One Baby at a Time

Our blog is dedicated to what we can do to optimize fertility and help with the ultimate goal of bringing home a healthy child. Although there are lots of ways to build a family, many patients use IVF. In IVF, we use medications to grow multiple eggs at the same time with the hope of developing multiple embryos in the lab. Once we have a healthy embryo, we use embryo transfer to get our patients pregnant.

 

One baby at a time is always the safest thing for mom and baby.

 

When IVF first started, the success rates were low, so it was common for clinics to place multiple embryos back in with the hope of one of them sticking. Now that our field’s success rates are much better, we need to step back and look at the goal that our patients ask us to help them with on the initial patient consultation: building a healthy family.

 

Although success rates vary based on individual clinics, I work for a clinic that has the highest live birth rate in the nation. This means that the majority of patients get pregnant and bring home a healthy child later that year from the first embryo transfer. This also means that if we put back two embryos, there will be twins, but possibly even more, like triplets or even quadruplets.

 

One baby at a time is always the safest thing for mom and baby.

 

Multiple pregnancies, like twins, are higher risk for just about everything. Children from a multiple pregnancy are higher risk being stillborn, having a birth defect, developing autism, prolonged admission to the neonatal ICU, and cerebral palsy than single babies. For moms of multiples, they are at higher risk of developing severe complications including life-threatening conditions like pre-eclampsia, diabetes of pregnancy, and delivering preterm.

 

One baby at a time is always the safest thing for mom and baby.

 

Infertility treatments like IVF are expensive, both emotionally and financially. Putting back more than one embryo at a time will not save you money. It won’t get you that healthy family sooner. In fact, multiple studieshave shown that because of the higher risks of complications to mom and baby, these pregnanciescost much more than one pregnancy at a time.

 

That is why, in our practice, the majority of patients get one embryo transferred at a time. The average number of embryos transferred in our practice is 1.1. We are very proud of this! Other clinics are doing this across the countrytoo. Together, we are helping develop a generation of healthier moms and babies.

 

Take home points:

  • One baby at a time is always the safest thing for mom and baby.
  • Talk to your doctor if you have more questions

Current Estimate of Vitamin D’s Influence on Fertility and Miscarriage Rate

We have reviewed many previous studies on the why the hormone referred to as Vitamin D is so important to pregnancy. However, a new analysis resulted in a news release from the National Institute of Health. Simply put they stated the following findings:

  • Women with adequate vitamin D levels were 10% more likely to become pregnant
  • Pregnant women with sufficient vitamin D were 15% more likely to have a live birth

Simply put, now that we fully appreciate that vitamin D is a hormone produced in our skin—it makes even more sense that women insure that they have sufficient levels during their reproductive years.

 

If you’ve never had your levels tested, consider consulting your provider to discuss this simple life hack.

Shine on,

~Robert

 

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

Depression in Dads

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The stress related to a diagnosis of infertility parallels what is experienced with a cancer diagnosis or grief of the loss of a loved one. We all recognize that stress has a negative impact on our health and can impact fertility. However, most of what we know has been from studies based on the female partner.  New research demonstrates that the stress of infertility on male partners should be considered as well.

 

Nearly 50% of men seeking IVF reported symptoms of depression. 50%! This study found that although major depression is more common in female partners than in male partners, it can still have a significant impact on fertility success. Couples in which the male partner had major depression were 60% less likely to conceive and have a live birth than those in which the male partner did not have depression.

 

Although this study shows an association between male depression and decreased likelihood of success with fertility treatments, it leaves many questions about whether one causes the other unanswered. What this study does a great job at, however, is demonstrating the need for us to focus on the health of all our families prior to conception.

 

Take Home Points:

  • Infertility and the associated treatments are a major life stressor.
  • Depression during fertility treatments can be common, in both female and male partners
  • Untreated depression in men may decrease fertility
  • Talk to your REI and primary care doctor if you think depression is impacting your life

Your blood pressure matters

High blood pressure has long been known to be linked to heart disease and stroke, but why does it matter in our fertility patients, who are overall young & healthy? Doesn’t high blood pressure matter later in life? Why is your fertility clinic checking blood pressure? Many of our patients have noticed that we make a significant effort to measure blood pressure at each visit. So, what’s the deal? Is blood pressure also important for your fertility?

In a recent study, researchers found that women who had higher blood pressure had an 18% higher risk of suffering a pregnancy loss, or miscarriage, than patients with normal blood pressure. Although this study shows an association between elevated blood pressure and pregnancy, it does not prove that hypertension actually causes pregnancy loss. It does, however, show that the best way to have a healthy uncomplicated pregnancy is to start by being the healthiest you can be before conception.

 

What you can do:

  • Be a pro-active patient. Learn about your baseline normal blood pressure and talk to your doctor if you notice that your blood pressure is elevated

Fast food is bad for fertility

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Does anyone else remember when we first started realizing that fast food was unhealthy? I personally remember watching the documentary “Super Size Me”and being shocked; I think we all suspected that fast food wasn’t as healthy as a home-cooked meal, but few of us realized just how dangerous this food could be for our health. Documentaries like “Super Size Me” revealed the negative impact of fast food on health: significant physical and psychological negative impacts were found with regular fast food consumption. Worse yet, this documentary showed how corporations encourage poor nutrition through marketing in order to benefits its own profits.

 

New research now shows that fast food is particularly harmful when trying to conceive. In this study, the nutrition habits of couples trying to conceive were watched. What they found was that couples that ate the most fast food and the least fruits & vegetables took longer to conceive and were more likely to have infertility. This study also found that the effect was dose-dependent: couples that ate the most fast food (>4 times/week) had the highest risk of infertility.

 

Take home points:

  • There are many reasons why you shouldn’t eat fast food. Your fertility is one of them.
  • Limit or altogether avoid fast food while trying to conceive
  • Try to eat diets full of fruits & vegetables to enhance your natural fertility

Recharging Egg Health for Women Trying to Conceive; the role of CoEnzyme Q10

One challenge to diagnosing and managing fertility problems is our inability to estimate the healthfulness of any woman’s eggs. We know that as women age; egg quality declines. But that doesn’t really help us know the viability of the eggs that someone has now. Even more bothersome is nobody fully understands the physiology of immature eggs—the ones not yet fertilized. But we do know that they require a lot of energy.

CoQ10

CoEnzyme Q10 (CoQ10) is an essential aspect of the part of the egg that generates power (mitochondria). This enzyme helps our cells convert carbohydrates and fats into energy. It also helps protect our cells from the enzymes that cause them to breakdown—something that most of any woman’s eggs are destined to do. CoQ10 is also a potent anti-oxidant that can help protect the DNA in the egg from damage. These are three vital functions.

 

Although your body makes most of the CoQ10 you need; we do get some from our diet as well. The richest dietary sources are meat, chicken and fish as well as soybeans, canola oil and nuts. Unfortunately there is no easy way to measure which women have adequate CoQ10 and those that would benefit from more. There is no simple test. However, a recent study did provide some insights into the potential benefit of CoQ10 supplementation for fertility patients going through treatment.

 

A prospective, randomized study followed 186 women that were considered to have a reduced chance of achieving a successful pregnancy through IVF due to them being classified as having a decreased ovarian reserve. Half were placed on CoQ10 supplements beginning about 60 days before their egg retrieval. They found that the women placed on CoQ10 had a higher number of eggs retrieved, a higher fertilization rate and produced better quality embryos. Another randomized study found improved ovarian response and higher pregnancy rates in women with PCOS given a smaller dose of CoQ10 during ovulation induction treatment.

 

So if you’re trying to conceive, consider whether or not you may benefit from this important supplement. This may be especially important if you’re older than 35 years of age, have a low ovarian reserve, history of previous treatment failure or have PCOS. If you’re looking for a reliable brand of this supplement, here’s the one that I typically recommend to my patients: https://theralogix.com/products/neoq10-coenzyme-q10-supplement

 

Stay healthy,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado