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

More on pesticides

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Thank you for the excellent feedback from our last string of posts: “Top 10 ways to minimize your exposure to toxic chemicals in our environment.”

One of the tips that was covered in this list is to eat lots of fruits and veggies. I recommended eating a variety and to choose organic selectively by using tools such as EWGs “Clean 15” and “Dirty 12.”

Human fertility rates are declining. Although this was thought to be due to lifestyle changes and societal changes, could our environment be playing a role? Could environmental contaminants like pesticides in our food be contributing to infertility?

This study in China showed that women with high levels of organophosphate or pyrethroids exposure (common pesticides) took longer to conceive and were more likely to have infertility than couples that had lower levels of exposure.

What you can do:

  • Wash your produce for at least 20 seconds to minimize your exposure to pesticides.
  • Eat organic when you can and strategically by utilizing resources like EWG’s dirty list: certain items are worth the money of switching to organic (“Dirty 12”) more than other produce (“Clean 15”)

Caution about Sunscreen Use

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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

Considering IVF? Limit your exposure to DEHP.

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:

IVF might not be enough

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.

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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

Great resource

I spend a considerable amount of time working with my patients to prepare them for a healthy pregnancy.  Lifestyle modifications like small changes to your diet and environment can absolutely optimize your chances of conceiving, regardless of what kind of treatment you are undergoing. This blog is dedicated to exploring the research behind our recommendations to couples.

I want to share an additional helpful resource to those of you who are trying to initiate these lifestyle changes. This group helps you tackle lifestyle changes, one room at a time in a user friendly and interactive manner. Check them out!

 

 

 

 

Air pollution stinks!

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

Reduce your risk of autism with a vitamin!

My goal as a REI is to help provide patients with the information they need to not only boost their natural fertility, but also to help them have a healthy pregnancy and to, ultimately, bring home a happy healthy kiddo. Those of you who know a family affected by autism, know how terrifying the condition can be. Autism is a neurodevelopmental disorder characterized by impaired social interaction, impaired verbal and non-verbal communication, and restricted and repetitive behavior.

Autism is thought to develop during pregnancy. Many neurodevelopmental disorders, like problems with the baby’s spinal cord, are known to be impacted by maternal nutrition during pregnancy. New research suggests that what mom eats during her pregnancy may alter the risk of her child developing autism.

In this large study of over 270,000 mother-child pairs, women were screened for vitamin use and their children were followed to see if they developed autism throughout childhood. Maternal multivitamin use with or without additional iron or folic acid, or both was associated with lower odds of having an autistic child with intellectual disability in the child compared with mothers who did not use multivitamins, iron, and folic acid (odds ratio 0.69).  This study suggests that maternal multivitamin supplementation during pregnancy may be something women can do to decrease their risk of having a child with autism.

 

What you can do:

  • Take a prenatal vitamin when you are trying to conceive and throughout your pregnancy

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