The Girlfriends' Guide to IVF: Part 1

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I was chatting with a girlfriend going through IVF and realized that it might be helpful to share my experience in hopes that it could help others navigate the process as well. 

During my third round last year, I made the discovery that by changing my attitude towards IVF, it wasn't as mentally and emotionally daunting as it had previously been.  Was piercing myself with needles (or letting my husband do it for me) a party?  Well no, not quite. There are however a lot of uncontrollables during IVF, so feeling emotionally stable and maintaining a positive attitude was an absolute victory.  I learned to accept the process, perhaps even embrace it rather than resent it.  I let go of being attached to the outcome, and THAT helped me make peace with IVF.

I am in no way diminishing the emotional and physical hardships associated with IVF.  I don't wish the experience on anyone.  I just made a decision to look at the process differently than I had been and set other goals (like getting mind/body healthy,) so that I could win no matter the outcome.  Perhaps three (rounds of IVF) was a charm, but I am convinced that my efforts to take care of my overall health paid off.  It still took a lot of effort on my part, and I couldn't have done it without a community and support system.  My doctor, nurse, and husband were the best team that I could have dreamed of, and the support group from CCRM provided ongoing inspiration.  

I learned to not underestimate the importance of the right doctor.  Just because a doctor did wonders for your friend does not mean that he or she is the right fit for you.  If this sounds like the position that you are in, look for a doctor with good credentials, that you vibe with, and who is attached to excellent labs.  Also make sure that you really like your nurse.  Your nurse will be your lifeline.

Only you can control how you feel.  I found my peace through prioritizing my needs.  You will likely need the support of friends, family and possibly a like-minded community during this time, but you will also need to give back to yourself.  This was a rather awkward and difficult new habit for me to embrace but it became yet another silver lining on the journey.

And one more thing... No matter what anyone else tells you, including me, nothing can really mentally prepare you for the IVF process.  It is not for the faint of heart and you are a rockstar to travel this path.  Remember that you are not alone and you do not have to suffer in silence.  

I've put together a cheat sheet of the main points that I believe helped me optimize my outcome and feel decent during the process.  My hope is that these insights will help support your journey and make the ride a little less turbulent.  Read on to Part II to get started.

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  just be doing the egg freezing process.

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.

1. Eat clean whenever possible

Focus on a mostly 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 grains (gluten in general whenever possible.)  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 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.  (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, and phthalates (fragrance).  All of these items are known endocrine disruptors.  Check out EWG.org 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 
  • Cleaning Products: Puracy, Meliora K
  • 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 7 - 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.

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.  Many clinics also have groups available so make sure to enquire.  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.

2. Get a post-retrieval care package ready

A heating pad, Tylenol, coconut water (I love Taste Nirvana and Harmless Harvest), Ultima electrolyte mix, 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.

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 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:

1. Plan for bedrest for that day and the following

Avoid a heating pad.

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. The 10 day wait...

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 vibes your way! xo

 

Baby Makes Three...

I am grateful to my rock of a husband; friends and family for cheering us on; Elaine, an enormously talented healer who helped me understand my path; the designer who fortuitously sat next to me at a brunch last summer and introduced me to "the" doctor;  Claudia for helping me awaken to the concept that all of this was happening for me; Keri who taught me to look at food as fuel and medicine; Daryl for reminding me that (acupuncture) needles can actually be wonderful; and to Dr. Schoolcraft, Melanie and all of the amazing people at CCRM that I have had the great pleasure of meeting along this very long road.

Sound like an awards ceremony?  I sort of feel like I just won the greatest award in the world.  I have won the gift of pregnancy and I couldn't have done this on my own without the expertise, support, and love of so many incredible people.  I now know that every single person that I felt that tinge of energy around was meant to be in my life for a reason, whether for a season, or a lifetime.  For the first time, maybe ever, I feel like I am in alignment and exactly where I am meant to be.  

I have tried so many times to write this entry down over the last couple of months, and every time, I find an excuse to put it off.  First I had to wait until after three months to be sure, then I had to get my energy back, take care of my full time job, wait until the time felt right to share the news, and the list goes on and on...  Despite my very positive outcome, I have felt so many emotions through this process that coming back to center and sharing the news of my pregnancy has actually been more difficult than I could have imagined.

About 6 weeks after starting this blog, I got pregnant.  It’s mildly amusing that I had to expose my “dirty little secret,” and then I conceived so quickly.  The most interesting finding is that by sharing my secret, it was no longer dirty.  In fact, I found out that I was far from alone.  The path to finding fertility can mentally and physically suck the life out of you if you let it.  I am fortunate to have discovered solace and community from several groups consisting of thousands of women who struggle with their fertility.  These women bestowed upon me the invaluable gift of perspective.  And for those still on the journey, I will continue to root for you every single day.

I also thought that getting pregnant would be my end goal.  In hindsight, it is now clear that chapter was a stepping stone to the next leg of this incredible journey.  The lessons that I have learned, and continue to learn, about mental and physical wellness weren’t only the key to helping me conceive, they have become a way of life.

So as I sit here writing this at 6.5 months (26 weeks) pregnant with my little babe kicking inside of me, I am overcome with appreciation for this journey.  Being open to the possibilities, unattached to the outcome and surrounded by an amazing network is why I believe I am able to share this wonderful news with you.

A million thanks.  My cup literally runneth over in gratitude.

 

*A very special thanks to the talented Robert Grima for capturing me and my belly, as well as to Zimmerman for the beautiful dress.*

Learning how to lead a Nutritious Life with Keri Glassman

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I realized after some initial setbacks with my fertility that nutrition held the keys to the kingdom that I was looking for.  I became convinced that what I put in my body would ultimately help me achieve conception.  I got to reading books on foods for fertility and met with a couple of nutritionists, but ultimately knew that I just wanted to be more educated on the subject.  (Maybe the Type A in me?)  Cue Keri Glassman and The Nutrition School (TNS).  The courses not only solidified my understanding of nutrition, but also gave me a “wholistic” view on health, wellness, and nutrition.  Thanks to Keri and TNS, I am now Nutritious Life Certified and accredited by the American Association of Drugless Practitioners.

You may have heard about Keri… she is a nationally recognized celebrity nutritionist, registered dietician, healthy cooking expert, published author, and the founder of Nutritious Life and The Nutrition School.  Or you may have seen Keri on TV; she has been tapped as an expert to speak on The Today Show, Good Morning America, The View, The Talk, The Chew, Dr. Oz, and much more. 

I was recently fortunate enough to snag some time with Keri to discuss how her life was destined to be a nutritious one.  Read on to find out how you too can glean some important tips on leading your most nutritious life!

 

How do you spend most of your time?

Good question.  Every day varies but there are a few things that I do to keep my schedule consistent despite travel and projects.  I always take a look at my week and assess what I am doing with my kids, when I am having my family time, and what are the fun and exciting things that we are doing together based on their schedule.  I also always try to be home for breakfast unless I have early morning TV (interviews), as well as dinners to spend time with them.  Breakfast and dinner together is a huge part of our day. 

When you are your own boss and someone is not telling you where to be all day, it can lead to lack of structure and productivity.  I am an early riser and am my best in the morning so try to tackle one big project on my list between 5:30am and 7am.  That gives me a little bit of time for myself, plus a bit of time to organize and map out the day.  I pause, have breakfast with the kids, and when they go to school, I get my workout in.  Then I try to block out time to get in computer time (writing my own content, doing research) until around 1pm to harness my most productive hours.  I take the time after that to power through media interviews, calls, and meetings.  I find that I am better in those situations because I have crossed off things from my list earlier in the day, am clear-headed and focused.

What inspired you to launch Nutritious Life and TNS?  

Since I was a little girl, I was interested in nutrition without even realizing it.  I played sports and had a natural interest in how the body works and fuels itself.  In seventh grade science class, I told my friend that I was craving almonds so my body must need Vitamin E.  I probably had no had idea what Vitamin E actually did but I had read it somewhere, and was interested enough to remember that fact. 

Fast forward to college, I continued to play sports and eat well.  A lot of my friends did not.  They drank Diet Coke, didn't eat healthfully, yet I was the one who gained the “Freshmen Fifteen”.  As a result, I became interested in how to fuel the body for performance but also how to be lean and fit.  After I graduated, I worked with Sports Illustrated and because it was owned by Time Inc., I could get my hands on all the magazines.  I remember sitting at my desk and going over every last word in Health Magazine.  In fact, I was so interested that I went back to school part-time and took nutrition courses at NYU.

To some extent the rest is history, but when I graduated I started working for an online health and wellness company and was counseling people; first at Equinox, and then privately.  At the same time, I was getting my business experience at a small start-up.  The start-up pulled me away from hard-core nutrition because it took so much of my time so I decided to take the business skills that I had gained and couple it with my passion for nutrition. Then I went for it.

I quit my job (at the start-up) and opened up my own practice called Body Fuel about fifteen years ago, which has since evolved into Nutritious Life.  My practice from day one encompassed the mantra of a nutritious life, and it being more than just food.  In fact, my first logo was an icon for stress (a brain) with an arrow going to a drop of water (hydration) to an arrow going to a bed (sleep)!

I created TNS to scale my practice throughout the country.  It started with a binder to keep myself accountable and to eventually train others.  Then I hired my first dietician, trained her, and then the binder evolved into the program that it is today.

How old were you when you started playing with food?

I talk about this with my mother all the time… My mom still has a recipe box and found all of these cards with recipes that I had written, even though some were make-believe like Lizard Stew!

In the second grade, I made a “cookie dough machine” for a school project.  My dad brought cardboard and paper towel rolls for me to make it.  I always think of that as my first recipe and foray into entrepreneurship.

What’s the first thing that you remember cooking?

Growing up I cooked with my mother who made so many great recipes!  I remember the ritual and experience more so than what we actually made; sitting on the counter in the kitchen and being with mom, and cooking dinner every night.   We started every meal with half a grapefruit, and a salad with Ken’s Italian dressing.  Every night we had a vegetable, starch, and a protein, followed by dessert.  It may not always have been focused on health per se but it was always balanced.  We also always sat down as a family.

An ingredient that you can’t live without?

Nuts and nut butter.

One ingredient that you avoid at all costs?

There is almost nothing that I do not like but I can’t stand cilantro. 

What do you listen to when you cook?

Everything from what I listened to when I was growing up to what the kids listen to now.  From Coldplay, Eminem, U2 to the Bee Gees to Taylor Swift.  I was rocking out to Katy Perry the other night and loved it.  My daughter took the opportunity to share… “Mom, that song is not good”.

Favorite vegetable?

That is hard…  I have to pick one?!  Mmm…. Let’s go with spinach.

Favorite fruit?

Blueberries

Last cookbook that you used?  What did you cook?

I recently made a great recipe from “It’s All Good” by Gwyneth Paltrow.  I made Two-Pan Chicken with Harissa, Preserved Lemons and Green Olives. I love olives.  In fact, it inspired me to make poached olives and they were so good.

Do you have any secret talents?

Hand-eye coordination.  If you throw something at me, I will catch it.  I can also pogo stick for hours.  I think I beat a neighborhood record when I was a kid.

If you could have dinner with anyone, who would it be and why?

Oprah.  Who wouldn’t want to sit with Oprah all night and pick her brain?

What is the number one piece of advice you would share with those looking to lead a Nutritious Life?

The combination of eating real, whole foods in conjunction with listening to your body, eating when you are slightly hungry, and to stop eating when you are slightly satisfied.  You’ll never have to count calories or worry about anything food related if you can master that powerful combo.

Remember it’s not just about the food.  It’s also important to pay attention to the other areas like focusing on stress reduction, sleep, and to not forget that they are just as important as exercise and food.

 

Ready to get started?  I put together a sample meal plan below with balanced and healthy recipes designed by Keri.  Just click on the recipe links below to get started with leading a Nutritious Life!

Breakfast: Morning Glory Muffins

Snack: Avocado Banana Smoothie 

Lunch: Chopped Salad with Tofu & Soy Nuts

Snack: Carrots & (10) Almonds

Dinner: Noodle Free Turkey Lasagna

 

*Note: Look out for GMO-free soy products.  Also, all recipes shared were created by Keri Glassman, Nutritious Life.

pregnantish: An interview with Andrea Syrtash

Andrea Syrtash, a real life superhero bridging the gap between her work and personal life, talks about fertility, relationships, and embracing the“ish”of things.

 

If ever there was the definition of Superwoman, Andrea Syrtash is it.  Andrea is a dating and relationship writer, online broadcaster and author.  She has been featured as an on-air personality on ABC’s The View, Good Morning America, NBC’s Today Show, and Oprah to name a few.  Andrea has also spoken at TEDxNavesink Makers on “How to Make Love (Outside the Bedroom)”, and is a regular contributor to Glamour.com.  To add to her growing list of credits, Andrea also recently founded pregnantish, the first-ever digital lifestyle magazine dedicated to providing resources for the fertility-challenged, inspired by her own and others' experiences associated with the trials and tribulations on the road to getting pregnant.

I had the opportunity to catch up with Andrea in between the filming of a TV pilot that she is hosting. Before kicking off our discussion, Andrea thoughtfully shared that both aspects of her career, being a relationship expert and the Editor-in-Chief of her new fertility-focused site pregnatish, go hand in hand. “Infertility is not just a medical issue, it's a relationship one. That's part of my goal with the site - to help singles/couples/LGBT navigate the personal and practical parts of the process.”

 

What made you decide to launch pregnantish?

As I've navigated my own infertility and fertility treatments for a number of years, I've searched far and wide on the Internet for a smart resource that wasn't clinical and it's been tough to find.  Information on this primarily has lived on parenting sites; and while these can be helpful, I felt it was time that we had our own lifestyle destination.  There are amazing medical and advocacy sites and we're not competing with them. We're trying to fill a different need. Instead of waiting for it, I decided to create it.

pregnantish is a great name, what is the inspiration behind it?

Over the last six years, I've undergone many fertility treatments, have been very hormonal, and told by my doctor to take it easy: not to drink alcohol or exercise too much, in the case I might be pregnant.  I've also had a positive beta test and have literally been pregnant for a time, and have lost the pregnancy.  Essentially, the inspiration behind the name is that it's a misconception, and you can in fact be a little bit pregnant!

Three adjectives you would use to describe pregnantish?

Supportive.  Smart.  Relatable.  Our tagline is ‘Real Talk About Fertility.’

What is your mantra?

When in doubt, choose love.

The moment(s) when you knew you were “ready” (to be a mom)?

Some women have always known they wanted to become a mom.  In my case, it happened a couple of years into my marriage.  I realized my partner (who is a teacher) would be a great dad, and that I was ready to expand our family. Once my niece was born, almost 4 years ago, it was even more solidified to me that I would love to raise a child.

You’ve written dozens of books on relationships; fertility can be taxing on a relationship. What is your number one piece of advice to couples on navigating the potential fertility minefield?

Good question!  Firstly, couples should give themselves a break.  This is such a tough thing to navigate, as infertility challenges relationships in the deepest way: the relationship you have with each other, with yourself, with your bodies, with your work, with your community, with your bank account and more.  I'd suggest that couples leave the lines of communication open, so they don't feel as alone.  I'd also suggest that they don't just look to each other for support.  Each person in a partnership has a right to feel feelings of frustration, despair, hopelessness, confusion and more.  Sometimes, though, it's too intense to rely on your partner to help you through this.  I'd suggest finding a trusted source - a friend, clergy member, or therapist, to help each or both of you so that you have the support you need.

You recently posted a meme that “Facebook is constantly reminding me that everyone is pregnant but me.” How do you recommend handling the news of a friend’s pregnancy announcement?

I have learned that you can hold two emotions: you can be happy for a friend and sad for yourself.  You can celebrate your friend's pregnancy news, but you aren't a bad friend if your heart sinks and you feel sad for yourself at the same time.  That's normal.  It's helpful to remember that we can hold both emotions.

Has there been a silver lining to your experience? 

Some people have said to me, 'All this was worth it so you could create pregnantish.'  I have mixed feelings about this.  I'm an eternal optimist, who sees the good in most situations; and yet, I wouldn't wish these 6 years of pregnancy losses, intense fertility treatments, invasive surgery, emptying the bank account, etc. on anyone!  It's been a very tough road.  The silver lining is that hopefully I can help others feel less alone as they navigate this, too.

Your go-to for managing stress?

I'm a glutton for massages!  I don't get them often, but every time I go, I feel better after and well taken care of.  The body goes through so much during treatment that it's important to practice self-care!  I also swim regularly.  This helps me alleviate stress.

Cook or order-in?

In my head I cook a lot.  In reality, I go out or take out more (part of NY living, it seems!).

Favorite feel-good food?

I enjoy foods with a surprise inside (dumplings, empanadas, ravioli, etc).

Last book you read?

I re-read Emotional Intelligence.  So good!

Who inspires you?

So many people inspire me (including my parents!); but in terms of a public figure, I'm inspired by Oprah.  A few years ago I hosted a great show for her network and it was a great honor.  I grew up watching her show religiously.  What I appreciate about her is her authenticity, her commitment to helping people live well and her drive.  She's created so many amazing opportunities and platforms, and has made the world a better place.  I hope to do (at least a fraction of!) the same with the media platform I have and the writing I do...

Best piece of advice that you have ever received?

The most important thing you can offer in a relationship is your presence.

Number one piece of fertility advice that you would like to share?

As much as possible, embrace the 'ish' of things.  Life isn't black and white, and some of the best life paths aren't expected or linear.  I've realized that it's important to know the what (that you want to be a parent) and it's okay to not yet know the who (biological or not), how or where of it."

 

To find out more about Andrea Syrtash visit pregnantish and sign up for the newsletter.  You can also follow along @pregnantish on Facebook and Instagram, and @pregnantishmag on twitter.

 

 

Supplements to Optimize Fertility

I am so excited to share that after a third round of IVF and a year later (and older), I recently DOUBLED my number of eggs from both our first and second cycles to 16!  15 were mature, most fertilized and some even went on to blastocyst.  I am convinced that editing my lifestyle, eating habits and taking supplements played a large part in making me feel better and putting me in a better headspace, which ultimately produced overall better results. 

For those that may be considering IUI, IVF or are even trying naturally, you may be wondering what supplements you can take to optimize your outcome.  I've put together a cheat sheet for you.  Please just remember that supplements are meant to be just that: “supplement” your diet.  Eating clean and healthfully is the first best step.

Using the CCRM (Colorado Center for Reproductive Medicine) “Female Fertility Cocktail” that I was thrilled to get my hands on, coupled with my own research, and discussing with my doctor and a certified nutritionist, here is where I landed to safely “supplement” my own diet.

The supplemental basics:

1.     Probiotic - once a day first thing in the morning

2.     Pre-Natal Multi-Vitamin - as directed each day 

3.     DHA (Omega 3 Fatty Acids) – 1,000mg once a day

4.     Co-enzyme Q10 Ubiquinol (Kaneka QH) – 400mg twice a day in both AM and PM  

5.     Vitamin C – 500mg once a day

6.     Vitamin D – Once a day and levels dependent on any deficiency (Mild: 1,000 – 2,000mg)

7.     Vitamin E – 200iu once a day

The items in italics (Probiotic, Pre-Natal and Vitamin D) were not on the CCRM list that I received but are important supplements that my doctor and most recommend. I was so adamant about getting this right that I lugged a bag full of the physical bottles to show both my doctor and fertility nutritionist for their review and blessing.

The recommended amount of time to take supplements is 90 – 120 days prior to trying naturally during ovulation, or attempting an IUI or IVF cycle.  This is based on recent studies that show that egg quality might be positively improved during this critical time frame when they could be most impacted by diet, supplements and environmental factors.

 

The full CCRM "Female Fertility Cocktail":

The Colorado Center of Reproductive Medicine known as the nation's leading fertility clinic recommends the below supplements to increase fertility.  Many believe this list that updates as more research becomes available the holy grail of fertility supplements.  I've included it here.

1.     DHA (Omega 3 Fatty Acids) – 1,000mg once a day

2.     Co-enzyme Q10 Ubiquinol – 400mg twice a day (Kaneka QH)

3.     Vitamin C – 500mg once a day

4.     Vitamin E – 200iu once a day

5.     L’Arginine – 1,000 mg twice a day. (Might be detrimental to most but helpful to some poor IVF responders)

6.     Pycnogenol – 100mg once a day. (Might be best for those with endometriosis)

7.     Myo Inositol - 2 grams OR (3) 750mg tablets AM, and (2) 750mg tablets PM. (Based on research this may be best for those with PCOS)

8.     Melatonin – 3mg only at bedtime at the beginning of an IVF cycle only and as necessary       *Contra-indications: If you are taking thyroid medicine, avoid melatonin as it has been shown to increase T3 – T4 levels

** This is the CCRM list as of 11/2016, is meant to be coupled with a Prenatal, and is not a one-size fits all approach.  Please consult with your physician or health care provider based on YOUR individual needs and especially with the supplements above numbered 5 - 8.**

 

So what’s the WIFM (what’s in it for me)?!

If you are interested in knowing details on each supplement, read on…

1.     Probiotic - New research is looking at the possibility that a GI tract brimming with microbes helps to maintain a healthy weight.  Plus probiotic bacteria helps fight bad bacteria found in your intestines, promotes good digestion, may also help with infections of the digestive tract, enhance immune function, and control IBD (inflammatory bowel disease.)*  If you’re going through any sort of IVF journey, it can also help with the discomfort including cramping caused by the medicine and procedures.  A daily probiotic may also be a great tool for anyone who does not eat enough probiotic-rich foods. Common sources are yogurt, kefir, sauerkraut, sour pickles, tempeh, and miso soup. If you are going down the “I just need a supplement version,” my pick is Natren Healthy Trinity Probiotic.  Make sure that they arrive cold if you buy them online and keep them refrigerated once at home to keep the cultures alive!

2.     Prenatal Multi-Vitamin – There is very little difference between the brands available by prescription and non-prescription.  There are high quality prenatal vitamins available without prescriptions. I take New Chapter Perfect Prenatal, made with organic veggies and herbs, and without any preservatives, additives or fillers which was very important to me.  However, the Folate is a little on the low side at 600mg so if you don’t get the additional 200mg or so from your diet, you may want to consider a Folate supplement.  Pure Encapsulations (400mg) is awesome. Note that  prenatals that cause nausea or digestive issues might be resolved with a version containing chelated iron.

3.     DHA (Omega 3 Fatty Acids) –Omega-3s are important for immune functioning, brain health and inflammatory response.   EFA (Essential Fatty Acids) may reduce inflammation throughout the body (a possible cause of PCOS and other types of infertility) and promotes overall health.  The best source is whole fish oil.  My pick is Nordic Naturals or New Chapter Whole Mega.

4.     Co-enzyme Q10 Ubiquinol - Ubiquinol not only works as an antioxidant but is crucial in the body’s production of energy. It is the very fuel that makes your heart beat. With age, our bodies progressively produce less CoQ10 and struggle to convert it into Ubiquinol, which is the usable form of CoQ10.*  Fertility speaking, Ubiquinol may also improve egg quality and improve chromosomal division during fertilization. Ubiquinol is the concentrated version of Ubiquone, and there are no known safety risks for either.  There are plenty to choose from but I like Doctor’s Best Ubiquinol with Kaneka QH.

5.     Vitamin C – Highly effective antioxidant that plays a role in egg health by helping to combat free radicals.  I am a fan of Garden of Life, Vitamin Code, Raw Vitamin C.

6.     Vitamin D - Assists in maintaining a healthy immune system.  Vitamin D2 is the form from eating foods rich in it, and vitamin D3 is synthesized in the skin from sun exposure. (Fun fact, since the body makes D3, it’s actually considered a hormone and not a vitamin.)*  A simple blood test can determine any deficiency.   I take Pure encapsulations Vitamin D.

7.     Vitamin E – Antioxidant that fights against free-radicals and cell membrane damage.  (May be especially helpful in reducing free radical damage in ovarian follicles.)  My pick is Blue Bonnet Vitamin E 200iu.

9.     L’ArgininePlease consult with your doctor before taking to make sure it’s right for you.  Recent research indicates that for most this could potentially reduce egg quality as opposed to improve it.  CCRM promotes this to a specific group of people that fit within a specific framework that could actually benefit from this amino acid which helps with cell division, immune function and release of hormone.

10.  Pycnogenol - Please consult with your doctor before taking to make sure it’s right for you.  A patented extract from pine bark, which is not naturally occurring in the body, and may help stimulate the immune system and increase blood flow.  Since it’s not naturally found in the body and good-quality clinical studies have not been able to confirm that it improves egg quality or even that it is safe made this one not worth the risk in my book.  However, there are studies that show that Pycnogenol might be helpful for patients with endometriosis.

8.     Myo Inositol Please consult with your doctor before taking to make sure it’s right for you. Might be best for women with PCOS.  Vitamin B component of cell membrane helpful in restoring ovulation and improving egg quality in women with PCOS or insulin resistance.  It may also reduce the miscarriage risk associated with insulin resistance.  Note that studies have shown that Myo Inositol may be unfavorable to non-PCOS patients by possibly reducing the number of mature eggs and embryos.

9.     Melatonin – This helps calm the head chatter and promotes shut-eye.  During IVF, it’s clearly a better alternative to an Ambien.  Melatonin is a powerful antioxidant that helps to regulate circadian rhythm.  Again, based on your needs, this one is best to discuss with your doctor.  Pure encapsulations makes a nice version.

And for those of you wondering about DHEA… It’s a steroidal hormone that turns into testosterone and estrogen which seems to be quite controversial and fertility doctors either are or aren’t a fan.  DHEA is produced naturally, peaks at age 20 and diminishes thereafter; it is thought to help with ovarian function.  The synthetic version may have side effects though.  Side effects may include acne, hair loss, stomach upset, and high blood pressure. Some women can have changes in menstrual cycle, facial hair growth, and a deeper voice after taking DHEA.  So that was enough for me to say no thanks.  My doctor also shared that he’s not really a fan based on more recent studies.  Even if your doctor recommends it, always remember that you have a choice.

Speaking of doctors, please know that I am not one.  I have taken a genuine interest in nutrition and wellness and use my recent education/certification by The Nutrition School by Keri Glassman, my own research (not from Internet chat forums), and validation from doctors and nutritionists that I have worked with.  My hope is that you will use this as a guide to help you see the options available and determine your own course of action with your own doctor or certified health professional.

 

The last word.

Remember to stop taking all supplements outside of your Prenatal (with extra Folate if necessary,) Probiotic and Vitamin D once you start stimming (stimulating with medicine).  I didn’t get that memo until my third IVF and AMAZING doctor #5.  I guess that three really is a charm…

 

*Credit: The Nutrition School by Keri Glassman.  I found this program to be so beneficial that I became an affiliate, which means that if you sign up for TNS after clicking on that link, Fertilust may get some funds.  Thanks.  

Breakfast for Days

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I was not a breakfast person until recently.  While I love breakfast and have been known to eat it for dinner, I never quite made the time to "break the fast" in the morning.  Between the snooze button on my phone and finding myself rushing out the door, I could never quite get to it.  Sound like you too?

Motivated to have it all (the extra sleep plus fit in breakfast,) I have made eating breakfast a priority and possible thanks to meal prep in advance.  Here's what prompted me to get excited about breakfast...

A healthy breakfast kick starts your metabolism for the rest of the day.  (Really; starting your day with a morning meal initiates thermogenesis, the metabolic process that gets your body going.)  Skipping breakfast might initially mean saving on calories but the body gets conditioned to make up for it and then some by looking for more food and usually less healthy options later in the day*  If the potential weight gain isn’t convincing enough; when the body is focused on basic survival and when it is going to eat next, it isn’t working as optimally and is certainly less focused on making new life happen.

If breakfast is something you'd like to get add in to your daily ritual without sacrificing something else; here is one of my favorite healthy prep-in advance recipes for Overnight Oats to help get you started.  The following is a recipe that I have adapted from Angela Liddon’s cookbook: “Oh She Glows Every Day," for Apple Pie Overnight Oats.

Apple & PB Overnight Oats


HERE’S WHAT YOU’LL NEED

  • 1 cup Gluten-Free Rolled Oats (I like Bob’s Red Mill)
  • 1 ½ cups Almond Milk
  • 2 tbsps Natural Peanut Butter (or Almond Butter.  I like Justin’s either way)
  • 1 tbsp Raw Honey
  • 1tsp Cinnamon
  • ½ tsp Vanilla Extract
  • Pinch of Sea Salt (I like Himalayan)
  • 1 large Apple diced (Organic when possible)
  • 3 tbsps Chia Seeds

OPTIONAL TOPPINGS

  • Hemp Seeds
  • Ground Cinnamon
  • Dried Cranberries
  • Additional Apple

The Recipe

10 Minutes Prep & Let Refrigerate for 2 Hours+ or Overnight

  1. In a medium-sized bowl, combine the oats, milk, peanut butter, honey, cinnamon, vanilla, salt, apple, and chia seeds.  Stir to combine.
  2. Cover or transfer into a large mason jar to settle.  Refrigerate for 2 – 3 hours or overnight to soften the oats.  If the mixture is too thick for your liking, add a little extra almond milk and stir.
  3. Serve chilled or warm up.  Add toppings if you would like.  Keep any leftovers in an airtight container (or mason jar) in the fridge for a few days.   

Go nut-free:  Swap almond milk for nut-free milk and lose the peanut butter.

 

WHY I LOVE THIS RECIPE

A quick, easy to make and tasty gluten-free breakfast for days that provides a good ratio of protein, (healthy) carbs and (good) fats.  

FOOD FOR THOUGHT

Cinnamon is a super spice and chock full of antioxidant properties. It can destroy fungal infections, soothe indigestion, ward off urinary tract infections, fight tooth decay and gum disease, prevent ulcers, and is believed to control blood sugar in people with diabetes.  Plus the scent is linked to curbing fatigue, easing frustration and increasing alertness.

Chia Seeds are high in fiber and are a great source of Omega-3s (7 grams in a 11⁄2 tablespoon or 1⁄2 oz serving or more than 1⁄4 of your daily needs.)  They are also packed with protein, calcium, manganese, magnesium and phosphorus. Chia is linked to heart health, bone health, blood sugar control and exercise performance.  Please don’t consume chia unless it’s incorporated into liquid or foods, otherwise it could pose health risks.

Hemp Seeds provide essential amino acids in a vegan and gluten free seed.  Thanks to the omega-3s packed into these little gems your heart and brain function optimally.  Like chia, it’s abundant in fiber (12 grams in a tablespoon and a half,) and keeps the pipes working smoothly.

Credits: The Nutrition School, Nutritious Life by Keri Glassman.

 

*The National Weight Control Registry is a log of menu and women who have lost anywhere from 30 to 300 lbs and have kept it off for at least 5 1/2 years.  Interestingly enough, 78% eat breakfast every day.  Another study from The Organization for Economic Co-operation and Development reported that as of 2011, the percent of obese adults (BMI > 30) in America is 26.1% while the percent of obese adults in Germany is 13.7%.  According to the study, over 75% of Germans eat breakfast every day while only 44% of Americans do.  Credit: The Nutrition School, Nutritious Life by Keri Glassman.

All About the Egg.

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One of the first things I learned on this path is that for someone who had an absolute obsession with a perfect outcome for every professional marketing campaign that I touched, I wasn’t practicing this behavior personally.  Case in point, nutrition and wellness.

Since I moved to NYC 9 ½ years ago, I have survived as a result of eating out and Seamless food delivery.  Beyond the taste, I had zero idea what was actually making up these meals.  From ingredients to quality control, I was not at all conscious of my daily nutritionally intake.  In fact, I really wasn’t even a fan of vegetables.  True story, I ate everything in a salad except for the greens.  Most meals were focused on an animal protein because the menu items always seemed more exciting. So if I indulged with a cheeseburger, pizza, and more cocktails and glasses of wine than I could remember, I’d solve the program with a Berocca and a spin class the next day. I figured that as long as I wasn’t putting on too many pounds, my lifestyle must be working.

Then my fourth fertility doctor told me to take a pre-natal and focus on eating a Mediterranean diet. (Seriously what does Mediterranean diet actually mean to someone that defines cuisine type based on restaurant reviews and delivery site filters?)  So I did what I was told and incorporated grilled octopus, Greek salad, hummus, and pita chips from the local Greek restaurant as staples into my diet. 

My IVF outcomes were less than stellar for my first two rounds at the beginning of 2016 and I was also plagued with a flu or cold every month for the first four months of the year.  Following my second failed IVF and sick once again, I lapsed into a slight depression fueled by an overwhelming feeling of helplessness.  I had just wanted someone to tell me what to do to get pregnant so that I could focus on the rest of my life, but clearly that wasn't working.

Then something happened…. I decided that I was going to figure out what part I could actively play because I didn't feel like it needed to be the end of this journey.  I called it after three days of a major pity party and dove head first into the sea of the Internet.  After sifting through a lot of junk diguised as schemes and products to get pregnant quickly, I stumbled across an incredible book that I proceeded to download off of Amazon.  “It All Starts with the Egg,” by Rebecca Fett, gave me hope and actual, tangible tools that got me started with my journey.

The book focuses on egg quality as the key to improving IVF odds and reducing miscarriage.  It  also has great research-backed concepts that might actually help natural conception.  I wish I had found it so much earlier and credit it as my learning springboard.  Rebecca’s personal story of trial turned to success inspired me to begin an action plan of my own centered around nutrition and wellness.

If you are interested in checking it out for yourself, you can find it here.

Amazing Almond Milk

When I first started my journey of eating clean, my friend Shannon sent me a kit to make my own almond milk.  I was a serial breakfast skipper and I think that this broke her heart a little.  Shannon wanted to ensure that I was covered from a non-dairy alternative in my coffee to easy pre-made breakfasts.  (Almond milk is a key ingredient to my now go-to breakfast, Overnight Oats.)  I am pretty sure that this was one of the first times that I began using my kitchen since we had moved in to our new home two years ago.  I have since played around  enough to make a recipe that I love and hope that you will too.

Homemade almond milk is a fantastic substitution for dairy milk; from coffee to baking.  Most importantly it tastes great plus is so ridiculously easy to make.  It seriously only takes around 10 minutes or so to achieve an awesome dairy-free milk alternative without all of the gross additives like Carrageenan* that might be found in the store bought versions.

Here's what you’ll need

  • 1 cup Raw Almonds (ideally sprouted)
  • 3 ½ cups Filtered Water
  • ½ tsp salt (I recommend Himalayan Pink Sea Salt because of its added benefit of trace minerals)
  • Zimtal Nut Bag

And because I was always a sucker for the sweet drinks at Starbucks, I sometimes sweeten the pot with the following:

  • ½ tsp Vanilla
  • ½ tsp Cinnamon
  • 1 tsp raw Honey

The Prep

  • Soak almonds in salted water, in a covered container, in the fridge overnight (or at least 8 hours).

The Process

  1. Rinse almonds thoroughly, throw into a blender and blend away.
  2. Grab a small bowl, line the bowl with your nut bag and pour the liquid through.  Remove the bag from the bowl and squeeze the liquid through the bag. (I always imagine this is what it must feel like to milk a cow.)  
  3. Once all liquid contents are in the bowl and you are just left with the almond bits in the bag, pour the liquid back into the blender.  (Don’t forget to give your blender a quick rinse in between to lose any almond bits.)
  4. Add in the natural sweeteners as recommended or to taste, blend and viola, you are done!
  5. Your almond milk should last 3-4 days in the fridge.

*Carrageenan is a food additive that keeps products and beverages from separating.  It can be labeled as organic and natural since it is made from algae.  The seaweed is cleaned, extracted, filtered, concentrated, combined with chemicals, pressed, dried, blended, and refined.  Still sound organic to you?  Research studies link carrageenan as a trigger to inflammation that could be a factor in severe health conditions including cancer, diabetes, colitis, and other GI tract damage.