Today, the Center was featured on WTNH’s Connecticut Families with Sarah Cody. She spoke with Helen BetGivargis, the Center’s acupuncturist, about acupuncture and how it can be helpful in fertility treatments, as well as with a couple who spoke about their experience. We hope you enjoy the piece as much as we do! And don’t forget…if you’re interested in learning more about acupuncture, come to our Community Fertility Acupuncture event on October 27th. Navigate to our News and Events page for more information and to register.
September is PCOS month, and PCOS-related infertility affects so many women these days. PCOS symptoms often include:
Irregular periods,
Weight gain or weight loss resistance,
Hair growth on your face or body,
Acne, and
Dark patches of skin
…. but you already know this if you have PCOS.
So, let’s talk about how you can manage your symptoms to support your fertility journey.
Insulin resistance is often a major factor associated with PCOS, and this means that your body cannot respond properly to the insulin it makes. Keeping your blood sugar steady throughout the day will help you sustain healthy hormone levels, keep your mood even, and support a more regular menstrual cycle.
I work with women who want to maximize their chances of getting pregnant by optimizing their health. These are women who are asking their doctors, “what else can I do outside of treatment.” These are some tips I share with them to get them started…
Step 1: The Winning Food Formula
Food is where I start, and the first step to managing your PCOS is to eat in a way that keeps your blood sugar steady. The winning formula is: Fiber + Protein.
I recommend eating both fiber – in the form of veggies – and protein in every meal. This dynamic duo will keep your blood sugar from spiking in either direction. And, it works regardless of what diet you subscribe to…from vegan to keto. It will keep you from feeling hangry, irritable, or sleepy. And it will help you keep your weight in check. If you are trying to lose weight, remember this catchy phrase…
“Fiber and protein in every meal makes losing weight no big deal.”
You can apply this to your daily meals by:
Adding spinach to your scrambled eggs,
Including kale with a low sugar smoothie and a plant-based protein,
Eating a big salad with chicken for lunch, and
Covering half of your plate in veggies plus a protein for dinner.
Step 2: Move Your Mass
Next, incorporating high intensity interval workouts decreases insulin resistance and is the best exercise to mobilize excess body fat.
This can look like a 20 minute HIIT workout from Fitness Blender (check out some the HIIT workouts here🙂
…or 3 sets of the Scientific 7-Minute Workout (here is the app).
If you have had a heavy meals and need a quick blood sugar stabilizer, lace up your sneakers and go for a walk. Even 10 minutes around the block will help lower your blood sugar.
Step 3: Flush it out
Finally, drink your H20.
I know you know this, and you have heard this a dozen times… But, how often are you doing this? Staying hydrated helps remove excess sugar from your blood through your urine. Half of your body weight in ounces is often the guideline, so if you weigh 150 pounds, aim for 75 ounces of water. Another way to know is to check the color of your urine. Aim for pale yellow.
Hydration isn’t only about drinking water.It also means making sure you have an adequate electrolyte balance. Electrolytes – like potassium, magnesium, and sodium – can be added to your water and are critical for replenishing needed minerals and feeling hydrated. They support chemical reactions that take place in your body for optimal hormone health.
A basic rule of thumb is this: if you have go to the bathroom within 5-10 minutes of drinking water, consider adding electrolytes (or even a pinch of pink sea salt) to your to your next glass.
Stick with these basics and be sure you are sleeping 7-9 hours, and you will notice results…from better energy and weight loss to calmer hormones.
Want help getting started? Check out my free PCOS 7 Day Meal Plan. Simply share your email here, and I will send it (plus additional fertility tips) to you right away!
Congratulations to the Center’s Dr. Nulsen, Dr. Benadiva and Dr. Grow for making the 2019 Best Doctors in in America® List which includes the nation’s most respected specialists and outstanding primary care physicians in the nation.
“Infertility treatment, which typically involves a multi-faceted physical, emotional and financial investment, can be psychologically debilitating for some. For many patients, infertility is perceived as the most distressing experience they’ve ever gone through.” Read “The Mental Health Provider and Infertility: An Option for Support” by Kim Crone, PhD.
We certainly let our presence be known this past weekend! 15 staff members attended 3 different conferences in 3 different states.
Jen Christensen and Allie Revoir attended the American Society for Reproductive Medicine’s [ASRM] Association of Reproductive Mangers [ARM] annual conference in Austin, Texas. ARM is a professional society of ASRM and meets 2x annually. The next meeting will be the Post Graduate Course at ASRM in Philadelphia in October.
Kathy [Varkal] Paniati, RN headed south to South Carolina for the Annual Egg Donor Conference in Charleston. This is the preeminent conference for nurses and doctors who work primarily with Third Party reproduction. Kathy will no doubt have lots to share with us about what is state of the art in this area of our practice.
Finally, 11 of us headed north to New Hampshire for the New England Fertility Society Meeting [NEFS] annual meeting. We were definitely the most represented Center there both in term of attendees and meeting presenters. In attendance were: Dan Grow, MD, Lawrence Engmann, MD, Chantel Bartels, MD/REI Fellow, Evelyn Neuber, Phd, Paul Verrastro, CEO, Alison Bartolucci, Lab Director, Darlene Davies, Senior Embryologist, Lia Shuhaibar, Embryologist/Visiting Scientist, Peg Demers, RN, Haley Krivensky, RN and Scott Yohe, Research Manager. Highlights included:
Evelyn Neuber, Phd and Chantel Bartels, MD each had posters:
•What does age have to do with it? Did the lifting of CT Mandate on age restrictions affect access to IVF care within context of larger eIVF data base.
•Contrary to previous reports the large eIVF database shows day of trigger Progesterone elevation reduces live birth rates among the young and good responders.
Darlene Davies, Senior embryologist was the winner of the eIVF grants and invited to give an oral presentations
•eIVF Research Winner: Retrospective Analysis of the effect of laser assisted hatching at the blastocyst stage on Implantation Rate
~ Darlene Davies
Evelyn Neuber, PhD and Scott Yohe, Research Manager led a lively Round Table discussion:
•Barriers to Recruiting Patients to clinical studies and barriers to overcoming them
This was the 30th Anniversary meeting of NEFS and Dr. Grow and Dr. Neuber were both honored for having served as past presidents of the organization.
As always, it was fun to spend time together outside of the office and get reacquainted with old friends!
It’s Baby Week on WFSB Better Connecticut, and we’ll be talking about gestational carriers. Tuesday afternoon’s show features (BetterCT starts at 3 PM) an interview with Victoria Ferrara, founder and legal director of Worldwide Surrogacy Specialists as well as one of our patients. If you’re interested in learning more, check out the information on our website under Specialized Services/Gestational Carriers or go to Worldwide Surrogacy at www.worldwidesurrogacy.org.
We are so proud of Dr. Engmann and Kathy Varkal, and we also know firsthand what caring and compassionate individuals they are. Congratulations to them both for this wonderful award.
Feeding Fertility: Using Nutrition to Support Preconception Health By Ami Chokshi, Integrative Nutrition Health Coach and Outreach Manager
“If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” – Hippocrates, 4th century BCE
Our diets have changed dramatically since Hippocrates. There are a multitude of approaches to eating these days including several popular diets, Paleo, Keto, Mediterranean, and Vegan. For women who are trying to conceive, it can be overwhelming to understand what to eat for fertility, preconception, and pregnancy.
Much of what we know about nutrition and fertility comes from the landmark Nurses’ Health Study, where 18,000 women who were trying to conceive tracked their nutritional and lifestyle habits over eight years. Following a plan that was highly plant-based – including fruits, vegetables, whole grains, and beans, protein-rich foods, healthy fats, and a small amount of full fat dairy – correlated to a 66% decreased risk of ovulatory infertility and a 27% lower risk from other causes.
Additional sources confirm that nutritional and lifestyle adjustments supports optimal preconception health. These guidelines suggest both men and women will benefit, so a couple trying to conceive can work together to optimize their fertility health.
Lower Pesticide Foods
A preconception and fertility diet looks similar to the one in the Nurses’ Health Study, but there is currently a greater emphasis on eating foods with a low-pesticide profile, typically found in organic foods, due to a January 2018 study in JAMA Internal Medicine.
The results found that the “in a cohort of 325 women undergoing infertility treatment with assisted reproductive technology, intake of high–pesticide residue fruits and vegetables was associated with a lower probability of live birth, while low–pesticide residue fruit and vegetable intake was not associated with this outcome.”
However, eating organic foods are often cost prohibitive. Fortunately, The Environmental Working Group (EWG) creates a yearly review of the most pesticide-ridden produce, called The Dirty Dozen, and well as the cleanest fruits and vegetables, called The Clean 15. There are pocket guides on its website (ewg.org) as well as an app for quick access when grocery shopping.
For 2018, The Clean 15, produce that are safe to be purchased conventionally, include pineapples, papayas, mangos, honeydew melon, kiwi, cabbage, onions, frozen sweet peas, asparagus eggplant, cauliflower, and broccoli.
The Dirty Dozen produce for 2018 are often those with thin, penetrable skins, including strawberries, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes, sweet bell peppers, and hot peppers.
What is A Fertility Diet?
The best options for a fertility diet is one that includes plenty of vegetables as well as fruits, whole grains, beans, healthy fats, and quality sources of proteins.
While fruit has been demonized recently with current keto craze, fruits offer powerful vitamins and antioxidants that help fight off oxidative stress caused by poor nutrition, emotional stress, and environmental factors. They are best eaten raw and ripe because they are heat sensitive and because the whole fruit contains blood sugar-stabilizing fiber. Examples include wild blueberries, strawberries, raspberries, prunes, and pomegranates. They can be eaten as a whole fruit or added to a smoothie, which preserves the beneficial fiber when blended (not juiced).
Vegetables, like leafy greens and crucifers, offer much needed minerals and fiber to support healthy blood sugar levels and optimal digestion. 2-3 servings or covering ½ of your plate with vegetables encourages satiety, crowds out junk food, fuels your cells with nutrients, and provides sustained energy throughout the day. It also keeps your mood stable, which is especially helpful when patients are experiencing the stress of several months of trying to conceive. Prebiotic fibers from vegetables help support digestive health and help move bowels and toxins that go with it.
Healthy fats support egg, sperm, and embryo health, provide energy, and protect organs. Some examples of food-based fats to eat include wild-caught salmon (farm-raised salmon should be avoided due to contaminants), nuts (walnuts, pecans, macadamias, almonds), seeds (pumpkin, chia, hemp, sunflower), avocadoes, olives, and coconut. Healthy fats are best eaten as a whole food. Healthy oils like avocado, coconut, olive, and grapeseed, are best when used in smaller amounts, i.e. for cooking, since oils are a processed food. Trans fats, which are often found in donuts, pastries, and french fries, should be avoided entirely.
Organic proteins should be about ¼ of a meal. These include meat, eggs, tofu, tempeh, and beans. Organic is again ideal to avoid the antibiotics and pesticides, that contribute to a greater toxic body burden. Specifically, these include grass-fed beef, free-range chicken, wild-caught salmon, turkey, and smaller, less contaminated fish. Since according to Michael Pollan, “you are what you eat eats,” it’s important to look at what the animal that we are eating is also consuming and source accordingly.
Gluten free whole grains like brown and black rice, quinoa (this is actually a protein-rich seed but often treated as a grain), buckwheat, amaranth, millet, and oatmeal are beneficial staples to a fertility diet. It’s the refined grains, like breads and pasta, that wreak havoc on blood sugar, add to bodily stress, and should be limited.
The focus on gluten free grains relates to how our wheat is produced in the US. The majority of wheat is mostly ridden with pesticides and is genetically-modified to be resistant to glyphosate, which is a carcinogenic herbicide found in Roundup.
How to combine these foods?
When combined appropriately, these foods support optimal blood sugar and prenatal nutrient needs. The aim here is to integrate fiber in the form of vegetables and protein into the three main meals. Typically, ½ of the plate is covered with mostly vegetables and some fruit, ¼ is a protein, and the remaining ¼ would be a healthy fat or a whole grain.
Patients often question how to integrate more vegetables into their meals; here are some examples. Some of these ingredients can be prepped ahead of time to be easily and quickly assembled later.
Breakfast: 2 eggs scrambled with 2 servings of your favorite veggies (spinach, broccoli, kale, etc…)
Adding 2 handfuls of spinach to a smoothie
Lunch: Make ahead soup with lots of veggies topped with diced avocado
A large green salad topped with wild-caught salmon
Dinner: Stir fry of veggies and chicken over steamed cauliflower rice
Dinner bowl with quinoa, sauteed veggies, a grass-fed steak, and a savory chimichurri sauce
Snacks: Carrots and Hummus
Celery slices with Almond Butter
Given that 1 in 8 women struggle with infertility, many are often seeking ways to better manage the ongoing stressors related to trying to conceive. Eating to support conception can not only be delicious and nutritious, it can support hormonal and digestive health, blood sugar regulation, a healthy inflammatory response, as well as level energy and better mood.
Although this is a recipe for a summer salad, it’s really great in the Winter as well. From Ami Chokshi, the Center’s Fertility Health Coach in honor of Healthy Weight Week.
Are you getting 7-9 servings of veggies in a day to support your fertility? If not, the summer is a great season to get started because of the many fresh veggies available at the store, at farmers markets, and in your garden.
Not only are vegetables chock full of vitamins and minerals to ensure you are getting optimal daily nutrients for your fertility, but the fiber also supports healthy digestion and a steady energy level, which is vital when you are trying to conceive.
I chose these ingredients for this salad because they are in season, rich in fertility supporting nutrients, diverse and colorful, and support healthy digestion and elimination.
Consider doubling or tripling the ingredients and make a few salads for the week and store in the fridge. “Make once, eat twice” saves us time and energy.
Here are some benefits of the ingredients I chose –
Choose organic lettuce to reduce pesticides in our body. Green lettuce is rich in folate, an important B vitamin for fertility. Also, during colder months, wash lettuce under warm water to take the chill of the salad.
Beets and lemon juice support liver health and detoxification.
Carrots are rich in beta carotene. They support healthy blood pressure and steady nerves,
Avocado offers healthy and satiating fats, which have numerous benefits both to your health and fertility.
Cucumbers are hydrating and alkalinizing
Pumpkin seeds are rich in both zinc and magnesium.
Raw Honey is an antiviral food and is rich in amino acids, minerals, and enzymes.
Apple cider vinegar supports digestive health and hydrochloric acid production in the stomach.
I added additional protein (did you know veggies contain protein?) with the organic chicken. Protein plus the fiber of the salad support healthy blood sugar and energy levels. If you are a vegetarian and would like additional protein, try 1/4 cup of black beans or chickpeas.
In recognition of Healthy Weight Week, Ami Chokshi, the Center’s Fertility & IVF Health Coach offers some tips and recipes. As a former fertility patient, Ami uses her experience and education to help women and couples to optimize their health and fertility. She does it through nutrition, supplementation, and lifestyle shifts that maximize their chances of conception.
“Smoothies are a wonderful way to get a bunch of nutrients in one meal, but when winter arrives, keeping your core warm with warming foods and spices is a better option to support your fertility health and nourish your soul!
That’s why during the winter, I like to replace my cold smoothie with a warm blended soup. And, this dairy-free recipe is one of my favorites for many reasons. First, it’s quick and easy to make. And, you can replace the main ingredient with any vegetable on hand, like broccoli, squash, pumpkin, mushrooms, or asparagus.
Also, soups are a terrific way to get more veggies in. To optimize our nutrition, we should be eating a minimum of five servings a day. It’s even more important if you are trying to get pregnant. This can be challenging otherwise, but blending them can make this important fertility booster easier.
I know many who dislike veggies but love this recipe! Learning new ways to prepare vegetables and cooking them with different spices can make a huge difference in taste, especially if you’ve grown up on boiled, bland veggies. Spices, like the curry powder in this soup, enhance the flavors, build circulation, warm your core, and fuel your body’s detoxification systems.
Adding chicken bone broth instead of water or vegetable broth makes this soup a complete meal, having protein, fat, and carbohydrates. So, it can be a great breakfast, lunch, or dinner. Yes, I said breakfast. We are programmed to think that breakfast foods have to be traditional foods like eggs and cereal, but that’s not so. Rethink what you eat, and the doors will open to new ideas.
Bone broth is not only a fertility superfood. It also offers superior gut healing properties as well as much needed minerals. The collagen in the broth nourishes your intestinal lining and reduces inflammation.
I hope you enjoy this recipe as much as I do! I would love to know how you made it your own.
Winter Carrot Ginger Soup
Ingredients
1 Small Onion, diced
1 T of Coconut Oil
2 lbs of Carrots, chopped
1 T of fresh Ginger, peeled and grated
4 C of Chicken Bone Broth
1 T Apple Cider Vinegar
2 t Curry Powder (or Turmeric)
1 t Sea Salt
Directions
Saute onion in coconut oil until soft, about 5-8 minutes
Add Carrots, Ginger, Chicken Bone Broth, Apple Cider Vinegar, Salt, and Curry Powder. Bring to a boil and then reduce heat to a simmer for about 20 minutes or until carrots are soft.
Use a hand-held blender or a high-speed blender to blend the soup until smooth or desired consistency.
Divide into bowls and adjust salt if necessary.
Top with cilantro and/or hemp seeds.
Save remaining soup in mason jars for another day’s meal.
Enjoy!
Recipe published in the Dec. issue of Positive Fertility Magazine.
•What does age have to do with it? Did the lifting of CT Mandate on age restrictions affect access to IVF care within context of larger eIVF data base.
•Barriers to Recruiting Patients to clinical studies and barriers to overcoming them
ervings of veggies in a day to support your fertility? If not, the summer is a great season to get started because of the many fresh veggies available at the store, at farmers markets, and in your garden.
Also, soups are a terrific way to get more veggies in. To optimize our nutrition, we should be eating a minimum of five servings a day. It’s even more important if you are trying to get pregnant. This can be challenging otherwise, but blending them can make this important fertility booster easier.