For decades, infertility patients have been told to avoid caffeine consumption when trying to conceive and during fertility treatments. As we have previously reviewed, moderate caffeine consumption is ok, and could even help! New data is showing us that what you put in your coffee, could be more dangerous than the caffeine itself
We have previously discussed this topic: You are what you drink. This study looked at couples doing IVF and found that women who drank beverages with artificial sweeteners had lower pregnancy rates than women who did not consume these beverages. Similarly, any type of soft drink consumption (regular vs diet) was associated with worse outcomes: poor embryo development in the lab and lower pregnancy rates.
If you are doing IVF, avoid using artificial sweeteners or consuming soft drinks in order to optimize your chances of success.
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.
If your family is anything like ours, sunscreen is a routine part of our daily lives. Sunscreens protect our skin from sunlight using mineral or chemical filters. Mineral sunscreens use zinc oxide or titanium dioxide. Most sunscreens use chemical filters that contain active ingredients such as oxybenzone. Studies have demonstrated that these chemical filters mimic hormones and can act as endocrine disrupting chemicals.
Sunscreen exposure increases our exposure to chemical filters, such as oxybenzone. Oxybenzone use is widespread throughout the US. It is detected in nearly every American.
The reproductive system is sensitive to environmental factors. Early pregnancy is a particularly vulnerable time for endocrine disruption. Exposures when trying to conceive can impact the likelihood of conceiving as well as the health of the pregnancy.
Oxybenzone exposure and exposure to related compounds is associated with male infertility and poorer reproductive success in men undergoing fertility treatments. Similarly, men with greater exposure to a similar compound found in sunscreen had poorer sperm quality and took longer to conceive. Female exposures to oxybenzone and related chemicals have been linked to increased risk of endometriosis and problems with ovulation. These chemicals have also been associated with oxidative stress and inflammation in pregnancy.
The good news is that we can be informed consumers and change our exposure.
This is a great resource of safer sunscreen alternatives.
Take home points
- Avoid sunscreens with chemical filters, particularly oxybenzone
- Use mineral sunscreens when possible when trying to conceive
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:
- 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.
- 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.
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:
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.
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
Common air pollutants include ozone and fine particles. Exposure to air pollution may increase the risk of problems with fertility and pregnancy complications like pregnancy loss.
A recent study conducted in Michigan and Texas found that ozone, commonly found in urban smog, was associated with early pregnancy loss. These researchers found that couples that had higher exposures to ozone were more likely to experience and early pregnancy loss than couples who had lower levels of exposure to air pollution. We do not know why exposure to air pollutants might cause pregnancy loss, but it could be related to inflammation and oxidative stress.
This is not the first time we have seen that air pollution can negatively impact fertility. Researchers in Salt Lake City found that sperm parameters like sperm motility were decreased for two to three months after exposure to higher air pollution. In a study done in Korea, researchers found that exposure to air pollution resulted in pregnancies rates through IVF.
These findings suggest that women who are trying to conceive and pregnant women may want to consider avoiding outdoor activity during air quality alerts, but more research is needed to confirm this association.
What you can do:
- Click here to learn more about air pollution and how you can reduce your exposure
Has anyone else noticed that just about everything is available now as “organic?!” Should we buy organic everything? I mean, Oreo’s?! How is that even an option? 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 anti-oxidant 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 was true even though the couples were going through fertility treatments. 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.
- Just because something is labeled as “organic” doesn’t mean it’s healthy. Organic junk food is still junk food.
- Buying organic doesn’t fix everything. 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.
We have previously reviewed the negative impact that chemicals in plastics may be having on our health and fertility. One of the best ways that we can reduce this exposure is in our kitchen. When food is stored or heated up in plastic, the dangerous chemicals can leach into the food that we ingest. These chemicals can then interact with our endocrine system and cause disease.
When I first started considering my exposure to plastics, it felt like an impossible uphill battle. By starting in my kitchen, the task of reducing plastic exposure felt more manageable. I started by removing all plastic storage containers and making sure that we do not heat up food in plastic.
Here is a quick article that I thought I would share to help reduce your plastic exposures at home in the kitchen. I hope this helps you find reasonable solutions for limiting your plastic exposure in your home.
At a recent trip to Target, I realized just how many things are labeled as “antibacterial.” But what is antibacterial, anyways? And why do we need it?
“Somehow, through marketing or misinformation, we’ve been led to believe that if we get rid of bacteria, we’ll improve our lives and our health. In fact, the opposite is probably true” –Dr. Martin Blaser In fact, to date, there is no evidence that washing your body and home with antibacterial products does any good compared to old fashioned soap, water, and scrubbing!
Triclosan is an anti-bacterial compound added to personal care products like soaps but it is also added to plastics found in toys and medical devices. Triclosan is so common that the majority of people in the US population are exposed to this chemical; triclosan exposure is real and widespread.
Breaking news this week reveals that triclosan may target the ovary and make it harder for a woman to conceive. This group investigated whether ovarian reserve, a marker of how many eggs a woman has and how she might respond to fertility treatment, was different in women with high levels of exposure compared to those with lower levels of exposure. They found that antral follicle count, a marker of ovarian reserve, decreased as the triclosan levels increased. Perhaps even more concerning was that this relationship became even stronger in lean and young women, suggesting that this may contribute to reduced natural fertility and could lead to a need for fertility treatment at a younger age.
Other studies have found similar concerning results: women with higher levels of triclosan exposure take longer to conceive when compared to women with lower levels of this chemical. Triclosan is also associated with lower oocyte yield in couples undergoing IVF. Similarly, triclosan has been found to disrupt implantation of a pregnancy and alter placental function, leading to pregnancy complications in animal models.
The good news is that the FDA is banning the use of triclosan in antibacterial soaps, effective next month (September 2017). Way to go FDA! Thank you! Unfortunately, manufacturers can still add this chemical to dish soaps and toothpaste.
What you can do:
- Reduce your exposure. Avoid purchasing anything labeled “antibacterial”.
- Use bar soap and water, instead of hand-sanitizers.
- Avoid toothpastes that include triclosan, such as Colgate Toothpaste
- Read here if you want to learn more about triclosan and how to reduce your exposure
My neighborhood pools opened this week for summer and my family couldn’t be more excited. Unfortunately, mosquitos are popping up again and reminding me of the importance of discussing insect repellants with my friends, families, and patients.
Many women who never wear insect repellants have recently become interested in these products because of the news coverage of the Zika virus. The Zika virus was introduced to the world during the most recent Olympic games in Brazil. Mosquito bites were linked to severe birth defects and the Zika virus was identified.
The number of pregnant women with laboratory evidence of possible recent Zika virus infection and the number of fetuses/infants with Zika virus–associated birth defects continues to increase in the United States. About 1000 pregnant women in the US were diagnosed with Zika virus infection last year. Of these pregnancies, birth defects were reported in 15%. Congenital microcephaly, or severely small head in the affected child, has been a hallmark of intrauterine infection with Zika virus. However, the full clinical spectrum and severity of Zika remains unknown. Others have recently reported much lower rates of confirmed Zika virus in other parts of the US and no confirmed fetal or neonatal infections, which puts some doubt on the true prevalence of this widely publicized virus. The field of perinatal Zika virus infection is evolving and we continue to learn more about the virus as well as the risk of disease.
Insect repellants can be a good option for reducing your exposure to mosquitos and tics. The EWG has published excellent resources for consumers to learn about what is in their bug repellent.
My family uses DEET. It protects you against tics and mosquitos. DEET is the only insect repellant that has been tested on pregnancy women. The children of mothers who used DEET in their second and third trimesters showed no birth defects, changes in body size or developmental problems. No studies have examined the children of women who applied DEET during their first trimester. However, at toxic doses, DEET has been associated with seizures and neurological damage. Although this risk is scary, The EPA reports that this risk is very low- 1 per every 100 million persons. As with medications, I tend to recommend limiting the use of multiple products in order to limit exposure to multiple chemicals. Choose one insect repellant and stick with it.
A more natural alternative is also available as oil of lemon eucalyptus. The tree extract is refined to intensify the concentration of the naturally occurring substance para-menthane-3,8-diol (PMD) from 1 to 65 percent. The resulting oil is very different from unprocessed tree oil. Some testing shows that concentrations of 20 to 26 percent PMD may perform as well as 15 to 20 percent DEET against both mosquitoes and ticks (Barnard 2004, Consumer Reports 2010). I think it is important for us to recognize the limited safety data available on essential oils in pregnancy and in children. Refined oil of lemon is classified as a possible biochemical pesticide. Oil of lemon eucalyptus and essential oils have disadvantages but is a good choice for people who want a botanically based bug repellant. EWG recommends that consumers who are in high-risk areas for bug-borne disease or need long-lasting, effective bug protection avoid botanically-based bug repellents, aside from Oil of Lemon Eucalyptus. In other cases, you may find it worth your while to try botanical repellents to identify one that works well for you.
What you can do:
- Avoid exposure to mosquitos: use insect repellants with <50% DEET when trying to conceive and during pregnancy. More is not better. My family uses 30%.
- Wash your hands well after applying insect repellant. Wash repellant-coated skin at the end of each day.
- You and your partner should avoid travel to areas with Zika virus when trying to conceive and during pregnancy. Discuss your travel plans with a physician if there is any question about the safety of travel. Talk to your physician if you or your partner are concerned that you have been exposed to the Zika virus.
For more information: