IVF Nutrition

From Bumps to Baby with Liz Shaw

Liz Shaw and her baby girl. Photo provided by Liz.

Liz Shaw and her baby girl. Photo provided by Liz.

Although you wouldn’t know it, I only recently met Liz Shaw. Liz has quickly become a friend, confidante and source of nutritional expertise for me. I met Liz as she was launching her Stress-Free IVF Nutrition Guide and am so grateful that I had the opportunity to recently review it during my recent (fourth) IVF cycle. (You can read more about the Guide here.)

Liz is a Registered Dietician, Certified Personal Trainer and owns a nutrition consulting business. Based on her own experience with infertility she has bridged the gap between diet/nutrition and the process. Liz lets us in on all of her secrets with her recently published Stress-Free IVF Nutrition Guide and also her Fertility Foods Cookbook.

Liz is someone that you need to know. Not only because she may be the world’s kindest and gentlest soul but because her understanding of nutrition as it relates to fertility and overall health is an absolute game changer. I caught up with Liz the other day and am excited to share our discussion with you!

What does fertility warrior mean to you?

LS: That’s a great question! I have a whole series devoted to the women (and men!) who’ve gone down a path that’s not so easy to expand their families. A warrior in the sense that they continue to persevere despite the challenges of their “battle” with infertility.  I have a colleague who’s trying to open up and change the negative connotation around warrior and instead focus on the strength and power of the women (and men!) and I love that vision too! 

Since you are a RD, were you surprised when you struggled with your own fertility?

LS: Yes! But then again, even doctors get cancer and dentists get cavities, so we are all human!  As we know, infertility doesn’t have a type. It affects all of us, health professionals and athletes and people of faith, there’s no discrimination. What’s important for people on the outside to remember is that infertility is not something someone can control. It’s often caused by so many factors in which there is no one size fits all approach to treatment.

I like to try and remind people that finding the right treatment plan for them, the right professionals to guide them on THEIR path is what will make this entire process that much more bearable in the long run. And let’s be real, sometimes this is a VERY LONG RUN! 

Please share your story

LS: My husband and I started our journey to expand our family about a year after we got married in 2012. Realistically, we didn’t intend to get pregnant right away, but I had been on birth control since I was 13 years old and we knew it would take some time for my body to regulate.  Lo and behold, we waited, and waited some more. 

I was finally diagnosed with unexplained infertility related to my hypogonadotropic hypogonadism  (HH), which is a lack of hormonal regulation in which little to no sex hormones are produced. You can read more about that experience here, but essentially it was the beginning of a long road for my husband and I which also coincided with entry into the assisted reproductive technology route to expand our family. 

I truly believe any period of waiting is challenging for a want-to-be-mama. Be it a two-week-wait or a trial time for your body to “figure itself out”, neither is a desirable scenario. Thus, we did a mix of both. We started with an IUI, entering full force with the notion that this was our ticket to baby. After our first failed attempt, I was crushed. I never fathomed the emotional pain of that particular experience and surely wasn’t ready to jump into another emotionally, financially, and physically exhausting experience. Side note, because of my HH, I was placed on the IVF medication regimen for my IUI round.

Our doctor at the time assured us that the highest rate of success would be to start IVF. In February of 2016, we decided that was our next step. We took some time off since we had been on this rollercoaster since 2013 and knew we needed to find the joy in our marriage again. We signed up for a Spartan Race in Hawaii, dominated that race and came home to start our first round of IVF…

It was during this time of waiting, I began to feel lost, alone and so confused. I knew I needed to seek help, and through that formed the community known as Bumps to Baby. This community has been my rock, my outlet to share the innermost thoughts I’ve felt on this journey to baby and most importantly, a safe place for others to find security and friends through. While it began as an Instagram account, it quickly morphed into a private Facebook Community and a full website with a special feature for others to share their stories, too, known as Warrior Women Wednesday. 

After our IVF retrieval, my body responded very poorly and we were unable to do a fresh transfer. Of the 15 eggs retrieved, only two embryos were viable for cryopreservation. As bad as that day was getting the news that our 15 had turned into two, the worst was yet to come. The two days in which we received the news that both embryos didn’t take (during the transfer) was by far the lowest of the low in our 4.5 year journey to baby. Honestly, it was during our final failure in August of 2017 that I knew I needed to take a step back from ART treatments. I needed to regroup, find a new sense of peace with my body and begin to remember, baby or not, I (needed to know that I) was enough as a person, a wife, a woman.

Fortunately, my husband was also traveling back and forth between Switzerland and the US for work during this time. I was blessed with the opportunity to join him for the remaining part of 2017 and so we packed up our belongings and moved to Locarno from the end of October through mid-December of 2017.

During this time, I was able to find that sense of peace. I was able to mourn our losses, the trials and tribulations that infertility had taught me and began to refocus on the community of Bumps to Baby and the messages that I wanted to help communicate. It was also during this time the passion project I had worked on with a close colleague and friend was released, The Fertility Foods Cookbook. The cookbook helped merge my love of nutrition and heart for the fertility community into one.

This experience, this break, this opportunity to learn to trust my body again is ultimately what led to the greatest twist and joy in our journey to baby. I’m happy to report our miracle baby made her way into our arms August 4, 2018. A true testament to the powerful role stress can play in your health and most importantly, the importance of finding trust and healing your relationship with your body, remembering you too are enough! 

What pieces of advice would you share with someone on their (in)fertility journey?

LS: I think I would sum up my advice in the hashtag #NeverLoseHope. Infertility can feel like such an isolating journey when you’re in the thick of it. I was there for years before I decided to break the silence and find comfort from my #ttcfamily. And believe me when I say, we are not alone! We know the statistics show that 1 out of 8 couples struggle and lets be real, likely someone close to you is going through the thick of this disease too.

When you feel comfortable enough to share your story, to seek help, know we are here for you. Join the Bumps to Baby Private Support group and begin feeling a new sense of peace and warm welcome into the family you never wanted to have, but are blessed to be a part of!

How do you feel about the word “journey”? Love, hate or both and why?

LS: Love the word journey! It shows that it’s not a start and stop point but a continuous path, especially once the individual does see their rainbow and begins the new journey of motherhood.

You recently wrote the Stress-Free IVF Nutrition Guide, what was the inspiration? 

LS: It was a way I could give back to the community that has been such a rock for me time and time again over our five-year journey. As an RDN, it was everything I wish I could help tell patients who are lost, confused and consulting Dr. Google before beginning their cycle. Truthfully, it’s the guide I wish I had when I was going through our cycle, too. You can pick up your guide here. Use the code fertilust for a 10% discount.

Favorite fertility foods ranked

LS: Tough call! I love variety so really a plethora of fruits and veggies in nourishing bowl or pile high on thick, seedy whole grain bread!

This  Amaranth Buddha Bowl and these Beet Burgers recipes are some of my favorites!  

Pineapple core pre-transfer. Myth or reality?

LS: Myth, to some degree! Little to no scientific evidence exists on this. Every Friday a group of RDNs and I debunk myths and share fertility nutrition information! We actually covered this one here, and you can follow the weekly series here!

What gets you out of bed in the morning?

LS: My sweet little pineapple, aka my rainbow baby! Even before her arrival, I was driven in my career and lucky enough that my passion is able to be pursued each day by helping women and men understand the important role nutrition can play in their bodies. 

What keeps you up at night? 

LS: The endless tabs I have open in my brain! Whether it’s work, parenting, family, the Bumps to Baby community, or what I want for breakfast, I have a hard time unwinding and closing down at night! 

 

About Liz Shaw: Liz is a Registered Dietitian and Certified Personal Trainer in San Diego, California. She owns a nutrition consulting business in which she works with brands to help disseminate key health messaging to practitioners and consumers at large via national speaking, TV segments, and through her strong social media presence. Liz also runs a maternal health private practice in which she specializes in fertility nutrition. She is an author of the Fertility Foods Cookbook published last fall and a blogger at both Shaw’s Simple Swaps and Bumps to Baby.

Liz is also a freelance writer and serves as a nutrition expert for many national publications, such as Shape, Women’s Health, Men’s Health, Muscle and Performance, Fit Pregnancy, Parentsand others. Her current position has led her to what she loves most, educating the public at large about the importance of nutrition and health in daily life while connecting individually with those struggling to build their families. Helping to empower others through nutrition is truly what brings Liz joy!

 

 

Review: The Stress-Free IVF Nutrition Guide by Liz Shaw

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I have been around the (in)fertility block a few times. Even though I have educated myself about the role and importance of nutrition for overall long-term health, it’s amazing how I have had amnesia about how to nourish my body beyond the basics during the IVF journey. I recently did my fourth (yep you read correctly) IVF cycle at the age of 40. Although my diet is predominantly plant-based with a side of meat at this point, I was so grateful that Liz offered to let me try out her Stress- Free IVF Nutrition Guide leading up to and during my cycle. Liz said that I needed one less thing to worry about and she was right.

Under the expert tutelage of Liz who is a Registered Dietician with her own fertility story, she has created a concise, poignant, evidence-based guide aimed at elaborating on the Mediterranean diet with a Pro-Fertility diet and lifestyle. If you are anything like I was when I started all of this out, that may have just as well been written in Taiwanese. In a nutshell, Liz breaks down which nutrient-dense foods have been researched to help optimize cellular growth for egg quality. She also shares how fitness, self-care and avoiding endocrine disrupting chemicals are supportive to a possible optimized outcome. To put the new found knowledge in to action, Liz provides tips on how to easily stock your pantry with a checklist and provides sample recipes for every step of IVF, from retrieval to transfer.

I found the recipes tasty, quick and easy to make. (Just to elaborate, I am that person that when it says a recipe takes 30 minutes to make, it usually takes me an hour.) I was grateful that the length of time required for the recipes was actually accurate! My favorite recipes that I batched to last over a few days were the Berry Chia Slow Cooked Oats, and BBQ Lentil Burgers. Post-Retrieval, I enjoyed the Roasted Potato Tacos with Eggs as a healthy way to get the sodium necessary to dry out the egg follicle sacs and stave off OHSS (Ovarian Hyperstimulation Syndrome). I also appreciated that the Guide helps the reader put a nutritional plan into action at home and/or on the go. Let’s face it, while cooking at home is ideal, it isn’t always possible or convenient.

I spent a semester to get my holistic health coach certification so that I could understand the basics of nutrition to then decipher how it tied back to fertility. Liz broke down the IVF process and an IVF supportive nutritional/lifestyle plan in 47 pages. I am grateful that this Guide exists now because it is what I dreamed of finding so many cycles ago…

After reading the guide, I am also rethinking my hard and fast stance on avoiding dairy altogether during IVF. According to Liz, “the longitudinal evidence really has found it's somewhat moot, meaning it doesn't necessarily help or harm fertility. The benefits have been shown in those with anovulatory infertility, but in the long run, it's totally an individual preference. If you have difficulty digesting dairy, I always tell my patients that the best rule of thumb is to choose other calcium and vitamin D rich foods like fortified plant milks and mushrooms!” (In full transparency, I don’t consume much dairy in general as it is known to be inflammatory and I am a little lactose intolerant, however having good quality cheese from time to time in moderation is now something that I am comfortable with in my general diet.)

By the time that you complete the Guide, my sense is that you will feel empowered by being able to control the one and most important thing that you can do during the process; what you put into your body. I am also willing to bet that you’ll want to be best friends with Liz because she may be one of the most kind, gracious and supportive souls that you might ever encounter.

As Liz can attest, this way of eating may not necessarily guarantee the outcome of a baby, however, you will be and feel healthier following a Pro-Fertility diet which is largely anti-inflammatory and anti-bloating. The upside of long-term health benefits is definitively also a positive. I appreciate that the Guide offers a long-term health solution, not just a fad diet.

Interested in taking your nutrition into your own hands? You can pick up a copy of Liz’ Stress-Free IVF Nutrition guide here. Use the promo code fertilust for 10% off!

*Please note that this review is entirely voluntary and no funds, services nor goods were exchanged outside of an advanced copy to read.*

The Girlfriends' Guide to IVF: Part 2

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Phase One/The Prep for Retrieval:

Similar to a recipe, here is the plan that I followed prior to egg retrieval and leading up to transfer.  This may also be helpful for anyone, including those doing egg freezing, IUI and IVF.

Try to take 90 - 120 days to reset your overall health and mindset to optimize egg quality and ultimately set the stage for a productive IVF cycle.  And go with your gut.  Start on your schedule.  Some doctors will try to rush you by telling you that your eggs will be 2 - 3 months older if you wait.  While true, if that is the case, I find it interesting that my results got better after hitting the pause button for 8 months. It’s really more about quality than quantity.

Here are my tips:

1. Eat clean whenever possible

Focus on a mostly organic plant-based protein diet with an equal quotient of healthy carbs and fats.  (Translation for carbs/fats: fruits, veggies, nuts, and oils.) 

Pass on dairy, refined sugars, and refined grain.  Also beware of gluten replacement foods and especially any gluten-free foods that come in a box or bag as they might be laden with refined sugars and possibly chemicals.  These items all have an inflammatory effect on the body which doesn't help the optimal egg health cause.

2. Take quality supplements 

This is in addition to eating whole foods and shouldn't be the replacement for them. Check out my recommendations here. If you already know that you are challenged with egg quality issues, consider adding an organic Acai supplement.  Navitas makes a great supplement that I use for smoothies. (Avoid any Acai that is not pure or products like Sambazon that have a high sugar content.)

3. Drink water and lots of it

Ideally 8 glasses a day as a benchmark and preferably from glass.  Avoid plastic when possible.  BPA which is found in plastic is a known endocrine disruptor.

4. Try your best to cut caffeine

You'll have to do so anyway to ensure proper labs/monitoring.  Consider replacing your coffee ritual with hot water and lemon which is alkalizing (inflammatory reducing).  Pair it with an awesome refrigerated Probiotic like Natren Healthy Trinity to promote digestion and combat bloat.  

4. Cut alcohol

I'm sorry!  This was extremely difficult for me too.  I promise that you can do anything you set your mind to for 90 - 120 days!

5. Be aware of what you put on & around your body  

Avoid products with sulfates, parabens, phthalates (fragrance) and phenoxyethanol.  All of these items are known endocrine disruptors.  Check out EWG to give you a better gauge on how products rank or to demystify ingredients in products.

Go ahead, be a sophisticated hippie with some of these awesome products that I have tested. I am not affiliated with any of these brands, I do however believe in their ingredients.

  • Skin/Hair Products: S.W. Basics, Body Deli, Rika

  • Natural Deodorant (that works): Joyous Organics and Primal Elements

  • Cleaning Products: Puracy, Meliora K, Branch Basics

  • Glass Water Bottle: BKR

6. avoid receipts

I am aware that this sounds crazy and especially if you live in a city or travel for work.  The thin powder coating found on receipt paper contains an unusually high amount of endocrine disruptor, BPA.  Not sure what to think? Search the terms "bpa receipts" and look for a credible source to learn more.

7. sleep

Try for 8 hours of uninterrupted sleep a night if at all possible.  This time is imperative to repair and restore cells.

8.Get your head on straight

Take ten minutes every morning for yourself to set the tone for the day.

Check out the 5 Minute Journal to remind yourself of what you are grateful for and/or meditate with the Headspace App.

Exercise easily.  Think yoga, barre, micro-toning, hiking/walking. The reason why cardio isn't recommended is because it promotes a fight/flight response during exercise, inducing unnecessary added stress on the body which isn't great for optimal cellular growth and creating the healthy maturation of eggs.  (The IVF process is already stressful enough, no?)

9. Consider Acupuncture

It blissed me out and has known benefits to increase blood flow.  In other words, it's good for egg heath and might also stimulate a thicker lining to promote transplantation when it comes time. However if this stresses you out for any reason to get acupuncture, take a pass because that will defeat the purpose of your going.

Phase Two/Stimming:

1. Keep on practicing self-care

This includes taking time for you, sleeping enough, staying hydrated and continuing healthy eating habits.

2. Discontinue most supplements

Continue with a daily Probiotic, Pre-Natal and Vitamin D (if you are deficient).

3. Stop any exercise outside of walking

The key is to not get your heart rate up.  If you are out of breath, chances are that you should ease up.

4. join a support group

Check out Pregnantish.  There are also plenty of private support groups on Facebook. Need some ideas - send me a note!

Many clinics also have groups available so make sure to inquire.  It's so nice to know that you can ask a burning question at 3a to a group of people that are going through the same things that you are, right now.  

Phase Three/Retrieval:

1. Try your best NOT to be attached to the outcome

I know that this is easier said than done.  Think of the many ways you have already won with a healthy mind and spirit. no matter what happens you are making strides towards life long wellness with new, good for you habits.

2. Get a post-retrieval care package ready

A heating pad, Tylenol, coconut water (I love Taste Nirvana and Harmless Harvest), Ultima electrolyte mix (please stay away from Gatorade), and a bag of salty Kettle Chips will do wonders. I am aware that the chips sound a little crazy but the high levels of sodium just following retrieval actually help drain the fluid that builds up in the empty egg sacs which can cause uncomfortable bloat. I also love enjoying my chips with guacamole - you need the healthy fats right now so dig in!

3. Go native on the day of your retrieval

You and your partner should avoid wearing perfume, deodorant, and anything with fragrance in it.  Why you ask?  Because the fragrance (phthalates) could potentially damage eggs retrieved making them abnormal. 

Phase 4/The In-Between:

Between the time of retrieval and transfer is not the time to go cold turkey on all of the incredible healthy habits that you have been practicing.  Keeping a healthy lifestyle between retrieval and transfer will reward you with a better state of mind, more energy, faster recovery, and possibly better odds of conceiving during transfer.

Phase 5/The Road to Transfer (Egg Implantation):

Congratulations on making it to the transfer stage.  You should feel really good as this is not a given.  Many of the positive habits that you have picked up or already practiced along the way will continue to serve you.

1. Continue to eat, sleep, and hydrate well

2. TAKE supplements

Specifically continue a Probiotic, Pre Natal, and Vitamin D if you need.  Add back in Omega 3s.

3. Keep taking time for yourself

If you like acupuncture, try going once a week to help promote lining growth.  Only go if it doesn't stress you out to manage it into your schedule and get there in the first place.

4. Cut out alcohol and caffeine again

Much to my dismay I was reminded that chocolate has caffeine too.  Just remember that this is not forever.

5. maintain a positive outlook

Be excited but unattached to the outcome. It is a blessing to have gotten this far.  The universe doesn't promise or owe anything; all we can control is our attitude and embrace the silver linings that we encounter along the way.

Phase 6/Time for Transfer:

1. pre/post transfer acupuncture

Many fertility outpatient facilities offer this.  If this interests you, consider it for its calming, blood flow stimulating benefits that helps the eggs get cozy in the uterus.

2. Get yourself in a good headspace 

Consider taking a restorative style yoga or meditation class the night before the transfer.

3. Wear comfortable clothes and "happy" socks

You will be looking at them for a while.

4. go fragrance free

This applies to you and your partner and will minimize any damaging exposure to your hard-earned blastocyst(s).  (A blastocyst is a Day 5 - 7 fertilized embryo.)

Phase 7/Post Transfer (AKA: the Two Week Wait):

First of all, congratulations for reaching this milestone, it is no small feat!

1. Plan for bedrest for that day and the following

I know that this is now controversial but it certainly does no harm so I did it. Either way, avoid a heating pad and hot showers/baths.

2. Eat warm, nourishing foods

This includes organic bone broth to promote a comfortable zone for the embryo to implant.  Wild salmon, dark leafy greens, ginger, and fermented vegetable are also thought to be helpful.

Hydrate, hydrate, hydrate. 

3. Eat fresh pineapple core and raw Brazil nuts

Beginning the day of transfer and continue for a few days... 

Pineapple contains an enzyme bromelain, known for it’s powerful anti-inflammatory properties.  Reducing inflammation in the uterus helps set the stage for implantation by potentially creating a sticky lining where the embryo can settle in comfortably.

Eat 6 - 8 Brazil nuts a day.  Chockfull of selenium, Brazil nuts are thought to help thicken the uterine wall promoting a healthy lining to aid with implantation.

4. Meditate and visualize your embryos getting cozy

What is the downside?

5. Binge on funny movies or shows

In case you are looking for suggestions, I liked Up Schitt's Creek and Master of None on Netflix.

6. Rest and sleep a lot

7. more about the 2ww...

This will feel like the longest week and a half of your life (so far!) to find out what your results are from the blood test.  Try to be stoic.  Unfortunately OTC pregnancy tests can potentially provide a false negative or positive.

8. Be excited but not attached to the outcome

I know that I keep saying this.  This is a friendly reminder that whatever happens doesn't define you one way or the other.  You are also not alone in this journey.

Sending positive thoughts your way! xo