long road. You might as well enjoy it. So Maria, who will we be speaking to next week?
Maria: We will be speaking to the fit midwife. So the fit midwife, her actual name is Nikki Oliver. Nikki is an amazing person to speak to because she is a midwife. She has experienced endometriosis and she also is a personal trainer. So we're going to get Nikki on to talk about training when trying to conceive, how she experienced endometriosis and really importantly, when you become pregnant, the type of information that you should be giving to your midwife so that they can support you on your pregnancy journey. Because we know that after treatment and after experiencing fertility, that can be a really tricky time.
Thank you so much for listening to this week's show. Remember to subscribe to get a shiny new episode each week and please rate, comment and really importantly share with your friends, especially our trying to conceive sisters. You never know who's struggling and they may need that little bit of extra help.
Roisin: This may come as a surprise, but we are not doctors. We strongly recommend that you consult with your doctor before beginning any exercise or nutrition program. Get everything checked out first. Your safety is our priority. This has been a Worth a Listen production.