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Monthly Archives

January 2018

The 10 Foods You Should be Eating During the 2-Week Wait

By | Natural Fertility Support, Prenatal Nutrition | No Comments

You’ve made it through!

Through the countless appointments, medications, and procedures! Now all there’s left to do is wait, and maybe wait a little more. These two weeks are a time for you to do absolutely nothing: love yourself, hug yourself, and reflect on how you’re stronger than was ever thought humanly possible!

I’ve heard from my patients that the hardest part of the 2-week wait is feeling like there is nothing else they can do, which makes the wait that much…crappier. They want to support their body in every way they can and they’re not sure how to do this after the embryo transfer. Luckily there IS something you can do, and that’s optimize diet! There are simple foods you can eat to increase pelvic circulation, build blood, decrease inflammation, and support progesterone. Eat them often and feel confident that you’re supporting your embryo and overall health!

  1. Blackstrap Molasses

    1 tbsp of molasses has the same iron content as half of a small steak! Iron is needed to build nutrient rich blood. You can add it to oatmeal, smoothies, and in place of sugar in baking and cooking.

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  2. Beets

    Beets produce nitric oxide (NO), which dilates the pelvic blood vessels. Beets allow your nutrient rich blood to be delivered to where it matters most – your embryo!

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  3. Spinach

    Not only does spinach contain lots of iron, but it also benefits pelvic blood flow so that you can build a thick and plush uterine lining.

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  4. Lentils/ Beans

    They’re the ultimate vegetarian source of protein, iron, fiber, zinc, potassium, and b-vitamins…everything your growing embryo needs.

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  5. Beef/Tofu

    Organic, grass fed, hormone-free beef for the omnivores and non-GMO, organic tofu for the vegetarians. Both are powerful blood building foods. Beef is a source of heme iron, which is better absorbed than plant based irons for a quick boost. If you’re feeling adventurous, liver and oysters contain even more iron but they’re a hard sell with my patients!

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  6. Oats

    Are you tired of hearing about iron yet? You need a heck of a lot of it to grow a baby and oats are another great source! Oats also contain beta-glucans, which support your immune system which takes a pretty big hit when you’re growing a baby.

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  7. Nuts: Almonds & Walnuts & Brazil nuts

    Almonds and walnuts contain anti-inflammatory fatty acids AND nitric oxide for improving blood flow. The embryo implantation process actually requires a small amount of inflammation to succeed, but too much inflammation is detrimental.

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  8. Salmon

    Alaskan, non-farmed salmon is the healthiest and highest source of omega- 3 fatty acids (EPA & DHA). These fats are found in every cell in your body, even your embryo’s. They support hormone production and cellular regeneration.

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  9. Seeds: Sunflower & Sesame & Hemp seeds

    These 3 seeds have fatty acids that mimic progesterone, thus increasing overall progesterone levels in your body. Progesterone is needed to maintain endometrial thickness.

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  10. Pineapple

    It’s a well-adopted symbol for the fertility community, and for more reasons than one! Pineapple contains an enzyme called bromelain, which can support embryo implantation and endometrial receptivity.

The 2-week wait is all about doing things that support your body and mind and make you feel happy; the hardest part of the IVF process is over. If you can fit in some of these healthy foods too, your embryo will thank you. They’re also all foods that are great for pregnancy nutrition.

Book an appointment to prepare for your upcoming IVF or FET cycle

5 Natural & Effective Ways to Increase Uterine Lining Thickness

By | Fertility Acupuncture, Fertility Supplements, Natural Fertility Support, Prevent Miscarriage | No Comments

During natural cycles, cycle monitoring, IUI, IVF & FET

Uterine (or endometrial) lining thickness is a useful predictor of embryo implantation and miscarriage prevention. It is measured via ultrasound during cycle monitoring, IUI, IVF, and frozen embryo transfers. A thin lining can halt the entire fertility process, and not seeing any growth in thickness, despite medical efforts, can be really frustrating.

The Lining “Norm”


Uterine lining thickness varies depending on the phase of your menstrual cycle and hormonal influence.

On your period: 2-4mm

Follicular phase (before ovulation): 5-7mm

Ovulatory phase: 7-11mm

Luteal phase (after ovulation): up to 16mm

A lining < 8mm is associated with implantation failure, poor receptivity, and low pregnancy rates. The numbers aren’t the only measurement that matters. The endometrial pattern is also relevant; the most receptive lining is called triple-line or tri-laminar (due to its 3 layer appearance).

The most common pharmaceutical approach to a thin lining is supplementation with synthetic hormones; conjugated estrogen, progestin, or a combination of both like the oral contraceptive pill. Viagra is also used to increase pelvic blood flow (it ain’t just for men!) Not all women respond to these options, but thankfully there are natural alternatives. Naturopathic medicine and fertility supplements can be used in conjunction with hormones or alone to optimize your lining.

  1. Vitamin E

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    A 2017 study showed that 12 weeks of low-dose vitamin E supplementation in women with prior implantation failure increased endometrial thickness by 2mm and decreased inflammatory cytokines.

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  2. L-Arginine

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    A pilot study in 2010 used high-dose L-arginine to increase endometrial thickness and pelvic blood flow.

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  3. N-Acetyl-Cysteine

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    NAC is a super-fantastic-marvelous supplement. It has proven to improve endometrial thickness (pertinent here) as well as: induce ovulation, recruit mature follicles, reduce insulin sensitivity, and break down endometriomas! Woah!

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  4. Fruit: lemon, lime, orange, pomegranate, watermelon

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    What do all of these fruits have in common? They are nitric oxide producers. Nitric oxide dilates your blood vessels so more blood can be delivered to your uterus to build up that lining. Viagra works the same way, which means pomegranates are nature’s Viagra!

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  5. Acupuncture (including electro-acupuncture)

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    Fertility acupuncture is used to support embryo implantation and promote pelvic blood flow. It supports endometrial thickness by reducing stress on the uterine artery. Multiple studies have shown a statistically significant increase in pregnancy rates with acupuncture before embryo transfer and on the day of transfer.

When all else fails, remember that lifestyle makes a huge difference! Simple strategies like drinking at least 2L of water daily and moving your body with gravity can increase endometrial thickness.

Book an appointment to support your uterine lining!

References:

Jimenez, P. T., Schon, S. B., Odem, R. R., Ratts, V. S., & Jungheim, E. S. (2013). A retrospective cross-sectional study: fresh cycle endometrial thickness is a sensitive predictor of inadequate endometrial thickness in frozen embryo transfer cycles. Reproductive Biology and Endocrinology11(1), 35.

Zhao, J., Zhang, Q., & Li, Y. (2012). The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles. Reproductive Biology and Endocrinology10(1), 100.

Al-Ghamdi, A., Coskun, S., Al-Hassan, S., Al-Rejjal, R., & Awartani, K. (2008). The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reproductive Biology and Endocrinology6(1), 37.

Hashemi, Z., Sharifi, N., Khani, B., Aghadavod, E., & Asemi, Z. (2017). The effects of vitamin E supplementation on endometrial thickness, and gene expression of vascular endothelial growth factor and inflammatory cytokines among women with implantation failure. The Journal of Maternal-Fetal & Neonatal Medicine, 1-8.

Takasaki, A., Tamura, H., Miwa, I., Taketani, T., Shimamura, K., & Sugino, N. (2010). Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium. Fertility and sterility93(6), 1851-1858.

Nasr, A. (2010). Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study. Reproductive biomedicine online20(3), 403-409.

di Villahermosa, D. I. M., dos Santos, L. G., Nogueira, M. B., Vilarino, F. L., & Barbosa, C. P. (2013). Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial. Acupuncture in Medicine31(2), 157-161.

What Your Semen Analysis Really Means & How to Get the Results You Want

By | Hormone Testing, Natural Fertility Support | No Comments

A Brief History of the Mighty & Motile

The World Health Organization has the very influential job of determining the reference ranges for semen analysis. These reference ranges were overhauled in 2010 from the previous 1999 ranges, which were much higher. There is no doubt that sperm quality has declined over the past 50 years. Some may argue that it’s due to emerging standards of scientific evidence, but in my opinion the strongest evidence is the western lifestyle: poor diet, toxic exposure, xenoestrogens, electromagnetic frequencies, obesity, sedentary habits, the list is endless.

The 2010 standards are based on the semen of fertile men who fathered children within the 12 months preceding the study. The ranges represent the lowest 5th percentile of these men. Meaning:

1) 95% of men should have higher sperm parameters than the reference range

2) Values deemed “normal” are in fact suboptimal for natural conception

The 5 Ws of Semen Analysis

Who: All men wanting to conceive

What: You ejaculate into a cup. It’s not comfortable, but it’s important. You need to abstain from ejaculation 2 days prior to collecting your sample, but you need to have ejaculated at least 5 days before your sample. This is to prevent DNA fragmentation and death of the sperm, if they sit around for too long they actually kill themselves…

When: Your doctor may advise you to try for a year before going for a semen analysis. This doctor says 6 months is enough waiting, especially if you’re over 35 (it’s not just women who age you know!) Once you’ve completed one semen analysis, repeat testing is recommended in two weeks. Semen is ever changing and one snapshot is not enough.

Where: Most likely in a private room at a fertility clinic (bring your own “motivation”), but you may be given the option of home. If you’re obtaining your sample at home you essentially have to sprint like Road Runner to the lab afterwards because the sperm do not survive long outside of body temperature. It’s not recommended.

Why: To determine if you have sperm (in your semen) capable of natural conception, or if they’re going to need a little help getting to their destination.

The Numbers At a Glance

Parameters WHO 2010 Criteria – 5% percentile What if you want sperm that’s 50% better than your friends?
Volume of semen (ml) 1.5 3.7
Concentration of sperm (per 1ml of semen) 15 million 73 million
Progressive motility *forward moving sperm 32% 55%
Morphology

*normal sperm forms

4% 15%

Other Important Tests For Your Semen

  1. Liquefaction – Your semen should liquefy within 15 minutes so that the sperm can be free to swim
  2. Colour – Semen is grey and opaque. The more translucent it is the less sperm is in it.
  3. pH – Semen has a basic pH of 7-10, this is to help the sperm survive upon ejaculation.
  4. DNA Fragmentation – This is a measure of damaged sperm DNA. A value > 50% is very poor DNA integrity and is linked to poor conception and miscarriage.
  5. Sperm antibodies – These are antibodies the sperm develops against itself. Antibodies affect the sperm’s ability to bind to the egg and for the embryo to develop normally.

 

Beyond Semen: Tests for Whole Body Health

Sperm health depends on whole body health. Blood pressure, blood sugar, cholesterol, thyroid hormones, adrenal hormones, liver health, and weight are all contributing factors to sperm health. Other hormone tests can be run as well.

 

What do the Numbers Mean?

If you score lower than the 5th percentile, the next step is hormone testing and a referral to a urologist to determine the root cause. The most common causes of low sperm counts include:

  • Retrograde ejaculation – semen enters bladder instead of urethra
  • Hypospadias – opening of urethra on underside of penis
  • Cryptorchidism – undescended testes
  • Absent vas deferens – congenital condition
  • Klinefelter syndrome – extra X chromosome without symptoms
  • Varicocele – testicular swelling and block of blood flow
  • STI – chlamydia, gonorrhea
  • Endocrine dysfunction – hypogonadism
  • Metabolic dysfunction – diabetes, high blood pressure, high cholesterol
  • Lifestyle factors – smoking, alcohol, medications, poor diet, sedentary etc.
  • Age – semen parameters decline around age 35-38

What Are Your More Invasive Treatment Options?

Based on sperm concentration:

  • IUI – between 5 and 10 million/ml
  • IVF – less than 5 million/ml
  • Hormone therapy – less than 5 million/ml
  • TESE (testicular sperm extraction) – undetectable sperm but normal testosterone

What Are Your Less Invasive Treatment Options?

It takes 90 days for sperm to mature. Lifestyle has the potential to change EVERYTHING

Lifestyle: YESSES

  • Ejaculate often – every 3 days to prevent DNA fragmentation. Your semen volume may decrease but your sperm concentration will not
  • Wear protection…when playing sports – injury causes the production of sperm antibodies
  • Brush your teeth – periodontal disease is linked to poor sperm quality
  • Sleep well – melatonin is an essential antioxidant for sperm protection
  • Buy organic & filter your tap water – pesticides and chemicals distrust hormones
  • Use a sperm friendly lubricant, like: Yes Baby, Astroglide TTC, and Pre-Seed
  • Foods to incorporate on a daily basis for sperm production & protection: pumpkin seeds, eggs, olive oil, garlic, POM juice, oats, barley, walnuts, almonds, brazil nuts

Lifestyle: NOT SO MUCH

  • Chemical sunscreens – contain benzophenones, which are harmful to your testes
  • Direct Wi-Fi – the frequencies and heat from your laptop are damaging, turn your laptop into a standing desk
  • Extreme heat- the scrotum likes a breeze! Avoid seat warmers, hot tubs, long stretches of sitting, skinny jeans, tighty-whities, long distance biking etc.
  • Extremely strenuous exercise – don’t decide to compete in an Iron Man or train for your first marathon while trying to conceive
  • Smoking – including marijuana, it impairs sperm count and motility
  • Alcohol – no more than 3 drinks a week
  • Coffee – no more than 200mg daily (that’s 1 small Starbucks/ Tim’s)
  • Processed meats – they’re full of crap, need I say more

Naturopathic Strategies

Book an appointment . As a Naturopathic Doctor, I use herbs, supplements, nutrition, and acupuncture to help you produce more sperm and optimize the sperm you already have.

  • Your sperm needs fuel just like any other cell in your body and sometimes it needs a little supplemental support
  • Your sperm also needs anti-oxidants and vitamins to protect it from damage
  • Herbs and acupuncture can improve your libido and decrease erectile dysfunction
  • Most of all, I can answer all of your questions and support you through the conception process. Simple solutions can make all the difference