Vitamin D: why you need more of it

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We are learning more and more about the important role that Vitamin D plays in terms of our fertility. We have previously discussed the role of vitamin D and your sleep/wake cycle in terms of optimizing your health. Recent studies have added to this to demonstrate just how important Vitamin D is when trying to conceive.

Vitamin D may improve your ovarian reserve, a marker of how many eggs women have compared to others their age. Vitamin D may help support your ovarian function.

Similarly, women with higher vitamin D levels, are more likely to conceive than women with low vitamin D levels.

Vitamin D may also be important for treating hormone imbalances, particularly if you have polycystic ovarian syndrome (PCOS). If you are undergoing fertility treatments like IVF, Vitamin D may even help decrease your risk of ovarian hyperstimulation syndrome (OHSS) and prevent dangerous complications from OHSS.

Why not consider taking a vitamin D supplement to boost your fertility naturally?

 

What you can do:

  • Ask for your vitamin D level to be checked annually when you are trying to conceive
  • Consider starting a supplement of at least 2000 IU of vitamin D to help support ovarian function
  • Target a serum 25-hydroxyvitamin D level of >50 nmol/L to enhance your fertility

Keeping plastics out of your kitchen

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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.

Are hand sterilizers making you “sterile?” The impact of triclosan on ovarian health

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!

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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

 

 

Be Kind to Yourself

One of the best parts of my job, is getting to know individuals and hearing their “story.” I love learning about occupations, interests, and their goals for a family. I spend a lot of time listening to my patients so that I can fully grasp all that my patients have been through leading up to their visit with me.

I have to be honest: I’m saddened by how hard my patients are on themselves. There is so much unnecessary blame and justifying in fertility. For example, a common thing I hear can be something like the following: “I love coffee, but after trying to conceive for so long I gave it up. I miss it but I’m willing to give up anything in order to prove that I’m ready for a family.” Does this sound familiar to you? First off, you can drink coffee. Secondly, please try to be kind to yourself.

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Research suggests that kindness and mindfulness will not only help you cope with fertility struggles, but may even improve your outcomes. Unfortunately, this important step is often overlooked in many fertility clinics. I try to address the potential benefits these practices may have with my patients.

As a self-diagnosed perfectionist, I will be the first to admit that I have very high expectations that I set for myself. When I fail to meet a certain goal that I’ve set for myself as a physician or a mom, I beat myself up about it. My advice to you: try kindness instead. Pretend a friend told you the exact same story. How would you react to your friends’ tribulations?

Life is stressful and that won’t change, even once you get pregnant. We can’t control the stressors in our life but we CAN control how we react to them. So please, consider being kind to yourselves and help me support you through this fertility journey.

Doctors like me tell you to eat less meat. It’s time to start listening.

“If the benefits of better diet came in a pill, it would be hailed as a medical miracle.” 

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I spend a portion of each new patient visit evaluating diet and lifestyle. Since I started asking, I’ve been surprised by how many patients have confided in me that they are willing to try something new and want to change.  I believe that as your doctor, I have the responsibility to share with you the evidence that diet and lifestyle absolutely can work for or against you in terms of fertility. I also believe that one of the most important parts of my job is helping families become the healthiest they can be BEFORE conceiving.

I want to be honest. I’m not perfect and I would never pretend to be. My family members love meat- including (gasp!) hot dogs! Being vegetarian is challenging, especially when kids and working parents are involved. I get it. My goal is to make my family as plant -based as is reasonable. I hope that it will work, but I also recognize that the benefits of a plant-based diet are not “all or nothing.” Any change is a step in the right direction. And I absolutely will not shame or judge you if this doesn’t work for your family. With that, I encourage you to consider learning more about plant-based diets and whether it might be something you would be willing to try. It can’t hurt, but it may help enhance your fertility naturally and reduce your risk of a number of medical problems.

If you are interested in learning more, here are a few links to evidence-based resources that sold me on plant-based.

I would love to hear from you. What is the biggest challenge in your family that prevents you from going plant-based? Have you tried being vegetarian? What worked? What didn’t? What are your favorite plant-based meals to help convince my family?

Are Low-Calorie Sweeteners Making Your Baby Fat?

Obesity is a major risk factor for problems conceiving and pregnancy complications. Obesity is a potentially modifiable risk factor, meaning this is something that you can change to improve your chances of getting pregnant, having a healthy pregnancy, and having a healthy kiddo. This subject is so important that I thought I would blog about it again.

 

In December, our blog brought you new data that revealed that people that used low-calorie sweeteners in their lifetime were more likely to be obese than those who didn’t use these sweeteners.

 

Today, we want to caution you even more about using these sweeteners. Researchers have found that women who drank at least one artificially sweetened beverage per day during pregnancy had children who were more likely to be obese by the time they turned 7 years old. These findings suggest that artificially sweetened beverages during pregnancy are not likely to be any better at reducing the risk for later childhood obesity than sugar sweetened beverages! So these patients may have been drinking the diet version without any measurable benefit for their children; diet versions may have actually lead to harm! Interestingly, substituting a glass of water for a sweetened beverage reduced their children’s obesity risk by nearly 20%!

 

I am always cautious in interpreting data, particularly when it comes to weight because we know that so many other factors could influence children’s weight gain (Ex: physical activity, etc). Although the data doesn’t prove that maternal artificially sweetened beverage consumption caused children to gain weight, the data is strong enough for me to counsel my patients to avoid drinking any drinks with artificial sweeteners when pregnant.

 

Take home points:

  • Limit using artificial sweeteners during pregnancy
  • Consider trying some of these more natural sweeteners; note that there are limited long-term studies of these alternatives in pregnancy.
  • If all the natural sweetener options are overwhelming, stick to the basics: a cold glass of water!

Another reason to eat whole grains

I spend a significant amount of time with each of my patients reviewing their lifestyle and dietary habits. Ultimately, we all have the same goal: happy healthy families. I strongly believe that part of my job as a reproductive endocrinologist and infertility physician is helping build healthier families. As I reviewed in previous posts, we believe that our habits before and during pregnancy can program many diseases in childhood and later in life.

 

I previously discussed the importance of whole grain diet as it relates to fertility. New research suggests yet another reason why you should consider whole grains, and stick with it throughout a pregnancy. Researchers found that children born to women with gestational diabetes who consumed the most refined grain (more than 156 grams per day) were twice as likely to be obese at age 7, compared to children born to women with gestational diabetes who ate the least amount of refined grain (less than 37 grams per day).

 

Take home point: eating refined carbs in pregnancy could increase the risk of your child being obese at a young age.  “You are what you eat” … and based on this study, your future child will be too.

 

What you can do:

  • Substitute one meal a day for something with more whole grains.