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Toowoomba Acupuncturist Specialising in Infertility Discusses Fertility Boosting Supplements

There are numerous natural healthy supplements and foods that may dramatically increase the likelihood of falling pregnant naturally. These same substances have been shown to boost the IVF success rate of having a baby via Assisted Reproductive Technology (ART). I believe that there is sufficient evidence that shows that several substances when correctly applied leading up to the IVF procedure, sometimes for several months, can enhance the success rate of IVF and other ART procedures. These reported substances include DHEA, Testosterone, Prednisone, L-Arginine, Er Zhi Tian Gui granules, MACH (macrophage-activating Chinese herbs), Saizen Growth Hormone, Selenium, Myo-Inositol, a Lipiodol flush and Vitamin D3 according to my research. I am still digging deeper.Smile

Traditional Chinese Medicine (TCM) along with a course of Acupuncture have been shown to increase the success rate of falling pregnant naturally and also boosting the success rate of IVF procedures. My name is Louis Gordon and I am a qualified acupuncture practitioner specialising in boosting fertility in infertile couples. I practice acupuncture from ANTRAC Acupuncture Clinic in Middle Ridge, Toowoomba, 4350, Queensland, Australia. I have over 3 decades of fertility-enhancement acupuncture experience, and I can assist in all aspects associated with male and female Infertility Treatments and especially when used alongside Assisted Reproduction Technology (ART) procedures including IUI Procedures, IVF Procedures and ICSI Procedures. Call for more information or to make an appointment on (07) 4636 6100.

 MISSION STATEMENT: “I aim to get my patients as WELL as possible, as quickly as possible, and then to keep them WELL”.

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Lipiodol Flush: May Boost Conception Especially if you have Endometriosis

“The tip I am sending out today is very exciting for me to share because it has recently appeared to have helped couples who have dealt with unexplained fertility as well as endometriosis issues for several years. So if you or someone you know is dealing with this issue hopefully it will help you and or them create that life you long for.About 6 or 7 years ago I read about a study on a treatment that appeared to improve pregnancy rates in couples either naturally or with IVF. I read the study because a couple from New Zealand were my patients for approximately six months when they had this procedure done and subsequently became pregnant naturally after trying for 5 or 6 years.I was intrigued by the information in the study showing high pregnancy rates for those undergoing the procedure. But for the life of me, I could not find any physician in Australia doing the procedure consistently at that time and it seemed to fall out of favour despite the great results reported in several studies from 2002 -2007.Recently however, a few physicians whose patients we regularly see have started using this procedure again and I am seeing great results. Pregnancies from couples who were “unexplained” and two women with a history of endometriosis have now become pregnant after years of trying.What is the procedure? It is called the Lipiodol Flush. An iodised extract of poppyseed oil is put into the uterus and the tubes are flushed prior to a procedure or to enhance the endometrial receptivity for a natural pregnancy as well.This procedure can be done through a hysteroscopy which would not require a patient to necessarily have a laparoscopy or go under anesthetic though each physicians protocols may vary. What is also interesting is that couples with endometriosis and unexplained fertility noted increased pregnancy rates even after the procedure. For example, within six months of receiving the treatment in comparison to couples who did not have the treatment at all there was a much higher pregnancy rate, 48% (pregnancies in couples that had the lipiodol flush) than those who did not have the treatment, 10% pregnancies. That is a very significant outcome.Why would poppyseed extract work? No one knows really but it may make the uterus more receptive. Also I think the iodine present in the solution may help as well. Patients often have a aluggish thyroid that is overlooked because basic blood tests like TSH turn up normal even when many other symptoms show and objective finding show the thyroid may be sluggish. Iodine is an extremely important part of thyroid function so it is possible that the combination of iodine and the poppyseed oil holds the key to the great results for many after the procedure.Whatever the reason this is definitely worth discussing with your fertility specialist. And if he or she is not doing it, you may want to ask why or find a doctor that will try it, especially if you have been diagnosed as unexplained or have had a previous history of endometriosis and the tubes are clear.”

REFERENCE: Stacey Roberts at http://haveababy.blogspot.com.au/2011/01/lipiodol-flush-may-help-you-increase.html
Lipiodol is now solely produced and marketed by Guerbet since Savage Laboratories discontinued manufacturing in 2010. It appears that many IVF Clinics don’t offer the procedure because it is not very profitable for them, inspite of being very successful for the patient.

Green Tea And Resveratrol May Help Endometriosis

If you are trying to conceive with endometriosis, you may be interested to learn that extracts from tea and grapes may be able to help. A study – published in the medical journal Human Reproduction, 2013 – concluded that an extract from green tea and resveratrol, an antioxidant derived from grapes, may be able to deter the growth of endometriosis. These new techniques may be especially helpful after laparoscopy to keep re-growth of endometrial implants at bay.This study sought to evaluate whether epigallocatechin-3-gallate (EGCG) and resveratrol may be able to effectively inhibit the growth and survival of endometriotic-like lesions in vitro using cultured human endometrial epithelial cells. The results demonstrated that tea and grapes may help your pelvis to become more baby friendly if you have endometriosis. The researchers concluded that:”Resveratrol and EGCG (from green tea) exerted a potent inhibitory effect on the development of endometriosis in a BALB/c murine model and on the survival of EECs (human endometrial epithelial cells).”Resveratrol and EGCG are both polyphenols and are know to possess strong antioxidant properties, both have also demonstrated significant anti-estrogen activity which may be responsible – in part – for their anti-endometriosis activity. EGCG is also known to have an anti-angiogenic effect; anti-angiogenic activity simply means that a substance can deter the growth of new blood vessels which is critical for both tumor formation and endometriosis growth. Substances such as EGCG which can curb the growth of new blood vessels are thought to be able to put the brakes on endometriosis and may help existing endometriosis to regress.This study combined research on both animals and humans: the researchers tracked the effect of EGCG or resveratrol supplements over 4 weeks in fifty-six mice with endometriosis. In the human arm of the study, biopsies were taken from 16 women with untreated endometriosis – and 15 controls – who underwent diagnostic laparoscopy for infertility. The study discovered that:

“In the mouse model, both treatments significantly reduced the mean number and the volume of established lesions…”

Both treatments were able to: significantly curb cell proliferation, reduce the density of blood vessels and trigger apoptosis – or cell death – within endometriosis lesions. All these elements are promising signs of endometriosis regression. The study concluded that:

“Both compounds induced reduction in human EEC (human endometrial epithelial cells) proliferation (P < 0.05 versus basal) and increased apoptosis (P < 0.05 versus basal) in primary cultures.”

If you are struggling to conceive with endometriosis, ask your physician whether green tea extracts and resveratrol supplements may be helpful for you.

Important note: This article is intended for purely informational purposes and is not designed to replace medical or dietetic advice for which you should consult a physician or dietitian.

REFERENCES:
http://www.bellaonline.com/articles/art179400.asp/zzz
Human Reproduction, Volume 28, Issue, (January 2013), p. 178-188 ISSN: 0268-1161, DOI: 10.1093/humrep/des369 Oxford University Press
Natural therapies assessment for the treatment of endometriosis Ricci, A.G.1; Olivares, C.N.2; Bilotas, M.A.1; Bastón, J.I.1; Singla, J.J.1; Meresman, G.F.1; Barañao, R.I.1

Fish Oil May Curb Endometriosis And Cytokines

If you are struggling to conceive with endometriosis you may be interested to learn that fish oil has been demonstrated to have a calming, anti-inflammatory effect on endometrial cells which may be helpful for curbing endometriosis and restoring fertility.A Scottish study from the University of Aberdeen – published in Fertility and Sterility, 2001 – incubated endometrial cells in various mediums containing normal and high ratios of omega-3 fatty acids and omega-6 fatty acids and tracked the production of an inflammatory cytokine – interleukin-8 (IL-8) – from the endometrial cells.

Women with endometriosis are known to produce higher than average levels of inflammatory cytokines which are thought to create an unfavorable environment for embryo implantation. Cytokines can be produced directly from endometrial lesions and are known to be curbed or exacerbated by dietary fats.

Having too much omega-6 fat in your diet – think vegetable oils – is though to trigger an uptick in inflammatory cytokine production whereas omega-3 fats – especially from fish – are known to curb inflammatory cytokines. What’s on your plate every day may make a difference to how your endometrial cells behave, could you be fueling their growth?

Much of the omega-6 fat in our diets comes from processed foods; vegetable oils are added liberally to many foods, sauces, dressings, chips and baked goods, and we have become accustomed to the texture of these fat-enriched foods. A Mediterranean diet which uses predominantly olive oil with regular fish meals is though by many to be an ideal diet-style when inflammation needs to be curbed. Similarly, a high quality fish oil supplement may increase the omega-3 fats – and the inflammation-fighting power – of your diet considerably.

Some physicians, particularly reproductive immunologists measure inflammatory cytokine levels and offer various treatments – such as low dose steroids – to curb cytokine production and make the body more baby-friendly. Fish oil may be another means by which excessive cytokine production may be tamed to create a more baby-friendly environment. The researchers of this study discovered that:

“…survival of endometrial cells from women with and without endometriosis was significantly reduced in the presence of high omega-3:omega-6 PUFA (poly-unsaturated fatty acid) ratios…”

Cells were incubated in various mediums including a balanced omega-3:omega-6 ratio, and a high omega-6:omega-3 ratio medium, only the high omega 3 mediums were effective for significantly reducing endometrial cell survival, the researchers concluded that:

“Omega-3 PUFA (poly-unsaturated fatty acids) may have a suppressive effect on the in vitro survival of endometrial cells and omega-3 PUFA be useful in the management of endometriosis by reducing the inflammatory response and modulating cytokine function.”

If you have been diagnosed with endometriosis and are considering taking a fish oil supplement, be sure to consult with your physician first; many physicians have preferred brands of fish oil for purity and efficacy, some physicians may even offer to prescribe a fish oil for you.

Fish oil does have an anticoagulant effect and most surgeons ask that you stop taking fish oil a few weeks before surgery to reduce the risk of bleeding. It is especially important to mention fish oil to your physician if you also take anticoagulant medication which may have been prescribed if you have a clotting disorder or test positive for anti-phospholipid antibodies.

This information is intended for purely informational purposes with the intent of making current research more accessible to the public. This article is in no way intended to diagnose or to offer medical or dietetic advice for which you should consult a physician or dietitian.

REFERENCES:
Fertil and Steril 2001. 2001 Oct;76(4):717-22. High omega-3:omega-6 fatty acid ratios in culture medium reduce endometrial-cell survival in combined endometrial gland and stromal cell cultures from women with and without endometriosis. Gazvani MR, Smith L, Haggarty P, Fowler PA, Templeton A.
http://www.bellaonline.com/articles/art179184.asp/zzz

High Homocysteine Level Drops Fertility and IVF Success

Some women have a tendency to produce higher-than-ideal levels of a substance called homocysteine in their bodies which can harm fertility and IVF success. Unfortunately homocysteine levels are seldom measured prior to fertility treatments, so high homocysteine values can be a ‘hidden infertility factor’ that may sabotage the chances of pregnancy success. What exactly is homocysteine you may wonder?In short, homocysteine is a non-protein amino acid that is produced within the body when the amino acid methionine is broken down; methionine is contained in all animal protein foods such as meats, seafood, eggs and dairy foods so you will be breaking down large quantities of this amino acid on a daily basis unless you are vegetarian or vegan.Vegetarian and vegan proteins have far less methionine – except for brazil and sesame seeds – however, vegetarian diets also contain far less vitamin B12 so you can still develop a homocysteine excess if you are vegetarian. A vegetarian diet can significantly compromise your ability to process methionine efficiently triggering homocysteine excess.To break down homocysteine efficiently the body needs certain key nutrients to fuel either ‘re-methylation’ and ‘trans-sulfuration’ reactions. We all have *some* homocysteine in our bodies, but some can have far more than others. A blood test can tell you how well your body is clearing homocysteine; a normal blood homocysteine level is considered to be in the range of 5 to 15 micromols/L. Some experts argue that the normal reference range is too wide ranging and that the upper cut-off for normalcy should be far lower, an upper cut-off of 7-8 micromols/L has been proposed.

Homocysteine levels can rise in response to a number of factors such as:

* Low levels of folate, vitamin B12 required for methylation

* Low levels of vitamin B6 required for trans-sulphation

* Low levels of vitamin B2 and magnesium required for homocysteine metabolism

* Poor thyroid function

* A common gene mutation called MTHFR which can impair folate metabolism

Also, women with certain infertility diagnoses are more at risk than others; having PCOS increases the chances that your body will have higher homocysteine levels and the MTHFR mutation which can trigger high homocysteine levels is more common in women who have experienced recurrent miscarriage. If you have one of these diagnoses make doubly sure to get your levels checked.

So, how does homocysteine interfere with fertility? A number of studies have investigated the role that higher homocysteine levels can play in IVF failure and have reached some interesting conclusions. A Turkish study (1) – published in 2012 – studied fifty infertile women who underwent IVF and analyzed the levels of homocysteine with their ovarian follicles at egg retrieval.

The study demonstrated that lower homocysteine levels were correlated with pregnancy success; women who became pregnant had a mean homocysteine level of 9.6 compared to non-pregnant women whose mean homocysteine was substantially higher at 14.9, close to the upper cut-off for normalcy. The researchers found that homocysteine levels over 11.9 were greatly predictive of pregnancy failure and concluded that:

“Low follicular fluid homocysteine level is associated with a better chance of clinical pregnancy.”

A Turkish study (2) – published in Human Reproduction, 2009 – discovered that there may be a link between higher follicular homocysteine levels in PCOS women and egg and embryo quality in IVF. The study followed fifty two PCOS women who were undergoing IVF, and discovered that:

* Homocysteine levels were lower in follicles that produced higher grade embryos (grade 1 and 2).

* Follicular vitamin B(12) levels were lower when follicular homocysteine was elevated.

* Elevated follicular homocysteine was linked with lower B12, folate, lower fertilization rates, and higher levels of oxidative stress within the follicle (MDA).

The study concluded that:

“Concentrations of Hcy (homocysteine) in follicular fluid on the dOPU (day of embryo retrieval) may be a useful marker for fertilization rate, and oocyte and embryo quality in PCOS patients undergoing assisted reproduction.”

Another study (3) – published in 2003 – assessed homocysteine levels in eight women who had experienced recurrent spontaneous abortion and compared their levels to eight healthy women who had experienced successful healthy pregnancies and fifteen women who were undergoing IVF with diagnoses of unexplained infertility or male factor.

The women who had experienced recurrent spontaneous abortion had out-of-range homocysteine levels averaging 18.63 mumol/L. when compared to the women who had had healthy pregnancies who averaged 13.98 mumol/L. The study concluded that:

“We found that RSA (miscarriage) women have had significantly higher serum homocysteine concentration when compared to normal healthy women”

“Our preliminary data suggest that high homocysteine level may negatively influence pregnancy outcome following natural or in-vitro fertilization.”

“It cannot be excluded that elevated homocysteine concentrations contribute to defective chorionic villous vascularization during early stages of gestation.”

If you have PCOS, MTHFR or a history of pregnancy loss, be sure to get your homocysteine levels checked before trying to conceive. If your diet is low in vitamin B12 – think vegetarian or vegan diets – you may want to consider taking a separate vitamin B12 supplement to ensure that you don’t run short. Women with digestive and intestinal conditions such as celiac disease can also run short of B12 (and folate) and may benefit from taking sub-lingual vitamin B12 which is absorbed under the tongue, bypassing the intestines.

If you discover that your homocysteine levels are high your physician will usually prescribe a specific nutritional supplement containing high levels of folic acid, vitamin B6 and B12 to help your body to reduce homocysteine naturally.

This article is for informational purposes only and is not intended to diagnose or treat health problems nor to replace that advice of a suitably qualified dietitian or physician.

REFERENCES:
(1) J Assist Reprod Genet. 2012 Jan 21. [Epub ahead of print]
The association between homocysteine in the follicular fluid with embryo quality and pregnancy rate in assisted reproductive techniques. Ocal P, Ersoylu B, Cepni I, Guralp O, Atakul N, Irez T, Idil M.(2) Hum Reprod. 2009 Sep;24(9):2293-302. Epub 2009 May 14.
Homocysteine concentrations in follicular fluid are associated with poor oocyte and embryo qualities in polycystic ovary syndrome patients undergoing assisted reproduction. Berker B, Kaya C, Aytac R, Satiroglu H.
(3) Ginekol Pol. 2003 Sep;74(9):949-52. [Homocysteine level in ovarian follicular fluid or serum as a predictor of successful fertilization]. [Article in Polish] Jerzak M, Putowski L, Baranowski W.
http://www.bellaonline.com/articles/art177901.asp/zzz

Lignan-Rich Foods May Speed Conception

Eating foods rich in dietary lignans, regularly, may help to speed conception according to a 2014 study. Lignans are part of the phytoestrogen or plant estrogen family and are particularly rich in flaxseeds which are often called linseeds in Europe and the UK.This study (1) followed 501 couples as they tried to conceive for one year or until conception occurred and discovered that women with higher levels of dietary lignans tended to conceive far more quickly.”Our results suggest that female urinary lignan concentrations at levels characteristic of the U.S. population are associated with a shorter TTP among couples who are attempting to conceive, highlighting the importance of dietary influences on fecundity.”If you want to make sure that you have a lignan-rich diet you’ll need to up the amount of natural, whole, unprocessed food that you eat, or, eat a spoon or two of finely ground flaxseeds daily. Rich sources of lignans include pumpkin seeds, sesame seeds, sunflower seeds and poppy seeds, whole grains, especially bran, fruits – especially berries and vegetables. Sesame seeds are the second richest dietary source after flaxseed.Once ingested, dietary lignans are fermented in the gut by intestinal bacteria to produce bioactive enterolignans: enterodiol and enterolactone. It is these fermented substances that are measured when comparing lignan levels between people, so, to a certain degree your lignan levels will depend upon a healthy gut flora. If you have had a lot of antibiotic use you may want to consider using probiotics to restore a healthy gut flora to optimize lignan fermentation.This article is intended for purely informational purposes and is not intended to diagnose or to offer medical or dietetic advice for which you should consult a physician or dietitian.
REFERENCES:
(1) J Nutr. 2014 Mar;144(3):352-8. doi: 10.3945/jn.113.184820. Epub 2014 Jan 8.
Higher urinary lignan concentrations in women but not men are positively associated with shorter time to pregnancy. Mumford SL1, Sundaram R, Schisterman EF, Sweeney AM, Barr DB, Rybak ME, Maisog JM, Parker DL, Pfeiffer CM, Louis GM.
Original article is at: http://www.bellaonline.com/articles/art182976.asp/zzz

Amino Acid L-Arginine May Improve Poor IVF Response

A research study in 1999 with women who were categorized as poor IVF responders showed excellent results when the amino acid L-arginine was taken during IVF. L-arginine may be effective due to an increase in the blood flow to the arteries that supply the ovaries. This increase in blood flow may permit more nutrients, gonadotrophins and hormones to nourish the ovaries and subsequently enhance the IVF response.

Previous studies have confirmed that decreasing the ‘Pulsatility Index’ (a measure of blood flow) through the arteries which supply the ovaries and uterus can have a positive effect upon pregnancy rates. Top infertility clinics routinely measure the ovarian blood flow before IVF to ensure that blood flow is adequate. A Pulsatility Index (PI) below 3.0 is considered to be ideal.

When the ovarian blood flow is insufficient, a specific electro-acupuncture treatment has proven to increase the blood flow. A course of biphasic electro-acupuncture stimulation at certain acupuncture points administered twice a week, for the four weeks prior to the IVF procedure has proven to increase the blood flow to the ovaries and uterus. This course of electro-acupuncture treatment has also been found to increase the IVF success rate and the take-home-baby rate, and has also been shown to decrease the incidence of miscarriage and ectopic pregnancy rates too.

Daily EarthingTM using earthingTM Products has been shown to effectively thin the blood. Medications with blood thinning properties may also be used to improve blood flow to the pelvic organs.

Women in the L-arginine group took 16 grams of L-arginine per day. There was an increased number of oocytes at egg pick-up in the L-arginine treated group and there were significantly fewer cancellations. Test results showed that women in the L-arginine group had increased levels of nitric oxide and insulin-like growth factor (IGF-1) in both their serum and follicular fluid. Levels of L-arginine and citrulline were also increased. Both L-arginine and citrulline are thought to be markers of healthier follicle development.

The supplemented L-arginine group of women had three pregnancies compared to zero pregnancies in the control group. The study concluded that “…oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rate.”

REFERENCES:
http://www.bellaonline.com/articles/art61104.asp

Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients. Battaglia C. et al. Hum Reprod. 1999 Jul;14(7):1690-1697.

Herbal Formula Increases Pregnancy Rates in IVF

Chinese researchers have found that adding Er Zhi Tian Gui granules (ETG, Two Ultimates Tian Gui Granules) to the treatment regime of women undergoing IVF can reduce the dosage of gonadotropin (Gn) required for ovarian stimulation and shorten treatment duration, as well as alleviating clinical symptoms and improving clinical pregnancy rates. Sixty-six (66) infertile patients diagnosed with the TCM pattern of Kidney yin deficiency who were to undergo IVF embryo transfer (IVF-ET) were randomly assigned to either a treatment group or a control group.

Both groups received Gn therapy: the treatment group received ETG for three menstrual cycles before IVF-ET, while the control group received placebo granules. Scores for Kidney yin deficiency syndrome were assessed for each patient at baseline. Statistically significant differences were found between treatment and control groups in syndrome score changes before and after treatment.

The dosage required and duration of Gn treatment were also significantly lower in the treatment group than those in the control group. Rates of high-quality oocytes and embryos, as well as clinical pregnancy rates, were all higher in the treatment group than in the control group. In addition, levels of endometrial expression of the DNA methylating enzyme DNMT1 were found to be much higher in the treatment group than that in the control group after treatment.

The authors postulate that upregulation of the expression of this protein may lead to enhanced endometrial receptivity and may explain the improvement in clinical pregnancy rates.

REFERENCE: Effects of Chinese Medicines for Tonifying the Kidney on DNMT1 Protein Expression in Endometrium of Infertile Women During Implantation Period. J Altern Complement Med. 2012 Oct 17.

Embryo Quality Linked To Pesticides And Seafood

Unintentional daily chemical exposures may be assaulting your fertility from multiple sources. Your diet – think farmed fish, fast food, canned foods, non-organic, pesticide-laden food – personal care products, cleaning products and even your laundry soap provide a direct route of entry for a multitude of chemical compounds which have been termed endocrine-disrupting chemicals or ‘EDCs’.The presence of EDCs within ovarian follicles may have a determining effect upon the fertilization rate of your eggs and the quality of your embryos. Endocrine-disrupting chemicals – albeit at trace levels – can have a negative impact on fertility according to a study from Belgium, published in Human Reproduction, 2012.Taking steps to reduce your exposure to endocrine-disrupting chemicals could have a very positive effect upon both natural conceptions and the outcome of IVF. This eye-opening study describes the ovarian follicle as:”…a very fragile micro-environment where interactions between hormones, growth factors, the oocyte and its surrounding somatic cells are essential to generate a fully competent oocyte.”

The researchers involved in this study measured the presence of common endocrine-disrupting chemicals within ovarian follicular fluids – which are withdrawn during IVF at egg retrieval – and correlated this data with fertilization rates and embryo quality.

The study sought to explore the effects EDCs upon the finely tuned balance within ovarian fluids, and also measured levels of EDCs within serum which were found to match the levels of EDCs within ovarian follicles. The study tracked levels of EDCs such as polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) – derived from flame retardants – and organochlorine pesticides and discovered:

“An overall higher EDC (endocrine disrupting chemical) contamination in the follicular micro-environment was associated with a decreased fertilization rate and consequently with a lower chance of an oocyte to develop into a high-quality embryo.”

“In addition, EDC (endocrine disrupting chemical) concentrations in serum were reliable predictors of the contamination status of the follicular micro-environment.”

If you are trying to conceive it may be time to clean-up your act! One of the main voluntary sources of PCB ingestion is though to be certain kinds of seafood particularly farmed salmon. An independent study by the Environmental Working Group – ewg.org – in 2003 discovered that:

“These first-ever tests of farmed salmon from U.S. grocery stores show that farmed salmon are likely the most PCB-contaminated protein source in the U.S. food supply.”

“On average farmed salmon have 16 times the dioxin-like PCBs found in wild salmon, 4 times the levels in beef, and 3.4 times the dioxin-like PCBs found in other seafood.”

“The levels found in these tests track previous studies of farmed salmon contamination by scientists from Canada, Ireland, and the U.K. In total, these studies support the conclusion that American consumers nationwide are exposed to elevated PCB levels by eating farmed salmon.”

Your body is exposed to PBDEs through other kinds of seafood too; PBDEs are derivatives of flame retardant chemicals which are used in hard plastics and fabrics. These long-lived chemical compounds tend to accumulate in the fatty tissues of seafood. The presence of PBDEs in seafood is directly linked to the PBDE levels within the waters fish live in, and Chinese waters are known to be especially highly contaminated.

PBDEs also accumulate in house dust and you can reduce your exposure level by dusting with a damp cloth to mop up dust rather than dry dusting. Using a vacuum with a HEPA filter to remove dust from carpets and furnishings can also help to keep PBDE exposure low.

Certain furnishings may have lower levels of flame retardants that others and you may want to investigate carefully when purchasing new items of furniture, bedding and carpeting.

Pesticide exposure can be reduced by switching to an organic diet; if a 100% organic diet is not practical for you, consider avoiding the ‘dirty dozen,‘ the twelve most contaminated fruits and vegetables which are published yearly by the environmental working group at www.ewg.org. Switching to organic dairy foods and cheeses may help too; organic meats are produced from animals which have been fed only organic feeds which may also reduce pesticide contamination.

Wild salmon is widely regarded as being one of the cleanest forms of fish to consume if you are a fish-eater, and it may be wise to minimize consumption of fish sourced form China. Taking a carefully-processed fish oil supplement can help you to have the benefits of a high-fish intake without the risks of frequent fish meals. You should ask your physician before commencing any new nutritional supplements.

While it is near impossible to avoid all sources of environmental and dietary contaminants, you can take steps to minimize your exposure levels which could in turn help to protect your fertility and your baby-to-be.

This article is intended for purely informational purposes and is not intended to diagnose or to substitute for medical or dietetic advice for which you should consult a physician or dietitian.

REFERENCES:
Human Reproduction, Volume 27, Issue 4, (April 2012), p. 1025-1033, ISSN: 0268-1161, DOI: 10.1093/humrep/der448 Petro, et al. Endocrine-disrupting chemicals in human follicular fluid impair in vitro oocyte developmental competence
http://www.ewg.org/reports/farmedpcbs
http://www.bellaonline.com/articles/art179302.asp/zzz

BPA May Harm IVF Success

A Harvard study – published in Human Reproduction, 2012 – has confirmed that the ubiquitous plastic-derived toxin, BPA, can have an adverse effect upon IVF success. If you are pursuing IVF – or are otherwise trying to conceive – you may want to take an inventory of the various sources of BPA exposure in your diet and take steps to reduce your BPA load. BPA is known to have a short half-life which means that it will wash out of your body relatively quickly once your intake is reduced, therefore, the steps that you take to reduce BPA will likely have a positive impact upon your IVF cycle.Previous research has linked BPA with lower ovarian responsiveness which is a key factor for IVF success. Poor oocyte maturation, fertilization, and embryo quality have also been linked to BPA toxicity.This study was a ‘prospective preconception cohort study’ which included one hundred and seventy-four women aged 18–45 years and BPA was measured from urine samples. These women underwent 237 fresh IVF cycles and were tracked until they either had a live birth or discontinued treatment.

The researchers discovered that there was a ‘significant linear dose–response association’ between increased urinary BPA values and: decreased number of oocytes; decreased numbers of normally fertilized oocytes; decreased blastocyst formation and decreased estradiol levels when compared to women with BPA values in the lowest quartile. The researchers concluded that:

“The results from this extended study, using IVF as a model to study early reproductive health outcomes in humans, indicate a negative dose–response association between urinary BPA concentrations and serum peak E2 (estradiol) and oocyte yield, confirming our previous findings.”

“… BPA may alter reproductive function in susceptible women undergoing IVF.”

One of the key dietary sources of BPA is canned foods, especially canned soups; avoiding canned foods, unless the can stipulates that it is BPA-free and switching out your plastic food storage containers for glass may reduce your BPA load. Take time to de-plasticize your diet, your food and beverage storage containers and reduce your fast-food intake to keep your BPA exposure low while you prepare for pregnancy.

This article is for informational purposes only and is not intended to replace medical or dietetic advice for which you should consult a physician or dietitian.

REFERENCES:
Human Reproduction, volume 27, Issue 12 (December 2012), p. 3583-3592, ISSN: 0268-1161, DOI: 10.1093/humrep/des328
Oxford University Press. Urinary bisphenol A concentrations and early reproductive health outcomes among women undergoing IVF, Ehrlich, Shelley1; Williams, Paige L.2; Missmer, Stacey A.3; Flaws, Jodi A.4; Ye, Xiaoyun5; Calafat, Antonia M.6; Petrozza, John C.7; Wright, Diane1; Hauser, Russ1
http://www.bellaonline.com/articles/art179239.asp/zzz

Chinese Herbs Improve Embryo Quality in Women with Refractory Infertility

A preliminary study conducted in Japan suggests that women who have failed to become pregnant from IVF could benefit from taking Chinese herbs during future IVF treatments.

The study involved 30 women with unexplained infertility, who had experienced three or more failed cycles of IVF. A Chinese herbal medicine formula, known as MACH (macrophage-activating Chinese herbs), was given orally to the women during a further course of IVF. The results showed that the combination of herbs used in this study significantly increased the percentage of good quality blastocysts (at both early and late stages) in all patients.

Furthermore, treatment with MACH significantly decreased plasma concentrations of follicle stimulating hormone (FSH) on the day of oocyte retrieval. No adverse events were reported as a result of the administration of herbs.

REFERENCE: Clinical efficacy of macrophage-activating Chinese mixed herbs (MACH) in improvement of embryo qualities in women with long-term infertility of unknown etiology. Am J Chin Med. 2012;40(1):1-10.

 Boosting Fertility with Saizen Growth Hormone

In her article “Saizen Growth Hormone Helps Infertility”, Hannah Calef reports “previous studies have shown that the levels of hormones within ovarian follicles – especially growth hormone – are critical for the development of normal healthy embryos that are able to implant. Levels of growth hormone are tightly correlated to an oocyte’s ability to be of high quality, with a high potential for implantation. (Mendoza et al. 1999, 2002)

Adequate Human Growth Hormone (HGH) levels are critical for good ovarian follicle development, and growth hormone levels are known to decline significantly with age. Recent studies have shown that adjuvant growth hormone treatment during IVF procedures can help older women to conceive more readily.

Saizen is a commercial preparation of synthetic somatropin (growth hormone, a.k.a. GH). Saizen is produced by recombinant DNA technology from a mammalian cell line (mouse C127) that was modified by the addition of the human GH gene, resulting in an identical 191-amino acid sequence and structure.

In her article, Calef reports that the results of recent trials where HGH has been used by women 40 years of age or older during IVF procedures are quite amazing. One study involved one hundred women who were 40 years of age or older, and all had a poor prognosis for conceiving through an IVF procedure. Half the women received growth hormone with their ovarian hyper-stimulation medications, and the other half did not.

Calef reported: “the numbers of eggs, embryos and pregnancies were similar in both groups but the growth hormone-treated women had far fewer miscarriages and a higher take-home-baby rate. Women being co-treated with growth hormone had far less biochemical pregnancies, and a pregnancy rate of 26% compared to 6% in untreated cycles. The delivery rate was significantly improved also, 22% of cycles versus 4% in the untreated group”.

“In conclusion, this prospective randomized study shows that women aged >40 years undergoing assisted reproduction treatment and co-stimulated with GH achieve more ongoing pregnancies and suffer less pregnancy wastage, resulting in more deliveries and live births, as compared with women of the same age category stimulated with gonadotrophins alone.”

Regarding the results of a third study on growth hormone supplemented IVF cycles in poor responders, Calef noted that the researchers concluded that: “GH cycles resulted in significantly more babies delivered per transfer than non-GH cycles… (20% versus 7%). The data uniquely show that the effect of GH is directed at oocyte and subsequent embryo quality.”

Calef further discussed the results of a large study of 100 couples where the female partner was over 40 years old. The women were split into two groups. One group undergoing an IVF procedure received growth hormone treatment of 8 IU of Saizen from day 7 until the day after the hCG trigger. The control group also undergoing an IVF procedure received a placebo treatment. Calef reported that the study concluded: “this prospective randomized study shows that women aged >40 years undergoing assisted reproduction treatment and co-stimulated with GH achieve more ongoing pregnancies and suffer less pregnancy wastage, resulting in more deliveries and live births, as compared with women of the same age category stimulated with gonadotrophins alone.”

To review the original article click the following link: http://www.bellaonline.com/articles/art29850.asp

Myo-Inositol Supplementation May Produce Greater Implantation Rates

In her article “Myo-Inositol During IVF and Non-PCOS Women” fertility expert Hannah Calef reported that “numerous studies have demonstrated how taking myo-inositol daily in the months preceding IVF may help to improve IVF success in various ways, and some of these studies have continued myo-inositol supplementation alongside gonadotropin stimulation.”

Because IVF physicians often stipulate that except for prenatal vitamins, no nutritional supplements should be taken once treatment with gonadotropins has begun, women who are taking myo-inositol are often a little confused about whether to keep taking it.

A recent 2012 Italian study explored the effects of myo-inositol pre-treatment in a large group of non-PCOS women. One hundred women were studied. All of the women were under forty years of age with FSH values below 10.0 mUI/mL. Women in the Test group received myo-inositol with folic acid for three months prior to the IVF and also DURING the stimulation phase itself. The women in the Control group took only folic acid.

Calef reported that the results showed that the women taking myo-inositol required significantly less gonadotropin medication to mature their follicles and significantly less follicles were retrieved in this group. The clinical pregnancy and implantation rates were similar in both groups. However, the myo-inositol pre-treated women tended to have greater implantation rates.

Calef noted that the study concluded: “Our findings suggest that the addition of myo-inositol to folic acid in non PCOS-patients undergoing multiple follicular stimulation for in-vitro fertilization may reduce the numbers of mature oocytes and the dosage of rFSH whilst maintaining clinical pregnancy rate.” From a Traditional Chinese Medicine (TCM) point of view I believe that this outcome represents a preservation of vital Jing Qi, which would prevent the wasteful consumption of reproductive potential.

The study also noted “a trend in favor of increased incidence of implantation in the group pretreated with myo-inositol was apparent in this study. Further investigations are warranted to clarify this pharmacological approach, and the benefit it may hold for patients.”

Calef concluded “it may be too soon for physicians to recommend taking myo-inositol alongside gonadotropin stimulation if you don’t have PCOS, but taking myo-inositol for the three months prior to IVF seems to have multiple positive effects and is recommended by many fertility physicians and top IVF clinics.

The original article can be seen at http://www.bellaonline.com/articles/art177946.asp

REFERENCES:
Reprod Biol Endocrinol. 2012 Jul 23;10:52.
Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study.
Lisi F, Carfagna P, Oliva MM, Rago R, Lisi R, Poverini R, Manna C, Vaquero E, Caserta D, Raparelli V, Marci R, Moscarini M.

Higher Myo-Inositol in the Follicular Fluid Correlated with Improved Egg Quality

In a related article “Myo-Inositol May Up Egg Quality And IVF Success”, Hannah Calef reported that “Myo-inositol is being used by top fertility clinics to help improve egg quality in women undergoing IVF, especially when poor embryo quality is a concern. Previously, myo-inositol has been studied for its ability to reduce androgen and insulin levels in women with PCOS – and to prevent ovarian hyper-stimulation – but all women it seems may benefit from this nutrient’s ability to improve egg quality.”

Calef reported that studies have shown that during IVF procedures, good concentrations of myo-inositol within the follicular fluid are correlated with improved egg quality. Multiple studies have also confirmed that myo-inositol is a safe supplement, without worrying side-effects and has even been used during the gonadotropin stimulation phase of IVF procedures with beneficial outcomes.

This study determined which nutrients and substances within the micro-environment of the ovarian follicle determine egg quality. Similar research studies have shown that stellar levels of melatonin and vitamin D3 within ovarian follicles can boost the success rate of IVF procedures. Fifty three women undergoing IVF procedures participated in the study. Couples with male factor or PCOS were excluded.

Calef advised that the study showed that the follicles containing a higher level of myo-inositol were more likely to produce mature oocytes which fertilized well, and higher levels of myo-inositol were correlated with higher E2 (estradiol) levels within the follicular fluid and better quality embryos.

The study concluded that:

“We propose that higher concentrations of MI (Myo-inositol) and E2 (estradiol) in human FF appear to play a role in follicular maturity and provide a marker of good quality oocytes.”

“In conclusion, follicles containing good quality oocytes have higher concentrations of MI (Myo-inositol) in FF (follicular fluid).”

Calef commented that the dose of myo-inositol which has been used in most studies for improved egg quality and for treatment of PCOS, is 4 grams per day, which is usually taken in two separate doses of 2 grams. Myo-inositol is often taken along with other egg quality boosting nutrients for the full 3 month long egg generation cycle prior to IVF.

Calef noted that “myo-inositol is actually a member of the B-vitamin family, and has been demonstrated in animal studies to help with blastocyst development.” She also noted that “myo-inositol has even been added successfully to blastocyst culture mediums”.

REFERENCES: Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF: relationship with oocyte quality Hum. Reprod. (2002) 17 (6): 1591-1596. Chiu et al.

For the complete article see http://www.bellaonline.com/articles/art18661.asp

Myo-Inositol During IVF And Non-PCOS Women

Should women continue to take the nutritional supplement myo-inositol during gonadotropin stimulation in IVF if they don’t have PCOS? Numerous studies have demonstrated how taking myo-inositol daily in the months preceding IVF may help to improve IVF success in various ways, and some of these studies have continued myo-inositol supplementation alongside gonadotropin stimulation.Women who are using myo-inositol and their physicians are often a little confused about how to proceed; some studies show positive results from co-treatment with myo-inositol during IVF stimulation and yet some physicians often stipulate that no nutritional supplements should be taken – except prenatal vitamins – once gonadotropins have begun. What to do? You should always ask your physician about nutritional supplement use in IVF programs and maybe show them this study.A 2012 Italian study explored the effects of myo-inositol pre-treatment in a large group of non-PCOS women. One hundred women were studied, all were under forty yeaars of age with FSH values below 10.0 mUI/ml, some of the women received myo-inositol with folic acid for three months prior to the IVF AND during the stimulation phase itself. These women were compared with women who took only folic acid.The women taking myo-inositol required significantly less gondotropin medication to mature their follicles and significantly less follicles were retrieved in this group. The clinical pregnancy and implantation rates were similar in both groups although the myo-inositol pre-treated women tended to have greater implantation rates. The study concluded that:

Our findings suggest that the addition of myo-inositol to folic acid in non PCOS-patients undergoing multiple follicular stimulation for in-vitro fertilization may reduce the numbers of mature oocytes and the dosage of rFSH whilst maintaining clinical pregnancy rate.

“Further, a trend in favor of increased incidence of implantation in the group pretreated with myo-inositol was apparent in this study. Further investigations are warranted to clarify this pharmacological approach, and the benefit it may hold for patients.”

It may be too soon for physicians to recommend taking myo-inositol alongside gonadotropin stimulation if you don’t have PCOS, but taking myo-inositol for the three months prior to IVF seems to have multiple positive effects and is recommended by many fertility physicians and top IVF clinics.

This article is for informational purposed only and is not intended to diagnose or treat health problems or substitute for medical or nutritional advice from a suitably qualified physician or dietitian.

REFERENCES:
Reprod Biol Endocrinol. 2012 Jul 23;10:52.
Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study.
Lisi F, Carfagna P, Oliva MM, Rago R, Lisi R, Poverini R, Manna C, Vaquero E, Caserta D, Raparelli V, Marci R, Moscarini M.
http://www.bellaonline.com/articles/art177946.asp/zzz

Fish Oil May Benefit Women With PCOS

Could a daily fish oil supplement improve PCOS signs and symptoms? An Iranian study (1) – published in the Asia Pacific Journal of Clinical Nutrition, 2012 – discovered that fish oil may have a therapeutic effect in women with PCOS. Specifically, this study demonstrated that increased fish oil consumption may be able to benefit insulin resistance, adiponectin levels and lipid profiles which could help to remedy the metabolic imbalances which affect many women with PCOS. Metabolic syndrome is thought to have an adverse effect upon egg quality, therefore, by taking steps to resolve PCOS-related insulin and lipid disorders you may help your eggs to be healthier, and more fertile.

This study was a double-blind randomized controlled clinical trial which tracked 64 overweight PCOS women who were aged between 20-35 years. The women who were being treated with fish oil received 4 omega-3 fatty acids capsules containing 180 mg eicosapentaenoic (EPA) acid and 120 mg docosahexanoic acid (DHA) daily for 8 weeks.

The results of the study demonstrated that fish oil consumption was able to trigger significant decreases in fasting glucose and insulin and insulin resistance. Treatment also benefited total cholesterol, LDL and triglyceride levels and the fish oil treated women had higher levels of healthy cholesterol: HDL. The study concluded that:

“Omega-3 fatty acids had some beneficial effects on serum adiponectin levels, insulin resistance and lipid profile in PCOS patients and may contribute to the improvement of metabolic complications in these patients.”

A Turkish 2013 study (2) published in the Journal of Obestetrics and Gynaegology also found that women with PCOS benefit form long-term fish oil supplementation. This study treated 45 non-obese PCOS women with 1,500 mg of omega-3 daily for 6 months and discovered that BMI (body mass index), hirsutism, insulin and HOMA scores – a metric for insulin resistance – decreased significantly during treatment. The levels of lutenizing hormone (LH) and testosterone also decreased and levels of sex hormone-binding globulin which mops up excess hormones increased significantly after the 6 months of treatment. The study concluded that:

“Omega-3 may be also effective in improving hirsutism and insulin resistance in patients with PCOS.”

Fish oil may be able to benefit fertility in other ways too. Fish oil consumption has been demonstrated to improve the flow of blood to the uterus which is a key factor for enhanced uterine receptivity. Fish oil consumption has also been linked with lower levels of NK cells; NK cells can make the uterus inhospitable when these cells are in excess or if they are overly aggressive. Fish oil has also been linked longer telomeres; longer telomeres are thought to be a marker for improved egg quality.

You may want to ask your physician about incorporating a good quality fish oil supplement into your PCOS treatments; some physicians like to prescribe fish oil supplements to ensure that you are taking a high quality product and can monitor your progress. Fish oil is an anticoagulant and you should always ask your physician before beginning a new nutritional supplement.

This article is for purely informational purposes and is *not* intended to diagnose or to offer medical or nutritional advice for which you should see a physician or dietitian.

REFERENCES:
(1) Asia Pac J Clin Nutr. 2012;21(4):511-8. Effects of omega-3 fatty acids supplementation on serum adiponectin levels and some metabolic risk factors in women with polycystic ovary syndrome. Mohammadi E, Rafraf M, Farzadi L, Asghari-Jafarabadi M, Sabour S.

(2) J Obstet Gynaecol. 2013 Apr;33(3):289-91. doi: 10.3109/01443615.2012.751365. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. Oner G, Muderris II.

(3) http://www.bellaonline.com/articles/art178989.asp/zzz

Selenium May Help Improve Egg Quality

Many prescription prenatal vitamins do not contain the trace mineral selenium yet this nutrient may be an important nutrients to have an adequate intake of pre-conceptually to protect egg quality especially if you have infertility.As women sail through their thirties and early forties, preserving egg quality becomes and important focus for peak fertility. A number of nutrients are thought to have a protective effect on egg quality including melatonin, myo-inositol and co-enzyme Q10. Selenium, although lesser known as an egg-quality protecting nutrient may also be very valuable.A 2010 Iranian study – published in the journal Human Reproduction – investigated the effect of selenium on ovarian oxidative stress, known to be a key cause of reduced egg quality as women age. Researchers measured the production of reactive oxygen species (ROCs) along with the total antioxidant capacity (TAC) and levels of one of the body’s most vital antioxidants, glutathione peroxidase (GPx) within ovarian pre-antral follicles which were cultured with and without selenium.In the group supplemented with selenium, ovarian follicles, oocytes and embryos were all of significantly higher quality. Selenium was demonstrated to reduce the production of reactive oxygen species (ROCs), increase total antioxidant content and glutathione production leading the researchers to conclude that:”SS (selenium) caused an increase in follicular TAC (total antioxidant content) level and GPx (glutathione peroxidase) activity and a decrease in ROS (reactive oxygen species) level, thus improving the in vitro development of follicles.”

Some high quality pre-natal vitamins do contain selenium at a level of around 200 mcg per day which is often considered to be a reasonable and effective dose for supplementation. Selenium is trace mineral that can accumulate within the body and taking high doses – more than 400 mcg per day – is not recommended.

Selenium is present in plants and animal foods, particularly whole grains, sunflower seeds, fish and chicken. Selenium is especially rich in brazil nuts; just one ounce of brazil nuts nuts may contain a whopping 544 mcg. The selenium content of a food depends very much on the content of the soil and so can be variable, not all brazil nuts will be this rich in selenium.

If you are trying to get pregnant and are looking for ways to boost your egg quality naturally, ask your physician about taking a selenium-containing prenatal vitamin such as Simply One.

This article is for informational purposes only and is not intended to replace medical or nutritional advice for which you should consult a suitably qualified physician and/or dietitian.
REFERENCES:
Hum Reprod. 2010 Apr;25(4):977-85. Epub 2010 Feb 6. Sodium selenite improves the in vitro follicular development by reducing the reactive oxygen species level and increasing the total antioxidant capacity and glutathione peroxide activity. Abedelahi A, Salehnia M, Allameh AA, Davoodi D.

http://www.bellaonline.com/articles/art177397.asp/zzz
NOTE that Australian soils are notoriously low in Selenium, and a supplement containing 200 mcg of Selenium can be obtained inexpensively from http://www.puritanspride.com.au/

Selenium May Protect Against Miscarriage

Does your prenatal vitamin contain adequate selenium? Making sure that your prenatal vitamin contains a small amount of this trace mineral may help to confer welcome protection against miscarriage according to a Polish study published in the British Journal of Gynaecology.This study investigated the link between blood levels of selenium, glutathione and glutathione peroxidase (glutathione-Px) in women who had experienced a prior miscarriage. The study included forty women who had experienced first or second trimester pregnancy losses.For accuracy, the levels of these powerful antioxidants were measured in both whole blood and plasma. The levels of glutathione and glutathione peroxidase were also measured within red blood cells which is thought to more accurately represent the true levels of these key antioxidants. The results were compared with 36 women with viable pregnancies and with twenty eight age-matched, healthy, non-pregnant controls.The study discovered that there may be a link between lower levels of selenium glutathione and glutathione peroxidase and pregnancy loss. Red blood cell and plasma glutathione peroxidase (px) activity was found to be significantly lower in women who had experienced a miscarriage when compared to both women with normal pregnancies and the control group. The study concluded that:”The decreased activities of the antioxidant enzymes, red cell and plasma glutathione-Px, may play an important role in the aetiology of spontaneous abortion.”Glutathione and glutathione peroxidase are selenium-dependent enzyme antioxidants whose activity may be depressed when dietary selenium levels are low. Many prenatal vitamins do not contain selenium and if you are restricting carbs or consume few whole grains you could go short.Some high quality prenatal vitamins do contain selenium at a level of around 200 mcg per day which is considered to be a safe dose for supplementation. Selenium is a trace mineral that can accumulate within the body and therefore taking high doses – more than 400 mcg per day – is not recommended. You should always ask your physician before starting a new nutritional supplement regime.Selenium is present in plant and animal foods, particularly whole grains, fish and chicken, selenium is especially rich in brazil nuts; just one ounce of brazil nuts nuts can contain a whopping 544 mcg. The selenium content of a food depends very much on the content of the soil and so can be variable, and not all brazil nuts will be this rich in selenium.So, if you have had a prior miscarriage, ask your physician about a selenium-containing prenatal vitamin.

This article is for informational purposes only and is not intended to replace medical or nutritional advice for which you should consult a suitably qualified physician and/or dietitian. 

REFERENCES:
http://www.bellaonline.com/articles/art177857.asp/zzz
BJOG. 2001 Mar;108(3):244-7. Blood selenium and glutathione peroxidases in miscarriage. Zachara BA, Dobrzyński W, Trafikowska U, Szymański W.

Unexplained Infertility Linked To Low Selenium

IVF has opened up a fascinating new field of fertility research which involves detailed exploration the ovarian follicular fluids, these vital fluids comprise the tiny micro-environment in which an egg develops.Which ingredients within the follicular micro-environment makes an egg thrive and fertilize successfully or fail? This is a question asked by many researchers who examine follicular fluids to analyze the levels of minerals, vitamins and other substances to gain a deeper understanding of fertility…and what makes a fertile egg.Data gleaned from follicular fluids can then be correlated with various causes of sub-fertility and aspects of IVF success such as: fertilization rates, egg and embryo quality, pregnancy and live birth rates. Levels of various nutrients and reproductive toxins within ovarian follicles may have a profound effect upon fertility and IVF outcomes.Unexplained infertility, it seems, may be linked to a deficiency of a trace mineral not usually found in prenatal vitamins: Selenium. Selenium is vital to the production of one of the most powerful antioxidants, glutathione peroxidase which is very active within healthy ovarian follicles.Glutathione is manufactured within the body directly from the trace mineral selenium. Glutathione plays vital roles within ovarian follicles, where it protects egg quality and reduces oxidative stress.Research(1) has demonstrated that follicular fluid and blood levels of both selenium and glutathione peroxidase (GSHPx) may be low in women with unexplained infertility. Selenium and glutathione peroxidase levels were evaluated in a total of 112 women who were undergoing IVF and revealed that:”Patients with unexplained infertility had significantly decreased follicular selenium levels as compared with those with tubal infertility or male factor.””The mean GSHPx (glutathione peroxidase) activity in follicles yielding oocytes which were subsequently fertilized exceeded that of the follicles with non-fertilized oocytes (eggs).”

“The Se/GSHPx (selenium/glutathione peroxidase) pattern of the FF (follicular fluid) seems to be significant for the evaluation of the follicular milieu.”

“…The findings suggest that the anti-oxidant activity of selenoenzyme glutathione peroxidase in the follicular micro-environment may play a role in the process of gametogenesis and fertilization.”

Selenium is particularly rich in whole grains and certain nuts, such as Brazil nuts, and seafood so if you eat a diet of predominantly refined grains, or no grains at all and eat little seafood, you could theoretically run short. Some high quality prenatal vitamins *do* contain selenium – usually at level of around 200 mcg per day – while most prenatal vitamins contain none at all.

Brazil nuts can be an incredibly rich source of selenium, but the level of selenium in each nut can vary considerably depending upon the soil where the tree grew. If you have been trying to conceive for some time, ask your physician about a selenium-containing pre-natal vitamin.

This article is for informational purposes only and is not intended to diagnose to treat health problems, or to replace that advice of a suitably qualified physician and/or dietitian.

REFERENCES:
http://www.bellaonline.com/articles/art177900.asp/zzz(1) ClinicaChimica Acta Volume 236 issue 2. (May 15, 1995), p. 173-180. Selenium dependent glutathione peroxidase activity in human follicular fluid Paszkowski, T.1; Traub, A.I.2; Robinson, S.Y.2; McMaster, D.

Unexplained Infertility Tied To Poor Blood Flow

Many women with unexplained infertility say that they feel cold easily and have poor circulation. It turns out that they may have poor circulation to their ovaries and uterus too, not just their hands and feet!

A number of studies show that poor uterine and ovarian blood flow can be an important – often undiagnosed factor – in infertility, miscarriage and IVF failure; research shows that poor blood flow may be at the root of ‘unexplained infertility’ too. However, most women with a diagnosis of ‘unexplained’ will never be offered the diagnostic test for uterine blood flow impairment and will never be offered treatment, instead they will retain their frustrating non-specific diagnosis of ‘unexplained.’ Gaining access to testing can change your treatment options as concluded by the study cited below:

“Pre-treatment assessment of women with unexplained sub-fertility with 3D-PDA may prove useful as a diagnostic tool or facilitate the development of alternate, less invasive and ultimately more affordable management strategies.”

A growing number of progressive reproductive endocrinologists *do* recognize the critical importance of both evaluating and optimizing ovarian and uterine blood flow especially prior to IVF/ICSI.

One of the first proponents of this important vital aspect of fertility medicine was Dr. Sher who routinely evaluates blood flow dynamics in his patients as does Dr. Schoolcraft at Colorado Center For Reproductive Medicine. These fertility clinics – with stellar success rates – screen women for blood flow impairment precisely so that they can apply treatments that work efficiently to restore good blood perfusion and increase their success rates; they go the extra mile to make sure women have the best chances of success.

Most studies on blood flow dynamics have been performed around IVF cycles however a British study – published in Human Reproduction – sought to evaluate the extent of blood flow problems in women with unexplained infertility in a natural menstrual cycle.

The researchers used three-dimensional power Doppler imaging to evaluate the endometrial (and sub-endometrial) blood flow to the uterus and endometrial development in twenty nine women with unexplained infertility and nineteen controls. Monitoring was performed on alternate days from day three of the menstrual cycle through ovulation then every forth day until menses. This form of Doppler imaging is far more sensitive than that used in previous studies.

The study demonstrated that the women with unexplained sub-fertility had blood flow patterns similar to the controls but at critical times during the mid-late follicular phase (before ovulation) and in the early luteal phase (just after ovulation) blood flow to the endometrium was significantly impaired despite similar hormone profiles and thickness of the uterus lining. The researchers concluded that:

“Endometrial and sub-endometrial vascularity are significantly reduced in women with unexplained sub-fertility during the mid-late follicular phase irrespective of estradiol or progesterone concentrations and endometrial morphometry.”

A specific electro-acupuncture treatment performed by fertility specialists has been proven to significantly improve uterine and ovarian blood flow and may be one of the reasons why acupuncture is often helpful to women with unexplained infertility. If you are looking for a fertility acupuncturist check the website of the American Board Of Oriental Reproductive Medicine (ABORM)for a certified practitioners near you.

Certain herbs, foods and nutritional supplements can also positively alter blood flow as can aspirin. Vitamin E, L-Arginine and HCG shots have been shown to increase blood flow in the corpus luteum and fish oils are helpful natural blood thinners which may also help. Chinese medicine often uses powerful circulation stimulating herbs to enhance fertility especially in women who tend to feel cold. Cinnamon or ginger tea are great examples of simple and effective blood circulating herbs that you can try daily to boost your blood flow.

If you have unexplained infertility, having your blood flow evaluated may help to fine-tune your diagnosis and help you to get pregnant faster.

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REFERENCES:

Endometrial and subendometrial perfusion are impaired in women with unexplained subfertility N.J. Raine-Fenning, BK Campbell, NR Kendall, JSClewes, IR Johnson. Hum. Reprod. (November 2004) 19 (11): 2605-2614. doi: 10.1093/humrep/deh459 First published online: October 1, 2004

http://www.bellaonline.com/articles/art173281.asp

N-Acetyl Cysteine May Improve Egg Quality

N-Acetyl Cysteine (NAC) is a powerful antioxidant that may have a very protective effect on egg quality as women age. NAC has been shown to help female fertility in other studies too; treatment with NAC has been shown to help Clomid-resistant women with PCOS to ovulate successfully and may help to reboot ovulation after ovarian drilling. Other studies have shown that NAC may drop miscarriage rates significantly.A 2012 study – published in Human Reproduction – is the first to find that NAC may protect the quality of oocytes significantly reducing the signs of oocyte aging. Strategies to improve egg quality become a huge concern when trying to conceive over age 35 years and top IVF clinics often recommend antioxidant supplements to help women with poor ovarian reserve to have greater success rates.A prime causative factor in ovarian aging is thought to be ovarian oxidative stress which can trigger oocyte damage which may involve apoptosis (cell death) and telomere shortening. Ovarian oxidative stress occurs when the levels of reactive oxygen species (ROS) or free radicals within the ovary are elevated and the levels of antioxidants are insufficient. Oxidative stress is extremely sensitive to diet and changes to diet and lifestyle can have a huge impact on ovarian health along with carefully chosen antioxidant supplements such as NAC.NAC has been previously shown to protect oocytes from harm in test-tube studies where it was reported that NAC ‘rescues oocytes and embryos from ROS-induced telomere shortening and apoptosis.’ Telomere shortening is a key marker for age-related decline in egg quality so it is very significant that NAC can protect telomeres and maintain their length.In the current study, one group of mice were fed NAC for two months, another group had a one year long treatment with NAC and the quality of their oocytes (eggs) and embryos were examined. In the group that were treated for two months 2 months it was demonstrated that:”NAC improved the quality of fertilized oocytes and early embryo development.”When mice were treated for a year with a low concentration of NAC they had increased litter sizes and the researchers noted that:”NAC also increased the quality of the oocytes from these older mice.””…the expression of sirtuins was increased, telomerase activity was higher and telomere length was longer in the ovaries of mice treated with NAC.”These findings all indicate that NAC is able to confer significant protection on aging oocytes which may make it a helpful supplement for improving egg quality as women age. The study concluded that:”These data suggest that appropriate treatment with the antioxidant NAC postpones the process of oocyte aging in mice.”The amount of NAC that has been used safely and successfully in human studies is 600 mg twice a day. NAC is regarded as being extremely safe and has even been studied in pregnancy. You should however always ask your physician before embarking upon a new nutritional supplement regime.This article is intended for informational purposes only and is NOT intended to diagnose, offer medical or nutritional treatment or replace medical or nutritional advice for which you should consult a suitably qualified physician or licensed dietitian.

REFERENCES:
Hum Reprod. 2012 Feb 21. [Epub ahead of print] Delay in oocyte aging in mice by the antioxidant N-acetyl-L-cysteine (NAC). Liu J, Liu M, Ye X, Liu K, Huang J, Wang L, Ji G, Liu N, Tang X, Baltz JM, Keefe DL, Liu L.
http://www.bellaonline.com/articles/art175672.asp/zzz

NAC May Improve Ovarian Drilling Outcome in PCOS

If you have PCOS and are about to undergo ovarian drilling to restart regular ovulation, you may want to ask your physician about the antioxidant supplement N-Acetyl Cysteine (NAC). NAC can be used as an adjuvant treatment to improve the success of your ovarian drilling procedure.A randomized, double-blind, placebo-controlled trial – published in Reproductive Biomedicine Online – evaluated the effectiveness of offering women treatment with N-Acetyl Cysteine after unilateral laparoscopic ovarian drilling (LOD). The sixty women in the study were all clomiphene citrate-resistant women with polycystic ovary syndrome (PCOS). The NAC group received 1.2 grams per day (1,200 mg) of N-Acetyl Cysteine for 5 days beginning on day 3 of the menstrual cycle for 12 consecutive cycles.Women who took N-Acetyl Cysteine experienced a significant increase in ovulation rates – 87% versus 67% – and pregnancy rates – 77% versus 57% – compared with the placebo group.Another positive finding of the study was that NAC-treated women experienced significantly fewer miscarriage rates – 8.7% versus 23.5%. Meanwhile, live birth rates were significantly higher in NAC-treated women – 67% versus 40% – leading the researchers to concluded that:”In conclusion, NAC is a novel adjuvant therapy after unilateral LOD (ovarian drilling) which might help improve overall reproductive outcome.”N-Acetyl cystine has been extensively studied in medicine where it has been used for purposes as diverse as reducing mercury toxicity to thinning mucus in chronic lung conditions. In the field of reproductive medicine, NAC in doses of 600-1,800 mg per day has been demonstrated to:*Improve egg and embryo quality
*Improve response to clomid in PCOS women
*Improve sperm health
*Improve ovulation rates and decrease androgen rates in PCOS womenIf you have PCOS and you are about to undergo – or have recently undergone – ovarian drilling , ask your physician about adding NAC to your treatment protocol, you might get pregnant faster and have significantly lower miscarriage risks.This article is for informational purposes only and is not intended to diagnose or treat any health problems or to substitute for the advice of a suitably qualified physician or dietitian.
REFERENCES:
http://www.bellaonline.com/articles/art177862.asp/zzz
Reprod Biomed Online. 2010 Mar;20(3):403-9. Epub 2009 Dec 14.
Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study.
Nasr A.

NAC May Lower Mercury Before Conception

If you are concerned about studies which have linked lower IVF success rates to higher levels of mercury in ovarian fluids you may be interested in the merits of adding N-Acetyl Cysteine to your pre-conceptual nutrition program.N-acetyl cysteine may significantly reduce mercury levels which may improve fertility and IVF success rates in women who are suspected to have higher mercury levels. You should always ask your physician before embarking upon a new nutritional supplement regime.One of the greatest dietary sources of methyl mercury exposure is fish; women who have been consuming fish-based meals regularly may have unknowingly accumulated higher residues of this metal within their bodies, especially tuna-eaters.Low level mercury exposure over a long period of time can create a build-up of mercury residue within the body, and most importantly, within the ovaries. Although higher mercury levels have been linked to lower fertility and particularly lower levels of IVF success, assessment of methyl mercury in women’s bodies is not yet part of standard fertility work-ups.N-Acetyl Cysteine (NAC) is a proven mercury detoxifier which can trigger mercury excretion at a rate commensurate with the body burden level. According to a study by the Department of Environmental Medicine, University of Rochester School of Medicine:”Many people, by means of consumption of seafood or other anthropogenic sources, are exposed to levels of methylmercury that are generally considered to be quite low, but that may nevertheless produce irreversible brain damage, particularly in unborn babies.””The only way to prevent or ameliorate methyl mercury MeHg (mercury) toxicity is to enhance its elimination from the body.”

“…NAC causes a transient increase in urinary excretion of MeHg that is proportional to the body burden…”

“…because NAC is effective at enhancing MeHg (methyl mercury) excretion when given either orally or intravenously, can decrease brain and fetal levels of MeHg (methyl mercury), has minimal side effects, and is widely available in clinical settings, NAC should be evaluated as a potential antidote and bio-monitoring agent in humans.”

N-Acetyl cysteine has been studied for it’s various meritorious effects on male and female fertility; at doses of 600-1,800 mg per day N-Acetyl Cysteine has been demonstrated to:

* Improve embryo / egg quality
* Improve sperm health
* Reduce testosterone and increase ovulation in women with PCOS
* Improve clomiphene response in women with PCOS
* Reduce miscarriage risks

Taking N-Acetyl Cysteine in the months leading up to conception may help to decrease the mercury levels in your body prior to pregnancy and may be worth discussing with your physician, especially if you have been a regular fish eater, especially tuna.

Please note: This article is for informational purposes only and is not intended to diagnose or treat medical conditions or replace the advice of a suitably qualified dietitian or physician.

REFERENCES:

http://www.bellaonline.com/articles/art177859.asp/zzz
Enviro Health Perspect. 2008 Jan;116(1):26-31. N-acetylcysteine as a potential antidote and biomonitoring agent of methylmercury exposure. Aremu DA, Madejczyk MS, Ballatori N.

N-Acetyl Cysteine May Perform As Well As Metformin In PCOS

Metformin has been proven to be a useful treatment for many women with PCOS, but many women cannot tolerate the side-effects. A natural antioxidant – N-Acetyl Cysteine – has been shown to perform equally well with no side-effects and may help women with PCOS to conceive faster.A Turkish study – published in 2011 – compared the effect of Metformin – 500 mg three times per day – to N-acetyl Cysteine at a dose of 600 mg three times a day in one hundred women with PCOS. The women were randomly assigned to receive either treatment for 24 weeks.Both treatments proved to be effective for improving many of the signs and symptoms of PCOS resulting in significant decreases in: body mass index, hirsutism, fasting insulin levels, HOMA index, total cholesterol, free testosterone and menstrual irregularity. Very important to note is the fact that:”…both treatments had equal efficacy.”However, NAC had an added benefit in that treatment led to a significant decrease in low-density lipoprotein levels which can pose a significant risk to vascular health in PCOS women. The study concluded that:”Metformin and NAC appear to have comparable effects on hyperandrogenism, hyperinsulinaemia and menstrual irregularity in women with PCOS…”If you are trying to conceive with PCOS and have not responded well to Metformin – or if you simply experience too many side-effects with Metformin treatment – you may want to consider asking your physician about a trial of N-Acetyl Cysteine instead.Other studies have shown that N-acetyl cysteine may help women to respond to Clomid with greater success and NAC may improve egg quality too. Other studies have indicated a reduction on miscarriage rates when NAC is used so you may experience multiple benefits from treatment.This article is for informational purposes only and is not intended to replace the advice of a suitably qualified physician or dietitian.
REFERENCES:
http://www.bellaonline.com/articles/art177877.asp/zzz
Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):127-31. Epub 2011 Aug 9.
Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome.
Oner G, Muderris II.

PCOS? You May Have Poor Uterine Blood Flow

If you have PCOS, you may be more likely to have a little known, hidden cause of sub-fertility: Poor uterine blood flow. This sub-fertility factor can be very remediable once diagnosed making a timely diagnosis important, especially before IVF.Poor uterine blood flow may put the brakes on pregnancy success, making conception more difficult while increasing the likelihood of pregnancy loss after conception.The hidden problem of poor endometrial blood flow is a factor that you may never have heard of before. Poor uterine blood flow is a much marginalized cause of sub-fertility, even though multiple studies confirm how very important good uterine blood flow is for pregnancy success. Select IVF clinics do measure blood flow prior to IVF and recommend corrective treatments such as electro-acupuncture to women whose uterine blood flow is sub par.Poor uterine blood flow is known to be prevalent in women with PCOS, especially those with high androgen levels. A study (1) set out to examine the frequency of uterine blood flow disorders in women with PCOS by measuring the blood flowing through the arteries that supply the uterus – the uterine arteries – and also within the uterus itself which can indicate whether blood can flow to the implantation sites adequately. Thirty six PCOS women were studied and compared to 36 controls.The study showed that women with PCOS who were both anovulatory and who had higher levels of androgens – male hormones – tended too have multiple restrictions to uterine blood flow including lower endometrial blood flow to the implantation sites. The study concluded that:

“Subendometrial and endometrial blood flow is significantly impaired in women with PCOS who have clinical signs of hyperandrogenism.”

If you are trying to conceive with PCOS you may want to consider asking your physician about uterine blood flow testing. A number of natural treatments have been proven to help poor uterine blood flow as have treatments that reduce androgens.

This article is for informational purposes only and is not intended to diagnose or treat health problems for which you should see a suitably qualified physician.

REFERENCES:
Ultrasound Obstet Gynecol. 2009 Sep;34(3):326-34. Endometrial blood flow is impaired in women with polycystic ovarian syndrome who are clinically hyperandrogenic. Lam P, Johnson I, Raine-Fenning N.
http://www.bellaonline.com/articles/art177937.asp/zzz

Resistance Exercise Helps to Resolve PCOS

Women who have been diagnosed with PCOS (polycystic ovarian syndrome) are often unclear about which forms of exercise are most likely to restore a more fertility-friendly hormone balance and restart menstruation. A study – published in Fertility and Sterility, 2012 – suggests that resistance physical training – think bench presses, arm curls and leg extensions – may be very helpful for rebooting normal menstrual cycles within just four months of regular use.

This study tracked changes in muscle mass, body composition, hormones and menstrual frequency in PCOS women as they underwent regular resistance physical training. Thirty nine sedentary women aged 18-37 were studied with BMIs varying from 18 – 39.9.

At the end of the study period, PCOS women had significantly lower testosterone levels, and nine of the PCOS women with amenorrhoea (almost half of the treated group) experienced resumption of menstruation. The study concluded that:

“Comparing to CO (control group), in short-time RPT (resistance physical training), PCOS women gained more MS (muscle strength) and lean mass. Although both groups did not present changes in glucide and lipid metabolism, PCOS women presented a decrease in testosterone levels and a return of menstrual cycle.”

Regular exercise can be a powerful tool for helping to resolve the signs and symptoms of PCOS especially in women who tend to be overweight and have higher than average androgen levels. Just four months or regular work-outs could significantly drop your androgen levels and restart regular menses or improve your response to ovulation induction medications. A personal trainer can get you set up with a work-out schedule which is appropriate for your fitness level and help you to gradually increase the intensity of your work-out as you get used to exercising regularly.

This article is for purely informational purposes and is not intended to diagnose, recommend treatment or to substitute for the advice of a physician or dietitian.

REFERENCES:
Fertil Steril Supplement Vol 98 Issue 3 sept 2012 P S3 O-375 Wednesday, October 24, 2012 04:45 PM
Effects of resisted physical training on muscle strength gain, body composition and metabolic repercussions in women with Polycystic Ovary Syndrome. G. S. Kogure, F. K. Picchi, C. S. Vieira, M. F. Silva de Sa, R. A. Ferriani, R. M. Reis. Gynecology and Obstetric, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil.

http://www.bellaonline.com/articles/art178827.asp/

Herbs Better than Drugs for Infertility

A systematic review of the use of traditional Chinese herbal medicine (CHM) in the management of female infertility has concluded that it can significantly improve the chances of pregnancy, compared with Western medical (WM) drug therapy or IVF. The Australian authors included eight RCTs, 13 cohort studies, three case series and six case studies (a total of 1851 women) in their review.

Meta-analysis of RCTs (1005 women) suggested a 3.5 times greater likelihood of achieving a pregnancy with CHM therapy over a four-month period, compared with WM drug therapy alone. Mean pregnancy rates were 60% for CHM, compared with 32% using WM drug therapy. Meta-analysis of cohort studies (616 women) suggested a mean clinical pregnancy rate of 50% using CHM compared with 30% for IVF. The study also provided evidence that herbal treatment tailored to the specific traditional diagnosis of each individual’s reproductive health pathology was a key factor in successful treatment.

REFERENCE: Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review. Complement Ther Med. 2011 Dec;19(6):319-31.

Vitamin B6 to Regulate the Luteal Phase

Vitamin B6 has long been associated with woman’s fertility and specifically in assisting to regulate your luteal phase. What is your luteal phase?

The Luteal Phase is the length of time calculated from the day you ovulate until the time your next cycle begins. The average luteal phase length is 14 days. If your luteal phase is short, like 9 or 10 days, then your body will have a difficult time maintaining a pregnancy, and could very well end with your cycle beginning anew.

Also, if your luteal phase is much longer than 14 days, like 20+, then you are more likely to miscarry even if you fall pregnant. So assisting with getting your luteal phase right on target is really a key ingredient to falling pregnant quickly.

REFERENCE: http://www.conceiveeasy.com/get-pregnant/pills-to-get-pregnant/

Vitex agnus-castus (Chasteberry) to Balance Female Hormones & Lengthen Luteal Phase

Vitex agnus-castus, or Chasteberry, is a traditional herbal folk remedy that you will hear many women talking about. Research has shown that it is very helpful in balancing female hormones, and it too has been shown to lengthen a short luteal phase. Other uses are to stimulate the formation of the corpeus luteum, help prevent miscarriage, and combat amenorrhea (which means those that have no period), to help stimulate the onset of menses, i.e. bring on a period.

REFERENCE: http://www.conceiveeasy.com/get-pregnant/pills-to-get-pregnant/

Vitamin C May Help Luteal Phase Defect

Vitamin C may have a profound effect upon hormone levels in the second half of the menstrual cycle where research shows that vitamin C may help to resolve luteal phase defect. Luteal phase defect is defined by progesterone levels in the mid-luteal phase which are less than 10 or 15 ng/mL. Too much vitamin C though is thought to harm female fertility though; you may need to take just the right amount of vitamin C daily for optimum results.

Luteal phase defect is thought to affect between 3-5% of women with infertility and affects approximately 35% of women who have experienced repeated miscarriage. Although a diagnosis of luteal phase defect is established through identifying low luteal progesterone levels, estrogen levels are frequently lowered too which can also disfavor successful embryo implantation and pregnancy.

Interestingly oxidative stress has been found to be a significant factor in luteal phase defect connecting the disorder to low levels of dietary antioxidants. Studies have found that women with luteal phase defect – and recurrent miscarriage – have lower than usual levels of antioxidants such as vitamin C, vitamin E, and glutathione.

In one study – published in Fertility and Sterility – One hundred fifty women with infertility and luteal phase defect were randomly assigned to receive 750 mg of vitamin C daily – or no treatment – after two cycles of hormone monitoring.

Women who took the vitamin C experienced significantly increased progesterone levels but there was no change in the untreated women; estrogen levels also increased significantly in the vitamin C group only. In addition to healthier hormone levels there was also a significantly higher pregnancy rate in the vitamin C group: 25% of the women receiving vitamin C became pregnant within six months of treatment compared to only 11% of untreated women during the same time period.

Be sure to ask your physician before embarking upon new nutritional supplement regimes and be careful not to take too much vitamin C if you do decide to try this treatment. Stick to the amounts used in the study -or those recommended by your physician – to avoid drying cervical mucus.

This article is intended for informational purposes only and is NOT intended to diagnose, offer medical or nutritional treatment or replace medical or nutritional advice for which you should consult a suitably qualified physician or licensed dietitian.

Would you like studies like this delivered to your email weekly? Sign up for the BellaOnline weekly infertility newsletter. It’s free and you can unsubscribe anytime you like. The link is below.

REFERENCES:Henmi H, Endo T, Kitajima Y, et al. Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. Fertil Steril 2003;80:459–61.

http://www.bellaonline.com/articles/art172627.asp

Melatonin May Help Luteal Phase Defect

A number of studies have demonstrated how melatonin can improve fertility by boosting IVF success rates and improving egg quality, but few studies have researched the possible benefits of melatonin in natural conception cycles. It seems that melatonin may have an important role in helping the ovaries to produce progesterone more efficiently in the luteal phase through its strong antioxidant effects.

Previous studies have noted that women with luteal phase defect often have lower than usual antioxidant levels and that vitamin C – which functions as an antioxidant – may help the luteal phase in some women by raising both progesterone and estrogen. Melatonin it seems may work in a similar fashion helping to raise flagging hormone levels in the luteal phase.

Part of this fascinating study was designed to establish whether melatonin protects the vital hormone-producing granulosa cells of the ovary from free radical attack by reactive oxygen species (ROC). If melatonin were able to do this – by acting as an antioxidant within the ovary – progesterone levels may be expected to rise.

The study showed that when follicular fluid was withdrawn from ovarian follicles at the time of peak egg maturity melatonin levels did indeed correlate with progesterone levels. Higher levels of melatonin also correlated with lower levels of certain reactive oxygen species (ROS) known to harm progesterone production.

Luteinized granulosa cells from the ovary were then incubated with an aggressive ROS agent known to impair progesterone production with or without melatonin to measure its protective effect. The researchers were able to show that although progesterone production was significantly decreased by the ROS agent melatonin was able to protect the ovarian cells and maintain progesterone production.

Lastly a group of 25 women with established luteal phase defect (mid-luteal progesterone levels below 10 ng/mL) were divided into two groups, one group received melatonin 3 mg daily at 10.00 pm throughout the luteal phase and the other did not.

In 64.3% of the treated women progesterone levels improved compared to only 18.1% in the control group. This led the researchers to conclude that:

“Melatonin protects granulosa cells undergoing luteinization from ROS in the follicle and contributes to luteinization for progesterone production during ovulation.”

This is more evidence that melatonin is a super-star fertility supplement that may help you conceive whether you wish to become pregnant naturally or are conceiving using ART/IVF. You should always ask your physician before embarking upon a new nutritional supplement regime. Some fertility physicians routinely recommend melatonin for increasing female fertility while others do not.

This article is intended for informational purposes only and is NOT intended to diagnose, offer medical or nutritional treatment or replace medical or nutritional advice for which you should consult a suitably qualified physician or licensed dietician.

Would you like articles like this delivered to your email weekly? Sigh up for the BellaOnline weekly newsletter, it is free and you can unsubscribe anytime you like. The link is below.

REFERENCES:

Protective role of melatonin in progesterone production by human luteal cells. Toshiake Taketani et al., Journal of Pineal Research, doi: 10.1111/j.1600-079X.2011.00878.x

http://www.bellaonline.com/articles/art172630.asp

Can Melatonin Boost Egg And Embryo Quality?

Can a daily dose of the sleep hormone melatonin improve egg and embryo quality? Quite possibly. A 2014 study (1) published in Gynecology and Endocrinology gave women 3 mg of melatonin nightly for at least two weeks prior to IVF and researchers compared outcomes of women who underwent two treatment cycles, the first with no melatonin and the second with melatonin treatment.For women whose embryos had poor fertilization rates in the first cycle there was a dramatic increase in fertilization rates after melatonin treatment (35.1% versus 68.2%). Also, the rate of good quality embryos increased from 48% to 65.6% and the study concluded:

“An important finding in our study was that oral melatonin supplementation can have a beneficial effect on the improvement of fertilization and embryo quality and this may have occurred due to a reduction in oxidative damage.”

Earlier studies have also found a link between melatonin pre-treatment and improved IVF outcomes. A 2012 study (2) published in Gynecology and Endocrinology evaluated the efficacy of melatonin treatment in eighty five women who were undergoing IVF. The study concluded:

“Melatonin is likely to improve oocyte and embryo quality in women undergoing IVF or intracytoplasmic sperm insemination (ICSI).”

An earlier 2011 study (3) analyzed the effect of melatonin in women with sleep disturbances. Sixty women were randomized to receive melatonin or no treatment prior to IVF and although sleep status remained roughly the same melatonin-treated women had significantly more oocytes retrieved of greater quality. The study concluded:

“IVF patients with sleep disorders may benefit from melatonin administration in improving the oocyte and the embryo quality…”

Melatonin pre-treatment in the three months prior to IVF is recommended by some of the top fertility clinics in the US especially for women who are classed as ‘poor responders.’ It is important that you ask your physician before taking nutritional or hormonal supplements prior to IVF.

This article is for purely informational purposes and is not intended to diagnose or to give medical or nutritional advice for which you should see a licensed physician.

REFERENCES:

http://www.bellaonline.com/articles/art183190.asp/zzz
(1) Gynecol Endocrinol. 2014 May;30(5):359-62. doi: 10.3109/09513590.2013.879856. Epub 2014 Mar 17.
Oral melatonin supplementation improves oocyte and embryo quality in women undergoing in vitro fertilization-embryo transfer. Nishihara T1, Hashimoto S, Ito K, Nakaoka Y, Matsumoto K, Hosoi Y, Morimoto Y.(2) Gynecol Endocrinol. 2012 Feb;28(2):91-3. doi: 10.3109/09513590.2011.589925. Epub 2011 Jul 20.
The efficacy of melatonin administration on oocyte quality. Batıoğlu AS1, Sahin U, Gürlek B, Oztürk N, Unsal E.(3) J Assist Reprod Genet. 2011 Sep;28(9):815-20. doi: 10.1007/s10815-011-9604-y. Epub 2011 Jul 12.
Melatonin improves the oocyte and the embryo in IVF patients with sleep disturbances, but does not improve the sleeping problems. Eryilmaz OG1, Devran A, Sarikaya E, Aksakal FN, Mollamahmutoğlu L, Cicek N.

Red Raspberry Leaf to Strengthen the Uterus and Prevent Miscarriage

Red raspberry leaf can be found in most health food stores, and is taken in either tablet form or brewed as tea. It has long been known as an herbal remedy effective at toning the uterus to its optimal condition. Thus, because it helps to strengthen the uterus and minimize extra bleeding, it has been shown to be effective for recurrent miscarriages, improving egg health, as well as to help heal the uterus after uterine fibroids, endometriosis or ovarian cysts.

REFERENCE: http://www.conceiveeasy.com/get-pregnant/pills-to-get-pregnant/

Evening Primrose Oil (EPO) to Improve Cervical Mucus Quality

This herbal remedy, again found at health food stores, comes in capsule form. Evening primrose oil (EPO) helps improve the quality of cervical mucus. Cervial mucus is necessary for the sperm to find their way to the egg, and EPO enables a better environment for the sperm, which will stay alive for up to five days, thereby increasing the chances of getting pregnant. Take only up until ovulation, as it does have negative effects in the case of early pregnancy.

REFERENCE: http://www.conceiveeasy.com/get-pregnant/pills-to-get-pregnant/

Daily Consumption of Montmorency Cherry Juice (Melatonin) May Boost Fertility

In her article, “Cherry Juice May Increase Melatonin Naturally” Hannah Calef reported on a 2011 study from Northumbria University regarding the benefits of drinking cherry juice daily.

In her article Calef stated “Melatonin is a natural hormone which the body produces during the night while you sleep; melatonin acts as a strong ovarian antioxidant and has been shown to have a protective and rejuvenating effect upon female fertility. A number of studies have found that supplementing 3 mg of this hormone at night before sleep may help to increase egg quality, improve IVF success, boost the success of Clomid cycles and may help to correct luteal-phase-defect. The results are impressive, plus many women find that they get much better sleep quality when they take melatonin regularly.”

Calef went on to say “However, if you live in a part of the world where you cannot purchase melatonin you may need to find ways of increasing your melatonin levels naturally with products such as cherry juice. According to a 2011 study from Northumbria University cherry juice can significantly increase the levels of melatonin that your body produces and improve the ‘efficiency’ of sleep by increasing the duration and quality of your zzzzzzzs.”

In the study led by Dr Glyn Howatson, urine samples from 20 healthy volunteers were analyzed after they drank 30 mL of either tart Montmorency cherry juice or a placebo juice twice daily for one week. In the study, it was found that drinking cherry juice daily was associated with a 15-17% increase in natural melatonin production. While this amount was less than the 3 mg used in the studies on melatonin and fertility, boosting melatonin production naturally may help when melatonin supplements are not available.

Co-author Dr. Ellis was quoted as saying “Although melatonin is available over the counter in other countries, it is not freely available in the UK. What makes these findings exciting is that the melatonin contained in tart cherry juice is sufficient to elicit a healthy sleep response.”

Calef speculated that “Tart cherry juice also contains an abundance of antioxidants which may also help to resolve sub-fertility; many studies have correlated both male and female infertility with increased oxidative stress which is largely caused by antioxidant deficiencies.”

Please note that this article is intended for informational purposes only and is NOT intended to diagnose, offer medical or nutritional treatment or replace medical or nutritional advice for which you should consult a suitably qualified physician or dietician.

REFERENCES:

European Journal of Nutrition Online Nov 2, 2011.

http://www.bellaonline.com/articles/art173805.asp/zzz

Vitamin D3 May Protect against Gestational Diabetes, Miscarriage and Implantation Failure 

A key factor for the success of early pregnancy is the ability of the placenta to produce adequate levels of estrogen and progesterone to nourish and support ongoing gestation. A shortfall of progesterone is a known trigger for miscarriage and implantation failure so ensuring good levels of hormone production is vital for preventing miscarriage and early pregnancy loss.

In very early pregnancy estrogen and progesterone are produced from the corpus luteum which is a tiny, temporary endocrine gland which develops on the ovarian surface from remnants of the collapsed ovarian follicle. As pregnancy develops the tiny placenta must take over this important job of hormone production, and this transition can happen as early as the seventh week of gestation (gestation is calculated from the first day of your last period).

A 2007 study (1) discovered that the efficiency with which the placenta produces pregnancy-sustaining hormones is greatly influenced by the availability of vitamin D3 – or calcitriol – which is known to be quite deficient in many women. This study concluded that:

“…calcitriol (vitamin D3) is a physiological regulator of placental E(2) (estrogen) and P(4) (progesterone) production and suggest a novel role for calcitriol upon placental steroidogenesis (hormone production).”

Vitamin D deficiency has been described as a virtual epidemic in some studies. Simply restoring adequate vitamin D3 levels may help the placenta to produce more estrogen and progesterone and prevent miscarriage in a very natural way.

If you have had a prior miscarriage it may be wise to ask your physician to test your vitamin D levels with a test for 25-hydroxy-vitamin D or 25-OHD which measures the circulating levels of active vitamin D. The normal reference range is rather wide, ranging from 30-100ng/ml and many experts feel that the lower end of this range, although ‘normal,’ is set a little too low for optimal health, fertility and pregnancy wellness.

How much vitamin D is safe in pregnancy? Despite the relatively low RDA for vitamin D, recent studies have given pregnant women 4,000 IU of vitamin D3 during pregnancy and have found that this dose may reduce the incidence of gestational diabetes and pre-term birth.

A 2011 review from the Medical University of South Carolina has shed light on the controversial topic of vitamin D requirements in pregnancy. Although the RDA for vitamin D has been increased from 400 IU a day to 600 IU – the level in many prenatal vitamins is still 400 IUs, a level considered by many experts to be wholly inadequate especially during pregnancy. The topic of vitamin D supplementation is rarely addressed pre-conceptually or at the twelve week ante-natal visit leaving many women in the dark about new recommendations. This 2011 review concludes that ten times the usual amount of vitamin D may be needed:

“Current evidence supports the concept that circulating 25-hydroxyvitamin D should be 40-60 ng/ml (100-150 nmol) during pregnancy and a daily intake of 4000 IU vitamin D3 is required to attain that circulating level.”

If you are newly pregnant ask your physician for a 25-hydroxy vitamin D test to check your levels. If they are low ask about beginning a supplement program and re-testing to make sure that your levels are adequate to conceive, and to have a healthy pregnancy.

Vitamin D3 is considered to be the safest form of vitamin D to supplement and because it is a fat-soluble vitamin it is best absorbed with a fat containing meal. Studies have shown that having good vitamin D levels can have a protective effect upon your pregnancy reducing the incidence of premature birth so it is important that your levels are good.

This article is for informational purposes only and is not intended to replace the advice of a suitably qualified physician or dietitian.

REFERENCES:

(1) J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):529-32. Epub 2006 Dec 23.
Estradiol and progesterone synthesis in human placenta is stimulated by calcitriol. Barrera D, Avila E, Hernández G, Halhali A, Biruete B, Larrea F, Díaz L.

http://www.bellaonline.com/articles/art177688.asp/zzz

Vitamin D3 May Help Depression And Boost Fertility

The following article has been extracted and modified from information supplied on the “BellaOnline Infertility Newsletter” referenced at the conclusion of this article.
Could some of your infertility stress and depression be related to a deficiency of vitamin D3? Quite possibly according to a 2011 study (1) on more than 81,000 women. The study showed that those with the highest intake of vitamin D from their diet had a significantly fewer symptoms of depression. The researchers concluded: “Our results support an inverse association of vitamin D intake from foods and the occurrence of depressive symptoms in older women.”Prior studies have shown that vitamin D deficiency is prevalent in infertile women, and that vitamin D deficiency reduces the likelihood that IVF will succeed. It seems that vitamin D may have a powerful effect upon your fertility and your brain, helping neurotransmitters such as dopamine and norepinephrine function in a more balanced way. In the article they stated “Vitamin D may affect the function of dopamine and norepinephrine, which are monoamine neurotransmitters that are likely involved in depression. Furthermore, vitamin D may modulate the relation between depression and inflammation.”

Optimizing your vitamin D levels could be a beneficial way to buffer yourself against infertility stress while increasing your chances of conceiving. Vitamin D is also known to reduce inflammation in the body too, and this may be another mechanism whereby improved vitamin D helps infertility. Some forms of infertility, especially endometriosis, are linked to excessive inflammation.

Vitamin D also seems to reduce many forms of auto-immune diseases, and an over-aggressive immune system has been implicated in various forms of infertility, implantation failure and recurrent misscarriage. This could be yet another key way that vitamin D may help to increase the incidence of conception.

If you are suffering from infertility (and depression) – you may find great benefit physically, mentally and emotionally from spending more time in the sun – without sunscreen – and asking your physician about taking a vitamin D3 supplement daily. In the wintertime the noontime sun is most likely to up your levels. But do keep exposure time below 30 minutes at a time.

A connection between vitamin D and depression has been discovered before; in 2006 a study evaluated the vitamin D levels of eighty people and assessed their mental health. It was discovered that those with the lowest levels of vitamin D were eleven times more likely to be depressed than those with higher vitamin D levels.

Although the current RDA for vitamin D is a scant 600 IU per day, studies show that most adults may need ten times this amount – or more – of vitamin D3 daily to get their vitamin D levels in the middle of the reference range. The reference range – for the 25 OHD test in current use is 30 – 100 ng/mL and it is thought to be ideal to raise your vitamin D levels to the mid-range, ideally between 50-70 ng/mL. Some will need 8,000 IU of vitamin D3 per day or so to reach that goal.

As vitamin D is a fat-soluble vitamin it is best taken with a fat-containing meal to maximize absorption and vitamin D3 is thought to be the best form of the vitamin to supplement with. A prescription vitamin D is also available which many physicians prescribe when levels fall too low. Be sure to ask your physician for a vitamin D test and for further monitoring to check your progress if you choose to supplement.

This article is purely for educational and informational purposes and is not intended to substitute for medical diagnosis or treatment or nutritional advice for which you should consult a physician or a licensed dietitian.

Would you like articles like this delivered to your email weekly? You can sign-up for the “BellaOnline Infertility Newsletter” using the second link is below.

1. Am J Clin Nutr. 2011 Oct;94(4):1104-12. Epub 2011 Aug 24.
Vitamin D intake from foods and supplements and depressive symptoms in a diverse population of older women.
Bertone-Johnson ER, Powers SI, Spangler L, Brunner RL, Michael YL, Larson JC, Millen AE, Bueche MN, Salmoirago-Blotcher E, Liu S, Wassertheil-Smoller S, Ockene JK, Ockene I, Manson JE.

2. http://www.bellaonline.com/articles/art173963.asp/zzz

Important – Take Vitamin D With A Main Meal

Many women take vitamin D while trying to conceive and in preparation for IVF knowing that having stellar vitamin D levels may improve their chances of conceiving considerably. What they may not know, is that taking vitamin D at the optimal time of day can dramatically improve absorption of this vital fertility vitamin.Vitamin D is a fat-soluble vitamin, this means that you will absorb it far better with food, not just any food, it really needs to be taken with a meal that contains other fats or oils to trigger the digestive enzymes and processes that break down and assimilate fats. Taking vitamin D with a piece of fruit, a glass or water or a light, low fat meal may be akin to taking very little vitamin D at all. Not so great for your fertility.A Cleveland clinic study (1) sought to examine the effect of consuming vitamin D with different types of meals and discovered that vitamin D absorption may increased by an astonishing 56.7% simply by taking the vitamin with a main meal. The researchers concluded that:”…it is concluded that taking vitamin D with the largest meal improves absorption and results in about a 50% increase in serum levels of 25(OH)D levels achieved. Similar increases were observed in a wide range of vitamin D doses taken for a variety of medical conditions.”This is very important information to take note of if you are taking vitamin D to improve your fertility, this is also good to remember during pregnancy when good vitamin D levels are also vital to maintain.A 2011 review (2) from the Medical University of South Carolina has shed light on the controversial topic of vitamin D requirements in pregnancy. Although the RDA for vitamin D has been increased from 400 IU a day to 600 IU – the level in many prenatal vitamins is still 400 IUs, a level considered by many experts to be wholly inadequate especially during pregnancy.

The topic of vitamin D supplementation is rarely addressed pre-conceptually or at the twelve week ante-natal visit leaving many women in the dark about new recommendations. The 2011 review concludes that ten times the usual amount of vitamin D may be needed:

“Current evidence supports the concept that circulating 25-hydroxyvitamin D should be 40-60 ng/ml (100-150 nmol) during pregnancy and a daily intake of 4000 IU vitamin D3 is required to attain that circulating level.”

If you are trying to conceive or are pregnant ask your physician for a 25-hydroxy vitamin D test to check your levels. If they are low ask about beginning a supplement program and re-testing to make sure that your levels are adequate to conceive, and to have a healthy pregnancy.

Vitamin D3 is considered to be the safest form of vitamin D to supplement. Studies have shown that having good vitamin D levels can have a protective effect upon your pregnancy reducing the incidence of premature birth so it is important that your levels are good.

This article is for informational purposes only and is NOT intended as a substitute for medical or nutritional advice for which you should consult a medical physician or dietitian.

1. J Bone Mineral Res. 2010 Apr;25(4):928-30.
Taking vitamin D with the largest meal improves absorption and results in higher serum levels of 25-hydroxyvitamin D.
Mulligan GB, Licata A.
2. Curr Opin Endocrinol Diabetes Obes. 2011 Aug 17. [Epub ahead of print] Hollis BW, Wagner CL. Vitamin D requirements and supplementation during pregnancy.

http://www.bellaonline.com/articles/art177911.asp/zzz

Restore Key Fertility Minerals After Being on the The Pill

If you have been using the contraceptive pill for some time, perhaps to control PCOS or endometriosis prior to trying to conceive, you may want to take note of various nutrient deficiencies which can occur after using the contraceptive pill for some time. These nutrient deficiencies may have an adverse effect upon fertility and pregnancy.Restoring optimal levels of specific nutrients which are depleted by the contraceptive pill may help reboot your fertility more quickly, and help you to have a successful pregnancy after stopping the pill. The longer you have taken the contraceptive pill, the more likely it is that you may have developed pill-related nutrient deficiencies.A study (1) – published in 2011 – set out to investigate the relationship between contraceptive use and trace elements by collecting blood samples from one hundred women who had used various forms of contraception. The participants had used: contraceptive pills (50), injectable contraceptives (25) and IUDs (25). Trace minerals which were analyzed in this study were: zinc, copper manganese, iron, selenium, cadmium, lead and magnesium, phosphorus and calcium.The mean serum values for a number of key fertility nutrients: zinc, selenium and magnesium, were significantly lower in women who had used oral contraceptive pills. Also, the mean serum values for a known anti-fertility metal: cadmium, were significantly higher in women who had used oral contraceptives. The researchers concluded that:”The study showed and confirmed reduced levels of trace elements in women on contraceptives. The reduction is proportional to the duration of contraceptive use.”This is important information if you are trying to conceive after long-term contraceptive pill use. Studies have shown that when selenium levels are reduced within ovarian follicles, fertilization rates may drop and production of one of the body’s key antioxidants – glutathione peroxidase – can be impaired. Good glutathione peroxidase levels are know to have a very protective effect upon egg quality. Low magnesium levels can negatively impact fertility and pregnancy wellness in many ways, and zinc is vital to fertility and pregnancy success.If you have used the contraceptive pill for some time, you may want to ask your physician about using a prenatal vitamin which contains adequate levels of selenium and zinc, and magnesium to make up any deficits that have developed.This article is intended for informational purposes only and is not intended to diagnose or treat health problems or to replace the advice of a suitably qualified physician or dietitian.
REFERENCES:
http://www.bellaonline.com/articles/art177886.asp/zzz
West indian Med J. 2011 Jun;60(3):308-15. Effects of contraceptives on serum trace elements, calcium and phosphorus levels. Akinloye O, Adebayo TO, Oguntibeju OO, Oparinde DP, Ogunyemi EO.

High Fiber Diets May Promote Anovulation

The following article has been extracted and slightly modified from information provided by Natural Infertility expert Hannah Calef on the “BellaOnline Infertility Newsletter” referenced at the conclusion of this article.

Hannah stated in the article “If you are trying to conceive and have anovulation, you may want to take a close look at the amount of fiber in your diet; if you regularly consume lots of dietary fiber – especially fruit fiber – and if you also consume low fat – or no-fat – dairy foods your fertility may be affected. High fiber diets have long been associated with a decreased risk of breast and some other cancers. The positive effect of fiber upon cancer is thought to be due largely to the way in which dietary fiber can influence the level of estrogens circulating throughout the body.The key problem here is that this same estrogen which can at certain times fuel cancer is also vital to ovulation and fertility; having too little estrogen may lower your fertility especially if you have a low BMI and low body fat. Because estrogen production in the body is dependent upon sufficient body fat levels, being on the skinny side may compound the estrogen-lowering effects of a high fiber / high fruit diet.A study (1) was developed to test the hypothesis that high fiber diets may disfavor ovulation by reducing estrogen levels. Two hundred and fifty women (aged 18-44 years, average age 27.5 ) were studied for two menstrual cycles and their dietary fiber intake was assessed. Levels of various hormones: estradiol, progesterone, LH and FSH were measured as were anovulatory cycles. The women all had healthy body weight (average BMI 24) and had healthy exercise levels.The results of the study showed that increased dietary fiber intake was associated with lower levels of ALL reproductive hormones measured (estradiol, progesterone, LH and FSH) and also increased the incidence of anovulatory cycles. Each 5-g per day increase in total fiber intake was linked to a 1.78-fold increased risk of having an anovulatory cycle. Fruit fiber had the strongest effect as a promoter of anovulation and fiber from whole grains and vegetables did not have a significant effect.
The researchers concluded that: “These findings suggest that a diet high in fiber is significantly associated with decreased hormone concentrations and a higher probability of anovulation…””
Hannah went on to say “Don’t get me wrong, high fiber diets maybe great for long-term health and cancer prevention – I follow one myself – but if you have anovulation you may need to take a closer look at nutritional factors which may be dropping your estrogen levels a little too low. Low fat or fat-free diets and excessive work-outs or running can also drop estrogen levels significantly. These diet and lifestyle choices may be great for long-term cancer prevention and health but by significantly reducing reproductive hormones such strategies can create difficult conditions for optimum fertility and ovulation. Be sure to discuss any diet changes with your fertility physician”.

Can Vitamin D Help Donor IVF Suceed?

A number of studies have demonstrated that women are more likely to conceive with IVF if they have adequate levels of vitamin D, but no one has been quite sure whether vitamin D largely effects implantation dynamics, the quality of the embryo or some other factor.A study published in Fertility and Sterility, 2014, sought to clarify this issue by examining the effect of vitamin D status in donor-recipient IVF cycles. Ninety-nine recipients of donor-IVF cycles were followed as they underwent treatment and vitamin D levels were assessed in egg donors and recipients.Pregnancy was far more likely (78% versus 37%) in women with replete vitamin D levels. Live birth rates were also higher: 59% versus 37% in women who had healthy vitamin D values. In this study, the cut-off value for vitamin D normalcy was set at 30 ng/mL and the researchers concluded:

“Nonreplete vitamin D status [25(OH)D<30 ng/mL] was associated with lower pregnancy rates in recipients of egg donation.”

“Since the oocyte donor-recipient model is able to separate the impact of vitamin D on oocyte vs. endometrium, these data suggest that the effects of vitamin D may be mediated through the endometrium.”

How ever you are trying to conceive, making sure that you have adequate vitamin D levels could help your endometrium to be more receptive to pregnancy. If your levels are low ask your physician about taking a vitamin D3 supplement and be sure to take it with a main meal that contains some fat or oil for maximum absorption.

In the USA and UK during the winter months very little if any vitamin D is synthesized in the skin even if you are out in the sunshine. The skin only synthesizes vitamin D when the wavelength of light changes in late Spring/Summer.

This article is for purely informational purposes and is not intended to diagnose or offer medical or dietetic advice for which you should consult a physician or dietitian.

References:

http://www.bellaonline.com/articles/art182765.asp/zzz

Fert Steril Vol 101, Issue 2, (February, 2014), p. 447-452. ISSN: 0015-0282, DOI: 10.1016/j.fertnstert.2013.10.008. Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles. Rudick, Briana J.1 ; Ingles, Sue Ann2; Chung, Karine3; Stanczyk, Frank Z.3; Paulson, Richard J.3; Bendikson, Kristin A.3

DHEA May Help Increase AMH Levels And Ovarian Reserve

One study (1) has shown that when DHEA (dehydroepiandrosterone) is supplemented prior to IVF in women with poor ovarian reserve, embryo quality and pregnancy rates increase. This study concluded that:”DHEA treatment resulted in significantly higher cumulative pregnancy rates. These data support a beneficial effect of DHEA supplementation among women with diminished ovarian function.”A 2010 study (2) – published in Reproductive Biomedicine Online – has furthered this research proving that levels of anti-mullarian hormone (AMH) – known to represent ovarian reserve – are significantly improved when DHEA is supplemented. DHEA seems to have a rejuvenating effect on the ovary and female fertility.When AMH levels are low IVF success rates tend to suffer compared to success rates of women with higher levels of AMH which indicate a better quality of ovarian reserve.In this study one hundred and twenty women with diminished ovarian reserve were supplemented with 25mg of DHEA three times a day for 30-120 days. AMH levels were found to significantly improve after treatment with DHEA, especially in women under 38 years of age.AMH levels were found to improve longitudinally by an astonishing 60% and women who were able to pursue IVF had unexpectedly good success rates. The IVF success rates for women with poor ovarian reserve who were pre-treated with DHEA were 23.64%. The women who conceived had experienced significantly greater improvements in AMH levels that those who did not have such improvements. The researchers concluded that:”DHEA supplementation, thus, significantly improved ovarian reserve in parallel with longer DHEA use and was more pronounced in younger women.”If you choose to take DHEA be sure to ask your physician who can prescribe a pharmaceutical grade DHEA. DHEA may be one of the most powerful ovary rejuvenating supplements to date.This article is intended for informational purposes only and is NOT intended to diagnose, offer medical or nutritional treatment or replace medical or nutritional advice for which you should consult a suitably qualified physician or licensed dietitian.Would you like articles like this delivered to your email weekly? Sign up for the Bellaonline weekly newsletter, it is free and you can unsubscribe anytime you like. The link is below.
REFERENCES:
1. J Assisted Reprod Genet. 2007 Dec;24(12):629-34. Epub 2007 Dec 11. Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function. Barad D., et al.
2. Reprod Biomed Online. 2010 Sep;21(3):360-5. Epub 2010 Apr 18. Improvement in diminished ovarian reserve after dehydroepiandrosterone supplementation. Gleicher N, et al.
http://www.bellaonline.com/articles/art172725.asp/zzz

Malaria Drug Treats Recurrent Miscarriage

A drug commonly used for treating malaria is showing promise as a much-needed solution for women who have been plagued with the devastation of recurrent miscarriage. The treatment is inexpensive, easy to take – no shots or infusions – and has demonstrated safety in a number of prior studies.

Pioneering this new treatment is consultant obstetrician and gynecologist Dr. Hassan Shehata who practices in the UK at Epsom Hospital, Surrey, The Portland Hospital for Women and Children, and The Miscarriage Clinic both in London. The new treatment shot into the headlines after one of Dr Shehata’s patients who had experienced 20 miscarriages gave birth to a son after being prescribed the immunosuppressive, anti-malaria pill: hydroxychloroquinone.

Pregnancy loss has long been linked with a hostile, over-active immune system and hydroxychloroquinone is a widely used immunosuppressive drug. The rationale behind this novel anti-miscarriage treatment is that by quieting over-active and over-aggressive components of the immune system, the womb may become more baby-friendly, allowing pregnancy to proceed normally.

Dr Shehata is one of a growing number of physicians who test the level and activity of key immune cells such as natural killer cells (NK cells), when evaluating women who have experienced recurrent pregnancy loss. Elevated levels – or over aggressive activity – of NK cells have been linked with miscarriage in a number of studies and immune-targeted treatments may be very successful for some women who suffer from autoimmune pregnancy loss.

Although other treatments such as steroids and IVIG (intravenous immunoglobulins) are currently available for suppressing NK cells during pregnancy they do carry a certain element of risk and in the case of IVIG: very high expense. For some of Dr. Shehata’s patients, hydroxychloroquinone treatment has worked after other more widely used immunosuppressive treatments have failed.

The anti-malaria drug hydroxychloroquinone is an immune-modulating, anti-inflammatory drug which has long been used to curb inflammation in conditions such as lupus and rheumatoid arthritis. Hydroxychloroquinone is known to cross the placenta and enter cord blood therefore a number of studies have sought to evaluate it’s safety in pregnancy.

The largest study to date on the efficacy and safety of anti-malarial drugs in early pregnancy was published in 2011(1). This study discovered that women who were treated with anti-malaria drugs did not experience increased miscarriage risks, nor did they have serious adverse effect from the treatment. The chances of miscarriage in women using anti-malarian treatments – chloroquine and quinine – were similar 26-27% which is not dissimilar to average miscarriage rates in healthy women. No differences in birth outcomes were noted in women who received anti-malaria treatments.

Other studies (2) which have examined the outcome of hydroxychloroquinone in pregnant patients have similarly concluded that the drug is safe with no evidence of birth defects or toxicity. A 2005 review of the drug in patients with connective tissue diseases concluded that:

“…HCQ should probably be maintained throughout pregnancy in patients with SLE (lupus) and it does not seem necessary to advise against breastfeeding.”

A 2006 study (3) compared the outcomes of 56 women who used hydroxychloraquinone continuously throughout pregnancy with outcomes of women who did not undergo treatment. Occurrence of miscarriage, stillbirth, pregnancy loss and birth defects were similar between groups and the researchers concluded:

“We recommend the continuation of HCQ treatment during pregnancy. Our findings are consistent with prior reports of the absence of fetal toxicity. Similar to studies of non-pregnant women, the cessation of HCQ treatment during pregnancy increases the degree of lupus activity.”

Yet another study (4) published in 2003 evaluated the outcome of continuous treatment with hydroxychloroquinone in 133 pregnancies at two different doses: 200mg twice per day or 200 mg once per day. Results were compared with those of untreated women and the study concluded that:

“Our findings support preliminary evidence for the safety of HCQ therapy during pregnancy. This treatment probably should be maintained throughout pregnancy in patients with systemic lupus erythematosus.”

It can take a number of months for hydroxychloroquinone to reach full effectiveness within the body so treatment is usually commenced some months prior to conception. For women who have struggled with recurrent miscarriage, hope may be on the horizon thanks to Dr. Shehata.

REFERENCES:
(1) Adverse effects of falciparum and vivax malaria and the safety of antimalarial treatment in early pregnancy: a population-based study. Dr R McGready et al.
The Lancet Infectious Diseases, Early Online Publication, 13 December 2011 doi:10.1016/S1473-3099(11)70339-5

(2) Autoimmun Rev. 2005 Feb;4(2):111-5. Epub 2004 Dec 14. Safety of hydroxychloroquine in pregnant patients with connective tissue diseases. Review of the literature.
Costedoat-Chalumeau N, Amoura Z, Huong DL, Lechat P, Piette JC.

(3) Arthritis Rheum 2006 Nov;54(11):3640-7. Hydroxychloroquinone in lupus pregnancy
Clowse ME, Magder L, Witter F, Petri M.

(4) Arthritis Rheum. 2003 Nov;48(11):3207-11.
Safety of hydroxychloroquine in pregnant patients with connective tissue diseases: a study of one hundred thirty-three cases compared with a control group.
Costedoat-Chalumeau N, Amoura Z, Duhaut P, Huong DL, Sebbough D, Wechsler B, Vauthier D, Denjoy I, Lupoglazoff JM, Piette JC.

http://www.bellaonline.com/articles/art182497.asp

Prednisone or Lovenox for Unexplained Recurrent Miscarriage Prevention?

All too often, miscarriage is chalked up to poor chromosomes, or bad luck, yet a number of studies demonstrate how innovative, low-tech treatments can significantly reduce the incidence of pregnancy loss. An Egyptian study – published in the Archives of Gynecology and Obstetrics, 2008 – explored the effectiveness of an innovative combined treatment consisting of prednisone, baby aspirin and progesterone for women with unexplained recurrent miscarriage.

This prospective, randomized, single-blinded, placebo-controlled trial included 170 women with a history of recurrent pregnancy loss – at least 3 losses – of no known cause. The women were allocated to receive either Lovenox (enoxaparin) which is an injected anti-coagulant medication, or a combination of oral prednisone, aspirin, and progesterone, or a placebo. Astonishingly, 81% percent of the Lovenox group and 85% of the combination-treated group delivered a live baby compared to just 48% of the women in the placebo group. The study concluded that:

A combination treatment consisting of high-dose, low-duration prednisone, progesterone and aspirin might be an effective treatment as enoxaparin alone. Both regimens were associated with a good pregnancy outcome in terms of live births and late pregnancy complications.

“…this study brings into question the need for pharmacological intervention for women with IRM (unexplained recurrent miscarriage).”

Although there has been concern regarding the safety of prednisone in pregnancy, especially when used in the second trimester, this study demonstrated a lower incidence of adverse effects in the treatment groups when compared to the placebo group!

“The differences in the incidence of late obstetric complications including preterm labors and IUGR in both enoxaparin (Lovenox) and combination-treated groups were lower compared with placebo.”

“…there were no differences in medical complications including gestational diabetes, bleeding (any in pregnancy), thrombocytopenia (platelets <150,000) or preeclampsia.”

“There were no significant episodes of major bleeding or thrombosis.”

If you are considering asking your physician about trying this form of treatment, you may be like to know the exact doses of the various medications used in this study and the duration of treatment. The dose of prednisone used was 20 mg which was continued – with 20 mg of progesterone daily for the first 12 weeks of pregnancy. The dose of baby aspirin was 75 mg which was continued for the first 32 weeks of pregnancy. 

This article is for informational purposes only and is not intended to diagnose or treat any health problems for which you should seek the advice of a suitably qualified physician.

REFERENCES:
Arch Gynecol Obstet. 2008 Jul;278(1):33-8. Epub 2007 Dec 11.
Treatment options and pregnancy outcome in women with idiopathic recurrent miscarriage: a randomized placebo-controlled study.
Fawzy M, Shokeir T, El-Tatongy M, Warda O, El-Refaiey AA, Mosbah A.

http://www.bellaonline.com/articles/art177952.asp

Hormone Treatment Combats Clomid Side-Effects

Clomiphene citrate (Clomid) may help women with anovulatory sub-fertility to ovulate but treatment may be accompanied by an undesirable side-effect: a thin the uterus lining. This unfortunate side-effect of Clomid may reduce the chances of implantation and increase miscarriage rates; cervical mucus production may also be reduced which can impede the passage of sperm through the cervix.A thicker uterus lining has been linked with better pregnancy rates and lower miscarriage risks.Clomid adversely affects the uterus lining via an anti-estrogen effect; Clomid’s ability to effectively block estrogen receptors is the mechanism that triggers a nice surge of FSH which stimulates follicle development. But this same anti-estrogen effect has a down-side: it blocks estrogen needed for development of the uterus lining and for cervical mucus production.An American study – published in Human Reproduction – tested the theory that suppositories of extra estrogen applied close to the uterus may overcome this problem.This study randomized oligo-ovulatory (irregularly ovulating) women into four groups who received either:* 50 mg of Clomid from day three-eight either with or without hormonal support

* 100 mg of Clomid from day three-eight either with or without hormonal support

The hormonal support consisted of estradiol suppositories (E2) 0.1 mg twice a day from day eight until the LH surge followed by progesterone gel applied close to the uterus as directed beginning three days after ovulation. All the women had an endometrial biopsy ten days after ovulation.

The endometrial biopsies were very revealing and demonstrated that women who received hormonal support with estrogen had uterus lining which were ‘in phase’ with “complete predecidual changes” indicating that they were perfectly ready for implantation. About half of the women without hormonal support (4/6 and 3/6) did not show the predecidual changes indicating a lack of readiness for implantation leading the researchers to conclude:

“The addition of…E2 (suppositories) and progesterone to CC (clomiphene citrate) ovulation induction regimens normalizes the alterations in endometrial morphology. Hormonal treatment combining…E2 (suppositories) and progesterone may improve endometrial receptivity in CC cycles and ultimately yield higher pregnancy rates.”

If you have been unsuccessfully trying to conceive with Clomid try asking your physician if you can try a hormonally supported Clomid cycle to see if it makes a difference.

This article is intended for informational purposes only and is NOT intended to diagnose, offer medical or nutritional treatment or replace medical or nutritional advice for which you should consult a suitably qualified physician or dietitian.

Would you like articles like this delivered to your email weekly? Sign up for the Bellaonline infertility newsletter, the link is below.

REFERENCES:
Hum Reprod. 2002 Feb;17(2):295-8. Sequential hormonal supplementation with ……. estradiol and progesterone gel corrects the effect of clomiphene on the endometrium in oligo-ovulatory women. elkind-Hirsch KE. Phillips K, Bello SM, McNicho M, de Zeigler D.

http://www.bellaonline.com/articles/art172894.asp/zzz

Alcohol May Lower Chances of Conception

If you had planned to give up alcohol when you get a positive pregnancy test you may want to rethink your timing. Numerous studies show that cutting out alcohol in the months before you plan to get pregnant could up your chances of conceiving, and it’s not just female alcohol consumption that matters.

A Harvard study (1) discovered that when couples drank even moderately in the month before IVF they reduced their chances of conceiving with IVF by over 20%. Given the enormous cost – financial and emotional – of IVF it may be worth cutting alcohol out entirely in the months before conception is planned.

In this huge study 2,545 couples were questioned about the type of alcohol they drank, the amount they consumed and frequency of use prior to a total of 4,729 IVF cycles; 41% of females and 58% of males consumed between one and six drinks per week prior to IVF. The results showed that when women drank at least four drinks per week they experienced 16% less chance of having a take-home baby when compared to women who drank less than four drinks per week.

When both partners consumed at least four drinks per week, the chances of a live birth were even further reduced by 21% compared with couples who both consumed less than four drinks a week. The researchers concluded that:

“Consumption of as few as four alcoholic drinks per week is associated with a decrease in IVF live birth rate.”

In response to the study, the chairman of the British Fertility Society, Tony Rutherford suggested that:

“It may well be that couples who are already subfertile are more affected by alcohol that those who are perfectly fertile…If you are going to have IVF, my recommendation would be that it makes sense to avoid alcohol all together, from three months beforehand.”

Other studies have come to the same conclusion; another study (2) – published in Fertility and Sterility – was the first to show that alcohol intake prior to IVF significantly lowers the chances of success. Two hundred and twenty-one couples with female infertility were studied at fertility clinics in California as they pursued IVF or GIFT cycles.

Female alcohol consumption was found to be associated with: a significant decrease (13%) in the number of eggs retrieved during IVF, a 2.86 increased odds of not becoming pregnant, and a 2.2 times increased chance of miscarriage. One additional drink per day in the year before IVF also dropped the odds of conceiving raising the question of how longer term alcohol consumption influences fertility.

Male alcohol intake also had an impact; just one extra drink per day increased the risk of not fathering a child by 2.28 to 8.32 times, there was more risk if the drinking was closer to the IVF cycle. Beer consumption prior to IVF was particularly shown to reduce live birth rates and to be associated with a significant increase in the risk of miscarriage by 2.70 to 38.04 times especially when beer was consumed in the month prior to the IVF/GIFT procedure. The researchers concluded that:

“This is the first study to report an association between alcohol use and reproductive endpoints of IVF and GIFT. Because alcohol use is ubiquitous, modifying drinking habits may increase assisted reproductive technology success rates.”

A Swedish study (3) – also published in Fertility and Sterility – similarly set out to investigate the effects of alcohol consumption on female fertility. The researchers questioned 7,393 randomly selected women between ages 18-28 years and analyzed their fertility and pregnancy records.

The researchers discovered that women who consumed more alcohol underwent more examinations for infertility compared to moderate or low consumers of alcohol and the researchers concluded that:

“High alcohol consumption was associated with increased risk of infertility examinations at hospitals and with lower numbers of first and second partus. It may be important for the female partner in an infertile couple to limit alcohol intake or to not drink at all.”

In another study (4) – published in the American Journal of Public Health – 3833 women who had recently given birth, and 1050 women from multiple infertility clinics were questioned about their alcohol usage. The study found an “increase in infertility due to ovulatory factor or endometriosis with alcohol use” and found that “the risk of endometriosis was roughly 50% higher in case subjects with any alcohol intake than in control subjects.” The study concluded that:

“Moderate alcohol use may contribute to the risk of specific types of infertility.”

A similar study (5) – published in the British Journal of Medicine – examined the effects of alcohol on conception studying 430 Danish couples aged 20-35 years who were trying to conceive for up to six menstrual cycles. The study discovered that the odds of conceiving decreased with increasing levels of alcohol and the researchers concluded that:

“A woman’s alcohol intake is associated with decreased fecundability even among women with a weekly alcohol intake corresponding to five or fewer drinks….it seems reasonable to encourage women to avoid intake of alcohol when they are trying to become pregnant.”

Other studies on animals have also concluded that alcohol consumption prior to conceiving can up the odds of miscarriage and decrease pregnancy rates, if you are trying to conceive you might want to consider becoming tee-total until your baby has finished nursing!

This article is intended for informational purposes only and is NOT intended to diagnose, offer medical or nutritional treatment or replace medical or nutritional advice for which you should consult a suitably qualified physician or licensed dietitian.

Would you like articles like this delivered to your email weekly? Sigh up for the BellaOnline weekly newsletter. It is free and you can unsubscribe anytime you like, the link is below.

REFERENCES:
1. Effect of Alcohol Consumption on In Vitro Fertilization, Rossi, Brooke V. MD., et al.,Obstetrics & Gynecology: January 2011 – Volume 117 – Issue 1 – pp 136-142.
2. Effects of maternal and paternal alcohol consumption on the success rates of in vitro fertilization and gamete intrafallopian transfer.Hillary Klonoff-Cohen PhD., et al., Fertility and Sterility, Vol. 79, Issue 2, Feb 2003, Pages 330-339.
3. Effects of alcohol consumption on female fertility during an 18-year period. Jan Eggerd, et al., Fertility and Sterility, Vol 81, Issue 2, Feb 2004, Pages 379-383.
4. Am J Pub Health 1994;84-1429-1432.
5. BMJ. 1998 August 22; 317(7157): 505–510. Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy. Tina Kold Jensen, et al.

http://www.bellaonline.com/articles/art172661.asp

Magnesium Boosts Uterine Blood Flow

Many women who are trying to conceive are unknowingly deficient in the mineral magnesium which could have an adverse effect on a key aspect of fertility: uterine blood flow. Correcting this common nutritional shortfall may have a very positive effect upon the health of blood vessel walls – or endothelial function – and may enhance blood flow to – and within – the uterus, a key factor for peak fertility.If you have not considered the connection between blood flow and fertility before you may be interested to know that the health of your blood vessel walls – specifically the endothelial lining of the walls – play a central role in maintaining female fertility. According to a 2011 study (1):”…infertility in both males and females appear to be linked by a profound loss in endothelial-dependent vascular function.”Magnesium has a history of safety and is given – in large quantities – by IV to pregnant women with pre-eclampsia because it can powerfully help reduce pre-eclamptic seizures and ameliorate the symptoms of this serious disorder of pregnancy.

A 2011 study (2) highlights the multiple ways in which magnesium can be beneficial to vascular health and states that magnesium acts as a natural vasodilator, opening up blood vessels to increase flow:

“…Preliminary evidence suggests that insulin sensitivity, hyperglycemia, diabetes mellitus, left ventricular hypertrophy, and dyslipidemia may be improved with increased magnesium intake…”

These helpful effects of magnesium supplementation can be especially helpful to women with PCOS who have insulin, blood sugar and lipid (fat) irregularities.

“Oral magnesium acts as a natural calcium channel blocker, increases nitric oxide, improves endothelial dysfunction, and induces direct and indirect vasodilation.”

This is good news for women who have been diagnosed with – or who suspect – poor uterine blood flow; ensuring that your magnesium intake is adequate may help your vascular system to be in peak condition for conception. The richest food sources of magnesium are whole grains, beans, nuts, dark leafy greens, and very dark chocolate (3). If your diet is low in these foods you simply may not be getting enough fertility-friendly magnesium.

The RDA for magnesium in an adult women is around 310-320 mg per day and in pregnancy the RDA is slightly higher – 350-360 mg per day – but many diets don’t make the mark. To ensure that you are getting enough magnesium you need to look carefully at your diet and if necessary consider asking your physician about taking a high quality magnesium supplement such magnesium citrate (preferably in a capsule) to make up any shortfalls. Many diets do fall short, according to a 2012 study (4)

“…Almost half (48%) of the US population consumed less than the required amount of magnesium from food in 2005-2006, and the figure was down from 56% in 2001-2002…”

Making sure that any magnesium deficits are corrected before you conceive may help to protect your pregnancy from harm. Bring on the greens.

This article is for informational purposes only and is not intended to diagnose or to substitute for the advice of a suitably qualified physician or dietitian.

REFERENCES:
(1)Antioxidants to enhance fertility: Role of eNOS and potential benefits Francesco Visiolia,b,∗, ToryM.Hagena,b Pharmacological Research 64 (2011) 431–437
(2) J Clin Hypertens (2011 Nov;13(11):843-7. doi: 10.1111/j.1751-7176.2011.00538.x. Epub 2011 Sep 26.
The role of magnesium in hypertension and cardiovascular disease. Houston M.
(3) http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
(4) Nutr Rev. 2012 Mar;70(3):153-64. doi: 10.1111/j.1753-4887.2011.00465.x. Epub 2012 Feb 15. Suboptimal magnesium status in the United States: are the health consequences underestimated? Rosanoff A, Weaver CM, Rude RK.
(5) http://www.bellaonline.com/articles/art177716.asp/zzz

Magnesium May Boost Post-Pill Fertility

Restoring adequate magnesium levels may help to reboot your fertility more quickly after stopping the contraceptive pill according to a 2011 study. Magnesium is barely present in many prenatal vitamins and multivitamin formulas but may deserve a higher profile in your prenatal nutrition program. Magnesium is one of a number of key nutrients that may be depleted by contraceptive pill use which may make women vulnerable to magnesium deficiency after long-term contraceptive pill use, especially when a low-magnesium diet is also consumed.The RDA for magnesium for adult women is 310-320 mg per day and in pregnancy the RDA is slightly higher – 350-360 mg per day – but many women’s diets still don’t make the mark. Population studies show that a large proportion of us don’t even meet two thirds of the RDA which is perhaps not surprising when you consider the richest food sources (3) for magnesium: dark leafy greens, whole grains, nuts and beans.In this study ninety nine women who had recently ceased taking the contraceptive pill had their diets analyzed and underwent blood tests for trace minerals. Time to pregnancy was recorded as the women were followed for up to one year and it was discovered that the women who had more magnesium in their diets – and in their blood – had a 51.5 percent higher probability of getting pregnant after stopping the pill. The study concluded that:

“Findings indicate that Mg and Zn may impact female fecundity…”

Magnesium levels in blood are kept within a very tight range so blood tests are generally not useful as a measure of this fertility-friendly mineral. To ensure that you are getting enough magnesium take a careful look at your diet and if necessary ask your physician about taking a magnesium supplement such as magnesium citrate to make up any shortfalls. Many diets do contain inadequate magnesium, according to a 2012 study (2)

“…Almost half (48%) of the US population consumed less than the required amount of magnesium from food in 2005-2006, and the figure was down from 56% in 2001-2002…”

Your best food sources (3) for magnesium include: dark leafy greens, very dark chocolate, whole grains, beans, legumes and nuts. A healthy whole-food diet – with high quality very dark chocolate – may be a good bet for restoring fertility-friendly magnesium levels.

This article is for informational purposes only and is not intended to substitute for the advice of a suitably qualified physician or dietitian.

REFERENCES:
(1) Associations between blood metals and fecundity among women residing in New York StateBloom, M.S.; Buck Louis, G.M.; Sundaram, R.; Kostyniak, P.J.; Jain, J. Reproductive Toxicology, Vol 31, Issue 2, (February, 2011), p. 158-163ISSN: 0890-6238, DOI: 10.1016/j.reprotox.2010.09.013
Elsevier Science(2) Nutr Rev. 2012 Mar;70(3):153-64. doi: 10.1111/j.1753-4887.2011.00465.x. Epub 2012 Feb 15.
Suboptimal magnesium status in the United States: are the health consequences underestimated? Rosanoff A, Weaver CM, Rude RK.(3) http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
(4) http://www.bellaonline.com/articles/art177689.asp/zzz

Endometrial Biopsy Helps Unexplained Infertility

In unexplained infertility implantation failure is a common experience; over 50% of embryos are thought not to implant successfully. Everything may look good cycle after cycle: good lining, good follicle, good blood work but no pregnancy occurs. If this situation sounds familiar you may want to explore the merits of endometrial biopsy; superficial scratches to the uterus surface may change the immunological environment favorably and increase the likelihood of a successful conception and pregnancy. This technique – called endometrial scratching or endometrial biopsy – has been found to help women with unexplained infertility to conceive.An Egyptian study (1) – published in the Journal Obstetrics And Gynaecology Research, 2012 – examined the effect of a single uterine scratching procedure in women with unexplained infertility. A group of 105 couples who had experienced unexplained infertility for over a year were randomized to undergo a four quadrant endometrial scratch procedure in the luteal phase of a natural menstrual cycle – or no scratching – and conceptions were tracked for the following 6 months.For women who underwent endometrial scratching, the clinical pregnancy rate was more than double that of the control group: 25.9% versus 9.8% over a six month period and miscarriage rates were similar though marginally lower in the endometrial scratching group: 12.5% versus 16.5%. The study concluded that:”Endometrial scratching may improve clinical pregnancy rates in couples with unexplained infertility. Adequately powered studies are mandated to confirm or refute the findings.”In this study, the biopsy was performed in the luteal phase between days 21 and 26 and the procedure was followed by a 5 day course of the antibiotic doxycycline, orally, 100 mg twice a day to prevent infection.In a further study on the effectiveness of endometrial biopsy for couples with unexplained sub-fertility attempting non-IVF conception cycles, similarly positive results were obtained. In this study (2) which was a randomized clinical trial, conducted in Shiraz University Infertility Clinic of Ghadir Hospital 217 women with unexplained infertility aged 23-35 years old were divided into two groups and studied.

After taking clomiphene citrate and gonadotropins to induce ovulation the women were the women were randomized to receive endometrial scratch biopsy – on the back wall of the uterus – when a dominant follicle reached maturity at 18-20 mm. The procedure was performed prior to ovulation and results demonstrated that conception rates more than doubled in women who underwent biopsy (14.9% versus 5.8%). The study concluded:

“Local mechanical injury of the endometrium can enhance the uterine receptivity and facilitates the embryo implantation.”

“This simple, easy, and cost effective procedure is worth considering in selective unexplained infertility patients who implantation failure is the likely causes of infertility before complex treatments.”

“This procedure may help reduce psychological tensions and high expenses imposed through such interventions.”

Although these are the first studies on endometrial scratching for the treatment of unexplained fertility, a number of studies have evaluated the value of this technique for women undergoing IVF when there has been a history of implantation failure. Logically one would expect to see similar results from using the procedure for treating implantation failure in unexplained infertility.

In my practice, women undergoing IVF who have undergone this technique have often had successful pregnancies after long-term implantation failure. Here are some conclusions from prior studies on endometrial scratching and IVF.

A huge 2012 review (3) from the University of Liverpool, UK, published in Reproductive Medicine Online examined the effectiveness of endometrial injury for recurrent implantation failure in women undergoing IVF. The review pooled data from seven controlled studies (four randomized and three non-randomized), with 2062 participants and concluded that:

“…local endometrial injury induced in the cycle preceding ovarian stimulation is 70% more likely to result in a clinical pregnancy as opposed to no intervention….”

“The evidence is strongly in favour of inducing local endometrial injury in the preceding cycle of ovarian stimulation to improve pregnancy outcomes in women with unexplained RIF (recurrent implantation failure).”

“The results suggest that inducing injury is 70% more likely to result in a clinical pregnancy as opposed to no treatment.”

“Furthermore, scratching of the lining was 2-times more likely to result in a clinical pregnancy compared with telescopic evaluation of the lining of the womb.”

“This study suggests that in women with RIF, inducing local injury to the womb lining in the cycle prior to starting ovarian stimulation for IVF can improve pregnancy outcomes.”

Another 2012 review (4) of randomized control trials on this technique by the Cochrane database included 591 women and also concluded favorably that endometrial scratching makes the uterus more baby-friendly and more likely to secure implantation:

“Endometrial injury performed prior to the embryo transfer cycle improves clinical pregnancy and live birth rates in women undergoing ART…”

Although both reviews call for more studies before this technique becomes accepted as standard practice top IVF clinics have been using endometrial scratching to improve pregnancy success for some years now. Many fertility physicians will allow you to pursue this treatment if you simply ask and present them with the studies. The procedure is simple and quick and OB/GYNs are familiar with the technique for performing uterine biopsies for other purposes.

If you do undergo this in-office procedure it can be a little ouchy, be sure to ask your physician about ways to minimize any discomfort with anti-inflammatory medication or a topical such as ‘Emla’.

Please note: This article is not intended to diagnose or to provide medical or dietetic treatment for which you should see a physician or dietitian. You are encouraged to discuss any new treatments or diet changes that you wish to pursue with your physician.

(1) J obstet Gynaecol Res. 2012 Oct 29. doi: 10.1111/j.1447-0756.2012.02016.x. [Epub ahead of print]
Endometrial scratching to improve pregnancy rate in couples with unexplained subfertility: A randomized controlled trial.
Gibreel A, Badawy A, El-Refai W, El-Adawi N.

(2) Iran J Reprod Med. 2013 Nov;11(11):869-74.
Pregnancy rate after endometrial injury in couples with unexplained infertility: A randomized clinical trial.
Parsanezhad ME1, Dadras N1, Maharlouei N2, Neghahban L1, Keramati P1, Amini M1.

(3) Reprod Biomed Online. 2012 Dec;25(6):561-71. doi: 10.1016/j.rbmo.2012.08.005. Epub 2012 Sep 12.
Endometrial injury to overcome recurrent embryo implantation failure: a systematic review and meta-analysis.
Potdar N, Gelbaya T, Nardo LG.

(4) Cochrane Database Syst Rev. 2012 Jul 11;7:CD009517. doi: 10.1002/14651858.CD009517.pub2.
Endometrial injury in women undergoing assisted reproductive techniques.
Nastri CO, Gibreel A, Raine-Fenning N, Maheshwari A, Ferriani RA, Bhattacharya S, Martins WP.

(5) http://www.bellaonline.com/articles/art179775.asp/zzz

UNDER CONSTRUCTION

Walnuts Improve Sperm Health 

In Chinese herbal medicine, walnuts are ascribed the function of tonifying the Kidneys which, among other things, govern sexual function and fertility. Now a study has found that regular consumption of walnuts can improve sperm count, morphology, motility, vitality and chromosomal abnormalities.

REFERENCE: Walnuts improve semen quality in men consuming a Western-style diet: randomized control dietary intervention trial. Biol Reprod. 2012 Oct 25;87(4):101.

Three Key Nutrients For Boosting Sperm Motility

When sperm motility is well within the normal reference range pregnancy is more likely to occur, quickly, even when IUI is used. When sperm motility is low or borderline, men are seldom advised that with a little care and attention they may be able to improve their sperm motility – and fertility – in just a few short months which may quicken the journey to pregnancy.Three key nutrients with a decent track record for improving sperm motility are L-carnitine, acetyl-L-carnitine and co-enzyme Q10 which are readily available for purchase without a prescription.Multiple studies have been performed upon carnitines and male fertility and most such studies have used a dosage of L-carnitine, 1000 mg twice per day and acetyl-L-carnitine, 1,000 mg per day. A 2007 review (1) of the efficacy of these nutrients for resolving male infertility notes that:”In conclusion, the administration of LC and/or LAC may be effective in improving pregnancy rate and sperm kinetic features in patients affected by male infertility…”Co-enzyme Q10, also called ‘ubiquinone’ is the third key nutrient for improving sperm motility which has also been the subject of multiple studies. Ubiquinone is naturally present in semen and is present in low levels in the semen of infertile men, especially when sperm motility and counts are low. As ubiquinone levels in semen rise, sperm motility increases in short order; a 2009 review (2) of studies on co-enzyme Q10 and sperm quality notes that:”In conclusion, the exogenous administration of CoQ10 increases both ubiquinone and ubiquinol levels in semen and can be effective in improving sperm kinetic features in patients affected by idiopathic asthenozoospermia.”The amount of co-enzyme Q10 used in most studies was 200 mg per day and more recently there has been a trent towards using ubiquinol, a more efficacious form of co-enzyme Q 10.If you are struggling with poor sperm motility, the three nutrients profiled above have been proven to make a difference, ask your physician if they may be a good choice for your situation. It is also very important to tend to your diet, lifestyle and to address the full spectrum of factors that can reduce – and restore – sperm motility.Please note that this article is for purely informational purposes and is not intended to diagnose or to offer medical or dietetic treatment for which you should see a licensed physician or dietitian.
REFERENCES:
(1) Asia Pac J Clin Nutr.2007;16 Suppl 1:383-90. Effect of L-carnitine and/or L-acetyl-carnitine in nutrition treatment for male infertility: a systematic review. Zhou X1, Liu F, Zhai S.
(2) J Endocrinol Investigat. 2009 Jul;32(7):626-32. doi: 10.3275/6301. Epub 2009 May 21.
Coenzyme Q10 and male infertility. Balercia G1, Mancini A, Paggi F, Tiano L, Pontecorvi A, Boscaro M, Lenzi A, Littarru GP.

 

Acupuncture Infertility Treatments and IVF Procedure in Toowoomba Video

DISCLAIMER
The information and opinions expressed on this website are in no way a substitute for professional medical advice, diagnosis, or treatment. You must consult with your fertility specialist, pharmacist, or health care provider before implementing any suggestions or taking any supplements or following any treatment advice suggested by information on this site. Only your personal health care provider, your personal physician, or your pharmacist can supply you with advice that is deemed safe and effective for your individual health needs or diagnose medical conditions based on your personal medical history.

Accupuncture, Acupunture or Accupunture common misspelling

Note that “Acupuncture” is often misspelt as accupuncture, acupunture or accupunture, that is with either too many c’s or not enough c’s. I would love to be able to clear up this very common spelling mistake, and set the record straight.

Ac·u·punc·ture – pronounced ak-yoo-puhngk-cher; Origin: 1675–85; < Latin acū with a needle (ablative of acus  needle) or acu- (as combining form of acus ) + puncture.

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