It is estimated that between 8 and 12% of women will develop endometrial polyps during their reproductive years. These represent outgrowths of the uterine lining that can vary in shape and size but reflect uneven development of the tissue that is responsible for promoting implantation of embryos to initiate pregnancy. Therefore, it’s not surprising that they seem to be more common in women with infertility. In fact, one study of 1000 women undergoing IVF found about 32% of them had endometrial polyps.
In an attempt to estimate the impact of endometrial polyps on infertility, one study randomized 215 women with endometrial polyps to having surgery prior to starting Ovulation Induction with Insemination treatment vs not having surgical correction prior to starting treatment. They found that those that had surgery were twice as likely to become pregnant.
Other studies have also looked at mechanisms for how polyps could interfere with implantation. Here the evidence is equally compelling. In addition to the mechanical interference; polyps have been linked to various chemical changes in the uterine environment—especially involving certain markers of implantation and inflammation.
At our center, we go through great lengths to create and identify the healthiest embryos possible to help our patients achieve the highest attainable live birth rate. Therefore we always take steps to make sure that we’re placing embryos into the best possible uterine environment. Timing is also important in considering when to remove polyps. At least one study found that 27% of polyps will go away on their own. So we don’t plan any such surgery until we know we have healthy embryos to transfer or our patient is ready to become pregnant.
Robert Greene, MD, FACOG
Conceptions Reproductive Associates
Many women underestimate the potential negative impact of over-the-counter products. Herbal medicines are any plant derived product taken as a preventative or curative treatment. Dietary supplements are defined as products taken by mouth including vitamins, minerals and herbal or botanical products. Currently, the supplement industry is valued at over $133 Billion per year with a projected growth of 8.8% annually. Women of reproductive age make up a large portion of these consumers.
Are you sure that your supplements are safe?
Estimates are that nearly half of women take dietary supplements during pregnancy and about 30% continue their use into the postpartum period while breastfeeding. Studies indicate that it is naïve to assume these products do not have a negative impact upon pregnancy. Yet it is only after concerning data has emerged that warnings for supplements are issued. Take for instance the recent recall of Periwinkle.
A supplement ingredient called vinpocetine, but also marked as periwinkle extract or vinca minor, has been advocated for many purposes including weight loss, boosting energy or improving memory—all common concerns of reproductive age women. Yet last week, the Food and Drug Administration issued a warning that based upon data from the National Institute of Health that this product has been linked to an increased risk of miscarriage. Some other potential problematic supplements include the following:
- Almond oil—used topically to treat stretch marks—may increase the risk of preterm labor
- Chamomile—may increase the risk of preterm delivery and low birth weight
- Raspberry leaf—often used to induce labor—is associated with an increased risk of c/section
- Licorice root (glycerrhizin)—increased risk of preterm birth and blood pressure problems as well as possible developmental issues
In closing, if you’re pregnant or hoping to become pregnant it’s best to discuss any supplements that you choose to use with your OB/GYN provider.
Robert Greene, MD, FACOG
Conceptions Reproductive Associates of Colorado
Your mental health matters. It is estimated that up to 54% of couples with infertility experience a high level of stress, anxiety, and depression before and/or during fertility treatment. It is incredibly common to need additional help when going through fertility treatment, which is why I encourage the use of complementary stress reduction techniques with my patients.
But sometimes yoga, acupuncture, and mediation isn’t enough and more help is needed. The most commonly prescribed antidepressant is a group of medications called selective serotonin reuptake inhibitors (SSRIs).
A recent study compared women on SSRIs going through IVF to women who were not on antidepressants. They found that the embryo health and IVF outcomes did not differ between the groups. This suggests that, from a fertility standpoint, there is no reason to avoid using an antidepressant if you need it.
Fertility treatment is hard enough. There is no reason to suffer through poorly controlled anxiety and/or depression while going through fertility treatment. If you need additional help, please reach out. The best way to have a happy healthy family is to start with a healthy mom before conception. You are not alone.
Take home points:
- The diagnosis and treatment of infertility is stressful
- It’s common to struggle with stress, anxiety, and depression at any phase of treatment
- Antidepressant use does not impact IVF success rate.
- Do not hesitate to get additional help if needed
How important is eating #organic when you are trying to be healthy and TTC? Is buying organic worth it?
Organic food refers to food produced with limited pesticides, fertilizers, and additives. Organic foods tend to be higher in vitamins, minerals, and antioxidant content compared to conventionally grown food. Conventionally produced food is associated with higher rates of various cancers compared to organic foods.
Organic food is usually more expensive than conventionally produced food. But is the cost worth it?
A recent study evaluated pesticide exposure in couples going to a fertility clinic. They found that the more pesticides a couple consumed, the less likely they were to get pregnant and bring home a healthy child. This finding was dose dependent: women with the highest pesticide exposure had the lowest pregnancy rates. This suggests that dietary pesticide exposure can be associated with difficulty conceiving.‼️
Switching to organic products can also reduce your exposure to hormone disrupting chemicals and support beneficial practices for our environment.
What you can do:
✅Buy organic produce whenever possible. Some products are more worth the cost than others. Consider being selectively organic to keep your budget on track.
✅I will post on IG stories which foods our family tries to buy organic
✅Just because something is labeled as “organic” doesn’t mean it’s healthy. Organic junk food is still junk food.
✅Organic food has just as many calories as conventional food. And buying organic is healthy, but should not be used as a substitute for going to the gym.
My goal is to help support you becoming a happy healthy family. As we offer everything that today’s technology has available, it is also important that we also encourage you to take whatever steps possible to optimize the quality of the eggs that we are trying to fertilize.
We are all exposed to thousands of chemicals a day. Some of us are more sensitive to the dangerous impact of these chemicals on our health than others. Many of these chemicals can interfere with how our bodies, particularly our hormones work. This is important to consider when you are undergoing fertility treatments. Here is what you can do to reduce your exposure to dangerous chemicals that can impact your fertility.
-Avoid use of plastics, particularly with your food.
-Be an informed consumer about potential toxins in and around your home.
-Avoid heavily scented products
-Use glass/ceramic water bottles and cups with your beverages to reduce your exposure to chemicals.
-Wash your produce before eating to minimize exposure to pesticides
-Don’t use tobacco.
-Take your shoes off when you enter your home.
-Wash your hands before you eat
Today, I’m reviewing what things you can do with your diet and nutrition to optimize egg health.
Women are born with all the eggs they will ever have at birth. Every month, you lose a certain number of eggs regardless of whether you are TTC, pregnant, or going through fertility treatments. Women are always losing eggs until they run out, unlike men, who can re-generate sperm every few months. Honestly, the first time I heard this, I found it pretty depressing.
But ladies, there ARE things that we can do to optimize our egg health, particularly if you are doing fertility treatments. I personally found it empowering to make these diet changes when I was TTC because it felt like I had some control over how well we were able to do. There are many factors that play into success in a fertility treatment cycle, but why not consider doing these cheap/easy diet changes to optimize your chances of success?!
-Avoid fad diets like keto. Instead, stick to whole simple ingredients, like those found in a Mediterranean diet.
–Caffeine is ok. Just keep it in moderation (<2 cups of coffee/day)
-Consider eating organic produce
–Eat whole grains. You do not need to be gluten-free to optimize your fertility.
-Add tofu to your diet
-Avoid drinking sweetened beverages during a treatment cycle, particularly sodas.
Picture is of me giving a presentation last week to OBGYN providers about the importance of reviewing nutrition with our patients. Can you tell I LOVE talking about this issue?! It was my first time giving a talk term pregnant!
Nearly 40-50% of couples who are having trouble getting pregnant have a male factor impacting their ability to conceive. Today, I’m reviewing what men can do to optimize their fertility naturally. Chemicals in our environment can impact male fertility. So guys, listen up!
The chemicals we are all exposed to everyday can impact our fertility. Lifestyle changes are one of the best tools you have to optimize your fertility naturally.
-Avoid marijuana use
-Avoid tobacco smoke. Smokers take longer to conceive than non-smokers.
-Do NOT use supplements that contain testosterone or any form of steroids without talking to your REI.
-Avoid sunscreen containing oxybenzone
-Avoid exposure to the dangerous chemical BPA
-Switch to shaving creams and soaps that are paraben-free