This is your home for learning more about fertility factors--medical, emotional, and physical. Our team of bloggers, from physicians to nurses, financial counselors to patients, are all dedicated to giving you news, information and thoughts relating to the the fertility journey. Please explore and let us know if there other topics of interest to you.
Juicing is the new, healthy diet “trend” and for a good reason. Statistics from the Centers for Disease Control and Prevention (CDC) show that only 33% of American adults eat enough fruit and only 27% take in the recommended amount of vegetables. So, why not go the easy route and just throw some kale, strawberries, spinach, and banana into your juicer to meet your daily produce quota?
As “healthy” as it sounds, an on-the-go juice/smoothie meal may not be the best way to lose weight in order to increase your fertility outcome. And calories and body weight matter when trying to increase your fertility. In fact, a 2011 systematic review of more than 47,000 treatment cycles in Reproductive Biomedicine Online, found that body mass index (BMI) of greater than 25 is associated with adverse pregnancy outcomes in women undergoing IVF/ICSI treatment, including lower live birth rates. This effect is present in both overweight (BMI of 25 to 30) and obese women (30 or higher).
What goes on in your body when you juice? Mainly, the carbohydrates from the fruits–particularly the ones high in starch and fructose–easily breakdown into glucose, which causes a sugar surge, followed by an insulin rush to try to lower the sugar level. And it won’t be long before you’ll be looking for something else to eat because of the rapid glucose release. In other words, you will eat more later on. To lose weight, you must keep the glucose and insulin response under control to maximize your metabolism. Too much insulin keeps fat from breaking down.
Does that mean you should avoid juices/smoothies? Not necessarily. These liquid meals can have a role in improving your diet—and fertility—if you make them the right way by combining the right amounts of protein, healthy fats, and fiber. Indeed, Harvard researchers conducted a groundbreaking fertility study that highlighted dietary considerations to increase fertility: eat more vegetable protein, like nuts and beans, and whole grain sources of carbohydrates to slow sugar and insulin responses; switch fat-free dairy for a full-fat food option once a day; and, if overweight, decrease body weight between 5%-10%. Combined, these factors can make a difference in fertility success.
Of course, whole foods should be your first choice, but at times juices/smoothies can be a more-than-adequate replacement. So do not put your Nutribullet juicer on Ebay yet. Here are two fertility-supporting juice smoothies to get you going:
Fertility Pack Breakfast Smoothies
Kiwi Strawberry Banana Smoothie – one serving
1 Cup Milk, full fat + ½ cup ice water
2 Kiwi, skinned
1/2 medium Banana, frozen
1 Cup Strawberries, frozen
1 Tablespoon Sesame seeds
Calories per serving: 390
Creamy Green Berry Smoothie – one serving
1/4 Avocado, small, peeled
1 large handful Spinach, raw
3/4 Cup Blueberries, frozen
1 Cup Strawberries, frozen, sliced
1 Tablespoon Flaxseed, ground
1/2 Cup Almond milk, unsweetened
1/2 cup Greek yogurt, full fat
Calories per serving: 379
Note: If you need to lose weight, swap the full-fat dairy for 2%. You still get the fertility benefits, without the extra calories.
A new study has suggested that women with lack of Vitamin D were nearly half as likely to conceive through IVF as compared to women who had sufficient levels of the vitamin. Read the article below from U.S. News and World Report by Robert Preidt, HealthDay Reporter
Women’s Vitamin D Levels May Play Role in IVF Success
Vitamin D deficiency may lower a woman’s chances of getting pregnant through in vitro fertilization (IVF), a small study suggests.
Researchers in Italy compared the success of IVF in 154 women with vitamin D deficiency against that of 181 women with sufficient levels of vitamin D. Those with sufficient vitamin D levels were twice as likely to get pregnant as those with vitamin D deficiency, the team reported Aug. 14 in the Journal of Clinical Endocrinology & Metabolism
Women with sufficient levels of vitamin D were also more likely to have better-quality embryos and had a greater likelihood of an embryo implanting in the uterus, the study found. According to the study authors, vitamin D levels of 20 to 30 nanograms per milliliter in their blood are considered sufficient or healthy, so the vitamin D-deficient women fell below that threshold.
The study does not prove cause-and-effect, and study co-author Alessio Paffoni stressed in a journal news release that “randomized clinical trials are needed to confirm the findings.” However, Paffoni, of the Ospedale Maggiore Policlinico in Milan, believes that the findings “certainly suggest that low levels of vitamin D contribute to infertility.” He added that, “since vitamin D supplementation is an inexpensive and simple intervention with few relevant side effects, additional study in this area has the potential to markedly influence the way infertility is treated.”
Prior research has shown that vitamin D affects fertility in many mammals, the team pointed out.
More than 1 percent of infants born in the United States are conceived through IVF and other types of assisted reproductive technology, according to the U.S. Centers for Disease Control and Prevention.
Vitamin D is nicknamed the sunshine vitamin because the body produces vitamin D when exposed to sunlight. People also get vitamin D through foods like eggs, milk, yogurt, tuna, salmon, cereal and orange juice.
Nutrition, fitness and emotional support from other prospective parents can increase a woman’s chance of conceiving a child. Read the article below by Carrie Dennett special to The Seattle Times.
When conception and pregnancy don’t happen “naturally,” fertility treatment can involve drugs and even surgery. Some women, however, are finding that improved nutrition and fitness is the best medicine.
When Theresa, 37, and her husband moved to the Seattle area, she had been unable to conceive, even with in-vitro fertilization (IVF). She asked Dr. Angela Thyer, MD, at Seattle Reproductive Medicine what else she could try, and took her suggestion to enroll in Food For Fertility before attempting IVF again. Last year, Theresa (who withheld her last name to preserve privacy) gave birth to healthy twin girls.
“I’ve always been a big proponent of nutrition for women who are planning a pregnancy,” Thyer said. “We want healthy eggs and sperm, healthy embryos and healthy babies.”
Three years ago, Thyer and registered dietitian Judy Simon, MS, RD, CD, of Mind Body Nutrition developed the 7-week Food For Fertility class for women with infertility who would benefit from losing weight and improving nutrition. Simon said that most women she sees for infertility have polycystic ovary syndrome (PCOS) or insulin resistance. Some are not eligible for assisted reproductive technologies (ART) due to severe obesity while others are simply trying to increase their odds of ART success.
Although body weight is not always a concern, Thyer said that some ART procedures are less likely to work in women who are severely obese, and that excess fat tissue may contribute to chronic inflammation, which can interfere with conception. She said she works with her patients to improve health instead of focusing on a number on a scale.
“I see a lot of results with women who take an active approach to lifestyle changes,” she said. “Diet and regular exercise can sometimes promote ovulation without medication. We know that some women are going to be able to conceive just with [Food For Fertility] alone.”
Dr. Jorge Chavarro, MD, assistant professor of nutrition and epidemiology at Harvard School of Public Health and author of “The Fertility Diet,” has published extensive research on the link between nutrition and infertility.
“What we have been able to look at suggests that diet is quite important in fertility, but it will not help everyone,” he said. What it can do is help with ovulation and sperm production.
Chavarro said that monounsaturated fats, lower-glycemic carbohydrates, plant-based protein and iron and folic acid from supplements are all associated with a lower risk of infertility. Soda and partially hydrogenated oils (trans-fats) are associated with an increased risk.
Simon includes evidence-based nutrition information as well as a cooking segment and a group walk in each Food For Fertility class. “We focus on diet and lifestyle to promote weight loss, but in a very positive light,” Simon said. “They learn how fun movement can be. Many have gone on to become exercise partners and support for each other.”
The feedback has been positive. “They feel that they eating healthier, they’re more active, more mindful, and they’ve learned to deal with some of the stress in making lifestyle choices,” Simon said. “Many of these women have gone on to conceive and have healthy children and are supporting those who are still on that journey.”
Theresa said she believes that nutrition, fitness and emotional support made a difference. “Dr. Thyer took a very holistic approach, which was different and I appreciated it. I took the drugs and showed up to my (previous) clinic for a long time and nothing was happening. It was only after we added in all the other facets that we got things to work.”
The benefits of optimizing nutrition and health don’t end with conception, Thyer said. “People love coming back to me and telling me how well their pregnancy went, how they didn’t develop gestational diabetes and they carried full term with no problems. I like to look beyond the fertility and the baby to the next 10 to 20 years.”
Carrie Dennett, MPH, RDN, CD is a registered dietitian nutritionist at Northwest Natural Health in Ballard. Her blog is nutritionbycarrie.com and her website is carriedennett.com.
REDBOOK has joined forces with RESOLVE to launch “The Truth About Trying,” an online video campaign to start an open conversation about infertility, which strikes one in eight women in the United States. Here you’ll find infertility stories from celebrities and women like you. The message of those speaking out: It’s not always easy to get pregnant, and there’s no shame in that.
Below celebrity Garcelle Beauvais talks about her struggles with infertility.
In an interview on the Today Show, Jimmy Fallon reveals what a long and often difficult path to parenthood he and his wife, Nancy Juvonen, went through. Before having Winnie via surrogate, Fallon and Juvonen struggled to start their family for five years. ”We’ve tried a bunch of things,” he explained. “Anyone who’s tried will know, it’s just awful.” That’s why, after having shared past attempts and disappointments with friends and family, they decided not to tell anyone they were expecting this time.”We tried before, we told people and then it didn’t happen,” he recalled. “And it’s just really depressing. It’s really hard on everybody.”
Now Fallon hopes that other couples facing difficulties starting a family can have their own win now. ”I know people have tried much longer (than we have), but if there’s anyone out there who is trying and they’re just losing hope … just hang in there,” he insisted. “Try every avenue; try anything you can do, ’cause you’ll get there. You’ll end up with a family, and it’s so worth it. It is the most ‘worth it’ thing.”
However you want to add up the time, it still comes down to the dreaded two-week wait. Did you ever read the book Oh, The Places You’ll Go! by Dr. Seuss? Then you know “The Waiting Place.” It’s that place in life where everyone is…just waiting. The illustrations depict a bunch of sad people waiting and waiting and waiting for something in their life to happen. They always remind me of the two-week wait.
During the two-week wait, you’re basically waiting for the news that may or may not change your life. I think it should be renamed, “the crazy wait”. I did some crazy things during those two weeks. I overanalyzed every symptom my body had. If I sneezed, maybe it meant I was pregnant. If I coughed, I wasn’t. I replayed every ‘what if’ scenario in my head. By the end of the two weeks, in my head I had myself living alone in Utah with five cats! I felt obligated to try everything that was recommend by concerned friends. I ate pineapple, drank cough syrup, tried acupuncture, tried reiki, swallowed fish oil pills…even drove to Salem to buy fertility rocks. You name it I tried it.
One thing sticks out in my mind that I did during the “crazy wait” that I do attribute to helping me get pregnant. My sister flew out for a visit and we went to Boston for the weekend. We felt this weekend getaway would take my mind off things. One sunny morning as we were walking out of our hotel, a man dressed in Red Sox gear approached us. In a thick Boston accent he told us his car was stranded in the parking garage, and he needed $20.23 to get it. He proceeded to tell us that he would pay us back. “Is this your hotel?” he asked. “I’ll leave the money at the front desk for you.” Then he followed up with, “Listen, I work at Legal Seafood at the airport. If I don’t return your money, you can hunt me down there.” As I turned and slowly walked away, my sister called after me, “What are you doing?” I told my sister I needed good karma to get pregnant, so I’m going to the ATM to get him money. She looked at me and told me I was crazy. “Believe me I know!” I said. I took $40 out of the ATM and told him good luck. Every day after that for the remainder of our stay, I checked in with the front desk to see if any money was left for me. And every time it was the same thing, Sorry, Mrs. P, no one left anything for you.
As my sister was walking through the airport to go home, she stumbled upon Legal Seafood. She marched up to the bar and asked if Mark was working. The bartender looked at her with a half sad smile and said, “Oh, he got you too.”
For me, I like to think this little act of kindness was repaid to me ten fold. I am sure Mark is living large somewhere with all the money he has scammed off of people. But that’s ok because I’m living large with my two little boys. I sure did do some crazy things those weeks, but good karma always comes back to you.
Jen is mom to two amazing boys, thanks to the help of the Center for Advanced Reproductive Services. She’s also a middle school teacher and a peer support leader for Resolve. She credits her incredible husband for his support through their journey together.
Jaime King Opens Up About Her Infertility Struggles (Published on Redbook by Brie Schwartz)
We love ogling Instagram photos of A-listers posing with their adorable babies, but what the super-cute selfies don’t reveal are the fertility struggles that can happen along the road to having those children. According to the American Pregnancy Association, miscarriages occur in one out of every four to 10 pregnancies. However, they’re rarely discussed in the media. That’s why we owe Jaime King a special show of support.
This weekend, the Heart of Dixie star and mom to 9-month old James Instagrammed a photo, which has since been deleted, with the following words typed out: “For all the struggling women & moms out there that think they are alone – This is the truth about conceiving my son and struggles after. 8 yrs of pain and undiagnosed PCOS & Endometriosis. 9 doctors until Dr. Randy Harris diagnosed me & saved my life from a severe ectopic, 5 miscarriages, 5 rounds of IVF, 26 IUI’s, most with no outcome…worked until the day before I [gave] birth and went back after 6 weeks after because I was afraid of letting others down.”
She wrote in the caption, “For all the women you think you are alone in this #youarenotalone #ihavetobebravetosupportothers #realtalkthatterrifiesus.”
Jaime received an outpouring of support from fans, some of who shared their own stories on the comment thread, creating an unlikely but seemingly cathartic forum. One wrote, “Thank you for speaking out on this topic and being the brave voice for all of us who are too afraid to say it out loud!” Another typed, “So many couples are struggling and feeling totally alone and helpless. You are giving strength and hope to more people than you’ll ever know!”
We couldn’t have said it better ourselves. Thank you, Jaime, for sharing.
The issue of multiple births as a result of fertility treatments is frequently in the news. See the article below from Psychology Today which discusses the topic of twin births versus single embryo transfer.
More information about single embryo transfers (SET) here.
The More the Merrier, Cheaper by the Dozen? Be Careful What You Wish For! by Joann P. Galst, Ph.D. in Fertility Factor
From approximately 1915, the earliest year from which reliable data are available, until 1980, there was a 2% rate of twin births (i.e. about one in 50 babies). Over the years, that rate began to climb – until now, approximately one in every 30 babies born is a twin. What is causing this jump in multiple births?
Women are marrying later in the United States than in the past. As a result, they are also having children later and older women tend to conceive twins more frequently than younger women. This accounts for 1/3 of the increase in twin births. The rest is due to infertility treatment (both in vitro fertilization and fertility drugs). The increase in twin birth rates, however, does seem to be leveling off according to CDC reports and this is due, in part, to the push towards transferring fewer embryos in an IVF cycle. Single embryo transfer (SET) is a trend that was unheard of in earlier decades in the US, despite being encouraged in European countries for some time already. Thus, the increase in the twin birth rate has been slowed in the U.S. but has not yet been reversed.
Many prospective parents undergoing fertility treatment are highly resistant to the idea of SET. Their reasons are varied:
After waiting so long to have a child, getting a completed two-child family at once is enticing.
Finances come into play – and with “two for the price of one,” many parents embrace the idea of getting “more bang for their buck.”
Lack of insurance coverage – Since many insurance policies do not cover IVF, many prospective parents can only afford one cycle of IVF and since success rates are higher when two embryos are transferred, they want to have the best chance possible for a successful cycle with at least one take-home baby.
All of the above reasons have merit and validity. But many prospective parents are unaware of the realities of twin births:
• Harder pregnancies – increased rates of pregnancy induced hypertension/pre-eclampsia, gestational diabetes, anemia, and cesarean section.
• Harder births – increased likelihood of pre-term births and low birth weight babies, increased maternal blood loss during delivery.
• Harder parenting – increased rates of birth defects and long-term medical problems for babies; increased likelihood of infant death during the first year of life; higher rates of maternal depression and guilt as mothers report feeling they do not have adequate time to attend to either baby individually.
Merely looking at an embryo under a microscope to determine its shape and fragmentation level doesn’t offer enough information about the embryo’s fitness to predict successful implantation. Advances in chromosome testing of embryos can help determine which embryos give a woman the best shot at having a healthy baby, for example, preimplantation genetic screening in which a cell or two is removed from the embryo for analysis. This procedure, however, adds many thousands of dollars to the cost of an IVF cycle, is not usually covered by insurance, and may damage the embryo.
A new non-invasive embryo selection technique uses computer-automated time-lapse imaging, taking thousands of pictures of the growing embryo in the petri dish during incubation to study the development pattern and morphology of the embryo. This may allow determination of the chromosomal fitness and viability of an embryo without having to remove any cells or disturb the embryo in the incubator (exposure through removal of the embryo from the temperature-controlled incubator for observation by an embryologist can potentially damage the embryo), making it both safer to analyze embryos and contribute to a greater likelihood of IVF success rates with transfer of only one embryo at a time. In addition, it may be done at a lesser cost for prospective parents, although this technique is also unlikely to be covered by health insurance. Each IVF clinic would analyze the time-lapse images themselves and since clinics differ in how they culture embryos, timing of cell division events can differ between clinics thus making it difficult to develop an algorithm that could be applicable for all clinics.
Results thus far are exciting, but studies have used sample sizes too small to be definitive. Stay tuned for a further accumulation of data to see if this system actually improves pregnancies and live birth rates. That would be a most welcome advancement for those considering IVF and would support the greater safety of a singleton pregnancy.
Until this happens, additional changes are needed in policy and practice to help reduce multiples:
Expand insurance coverage for IVF (since pregnancy rates after double embryo transfer [DET] are similar to the cumulative pregnancy rates after two SET cycles).
Change the definition of a cycle of IVF to a stimulated cycle with IVF followed by consecutive SETs until a pregnancy is achieved. This would reduce the pressure on reproductive endocrinologists, wanting to keep their success statistics attractive to potential patients, to transfer more embryos for higher success rates while also reducing the rates of multiple births.
Improve communication to patients regarding the risks and benefits, both to mothers and babies, of available treatments. Research demonstrates that when patients are better informed, the decision for multiple embryo transfer is reduced.
Continue research to improve fertility treatment and identify embryos most likely to result in a live birth.
Taking the first steps on the path to seeing a fertility specialist may be difficult or even overwhelming for some patients. Patients are sometimes nervous about seeing a specialist because they don’t know what to expect, or they are fearful of receiving bad news. The article below, Why People Won’t Seek Help, by Jane Frederick, M.D touches on this subject.
Knowing what to expect at a consultation may offer reassurance and help alleviate some of these concerns. At the Center for Advanced Reproductive Services, we strive to make this a comfortable, stress-free process for all of our patients. We offer free fertility phone consultations for patients at different points in their fertility journey. The call will be scheduled between you and one of our board certified physicians at The Center and last about 15 minutes. Your fertility phone consultation will be an opportunity for you to obtain information about our program and learn about general treatment options.
Simply fill out this form to request your free fertility consultation.
Given that the majority of all infertility diagnosis’ can be treated with today’s medical technologies and advancements, it is surprising that many couples still suffer in silence when they fail to get pregnant after months and even years of trying. My research shows there are various reasons why couples choose not to seek help for their infertility and it is my goal to address these reasons and why they are easily overcome.
Reason #1 – Not aware they could see a specialist at this time in their process Most couples aren’t aware that they should see a specialist when they have been trying repeatedly to get pregnant. Each month, they pin their hopes on trying another time or attempting a different method to get pregnant. When every month brings heartache, it is time to see a specialist. The general recommendation for couples under the age of 40 is if you have been trying for over a year, you should seek help from an infertility specialist for a general infertility work-up. If you are over 40, it is really important to seek help within six months of failed attempts especially if the female is over 40. As we age, females egg supply and quality diminishes, making timeliness essential.
Reason #2 – Fear of multiple births
We have found that many couples are terrified of having twins or triplets. Unfortunately the media has sensationalized stories like the “Octomom” or “John and Kate plus Eight” – making many young couples fearful they will end up with multiple children. It is important to realize that when multiples occur at this number, it is often a mistake on the fertility clinic’s behalf. Any reputable and distinguished fertility clinic is careful to guide couples so they don’t end up with a multiple birth. Twins are more common with fertility treatments as they increase the changes of a pregnancy overall for a couple. But, the majority of babies born through infertility procedures are healthy singletons.
Reason #3 – MD or OB/GYN did not suggest seeking an infertility specialist soon enough
Unfortunately, many MDs or OB/GYN’s don’t encourage couples to seek help from an infertility specialist early enough. Often they encourage a couple to keep trying and to “just relax.” If there is a clear and definitive medical issue, no amount of relaxing will help a couple get pregnant. In addition, an infertility specialist is trained to find the exact issues that are preventing a pregnancy and are the experts that should be treating infertile couples. Often I hear from couples and they say “Why did we wait so long to see you.” Don’t make that same mistake and make sure you are your own health advocate.
Reason #4 – Lack of knowledge about treatment – believe In Vitro-Fertilization (IVF) is the only option Often couples believe that In Vitro-Fertilization is the only fertility option and they will need to do IVF. This is not the case. After seeing a specialist for the first time, many couples realize immediately what their issue is and there are various other treatments that couples can do before they need to move onto IVF. Sometimes it is simply taking a medication to get a female ovulating. IVF is an amazing medical technology that has allowed thousands of couples to build the family of their dreams, but it is not the only option available.
There are various other reasons beyond these four that I will be including in a series of articles for couples who are hoping to conceive. It is extremely important for couples to never lose hope; everyone who wants to build a family eventually is able to do so when they have the courage to take the steps to move forward and take control of their future.