In Episode 4 of the Fertility Journeys Podcast, Dr. Shala is joined by Lara Adler. Lara is an expert on environmental toxins, an educator, and a health coach.  

Here are some of the highlights of the discussion between Dr. Shala & Lara:

• Research on environmental toxins and what we now know about this topic.
• Information suppression by corporate interests, and how US policy around chemicals is different from other countries.
• Endocrine disruptors and the impact that they have on your hormones.
• Where to begin if you are experiencing infertility or wanting to get pregnant; how to limit your toxin exposure.
• Plastics, BPA, and considerations for removing them from your home.
• How to sort through all of the overwhelming information about toxins and make smart daily choices.

This episode also features a segment on navigating the holiday season while going through fertility treatment.

I hope you will listen to this episode and share it with any family, friends, or colleagues who might find it interesting.  You can listen to the podcast HERE.

In Episode 2 of the Fertility Journeys Podcast, Dr. Shala is joined by Marilyn Gomez.  She teaches women how to self-advocate on their own fertility and healing journeys.

Here are some of the highlights of the discussion between Dr. Shala & Marilyn:

• How crystals can be incorporated into your life for everyday healing, empowerment, or inspiration.
• The need for healing along the fertility journey and how non-traditional tools, when used with therapy or conventional methods, can be an extension of our own power to self-heal.
• A deep dive into Reiki and how Marilyn used it on her own IVF journey.
• Marilyn shares her emotional journey through infertility, treatment, and how she had to become her own advocate with her doctors.
• Using a therapist to help carry the “ebs and flows” of the journey
• Postpartum realities after having a child
• The healing powers in being of service to others through volunteering

This episode is will be relatable and likely comforting to anyone who has or is experiencing a fertility rollercoaster.  I hope you’ll listen and share it with anyone that it could help.  You can listen to the podcast HERE

Trying to bring a new child into the world tends to make us question all aspects of our lives!  Am I eating a well-balanced diet? Am I moving my body enough throughout the day? Is this headache medication safe while trying to conceive? What about my shampoo? Am I getting enough sleep?  Am I stressing out about all of this too much and causing more harm than good?

Nutritional supplements are just one more area of life you might find yourself reevaluating in light of your desire to conceive a child. Adding a prenatal vitamin is a no-brainer. And you might have heard the recommendation from healthcare providers to add a folate supplement as well.

But have you considered adding a powerful antioxidant like coenzyme Q10 to the mix? If so (or even if you’re not!), read on to find out how this could help you!

A Quick Chemistry Crash Course

If you haven’t thought about free radicals and antioxidants since your high school chemistry class, you’re certainly not alone! Here’s a crash course in case you’ve long since packed away your textbooks!

Free Radicals: Building Up in the Body and Causing Chaos

Most molecules contain an even number of electrons, which keeps them stable. Free radicals are different, though. These molecules contain an odd number of electrons.

This makes these unstable free radicals bind easily with other molecules in the body. These molecular combinations can cause very long molecular chains that have the potential to cause quite a bit of damage in the body.

These unstable free radicals, then, can build up to an unhealthy level. This results in oxidative stress, which can cause inflammation and other undesirable side effects. These could include autoimmune disorders, pain, cancer, and metabolic problems. This may also have a negative impact on fertility levels in both males and females.

(It’s important to note that a small number of free radicals in the body isn’t dangerous. In fact, exercise and similar healthy stressors can cause the release of free radicals. It’s a buildup of an excessive number of  free radicals that you want to avoid!)

Antioxidants to the Rescue!

Antioxidants, on the other hand, are able to help balance out free radicals. Antioxidants bind one of their own electrons to bring balance to an unstable free radical. But in doing this, they don’t give up any of their own stability!

In this way, antioxidants help provide a safer environment inside the body. They can also prevent cellular damage from oxidative stress caused by a buildup of free radicals.

Some Potential Benefits of Coenzyme Q10

Coenzyme Q10, or CoQ10, is a very powerful antioxidant. Research on this antioxidant is ongoing, and more studies are needed. But some current studies suggest that coenzyme Q10 could have benefits such as lowering risk of heart disease, migraine, and secondary heart attack after another cardiac event.

Coenzyme Q10 and Its Impact on Female Fertility

Even though more human studies are needed, preliminary studies have shown that supplementation with coenzyme Q10 could promote improved egg count. It may also possibly improve egg quality.

Coenzyme Q10 has also been linked to improved ovulation rates in patients with polycystic ovarian syndrome who are seeking ovulation induction through Clomid. There is also some evidence to suggest that it can contribute to improved ovarian response during IVF cycles.

It’s important to remember that while coenzyme Q10 has shown some promise in improving egg quality, most studies that have shown significance at the statistical level have been studies in animals. Human studies have been limited and have shown a limited benefit. (It may also be possible that the studies are too small to show coenzyme Q10’s full benefit.)

Coenzyme Q10 and Its Impact on Male Fertility

Studies have also shown that supplementation of coenzyme Q10 in males may increase their sperm concentration (number of sperm) and motility (movement of sperm).

Do You Have More Questions About Coenzyme Q10 or Another Supplement?

So the jury is still out on the actual benefits of coenzyme Q10 use in humans. But it appears to have promise, and supplementation with coenzyme Q10 is generally considered safe.

We know that trying to conceive can be a tricky time. So if you’re finding yourself analyzing and reanalyzing everything you put into your body, it might be time to consult with a specialist in the integrative fertility field who can help take some of the guesswork out of the equation for you.

Dr. Salem and her team are experts at finding the right fertility protocol for you. If you’d like to talk about whether or not coenzyme Q10 is appropriate to add to your supplement regimen, reach out today to schedule a consultation!

If you follow world news at all, especially since the beginning of 2020, you’ve probably felt the burden of negativity weighing you down.  The same can be true in your personal life, your work life, or anywhere that people are present, if you look for it there is plenty of negativity to go around. 

So how could a little positivity possibly be a bad thing?

The truth is… it’s not! A positive outlook, at its core, is a great asset. In fact, there’s plenty of research backing up the benefits of taking a more upbeat outlook on life.  For example, when medical researchers studied a group of people with a strong family history of cardiac disease, they found that patients with a more positive outlook were a full third less likely to have a heart attack or other cardiac event!

So What Is Toxic Positivity? Can You Be Too Positive?

Dr. Susan David defines toxic positivity as “forced, false positivity. It may sound innocuous on the surface, but when you share something difficult with someone and they insist that you turn it into a positive, what they are really saying is, ‘My comfort is more important than your reality.” 

(This incredible quote from Dr. David was taken from her guest appearance on Brene Brown’s podcast.)

The Consequences of Toxic Positivity

While being overly positive may not seem too destructive on the surface, it has many consequences. This can even be true when we find ourselves speaking with toxic positivity in our own self-talk!

Denying Emotions

Toxic positivity can lead us to deny the reality of the emotions that we’re facing. Depending on your personality type, you may tend to deny your emotions (or at least the ones you deem negative!) in general. This rarely ends well. Usually, it ends up with the negative feelings building and building and building.

In the end, these feelings will be released. It’s only a matter of time. They might “seep out sideways” through passive aggression or snapping at a stranger in the grocery store. Or you might wind up having a major meltdown.  But regardless of how these feelings end up presenting themselves, the fact is this: emotions that you deny and repress never stay repressed.

Guilt for Feeling Negative Emotions

Some people tend to deny or repress emotions they don’t want to feel. Others of us feel that we have no choice but to experience feelings like sadness, fear, and anxiety. But even people who don’t struggle to feel their feelings can have a tendency to feel guilty for them!

And toxic positivity can intensify this guilt. But in reality, feelings are just that: feelings. They don’t define who we are, and we aren’t defined by our fears or worries. And we don’t need to feel guilty for being fearful or worried.

Fertility treatments can be trying, even in the best of circumstances! Worrying about the outcome of a treatment or test is a sign that you’re normal, not that anything is wrong with you!  People who operate in a mindset of toxic positivity will make statements like, “You should just be grateful for the things you have in your life!” “Everything happens for a reason!” “Don’t focus on unwanted test results!”  These kinds of statements are not helpful. In fact, they are dismissive of your true feelings.

But the fact of the matter is that it’s completely possible to feel more than one emotion at a time. The fact that you are disappointed with a negative pregnancy test doesn’t mean you are any less grateful for your friends, family, or all the other wonderful things in your life.

Not Seeking Support

One of the most dangerous things about toxic positivity is this: It can discourage us from seeking emotional support during the very times we need it most!  When we feel shamed for our feelings by others, we tend to shut down and not seek help from them again. No one wants to share their darkest feelings if we know that our supposed source of support is going to encourage us to “think happy thoughts!”

Things To Try Instead

Whether you are tempted to scold yourself or others for feeling sad and downtrodden, resist the urge to act as if life is all rainbows and unicorns.  Acknowledge your feelings, and let them flow through you. Sit with your grief. Acknowledge when you or a loved one has experienced a loss, even a perceived loss.  As painful as it can be, it’s important to acknowledge the possibility of undesirable outcomes.

Possibly the most important part of this process is acknowledging that poor outcomes are a possibility. And, that you can handle whatever comes your way. So much of toxic positivity comes down to a belief that we can’t handle the difficulties that life throws at us!

When you’re supporting others, empathize with them.  Let yourself feel the emotions that they are describing. Ask yourself how you would feel in their situation.  Avoid jumping straight into encouragement. Let them share their feelings without judgment.

Need a Place to Vent Without Being Told to Think Positive?

Life can seem uncertain, and you aren’t sure where this journey will take you. That’s completely normal.  Even though we are generally upbeat and positive at The Integrative Fertility M.D., we understand the road that you are walking during your fertility testing and treatments. We understand the confusion that comes with test results you weren’t expecting.

We empathize with the disappointment you feel when treatments don’t have the outcome you’d been hoping for. Even after pregnancy is achieved, mixed feelings are a normal part of the process! And even in your celebration, you might feel anxious, scared, or ambivalent. It’s okay (and healthy!) to acknowledge these mixed emotions.

If you need a place to turn for support without the toxic positivity, consider The Integrative Fertility M.D. for your fertility consultation, testing, and treatment needs. We are here to help and hold space for you!

No one wants to struggle with infertility, regardless of its origins. But if you’ve conceived in the past with no apparent difficulty, infertility can be particularly shocking.

What is secondary infertility?

Secondary infertility is when an individual or a couple has difficulty conceiving or carrying a pregnancy to term, despite having prior biological children with no difficulty.

About ten percent of couples who had no trouble conceiving previously will experience secondary infertility. Though it has many of the same causes as primary infertility, this topic doesn’t seem to receive as much attention in the media or in society.

Unfortunately, many couples struggling with secondary infertility find themselves suffering in silence. Well-meaning family and friends try to convince them that they should be content with the family they already have. Coworkers remind them that they already have one or more children and should just focus on that. Your Great Aunt Sue reminds you to “just relax, and it will happen when you least expect it!”

Sadly, there are even medical providers that fail to take your concerns seriously, not giving your case the attention it deserves simply because you have successfully conceived a child before.

But regardless of whether the desired pregnancy is the first child or the sixth, no one should be shamed by others for their desire to grow their family.

What causes secondary infertility?

There are multiple possible causes of secondary infertility. Many of them are the same factors that cause primary infertility. Unexplained infertility is also a common diagnosis. These difficulties in conception can occur at any point in the early pregnancy process: ovulation, sperm production and travel, fertilization, travel of the fertilized egg, or implantation in the uterus. These problems can originate with either a male or a female partner. Though it would be rare for both partners to have developed problems in the time since the conception of the prior child, this is also a possibility.

Here are a few possible causes of secondary infertility, though of course you’ll need to work with your healthcare provider to determine what specific factors are at play in your case.

• Change in sperm quality and quantity. As a man ages or changes his lifestyle, the quality and number of sperm in each ejaculation can decline. This can be linked to smoking, alcohol intake,  changing testosterone levels and environmental exposures. Sperm morphology and motility can be checked through a semen analysis.

• Endometriosis. Endometriosis happens when tissue similar to the uterine lining (“endometrium”) grows outside of the uterus, in places like the ovaries or fallopian tubes. This lining can cause scarring in the pelvis and on the fallopian tubes, making it impossible for the sperm to reach the egg or for a fertilized egg to pass through the fallopian tube to the uterus.

• Uterine fibroids. Fibroids are noncancerous tumors found in the uterus. Some uterine fibroids occur in the uterine cavity and can make implantation difficult.

• New medical problems. If you have been diagnosed with a new medical condition since your last pregnancy, this could contribute to secondary infertility. Polycystic ovary syndrome, diabetes, autoimmune concerns, uterine polyps, and pelvic inflammatory disorder are examples of conditions that may make conception more difficult than it has been in the past.

• New medications. Likewise, if you are taking new prescription or over-the-counter drugs, this may affect fertility. Drugs taken for epilepsy, thyroid, pain medications, some steroids, and chemotherapy have been known to impact fertility.

• Complications from prior pregnancy. Any uterine scarring can cause difficulty with the implantation process. Talk to your physician about your particular prior pregnancy and birth experiences to see if this could be a factor.

• Complications from prior surgeries. Complications from prior surgeries can lead to scar tissue in the uterus or pelvis that can impact fertility.

• Age. It goes without saying that both partners are more advanced in age than they were when the prior pregnancies were conceived. Because female fertility tends to decline in the mid-30s, the more a woman ages, the lower her egg quality tends to be.

• Lifestyle factors. Habits frequently change after one becomes a parent. There are a few lifestyle factors that can possibly contribute to infertility. It’s harder to round up your child and the stroller and get out the door for a walk than it was when you just had to grab your keys and go. Maybe you’ve returned to a smoking habit you picked up in college. Perhaps you find yourself reaching for the wine bottle more often than you did before. It’s easy to slip back into these methods of coping in the busy years of raising small children. Focusing on eating whole, nutritious foods, moving your body more, stopping smoking, and cutting back on heavy alcohol consumption can contribute to a healthy lifestyle that can support fertility.

What is the treatment for secondary infertility?

Just as the causes of secondary infertility are similar to primary infertility, the treatments can be similar as well. After performing a thorough examination and history, your provider can order lab tests to check your hormone levels. A semen analysis is also commonly ordered to check the number and motility of viable sperm.

There are a number of treatments that can be helpful for secondary infertility. These can include medications such as Clomid or letrozole. Intrauterine insemination (IUI) or IVF may be considered as well.

When should I get help for secondary infertility?

If you’ve been having unprotected sex for more than a year, consider seeking medical help. If you are over the age of 35, this time period can be shortened to six months. And if you are over the age of 40 or you have been experiencing irregular menstrual cycles, contact a fertility specialist right away to get the help you need.

Secondary infertility can be a very unwelcome surprise, but The Integrative Fertility M.D. is here for you. Reach out – we’d love to help you with your family planning goals!