Canary in the coal mine

This is an expression that describes when miners would carry birds (canaries) down into the mine tunnels with them. If dangerous gases such as carbon monoxide collected in the mine, the gases would kill the canary before killing the miners, thus providing a warning to exit the tunnels immediately


New research suggests that  infertility can be the canary in the coal mine for men . 


Men with infertility are at higher risk of prostate cancer. In particular, men who needed IVF technology for male factor were more likely to develop prostate cancer and at an earlier age than men who fathered pregnancies naturally. This finding does not mean that fertility treatments themselves raise men’s prostate cancer risk. 


Men with infertility should tell their other doctors that they have infertility. Because infertility may be the canary in the coal mine for other medical conditions, including prostate cancer. 


Stress is not a cause of infertility


 Stress is not a cause of infertility


Infertility is caused by things like a male factor (low sperm count) or female factor (blocked fallopian tubes, endometriosis, low egg number). But stress is not a cause of infertility. 


Stress is very common when trying to conceive. As many as 57% of patients have clinical depression or anxiety before they even start fertility treatments. Stress during infertility can also be severe: many couples report higher stress levels with infertility diagnosis than those with a new diagnosis of cancer. 


Stress is something we need to consider because it is common in couples with infertility and because it impacts the chances of being successful with treatment. Stress reduction can increase chances of success with treatment and  improve pregnancy rates. This is true regardless of stress reduction technique: yoga, meditation, acupuncture, and/or therapy. 


I take a pro-active approach and talk about stress with all of my patients. At the new visit, I review how common stress is with infertility and provide resources. I also will try to check in on my patients during fertility treatments and ask “How are you doing with the emotional aspects of your treatment?” At times, I recommend pausing fertility treatments to optimize mental health. 


The best way to have a healthy uncomplicated pregnancy is to start with a happy healthy family before conception. You are not alone. Your mental health is worth taking care of and so are you.  ❤️

Is IVF bad for my health?

Is IVF bad for my health? 




Every month a woman’s body loses the same number of eggs, regardless of whether they are doing IVF or on birth control pills. So you don’t lose any more eggs doing IVF than you do each month on your own. Doing IVF will not make you run out of eggs sooner, or go through menopause earlier. 


The hormones used for IVF are similar to the hormones your body naturally makes each month. You are on these hormones for a limited time period. The impact of this is small on your overall health.


IVF does not cause cancer.

✔️Women who are doing IVF are often using these technique because of infertility and endometriosis; these conditions in themselves increase the risk of ovarian cancer.
✔️IVF does not  increase the risk of breast cancer, even in women predisposed to cancers due to genetic mutations like BRCA

✔️IVF does not increase the risk of thyroid cancer, melanoma, lymphoma, cervical, or colon cancer


As with any medical procedure, there are risks. But the risks of complications in IVF is low. 

IVF patients are exposed to endocrine disrupting chemicals⁣


A recent study found that women doing IVF are exposed to multiple EDCs. In particular, they found that women who were exposed to chemicals found in plastics called phthalates, had lower chances of success in IVF. Previous work from this group has shown that women who are exposed to phthalates have fewer eggs at egg retrieval and fewer embryos. 


What you can do:

✅Limit your exposure to phthalates, particularly if you are going to be doing IVF

✅Start simply by removing phthalate exposure in your kitchen

✅Use personal care products that are phthalate free. 

This post is for educational purposes only.

The power of social media


As a busy physician in private practice and working mama of 3 boys, my life is busy. And at times, I’ve questioned myself: “Why am I spending the time to do social media?” And then a study like this comes along and I am reminded. 

Whether we healthcare professionals like it or not, social media is here to stay for sharing information on specific health diagnoses

Reddit is a social media website with 330 million active monthly users. A recent study in JAMA found that there were over 16,000 posts asking for “crowd-diagnosis” of a sexually transmitted disease; many of these were requesting a diagnosis as a second opinion after seeing a healthcare professional. 87% got a response to their question, and it usually took less than 3 hours. The old medical dogma of calling your doctor’s office with a question and waiting a week for a response is gone. Social media is the new way that our society wants to embrace medical information. 

✅It’s common to look at social media for answers to medical questions

✅We want our answers fast

✅We need to help patients find reliable sources of information. We need to protect them from misdiagnosis from responders who may lack medical training. This is particularly important with STD screening which can impact their lifelong fertility if misdiagnosed.
✅I need to continue to evolve and challenge myself with the use of social media


𝒟𝑜𝒸𝓉𝑜𝓇𝓈 𝒶𝓇𝑒 𝓅𝑜𝑜𝓇𝓁𝓎 𝓉𝓇𝒶𝒾𝓃𝑒𝒹 𝒾𝓃 𝓃𝓊𝓉𝓇𝒾𝓉𝒾𝑜𝓃 ⁣ ❗️


A poor diet outranks smoking as the number one killer in the US. But this recent study shows that medical students are poorly trained in nutrition prior to becoming physicians. It’s possible that improved diets could prevent more than 1 in 5 deaths every year. Physicians can help by providing their patients with dietary advice, but they lack the necessary training. 


In my field of infertility, we know that nutrition impacts a couple’s chance of success with fertility treatments as well as their opportunity to have an uncomplicated pregnancy. Other studies have shown that how healthy we are prior to pregnancy not only impacts the future child, but also our grandchildren. As a REI, I have an obligation to share this information with patients because the health of our society, and future generations, is at risk. 

This is why I try to talk to all my patients about their nutrition when trying to conceive (TTC)⁣
✔️Improved chance of conceiving naturally⁣
✔️Greater chance of success with fertility treatments⁣
✔️Healthier egg and sperm⁣
✔️Decreased chance of complications in pregnancy⁣

Thank you to @cookingforboards and @flavors4wellnessmd for starting this campaign #foodtoheal⁣

Progress is possible ! Don’t give up!


𝗣𝗿𝗼𝗴𝗿𝗲𝘀𝘀 𝗶𝘀 𝗽𝗼𝘀𝘀𝗶𝗯𝗹𝗲! 𝗗𝗼𝗻’𝘁 𝗴𝗶𝘃𝗲 𝘂𝗽!⁣ ⁣
Unhealthy diet is a major risk factor for diseases, including infertility. In the United States, poor diet is estimated to be the leading cause of death. I’ve reviewed how important your diet is when trying to conceive previously. Today, let’s review how we are doing in the United States with our diet (1999-2016). 
✅Decrease in percentage of energy intake from low-quality carbohydrates 👍
✅Increase in percentage of energy intake from high-quality carbohydrates👍
✅Increase in percentage of intake of plant protein⁣👍
✅Increase in percentage of intake of polyunsaturated fat⁣👍


Despite improvements in macronutrient composition and diet quality, there is continued too high of intake of low-quality carbohydrates and saturated fats 👎

As a fertility specialist, to me this study shows #progress . Our diets are not great, but we are making progress. What we eat matters. And with slow and steady changes, we can all get healthier. In terms of fertility, a healthier diet means healthier egg and sperm, increased chance of success, decreased chance of complications in pregnancy, and healthier families for generations to come. ⁣

Is your diet making it harder to get pregnant?

𝐼𝓈 𝓎𝑜𝓊𝓇 𝒹𝒾𝑒𝓉 𝓂𝒶𝓀𝒾𝓃𝑔 𝒾𝓉 𝒽𝒶𝓇𝒹𝑒𝓇 𝓉𝑜 𝑔𝑒𝓉 𝓅𝓇𝑒𝑔𝓃𝒶𝓃𝓉?

A recent study looked at the impact of a processed modern diet on fertility. This study evaluated  areas of India that have recently adopted an urban diet with processed foods. They found that women who ate an urban diet were more likely to have problems with hormonal imbalances like what is found in polycystic ovarian syndrome (PCOS). Women who have PCOS are more likely to have difficulty conceiving. This suggests that as areas of India become more urbanized, infertility may become even more common. 


What you can do to optimize your fertility when trying to conceive:

✅Eat a whole foods plant-based diet

✅Avoid heavily processed foods like fast food

✅Cook your own meals whenever possible

✅Eat meat sparingly



Tea and Plastics: the most recent example of healthy food packaged/prepared badly

As fertility specialists we try to point out how diet/lifestyle can optimize your fertility efforts. Recently, I shared the latest information that coffee and tea can actually have some benefits—despite popular, but misguided beliefs. But it is always important to realize that it’s not just what we consume—but also how we prepare it that matters!

Fancy tea bags

Tea can easily become an example of a healthy drink gone bad if not prepared properly. A recent study from McGill University demonstrated that just one of the new fancy plastic tea bags can release 11 billion microplastic and 3 billion nanoplastic particles into your drink in as little as five minutes when prepared at standard temperatures. These tiny particles cannot be seen without a microscope. But because of their size they can enter your body much easier than they can ever leave. In fact, a study from the World Wild Life Fund found that it is not unusual for people to consume about 5 grams of plastic per week by eating sea food or drinking beer from cans lined with plastic. That’s equivalent to eating the amount of plastic in a credit card each week!

Although we don’t (yet) know of all of the potential health effects of micro-particles—we do know that plastics can have a negative impact upon fertility due to the chemicals that they contain. In fact, a direct link has been found between the ingredients used in plastics upon egg quality and maturation (their ability to be fertilized). More importantly, these plastic tea bags are not needed and have only recently been introduced.

Here are a few tips to consider:

  • Say “NO” to unnecessary plastics—as consumers you speak volumes with your purchases. Let companies know if you’re choosing to not use their products due to their packaging choices
  • Get a re-usable device to steep your tea
  • Support organizations like the Environmental Working Group that offer tips to minimize your exposure to plastics


As I said in my previous blog post, “these low calorie, plant based beverages may have some health and fertility boosting benefits.” But now I’ll modify my statement with a reminder that this is only true if packaged and prepared in a health way.

Stay informed and motivated,


Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

Modern Family Building strategies for the LGBTQ Community

Many of us take for granted that having children will become a natural outcome of our current relationship. For members of the LGBTQ community—this is not the case. A recent survey conducted by the Family Building Council found that 33% of the LGBTQ respondents over age 55 either had children or were planning to have children. This was a sharp contrast to LGBTQ Millennials—age 18 to 35—for whom 77% are either already parents or planning to have children. Even more encouraging among Millennials, is that there are nearly as many members of the LGBTQ community planning to have children as their non-LGBTQ peers—48% vs 55%. However, the LGBTQ Millennials know that they are going to need some assistance to achieve their family.

Booth at Pride Fest

The Family Building Survey also revealed among LGBTQ Baby Boomers—those 55 and older—nearly 75% became parents through intercourse. Many of those were children conceived in former relationships and therefore were “blended families.” This was in sharp contrast to Millennials. Among the 18 to 35 year olds, more than half planned to use Assisted Reproductive Technologies, adoption or fostering to meet their family building goals. That amounts to an estimated 3.8 million LGBTQ Millennials considering expanding their families and 2.9 million that are actively doing so.


If you’re among those seeking to become parents, consider the following:

  • Learn what options are available rather than simply thinking about the simplest way to initiate a pregnancy
  • Consider what your ideal completed family would like before finalizing your plan—it can be very difficult to find the same donor years later if you want a sibling
  • Seek out providers in the healthcare community that will serve as your allies and advocates
  • As more insurance companies are covering reproductive technologies as a covered benefit—investigate how those options apply to you


Stay informed,



Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado