Author: Natalia Grob, MD

Utilizing utilizing evidence-based medicine and applying the latest scientific findings, Dr. Natalia Grob shares what you can do to optimize your fertility through diet and lifestyle changes.

IVF is more common than most realize

by Natalia Grob, MD, posted in Uncategorized

Laboratory microscopic research of IVF (in vitro fertilization).

How many of you have seen celebrity couples that seem to effortlessly conceive only to think to yourself, “How is that even possible?!” The answer, to those of us who know about the journey of infertility, is that many get help through assisted reproductive technologies such as IVF. I want to share this recent article.

IVF is much more common than we all realize. At least 8 million babies have been born through IVF.

Your neighborhood friend, a celebrity, and even a family member may have used IVF to conceive and you would have no way of knowing that they needed the extra help- Their children are just as cute. And despite a growing number of celebrities speaking out about infertility recently, many still shy away from sharing their stories to family and friends.

My friendly advice is to let go of any insecurities or guilt about using help to create your family.  IVF is much more common than we all realize.

 

One Baby at a Time

by Natalia Grob, MD, posted in Elective Single Embryo Transfer, FET or Frozen Embryo Transfer, IVF, Uncategorized

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

Depression in Dads

by Natalia Grob, MD, posted in Male Fertility, Mood, Personal, Uncategorized

DepressedDadITN

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

by Natalia Grob, MD, posted in Uncategorized

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

by Natalia Grob, MD, posted in Diet, Dietary, Food and Diet, Uncategorized

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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

Women are Having Fewer Children Than They’d Like

by Natalia Grob, MD, posted in Uncategorized

A recent article in the New York Times caught my attention and I thought it would be worth sharing.

In summary: evidence from the CDC suggests that America’s fertility is in precipitous decline.

What you can do:

  • Be an informed patient. Know your fertility status to help plan your life and family goals.
  • Schedule an appointment with a REI for more information.

Doing an IVF cycle? A Mediterranean diet can help!

by Natalia Grob, MD, posted in Diet, Dietary, Food and Diet, IVF, Uncategorized

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Couples often ask me: “What else can we do to make this IVF cycle successful?” The first answer, is to pick the right lab. I’m fortunate to work with an amazing group of embryologists so I encourage my patients to consider the next step: using your diet and lifestyle to stack the odds in your favor. As we have discussed before in the blog, what you eat and what you do can absolutely impact your fertility and overall health. New research demonstrates that your diet, in particular, can impact your success with IVF.

 

As many of my patients know, I encourage a plant-based diet to enhance your fertility naturally. The problem with many of these studies that we have previously reviewed is that people who eat a plant-based diet are more likely to be thin and the following question emerges: “Is diet really impacting your fertility or does this have to do with your weight?” A new study helps us address this question.

 

In this study, women who had a normal weight (BMI < 30 kg/m2) underwent IVF in Greece. Women who ate a Mediterranean diet were more likely to get pregnant and bring home a healthy child compared to women who did not eat a Mediterranean diet. Women who ate better were almost 3 times as likely to bring home a child than women who did not eat a Mediterranean diet! The results suggest that dietary modifications may help increase the chances of a successful pregnancy and delivering a live baby for women undergoing IVF treatment.

 

What this study doesn’t answer, however, is when these dietary changes need to be implemented in order to have the full benefits on your fertility. My advice is simple: the sooner the better. The healthier you are when you start an IVF cycle, the more likely you are to get the full benefits of diet on your fertility. However, if you have a time crunch with regards to your fertility, with diagnoses such as diminished ovarian reserve, it may not be in your best interest to delay starting treatment. Talk to your doctor for more information about what the best next steps are for you.

 

Take home points:

  • Your diet can impact your chance of having success with IVF
  • Consider implementing a Mediterranean diet
  • Talk to your doctor for more information to help select the best diet for your goals

You are what you drink- continued

by Natalia Grob, MD, posted in Diet, Dietary, Food and Diet, Uncategorized

We have previously discussed in this blog the impact of the beverages we drink on fertility.The old saying of “You are what you eat” couldn’t be more true- what you eat absolutely impacts how we feel and our overall health.

sugary-drinks

New research is adding to this old saying- what you drink may be just as important as what you eat, when it comes to fertility. Similarly, we also discussed that the beverages you consume now can impact the health of your future children: women that drank beverages with low-calorie sweeteners are more likely to have obese children.

New research adds to these concerns. In this large study, the dietary habits of men and women were evaluated while they tried to conceive. Drinking sugary beverages was associated with decreased fertility for both men and women. Similarly, participants who had consumed the most sugary drinks (>7 servings/week) were found to have the lowest odds of fertility for both men and women.

This study looked at what couples drank during an IVF cycle and monitored their outcomes. They found that couples that drank more sugary drinks like soda did worse in IVF, when compared to couples who don’t drink sugary drinks: fewer eggs and fewer good quality embryos.

Take home points:

  • Men and women should avoid sugary drinks when trying to conceive, but particularly if they are using IVF
  • Using artificial sweeteners is not necessarily a safe alternative to sugary drinks
  • If you can’t completely eliminate sugary drinks, consider limiting your intake to <1 beverage a day.

Is going low carb dangerous?

by Natalia Grob, MD, posted in Diet, Dietary, Uncategorized

At the initial patient visit, I try to learn about any special dietary restrictions my patients may have. A common diet is going “low carb” in an effort to lose weight. Emerging research, however, suggests that this could be dangerous when trying to conceive.

Folic acid is a vitamin that reduces the risk of having a child with a problem with it’s spinal cord, known as a neural tube defect. Folic acid is added to many common meals, like cereal, in order to fortify the food. Women who intentionally avoid carbohydrates, thereby consuming fewer fortified foods, may not have adequate dietary intake of folic acid.

This study found that women eating low carb had significantly lower dietary intake of folic acid. Women eating low carb were 30% more likely to have an infant with a severe neural tube defect such as anencephaly or spina bifida.

What you should do:

  • Talk to your doctor about any special diets you have before trying to conceive
  • Women should take a daily prenatal vitamin in addition to having a well-balanced diet while trying to conceive