What’s in a Prenatal Vitamin?

What?

  • FOLATE aka FOLIC ACID (most important)
  • Iodine
  • +/- Iron (this can also be supplemented separately as needed, such as for anemia)

Why?

  • Folate reduces risk of neural tube defects (birth defects), such as spina bifida
  • Iodine optimizes thyroid health and fetal brain development

When?

  • Optimal to start about 3 months prior to conception
  • Take 1 serving (number varies by vitamin) daily

How much?

  • At least 400 mcg folate per day, but individual needs may be higher
  • 150 mcg per day of iodine

Where?

  • Any pharmacy or grocery store, or available online

Other ingredients?

  • Limited evidence for other ingredients, but they are usually not harmful.
  • It is important to avoid excessive quantities, such as for Vitamin A or B vitamins.

Which are legitimate products?

  • Prenatal vitamins can be given as a prescription from your doctor
  • Prescription brands are FDA-regulated
  • Direct-to-consumer (aka over-the-counter, or OTC) brands are not as strictly regulated
  • If you buy it OTC, check for the following certification standards:
    • Look for NSF (National Sanitation Foundation) certified
    • Or look for USP (United States Pharmacopeia) verified

Introducing Dr. Chiang!

Greetings to the Enhancing Fertility Blog community! I am happy to be joining the Conceptions team and looking forward to connecting with everyone via this blog. I recently relocated from Alabama to my husband’s home state of Colorado. My areas of interest are infertility, ovulation induction, intrauterine insemination, IVF, fertility preservation, and recurrent pregnancy loss.

I enjoy working with patients on building their families, particularly problem-solving and navigating the challenges of health and life. Deciding to pursue fertility, defer fertility, or choose fertility preservation can be a complicated decision, and it is a topic almost everyone comes across in their lifetime. It requires patients to consider many factors, including their health assessment, emotional reserve, and financial status. I love being the doctor people can trust for guidance with that decision.

I joined Conceptions because the practice stands out to me as a local, ethical, privately held Colorado business model. The dedication is to professionalism and doing right by our patients in the long run, not to corporate shareholders. We focus on the people we care for. We empower patients to make personalized decisions that nurture physical and mental wellbeing on the road to having a baby.

You can follow my Instagram @jasmineleechiang

Depression in Dads

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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

Fast food is bad for fertility

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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

Doing an IVF cycle? A Mediterranean diet can help!

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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

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.

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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?

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

Iodine deficiency may reduce pregnancy chances

A common question asked in a new fertility evaluation is: “Which prenatal vitamin is best?” We have previously tried to provide some guidance in choosing the best vitamin.  The ingredient list in your prenatal vitamin needs to be considered.

In particular, iodine is an often-overlooked but extremely important component that should be considered in a prenatal vitamin. Iodine is a mineral used by the body to regulate metabolism; it is also very important for brain development in children. It is often found in seafood, iodized salt, dairy, and some fruits and vegetables.

A new study shows that women who have low iodine levels take longer to get pregnant than women who have normal iodine levels.

Take home points:

  • Iodine is important in pregnancy and when you are trying to conceive
  • Boost your fertility naturally with iodine
  • Make sure you are on a good prenatal vitamin
  • Talk to your doctor about what levels of iodine are best for you

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.