As an integrative fertility specialist, my team and I help couples through their fertility journey with treatments and suggestions for lifestyle changes so they can start a healthy family.  In addition to state of the art technology to help my patients conceive, I can help patients prepare  their body and mind to maximize the chance of a successful pregnancy. This is referred to as integrative fertility. Here are some common questions I get from my patients.

Q: What should I eat to support my fertility?

A: The general nutrition principles for preconception are the same, whether you are trying naturally or going through fertility treatments. I usually recommend that prospective parents focus their diets on whole, fresh, and natural foods. Eat a lot of colorful vegetables and fruits, ideally, if you can get them locally and seasonally. Enjoy some nuts and seeds. 

Eat less meat. If you do eat meat or dairy products, choose organic because the non-organic ones can be high in pesticides and environmental toxins. Enjoy high-quality fish and seafood, but avoid high mercury ones, such as tuna and king mackerel. Also, cut sugary, fried, processed, canned, or prepackaged foods. 

Your nutrition plan should also take your health status into account, especially factors that led you to seek fertility treatment in the first place. For example, if you have polycystic ovarian syndrome (PCOS), you may do better with a lower-carbohydrate diet. If you struggle with PCOS or other conditions that could be treated with nutrition, I recommend working with a nutritionist to customize your diet program. 

Nutrition is one of the most important building blocks, both for pregnancy and raising children. I recommend cooking at home as much as possible so you can choose the ingredients that go into your food.

Q: What fertility supplements do you recommend?

A: When I see my patients during their preconception appointments, I use labs to identify nutritional deficiencies. Based on the labs, I help them get to optimal rather than just normal levels. Your bloodwork may indicate a need for therapeutic doses to achieve healthy levels of these nutrients. Many common nutritional deficiencies can affect fertility. 

Iron deficiency is widespread among women of reproductive age, and it can affect fertility ¹. 

Many North Americans are also deficient in vitamin D, which is important for fertility for both prospective moms and dads. A recent study found that among women seeking fertility treatments, those with healthy vitamin D levels had significantly higher live birth rates ². 

Magnesium is an essential mineral for general health, hormone balance, and pregnancy ³. It is also one that is harder to get through food alone. 

Folic acid is a standard recommendation for any prenatal regimes, although I now recommend methylfolate (MTHF) instead. 

Generally, a high-quality prenatal multivitamin with methylfolate, fish oil, magnesium, and vitamin D should cover your nutritional base. Antioxidants such as vitamin C and Coenzyme Q10 have also been shown to boost fertility for both genders. However, the best answer to this question would be to work with an integrative fertility specialist to optimize your nutrition status.

Q: What are natural ways to support my hormone balance?

A: Many women struggle with hormone imbalance symptoms such as premenstrual syndrome, acne, heavy bleeding, and fibroids. 

The modern diet and lifestyle expose us to a lot of substances that act like estrogen while depleting our progesterone. The good news is that you can fix much of the hormone imbalances naturally by:

• Managing stress – stress reduces progesterone, worsening hormone imbalance
• Using nontoxic home and body care products that are free of parabens, phthalates, and perfumes
• Eating organic meats to avoid pesticides and environmental contaminants
• Eating a lot of fiber and staying regular promotes hormone balance, as constipation hinder the elimination of old hormones 
• Filter your water with a filter that removes hormone disruptors. To learn about which ones I recommend, check out my resources page.

Q: Can we improve the quality of sperms and eggs without drugs?

A: During fertility treatments, it might look like the prospective moms do most of the work, but prospective dads can also do their part to maximize the chance of success. In other words, both partners can improve the quality of their sperms and eggs with these tips. 

• Managing stress. Don’t forget mental health and stress management for prospective dads, especially during fertility treatments. Couples counseling and stress management practices will come in handy during this time.
• Sleeping well is essential for hormone balance and reducing oxidative stress.
• Avoiding hormone disruptors and toxic exposures, including at work
• Eating a healthy diet with the rainbow color of plants to increase antioxidants
• Drinking less coffee. Excess caffeine intake may reduce sperm quality ⁴.
• Maintaining a healthy weight and exercising regularly
• Not smoking and reducing alcohol as much as possible 
• Making sure you consume enough zinc and folate. These nutrients are very important for the quality of both sperms and eggs, and overall pregnancy.
• Antioxidant supplements, such as CoQ10 and lutein, may be helpful for some couples.

Oxidative stress can damage the DNA and reduce the quality of sperms and eggs ^5,6. Therefore, these low oxidative stress lifestyle tips will improve the chance of having high-quality embryos.

The key to a fertility-supporting lifestyle is to build healthy habits and create a supportive network around you. If you’d like to schedule an integrative fertility consult, contact me today.

References:

1. Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Iron intake and risk of ovulatory infertility. Obstet Gynecol. 2006;108(5):1145-1152. doi:10.1097/01.AOG.0000238333.37423.ab

2. Chu J, Gallos I, Tobias A, et al. Vitamin D and assisted reproductive treatment outcome: a prospective cohort study. Reprod Health. 2019;16(1):106. doi:10.1186/s12978-019-0769-7

3. Tonick S, Muneyyirci-Delale O. Magnesium in Women’s Health and Gynecology. OJOG. 2016;06(05):325-333. doi:10.4236/ojog.2016.65041

4. Ricci E, Viganò P, Cipriani S, et al. Coffee and caffeine intake and male infertility: a systematic review. Nutr J. 2017;16(1):37. doi:10.1186/s12937-017-0257-2

5. Alahmar AT. Role of Oxidative Stress in Male Infertility: An Updated Review. J Hum Reprod Sci. 2019;12(1):4-18. doi:10.4103/jhrs.JHRS_150_18

6. Ruder EH, Hartman TJ, Goldman MB. Impact of oxidative stress on female fertility. Curr Opin Obstet Gynecol. 2009;21(3):219-222. doi:10.1097/gco.0b013e32832924ba

When women or couples experience challenges with fertility, they look for possible causes. While there may be medical reasons for a woman’s difficulties in getting pregnant, research has shown other factors such as stress and environmental toxins may also play a role. 

Many men and women encounter toxins in their personal care routines every day, often unaware of the impact these could have on their fertility.  Research has identified four primary areas of fertility that are impacted by toxins in personal care products. Learn more about these effects below. 

Endocrine Disruption and Reproductive Harm

The endocrine system is the body’s chemical messenger system. It is responsible for transmitting information that makes hormones. These hormones control everything from moods, growth, development, metabolism, and reproduction. 

Many cosmetics and personal care products contain synthetic byproducts such as parabens, phthalates, glycol ethers, fragrances, cyclosiloxanes, and bisphenol A (BPA).  These can act as endocrine disruptors causing interference with hormone signaling, production, and excretion. 

What’s In Your Personal Care Products?

An article by the Environmental Working Group cited women use an average of 12 products containing 168 unique ingredients every day. Men use about six products daily with 85 unique ingredients. Their study shows that some of the chemicals in personal care and cosmetic products have been linked to health problems.

The most common effects of exposure to endocrine disruptors appear to be reproductive and developmental effects. These include ovulation disorders, fibroids, disruption of thyroid function, male sexual dysfunction, low sperm count, possible link to cancer, and low birth weight in babies.

Common Toxins In Personal Care Products

• Parabens are perhaps one of the most common toxins added to personal care products as a preservative. They can act as estrogens and disrupt hormone signaling. They have been linked to potential fertility issues in men and women, congenital disabilities, a link to breast cancer, as well as a link to more aggressive tumor growth and the formation of malignant cancers. Many moisturizers, facial cleansers, sunscreens, deodorants, shaving gels, kinds of toothpaste, cosmetics, and other personal care products contain parabens. 

• Phthalates are commonly found in some cosmetic fragrance mixtures, nail polishes, hairsprays, after-shaves, deodorants, and other personal care products like shampoos, conditioners, and moisturizers. Phthalates have been found to cause reproductive abnormalities such as reduced testosterone and sperm quality in men and early puberty in girls.

• Formaldehyde is a preservative commonly added to products to add to shelf life and prevent mold and bacteria growth. Nearly one in five cosmetic products contains a substance that generates formaldehyde, a known carcinogen. These products include shampoos, conditioners, bubble baths, and other personal care products, including those marketed for children. Formaldehyde and formaldehyde like chemicals are also found in hair straighteners and “smoothing” creams marketing for the BIPOC community. Exposure to formaldehyde can include risks of reduced fertility and increased risk to the fetus. 

• Triclosan and triclocarban are chemicals found in a variety of products.  Triclosan was banned in antibacterial soaps in 2017. However, they are still found in some dish soaps, personal care products, and toothpaste. It is used in a variety of products but won’t be on the label. To avoid triclosan do not buy products listed as antibacterial. Although this might seem tempting and should make things cleaner, its all harm and no good in this situation.  Even at low levels, these chemicals have been shown to interfere with thyroid signaling and male and female sex hormone signaling leading to reproductive abnormalities. 

Unfortunately, the cosmetic industry in the United States is largely self-regulated at this time, and there is not any restriction on the use of harmful chemicals in personal care products.. In February 2020, the California Assembly reintroduced the Toxic-Free Chemicals bill under A.B. 2762 which proposes banning 12 toxic ingredients, such as mercury and formaldehyde, from the beauty and personal care products sold in California. This is the third time such a bill has been proposed, earlier iterations of the bill being blocked in April 2019 and failing in January 2020. You can read about their efforts here. 

Toxins such as those listed are readily absorbed into your skin and metabolized by your body. Because you use these products daily, the exposure to such toxins compounds over time creating a greater effect of harm on your body. 

Defend yourself against toxins

Your best defense is taking the time to educate yourself about the products you use and making changes to clean products. Although this article specifically addressed personal care products, environmental toxins are all around us. To learn more and find out how you can reduce your exposure you can find additional references and articles here on our website.

To start educating yourself about toxins in your personal care products and other purchases you make, I suggest the Environmental Working Group’s website www.ewg.org.  EWG is a non-profit, non-partisan organization dedicated to protecting human health and the environment. They also have a database created specifically for products. Some are EWG Verified, meaning the products are free from harmful chemicals, provide full transparency in labeling, and follow good manufacturing practices. Other products rated on a scale from 1 to 10 indicating least to most harmful in terms of your health. You can enter your current products in the search in the Skin Deep Database and see how they measure up. 

Reducing or eliminating toxins in personal care products is one facet of integrative medicine we suggest to women and couples we work with at our clinic.  If you are interested in a consultation to see if integrative techniques can further support your fertility journey, contact me at Shala Salem, MD