Fertility Diet and FSH Levels

For today's blog post, I answer questions about FSH (follicle-stimulating hormone) levels, which is one measure of our fertility from a medical standpoint, how dietary changes impact FSH, and how optimizing fertility is about more than just dietary changes.

QUESTION 1: I thought I read somewhere that you had a high FSH level before getting pregnant. I wondered after you changed your diet and did the yoga, meditation and so on, and then were able to get pregnant, did you retest your FSH level to see if it had dropped?

ANSWER 1: My FSH was elevated at the time (above 10), but not yet super-high. It was still indicative of “diminished ovarian reserve,” though, and combined with my age, I was given a 2% chance of being able to conceive on my own. A healthy, clean, fertility diet can definitely help to balance hormones and improve the quality of your eggs, as well as the quality of men’s reproductive health. (See my blog on the subject here: http://fertilekitchen.blogspot.com/2009/12/fertility-diet-and-healthy-eggs.html )

Acupuncture has also been known to improve reproductive health, and bring down FSH numbers too (although not always dramatically). (See: http://fertilekitchen.blogspot.com/2010/10/fertility-acupuncture-and-ivf.html for some general information on this.)

I did not have my FSH measured after I started my fertility diet and other modalities. I just felt great and obviously it had a positive impact, as I conceived our son four months later. I suspect my FSH numbers did not move too much; but keep in mind that FSH is only one measure of egg quality. As Julia Indichova details in her book, Inconceivable, at the age of 42 she had an FSH of 42. She completely changed her diet and other factors and became pregnant eight months later. Her FSH the month of her pregnancy was still very high, 30; yet, she went on to deliver a healthy baby. Something to keep in mind.

QUESTION 2: Was there anything else you did in addition to the yoga and diet changes that you feel helped you conceive? My story is similar to yours. I am almost 41 and was told that I have a 2% chance of conceiving naturally.  I am not prepared to accept this and am doing everything I can. However I do feel that my stress level is an issue and I also have an FSH level that the doctor says is indicative of peri-menopause.  I would love to hear if you have any further suggestions or recommendations for me.

ANSWER 2: I’m so glad to hear that you are choosing to do what you do have power over to optimize your health and fertility. There is a lot you can do. I talk about this in our book, under “Lifestyle Factors,” but in addition to strictly following the fertility diet, I did Yoga 4 Fertility three or so times a week, meditated 20 minutes every day, visualized the end result (holding my baby, breastfeeding, doing a playful activity w/baby) every morning and evening, and did Julia Indichova’s guided visualization from her CD (at www.fertileheart.com). I also cut my workload to help keep stress at minimum.

I believe strongly in the mind-body connection, and it’s very important to find healthy ways to manage stress (such as with mediation, yoga, etc.). Although I didn’t do these while I was TTC, I also recommend Circle+Bloom’s mind-body programs for deep relaxation (they have a free demo on their site) and definitely acupuncture, although I know that’s an added expense. For the acupuncture, find a practitioner who specializes in women’s health and fertility. Acupuncture has been proven to aid fertility, helping to lower FSH levels and improve egg quality.

Last recommendation, have patience (which I know is challenging!). It takes our bodies about 3 months to fully adjust to dietary changes (and acupuncture treatments).
All the best to you on your fertility journey!

photo by: http://www.worldwidehippies.com/2010/10/25/yoga-yoga-yoga/

Fertility and the Sugar in Fruits

In this blog post, I answer more of your questions, this time, on fruits and fertility.

QUESTION: I love orange juice. Is it OK to drink on a fertility diet?

ANSWER: Not really. The issue with fruit juice is that even when it’s pure and has no additives or preservatrives, the concentration of sugar in it is too high to consume (for our blood sugar levels).  In general, sugar negatively affects blood sugar levels, leading to hormonal imbalance, which we don't want while TTC. It’s also known to compromise our immune systems. Natural sugar, like that found in fruits, is OK, but in moderation. The issue with fruit juices, is, of course, that the amount of sugar found in juice is concentrated and too much.

If you want to drink pure, organic fruit juice, I recommend watering it way down (at least 50% water) and drinking only small amounts at a time. You’ll likely find it isn’t worth it. Much, much better to skip the juice and eat whole fruits instead.

QUESTION: What about dried fruit?

ANSWER: Dried fruit is a natural form of sugar (if processed simply, without preservatives or additives), which is great. However, the sugar in dried fruit is also very concentrated, so you really need to watch how much you’re eating and moderate. I would not eat more than 3 or 4 dried fruits a day, which is not much (meaning, 3 or 4 dried apricots, apples, peaches…). A handful of raisins is OK. Better to eat fresh fruit, though, whenever you have the choice.

QUESTION: Are sweet potatoes on the fertility diet?

ANSWER: Yes, absolutely. They tend to have a lot of sugar, so just be careful not to eat too many of them in one sitting (most people don’t). Avoid fried versions of these when eating out, though, as they are often prepared in oil heavy with trans fat (which is very bad for the health). Baked, pure and simple, is best.

All the best to you!

photo by: http://plantsforhumanhealth.ncsu.edu/extension/programs-resources/the-produce-lady/videos/sweet-potatoes/

Fertility Diet and Eliminating Coffee, Even Decaf

QUESTION from a reader: You mentioned in your talk that there were a lot of other properties in coffee apart from caffeine that were detrimental to fertility. I'm interested in knowing a little more about that. Also, what about Swiss filtered decaf coffee?

ANSWER: We say no to coffee, even decaf coffee, because, caffeine aside, roasted coffee contains hundreds of chemicals, of which about half of those tested were found to be carcinogenic on rodents (Ames, Bruce N; Gold, Lois Swirsky [1998]. "The causes and prevention of cancer: the role of environment". Biotherapy 11 [2–3]: 205–20). Also, many of the chemicals in coffee and decaf coffee irritate the stomach lining causing an increase of stomach acid, leading to digestive disorders, something you don’t want when trying to conceive. You want to be as easy on digestion as possible and maintain a slightly alkaline pH in your body. Coffee can also hamper the absorption of essential minerals and vitamins, such as magnesium, zinc, iron, potassium, and B’s, and it is also one of most heavily pesticide sprayed crops.

Harsh chemicals are used in the decaf process. With organic, Swiss water-filtered decaf, you are getting a much better product (the decaf process is not nearly as harsh), but for what I’ve listed above, coffee and decaf still have to go while trying to conceive and while pregnant. My theory is that if something has a chance of getting in the way of conception, it comes off the list, at least temporarily until after the baby is born.

All the best to you!

photo by: http://www.jacksonscoffeeandgelato.com/

Fertility Diet and the Journey to Our Second Child

Now that I am in my mid-forties and eight months pregnant with our dream second child, I thought it was important to share the story of our journey toward baby number two--which was different (and even more challenging) than the one toward our first baby.

If you’ve been following our blog or have a copy of our book, you probably already know the story of how we conceived our first child, our son, Julien, but I’ll summarize here. My husband and I had been trying for over a year to get pregnant when finally we went to see a reproductive endocrinologist (a fertility specialist). I had just turned 40. After all tests were done, this doctor explained that we had a 2% chance of conceiving on our own. This, even after polyps discovered in my uterus were removed.

Although devastated, I decided it was simply not acceptable that I don’t get to have a child, so I began to research all that I could do to help myself, to increase the odds. I ended up putting myself on a fertility friendly diet (the one outlined in our book), along with doing yoga, meditation and visualizations. My husband also followed the diet, and just four months later we conceived our son.

I believe deeply and whole-heartedly that we can make a difference in our fertility and our health—by the choices we make in what we eat and how we live.

Every day, we are utterly grateful for the miracle of our son—who is a complete delight, filling us with unexplained joy. Nevertheless, when we decided to have a family, in my mind that meant at least two kids. My husband and I both had siblings and were grateful for them. How could Julien not have a sibling?

When Julien was almost a year old, we tried (in earnest) again to conceive. By then I was 42 years old and my FSH had risen even more (to 16; the normal is below 10), telling me, from a western medicine standpoint, that the quantity and/or quality of my eggs was even further diminished than two years prior.

I did not let that deter me, as I thought of Julia Indichova, author of Inconceivable, who at 42 had an FSH of 42, and yet still conceived her daughter naturally after changing her diet and lifestyle.

But I did find it much harder to get into a Zen-like state with a toddler running around, and I feel that managing one’s stress is critical to fertility. As my 43rd birthday approached, I decided to step up the game. I got more strict with my fertility diet—which in any case had become mostly a habit for me—and started acupuncture.

A few months later, I felt my body was ready for one last shot at baby #2: we would do an IVF. The reproductive endocrinologist we saw remarked on my superb health; the perfect state of my uterine lining; and the strong, vigorous circulation of my blood. I knew this was the result of the work I had been doing and felt optimistic in spite of the dismal statistics (5% chance of IVF success due primarily to age).

But that cycle failed and left me thoroughly devastated.

It was our last chance. We had burned through our finances and beyond (our debt was huge!). There would be no repeat IVF. I wouldn’t want another IVF anyway. I believe when age is the primary factor, for most, one stands a better chance with nature. So, either I would get pregnant naturally, or I would have to find another path toward my second child.

But first I needed to heal. I needed to completely let go, and allow my husband to let go too. I didn’t realize until then, exactly how much pressure we had put on ourselves during this process.

Four months later, just two months shy of my 44th birthday, we got a happy surprise and conceived naturally. Our excitement turned to sadness, though, as I miscarried at 10 weeks.

After that, I did not give up on conceiving naturally, but I didn’t count on it either. I just “surrendered” to whatever was, and whatever will be. Finally, I had found some peace.

It’s at that time when I first allowed the idea of donor eggs to enter my mind.

It’s amazing that before, I wouldn’t even hear the words, donor eggs, but now that it might be, along with adoption, the only way I could be a mom again, my perspective completely changed. I not only opened up to the idea, but embraced it, and felt grateful the option was there.

Aiding my decision was this: my son, who was naturally conceived and has all my genetic material looks absolutely NOTHING like me. He is instead a carbon-copy of his Dad. And it doesn’t bother me in the least, because I know he’s mine and that’s all that matters. I have also had the privilege to meet all kinds of families and know that the good, strong ones are not defined by genetics, but instead by love, care, and a deep sense of security.

A donor egg baby, I knew, would be mine, too, just like my son.

One of the benefits of donor eggs (besides the 50 to 80 percent IVF success rates), is that the time pressure is relieved. As long as you and your uterus are healthy (for the most part), your age is not a factor. Not that we wanted to wait too long! But if we went through another baby-attempt, we were determined to do it from a calm, peaceful place—with our finances intact and minimal pressure.

We waited another year and a half or so, while we caught up on finances, passionately wrote and published our fertility book, and thoroughly enjoyed our son and our lives.

When I started to research donor egg programs, we found we couldn’t afford most of them. (Costs average between $40K and $50K.) Luckily, we found an affordable alternative in Reproductive Biology Associates (RBA)’s highly successful frozen donor egg program in Atlanta. For $16,500 (current price), we were guaranteed two high-quality embryos. We also selected RBA for their professional, caring staff and stellar referrals from many (pregnant) others.

Six months before our planned cycle, I got myself ready: I got more strict on our fertility diet again, as did my husband. I also practiced yoga when I had time, meditated daily, did visualizations and got weekly acupuncture treatments—but this time, in a calm “whatever will be” state. Although my eggs would not be in the picture, my uterus and body, which would be nourishing an embryo, helping it “take” and grow, most definitely would be a part of the picture, and I wanted that body, and its driver (my mind), to be in perfect health for the job.

As it turned out, I had polyps in my uterus again, but they were successfully removed. After that, our cycle could not have gone smoother. Not only did I get pregnant, but we had two high-quality embryos to freeze for possible future use.

Our daughter is due the end of July, 2011, and I cannot wait. My husband and five-year-old son are also very excited. I found, in being pregnant and feeling her kick and move inside me the last few months – she is already so much a part of me and our family, I feel so close to her, that I often forget that we used donor eggs to conceive her. I know this happens for other parents of donor egg babies too.

I share this journey with you to show that there are many routes to parenthood, although I know it’s important to be ready and open for the route you choose. I also share this story to demonstrate the importance of maintaining one’s health (physical, mental and emotional) through this process.

As always, I wish all the best to you on your journeys.
 
photo: me at 31 weeks of pregnancy.

Fertility and Wheat Germ - And Can You Have Too Many Supplements?

WHEAT GERM
The fertility diet I followed to help us conceive, and the one that is outlined in our book, The Fertile Kitchen(R) Cookbook, recommends giving up wheat. This is primarily because it is hard to digest and tends to be highly allergenic, making it very challenging for your digestive system, whose burden you really want to ease during the process of trying to conceive. I've written more about wheat here.

But I often get asked: What about wheat germ? Isn't it highly nutritious and great for fertility? So here's my answer to that question:

Wheat germ is high in vitamin E, a powerful antioxidant, which has been shown to improve fertility in men and women. It also has vitamin B6, another important nutrient.

Wheat germ is wheat, however. So if you’re eliminating wheat, as I suggest, it would mean cutting out wheat germ. You can get vitamin E from many other sources, such as nuts, seeds, olives, spinach and other green leafy vegetables, asparagus and vegetable oils, such as sunflower oil. But I also believe this a personal choice, whether to keep it in for its nutritional benefit, or take it out because as wheat it can be hard to digest, tends to be allergenic to many, and you can find the nutrients in wheat germ elsewhere.
 
NUTRITIONAL SUPPLEMENTS
Another question I've gotten: Is it possible to take too many supplements?
 
Our nutritionist, Virginia Watkins, contributed to this answer. Yes, it is possible to take too many supplements, so it's a good idea to get tested for your nutrtional intake to ensure you're not overdosing. Virginia says, "The best source of vitamins, minerals, antioxidants, and so on is food. Food is so complex that extracting just one part of it, for instance vitamin C, is not nearly as valuable as eating a food with a high content of vitamin C."
 
Keep that in mind, especially if you're thinking of using supplements to make up for a less than healthy diet. You still need the clean, healthy, well-balanced diet!
 
Photo by: http://www.service-1.org/product,236928,wheat-germ-essential-oil.html

Fertility Diet: Stevia and Fertility

I have written about how wonderful Stevia is as an alternative to sugar. It's a natural herb said to be 10 to 15 times sweeter than table sugar and it won't negatively impact blood sugar levels. For those with a sweet tooth especially, I think it's great.

I recently received this question, though: I have heard various things about staying away from stevia while trying to conceive. Have you? What do you think?

Here's my answer:  Yes, I have caught wind of some controversy over stevia and fertility and have looked into it before. The study that some refer to regarding negative fertility is one in which extremely large amounts of stevia (something like 5 or 6% of their body weight) was given to both male and female rodents, which subsequently affected their fertility and led to fewer and smaller offspring. A couple of things to say about this: no one would consume such a huge amount, esp. given that it is 10 to 15 times sweeter than table sugar. (For a 120-pound person, that’s about 7 pounds of stevia/day). If we consumed that amount of regular table sugar per day it too would negatively affect our fertility, and health – dramatically. So the study can be taken out of context. Also, numerous other studies followed (including another one on hamsters also with high doses of stevia) and found this not to be true at all, and found stevia to be safe. Not only that, but it’s a natural herb that amazingly does not affect blood sugar levels, which makes it esp. great for those suffering from diabetes—and a great alternative to regular sugar.

I think where stevia can have potential problems is when it gets packaged as a sweetener. I advise in our book (on pg. 12) that when you purchase stevia, be sure to read the label and make sure it’s pure. Some packaged forms add maltodextrin (sugar) and silica (you can Google that) – and although it’s in small amounts, it’s better not to have those forms with additives. Get it pure and use in small amounts, as it was intended.

I speculate that part of the reason the FDA in the US resisted approving stevia for a long time, and perhaps why the EU has banned its use for now, is that if allowed to be used in products as a sweetener, such as to sweeten soft drinks and a wide array of food products, in-take across a population would increase a lot, and they may feel they need more information before allowing that. There is also the political side (sadly). Artificial sweeteners have a lot of money and lobbying power (in US) and although these chemical sweeteners have been proven time and again to have ill effects on our health, the FDA has approved them.

I feel stevia is completely safe and a great alternative to sugar in the normal amounts with which we would consume them. Finally, something I found on the Internet from the Laboratory of Functional Biology, KULeuven:

“In 2004 researchers of the KULeuven (Belgium) organized an international symposium on “The Safety of stevioside”. Scientists from all over the world concluded that stevioside is safe, and that stevioside has not any effect on male or female fertility, nor on development and state of fetuses.” More info: http://bio.kuleuven.be/biofys/Plantfys_e.htm

Hope this answers your question!

Fertility Diet: Fruits and Popcorn and Other Diet Questions

QUESTION: In your talk on eating to optimize fertility, you don't mention fruits. Why not? Are fruits OK?

ANSWER: I didn’t mention fruits because they are not essential on a fertility diet (because of their sugar content) the way that vegetables are. But fruits are a great source of nutrients! And the more variety of them you eat the better. Go for all colors. You do have to watch eating too many/too much in one sitting, though, again, because of the high sugar content. I’d suggest that three fruits a day is about right. Eliminate fruit juices entirely, however. The concentration of sugar is too great and will cause a rapid rise in blood sugar levels. Same goes for jam (even if it's just fruit with nothing else added.) Stick with whole fruits. (It's springtime and a great season for all kinds of fruits!_

QUESTION:  Can I eat popcorn on the fertility diet?

ANSWER: Popcorn is fine, as long as you don’t have an allergy or sensitivity to corn. However, either air-pop it or pop it the old-fashioned way (in healthy oil, such as canola, in a deep pan.) The microwavable version uses chemicals in its bag lining that are not good for us. Also, try to buy the corn kernels organic if you can, as most corn is genetically-modified, and you want to avoid that. (See my blog about GM foods and fertility.)

QUESTION: I know wheat is not allowed. Can I still eat corn tortillas?

ANSWER: Absolutely, as long as you don’t have an allergy or sensitivity to corn. Like the popcorn, try to buy it organic. And read the label to make sure the ingredients are all healthy and that nothing artificial has been added. No trans fat (hydrogenated oil) and no sugar!

Happy, healthy eating.