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Fertility Supplements

Your Natural Guide to An Easy Egg Retrieval

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

Your Natural Guide to an Effortless Egg Retrieval

Did you know that the egg retrieval procedure is considered minor surgery? No to worry though, you’ll be sedated! (Which means don’t go alone, you’ll need someone to drive you home.) This blog is filled with tips and tricks to get you through the procedure with knowledge and ease. No surprises here!

What’s happening exactly?

Your eggs are typically retrieved through transvaginal ultrasound aspiration (the same ultrasound you’re already used to.) A fine needle is inserted into the ovaries to extract the eggs. In certain circumstances, the ovaries are accessed through the abdomen through laparoscopic surgery. The procedure itself typically takes 30 minutes.

Sperm is retrieved at the same time, so make sure your partner abstains for the recommended amount of time and is ready to provide a sample!

You will need to take the day off for the procedure as you’ll be recovering from anesthesia and experiencing a moderate amount of cramping.

Is there anything to do to prepare?

Of course! Here are my top tips on how to prepare for the egg retrieval procedure, and recover like a champ

Before the Egg Retrieval

  1. Sleep peacefully

You’ll have a faster recovery when your body is well rested, but you might be nervous the night before! Ease your nerves with a few soothing yoga poses like lying with your legs up the wall, or doing some deep breathing in child’s pose 10 minutes before bedtime.

  1. Stay hydrated

Dehydrated tissues are more sensitive and pain medications & anesthesia can cause dehydration. I know you’re used to those full bladder ultrasounds so you should be a water drinking pro by now!

  1. Pack your diet with fiber

Pain medications & anesthesia can also cause constipation. If you eat lots of fiber in the days leading up to the retrieval it will make going to the bathroom a lot easier. Incorporate foods like chia, flax, oatmeal, fruits and veggies, lentils, chickpeas, quinoa… the list goes on. While you’re eating those fiber rich foods, prepare your meals for the day of your retrieval ahead of time (or better yet get someone else to make them for you) to make healthy eating easier.

  1. Stay calm with breathing techniques and meditation

You’ll have to be at the clinic early, why not use the wait time to keep yourself calm and centered. There are so many amazing apps you can download that will guide you through quick and easy relaxation techniques to try before the procedure begins. Some of my favourites are: Headspace, Calm, and Aware.

  1. Go for regular acupuncture

If you’ve read my other blogs you’ll already know the incredible benefits of fertility acupuncture and acupuncture for IVF. Not only will it improve the delivery of meds and nutrients to the pelvis with ample blood flow, it will ease your recovery after retrieval through tissue healing and relaxation. One to two sessions per week, leading up to the day of your retrieval, is ideal. If in extreme circumstances you cannot be sedated, acupuncture can be performed during the retrieval procedure for pain management.

After the Egg Retrieval

  1. Ready your heating pad & castor oil

Expect to experience some mild to moderate cramping after the surgery. A heating pad can ease the muscle spasms. To make the relieving effects stronger, lather some castor oil over your pelvis and apply a cloth and heating pad over top.

  1. Invest in ginger capsules

 

You may be prescribed over-the-counter analgesic medications like Advil and Tylenol to ease cramping. Ginger is also an extremely effective analgesic/anti-inflammatory and in high doses does not cause bowel or gastrointestinal symptoms. It will also ease any post-surgery nausea. Fertility supplements can be very helpful.

  1. Have some organic pantyliners handy

You might notice a little bit of spotting the day of the surgery. I find organic liners to be a lot less irritating than conventional liners. Treat yourself to some new ones!

  1. Cue up your favourite movies

You typically won’t need to take more than one day off to recover, but you will need the day of to recuperate. Get in your PJs and slippers and enjoy your favourite chick flicks and Netflix B-list movies (does anybody else watch those but me?)

  1. Get some more acupuncture

Here it is again! You’ve already done 12 sessions of acupuncture to optimize your eggs, now acupuncture can be used to relieve post-surgery symptoms. If you’re experiencing constipation, nausea, cramping, bloating, etc. acupuncture is your best friend.

The more in-control and in-the-know you are regarding the egg retrieval process, the better you will feel. I’m here to support you every step of the way. Book an appointment with me here

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.

Can coenzyme Q10 supplementation make your eggs act a little bit younger?!

By | Fertility Supplements, Natural Fertility Support | No Comments

It’s an unfortunate fact of life: every single day we get a tiny bit older. I truly believe that you’re only as old as you feel, and just because you’ve hit your 35th birthday doesn’t mean you don’t look and feel 25! Unfortunately our eggs, or oocytes, don’t agree with the theory that feeling young at heart makes us look young at heart. As women, we are born with an unchangeable number of eggs. Over time the quality of these eggs naturally declines, regardless of how we feel about it, but it’s not all downhill from there! Although we can’t change the number of eggs we have, we may be able to change the quality of those eggs and quality is more important than quantity, right?! And while we’re on the topic, we can influence the quality and quantity of sperm too!

How can we influence egg quality?

Even though we’re stuck with a certain number of eggs, we can influence the quality of our eggs because they are arrested in a stage of cell division called meiosis I. This means they are not mature and they have not completed cell division. It’s the maturation process that we can influence! Female eggs remain in the early stage of cell division until a woman reaches puberty. Once a woman has a menstrual cycle, a few of these eggs mature each cycle and compete for ovulation and move into the next stage of cell division. This cell division is responsible for dividing DNA and ultimately influencing the end quality of the egg.

Where does CoQ10 come in?

If you remember grade 8 science class (I know that’s a lot to ask) then you’ve probably heard of the mitochondria being the “powerhouse” of the cell. In order for the oocytes to divide efficiently, they need lots of energy from their mitochondria and coenzyme Q10 is an antioxidant that is essential for providing this energy. Our eggs cannot function without CoQ10, which is why our body naturally makes a certain amount. However, as we get older we produce less CoQ10 and we end up with eggs that aren’t great at dividing and have poorer development.

This lack of mitochondrial energy translates into: difficulty ovulating, trouble conceiving, and in the case of IVF- issues with making an embryo that survives to day 5 to be transferred. Poor quality eggs put you at greater risk of miscarriage due to aneuploidy, a term that refers to an abnormal number of chromosomes in the embryo. Poor egg and sperm quality are major causes of infertility. This can all sound very overwhelming, but CoQ10 plays a role in improving the quality of both eggs and sperm!

The possibilities of CoQ10 for egg development:

  • Decreases the rate of aneuploidy (abnormal chromosome numbers)
  • Boosts mitochondrial function and cell division
  • Increases energy, or ATP, production in the egg
  • Stimulates more eggs to develop in combination with IVF
  • Prevents DNA oxidation, causing damage
  • Induces ovulation in combination with clomid in cases of clomid-resistant women with PCOS
  • Significantly improves endometrial thickness, serum estrogen, and serum progesterone in clomid-resistant women with PCOS
  • Significantly improves clinical pregnancy rates in clomid-resistant women with PCOS
  • Greater concentrations of CoQ10 are associated with higher grade embryos in IVF and better embryo development

The possibilities of CoQ10 for sperm development:

  • Decreases the rate of aneuploidy (abnormal chromosome numbers)
  • Increases energy, or ATP, production in the sperm
  • Prevents DNA oxidation, causing damage (decreases DNA fragmentation)
  • Increases sperm concentration
  • Increases mitochondrial function and sperm motility
  • Decreases abnormal sperm morphology

Wow that’s a lot! Are you hooked on CoQ10? Here’s what you need to know to incorporate it into your life:

If you’ve been to the health food store lately you’ve likely seen the innumerous number of brands and forms of CoQ10. There are two forms of CoQ10 that are important to know: ubiquinone and ubiquinol. They both exist in our cells; in fact our mitochondria depend on the interconversion between the two forms. According to current research, ubiquinol is slightly more readily absorbed in the gut compared to ubiquinone. However, even more important than the form of CoQ10 is the method it is delivered. Since CoQ10 is a fat-soluble substance, it needs to be compounded in a fat-soluble material. This can be tricky to figure out based on a label alone, so it’s best to trust your neighbourhood naturopathic doctor in prescribing the best option for you. You should also refer to a naturopathic doctor to determine the optimal dose to suit your unique needs. Dosing can range from 200-800mg depending on your requirements, but there’s also a maximum amount of CoQ10 your body can absorb at one time.

The take home message:

CoQ10 has the potential to significantly improve egg and sperm quality due to age related decline. It takes both an egg and sperm about 3 months to mature, so if you’re considering fertility supplements you and your partner should begin at least 3 months prior to conception. May you always be ageless, including your eggs!

Book an appointment with Dr. Sumner. Learn about natural fertility support

  References:

Ben‐Meir, A., Burstein, E., Borrego‐Alvarez, A., Chong, J., Wong, E., Yavorska, T., … & Alexis, J. (2015). Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell, 14(5), 887-895.

El Refaeey, A., Selem, A., & Badawy, A. (2014). Combined coenzyme Q10 and clomiphene citrate for ovulation induction in clomiphene-citrate-resistant polycystic ovary syndrome. Reproductive biomedicine online, 29(1), 119-124.

Barakat, A., Shegokar, R., Dittgen, M., & Müller, R. H. (2013). Coenzyme Q10 oral bioavailability: effect of formulation type. Journal of Pharmaceutical Investigation, 43(6), 431-451.

Turi, A., Giannubilo, S. R., Brugè, F., Principi, F., Battistoni, S., Santoni, F., … & Tiano, L. (2012). Coenzyme Q10 content in follicular fluid and its relationship with oocyte fertilization and embryo grading. Archives of gynecology and obstetrics, 285(4), 1173-1176.

Bentov, Y., Hannam, T., Jurisicova, A., Esfandiari, N., & Casper, R. F. (2014). Coenzyme Q10 supplementation and oocyte aneuploidy in women undergoing IVF-ICSI treatment. Clinical medicine insights. Reproductive health, 8, 31.

Failla, M. L., Chitchumroonchokchai, C., & Aoki, F. (2014). Increased bioavailability of ubiquinol compared to that of ubiquinone is due to more efficient micellarization during digestion and greater GSH-dependent uptake and basolateral secretion by Caco-2 cells. Journal of agricultural and food chemistry, 62(29), 7174-7182.

Calogero, A. E., Condorelli, R. A., Russo, G. I., & Vignera, S. L. (2017). Conservative Nonhormonal Options for the Treatment of Male Infertility: Antibiotics, Anti-Inflammatory Drugs, and Antioxidants. BioMed Research International, 2017.



What I Take for Endometriosis

By | Endometriosis Pain Relief, Fertility Supplements | No Comments

Endometriosis (or “endo” for short)

It’s a female condition in which uterine tissue grows outside of the uterus. If you have this condition then you know it’s a real b!@*% and that’s the understatement of the century. The growth of uterine tissue on the ovaries, fallopian tubes, rectum, bladder, intestines, diaphragm….you name it….causes constant, excruciating pain. This is not your typical “period cramping”, this unrelenting and incurable pain has made headlines by the likes of fearless warriors Lena Dunham and Halsey (to name a few).

The tricky thing about endo is that there’s no known cause. It’s chalked up to be an autoimmune phenomenon, oh and yes there’s a genetic link (my mom was diagnosed in her early 20s). I care about endo because it’s one of the leading causes of female infertility, and have I mentioned enough that it hurts like hell every single day?! I’m always researching the best natural methods for endometriosis pain relief.

Conventional Treatment

So what are your treatment options? Well, there’s laparoscopic surgery, suppressive hormones, hospital stays, and a crap-load of painkillers (I’ll take the full cocktail, thank you for asking). Then there’s the integration of naturopathic medicine.

Naturopathic Treatment

Naturopathic medicine is NOT just about replacing pharmaceuticals with “natural” pills. The naturopathic approach to treating endometriosis looks at lifestyle and dietary changes. There is a significant amount of research on the avoidance of caffeine and gluten (I know, I’m Italian!), daily exercise, maintenance of detoxification pathways, and limiting exposure to endogenous estrogens. But sometimes you do need a few evidence-based supplements to take the edge off, so let me finally get to the punch line and tell you what I use to help manage my endo.

NAC

Patients treated with NAC show a statistically significant reduction in the growth of endometriomas compared to placebo, leading to cancellation of surgery

EGCG (and other antioxidants like pycnogenol)

It significantly inhibits endometrial cell proliferation, and reduces symptoms by 33% compared to drugs like lupron

Omega-3: EPA & DHA

Potent anti-inflammatory and antiangeogenic (stops the formation of new blood vessels supplying the endometriomas)

Herbs for decreasing flow:

capsella bursa-pastens & rubus idaeus

Herbs for reducing pain and spasms:

piscidia piscipula, viburnum opulus, dioscorea villosa

Want to learn more about unique pain relieving strategies for you? Check out my program on endometriosis

6 Ways To Know Your Supplement Will Actually Work

By | Fertility Supplements | No Comments

I’ve been in the health products industry for a number of years now, long enough to see the good, the bad, and the ugly (aka the life changing, the mediocre, and the complete waste of money) when it comes to supplement brands. It seems like there are more and more brands producing what seem like identical supplements, which makes it impossible for you to make a decision! The health products industry is not rigorously regulated to protect you as a consumer, which unfortunately leaves it up to you to choose brands that actually work.

This blog post is to help you navigate the supplement jungle and to share with you that all supplement brands are absolutely not equal. If you’re finding your supplements, especially fertility supplements, aren’t working for the reasons you bought them for, then this blog is for you. Please let me be the one to tell you that it’s not you, it’s the brand!

Here is my list of 6 things that ensure a fantastic brand, and an effective supplement:

1. Your supplement brand does not have any unnecessary additives.

There are so many brands that have countless non-medicinal ingredients that no one can pronounce!

Quick tip: if your pill is in a coloured capsule you know harmful ingredients have been added. Here’s an example of a common label that has unhealthy non-medicinal ingredients

2. The ingredients are standardized to the medicinal component.

This means a brand is not just throwing an herb in a capsule, but extracting the medicinal  ingredients from the herb. For example, the first label provides a guaranteed percentage of the medicinal ingredient in ginger: gingerol. The second label just has ginger, with no gingerol.

Quick tip: a percentage next to the herb indicates the medicinal standardization

3. The form of the ingredient is bioavailable to your body.

This means the ingredients are in a recognizable form for your body to absorb. If your body is not able to process the ingredients then you don’t get any benefits and they end up in your urine! Below there are two labels that include forms of folic acid. The first label describes the form of folic acid: L-MTHF (the most readily absorbed form). The second label does not list forms of ingredients at all.

Quick tip: form can be really confusing, your naturopathic doctor is trained to know what is best absorbed by your body

4. Fat-soluble herbs have fat-soluble ingredients

There are certain vitamins and herbs that need to be taken with fat in order to be absorbed. Did you know Vitamin D and Curcumin/Tumeric are examples of these? Curcumin supplements are extremely popular now for inflammation and pain. Every brand makes a curcumin supplement! But only a good brand makes sure it will be absorbed properly.

Quick tip: the terms for “fat soluble” include: glycine, phosphatidylcholine, lecithin, emulsified, liposomal.

5. Ingredients listed have been validated by third party lab testing

This means the product has been tested by an unbiased lab to ensure the ingredients are present in their labeled dosage. Unfortunately, health product companies aren’t forced to test their products at all in Ontario! So when you see a company that uses third party testing you can rest assure they care about your health!

Quick tip: brands that use third party lab testing include: NFH, AOR, Thorne, Cyto-Matrix, Designs for Health, MediHerb and Seroyal.

6. The dose

The dose on the bottle does not actually reflect therapeutic benefit. Depending on your concern, you may need to take less…or significantly more of the ingredient to see benefit. For example, a product may have 30mg of magnesium citrate, but for bowel function, sleep, and muscle pain you would need a much more powerful product.

Quick tip: your naturopathic doctor is an expert in the scientific evidence for effective dosage.

If you find yourself staring at a sea of supplement brands in your medicine cabinet that don’t meet this criteria, or you’re spending hours at the health food store surrounded by walls of brands, I can help you determine the most effective brands for you. If your supplements aren’t working it does not mean natural alternatives don’t work, it means the brand you’re using doesn’t work!

Book an appointment with Dr. Sumner

References:

Radomski, J. L. (1974). Toxicology of food colors. Annual Review of Pharmacology14(1), 127-137.

Kakkar, V., Singh, S., Singla, D., & Kaur, I. P. (2011). Exploring solid lipid nanoparticles to enhance the oral bioavailability of curcumin. Molecular nutrition & food research55(3), 495-503.

Akoglu, B., Schrott, M., Bolouri, H., Jaffari, A., Kutschera, E., Caspary, W. F., & Faust, D. (2008). The folic acid metabolite L-5-methyltetrahydrofolate effectively reduces total serum homocysteine level in orthotopic liver transplant recipients: a double-blind placebo-controlled study. European journal of clinical nutrition62(6), 796-801.