An apple a day … keeps the REI away?



The Mediterranean diet has long been promoted as a heart-healthy eating plan. This diet incorporates healthy eating like fruits, vegetables, whole grains, and limits unhealthy fats like animal fats. A recent study, however, suggests that the benefits of the Mediterranean diet may be further reaching.

A group in Greece evaluated men attending a fertility clinic and determined their adherence to a Mediterranean Diet. They then compared their semen analysis results. What they found was incredibly interesting: men who deviated the most from the Mediterranean diet were 2.6 times more likely to have lower sperm counts and decreased motility in their compared to men who followed the Mediterranean diet closely. These results suggest that greater adherence with this diet may help improve semen quality.

This study doesn’t directly answer all the questions we need answered like whether changing your diet will improve your semen parameters or whether you will be more likely to get pregnant on your own with this diet. So unfortunately, the answer is “no”: an apple a day may not keep you out of the fertility clinic. We still think it’s worth a try!

New Year’s Resolutions: why men should consider them too!

Happy 2017! Like many others, I use the new year as a time to reflect on what I can continue to improve on. The global obesity crisis is real and it is common for weight loss to be a new year’s resolution. Although the risks of infertility and pregnancy complications is understood with female obesity, men have largely been left out of these discussions until now.


A new study released by the NIH suggests that dad’s weight also has a significant influence on child development. Children of obese parents may be at risk for developmental delays. The study found that children of obese fathers were more likely to fail developmental tests, like measures of social competence or problem solving ability.


It is not known why parental obesity might increase children’s risk for developmental delay. But if you or your partner are obese, now is the time to re-consider what you can do to become healthier.


Wishing you all a healthy and fertile 2017!

Are Low-Calorie Sweeteners Making You Fat?

There is a global obesity epidemic. More than one BILLION adults are projected to be obese by 2025. Obesity is a major risk factor for the development of medical conditions such as diabetes and cardiovascular disease, as well as numerous types of cancers. Obesity, in either male or female partners, is associated with a decrease in the ability to become pregnant. Obese women are not only at an increased risk of having trouble conceiving, they are also at risk of: needing medications to conceive, being less responsive to fertility treatments, losing pregnancies to miscarriage, having children with birth defects, as well as having complications during pregnancy such as high blood pressure and diabetes.


Many people use artificial sweeteners or “diet” drinks as a substitute for whole ingredients with the hope of cutting calories. A recent study suggests that this may be a bad idea. This group followed people for 10+ years and found that people that used low-calorie sweeteners had a higher body mass index (BMI), larger waist circumference, and were more likely to be obese. This paper suggests that using low-calorie sweeteners may not be effective means of weight control, and might even lead to harm.


When I review studies like this, I think it’s important to note that these studies are NOT designed to prove that artificial sweeteners CAUSE obesity; rather, they show an ASSOCIATION at a population level. For me, as a physician and mom, this association is reason enough to be cautious about the use of artificial sweeteners. For others, especially die-hard Diet Coke drinkers, they might want more proof before changing their diet habits.


There is no easy solution for weight loss; diet drinks probably aren’t going to help. If you are overweight or obese, don’t lose hope. Even a modest weight loss (10-15% body weight) can enhance your natural fertility. It will take hard work through diet and lifestyle changes. Avoid sugary snacks and drinks in general. Consider using natural sweeteners like stevia (Dr. Greene’s favorite!) or honey (my favorite!) instead of artificial ingredients. Your selection in which sweetener you use, is likely going to depend on what is most important to you including considerations like why you are using a sweetener, why you are looking for artificial sweeteners (cutting calories), and taste. Please be an informed consumer and make sure that you know why you are making the choices that you make. Taking care of yourselves will help prepare you for a healthy pregnancy and prepare you to be healthy parents.

What’s really in those supplements?

As a fertility specialist, many of my patients come to me already taking multiple herbal supplements or have questions about a specific “cocktail” that will enhance their fertility. My blanket statement to patients and friends, is to use extreme caution.

Nearly 2/3rds of American adults take dietary supplements. I am a big believer in optimizing your fertility naturally (hence a dedicated blogger!), but I think that ensuring your safety is even more important.

Before you take a supplement, make sure you understand why you are taking it and what you hope it will achieve. Consider talking to your healthcare provider about potential interactions between any supplements and your existing prescription medications. Next, speak up if you are start noticing any side effects.

If a supplements makes claims that sound too good to be true; they usually are. In a recently published analysis, nearly 80% of the supplements tested did not contain the primary ingredient listed on the label.  As a mother and physician, it’s so disappointing to read how much the supplement industry can take advantage of vulnerable populations. I recommend that you consider using supplements that are sponsored by USP. Supplements that have a USP logo on them are subjected to higher quality control.  Another great resource is; the routinely test products that they purchase from store shelves and reveal who passed and who failed.

I plan to evaluate the evidence behind commonly recommended supplements often encouraged to boost fertility in future posts. In the meantime, stay healthy and be safe!

Safe Makeup DOES Exist! Become an Informed Consumer

I want to thank everyone for the overwhelming support for my first blog post. Several of you have contacted me for more details about safe cosmetics. I obtained my information from the Campaign for Safe Cosmetics. I strongly encourage you to use this website- it’s a great resource to be an informed consumer and an advocate for safer products!

What I love about their website is that they list safer alternatives to choose based on the beauty product that you may need. I haven’t had the opportunity to try all the companies listed, but I plan to use this website from now on to help me find safer products moving forward. Many of the companies are smaller companies and I think it’s a great to support their dedication to keeping their consumers healthy.

I urge you to look at the Campaign for Safe Cosmetics website for full information, but here is a quick summary of safer cosmetic product choices to make at the time of this posting. I love that these companies are transparent in what is and isn’t in their products since current regulations do not require them to do so. I am not sponsored by any of these companies and have no financial interest in their success. I’m just a fan that recommends them to my patients:

You don’t need to throw out all your makeup and personal care products at home today. But I do urge you to start questioning what IS in the things that you expose yourself to every day through makeup. Specifically, look for chemicals listed in each of the Red Lists, and try to avoid them whenever possible.

Things that you can do:

  1. Simplify your routine. Use fewer products. Choose products with simpler ingredient lists. Avoid fragrances.
  2. Consider making some personal care products yourself so you know exactly what is and isn’t in them. Disclaimer: I’ve never done this myself but would love to learn if you have some experience with this!
  3. Research the products yourself. The beauty industry is mostly unregulated. It’s up to you to keep your body safe. Consider trying an app like:

These will help you shop clean.

Is YOUR Makeup Speeding Our Journey Toward Menopause? The Scary Association That You Need to Know About


One of the first research projects I did on the impact that lifestyle can have on fertility showed that women exposed to a handful of common chemicals classified as EDCs (endocrine disrupting chemicals) go through menopause earlier than women who have less exposure. It gained a lot of media attention because several of the toxic chemicals I found in my study are common in makeup products. A more recent study highlighted the continued importance of addressing this issue in women’s health and prompted this post.

This group evaluated the top beauty brands for each type of makeup and found 1322 ingredients. They then went on to summarize the evidence suggesting the association between each of these chemicals and menopause. Most of the chemicals they found are absorbed through the skin, meaning that all these chemicals are entering our bodies each day. Although the group admits there aren’t enough studies to show a direct link between cosmetics use and menopause, I think it’s enough to have me question what I’m being exposed to on a daily basis and how it’s going to impact my health.

Even though you may be far from menopause, I think it is still important for you to consider how chemicals that you’re exposed to can be impacting your ovaries. Women who go through menopause early are likely to have a shorter fertility window, meaning that they may use up their eggs at a faster rate than someone else their age. In the fertility world, this can translate to women who respond less to medications or are less successful with their use of assisted reproductive technology compared to others their age.

As a woman, as a mother, and as a fertility specialist, my first response to learning how many chemicals we are exposed to daily was disbelief: Why aren’t we protected as consumers from these potentially toxic chemicals? Why are they still exposing people to these toxic chemicals? Although the Food and Drug Administration monitors the chemicals that go into food and drugs, cosmetics are not subjected to the same regulation. Here are a few things that we can do to protect ourselves by limiting the numbers of chemicals we are exposed to daily.


Take home points:

  • Women are exposed to 1000s of toxic environmental chemicals each day.
  • Some of the chemicals found in makeup have been linked to health problems, including earlier menopause
  • Physicians and patients need to do a better job learning about the risks to their health so that they can make more informed choices in selecting their personal care products
  • What you can do:
    • Limit the number of personal care products you use. For example, try to limit to one type of shampoo to minimize the exposure to multiple chemicals.
    • Avoid any personal care items that have fragrances or scents.
    • Read labels and support companies that disclose what their ingredients are and support their efforts to remove those that are not necessary or are suspected to be unsafe.
    • Be an informed consumer: know what you are being exposed to. Here is a list of great resources.

Blog updates

Hi everyone! Thanks for your patience as we update the blog!


I am very excited to be part of the fertility team at Conceptions Reproductive Associates! I’m thrilled to be joining this blog and for the opportunity to write about my personal interest of optimizing fertility using lifestyle changes.

Dr. Greene has a loyal following with his blog. I plan to stay true to his original blog style and hope to share with you all my enthusiasm for enhancing our fertility. My blog posts are meant to inform and will be my personal opinion. I hope to share with you my interpretation of the existing evidence and provide the same type of advice I would share in a conversation with a close friend or family member.


I first became interested in the impact of the environment on our health because of research that I conducted at Washington University in St Louis, where I found that exposure to a handful of common chemicals in our environment was associated with earlier menopause. At the University of Colorado, I received several grants to support further studies of how exposure to plastics can change the way our ovaries work and can impact the development of early pregnancies. I also serve on an advisory board for agencies that help advocate for reproductive health, such as the Agency for Toxic Substances and Disease Registry and Pediatric Environmental Health Specialty Unit.


As a physician mom, I understand how challenging the process of trying to conceive can be. In my free time, I love going on adventures in the mountains with my family, gourmet cooking, and distance running.


I look forward to your feedback on our new & improved website! I would also love to find out specific topics that you are interested in learning more about. I want to make this blog YOUR go-to source for enhancing fertility.