Wellness & Nutrition

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.*

Get Happy

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There could be a slew of reasons that might derail a day; the too-good-for-his-job guy/girl at the local coffee shop who was rude and got your order wrong to boot. Maybe you’re running late to an important meeting and a careless taxi driver just drenched you in toxic city sludge on your way to said meeting… 

Life isn’t perfect. We should allow ourselves the opportunity to mourn the big things and let go of the small things. We may not be able to control outcomes of situations but we can control how we react to them. In those moments we are presented with a choice and an opportunity.

There is something to be said about the power of optimism to combat stress and empower a positive mind-body connection crucial for any medical challenge including infertility. Poor mental stress may negatively affect fertility in ways that are not yet clinically understood. (I asked Dr. # 4 about the impact of stress and she said and I quote “we live in New York City, everyone is stressed and women get pregnant all of the time”. That statement literally crushed me at the time and now I think it is just plain ridiculous that I allowed her view to cloud mine.) Just because there isn’t enough clinical research to provide gold standard research on the affects of high cortisol levels doesn’t mean that we aren’t affected by stress. Stress is real and we have the power to either contribute to it through negative thoughts, thereby punishing ourselves, or through combating it through manifesting the positive.

There is only upside to practicing a positive outlook. A generally happy person enjoys a higher quality of life and it may also reduce disease so there’s that. Each morning is an opportunity for us to hit the reset button. While it applies to just about everything, focusing every waking moment on getting pregnant “or else you won’t have this, or that,” can create tunnel vision. (Cue that crazy spiral image from the Twilight Zone.) Being so attached to a fertility outcome may even make things worse for us mentally and emotionally should our reality not match our expectation. I’ve been there. We have a choice to be all consumed or practice counting our blessings for the things in our lives for which we are grateful right now.

So if you missed the memo on “National Happiness Day” today, remember that you’ve got another shot to get happy tomorrow. Before you go to bed tonight, reset. Close your eyes for a (whole!) minute and breathe deeply. First forgive yourself, maybe even forgive that self-absorbed barista, taxi cab driver, or your nosy colleague who keeps asking when you are going to have kids. Consider giving them the benefit of the doubt, as they are likely just unaware. Take three more minutes. Just three more! Write down three things that you are grateful for, and three moments that you are looking forward to in the new day. (Writing my thoughts and tasks in a pretty notebook gives me an insane amount of satisfaction for some reason. Maybe it will for you?) The moments that will make you smile as you think about the future may be as simple as hugging your dog, or seeing the sun/sky in the morning. On the back of the paper, dump anything else that you need to park outside of your head like calling your mom, the doctor, any work related items, and, and, and… Bonus points if you write down one self-care item (massage, manicure, etc.) that you plan to schedule for yourself, just because.. Then leave your phone in another room and affirm to yourself that you have set yourself up to get a good night’s sleep to reset and restore for the coming day ahead. Believe it when you say it.

Tomorrow, right when you wake up, read that list of six things at home and not on the run, saving the other side of the to-do’s for the office. Honor your brilliant mind and body by telling yourself how grateful you are, drink a whole glass of water and mentally prepare yourself for the day with a smile. And give yourself permission without judgement to fake that smile until it becomes real.

Wishing all of us endless National Happiness Days…

xx


Photo by Patrick Hendry on Unsplash

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.  

Apple Pie Overnight Oats

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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 Pie 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 single-ingredient Peanut Butter (or Almond Butter)

  • 1 tbsp Raw Honey

  • 1tsp Cinnamon (Simply Organic is a great option)

  • ½ tsp Vanilla Extract

  • Pinch of Sea Salt

  • 1 large organic Apple diced

  • 3 tbsps Chia Seeds

OPTIONAL TOPPINGS

  • Hemp Seeds

  • Ground Cinnamon or Nutmeg

  • Dried Cranberries

  • Bananas, blueberries, strawberries

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.

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.