Chelsey is a participant in Caitlin's Find Fertility with PCOS + Method course. She joined in May 2020 and began taking charge of her PCOS and fertility.  In this episode Chelsey describes her journey through two pregnancy losses, managing PCOS with diet and supplements, learning how to track her cycle beyond just when her period starts, but how to track BBT, detect ovulation, use cervical mucus to better time intercourse for conception, and the emotional journey  it can be trying to conceive.  Chelsey goes into detail on diet changes she made, supplements she took and what she learned about her PCOS. 

In this week’s episode, Caitlin interviews award-winning registered dietitian, Lauren Manacor, in a special episode discussing fertility in men.  After her own 5-year fertility journey, Lauren decided to take on the topic of fertility in men as she saw a need to break the habits society tends to place on women when trying to conceive. Her first book, Fueling Male Fertility, gained steps towards sharing her research and observations and as a regular contributor for PopSugar, Very Well Health, and Eat the Outcome, Lauren aims to help families approach fertility health from both the female and male perspective. In today’s episode, Caitlin & Lauren dive into sperm health, discussing male factor infertility and semen analysis by outlining testing steps & diet practices shown to help couples gain ground when starting a family.  Lauren & Caitlin start off by identifying foods and supplements research has shown to improve semen health.  In an eye opening dialogue, Lauren outlines the need for an individualized approach when it comes to assessing men’s health and next steps regarding proper nutrition for sperm health.  Foods containing antioxidants such as lycopene are discussed as studies have shown them to have a positive effect on men’s fertility.  Along with how to change your diet for the better, Lauren also outlines the realistic timeline of when to expect results, which helps those eager to see changes, set healthy expectations for their fertility journey. Lauren & Caitlin continue to discuss male fertility within the context of popular opinions relating to alcohol & smoking.  It may not be a surprise that smoking cigarettes results in a negative fertility effect in men while drinking alcohol moderately tells a different tale. In an effort to teach listeners the observations gathered around diet, Lauren & Caitlin place the emphasis on sharing hidden truths with listeners so individuals can be advised on where to place their focus when making lifestyle changes.  To outline a health plan for any listeners interested, Lauren pinpoints specific nutrients shown to support sperm health, such as vitamin C, along with purposed diet plans for anyone starting on this fertility path. Additionally, Lauren takes the time to explain how important sperm testing can be for men as a way to see the baseline of how nutrients and levels are presently established in order to create an individualized plan towards fertility.  By sharing helpful conversations of sperm testing, physical & diet practices, Lauren & Caitlin hope to encourage men and women to reach for equal, accountable heights when beginning their fertility journey.  nutritionowcounceling.com IG:  @laurenlovesnutrition  

In this episode of Food, Freedom, and Fertility, Caitlin interviews special guest, Lindsey Lusson, a registered dietitian who works in the fertility sphere of women’s health.  After experiencing her own journey of Hypothalamic Amenorrhea, Lindsey aimed to assist women whose physical & mental habits interrupt the natural fertility process based on their eating and exercise habits.  While Sophia is on maternity leave, Caitlin & Lindsey take the time to explain Hypothalamic Amenorrhea (HA) by diving into the signs, approaches to recovery, while discussing the researches that connects HA to infertility-related diagnosis’.   HA is a result of your brain halting communications with your reproductive organs.  The affect being your body doesn’t think it has enough energy to create a monthly cycle and ovulate properly, leaving women with no monthly period cycle.  Since the body has to account for important vital practices such as blood to your heart and air to your lungs, it enters reserve mode to cover those basic functions. Research shows the cause as a result of psychological and physiological stress from exercise along with mismanaged eating or under eating.  While both overweight and underweight women may have HA, it is important to zoom out and examine the full picture of what your body is going through when evaluating your likelihood of HA.   As seen in Lindsey’s experience, it may be hard to retrieve an official diagnosis from a certified Doctor, as HA is a relatively new term in fertility studies within the medical industry.  For this reason, Lindsey offers some advice to listeners who want to or have tried to navigate these waters but have not been able to retrieve accurate results when it comes to missed periods and fertility trouble.  Her advice includes what tests to request from your doctor, along with the ideal team to consider building around yourself when faced with HA.  One request being lap tests, even if not properly timed in your cycle.  As a baseline to see what is going on with your body, lab tests provide a starting point on your roadmap when navigating HA.   Both Caitlin and Lindsey aim to motivate listeners tuning in to evaluate their relationship to their health by means of eating and exercise during this honest, open dialogue about HA and its underlying causes as they relate to the “diet culture” and what we consider as healthy in 2021.  By bring honestly and vulnerability from their own stories, Caitlin & Lindsey hope to relate the content shared in this special episode to anyone hoping to step into a better approach to diet and exercise.  

In this episode of Food, Freedom, and Fertility, Sophia rejoins Caitlin to discuss the important test procedures women should seek when first discovering they are with child.  Caitlin and Sophia aim to provide reasons for listeners to catalog and tools to contribute when discussing next steps with a healthcare provider.  The ideal tests women should inquire about revolve around Progesterone, Vitamin D, and TSH.  Progesterone is a hormone your body produces right after ovulation and varies depending on if there has been successful egg fertilization. So if there’s no pregnancy, the production of progesterone will quickly diminish when a women gets her period. A reason to test progesterone levels in the early stages of pregnancy contributes to its way of sustaining pregnancy, as it is responsible for holding the uterine lining in place. During this segment, Sophia & Caitlin take the time to explain the ideal amount of this hormone as well as strong conversation points to discuss with your health care professional.   The other big test to consider asking for early on in pregnancy is Vitamin D. Vitamin D is a fat-soluble vitamin and is the only vitamin one can get from another means besides food consumption. Vitamin D comes into play in many phases of fertility as it is involved with many different processes our body needs to build new tissues. It is measured in a range of nanograms per milliliter. A different range is considered for sufficient human growth, apart from what is truly ideal for pregnancy, which is a contributing factor and point of conversation when requesting the test from a heath care provider.  The final test Sophia & Caitlin recommend requesting once you confirm a pregnancy is TSH, which stands for Thyroid Stimulating Hormone. Studies show a correlation between a higher window of TSH and miscarriages which is why Sophia & Caitlin recommend this test to their clients 100% of the time.   Since the number can change very quickly, it’s important to get this tested as soon as your pregnancy is known.  In this episode, Sophia & Caitlin lay out the facts research shows when testing THS and the ways in which your diet and other forms of medication can contribute to healthier thyroid numbers going forward.  In this episode, Sophia & Caitlin aim to prep listeners with the knowledge of what healthcare professionals first evaluate when you become pregnant, along with the truths of additional important factors to discuss in order to be proactive in a successful pregnancy. 

This week while Sophia is still on maternity leave Caitlin Johnson interviews Dr. Jordan. Dr. Jordan Robertson is a Naturopathic Doctor, the host of the Women’s Health Unplugged Podcast and a women’s health author. She published a book on miscarriage and recurrent pregnancy loss titled Carrying to Term: How to get pregnant, stay pregnant and carry a healthy baby to term (Amazon 2020). Her passion for women’s health began when she experienced three consecutive miscarriages in her final year of schooling. She turned her personal experience and her background in medical research into a springboard to support women in their own health journeys. She’s known for her relentless search for the best quality evidence in integrative medicine and her willingness to stand up for women as they pursue their health goals. Her passion is to educate and empower women to understand their health and how to care for themselves.    During this episode Dr. Jordan Robertson and Caitlin will discuss Jordan’s personal experience with carrying a baby to term and what she did to make that happen. In addition to her personal journey they dive into information that is beneficial to someone trying to carry to term. Information that could help couples ask the right questions when visiting with their Doctors. This episode will hopefully provide women and couples with additional knowledge around miscarriages to help them advocate for themselves.     https://www.instagram.com/drjordannd/?hl=en https://linktr.ee/drjordannd https://www.drjordannd.com/author/admin/

In this episode of Food, Freedom, and Fertility, Caitlin & Sophia take a different approach and independently choose two different topics in the world of fertility and PCOS along with their associated studies to dissect important topics in the world of women’s health so listeners can gather the data presented and understand the theories within their own frame of reference. The studies chosen by Caitlin and Sophia focus on Vitex, Letrozole, and Clomind.    Sophia started the conversation discussing a study involving Vitex, otherwise known as Chasteberry. Vitex is a supplement recommended for luteal phase to help with hyper prolactin anemia, which happens when your body’s body's makes too much prolactin. Most women notice this as a common reason for the luteal phase to be shorter than average with a menstrual cycle including heavy periods with intense pain and cramping. The study chosen aimed to prove whether or not Vitex could reduce elevated prolactin resulting in the luteal phase lengthening and progesterone levels normalizing.  As Sophia continues to dissect the study, both weigh in on their known benefits and drawbacks of Vitex through their own experiences and exposure to the herbal supplement.    Caitlin’s chosen study involved the debate on Letrozole versus Clomid. Clomid is a fertility drug which blocks your brain’s estrogen receptors and makes your body think its estrogen levels are low which results in the making of more follicle stimulating the FH hormone, the hormone responsible for triggering your body to grow follicles to size. Letrozole is a newer drug that also changes how your body makes estrogen but instead of using brain receptors, it triggers the enzyme responsible for turning testosterone into estrogen to stop. This causes your body to produce more estrogen in other ways to compensate for the lower levels in the body. Both are known to induce ovulating, which proves to be helpful for the population living with PCOS.  The Clomid study chosen focused on that group of women within the United States. In the study a somewhat shocking statistic rate is shared from Caitlin to make listeners aware of the drug’s success rate while also detailing the processes and side effects the body can withstand when taking Clomid.  The study related to Letrozole, identifies some advantages over Clomid while sounding similar processes within the body. Both studies show staggering statistics including strong differences of each drug, which Caitlin aims to share openly and critically with listeners who hold stake in the wellness of their fertility process.   When discussing these studies, Caitlin and Sophia aim to quantify the scientific descriptions into relatable context for listen to digest within their own world of fertility.  While focusing on discussion rather than hard persuasion, Caitlin and Sophia hope to give listeners helpful information so steps can be taken alongside a medical care professional in an effort to reach a healthy fertility process.

In this episode of Food, Freedom, and Fertility, Caitlin & Sophia discuss chemicals found to disrupt hormones within the body and outline ways to avoid them in an effort to support your liver health and in turn, fertility. By explaining the use our liver plays in our body’s ecosystem, Caitlin & Sophia hope to identify the ways in which we can help our system from constant cleaning overload with substances we consume on a regular basis.  The main chemicals, or toxins, discussed involve analyzing our relationships with Plastic, Pesticides, and Phthalates. These elements can be classified as endocrine disruptors which means they are known chemicals that impact our hormones and how our body communicates, which can ultimately affect our hormone levels and fertility in an unexpected, unintended way.   There’s no doubt we could be doing better when it comes to the way we use plastics in an ongoing disposable manner.  But aside from that, Caitlin & Sophia lay down the dangers in using plastic by outlining its characteristics and changes in every day use. Reason being, BPA mimics estrogen in the body and can cause a lot of damage by disrupting hormones resulting in harming the reproductive system and also brain development for expecting mothers.  This spans from water bottles and food storage containers we use to reheat leftovers at work, to canned products we shop for in the grocery store.     In addition to discussing plastic, Caitlin & Sophia provide resources for listeners to utilize when locating foods with little to no pesticide residue while also speaking about which foods endanger our bodies to more harmful chemicals and which foods are lower risk.  This involves looking at the phrase “organic” in, perhaps, a new light.  By reaching for certain foods research shows to include more pesticides, going organic is more important to consider when aiming to consume as little pesticides as possible. We don’t always have to spend the extra dollars checking out with organic products so Caitlin & Sophia help listeners create a road map of importance when considering different food products.  Additionally, they lead listeners to resources when avoiding phthalates which also count as unwanted harmful chemicals known to affect our hormone system.  This includes substances like soft plastic shower curtains but also more invasive items like feminine products and condoms.     Lastly, Caitlin & Sophia spend some time in this episode discussing the importance of air quality around us and our families.  By looking at healthy air through a practical lens of cost efficiency, Caitlin & Sophia aim to help listeners evaluate what they can do to make their immediate environment a little safer for their liver and in turn, their reproductive system.   All of these efforts combined can seem like an overwhelming, unattainable goal but bit by bit overtime, small changes can ripple into a more healthy, sustainable lifestyle for not only women focused on fertility but family members considering how they can assist their liver with frequently consumed products.     Environmental Working Group Think Dirty App Air Doctor Humidifier

In this episode of Food, Freedom, and Fertility, Caitlin Johnson & Sophia Pavia discuss the food group of fats and the role fats play in fertility, identifying fats with healthy nutrient contents which inherently support ovulation and pregnancy.  Not all fats are the same and in this episode, Caitlin & Sophia make an effort to explain how and why it’s important to consider the right fats when aiming for a healthy fertility journey.    Turns out, in order to achieve fertility, you need fats.  Fats hold the responsibility of sustaining many different types of tissues in the body necessary for fertility, all of which need reassurance that your body has a sustainable food source from ovulation until delivery. When approaching fats, it’s important to remember a term called fat-soluble vitamins, which include a number of vitamins, all of which are discussed in this episode with specific examples in real, adaptable context. The term, fat-soluble, comes into play, as these distinct vitamins need fat in order to absorb into your system. An example of one vitamin discussed that isn’t always a top priority for medical professionals to check levels of is Vitamin D.  In this episode, Sophia & Caitlin discuss the natural forms of Vitamin D, which may come to some as a surprise, does not include Milk. Aside from fat-soluble vitamins, fat is also important in the way it supplies the body with essential fatty acids.  These fatty acids are what your body uses to make tissues so, along with the fat-soluble vitamins, these acids are important in fertility as they reassure your body that it is ready and safe to make and feed a baby for 9 months.               While identifying foods that consist of the right type of fat, Caitlin & Sophia also dive into the uses of certain cooking tools like olive oil, coconut oil, and butter.  Debunking common misconceptions between those natural oils and artificial oils like canola oil. Caitlin and Sophia also discuss fat in terms of its connection to protein and fiber so listeners can route the most efficient path when consuming the right food groups. They continue to explain the relationship between healthy fats and high fiber vegetables, illustrating how these two food groups can collaborate in a helpful and perhaps surprisingly healthy way.  Caitlin and Sophia focus on rectifying the facts about fat, outlining a path to successfully link listeners to healthy fats in order to achieve fertility and meet their family goals. 

In this episode we hold space for a dear friend to share her fertility journey. Too many times women push other women into silence while in the middle of a fertility struggle. Everyone wants hope, and everyone wants a happy ending. Here, we discuss what life is like in the middle of the struggle when a healthy pregnancy has yet to be achieved. 40% of couples struggling to get pregnant have something called “unexplained infertility”. WHile not a diagnosis in itself, it’s basically the category people fall into when there really is no identifiable reason why a spontaneous pregnancy has not occurred. This can be especially challenging because when nothing is “wrong”, there is nothing that can be done to “fix” the problem. When nobody knows what’s wrong, yet there is still a problem, it can be beyond frustrating.    This episode is a lesson in empathy, community, and triumph. Jess talks about the boundaries she has built to stay sane during the madness of IVF, and she shares what it’s like to sit in the middle of the story, yet to have a happy ending… or an ending at all.    Also here is a link to Caitlin’s Protein Waffles: http://www.caitlinjohnsonrd.com/blog/high-protein-gluten-free-waffle-recipe   And to our favorite prenatal vitamin, Garden of Life! https://www.gardenoflife.com/content/product/mykind-organics-prenatal-multi-2/

In this episode of Food, Freedom, and Fertility, Caitlin and Sophia discuss the importance of sugar and its affects on fertility by breaking down sugar’s role in our hormonal system through insulin, the role it plays in ovarian health, and identify the characteristics of sugar addiction as it is often debated in the world of dietitians. Posing questions to help listeners determine for themselves if they have a healthy relationship to sugar.    Blood sugar is directly related to fertility as it affects a hormone called insulin.  Insulin is the key that opens up the door allowing sugar fuel to come into the cells of your body so that you can blink your eyes, breathe thru your lungs, basically anything relating to body functions. The issue comes to play when there is too much insulin caused by eating too much sugar. In the context of fertility, sugar is especially important for your ovaries as they include your follicles that become the eggs you ovulate and other tissues that create hormones in your body.  Like any substance, our bodies can build a resistance to sugar making them insulin resistant.  Issues arise due to your ovaries inability to adjust, causing damage over time.  Big influxes of sugar, followed by big spikes of insulin can result in over-stimulated ovulation, leading to egg quality problems and general ovarian stress. In this episode, Caitlin & Sophia also discuss Follicle Arrestment; the term used to describe how excess insulin creates more testosterone, which can lead to higher testosterone levels in the female body causing ovulation to halt.    Caitlin & Sophia also discuss the hierarchy of sugars, explaining the difference in natural versus processed and artificial sugars, drinking versus eating sugars, in an effort to help listeners understand the difference in healthy fruits and vegetables versus less than ideal sugars found in high fructose corn syrup (usually in soda’s or sugary beverages).  While there’s an importance of a well balanced diet including fruits and vegetables, Caitlin & Sophia encourage listeners to decipher their need for sugar by reviewing their impulses consciously as they happen, gauging one’s need for unwanted sugars found in many food and beverage products.  While sugar addiction isn’t necessarily an addiction Psychology DSM would diagnose, you can certainly have an unhealthy relationship with it if you’re consistently struggling to abandon the thought of consuming it or get shakiness when cutting it out of your diet.  In an effort to help listeners determine the role sugar plays in their lives, Caitlin & Sophia pose questions to help listeners critically think about their diet, the ways in which they can substitute sugar, and the ways in which they can help their body with the urge for sugar on a daily basis.  In discussing the importance of portion control, Caitlin & Sophia aim to help listeners gain an attainable sense of what makes a diet healthy in order to set achievable goals for themselves, and their fertility in 2021.

In this episode of Food, Freedom, Fertility; registered dietitians, Sophia Pavia and Caitlin Johnson expand the topic of weight loss for fertility to dive deeper into the nutritional balance required from both partners in order to see success in fertility.  In women, it’s important to not only address if there is a need for weight loss or gain and its relation to hormones but to also outline the nutritional needs your body requires. On one side of the spectrum, women may be dealing with dietary restraints brought upon by too much exercise and not enough nutritional reinforcement.  On the other side, overweight women may see excess in insulin levels leading to an increase in a number of different things that rise Androgens, DHEA, or Testosterone which can stall ovulation or lower egg quality. This episode will expand upon the notion of weight loss by discussing the topics of positive detoxing, blood sugar levels, popular diet plans, the role of sleep, all in an effort to identify ways in which women can build a better nutrition plan for themselves leading to a healthier lifestyle and successful fertility. While debunking the inclination of rapid weight loss, Sophia & Caitlin also discuss the difference between supporting the body’s detoxing systems and simply detoxing the body with the newest trends in nutrient-deprived cleanses. Studies show rapid weight loss mobilizes a lot of toxic components stored in your fat cells and can actually release these toxins into your reproductive system when it’s dealing with lower calorie intake and harsher nutrition deficiency during a cleanse. Sophia & Caitlin continue to explain how your body’s awareness catches on that its being filled with less than ideal toxins and may withhold your eggs ability to become fertilized.  That is why Sophia & Caitlin take the time to outline ways of supporting the body’s detoxing systems including monitoring your bowel movements and providing your body with a recommended amount of fiber and other key nutrients.  Blood sugar balance is also a factor when gauging the need for weight loss in order to achieve fertility.  Both dietitians discuss filling your plates with colorful vegetables; define the right carbs, proteins and fiber sources; while also diving into the positive and negative sides of diet trends such as Keto and intermittent fasting. In discussing these diet plans, Sophia & Caitlin make sure to outline the rewarding aspects of these routines so listeners can gather the facts and make the best decision for their body.   Fertility isn’t just on the women’s side of nutrition. This episode also discusses excess weight in men and its affects on men’s testosterone and estrogen levels. It takes two, and often even more help from professionals and love ones when aiming for successful fertility.  Conducting the tests and evaluating what’s right for your body boils down to nutrients and the study of your own bodily functions in order to guarantee success at starting or continuing a family.

In this episode of Food Freedom and Fertility, Caitlin Johnson and Sophia Pavia define the balance of a well-based diet and its relationship with fertility by dissecting the truths and reality around living a gluten and diary free lifestyle.  It’s a known fact, that trends have formed around gluten & dairy free diets however, Caitlin & Sophia discuss ways in which listeners can critically examine the need for these cutbacks in your diet based on defining the principles one should prioritize when addressing a well-balanced diet, the effects of these diets when applied to fertility and women with PCOS.  The reality is not everyone has to begin with a drastic step of becoming gluten and/or dairy free if their inherent diet does not meet the standard criteria of wellness and therefore, fertility. The other exception is of course, if there is known allergies and digestive disruptions that are illustrated by unwanted reactions or discomfort.  During this episode Caitlin & Sophia define strategies to ensure you’re meeting a standard level of nutrition in order to assess if drastic cuts of gluten and dairy are needed while defining the two so more women can grasp a full understanding when adjusting their diet for fertility.  Gluten is defined as a protein found in three grains, Wheat, Barley, and Rye.  Despite the fact that gluten appears in nearly everything, it can be defined in just those three food groups.  Its role can be blurred in the way mass food production works due to cross-contamination in the factories where gluten and other forms of grain are made.  Dairy is defined as any milk provided by an animal.  This excludes the many plant-based substitutes such as soy or almond milk.  Before diving into dietary restrictions, Caitlin & Sophia address strategies to ensure you’re meeting a standard level of nutrition defined as the balance of healthy nutrient density. Proper balance includes colorful fruits, vegetables, quality proteins and fats including vitamins A, D, E, and K.  Diving further into what qualifies quality proteins, Caitlin & Sophia suggest ways to ensure you’re meeting a standard level of nutrition and what to watch out for when it comes to unwanted gluten usage.  Blood sugar balance is also depicted as a check point when examining your diet and role of gluten and dairy in relation to PCOS.   Dietary restrictions including gluten and dairy free meals aren’t always the answer if it means substituting one unhealthy food item like, donuts, for a donut made gluten free. It’s about knowing your identifying your blood sugar levels and the ways in which incorporating healthy foods can turn your diet around after the necessary trial period, which usually takes 4-6 weeks for noticeable change.  This episode is beneficial for all people looking to create a healthy and balanced diet, but also focuses on the effects of your diet and how to determine if cutting dairy or gluten is a good fit for you. If after listening to this podcast you still have questions Caitlin or Sophia would love to schedule a time to discuss your eating lifestyle and habits.  

Our special guest Kendra Tolbert is a registered dietitian, nutritionist, and yoga teacher also certified in Aromatherapy with a specialty in Polycystic Ovary System (PCOS) & fertility. Her approach combines traditional wisdom and the latest evidence-based care to help women balance their hormones, prepare for pregnancy and increase their chances of conceiving. While working in the women's health institution, Kendra started to see more and more people with PCOS & infertility. With her 17 years of yoga expertise, Kendra thought yoga could serve as a wonderful way to support people, help them reconnect with their bodies and therefore, improve their chances of conceiving successfully. Yoga is often thought of as a physical practice but Kendra hopes to share the understanding that yoga can be so much more than just settling into the correct poses and exercises. Yoga also involves elements of meditation as it relates to breath exercises and a system of philosophy around how you interact with the world, including yourself. Other benefits include bringing awareness to how you use your body for everyday tasks including standing or sitting with a supportive posture. By doing yoga, your body naturally discovers its alignment and creates a noticeable awareness allowing simple, yet impactful habits (like poor posture) to improve with regular practice. With these discoveries, Kendra observed a noticeable switch in the way participants find a sense of ownership over themselves in a way that is both meaningful and motivating. In this episode, Kendra also addresses some common obstacles individuals share when deciding to start their yoga practice. These obstacles can include intimidation or hesitancy due to their environment or belief system.  Since yoga classes may be unattainable for some individuals, Kendra explains how to utilize what is available in your existing surroundings in order to accomplish the relaxing and beneficial aspects of the practice. She further discusses the body’s need for balance between lower impact exercises like yoga and vigorous workouts such as cardio or strength training. In an effort to address faith or religious hesitation, Kendra referred to her background in Christianity and spent time studying scripture in an effort to draw supportive ideas between her religion and the practice of yoga. Her observations illustrated no conflict and actually, an encouraging role between the two. She recommends people who are on the fence take a similar approach to see if bridges can be made between their own religion and yoga. The practice of yoga holds many benefits, all of which can be summed up by Kendra’s description of yoga as an opportunity to take time for oneself by doing something that is also kind for oneself. Kendra also shares some very interesting information regarding the research around yoga, PCOS, and fertility. Yoga is also very beneficial for people during the stimulation process during IVF, at it is an opportunity to encourage blood flow to the reproductive organs.  Kendra offers assistance via her YouTube channel: Live Fertile, and her membership website, livefertile.com. She can also be found on Instagram at @live.fertile.

Today we are joined by the @prenatalnutritionist, Ryann Kipping! Ryann is a clinically trained Registered Dietitian Nutritionist, Certified Lactation Educator, and author of the Feel Good Pregnancy Cookbook. She is the founder of the @prenatalnutritionist, a private practice which focuses on preparing women for pregnancy and conquering nutrition during and after pregnancy. She is also the founder of the Prenatal Nutrition Library, an online community for evidenced based nutrition and information before and during pregnancy.    We first discuss how someone should shift their focus with regards to nutrition when they go from TTC to now being pregnant. Ryann explains working with professionals like Sophia and Caitlin can set you up for a great foundation prior to becoming pregnant. She discusses how the initial shock of being pregnant drives curiosity for whether or not there are certain foods that you were regularly eating before that are now safe or not. Ryann explains overall, nutrition for TTC and pregnancy are the same. You should be making sure you are still eating well-balanced, well-rounded meals.    We then jump into combating morning sickness and nausea during pregnancy. While normally you might be eating all the greens and eating all the protein prior to pregnancy,  when nausea hits at 7 or 8 weeks into your third trimester, Ryann explains how to deal with this. She explains that the nutrition you fueled yourself with prior to becoming pregnant then becomes what your body relies on when you are pregnant and might not be able to stomach any food due to nausea. Ryann also explains some women can’t even get down their prenatal vitamins either, so she encourages women to do the best they can, and that “some calories are better than no calories.” So - if you can only eat plain noodles, that is better than not eating anything! If you know that every day at 3pm your nausea hits, then you can plan for it by maximizing your breakfast and lunch nutrition. When you are feeling bad around dinner time, you will know that you got in a lot of nutrients earlier in the day.    Ryann explains blood sugar management is also a major key in combating nausea. Having an empty stomach increases nausea, so it’s important to prevent huge blood sugar spikes throughout your day. Eating small frequent meals can help with this, as well as eating fat or protein with carbs. You can also try eating some carbs first to get your palette ready, and then try to stomach some protein after you get the carbs down. Caitlin shares that when she was pregnant and would wake up in the middle of the night, she would keep a small protein-rich snack on her nightstand to snack on for blood sugar balance. Sophia reminds listeners that this doesn’t have to be a super hearty protein-rich food; it can be peanut butter, string cheese, or cottage cheese. Ryann shares that one of her clients only wanted cereal for dinner, so she chose a healthier cereal option, used whole milk, and added a scoop of collagen to make it a more nutritious choice.    Ryann also explains that she recommends full fat dairy for pregnancy, even though eating low-fat dairy has often been engraved in our minds that it’s superior to full fat. In pregnancy, your need for fat soluble vitamins increases, so without enough of the fat, your body can’t absorb the vitamins (A, D, E, K). Sophia and Cailtin share that the patients with PCOS that they work with are caught in the middle because their doctors tell them to lose weight, yet now they are told they should be eating full fat dairy, and they ultimately end up worried that they will gain weight. Ryann debunks the myth that you will not suddenly gain more weight eating full fat dairy.   Ryann discusses common myths that often ruminate around what types of foods to avoid during pregnancy. One common myth is that you should avoid fish due to having too much mercury, when in fact, it’s so important to eat fish, specifically fatty fish, during pregnancy. She explains the benefits of eating fish far outweigh the risks, and the need for DHA is especially important during the third trimester. Ryann advises to avoid consuming shellfish raw. Her prescription of fish oil varies for clients; those who rarely eat fish could benefit from a DHA supplement whereas someone who might’ve grown up eating a lot of fish might not need it. Her favorite brands she recommends are Nordic Naturals and Carlson.    We also discuss ways for women who have had multiple miscarriages to have more insight on how to prevent future pregnancy trouble. Ryann explains it’s extremely important to make sure your thyroid is healthy, and getting your thyroid levels checked can be the first step to determine this.    The biggest component to getting through your first trimester, to Ryann, is prioritizing your mental health over any specific food. Her number one priority is to make sure her clients’ minds feel at ease about what they’re eating so that they can optimize the way they feel throughout their first trimester instead of worrying about specific foods to avoid. Speaking of foods to avoid - Ryann advises that raw shellfish and romaine lettuce are the two biggest foods to avoid during pregnancy. She emphasizes to wash your produce because produce in general often ends up on the foodborne outbreak list. News flash - if you are craving a sandwich... eat that deli meat, girl! You have such a less chance of getting sick from that pasteurized brie cheese and freshly sliced deli meat than you do eating something like raw shellfish or unwashed romaine lettuce. Ryann mentions veggie trays and fruit trays are also common foods you should avoid, since you have no idea how long they have been sitting out and/or what pathogens are growing on them.   So - your doctor prescribed you a certain prenatal, and your dietitian prescribed you a different one...now what? We emphasize that Ryann is a pregnancy nutrition EXPERT, and we are fertility nutrition EXPERTS, and doctors specialize in a different purpose than nutrition and vitamins. Just because a prenatal says “Check with your doctor before consuming,” doesn’t mean you have to listen to it. Remember to listen to the experts in their field - we would never recommend you go to a dietitian for a C-section. Ryann explains you have to see past some companies' brilliant marketing and make sure they are third party tested to ensure you’re getting a quality supplement.    Lastly, we discuss how to prevent ways to avoid gestational hypertension and/or preeclampsia. Although these are very complex topics, Ryann discusses the importance of including glycine, a conditionally-essential amino acid, in your diet (basically, increasing protein intake). She also talks about ways to lower inflammation by increasing Omega-3 fatty acids and decreasing intake of Omega-6 fatty acids in your diet. These two factors can help decrease your chances for developing gestational hypertension.    If you’d like to see more of Ryann, be sure to follow her on Instagram at @prenatalnutritionist or join her Prenatal Nutrition Library! 

  Best foods to eat in the two week wait?   The two week wait (TWW) is the time between a confirmed ovulation and a positive pregnancy test or your period. It’s about 2 weeks long If you are changing your diet to make general healthier choices this would be fine.   This is not a great time to completely switch up your diet and start something new. For example, this is not a good time to go gluten/dairy free because these changes might put you at risk of not getting enough calories as you learn how to eat.  Changing your diet can also increase your stress, which is detrimental during this period. Building a healthy uterine lining: During this time, the baby isn’t even attached to your body; this is the time when the sperm has met the egg and it is about to attach to the uterus.  Your job is to help your body build a healthy uterus to eventually feed the baby.  You need to have a lot of progesterone during this time. The corpus luteum is the follicle that is left over after the egg has been ovulated. This is what begins to produce progesterone.  Hormone support Two major focuses when thinking about nutrition: Green leafy vegetables which have a high folate content.  Pork, red meat, parmesan cheese, broth, parsley Foods rich in lysine which helps body build new tissues  Supports tissue growth, reducing inflammation Almonds, pumpkin seeds cashews, walnuts, brazil nuts, flax seeds, chia seeds, sunflower sesame  Nuts and seeds which have omega-3, selenium and zinc If you are exercising, make sure there is enough food energy to support activity so that your body can also put energy towards growing your baby.  Eat enough for your activity level What should I eat during the 2 week wait? Should you change your diet drastically?    What  are the top questions to ask your doctor if you haven’t gotten pregnant yet?   Blood work! Check hormone panel  These aren’t pregnancy specific but give us a good amount of information about how healthy your body is overall. This can help to make sure you aren’t sick or dealing with an underlying infection that might be preventing pregnancy.   CBC (complete blood count) and complete metabolic panel  Thyroid panel is important for someone who is having a hard time getting pregnant, especially if this runs in your family Celiac Hashimotos  Tests for underlying autoimmune that might impact ability to get nutrients from their foods. For example:  Make sure that you know that you are actually ovulating and WHEN you are ovulating to make sure that you are timing your sex appropriately. These are vital pieces of information that can inform how you move forward.  It’s never too early! But it’s also not too late. You can start at any point getting extra help. If you start early, you can work on learning about your cycle so that when you are ready to get pregnant you have a head start. If you have been trying for a while, there are specific things that you can look at with a specialist to increase your chances. It’s not “too late” to ask for help.  It’s important to address your reproductive health overall. It shouldn’t be considered “normal” to have painful, debilitating periods for your whole life. It’s not wrong to reach out for help if you know something isn’t right!  Even if you aren’t ready to have a baby right now or are unsure if you want a baby, you can still get help for current problems in your cycle.  Think about the type of team you want. Do you want to be on medications and look into surgery or do you want to focus on natural remedies? Both are valid but think through how you want your journey to look and what will align with your priorities.  If your intuition says that you should see someone- see someone! It can’t hurt to ask for help.  How long should someone ttc without seeking help? (before going to a doctor to help) / at what point do you recommend seeing a fertility specialist?      Are there any dietary changes for TTC with hypothyroidism?   Depends on what is going on with the thyroid. There are a lot of different combinations of hypothyroidism.  Adrenals? under-eating carbs, stress, sleep, etc.   Hashimotos? Maybe gluten free, high quality meats and broths, gut health Are cruciferous veggies OK? Probably not an issue unless you are eating a TON of cruciferous vegetables and this is probably not one of the heavy hitters affecting your thyroid.  Make SURE you are getting a full thyroid panel in your labs.  Find a doctor who is “thyroid literate” and knows how to interpret labs, give you the right medications, and support you appropriately.      Why is it that some women/couples can get pregnant so easily and other women can’t (outside of the standard diagnoses)?   Check sex timing and sex frequency first and foremost. It’s not really an issue of “more sex” but “well timed sex in relation to your ovulation.”  Make sure that you’ve had your partner's semen, blood sugar, testosterone, etc. checked. Causes of subfertility are not only a “female issue.”  There might be some underlying autoimmune condition or malabsorption disorder (ie digestion). Something else might be up that is not a “common” diagnosis. There is some issue that is preventing easy pregnancy. Keep digging until you have an answer or a pregnancy.  Consider age. The older we get, the more difficult pregnancy becomes.  The best thing you can do? Keep advocating for yourself! Keep learning, keep going, keep doing your best.     How do I lower Testosterone?   Spearmint tea, zinc supplements, peony can all help.  Most of the testosterone is made in the ovary. Excess insulin causes the ovaries to produce excess testosterone. Balancing blood sugar and eating foods that don’t cause your body to release a lot of insulin will help protect your ovaries from excess insulin and testosterone production. Myo-inositol can help here too.  Consider insulin resistance Balanced blood sugar, balanced hormone, nutrient rich diet throughout the holidays. Holidays are stressful already and consistently eating unhealthy foods can further increase stress. Having a big holiday sugar binge might feel good in the moment but it’s going to have a longer term impact that will throw you out of balance.  Exercise, sleep, get outside for fresh air.  Don’t overdo it with alcohol. This can really put you in a bad mood, increase anxiety the next day, impact your sleep, and your ability to stay calm. It makes you more susceptible to destructive behaviors and thought processes. Know your limits and don’t over do it.  Nutrition to support mood with holidays and struggling to conceive?   What should we do about sugar and “sugar addiction”?    Inherently, food is food. If you want to consume sugar, you just have to plan for it. BUT, it’s not necessarily your fault that you are craving sweets. Our hormones really affect cravings and insulin resistance.  To address insulin resistance- make sure you have a balanced plate. Include protein at every meal, colorful fruits and veggies, and fiber. Don’t necessarily completely avoid what you are craving (that can cause you to binge on it later) but include it in a balanced meal. Breakfast is important! Eat a protein rich, low sugar breakfast. Eating a high sugar breakfast can cause you to crave sugar throughout the day. Even if the foods aren’t high sugar but still have a sweet flavor (like pancakes or sweet protein powders) can make you crave sugar later in the day. A sweet treat with no calories can do the same thing (like artificial sweeteners) and cause your body to want more high sugar foods later to get the calories.  You may need to eat breakfast earlier so that you aren’t eating so late in the day. Often times people eat breakfast late (around 11am) and then end up eating high sugar foods late in the day. This can build a cycle in which you eat dinner late and then you aren’t hungry until later in the day, etc.  When you want something sweet, pair it with protein. This can balance your blood sugar and give you the sweet taste that you want.  See an addiction counselor if you have a true addiction. This can be a psychological and physiological issue that cannot simply be solved with a high protein breakfast.    Do you recommend the Ava bracelet in PCOS?   Sophia- recommended for women with PCOS who have shorter (less than 40 days) cycles. Not recommended for really long cycles. This wearable gives you a lot of data that might be helpful to look at.  Caitlin- All ovulation trackers track your temperature. It doesn’t matter so much what wearable you use as long as you are getting the data. If wearing one around your wrist is going to be more comfortable for you and you will be consistent about wearing it, then this would work for you. The problem is, it might not be very clear based on how it displays the data exactly when you ovulate because it displays so much data- the graph is really small on the app.  Get the wearable that you are most likely to use consistently!      If you don’t want to take metformin, what’s the next best thing…   If you’re taking metformin because you know that your PCOS is due to insulin resistance, there are definitely some things that you can do with your diet and supplements that can help with insulin resistance. Make sure that you are on the right med to address the underlying cause of your PCOS and on the right dose.  Balance your blood sugars with nutrition- increasing protein, fiber, colorful fruits and vegetables, limit sugar and refined carbs Move your body to help you become more insulin sensitive. Exercise can help decrease insulin resistance.  Pro of metformin- your insurance will probably cover it.  Cons- nutrient deficiency, side effects, pregnancy outcomes impacting baby’s cognitive development and baby’s potential future obesity risk.  Myoinositol can do very similar things as metformin Berberine is very therapeutic for insulin resistance, especially if the person also have fatty liver disease N-acetyl cysteine has very similar outcomes as metformin Pros of supplements- works the same as metformin with less side effect Cons- insurance might not cover it and you will probably have to work with someone to make sure you are getting the right dose.  Supplement options:

This episode features real-life Labor and Delivery nurse, as well as the host of the MommyLaborNurse podcast and Instagram page, Lisel Teen! Lisel helps shed some light on a lesser-known fertility issue: secondary infertility. This is the title we give to women who already have a child (or more than one!) and are struggling as they try to conceive the second or third time around. This concept can be mind-blowing for so many women since we have often been told since puberty that pregnancy is going to happen the moment you even think about unprotected sex. This is further reinforced when women get pregnant easily (or relatively easily) with their older children, but then it doesn’t happen as easily the next time around. So why does this happen? Lisel explains: Age can be a factor. Remember that you’re now older now than you were when you tried for your first. This certainly doesn’t disqualify you from having more children, but it may mean that your body needs more intentional support than when you were younger. Your partner - If you have the same partner as before, he is now a few years older too. His semen quality might be vastly different due to his age/diet/lifestyle/stress/sleep than it was when you conceived your older children. If your partner is new, there could be an issue there too. Birth outcome of your prior pregnancy - if you had a c-section or other uterus surgery it could be that there is scarring or some other kind of structural damage that is making pregnancy more challenging than it was before. Toddler lifestyle - Eating a steady diet of toddler scraps and waking up several times per night with your older child can tell your body that now is not a good time to get pregnant again. So what about the transition from postpartum to being ready to conceive again? This is something that really varies from woman to woman. Technically speaking, you CAN get pregnant before your period returns postpartum. Remember, true periods happen because ovulation occurred 12-14 days prior. But what about if you’re breastfeeding? Some women who are breastfeeding on demand don’t ovulate for many many months. Other women can still ovulate even when they’re nursing! The hormone your body makes to promote milk production often suppresses ovulation (a common problem in women with PCOS) but for some women, ovulation can still happen when breastfeeding. If you’re struggling to conceive or have a regular period postpartum, you may need to consider how frequently you breastfeed your older child. Some women don’t need to ween entirely in order to start ovulation again, while others do. On the other hand, women who don’t breastfeed can see a boost in fertility very soon after the birth of their older child. This is a biological response to what you body considers the loss of a child. Back before baby formula and bottles, if you didn’t breastfeed your body assumed your baby wasn’t alive. This triggers ovulation so that your body can conceive again and bring another child into your family (because your body doesn’t understand your baby is healthy and thriving, just eating formula!) Surgical birth can also change fertility. Remember that when you have a c-section, your body is not only going through everything that a postpartum body goes through; but it is also recovering from a major abdominal surgery. Depending on the nature of your c-section, your uterus can have scarring, disrupted blood flow, kinked tubes, or other issues that are making it harder to conceive. Seeing an abdominal massage specialist or pelvic floor physical therapist can help you assess whether or not your surgical birth is contributing to your challenges conceiving the second or third time around. Another factor can be that sex post-baby can be DIFFERENT! Perhaps now that you already have one (or more) children, having sex the same way as you did pre-baby might not be as comfortable or fun. Many women struggle with painful penetration, urinary leakage, weak orgasms, or other issues that make sex less fun after baby. Pain or discomfort with sex is NOT your fault and there are specialists who can help! Women (Sophia and Liesel included) can feel a lot of shame and guilt around this and feel like the pain and discomfort is due to their own lack of sexy-ness or virility. Your vagina, pelvis, and abdomen are filled with muscles that can get tight, loose, kinked, or damaged just like any other muscle in your body! Seek help if you’re uncomfortable during sex, because help is available! Disclaimer: Kegals are NOT always the answer! They can, in fact, make some pelvic floor problems WORSE! See a specialist and figure out what’s actually wrong.   Liesel goes on to share her journey getting pregnant with her second baby.   She candidly shares that she did initially get pregnant easily her second time around, but unfortunately she lost that pregnancy at 6 weeks. The stress and lifestyle/work/grief issues she was going through impacted her greatly, and it ended up taking another 6 months to get pregnant again. Liesel also shares about the mental health struggles that came along with trying to conceive as well as dealing with the loss of her second pregnancy. She struggled with anxiety and a lot of over-vigilance that included torturing herself with dozens of pregnancy tests. Taking a pregnancy test can seem fun at first, but over time you can become legitimately traumatized by seeing all the negative tests. She eventually started really prioritizing her mental health, nutrition, and stress relief and that’s when she was able to conceive and carry to term again. For her, she was able to make these changes by focusing on one thing at a time. She would start with something small like “eat a healthy breakfast”. Then, once she had that happening she would bring on another task like “2 workouts per week”. Slowly, she was able to build healthy habits that eventually lead to her body being ready for another baby. We also want to highlight that just because there are some things you *can* to  improve your fertility the second (or third) time around; it does NOT mean that your struggle is your fault. There are controllable factors in your life that impact your fertility, but that is not the same thing as being blamable for the struggle or loss that you experience. Liesel shares more of how she helps mothers by offering paid courses, as well as her blog, instagram, and podcast which are resources available to everyone for free! You can find her @MommyLaborNurse on instagram, as well as follow her blog and her podcast for even more free info on all things labor and motherhood!

Holiday Episode: How to navigate the holiday season- emotionally and nutritionally, when you’ve been trying to conceive?   Remember to be gentle with yourself and prepare for what’s coming. You can rehearse your responses to common pregnancy questions and social situations and have a game plan for whatever might be coming your way. While during COVID, these situations might come up less than in previous years, it’s still helpful to prepare for if they do come up.  Find ways to experience the holiday joy even when there is a lot of pressure around getting pregnant. This is a time of family and celebration! Remember that your feelings are valid no matter what! You don’t need to feel guilty about anything that you feel. Sad, stressed, overwhelmed- that’s all OK. We are here to give you support! You aren’t alone- lot’s of women are feeling these things. While you might be the only person in your family who has had a hard time getting pregnant or the first person who is changing their diet, other women are going through similar things.   Thanksgiving- what comes to mind when you think about this holiday?   Cooking all day, being with family, feeling busy? Feeling bored and hungry all day and then starving when you finally sit down to eat?   Thanksgiving food classics: Protein (ham, turkey, prime rib, tofurkey), mashed potatoes, sweet potatoes with marshmallows, stuffing, corn break, dressing, green bean casserole (fresh, frozen, canned? Pick your poison).    Navigating the Thanksgiving menu   There is a lot of food, which can feel overwhelming. Do you love all the foods? How do you enjoy what you love when you’re trying to conceive? Remember: YOU ARE NOT GOING TO RUIN YOUR CHANCES OF TRYING TO CONCEIVE WITH ONE MEAL! Maybe it will delay your ovulation for a little bit but it’s not going to derail your plans for months if it’s only one or two days of holiday eating. If you love it, go ahead and enjoy it. It’s just one day! Food is not just energy- it’s an experience. Remember that you are celebrating family and love and community.    Nutrition tips for thanksgiving: How to find balance when fertility is your goal:    Eat high carb foods (pumpkin pie) with protein,  Remember how important getting good sleep is,  Don't “save up” your calories for one big meal (this will help you not overeat when the big meal starts) Take care of yourself- going into the day hungry, tired, hungover, etc. can really make it more stressful and might cause you to make further unhealthy choices: set yourself up for success.  Start with a high protein breakfast, lots of veggies.  Feed yourself appropriately through the day. If you haven’t fed yourself, your blood sugar will drop (hint: don’t get “hangry”!)  What if you’re drinking? Make sure to eat! Alcohol might make it more challenging to be around certain family members in an emotionally charged situation.    Making choices about food   Consider dessert- just because it’s available and “traditional” doesn’t mean you need to eat it. If you like pie, eat pie. You don’t like pie? Eat something else. You can say “No, thank you!” That’s totally valid.  Don’t worry about your meals being judged. You make your own choices and you don’t have to validate them to other people.  If you don’t want to go to a gathering- that’s valid too. Especially during this COVID year.  Get some additional help if you feel like you need it! Absolutely go see a therapist and get some tools for navigating the holidays. It helps to just talk it over sometimes.    Holiday drinks- Pumpkin spice lattes, eggnog, peppermint lattes, gingerbread lattes.    Having these drinks day after day can seriously impact your hormones, sleep, blood sugar, and cravings. All these drinks are super sugary- basically a hot milk shake.  You can have them but consider it a DESSERT, not a beverage or a breakfast. There is nothing wrong with enjoying them but consider when and how much you are having.  Tips: choose decaf, get a small, eat it with or after a very protein rich  meal or snack. You can change the order by asking for fewer pumps of sweetener. You can make your own! Add spices (nutmeg, cinnamon, turmeric, all spice)  to whole milk in your coffee and 1 teaspoon maple syrup. You are familiar with all these ingredients AND they are great for you.  Experiment: when you have one of these drinks, really pay attention to how they make you feel? How did you sleep? How is your energy later in the day? Did you get a headache or stomach ache?    Ideas for using leftovers   Turkey pot pie, turkey chili, turkey enchiladas Shepards pie with extra mashed potatoes Bone broth: use the carcass for bone broth- bone broth is great for your gut health, your skin, your fertility.  Pick off all the meat and simmer the bones and skin, add veggies, and a little lemon or another acid source (ie: 3 tablespoons vinegar)  to pull out extra nutrients.  You don’t want to use raw bones- make sure they are cooked. You can even bake these first to make sure they are fully cooked.  Cook low and slow (12 hours on low heat) or do it in your pressure cooker for about an hour for a similar result.  Pick out bones or strain to get out additional sediment  There is nothing wrong with throwing away what you aren’t going to eat! It’s OK to toss it!    Alcohol and mocktails   Can you drink alcohol when you’re trying to conceive? It really depends on the person. Can you drink in true moderation and leave it at one drink or does that lead to having more and more drinks? Consider your personal habits around drinking. Alcohol can affect your estrogen levels and your cycle but one drink is not going to be the difference between getting pregnant or not.  If you’re going to drink, pick the drink that you really actually love and not the one that you think is healthier.  If it gives you anxiety, it’s fine to skip! You can decline a cocktail.  TIP: Declining a cocktail carries a lot of meaning (“are you pregnant??”)- you can rehearse and prepare an answer that takes the pressure off of you, like “it really hasn’t been agreeing with me lately.”     Questions from instagram:   How do you get around the “when?” questions? Consider who is asking and how much you trust them. Some people you can share the truth with. Other people you might be a little more protected around because you don’t trust them as much. You can give short answers or longer! Totally up to you how you respond and what you feel comfortable with. This question can really hurt, especially if you’re been trying for a long time and it might be helpful to rehearse answers that you feel comfortable giving when this comes up.  How do you handle stress in the holiday season, especially during a COVID year? Take care of yourself; make sure you are exercising regularly, exposing yourself to light, prioritizing sleep, checking in with your mental health. Consider all the things that you normally do for your mental health and double down your efforts to keep up with those things.  What is sometimes extra stressful about the holidays is being off of your regular schedule (like your regular breakfast and your movement routine). Focus on what you can do to stay in your normal routines and stick to some sort of regular routine as much as possible (remember to eat!). Serve someone else! If you have the mental space to do so but are feeling lonely and discouraged or stuck, find ways to safely reach out and serve someone else. This can be very healing and relieve stress, and loneliness. Ask yourself: what gifts do you have to serve other people?  If finances are tight and gift giving is hard this year, consider giving other types of gifts; make something, write a letter, send a card. If you do have the ability to give gifts, consider buying off of etsy to support a small business that might be struggling right now.  We are thinking about trying to conceive during the holiday season? Is this a good time, especially during COVID? Do what feels right: There is no right or wrong time to start your family. If you feel comfortable with it, go for it! Consider if you’ll be ok with some potential changes like going to ultrasounds alone. There is really no research that shows that being pregnant comes with additional COVID risks. Trends show that a lot of people do conceive during the holidays because it’s often a time of relaxation (lots of September babies!).  How are you defining “trying to conceive”: Depending on how you are planning to conceive might also impact this decision. If you are going down the path of making major changes or using medical interventions, this might be a stressful time to do it. If you are planning on stopping birth control, that is much less stressful and it might actually take some time to get in touch with your fertility and ovulation signs.  Holiday Parties:  Eat a nutritious meal before you go! It’s not going to work well to make your whole meal out of cocktails and appetizers when you arrive hungry. You will not feel good and there might not be choices that fit with how you want to eat.  Skip the stuff you don’t care about! You don’t have to eat it.

Today we are joined by Dr. Loree Johnson, a licensed marriage and family therapist who has  more than 25 years of experience coaching clients in her private practice. She helps others overcome the emotional challenges that come with infertility. Dr. Johnson has served on state and national boards, and she is on the board for the Society of Reproductive Medicine. So, needless to say, she is the perfect guest to bring on.   According to Dr. Loree, having a therapist on board is key for a few reasons: 1) physical well-being sacrificed through all of the medications and procedures; 2) close relationships being sacrificed from support exhaustion; and 3) mental well-being takes a big hit through each of the milestones, so having that support from a third party is vital to staying healthy through the journey. Do you find yourself saying, “not ANOTHER appointment to schedule!” when someone mentions seeing a therapist? If so, iit might be a good time to prioritize going to therapy over other activities because of how much it can greatly benefit your health in multiple ways.   Dr. Johnson introduces therapy as an invitation to explore through having a simple conversation that that person might not have otherwise. She counsels women, men, and couples alike, so each person in the journey has a role to be recognized. Her role to her clients is to help them practice skill building to manage stress/emotions, offering encouragement/support, and often act as a coach to help her clients get through their fertility journey intact.    Some of Dr. Loree’s top conversations she hears from clients are that the woman’s husband does not understand what she’s going through, or that he doesn’t care enough. She also discusses how sex is such an obstacle for couples because a lot of times women don’t actually feel sexy but are pressed for timed intercourse during ovulation, or that the man has performance anxiety as a result from the pressure. She enjoys helping couples reclaiming the fun in sex to produce authentic sex.   Dr. Johnson also shares how her own fertility journey has been a struggle, including losing a child, and she explains how her own experience inspires her to help others get through theirs. “Infertility issues can feel like trauma. You can’t mindset your way out of trauma.” - Dr. Loree Johnson   Therapy doesn’t have to be a lifelong commitment. You can come in with specific issues you want to discuss, even if it has nothing to do with your relationship with your husband or anxiety about your fertility journey. You can breeze in for 5 sessions and utilize the tools you learn, or you can continue on for continued support and skill building.  Having an amazing therapist like Dr. Loree Johnson could help you make great strides in enduring the trials and tribulations throughout your fertility journey -- if you’re just beginning it, or if you are in the trenches -- anyone is welcome.    You can find Dr. Johnson on instagram or on her website. She shares her Self Care Guide and her Grief Guide for free on her website. Do yourself a favor, and don’t wait to start therapy! 

Today we dive in talking about the most free resource there is to not only improve your chance to conceive, but just improve your health in general...ESPECIALLY if you are having hormone issues. You might’ve guessed it..sleep! Discussing sleep as a health intervention is so under-appreciated because it’s not glamorous and businesses can’t make a profit off of marketing it by itself. BUT- it is so crucial for our body’s everyday demands - digestion, hormone control, stress balance, appetite, and so much more.    Although there is limited research on sleep for fertility specifically, we do discuss one NIH review on sleep hygiene for fertility. Sleep hygiene is directly controlled by the HPA axis, which is comprised of your hypothalamus, pituitary, and adrenal glands. These glands basically control your brain/body response to stress and rest. This article discusses primarily that if one area within your HPA axis is out of whack, it can directly influence your sleep quality. The second pathway that this article discusses is how your sleep hygiene can be negatively influence your sleep duration. The third pathway is disruption in your circadian rhythm - or your body’s alarm clock.     The most significant factor that is derived from poor sleep is lack of production of fertility hormones. If you don’t get enough sleep, your body does not produce enough of some hormones and so much of others. The same part of your brain that’s responsible for sleep/appetite hormones is the same place that produces fertility hormones, which is why it’s so important to not neglect sleep habits when considering fertility probability.   But how much sleep is good sleep? One study found that women who were undergoing IVF and had between 7-8 but no more than 9 hours of sleep consistently had the highest chance of having a successful IVF cycle. In this episode, we talk about how you know you actually got a good night’s sleep, and below are some tips that we discuss that will enhance your sleep:   Resetting the circadian rhythm: expose yourself to natural light as soon as you wake up for 10-15 minutes to get your eyes adapted to the full spectrum light. This will help your body to naturally make melatonin easier later in the evening. If you aren’t able to do this (i.e. working long shifts), try buying a full spectrum lamp to shine on your face while you’re getting ready for work. Or, sit by your window and let the sun hit your eyes!  Limit caffeine. While every person has different genetics and processes caffeine differently, a solid recommendation would be one serving (i.e. 8-9 oz medium roast coffee) and stop drinking by 11am or noon. Caffeine can impact the length you’re able to sleep, but every person is different. This might not apply to you, but if you’re experiencing a lot of these symptoms, try limiting caffeine to get more restful sleep at night.  Stabilize Blood Sugar. Be mindful of having a balanced dinner (protein, fiber, complex carbs) to prevent high blood sugar spikes that can disrupt sleep. Also possibly add a bedtime snack that has protein in it.  Adding cherries or tart cherry juice right before bed can improve melatonin production.  Limit alcohol. It is taxing on your body in terms of antioxidant production to process alcohol (which it views as a toxin) and regulating hormone metabolism.  Limiting blue light at night. Wear blue light filtering goggles - not glasses - goggles will cover light coming from any angle. Pick activities like reading or journaling instead of looking at your phone or TV.  Limit sounds/interruptions in the room (i.e. don’t let your animals in your room if they disrupt your sleep, get an eye mask, black light curtains, or ear plugs if your spouse snores).  Move your body! Even an hour outside will improve your sleep quality.  Create a soothing bedtime routine. Our bodies love habits! Maybe you take an epsom salt bath, light a candle, read a book, use essential oils, journal, or pray.  Remove all clocks/alerts/phones away from your bed. This will help reduce anxiety about answering texts or looking at the time and thinking “oh my gosh, it’s already midnight and i'm not asleep?!”  Orgasms! They help produce prolactin and oxytocin which can help you wind down. Supplements like Melatonin, Magnesium, 5HTP, Linden leaves, Holy Basil, Chamomile, or Ashwagandha. Always talk to your naturopath MD, RD, or healthcare professional before starting a supplement.    Start with whatever in this episode sounds do-able for YOU! This should be personalized and what you think is a priority - where you really had your “AHA!” moment... and then if you feel ready, continue to work through the list. We hope you enjoy this episode!

Dr Carrie Jones Podcast Episode    On today’s episode we have Dr. Carrie Jones, a naturopathic doctor and the medical director at Precision Analytical’s DUTCH test - AKA the Hormone Doctor herself! She loves to empower women to understand more about their bodies so that they can advocate for themselves. We dive in with Dr. Jones to talk more about what women can do that struggle with estrogen dominance and endometriosis, since so many women suffer from these conditions and no one ever prepares us how to navigate them.    Many times we find women who are diagnosed with endometriosis face multiple dead-end suggestions by their doctors: 1) suck it up and move on; 2) go on birth control to treat symptoms; or 3)... get pregnant. Well- we know these are not ideal solutions to our problems. Many women go years without getting a proper diagnosis and therefore suffer from crazy symptoms for far too long, just to get tossed birth control as the end-all-be-all solution. Does this sound all too familiar?!    In this episode, we discuss how endometriosis should properly be diagnosed, how it can disrupt the TTC process, foods that can help estrogen detox, and natural techniques to detox our livers of estrogen. We also review the mechanism of how soy is linked to estrogen, the hidden beauty of castor oil, and how valuable unpeeled organic carrots can be.    Dr. Jones discusses estrogen detoxification in depth; the 1st and 2nd step happening in the liver and the 3rd step happening in the kidney. In the liver, phase 1 and phase 2 rely on veggies like broccoli, kale, unpeeled organic carrots, and brussel sprouts to detox optimally (cruciferous veggies).  Magnesium, zinc, and choline are also essential to detoxing in the second phase within the liver. She elaborates on the mechanism of why these veggies aid estrogen detox. The third step in the estrogen detox process occurs in the kidneys and hydration helps this to run efficiently. So - make sure you are having regular bowel movements every day! We discuss more about staying hydrated, having a regular peeing schedule, and Dr. Jones’ favorite electrolyte powders.    Have you ever wondered why you might feel bloated, have a ton of gas that could clear out a room, or have heartburn after a meal? Have you ever wondered how autoimmune diseases caused by gluten intolerance are formed? Dr. Jones shares with us techniques like how simply chewing your food completely with your mouth closed can really enhance digestion, absorption of nutrients, and prevent autoimmune diseases.    Lastly, Dr. Jones discusses common patterns she sees on a DUTCH test that indicate estrogen dominance or low progesterone production with regards to endometriosis. She also talks about what an ideal cortisol, melatonin, and glutathione pattern should look like throughout the day on DUTCH test results.

What if we told you your mindset has a lot to do with your fertility? This might be a shocker for some of you! Today’s episode we dive into what a healthy fertility mindset looks like and how that affects your overall fertility journey. You don’t want to miss this episode as we connect the physical aspect of becoming pregnant to the mental side of BELIEVING you CAN become pregnant!    Although we are practitioners helping women bring home a healthy baby, we are still human and have our own doubts. In this episode, we share our own stories about how we struggled internally with the mental olympics of believing we could become pregnant despite our own personal obstacles. First of all - take a step back and tell yourself you ARE a person that can do hard things. You do believe in yourself. You are taking steps to shift your mindset...after all, you are taking ownership of your life and listening to this podcast!    You do not wear a badge that defines your struggles. You do not wear a badge that says “Hi, I’m infertile.” No...you are YOU!  Talk to yourself like you’re talking to your best friend. Is the first thing you think about your best friend is “oh...she is infertile..” ..No! It’s likely more along the lines of, “She is strong, beautiful, and she WILL become pregnant.” It’s as simple as that. Begin to speak to yourself in a kind and gentle way. Simple techniques to begin developing this healthy fertility mindset are:    Inclusion vs Elimination: add in foods and nutrients that your body needs instead of removing things that you love! How can we add in more foods and nutrients that will enhance your diet/overall health? Can you add two cups of veggies to your dinner, and still have cheese sprinkled on top? How can you add more colors to your plate?  For example: Make a taco bowl with anti-inflammatory spices like turmeric, add grass fed ground beef, bell peppers, and black beans (healthy fats, lots of protein, micronutrients) and STILL include mac and cheese as a small topping to still enjoy the foods you love without making it the focal point of the meal Honor your body. Have the pasta dinner if you want a pasta dinner. Just learn to be strategic about adding things in that can better serve your fertility journey! You don’t have to take away your favorite foods...but begin to think about how certain foods will serve or take away from your fertility journey.  Focus on YOUR progress, not HER progress. In the world of social media, it’s easy to judge your behavior and habits and compare your progress to others. This will do nothing but make you feel inferior to others and isolate you. What works for someone might not work for you, so remember you are an individual and don’t let others’ journeys distract you.  Celebrate each other's victories and stay on your own journey.  Build positive patterns. Look for consistency and improvement in these small habits - adding in more colorful vegetables, possibly changing habits in your sex life, or going to bed 15 minutes earlier to get more sleep. Little by little these small actions will add up. You don’t need to strive for an A+ in “Fertility Nutrition”… we are just trying to accomplish a goal, so remember to find joy in life while still implementing small, consistent healthy habits.  When an obstacle comes up, like you miss a spin class, pivot and try something else. Take your dog for a longer walk or do a YouTube exercise video. Stay on a “winning” path! If you go to a birthday party and eat cake, pivot and make a healthy choice following that. Let setbacks set you up for comebacks! Don’t let these small things snowball into huge unhealthy habits. Be flexible.  Don’t let things you read or hear on social media dictate your behavior. Listen to your body and let that be your guide. If you see someone post about eating more seeds, don’t force them down your throat if you hate them just because they tell you they are the key to fertility. If someone talks about how good spin class is for your health, don’t kill yourself to make it to that 7am class if you feel run down. Make these habits fit for your individual lifestyle to honor your cravings, energy levels, and mood.  Focus on your own continued growth, not your past mistakes. Setbacks are a part of the growing process! Let them prepare you for comebacks. If you ate that chocolate cake you swore you wouldn’t, learn from it. Look at the details of your day leading up to that choice...were you hydrated? Were you in a bad mood? Did you go grocery shopping starving? How can we better prepare you for next time to not make the same mistake? Mistakes are great propellers to help you grow. YOU WILL NOT BE PERFECT, MISTAKES WILL HAPPEN!  Celebrate improvements - in your cycle, in your hormones, indications for ovulation, insulin/sugar cravings, etc.  Every step that you improve is worth celebrating and worth being excited about even though you haven’t reached your ultimate end goal of becoming pregnant. You are getting closer and closer to reaching your goal, so enjoy every step of the way!     Remember to enjoy and celebrate the small victories along the process. There needs to be JOY in your journey. You can do all of the things - take the courses, have sex, buy the tests, but if you struggle with developing this healthy mindset, don’t hesitate to see a therapist. Your mind is part of your body and it’s just as important to nurture and invest in your mind as it is your body. 

In this episode, we are honoring pregnancy and infant loss awareness month. Caitlin and Sophia are digging in deep about this topic with OBGYN and Reproductive Endocrinologist Sasha Hackman, MD. While we know this may seem like a downer, this is purely to inform all of you about statistics, where pregnancy loss is most common, and how we can try to stop this from happening. We all realize most people don’t feel comfortable talking about this, but if this has happened to you, this is NOTHING to be ashamed about.  This is something that happens frequently. You are not alone, you do not need to keep your feelings to yourself, and you are not a failure. In this episode we are trying to educate more people to know how to approach situations like these, become more informed about miscarriages, to open up the conversation and how to hold space for someone who has gone through a pregnancy or infant loss.   Sasha starts talking about how women in early pregnancy can tell the difference between normal discharge or if they are having a pregnancy loss. She says that unfortunately, sometimes a miscarriage can be completely asymptomatic so many women do not find out until they go in for an ultrasound. Some symptoms do include cramping, vaginal bleeding, spotting, low back/ pelvic pain, and sometimes more. The symptoms are very nonspecific and can lead to stress especially with a woman who has had a miscarriage in the past. Truth be told, spotting is not necessarily normal when pregnant, but it is common. If you are having bleeding or spotting, there is a really good chance it is completely benign and will still lead to a healthy pregnancy! Additionally, discharge can be very normal and does not indicate a miscarriage at all.    We had a question about what normal HCG values would be for women before their first ultrasound, around 4-6 weeks pregnant. Sasha explained how HCG should be doubled, or at least increased, after the first few days. Sometimes women only see a 20% increase and will still have a healthy pregnancy. However, the typical minimum cut off where they are absolutely confident about a healthy pregnancy is 53% or more.    Sasha dives into telling us what the main cause is for early pregnancy loss. She say by far, the main cause is genetic abnormality. With technology now, they can do something called a “Microarrye Test” that doesn’t require them to culture a tissue, but instead, they can ID small, little deletions rather than chromosomal duplications or lack of entire chromosome. They have distinguished that at least 75% of pregnancy losses are because of chromosomal abnormality. This is practically nature’s way of removing and absorbing pregnancy that eventually would not result in a relatively healthy child. That being said it doesn’t make this loss any easier.   We asked if someone has experienced early pregnancy loss, what would be the medical model of care, when should they do extra testing, and do they have to experience multiple pregnancy losses before going through diagnostics. Sasha said that technically, there should be 2-3x more losses before you start evaluation. However, it is all patient orientated. If a patient wants to get tested after one loss, that’s great. If a patient has had over 3x miscarriages, doesn’t want any tests done at all, and still wants to try to get pregnant again on their own, then that is totally fine, it’s her autonomy. She describes her role as a reproductive endocrinologist and how they see pregnancy as a very sacred thing that doesn’t come easy to many people. They understand that one loss is too many and they want to see how they can prevent another loss. In this case, they will always do a workup for their patients. This mentality is how they (and us as dietitians) are trying to handle medicine now. They are trying to shift away from paternalistic mentality where the doctors just give recommendations based on past evidence. She says everyone’s body is different, so this “old school” way of thinking needs to get thrown out the window. It should always be about the patient and what they want. Catering to their needs can make a world of difference.    Frequency of pregnancy loss, you ask. Well, Sasha gives us a very descriptive answer on what is really going on in terms of how many miscarriages are happening. Even though this is a “loaded question”, the general number of pregnancy losses would be 12-15% of clinically recognized pregnancies (pregnancies actually recognized by an ultrasound). However, if you were to actually count, a lot of the miscarriages happen before that first ultrasound or before the couple even knows they are pregnant. If you were to combine the clinically recognized pregnancy losses with the clinically unrecognized losses, the incidence rate would be around 30-60%. This HUGE range depends on multiple factors such as age and pregnancy history.  If under 30 years, and you have already had a live birth and/ or abortion your changes of miscarriage is LOW at a 4-6%. Generally, if you are under 30 years of age, your chances are only 7-15%. If 35-39 years old, your risk is about 30% and if you are over 40 years, your risk is about 35-50%. If you have a history of pregnancy loss your risk for reoccurrence is about 25%. With each miscarriage, the risk will go up slightly and will usually plateau at 50%. Yes, this seems high, but there is STILL a substantial chance of a live birth! Sasha also says that there is not really a difference in natural conception, IUI, or IVF in terms of miscarriages. Pregnancy loss really just depends on medical and pregnancy history, and age. And unfortunately, age is the biggest prognostic factor and is NOT a modifiable one (say what?!).    Some other reasons why someone might miscarry other than genetic factors is Asherman’s syndrome, developmental abnormalities, translocation of chromosomes, and well as other disorders. Asherman’s syndrome is when some women develop scar tissue within their uterus which can be caused by a history of abortion or miscarriages and need a DNC or any other type of instrumentation of the uterus. This can increase risk of scar tissue, poor vascularization, and the risk of miscarriage. Probably the developmental abnormality of the uterus that increases the risk of miscarriages the most is called a septum. With this septum, there is not enough vascularization to support a pregnancy, which can easily be fixed by removing the septum, the procedure being minimally evasive, and a patient can go home after. Although not as common, the translocation in one of the parent’s chromosome, meaning two pieces of chromosomes switch in both parents’, causes chromosomal abnormalities which can lead to a miscarriage or having a child with a developmental disability. IVF with genetic testing is a good option for parents having this issue. Clotting disorders, endocrine disorders (poorly controlled diabetes), thyroid disease, luteal phase deficiency, PCOS, and age can also increase the risk of a pregnancy loss. These are known things that will increase risk before going into a pregnancy so Sasha always want to tell these patients to not get pregnant until they can optimize their conditions first so they can decrease risk of miscarriage in the future.   Chemical pregnancy versus miscarriage? Sasha explains that a chemical pregnancy is an actual pregnancy with the presence of HCG, but there is nothing in the ultrasound to show sac is being formed. On the other end, there is something called a “blighted ovum” meaning that there is a gestational sac present but no embryo present. Both of these conditions are considered spontaneous abortions. Again, with all of these conditions, whatever they may present as, women should not be ashamed with themselves because IT IS NOT THEIR FAULT.    Does obesity increase risk of miscarriage? Sasha tells us that studies have shown that once you are in the range of obesity it definitely increases the risk. There is a huge correlation there. Sometimes even very mild weight loss, even 5% of total body weight, will show improved outcomes in pregnancies. This is when it is important to remind women it is not just the weight that matters, it is their overall lifestyle. Being dietitians, we had a few things to say in regard to obesity and pregnancy. We want to tell our listeners that if you are a woman of a larger body size are not eating things that are helpful for fertility, that it is possible to change the way you are eating into a way that DOES support fertility. This will make your fertility completely transformed but your body size does not have to change. This is why the "just lose weight" statement from doctors is not realistic or the issue, we need to talk about how to change the diet and lifestyle with the nutrients that are going to support a healthy baby. Sometimes this will result in a natural weight loss. What we want is to get your hormones under control, blood sugar more regulated, thyroid supported, digestion under control, and stress and inflammation reduced. Sometimes body size will change and sometimes body size will not. Your chances of having a healthy pregnancy will be dramatically increased but it will not always impact your body size.     Let’s say you are experiencing a loss in pregnancy. What can you expect in terms of medical intervention, managing it on your own, and how long should you wait before seeking medical care? The best practices are giving the women the option between 3 interventions. Do nothing. Sit and wait to see if your body will take care of it on its own. Advantage: is there is minimal risk. Downside: if it doesn’t happen right away, you may be waiting several weeks to actually complete the miscarriage and even then, it might not happen, and intervention would be needed.  Medical intervention would involve medication like Misoprostol where it can be given orally/ vaginally. Downside: cramping is really intense. Advantage: avoid having to go into surgery. Another medical intervention would be having a plastic tube inserted into the uterus which would suck everything out. Advantage: all products of conception can go for genetic testing so you can get a better answer (especially now with “microarraye” testing) which really helps with closure for patients. Surgery: if you are experiencing hemorrhaging of if you develop an infection.    What is an ectopic pregnancy and how would someone know if they are having one?  Ectopic pregnancy is different than a miscarriage because the embryo is actually implanted outside of the uterus. There is medication to manage an ectopic pregnancy if the woman is stable, but if unstable, then surgery would most likely be needed. You can tell if its ectopic when you go into doctor’s office and the HCG levels are fairly low compared to what is expected. Also, if the HCG levels are high, then they wouldn’t be rising as quickly as it should. The suspicions would either be a miscarriage, ectopic pregnancy, or sometimes it can even turn into healthy baby. (Wouldn’t it be nice if we could scoop up the ectopic pregnancy and plant it in healthy uterus???)   If someone has an early pregnancy loss, how long can they wait until they can start trying again? What about a further- along pregnancy loss (around 27 weeks)? Sasha says that for an early pregnancy loss the answer would be to start trying whenever you are emotionally and physically ready. Generally, she tells her patients to go for whenever they want, but it might be helpful to wait until they have their next period. For a further along pregnancy loss, also called a fetal demise, you really just want to give months for physical and emotional recovery and grieving. However, she really recommends looking into why this may have happened and if there is something specific that can be changed, then you want to work to see how you can change that and try to reduce risk for the next pregnancy.    Sasha explains that trying to prevent a miscarriage can be tough because the majority of the time it is chromosomal. Sometimes it can be stress related, which no one knows for a fact, but why they believe in this is because there is one intervention for recurrent pregnancy loss that’s called TLC (tender love and care). This is when they will bring patients in for weekly ultrasounds (or really whenever they just want it) to reassure them that their pregnancy is still viable and ongoing. Studies have shown that the live birth rate with this intervention is significantly higher. (Wow!) There is something to be said about constant reassurance, really being there for a patient, and allowing them to get as many ultrasounds that they need. This treatment may help you if you have been through a pregnancy loss more than once and might be scared it will happen again. Reassurance that everything is okay will reduce your stress. Staying active, staying distracted, including lifestyle interventions like proper sleep, mindfulness, mediation, eating whole foods, and doing things that make you feel good, will help you enjoy your pregnancy more, as well as taking care of your mental health and your growing baby.   To end on a happy note, to any woman who has gone through a miscarriage/ recurrent loss, the chances of you holding a baby in the next pregnancy is 70%. THAT’S HUGE. Just remember that and that will help bring you back some optimism.

*Trigger Warning* - It’s a story about labor and birth!   Here we dive in with Cohost Caitlin Johnson, RDN to hear about the birth of her sweet little girl! Caitlin answers all my questions about her birth prep, the birth itself, and the postpartum period.   Caitlin’s prep: She and her husband did a Bradly birth class before her first baby was born so BJ (Caitlin’s man) could get all the juicy deets on what to expect and what to do when his baby was being born. This time around they were already prepared from the last baby!   Red raspberry leaf tea and a nutrient dense diet were Caitlin’s nutrition prep for this birth. Dietitians have a hard go when it comes to early pregnancy nausea. Caitlin was no exception. It’s hard to talk about food all day for work when you feel like you could gag at any second.   Caitlin also upped the protein and sodium to combat low blood pressure and a family history of preeclampsia. She also altered her supplement and herb routine since she had SUCH a struggle nursing her first baby Fiona. Turns out there is a link between PCOS and nursing struggles!   Home birth was the option of choice for Caitlin and her husband. However, we DO want you to know that even though Caitlin chose that, we DO NOT think EVERY woman needs to birth that way! We don’t think you need to quantify your choice, so you choose whatever is right for you. What it comes down to is doing whatever makes you and your family feel safest. For Caitlin, that meant having her baby at home.   Early in the week before Fiona was born, Caitlin had a visit with her midwife. The midwife offered some cervical work to get the baby moving, but Caitlin decided that wasn’t right for her. Instead, later in the week she decided to see her acupuncturist! The acupuncturist also suggested that perhaps Caitlin get the cervical treatment done with her midwife later in the week. As the week rolled on, Caitlin decided that she was ready to bring the baby along, so she decided to tell the midwife she was ready to have her cervix swept.   The midwife spent a lot of time explaining the process of a cervical sweep to Caitlin, and it was great. Caitlin and Sophia are both BIG fans of informed consent, and they believe women should be informed of the risks, benefits, and procedures involved with any medical intervention. Lo and behold, the sweep opened Caitlin’s cervix a bit more! She then went on a walk with her neighbor, had dinner, and around 8:45 she began having real contractions.   Soon thereafter, labor was in full swing! Caitlin’s family set up her birthing tub, and soon thereafter the labor got really intense! This phase was called “transition”, meaning the baby is now low in the cervix, approaching the birth canal, and it’s almost time to push! Fun fact, this is usually when mamas start feeling the “I can’t do this” or “give me the drugs!” feeling. It feels bad, but this is actually good!   The midwife came back, and saw that this baby was coming quick! Caitlin was really feeling intense labor feelings, so the midwife suggested that she break her water and then try some new laboring positions. Up out of the tub she came, and tried a few positions before deciding sitting reverse cowgirl on the toilet was the way to go.   A few pushes later, Caitlin decided that birthing a baby in the toilet was not the deal, so she waddled back to the bedroom with the baby’s head about to crown. The next push, the baby FLEW out, head to toe, and the midwife caught her! By the way, it was 2:40am and Caitlin went into labor at 8:45p, so it was less than 6 hours from start to finish (this is Sophia’s dream, by the way!)   Baby is born, and for a second there they thought it was a boy! Side note, babys have pretty swollen genitals when they’re born. After a second look, the midwives announced with joy that Fiona, a beautiful baby girl, had arrived! Caitlin decided to do a delayed cord clamping, in case you’re interested, because that can help baby have more time to start breathing in case that’s a concern.   Then that was that! They cut the cord, Caitlin delivered the placenta (eventually), began to nurse her baby girl, and life continued! The placenta was huge (common with PCOS pregnancies) but caitlin’s was extra huge since she had a big blood clot attached to it. 

Here comes a special one! This episode features fellow dietitian Ayla Brammer, owner of Boston Functional Nutrition and creator of Full Circle Prenatal! Caitlin and Sophia both use this prenatal for themselves, and recommend it frequently in their private practices.   Ayla shares the roots of her practice and how she came to be the powerhouse dietitian she is now. She also works in pregnancy and preconception, but her passion is working with couples when they are first starting their journey to become parents.   Ayla shares her thoughts on one of the most common pieces of fertility advice shared by OBGYN and RE docs alike… “Lose weight before you get pregnant”. Of course we hate this blanket advice and don’t see it as helpful to women who want to be moms; but Ayla takes it a step further. Rapid weight loss is never a good idea, but when you’re trying to become pregnant, it’s even harder on your fertility systems. Our fat reserves can contain toxins and other dangerous compounds that we do not want to be rapidly circulating throughout our bodies. Remember that one tree in Ferngully, that had the weird evil smoke in it? Fat stores can be kinda like that.   Though some women do see some positive changes when their weight is stabilized, all 3 of us dietitians see the preconception period as a time to fill your body with nutrients, vitamins, and minerals with the right foods; not slashing and restricting everything in the name of weight loss. Our focus tends to be more on how to get your nutrients absorbed and kept, versus how to make your body smaller in order to somehow change your fertility.   Ayla explains some of the functional lab testing she uses in her practice. She’s an advocate of a comprehensive vitamin and mineral assessment to show patterns and gaps in the way your body is processing what you eat. This can also reveal stressors, genetic abnormalities, and other anomalies that impact your ability to get pregnant. Hormone and stool tests are also important tools to getting your body ready for pregnancy.   The girls talk about their pregnancies and nutrition choices while pregnant for a while, so if you’re not ready to listen to a pregnant story, skip from 17:30-22:30.   Ayla lists her 3 favorite foods for the preconception period! Ayla’s fertility curry - lots of veggies, protein, and nutritive spices Stinging Nettle Leaf Tea - very high mineral and easy to drink! Sophia’s husband isn’t a fan of her giant bag of nettle leaf taking up space in the cupboard, but it’s great for you! Liver - we all love/hate it. It’s so nutritious, but the taste is rough. Hide this food in meatballs, meat sauce, burgers, taco meat, etc. A little goes a long way.   If we are losing you on the liver, you’re not alone. Each one of us grew up on pizza and freezer waffles, so it was hard for each of us too! Please don’t try to just eat boiled liver. We want you to enjoy your food, and not choke down whole mouthfuls of liver. Start by hiding little 1oz portions of liver in ground beef dishes.   On to Ayla’s specialty creation: Full Circle Prenatal Vitamins!   The Full Circle prenatal is the best on the market for most pregnant women. One of the things that sets it apart is the Vitamin D content. This is slightly controversial, but Ayla made this leap since she is an RD and really sees the importance of Vitamin D in pregnancy. Vitamin D is vital for ovulation as well, so taking a prenatal like Full Circle while TTC is a great idea. PCOS sister especially need to test and treat their Vitamin D levels, as none of us have ever seen a PCOS patient who also have adequate levels of this vital nutrient!   Full Circle also has much more iodine than other prenatals. Ayla shares that this was a deliberate choice to put her vitamin in line with the optimal supplement in pregnancy recommendations from most major medical associations. A huge number of women don’t get enough iodine, especially when women aren’t eating dairy. Iodine isn’t only important for pregnancy, but it’s important for thyroid function in the preconception period and for postpartum. Iodine can also be found in fish and seafood, even sea vegetables like nori and other seaweeds.   Choline is another star of these kick-butt prenatals! Some folks are taken aback by the 8-capsule dose of these prenatals, but the reasons the serving size is what it is is for choline. If you look at other prenatals, you’ll see only a fraction of the amount that you’ll find in Full Circle. It’s a bigger nutrient, so it takes up more space. 95% of women aren’t consuming adequate choline; and it’s vital for fertility too. Choline is needed heavily for the processes of early pregnancy and to develop healthy eggs for quality ovulation. Yet another reason why we here at the FFF podcast looooooove Full Circle! Choline can be found in food too; mainly in beef liver and egg yolks. However, you’d need to eat a TON of egg yolks to get everything you need in preconception and pregnancy without supplementing with a product like Full Circle.   Ayla then touches on why her supplement isn’t “real food” based. Listen, we are dietitians and OBVIOUSLY we stake our careers on using food as medicine… yet here we are recommending a prenatal that isn’t made entirely from real food sources. Heres why:   Concentrated and dried veggies don’t give you that much nutrition per volume. A concentrated and dried spinach leaf gives you a teeny amount of nutrition compared to actually eating real food! When you buy green food powders or food based pills, you’re getting only a very small amount of fruits and vegetables per dose. Full Circle’s goal is bioavailability - what will your body absorb and use? Often, the “real food” version won’t give you enough of what you need or can absorb. Ayla hand-picked each nutrient in this supplement to ensure you’re getting enough of what you need, and in forms that can be readily absorbed.   Full Circle also does not contain iron, a controversial choice! Ayla explains this choice through explaining the variable iron needs during preconception, pregnancy, and postpartum. Not all women need iron, while some need a lot of it. Iron also has a lot of side effects and poor absorption in supplement form. Iron also can limit your absorption of other nutrients, and vice versa. Ayla chose to leave this nutrient out so that the rest of the nutrients can be absorbed well. If you need additional iron, it needs to be either eaten in food or taken at a different time of day from your prenatal vitamins.   Ayla gets a lot of questions and scrutiny for this choice, but she stands behind it. Developing this product has been very difficult, but Ayla is so proud of what she has created. Caitlin and Sophia are certainly glad she’s braved this world since they both take this supplement themselves.   So now the burning question on everyone’s mind… Why NOT a gummy?? Ayla explains that in order for gummy vitamins to be tasty, they skimp on nutrients while loading up on sugary syrups and flavors. Not conducive to actual preconception health! If you compare any gummy vitamin to Full Circle Prenatal, you’ll see just what we mean.   Ayla shares a message of hope; so many women get empowered and find their fertility through better nutrition and getting to the root causes of issues. If you’re feeling like you’re on the conveyor belt at your fertility center, it’s time to reach out to practitioners like Ayla, Sophia and Caitlin!   A big thanks to Ayla for stepping into the challenging supplement market, making a great product, and coming onto our show to share all her goodness!   If you want to try Full Circle Prenatal for yourself, use the code FFF10 at checkout for an exclusive 10% discount!

PCOS is treatable! Here’s how to start:   Personal Baseline: What do your labs say? What symptoms are you dealing with? Have you had any imaging done? These are all the first things to start looking at when it comes to PCOS. It’s important to note that while Caitlin and Sophia love working with women with PCOS, and we have many years of experience, we are dietitians, not doctors. We don’t diagnose!   So what to do with nutrition:   Balance blood sugar Make sure that there is a higher quality and quantity of protein at each meal and snack “Quality” means it’s not inflammatory and provides more protein than it does any other macronutrient. Examples: meat, cheese, nuts, and seeds Most women with PCOS tolerate high protein dairy products like greek yogurt, cottage cheese, and cheese! SOME women do have fewer symptoms when they eliminate gluten and dairy, but it’s not the magic answer to PCOS management that it’s often believed to be Not everyone needs to be dairy free! Veggies, fruits, nuts, and seeds are your best sources of fiber! Pro tip: artichoke hearts have a ton of fiber! Fiber is great at filling your plate and filling your belly! You’ll find that you get to eat a lot of food while managing your PCOS Eating real food, vs. a protein bar or shake will keep you full for longer. It will help you slow down and feel full, versus slamming down a protein bar in under a minute To succeed, you have to eat enough to feel full! Fiber and protein are keys in making that happen FIBER! Starting your day with nutrients and blood sugar balancing protein! Even though it might seem like a lot of calories to have 3 egg scrambled with spinach and feta, a slice of toast with nut butter, and with a cup of coffee; you will feel full for so long and it will keep your blood sugar steady for hours! Swapping sweet for savory when possible. Eating sweet makes you crave sweet! It’s not your fault, its PCOS! Eating the right fuel first thing in the morning will keep your cravings at bay. Breakfast Try cronometer.com! Plug in what you’re eating and let’s look at your vitamin/mineral/fiber intake in a day! Sometimes you can be eating “healthy” but missing key pieces for PCOS fertility Take a peek at your protein/carb ratio! Typical American diets can have way more carb to protein than is helpful for PCOS fertility Check out your current nutrition status Keto, Atkins, and other super restrictive diets are not needed to boost fertility with PCOS Food is slow medicine; sometimes it takes several months of eating right to balance your cycles and get pregnant! You need to do something that can be sustained long term, not another crash-diet plan. Sustainability Supplements Remember to check with your doc!! Some of these supplements can interact with medications or are contraindicated for certain medical issues. Is there insulin resistance present? How about high testosterone? Or high stress? How’s the thyroid? That’s where we start to dig into what supplements can help. We recommend myo-inositol and not d-chiro. PCOS ovaries can make too much d-chiro, so we are careful not to exacerbate that Inositols Helps improve insulin sensitivity and can boost egg quality, plus helps you make great cervical mucus NAC Another powerful blood-sugar/insulin supportive supplement Berberine Wherever you live in the world, most of us are vitamin D deficient. As levels of vitamin D rise, insulin resistance lowers! It’s also important for maintaining a healthy pregnancy! Vitamin D Support egg quality and improve insulin resistance Zinc Common mineral of deficiency in PCOS, helps with gut health, insulin resistance, and ovulation Magnesium You don’t want to wait until you’re pregnant! Start on a quality prenatal ASAP! (And stay tuned for our episode on prenatals dropping soon!) Prenatal We’re here for the omega-3’s! Omega-3’s are essential fatty acids that are vital for reducing inflammation and supports your body in building new tissues. Eggs, endometrial lining, and babies are all new tissues your body grows! DHA/EPA are the omegas you want! Don’t be seduced by algae oils! They don’t have the same DHA/EPA ratios as fish-based supplements Fish oil Movement and Exercise Sleeping 6-7 hours vs. 4-5 hours is a game changer for PCOS Blackout curtains or a sleep mask can help you stay asleep longer. Here is a link to Sophia’s fave sleep mask Meditation apps and sleep stories can help you quiet your thoughts and get into a deeper sleep Blue-light blocking glasses can help if you’re using screens prior to bedtime Sleep environment is key Sleep and stress management Many times women with PCOS have been told to lose weight in order to get pregnant, that they’re total exercise junkies! All that effort can be misplaced when it’s cranking up your stress hormones and stressing your immune system If you’re dreading your workout and coming up with every excuse not to go, find something else! Keep your own body in mind - if you’re 280 pounds, putting weights on your back and trying to squat is only going to put more strain on your body. Bodyweight exercises can be a lot more helpful! Cardio isn’t always the answer. Strength training and resistance workouts can do wonders for building muscles and changing insulin Find something that you like Stretching and breathing can lower your stress and help your body relax. Quality ovulation is dependent on your body feeling safe enough to become pregnant. Lowering stress hormones can be a big key in this Yoga Exercise Check out Caitlin's program: Find Fertility with the PCOS+ Method. 

Who wants to hear all about PCOS and fertility??   Well you came to the right place! In this episode, Caitlin and Sophia dive in to the #1 most common cause of fertility struggles in women: PCOS   So… what is it?   PCOS is an endocrine problem, meaning it is a hormone imbalance. It used to be thought of as a gynecological problem, but as science has advanced we now know PCOS goes beyond female sex organs.   Dietitians like us actually cannot diagnose PCOS, though both Caitlin and Sophia often have women come to them for fertility help, and when we send them back to their doc for some testing it’s discovered that they DO have PCOS.   PCOS is diagnosed using certain criteria (Rotterdam Criteria), and it’s more of a culmination of signs and symptoms. The symptoms your doctors typically look for are:   Cystic ovaries - ovaries with multiple cysts diagnosed with ultrasound High androgens - Testosterone, DHEA-S, Androsterone, etc. elevated higher than normal for women Excess body hair Male pattern baldness Lack of/delayed ovulation - your cycles are very irregular and ovulation is rare or absent   Caitlin was a mere teen when she was diagnosed with PCOS, and when she innocently asked her doc what this meant, his cold reaction was “PCOS is the #1 reason women can’t get pregnant”. Which, by the way, is a HORRIBLE thing to say to anyone, let alone a teenager!   **If you only take one thing away from this episode, let it be know that PCOS is NOT an infertility diagnosis! If left untreated, PCOS can certainly impact fertility; but PCOS is very treatable! This diagnosis does not mean you will never be a mom!!!!!**   Treating the factors that influence PCOS greatly increase your chances of getting pregnant!   So, what if you simply suspect you may have PCOS?   Cycles longer than 35 days Acne Hair loss Body hair growth Difficulty losing weight Excess weight around your belly How does PCOS affect fertility?   If you’re ovulating every 28-30 days or so, you’ll have roughly 12 chances to get pregnant in a year. If you, someone with PCOS, only ovulates every 50-60 days, you will have far less chances to get pregnant in a given year.   Why does this occur?   Almost always, the root cause of PCOS has something to do with insulin resistance. In simple terms, this means your body doesn’t manage your blood sugar well. Insulin is a hormone that moves the sugar/fuel in your blood into your body’s tissues and cells. Insulin resistance is where your body stops listening to the message of insulin, requiring your body to crank up the volume on insulin to get the job done. This causes ovaries to get overstimulated, increasing testosterone and other male hormone levels; causing many of the symptoms of PCOS   Brains are greatly affected too. Your brain has glands that make hormones that control ovulation. In healthy bodies, your brain makes a surge of luteinizing hormone (LH) and follicle stimulating hormone (FSH) just before ovulation. In bodies with PCOS, these hormones kick into high gear far too frequently as your body tries and tries to ovulate. This is why it’s so helpful to get lab work done so we can address exactly what is happening with each of these hormones.   Brains also make a hormone called prolactin. When prolactin is at its best, it helps nursing moms make milk for their babies. Part of the overstimulation of the ovaries and brain that come with PCOS cause your brain to make too much prolactin. High prolactin is good if you’re nursing a baby because it also tells your ovaries not to ovulate, since your body is still sustaining the life of the baby you’re nursing. However, if you have PCOS and your prolactin is too high, this hormone holds off ovulation and makes it harder to become pregnant.   Estrogen is also higher in many women with PCOS. This, again, can be because your body is trying and trying to ovulate. Estrogen can also be too high due to excess body fat, a piece of the cruel cycle of PCOS. Estrogen being too high is particularly problematic when it comes to the hormonal rhythm of ovulation. When estrogen dominates other hormones (like progesterone), many of the symptoms of PMS/PCOS are amplified. Migraines, cramps, anxiety, heavy bleeding, etc. are all symptoms of high estrogen to progesterone.   The last noteworthy hormone of PCOS is cortisol, the stress hormone. This hormone causes blood sugar to rise and thwarts the function of insulin, making your body naturally more insulin resistant. This is great if you’re in the midst of a bloody battle; not so good if you’re overwhelmed by the daily stress of life. While we cannot change the stressors that occur in your life, we do help each of our patients manage stress and react to stress differently.   These hormones are why both Caitlin and Sophia both do functional hormone testing as a part of their practices! We want to target your specific symptoms and root causes! No two women are the same, and there is no way to say simply by looking at symptoms what each of your hormones are doing.   This is also why advice from medical professionals that sounds anything like “lose some weight” is so infuriating! It’s not only unhelpful, but it’s psychologically damaging. Remember, one of the symptoms of PCOS is excess weight in the midsection. So, it’s not helpful to be told the very symptoms you’re there to address is same as the treatment.   ** Cue Sophia rant about doctors telling women to lose weight **   Another great test to run is an insulin assay. This includes a 2 hour glucose tolerance test and measuring insulin markers like the Homa-IR test   These labs we all mentioned are tests that Caitlin and Sophia use all the time in our practices! However, this is not a comprehensive list of all the hormones and tests to look at with PCOS. Even if you have done all this testing, and you still can’t figure out what’s up; don’t give up! There are more stones to overturn and Sophia or Caitlin are poised and read to help you get some answers!   What could happen if you go to the OB/GYN and say you want to get pregnant with PCOS Get a full panel of labs on varying dates of your cycle Your doc might give you Metformin (glucophage) and are told to come back in a few months if you’re not pregnant Your doc might also give you Clomid (clomiphene) or letrozole to try and trigger ovulation   You might also be simply told to lose 10% of your bodyweight… which is not helpful, as we’ve established.   Stay tuned to next week’s episode where we talk about REAL LIFE SOLUTIONS to PCOS fertility struggles! Tune in and be amazed.

If you are interested in trying this test for your family, use our FFFpodcast15 code to get 15% off your entire shopping cart from YoSperm.com What is fertility like from your man’s perspective? Our guest Eric from Yo Sperm gives his insights into at home sperm testing, in office semen analysis, and the male mind when it comes to fertility testing. This is one of our most valuable and interesting episodes yet! Yo Sperm is an at-home semen test. It’s fully private and works with your smartphone, revealing sperm count and motility from the privacy of your own home. The kit costs far less than a laboratory analysis, and can be repeated over time to see how your man’s semen changes. Not to mention you can forgo the clinical experience and crusty issue of Hustler from 1998. Eric from Yo Sperm talks about the benefits and drawbacks of at home semen testing, as well as options if your results come back as abnormal. Though Yo Sperm is not a replacement for a full clinical semen analysis, it can be a great place to start! You can order the kit yourself anytime, no need to wait 6-12 months for your doc to give you the go-ahead. The system works remotely with 100% privacy and confidentiality. Your results are even compared to other men who have fathered children. This episode then goes into the heart of the matter. WHY are so many of our male partners obstinate about getting a semen analysis? What makes men so reluctant to do this simple test, when women’s fertility testing is so much more expensive and invasive? Eric dives in and gives us a man’s perspective on why this is such a big deal for some men. While semen quality is NOT a reflection on masculinity or viability as a man, it IS a reflection of your overall health. Addressing semen quality issues can bring nutrition and lifestyle issues to light! Semen quality is not static. Your partner’s semen quality can change drastically with proper nutrition, exercise, and lifestyle changes. Even if your results aren’t amazing, don’t fret! There are so many things we can do to impact the quality of your man’s semen! Heavy hitters that impact semen quality are: Obesity/body composition Processed food/fast food Alcohol Tobacco Cannabis Testicular temperature (think cyclists, horseback riding, and working for hours in high heat) Anabolic steroids Testosterone replacement therapy Hair loss treatments and medications Stress Illness The Yo Sperm results page also gives recommendations about nutrition, exercise, and sexual health! All of these things can impact your semen quality, and even though there is no dietitian or doctor reviewing the Yo Sperm results, these recommendations are generally safe and effective for most healthy men. So, what about when it is time to bring some doctors and clinicians? Eric goes into the details of how semen analysis labs measure things like semen volume, DNA fragmentation, motility, sperm progression, morphology, shape, etc. Yo Sperm only gives a baseline analysis, and anything more nuanced needs to be done by a medical professional. Fertility is nuanced, and we want you listeners to feel empowered that there is a lot that can be done with nutrition and lifestyle to boost fertility and improve chances of conception. So how do you get your hands on one of these sweet Yo Sperm tests?? Ebay, Amazon, and directly through Yo Sperm are online options to get this test. Plus they ship internationally! Anyone, anywhere can test their semen quality and begin finding some answers. If you are interested in trying this test for your family, use our FFFpodcast15 code to get 15% off your entire shopping cart from YoSperm.com

Again, we know the audio quality on this episode is less than our usual. It should be back to easy listening next week. Thanks for your patience.  We have a MAN on the show! Our first man on the FFF podcast is Sophia’s husband, Louie. In this episode he shares the hilarious and honest details of sperm collection! NOTE: The audio on this isn’t the best, but we PROMISE you it’s worth it for how funny and informative this episode is! Louie opens by sharing with us WHY he went to the sperm cryopreservation bank in the first place. Since he is active duty military and deploying to combat zones, our local San Diego cryobank does a great service to active duty families by discounting their cryopreservation services! Unfortunately, military members tend to be guinea pigs, and sometimes years and years down the line we find out that the meds/exposures/chemicals/etc actually harm fertility. Military members are exposed to toxins, radiation, and dangerous situations that can damage your ability to reproduce. Sophia and Louie decided to take advantage of this wonderful program and store some of Louie’s goodness before he left on deployment. For them, it was like an extra layer of insurance making sure that there would be healthy sperm available set aside in the event that something catastrophic occured to Louie while in the line of duty. First thing first was to run some tests on Louie to make sure his reproductive system was healthy. Cryobanks want current info on HIV/STI tests, as well as other things. Louie HATES blood draws, and he recommends doing he blood draw a few days in advance to reduce added stress on the day that you make your sample(s). For him, the stress of a blood draw really impacted his ability to climax and produce a sample. Of course he pushed through and made it happen in spite of the looming needle-poke, but it wasn’t easy! Listeners, we CANNOT STRESS THIS ENOUGH: test your semen early! Things happen, and it’s not always possible to make a quality sample on the first go! Sophia and Louie had a looming deployment date and didn’t discover the cryobank benefits until just before Louie had to leave. So, they were on a tight deadline that put added stress on Louie. If that is NOT your situation, go as early as possible in your TTC journey to ensure plenty of time to spread things out and get the best possible sample! It’s important to note that before you go in to make your sample, you need to abstain from sex or anything that could result in ejaculation for 2-5 days before you go to the cryobank. You also need to avoid any hot baths/jacuzzis/sauna/etc. As well as trying to avoid stressful situations. Stress greatly impacts your semen quality and volume. This can put an extra pressure on men! When you’re TTC, it’s all about whether or not the man can orgasm. Women can get pregnant from sex whether or not they climax, but if the man doesn’t orgasm and ejaculate; no joy. The clinic we went to was a fully functional urology office! Turns out this clinic is also the urologist for the local men’s penitentiary! Louie was busily focused on his paperwork while a parade of shackled convicts were streaming through the lobby. Sophia was VERY uncomfortable, but thankfully Louie never looked up from his paperwork and was totally oblivious. The sample collection room was clean… but it made you feel dirty! There was a creepy recliner that was made of some kind of material that could be easily wiped. Also, a stale collection of pornographic magazines from the late 90’s. Important to keep in mind: the skin of the penis must be sterilized with wipes, and absolutely no lubricant, lotion, salvia, or vaginal secretions can be present. Though Sophia initially went into the sample room with Louie, this ended up not working out when Sophia had to run down to the truck and get Louie’s headphones.  Other recommendation: bring headphones! The walls are THIN in these cryobanks, and it’s hard to reach climax when you can hear doors opening and closing, clinicians talking, and other distractions. This is all mixed with the fact that you’re told again and again to “try and relax” because samples are greatly affected by stress. Miraculously, Louie was able to make a sample while Sophia was running down to get the headphones! After the sample was produced, the clinician analyzed the quality and told Sophia and Louie about it in the most AWKWARD way possible! Lo and behold, Louie’s sperm were healthy and his semen quality was stellar! Praise the Lord! Next, you have to decide what you want to do with the sample. For instance, samples that will be used for at home insemination or IUI are processed differently than samples destined for IVF. Because Sophia and Louie didn’t have time for extra samples, they decided to preserve the sample for IVF, since the sample was only enough for 1 IUI vs. 4 IVF cycles. After ALL of this, Sophia and Louie found out they could have done a home collection! Facepalm. If you’re like them, and you prefer the comforts of your own home, do the dang sample at home! As long as you can get it to the clinic within an hour, your sample can be successfully collected at home and used. Something important to note is the legal side of cryopreservation. If you are using the semen right away, or simply analyzing it to see if babies can be made from that sperm; it’s not an issue. If you’re freezing it for future use, a lot of other legal factors can arise. It could be worthwhile to sit down with your lawyer and go over the paperwork prior to the sample to sort out any issues that could arise down the line. Again, that’s only if you’re planning to freeze the sample for future use like Louie and Sophia. In this episode especially, we take plenty of time to laugh and make silly comments about fertility, sperm, and masterbation. We do this because fertility struggles are HARD! We believe that laughter is medicine, so though we fully embrace the sorrow and anguish that can come along with struggling to conceive, we want to make the process more enjoyable by finding ways to laugh. 

Sperm Quality -    Hang with us, the audio quality of this episode isn’t our best, but we have great information for you.    We all know that sperm is essential to creating a baby. This episode is all about helping your partner have the healthiest sperm to contribute to the party.    About 13% of the population has fertility struggles. About 30% of the cases of infertility are estimated to be male factor infertility. Could be too small of numbers, can’t swim, weird shape, genetic issues. Reflux, sperm not going into the urethra in ejaculate, but spilling back into the vas deferens, obstructions.  Female factor infertility can be unexplained infertility, anovulation, insufficient progesterone, eqq quality issues, immune system issues, blood clotting issues.     How would you know if it is a female factor or male factor or both? Get seman analysis done to rule out if something is going wrong. Sperm count, motility, morphology, and volume of ejaculate.    Sperm count - how many per unit volume Motility- Are they moving normally? Morphology -percent of sperm that have normal shape   Sperm count has dropped 33% over the past 50 years worldwide. The y chromosome is also shrinking, what?!   Have no fear listeners! Diet and lifestyle can have a huge impact on sperm quality.   Cantaloupe is shown to help increase sperm over-all quality. Across all studies, fruit and veggie intake , especially leafy greens. It’s not shocking as we return to whole foods, that sperm quality improves.   Higher exposure to pesticides affected sperm quality in a study. Don’t let this discourage you from eating fruits and vegetables. Eating conventional fruit and vegetables will always trump eating a bowl of sugary cereal for a snack before bed. When possible consider the clean 15 and dirty dozen when making decisions on organic versus conventional grown produce.  Everything but the bagel recipe knock off.  Yummy on eggs.    Food prep may be the key to help intake of snacks and meals that are healthier for sperm quality.    A lot of the vitamins in veggies are better absorbed when eaten with fat, so don’t be afraid to saute in oil, add cheese on top, or some avocado on the side.    High fat processed meat products are good to limit in the diet. Sourcing good quality meat, eating nose to tail, eating organ meats, can be very helpful in consuming enough vitamins. Organ meat consumption offered better concentration, better morphology, better sperm count, better motility, and ejaculate volume in studies. We know eating organ meat is something that is pretty abnormal in modern cultures, but getting back to eating more “nose to tail” - making use of all of the animal that you can, will improve health factors for both fertility partners.    Liver has a lot of iron and zinc, both very helpful for sperm quality.   Most people don’t even know how to source liver. You can source liver at: https://grasslandbeef.com/ (US Wellness Meats). We are NOT SPONSORED by them. You can also ask a local butcher or find at a local health food store like “whole foods”. I like to buy it frozen, then grind in my food processor, and save in 1-2 tbsp servings.    Cooking at home can help you save money and get better food than you will have at the drive-thru.    Fish - in and of itself is healthy. Can have some pollutants to the table. The omega-s are healthy for sperm. So try to source quality fish when consuming it while trying to conceive.  43:40   Milk and dairy are controversial topics. The research shows that high fat dairy has benefits in terms of fertility for females. It is suggested that high fat dairy intake might be related to sperm quality, and skim milk might be better. May not be beneficial to be drinking milk period. Having things like cheese on veggies, yogurt, cottage cheese could be good options.    Alcohol can have a negative effect on sperm quality. Decreasing drinking and especially binge drinking can help improve sperm health parameters.    Tobacco, chewing, smoking, even vaping will all negatively impact sperm quality. This is a great opportunity to help improve sperm quality, and overall health for a new dad. No better time than now to kill the tobacco habits.    Sugar and sugar sweetened beverages are not great for sperm. Obesity and extra weight are also negatively impacting sperm health. Decreasing intake of sugar, sodas, desserts will help impact sperm health.    If erectile dysfunction is something is affecting your ability to even have sex or have an ejaculation, it’s important to see your physician to get help with that. There is no shame in getting assistance when needed.   Supplements can be supportive. Antioxidants can be helpful to protect sperm from oxidative damage. Fish oil or omega-3 can be helpful to add in. Adaptogenic herbs can also be helpful during stressful times like ashwagandha. 

Hang with us, the audio quality of this episode isn’t our best, but we have great information for you.    We all know that sperm is essential to creating a baby. This episode is all about helping your partner have the healthiest sperm to contribute to the party.    About 13% of the population has fertility struggles. About 30% of the cases of infertility are estimated to be male factor infertility. Could be too small of numbers, can’t swim, weird shape, genetic issues. Reflux, sperm not going into the urethra in ejaculate, but spilling back into the vas deferens, obstructions.  Female factor infertility can be unexplained infertility, anovulation, insufficient progesterone, eqq quality issues, immune system issues, blood clotting issues.     How would you know if it is a female factor or male factor or both? Get seman analysis done to rule out if something is going wrong. Sperm count, motility, morphology, and volume of ejaculate.    Sperm count - how many per unit volume Motility- Are they moving normally? Morphology -percent of sperm that have normal shape   Sperm count has dropped 33% over the past 50 years worldwide. The y chromosome is also shrinking, what?!   Have no fear listeners! Diet and lifestyle can have a huge impact on sperm quality.   Cantaloupe is shown to help increase sperm over-all quality. Across all studies, fruit and veggie intake , especially leafy greens. It’s not shocking as we return to whole foods, that sperm quality improves.   Higher exposure to pesticides affected sperm quality in a study. Don’t let this discourage you from eating fruits and vegetables. Eating conventional fruit and vegetables will always trump eating a bowl of sugary cereal for a snack before bed. When possible consider the clean 15 and dirty dozen when making decisions on organic versus conventional grown produce.  Everything but the bagel recipe knock off.  Yummy on eggs.    Food prep may be the key to help intake of snacks and meals that are healthier for sperm quality.    A lot of the vitamins in veggies are better absorbed when eaten with fat, so don’t be afraid to saute in oil, add cheese on top, or some avocado on the side.    High fat processed meat products are good to limit in the diet. Sourcing good quality meat, eating nose to tail, eating organ meats, can be very helpful in consuming enough vitamins. Organ meat consumption offered better concentration, better morphology, better sperm count, better motility, and ejaculate volume in studies. We know eating organ meat is something that is pretty abnormal in modern cultures, but getting back to eating more “nose to tail” - making use of all of the animal that you can, will improve health factors for both fertility partners.    Liver has a lot of iron and zinc, both very helpful for sperm quality.   Most people don’t even know how to source liver. You can source liver at: https://grasslandbeef.com/ (US Wellness Meats). We are NOT SPONSORED by them. You can also ask a local butcher or find at a local health food store like “whole foods”. I like to buy it frozen, then grind in my food processor, and save in 1-2 tbsp servings.    Cooking at home can help you save money and get better food than you will have at the drive-thru.    Fish - in and of itself is healthy. Can have some pollutants to the table. The omega-s are healthy for sperm. So try to source quality fish when consuming it while trying to conceive.  43:40   Milk and dairy are controversial topics. The research shows that high fat dairy has benefits in terms of fertility for females. It is suggested that high fat dairy intake might be related to sperm quality, and skim milk might be better. May not be beneficial to be drinking milk period. Having things like cheese on veggies, yogurt, cottage cheese could be good options.    Alcohol can have a negative effect on sperm quality. Decreasing drinking and especially binge drinking can help improve sperm health parameters.    Tobacco, chewing, smoking, even vaping will all negatively impact sperm quality. This is a great opportunity to help improve sperm quality, and overall health for a new dad. No better time than now to kill the tobacco habits.    Sugar and sugar sweetened beverages are not great for sperm. Obesity and extra weight are also negatively impacting sperm health. Decreasing intake of sugar, sodas, desserts will help impact sperm health.    If erectile dysfunction is something is affecting your ability to even have sex or have an ejaculation, it’s important to see your physician to get help with that. There is no shame in getting assistance when needed.   Supplements can be supportive. Antioxidants can be helpful to protect sperm from oxidative damage. Fish oil or omega-3 can be helpful to add in. Adaptogenic herbs can also be helpful during stressful times like ashwagandha.   

Sophia and Lily jump right in and talk about their inner nerds and how easy it is to fall “down the rabbit hole” when digging in to juicy nutrition research.   First order of business is Folate vs. Folic acid. What’s the difference and what’s the big deal? Well first off, folic acid is synthetic folate. If you’re a nerd like us, you may know that folate comes in many forms in food. Folic acid never comes in food and it can actually block 40-60% of the population from using folic acid! Not only that, it can block you from absorbing the good stuff from your food. NOT ONLY THAT, but the gene mutation that makes this happen is called MTHFR. That stands for methylene tetrahydrofolate reductase… but let it be known it can be a real MTHF**R when it comes to absorbing nutrients.    So… why is folic acid added into food anyway? Short answer… it’s cheap. Food manufacturers and supplement companies don’t want to cough up the dough for the good stuff. Of course, you can avoid it all by simply avoiding refined grains and cereals! Done and done.    Sophia and Lily then debunk crazy nutrition myths in regards to pregnancy and conception nutrition.    Myth #1 - Eat fortified cereal for a healthy baby   Truth #1 - You can’t find the same amount of nutrients in refined grains as you can in whole, let alone in comparison to other whole foods. The #1 indicator of poor nutrient intake is high intake of refined grains. Eating a lot of bread, crackers, and pasta means you’re eating less fish, eggs, berries, and greens. Not to mention the impact that refined foods have on your blood sugar.    Myth #2 - Cereal is a breakfast food   Truth #2 - grains in cereal are primarily carbohydrates. Mixing cereal with milk or yogurt only increases the carb load. Mix in some fruit beyond that and you’re looking at one sitting that consists of ½ the carbs you need for the whole DAY! Physiologically, everyone who eats a meal like this will see a massive blood sugar spike. Research shows that when you start your day with a carb rich breakfast, you will eat more food and have stronger hunger signals for the whole day! Eating a fat and protein rich breakfast does the opposite, even if the fat/protein breakfast has more calories than that of a carb rich breakfast.    Mental health issues can also be abated by eating a protein and fat rich breakfast. It primes your brain to be happier and more balanced all day long! Whereas a carb rich breakfast is greatly associated with higher anxiety and deeper depression all day long. High carb breakfasts also include fruit smoothies! There are fewer things on planet earth that will spike your blood sugar more quickly than liquid fruit on an empty stomach.    If you want to have smoothies on an empty stomach, it needs to have 20+ grams of protein and 10+ grams of fiber while containing less than 20g of carbohydrates. And honestly, a smoothie with that profile doesn’t usually taste that good. Sorry to say but this includes that fancy bag of protein powder from your best friend’s MLM affiliation. Protein powders that taste sweet but are low in carbs contain artificial sweeteners. None of which are tested on fetuses or pregnant women. Though we do know that these sweeteners cause birth defects in mice so… let’s just say no to them for humans too.    Myth #3 - Eating only plants is best   Truth #3 - Listen, we understand all the arguments for and against consumption of animal products. We respect people’s choices. We never argue against people’s ethical and religious objections. However, there are significant nutrient gaps that strict vegan and vegetarianism can create. If you don’t eat animals, nutrients aren’t available in adequate quantities and concentrations to support fertility, pregnancy, and breastfeeding. These nutrients are choline, glycine, vitamin K2, iron, zinc, omega 3, and B12. Even if you eat these nutrients in a veggie-based way, you won’t be able to absorb them. The same goes for vitamin A. Even if you eat lots of beta-carotene, you can end up with deficient vitamin A without eating animals.   Supplements can help, but even great supplements don’t always have the right ratios, forms, and amounts of these nutrients to nourish the baby and the mother well. It’s not the same thing to take algae-based DHA, versus getting it from animal foods. We are just scratching the surface as far as what women need while TTC and pregnant.    Look, there’s a difference between knowing what’s best and choosing to eat plants-only because of your own preferences and eating plants only because you believe a lie that eating animals is bad for you. Nutritionally, it’s just not true that plants alone are best. However, we meet women wherever they are at, without judgement, and help them do what’s best for their lives as a whole.    Listen up though. When we say “plant based”, we are talking about the challenges of a vegan and vegetarian diet in pregnancy. We are not talking about NOT eating plants. We highly recommend that women eat lots and lots of plants! In fact, we recommend that you make your diet MOSTLY plants! We just know, from research, that eating animals and animal products in addition to plenty of plants is the best way to feed your body for fertility and pregnancy. Even though some people have seemingly been ok through a plants-only pregnancy; it’s just not best.    But here’s some good news for ethical vegans! Bivalve shellfish like oysters, clams, and mussels have no central nervous system and therefore do not feel pain. Plus, they are generally very sustainably grown and harvested. Many vegans decide to eat these foods while TTC or pregnant to boost their nutrition.   Myth #4 - Artificial sweeteners are better for you and they help prevent gestational diabetes by keeping sugars low   Truth #4 First off, this is the dumpster fire equivalent of nutritional advice. YOu might expect that eating something that provides no calories or sugar would be superior to something that does contain sugar and calories. However, it turns out our bodies aren’t so easily tricked. When it comes to artificial sweeteners, you actually can still raise your blood sugar in a similar way to as if you were eating/drinking sugar! This is due in part to how our bodies react to strong sweet tastes, and also due to the fact that these sweeteners greatly affect the bacteria in our digestive systems.    Sucralose, or Splenda, is one of the worst offenders on our gut bacteria. Sucralose also really affects thyroid function! Eww! Thyroid function is also really vital to healthy fertility before you get pregnant, and vital to your baby’s brain development after you’ve gotten pregnant.    There are also studies linking consumption of artificial sweeteners in pregnancy to childhood obesity! Women who consumed artificial sweeteners on a daily basis had bigger babies, and their children were almost twice as likely to develop obesity during childhood.    These sweeteners prime your taste buds and brain to crave more and more sweetness, which makes you in turn want to eat more sugar! We are fans of laying off the sweet flavors and letting your taste buds adjust back to nature.   Myth #5 Low carb diets are dangerous in pregnancy - 56:00   Gestational diabetes means carbohydrate INTOLERANCE in pregnancy. That means carbohydrate intake needs to be adjusted according to what your body can tolerate. With that said, we don’t have a lot of data on SUPER low diets during pregnancy (less than 40g of carbs per day), but Lily does recommend swapping higher carb foods for more nutrient-dense foods that has a higher nutrient-to-carb ratio. Unlike most health professionals, Lily is not afraid of ketosis or ketones in pregnancy. In fact, in all mammals, pregnant bodies use fatty acids and ketones MORE READILY than carbohydrates as fuel. Though this is a different conversation than we are having here, it's worth noting that eating low carb is certainly not something to be afraid of.    As dietitians when we put the MOST nutrient dense foods into a woman’s diet we find that she is eating at minimum 70-90g of carbohydrates per day. If you try to pull a daily diet lower than that, you start to cut out healthy foods to get to that point. Plus, we have to use our bodies and brains when planning diets for pregnant women. Meaning, in the beginning of pregnancy women usually have food aversions, taste changes, and appetite variations. It’s really hard to be low carb at the beginning of a pregnancy!   As far as fertility goes, the same rules apply. Limiting your intake of high carbohydrate foods and swapping them out for more nutrient dense foods boosts your ability to make healthy hormones. Swapping out leaner proteins (chicken breast) for the fattier and more nutrient-dense cuts (chicken thighs) can get your body ready to house a healthy baby. However, going through heroics to force down your carb and protein intake in order to induce ketosis has not been shown in research to help fertility or pregnancy. These kinds of diets are not supported by research and they’re largely not sustainable.    Let’s also keep in mind that what a lot of people call “low carb” or even “keto” is simply limiting refined carbohydrates and sugar while focusing on veggies and protein. We are all for diet changes like that! True low carb diets (less than 50g per day) or true ketogenic diets are very different from what your neighbor is describing as she eats a lettuce-wrapped burger with a side of sweet potato. 

Welcome back, listeners! Today we are having a chat with Lily Nichols, a kick-butt registered dietitian nutritionist who wrote Real Food For Gestational Diabetes and Real Food For Pregnancy. Here we learn about Lily’s work and research, her history as a dietitian, and get a nice sample of the wisdom and expertise she has to bring to women who are trying to get pregnant.    This episode starts off with Lily sharing with us her experience with the prenatal dietary guidelines. To sum it up: she’s not impressed with mainstream guidelines. Now she writes about how to actually feed yourself well while trying to conceive or pregnant, in spite of the messed up guidelines. If you don’t know what these guidelines are, Sophia clues you in. Basically RDA and other guidelines, like the ones you find on the back of a food container, are based on what is the minimum amount someone must consume to prevent a major deficiency. The research is done on adult men, and there is no consideration taken for women or people of other races or ages. Boo!   Lily promotes using REAL food to meet your nutrition requirements. She defines real food as unprocessed food made with simple ingredients, as close to nature as possible. Specifically, not processed in a way that removes nutrients. This means not stripping grains of their fiber to make them “refined. Not skimming the fat off of dairy, and not removing the skin or fat from poultry. You get more nutrition when you eat all the parts.   A lot of food in the American diet is not really “food”. Artificial sweeteners, thickeners, stabilizers, preservatives, etc. are made by food scientists to be “safe” to eat, though it’s not necessarily healthy. When we define REAL food, we are talking about what builds your body up with good nutrients, versus how much of a chemical or additive you can consume before it starts doing major harm. We also want to emphasize whole foods vs. isolating specific nutrients in a lab, and then trying to separate them from the rest of the food.   To clarify, we are NOT anti food science here on the FFF podcast! We know scientists have been involved in our food supply for centuries, and that a lot of the work they have done has been amazing! We are about food FREEDOM and fertility, meaning not limiting every food or only eating certain things. We just promote a natural diet of real food. There are very few foods that are 100% of the time a bad idea to eat, and according to Lily that list is limited to: refined carbohydrates and sugars and trans fats. That’s pretty much it!   So, what is it about all this “real food” stuff makes it helpful for women who are TTC? Lily says that all the ways that the primary factor is that increasing the provision of micronutrients in the diet. These nutrients play a strong role in hormone balance, detoxification, egg quality, regulating cycles, and more! Food is powerful, and getting yourself in a healthier place with better nutrient stores can help your body get ready for a pregnancy.    Sophia shares her experience at Bastyr University with helping the school adopt an omnivorous menu, and Lily shares how Bastyr School of Midwifery now uses her books as a part of their curriculum! How cool is that? In fact, both of Lily’s books are now available as book studies for dietitians worldwide to get their continuing education units!    Lily shares a bit of the praise and criticism she has received about her books. Pro tip: anyone giving anything a 1-star review on Amazon is generally someone who did not even read/use the product they’re reviewing. Good to know! It’s no mystery that on this show we are fans of informed consent. Traditional nutrition guidelines are built around the average consumer being too stupid/distracted/disconnected to make good choices. Information is deliberately withheld to keep from confusing people or making things “overly complex”.  I am sure this applies to some people, but we believe our audience (that means YOU!) is interested in learning, growing, and making their own choices. Lily details in her books what research shows is BEST when preparing for a baby, but it’s not hard and fast rules. When you’re empowered with knowledge, you can make whatever choices work best for you, your lifestyle, and your personal beliefs and preferences.    Lily reveals some tidbits she wishes she could have added into her books. One major one is a study on vitamin D. Women who have serum vitamin D levels over 40 have a significantly reduced rate or preterm birth! Boom! On this show, we are big fans of vitamin D, as both Caitlin and Sophia recommend their patients have vitamin D levels in the 50’s and 60’s. If you have pale skin, you can get vitamin D from the sun more easily! If your skin is dark, you’re going to have a harder time making it on your own without a supplement. Finally some good news for you folks who burn easily.   A major thank you to Lily Nichols, and thank you for listening!