Vitamin D and RPL

We here at the blog are big proponents of vitamin D supplementation to enhance your fertility. New research suggests that vitamin D supplementation may also be important for couples that have difficulty staying pregnant, also known as recurrent pregnancy loss (RPL). One of the causes of RPL has been attributed to an autoimmune condition. In this study, researchers evaluated the immune cells thought to be involved in pregnancy loss. They found that women who had low levels of Vitamin D were more likely to have abnormalities in the immune cells involved in pregnancy loss. This suggests that vitamin D supplementation may be a tool we can use to reduce the risk of pregnancy loss.

What you can do:

  • Check your vitamin D before trying to conceive
  • Talk to your physician about the evaluation of RPL and treatment options if you have had two ore more pregnancy losses.

Updates on BPA

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Bisphenol A (BPA) is commonly found in plastics and the majority of us are exposed to this hormone disruptor multiple times daily. We previously introduced BPA and the negative health impacts here. We know that BPA exposure when trying to conceive can negatively impact multiple aspects of your health, including your fertility and the likelihood of your children having health problems.

New basic science research is adding to our previous concerns about this endocrine disrupting chemical:

  1. BPA negatively impacts how an egg matures and egg quality by increasing DNA damage and oxidative stress. This study also shows the potential for the damage that BPA causes for mom to impact her future children.
  2. BPA can decrease sperm count in males and lead to neurodevelopment problems in their children. This study also was associated with increased obesity in female offspring.

What you can do:

  • Switch to BPA free drinking bottles like those with a #5 stamped on them or use either glass or metal instead;
  • Purchase soups and foods packaged in cardboard cartons or glass instead of the plastic lined cans;
  • Hand wash plastic dishware with mild soap in warm water instead of using dishwashers for these products;
  • Don’t place plastic ware in microwave ovens to warm;
  • Express your support to companies that are voluntarily phasing out the use of BPA in their products.

Happy moms

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

Considering IVF? Limit your exposure to DEHP.

Phthalates are a group of chemicals found in many types of plastics in a variety of consumer products. We have previously discussed the negative impact of phthalates on fertility. A recent study adds to this: phthalates negatively impact an IVF cycle. Women are disproportionally impacted by phthalate exposure.

 

In this study, women with high levels of phthalates had fewer eggs at the time of egg retrieval, fewer fertilized eggs, and fewer top quality embryos. This group suggests that DEHP, a specific type of phthalate, may impair early IVF outcomes, specifically targeting the oocyte. If you are thinking of undergoing IVF this year, I encourage you to investigate what you can do to optimize your IVF cycle by limited your exposure to phthalates!

 

What you can do:

Successful Fertility Treatment

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Defining goals is a key feature shared by people that we describe as “successful.” It is also a practical approach for those of us that diagnose and treat fertility challenges. So what is the best way to define successful fertility treatment?

Many patients present to us with the question of “why?” They want to know why they haven’t conceived. My first goal is to redirect them to thinking of “what?” What do they want their completed family to look like? This may seem like a small shift in focus; but in reality is a huge leap towards achieving that goal.

“Why-focused thinkers” tend to focus on the past. They often want to spend a tremendous amount of time and effort in diagnosing what their obstacle has been and what could they have done differently. Once they effectively become “what-focused-thinkers,” their momentum has already shifted forward. That simple shift in thinking dynamically places them on a path forward to actually achieving that goal.

At our center, we focus on Live-Birth-Rates because we know that is the only marker that really matters to our patients. With that in mind, we work towards minimizing obstacles to efficiently reach that goal—one (or occasionally two) babies at a time. But considering the answer to the “what” question—we often have to plan for subsequent pregnancies at the same time that we plan for the first/next one. Applying this approach, we became one of the elite centers that truly have the highest reportable success rates.

Our goal for the coming year is to not only stay in this elite group. But to continue to find ways to help push those rates higher—while continuing to share what we learn along the way. So thank you for checking in. Let’s focus on the future!

With dedication and humility,

~Robert Greene, MD

On behalf of the team at Conceptions Reproductive Associates

IVF might not be enough

I am incredibly proud to work at a REI clinic that has the highest live birth rate in the country. A recent study, however, suggests that IVF may not be enough. Lifestyle and the environment can impact your IVF success rates, even at a top notch REI clinic.

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In this study, levels of pesticides and common pollutants were measured in the fluid that was obtained from the ovary during an egg retrieval. They found that higher levels of Pretilachlor, β-cyfluthrin, PCB 28 and 180 was associated with fewer eggs at retrieval, lower fertilization rates, and impaired embryo development. They also found that high PCB and pesticide concentrations negatively affected embryological outcomes. This study provides evidence that these harmful chemicals are found in the fluid surrounding individual eggs and are associated with decreased success with IVF. This suggests that if you want the very best chances of success with IVF, you should consider optimizing your lifestyle to minimize exposure to these harmful chemicals.

 

What you can do:

  • Learn how to minimize your exposure to PCBs and pesticides
  • Make a plan to optimize your health before you invest in an IVF cycle
  • Talk to your doctor about a timeline for implementing these changes