Enhancing Fertility

As we continue to adjust to life during the SARS-CoV-2 outbreak it is important that we adjust our activities. Fertility treatment is ESSENTIAL care for those that need it. Our goal is to continue continue to provide this care for all of those seeking treatment–but it will require their assistance as well. Here in Colorado our use of social distancing has clearly reduced the severity of the outbreak. I’ve summarized in a videoblog the recommendations to keep our patients, our staff  and our community safe: https://youtu.be/7sBN7WgC35I .

So please continue to stay safer-at-home when possible and follow established social distancing when out in public place.

With kindness and support,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

 

As fertility treatment resumes following the pause created by the COVID19 Outbreak, we have experienced marked improvement in air quality. Many are unaware the of the unfortunate effects that pollution has upon fertility. Here on the 50th Anniversary of Earth Day is a great time to update you on how our improved environment can boost your chances of achieving and maintaining a healthy pregnancy: https://youtu.be/Iq93CXlrp4Q .

I hope that you found that information to be encouraging. Let’s see if we can take it a step further and make some better choices as we move forward in to the future.

REFERENCES from this video: 

• Air pollution and ovarian reserve: https://www.sciencedaily.com/releases/2019/06/190625181939.htm
• Air quality and male fertility: https://www.bmj.com/company/newsroom/air-pollution-linked-to-poorer-quality-sperm/
• Air pollution, IVF Treatment Outcomes: https://www.reuters.com/article/us-health-pregnancy-ivf-pollution/air-pollution-linked-to-fertility-treatment-failure-idUSKBN1HX3AW

Treatment for fertility patients has been challenging during the COVID19 Outbreak. There is agreement that fertility treatment is essential and not elective. But whether or not it was urgent created some confusion as whether or not treatment should be continued or halted during the early days of the outbreak in the United States.

At this point, it is becoming more apparent that various regions are experiencing this pandemic very differently. Here’s the latest update for patients seeking care at our center in Colorado: https://youtu.be/Ky5lcP-Rzus.

Stay safe, stay well and if you can please stay home.

With kindness,

~Robert Greene, MD, FACOG

There is increasing concern over Corona Virus or COVID19 as this infection spreads. In perspective there are other infectious diseases that people seeking pregnancy should also consider. Here is a link to a videoblog we recently created to try to answer some of these questions and provide some practical advice: https://youtu.be/a6p4uUC8hgk 

 

 

 

One of the most common questions that patients focus on is identifying the reason for not becoming pregnant easily. I typically begin a consultation by re-framing the question. Take a listen: https://youtu.be/XhPXGE9Q6ps

In our effort to remain relevant and provide you with current and relevant content–we’re starting a new YouTube Channel called Clinical Conversations. My partner in this project–Lisa White–is a licensed counselor that has actually gone through fertility treatment herself.

Our goal is to help support you by providing you with some short dialogues about topics that you find to be most relevant. Consider signing up or emailing us some suggestions for topics.

If you can’t find us at the link above just search “clinical conversations–fertility chats” on YouTube.

We hope to see you there!

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!

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

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

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.

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

 

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

About one in four pregnant women will experience a miscarriage. At least two thirds of miscarriages are believed to be due to a genetic abnormality in the embryo. It can make it even more emotionally devastating if the pregnancy was initiated following an IVF procedure with an embryo that had already been genetically tested prior to transfer. That’s why it is so very important that we investigate other—possibly preventable—causes of early pregnancy loss. One emerging strategy is to optimize vitamin B3 intake.

Vitamin B3—also called niacin—serves as critical component of energy within cells to support growth and development. It also serves as a key signal for a group of chemicals that are necessary to repair DNA as well as regulate your body’s stress response. These are all critical functions to initiating and maintaining a successful pregnancy. Unfortunately not all pregnant women are getting enough vitamin B3.

 

Surprisingly, not all prenatal vitamins contain niacin / B3. One study that was following over 500 pregnant women found that despite following a healthy diet and taking daily supplements—a high percentage of women were vitamin B3 deficient. More recently, a study published in the New England Journal of Medicine demonstrated that giving a group of high risk pregnant women a high dose vitamin B3 supplement seemed to reduce the risk of both miscarriage and birth defects. Additional studies are on-going to see how this may translate into women with average risk.

 

While we await the results of future studies in this area, there are some safe and simple steps you can consider to help minimize your risk of miscarriage:

• Eat fortified cereals and grains
• Include blueberries and grapes as part of your healthy diet—they contain a chemical pterostilbene which can enhance Vitamin B3 activity
• Check your prenatal vitamin to confirm that it has at least 20 mg of Vitamin B3
• Talk to your provider about whether or not you should consider a Vitamin B3 supplement

 

Stay informed,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

It is estimated that between 8 and 12% of women will develop endometrial polyps during their reproductive years. These represent outgrowths of the uterine lining that can vary in shape and size but reflect uneven development of the tissue that is responsible for promoting implantation of embryos to initiate pregnancy. Therefore, it’s not surprising that they seem to be more common in women with infertility. In fact, one study of 1000 women undergoing IVF found about 32% of them had endometrial polyps.

In an attempt to estimate the impact of endometrial polyps on infertility, one study randomized 215 women with endometrial polyps to having surgery prior to starting Ovulation Induction with Insemination treatment vs not having surgical correction prior to starting treatment. They found that those that had surgery were twice as likely to become pregnant.   

 

Other studies have also looked at mechanisms for how polyps could interfere with implantation. Here the evidence is equally compelling. In addition to the mechanical interference; polyps have been linked to various chemical changes in the uterine environment—especially involving certain markers of implantation and inflammation.

 

At our center, we go through great lengths to create and identify the healthiest embryos possible to help our patients achieve the highest attainable live birth rate. Therefore we always take steps to make sure that we’re placing embryos into the best possible uterine environment. Timing is also important in considering when to remove polyps. At least one study found that 27% of polyps will go away on their own. So we don’t plan any such surgery until we know we have healthy embryos to transfer or our patient is ready to become pregnant.

Stay informed,

~Robert

 

Robert Greene, MD, FACOG

Conceptions Reproductive Associates