4
Jun

Because Conception and Pregnancy Aren’t Easy

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Social media, cell phones, tablets, online ordering. So many parts of our society contribute to the “want it now” mentality. For some reason, that philosophy seems to apply to conception and pregnancy. That instant gratification mindset is becoming ingrained. When we want something, it’s at our fingertips, whether it be that cute shirt at Target, a toy on Amazon or the groceries you can get delivered to your door. Want a baby? Conceive on your first try! So unrealistic, but it’s how too many people think.

 

I’m no exception to that mentality. When we decided to try to conceive, I remember thinking that we’d be pregnant in six months tops. I freely shared that we were trying when people asked because I knew we would be pregnant soon. Then the months stretched into years and instead of wanting a baby now, it became a yearning for a positive pregnancy test. I’m proof of what our society doesn’t acknowledge enough: conception and pregnancy are not easy.

 

Despite what we’re taught, pregnancy is not a given. Historically, how many examples are there of women who struggled to conceive? Think about the queens and all the pressure on them to birth an heir. There are so many who only succeeded in producing one or two offspring. Infertility is not new, and thankfully, the taboo surrounding it has started to lift, especially as celebrities like Jaimie King, Hugh Jackman, and Sarah Jessica Parker talk about their struggles. And yet, it seems that every woman feels like pregnancy should happen within months of trying. After all, pregnancy is a natural thing for our bodies and has been an expectation for our gender since humanity began. The problem now is the weight of that expectation often makes becoming pregnant more stressful and emotional than it needs to be.

For example, I know someone who stopped trying to conceive her second child after two months. She said that it was too hard to see the negative pregnancy tests. Her words have stuck with me, and today I realized why. It’s not because it blows my mind that she’s giving up after two negative tests when I had who knows how many. It’s that she only tried for two months. That sense of instant gratification and the emotional toll of not fulfilling the desire for a pregnancy led her and her spouse to choose to focus on the beautiful little boy they already have.

 

Think about this: how many people do you know with one child? Have you ever asked them why they have only one? I can think of four couples off the top of my head. Here are their scenarios:

  1. The first child was a struggle to conceive, and they never succeeded again.
  2. The first child was a struggle to conceive, and they never succeeded again.
  3. They’re happy with just one child and want to focus on him.
  4. They conceive their first child almost immediately and decided to focus on him when baby number two wasn’t conceived quickly (the aforementioned example).

Notice that only one couple made a decision to not have another child without any other factors. Now I don’t know if my sample set is the norm, but I’m willing to bet that many only children don’t have siblings for a lot of reasons outside of “we only wanted one.” Because conception and pregnancy aren’t easy.

 

On the opposite side of the spectrum, I’ve talked to two elderly women recently who have been surprised when I’ve said we are stopping at three kids (honestly, with a toddler and baby twins—all IFV babies—I can’t imagine adding another). Those lovely women have large families of seven and ten children. But you know what else? I know at least one of them had a miscarriage. Yes, they were blessed with a large family, but loss was also a part of the journey. Because conception and pregnancy aren’t easy.

 

Do you know someone who has dealt with the heartbreak of a miscarriage? Even if you say no, I would bet you’re wrong. We talk about how overlooked infertility is, but miscarriages happen way more than I ever expected they would. Yes, many of those people go on to have a rainbow baby, but the miscarriages still happened. The struggle was still there. Odds are that you know more than one person who has gone through that tragic experience.

 

But, Ashley, you may be thinking, what about all those teenagers who seem to pop out babies like it’s their job? Trust me, I know exactly what you’re thinking. I’m an alternative high school teacher. A high percentage of teen parents and soon-after-high-school parents walk through my doors. It’s got a whole lot to do with their age and their carelessness. And, frankly, if you surveyed the entire world, my thought is that there would be many more who struggle than who had children early. And don’t forget secondary infertility. How many of those teen parents struggled to reproduce once they found their forever partner? Because conception and pregnancy aren’t easy.

 

The age old story is stamped into our minds. Boy meets girl. They fall in love and get married. They have kids and live in house with a white picket fence. Simple. Pretty. Delusional. Although, ironically, I’m sitting in a house with a white picket fence watching television with my mother, a woman who easily conceived both of her daughters. But is she the norm? Maybe she was in the 1980s, but she is not anymore. Maybe life has gotten more complicated or maybe or society has opened its eyes. Look at the world around you. Think of your ten closest friends. How many have kids? How many conceived right away? The answer may surprise you, but it shouldn’t. Our society has hung on to the idea that conception is a given. You decide to have kids, stop using birth control, and voila, baby! (Cue sarcastic snort.)

 

Look at the statistics:

1 in 8 couples (about 12%) can be clinically diagnosed with infertility[1]

10-15% of pregnancies end in miscarriage[2]

About 11% of American woman suffer from endometriosis[3]

PCOS affects 1 in 10 women of childbearing age[4]

Over a third of infertility cases result from male infertility[5]

And those numbers are just the tip of the iceberg. There are so many more factors that affect conception and successful pregnancy. One of the reasons I started writing about being infertile was that I was sick of the attention that infertility was not getting. I was sick of the illusion of the picket fence scenario, which works out beautifully for some but sets an unrealistic expectation for so many more..

 

 

Our society has become a place of contradiction: clinging to traditional views, like the picket fence, while also making room for all the wonderful differences in each piece of humanity. When I think about this in terms of infertility, it blows my mind a bit. Think of all the different ways people have conceived children: random intercourse, timed intercourse, failed birth control, fertility treatments, etc.. And yet, when we think of how to make a baby, the age-old story where unprotected sex results in a child sneaks in. But it is so much more than that. Because conception and pregnancy aren’t easy.

 

Despite the contradictions, one of the things I love about our current society is the push for people to embrace their best selves. Which is why I would be remiss if I didn’t point out an obvious truth: so many people in the LGBTQ community would be and are fantastic parents. Have you seen Neil Patrick Harris’ family’s Halloween costumes? Seriously, though, there is an entire group of people who cannot conceive naturally. If they want to have biological children, they have got to seek out fertility treatments. In their case, conception and pregnancy is not only not easy, it also needs medical science to happen.

 

No matter the circumstance, the fact remains that we need to rethink conception and pregnancy so that they are more of a journey than a sprint. If I could, I would stand on the rooftops and scream my story: I needed help to have babies! Honestly, I enjoy the shock on some people’s faces when I talk to them, and they learn that all babies aren’t made from intercourse. One of the reasons I love that eye-opening discussion is that people are often fascinated by the scope of what can be done to assist in conception, once they open themselves up to learning about it. Even with my twins, people seem surprised when I say they’re IVF babies.

(Sidenote: I find myself assuming most multiples are fertility treatment babies, which isn’t fair since some people just have crazy reproductive luck. Hence, my surprise when people don’t immediately think that fertility treatments helped me have my twins.)

Anyway, my point is that this is a message that needs to spread: pregnancy and conception aren’t easy. If you’re struggling, you are not alone. We have to get out of the mindset that pregnancy is easy and a given.

 

Take a deep breath and say it with me: pregnancy and conception aren’t easy.

 

Now go tell the world.

 

[1] “What Is Infertility?” CNY Fertility Center. Accessed April 29, 2019. https://www.cnyfertility.com/ttc/what-is-infertility/.

[2] “Miscarriage.” March of Dimes. Accessed April 29, 2019. https://www.marchofdimes.org/complications/miscarriage.aspx.

[3] “Endometriosis.” Womenshealth.gov. April 01, 2019. Accessed April 29, 2019. https://www.womenshealth.gov/a-z-topics/endometriosis.

[4] “Polycystic Ovary Syndrome.” Womenshealth.gov. April 01, 2019. Accessed April 29, 2019. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome.

[5] “Male Infertility.” Mayo Clinic. September 20, 2018. Accessed April 29, 2019. https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773.

 

4
Apr

Scrambled Eggs Seasoned With Holy Water

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It’s hard to be a competitive person, and be subpar egg creator.  But that’s what I am.  I am basically a dilapidated hen.  You can give me all the stim drugs and I will make follicles like nobody’s business, but I won’t make enough eggs for even a small omelet.  I usually make 1 extra egg to make egg plural.   I felt like I was getting a participants’ ribbon in the game of life.  No trophy, no medal, no baby, just bruises and laundry detergent bottles filled with old needles.  

I never thought that was going to happen.  My levels weren’t complete garbage, I started doing paleo months earlier and had dropped 30 plus pounds, I was taking high doses of stim drugs, I did weekly acupuncture, I went on leisurely walks, listened to fertility meditations on Spotify, all I needed was this little push and all this work, effort, time, tears, and money would pay off.  

It didn’t.  

I was 2 IVF cycles in, resulting in a combined total of 4 mature eggs.  All my eggs were meh quality.  You wouldn’t send them back to the kitchen, but you know you have had better.  None of my embryos were sticking.  All of my hopes were as meh as my eggs.

The money I had scrounged up from driving for Uber and schlepping the occasional pantsless man around Indianapolis plus the cash I had acquired from refinancing my house was running out.  It was a dark time with a very small night light at the end of the tunnel.  

After my 2nd failed cycle I had my WTF call with Dr. Kiltz.  We had a quick, compassionate, straight shooter talk about the state of the union.  We decided to take a less is more approach and give my eggs one last try.  Fewer meds, hopefully, better quality.  I also decided to throw myself all in on his Keto plan.  One meal a day at dinner.  Beef, butter, bacon, and eggs.  I figured I can’t completely control the meh-ness of my old eggs, but I can control my feeding regimen.  It’s amazing how much time you free up when you are only eating once a day.  I all but Marie Kondoed everything in my world.  I also decided to add c0-q10 into the mix.  

In a moment of realism with myself and my bank account, this was probably fiscally and emotionally the last cycle I had in me for now and possibly forever.  

With that in mind, I received an amazing gift from a dear friend.  My good friend since high school had embryos on ice.  The Cadillac of embryos is what I called them.  All high quality, and ready to drive off the lot into my empty womb.  She offered these supped up Caddies to me.  She not only offered them, but she and her husband also jumped through all the hoops and paperwork needed to make them available to transfer from Florida to NY.  Accepting this offer wasn’t necessarily a no-brainer.  I was worried about my friends, their kids, me, and the baby I might have with their embryos.  Is this a gift they can truly give and one I can fully accept?  After lots of talks and visiting a therapist the answer for us was yes.  It was both stressful and comforting to know that I had this state-of-the-art high-quality safety net waiting in the wings.  

I began cycle 3 in a headspace of optimism splashed with mindfully low expectations.  I knew to go in we were expecting fewer follicles and fewer eggs.  Knowing this helped me.  I continued my usual prep of acupuncture and walks with the added features of carnivore Keto.  It was a pretty similar scenario as my 2 prior attempts, but something was…different.

I was thinking of those differences one night as I was taking my evening walk and a bird went on my head.  Someone told me this is a sign of good luck.  It felt more like bird shit in my hair.

I was thinking of those differences again when I went in for my follicle monitoring ultrasound, and it looked as if my uterus was smiling at me.  Almost like it knew something I didn’t.  A friend told me my ultrasound looked like a mere cat.  In a side by side comparison, it did indeed look like a mere cat.

If this wasn’t going to be my best cycle it was going to be my funniest.  

Following the mere cat ultrasound, I was told it was time to head to Syracuse.  Armed with my best friend from 1st grade and a bottle of holy water her mom gave her for long car trips, we set off from Indy.  

Our visit to CNY went smoothly.  We sat in the waiting room splashing holy water like I was about to have an exorcism priority retrieval.  When I woke up, I was told they retrieved 2 eggs.  One egg enough to make it plural.  I ate a ginormous Burger King cheeseburger and milkshake and slept and waited.  

The CNY report call came the next morning while I was in the shower attempting to smuggle high-value Marriott shampoo into empty water bottles.  

Both eggs mature, both fertilized.  It was awesome news, but the news I had heard before.

I returned home with my moderate optimism, my carefully kept expectations, a ½ used Dasani bottle of holy water, and 6 ounces of stolen hotel shampoo and conditioner.  

I returned home to wait for my period, to wait for my 40th birthday, and to wait for my final transfer.

15
Feb

Keto, PCOS, and More

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Guest written by: LAURA GILSTRAP RD, LD/N

What’s all the hype about this ketogenic diet? Despite its recent spike in popularity, the ketogenic diet has been around for over 100 years. Dr. Atkins popularized his low-carbohydrate Atkins Diet with a strict ketogenic “kick-off” during the first two weeks of his plan. Recently, however, new research and clinical experience has shown it to be highly beneficial for those suffering from POCS and infertility in general.

So, What is the Ketogenic Diet?

In essence, the ketogenic diet is a diet that causes the body to release ketones into the bloodstream through a very low carbohydrate, high fat, moderate protein meal plan. The breakdown consists of about roughly 70% of your calories from fats, 20% protein, and 10% or less from carbs. To put this in perspective, the average American diet is usually 60-70% carbs, 10-30% fat, and 20% protein. In the absence of circulating blood sugar (energy from carbs), the body begins breaking down stored fat into molecules called ketones. This process is called ketosis, and it works by forcing the body to run off the fuel provided by the ketones.

The good news is that fats are an important part of the diet protocol. Fats support hormone production, brain function, and have 9 calories per gram, which helps us feel satiated.

What is PCOS and How Does Insulin Resistance Affect It?

PCOS is the most common endocrine disorder affecting women of reproductive age and is associated with obesity, infertility, hyperinsulinemia, and insulin resistance. PCOS is also associated with medical abnormalities such as type 2 diabetes mellitus and dyslipidemia (1,2). While the etiology of PCOS is still unknown, researchers have found that insulin resistance is one of the root physiological imbalances in most, if not all, PCOS women (3,4). Insulin is the body’s “storage hormone.” When carbohydrates are eaten, the body detects a rise in blood glucose and releases insulin.

Insulin is made in the pancreas. Its primary job is to control the body’s blood sugar levels and tells the cells to absorb glucose when blood glucose levels rise. With the addition of too many carbohydrates, the cells spend less time burning stored body fat and more time burning glucose. Eventually, insulin levels are high all the time, and the body stops burning stored body fat and instead, begins depositing fat – particularly in the belly region. Over time, this chronic exposure to excess insulin leads to “insulin resistance.”

Someone with insulin resistance is burning predominately glucose. When these people run out of glucose from their last meal, instead of easily transitioning over to a “fasted state” to burn fat, they become hungry for more glucose. Think about it this way…why would an obese person ever be hungry? They have enough fat stores to last a long time right?  The average overweight person is used to having a constant supply of glucose circulating in their blood, which means they are continually burning glucose rather than fat. So what happens when an overweight person stops eating for a few hours? They run out of glucose from their last meal, and instead of seamlessly transitioning to burning stored body fat, they become hungry for carbohydrates! It’s a vicious cycle and over time, the constantly elevated levels of glucose and insulin lead to resistance.

Insulin also acts on the ovaries, causing them to produce the male hormone, testosterone. When there is too much free-floating insulin, the ovaries respond accordingly and make a lot of testosterone. Insulin also decreases the production of sex-hormone binding globulin — a glycoprotein that prevents testosterone from entering the cell (5). With less sex-hormone binding globulin and more androgen production, free testosterone can freely float through the blood and interfere with normal cellular function. All this excess testosterone causes many PCOS women to have hair growth on the chest and face, thinning hair, irregular periods, mood swings, infertility, anxiety, fatigue, low sex drive, and/or acne.

PCOS and the Ketogenic Diet Research

Many studies have examined the benefits of the ketogenic diet and are showing promising results thus far in regard to an array of conditions such as acne, cancer, traumatic brain injury, and Alzheimer’s disease. PCOS, a very hot research topic, is being heavily researched with outcomes showing a strong connection.

One pilot study in North Carolina explored the six-month metabolic and endocrine effects of a low-carbohydrate, ketogenic diet (LCKD) on overweight and obese women with PCOS. 

Eleven women with a body mass index >27 kg/m2 and a clinical diagnosis of PCOS were recruited from the community. Participants limited their carbohydrate intake to 20 grams or less per day for 24 weeks. In the 5 women who completed the study, there were significant reductions from baseline to 24 weeks in body weight (-12%), percent free testosterone (-22%), LH/FSH ratio (-36%), and fasting insulin (-54%). There were non-significant decreases in insulin, glucose, testosterone, HgbA1c, triglyceride, and perceived body hair. Two women became pregnant despite previous infertility problems.

This LCKD led to significant improvement in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS over a 24 week period. (6)

Another study conducted at the Cleveland Clinic examined fertility treatments tailored to insulin resistance in four women with PCOS. The goal of the study was to see if the ketogenic diet would improve the outcome of fertility treatments by significantly reducing insulin levels and their harmful effects on the ovaries.  All four patients successfully adhered to the ketogenic diet and were able to lose weight (between 19 and 36 pounds). All four patients had irregular periods prior to starting the diet. Within just four to eight weeks of starting the diet, they resumed regular menstruation. Two women were able to conceive spontaneously without ovulation induction.

Putting It All Together

PCOS has been described as low-level chronic inflammation condition. The combination of the ketogenic diet, anti-inflammatory foods, exercise, and lifestyle changes can help ease PCOS signs and symptoms in many ways. Below are a few guidelines to create the right PCOS plan:

1.Adhere to a Very Low Carbohydrate Diet

Eating carbohydrates, especially refined carbohydrates with no fiber, raises both glucose and insulin. Set a goal to start below 50 grams total carbohydrates per day. If this makes symptoms worse after a couple of weeks, increase carbohydrate consumption by 5 grams per day until energy levels have returned. Once a healthy energy level has been obtained, try reducing carbohydrate intake by 5-10 grams per day to increase the free-floating ketone levels and fat-burning capacity.

2. Intermittent Fasting

There are a number of ways to do an intermittent fast, but the easiest and most popular way involves taking advantage of the natural overnight fast by skipping breakfast and eating at lunch time. Once the 12 hour mark from dinner the night before has been reached, the body is truly in a fasted state and will begin burning fat for fuel. Benefits of intermittent fasting include fat loss, insulin sensitivity, the starvation of bad gut bacteria, improvement of brain function and fatty liver, and the reduction of inflammation.

*If you are a diabetic, or taking diabetes medications, consult with a physician before starting a fasting protocol.*

3. Exercise

Mild exercising for a minimum of 30-45 minutes 4x/week will greatly help with fat adaptation, weight loss, and insulin regulation.

4. Hydration

Water is a key element in ones journey to PCOS recovery, as it transports hormones to different parts of the body, removes harmful toxins, and carries essential nutrients to reproductive organs.  Additionally, dehydration can alter mood and disrupt the mind-body connection, which is important for maintaining homeostasis and fertility.  It is recommended that the average woman drink roughly 1-2 liters of water a day.

5. Natural Supplements

Research shows that supplements may help with hormone regulation, insulin resistance, and inflammation associated with PCOS. Here is a list of the most popular:

{Supplements are not regulated by the U.S. Food and Drug Administration (FDA). Speak to a Physician before taking supplements. Some may interfere with other prescribed PCOS treatments and medications.}

Flax Seeds: Flax seeds are known to increase sex-hormone binding globulin levels and reduce androgen and insulin levels, making it an ideal supplement for women with PCOS.

Cinnamon

Cinnamon comes from the bark of the cinnamon tree and has been shown to have a positive effect on insulin resistance, mensuration, and ovarian function. Intake: ½ to 1 teaspoon per day is all you need.

Nuts

Nuts are a healthy addition to any diet. Walnuts and almonds, in particular, have the most beneficial effect on women with PCOS. Almonds decrease free androgen levels and walnuts increase sex hormone-binding globulin.

Apple Cider Vinegar (ACV)

Apple cider vinegar has been shown to increase insulin sensitivity in several studies, including a trial in women with PCOS. In this trial, seven women with PCOS took one tablespoon of ACV per day. After 40 days, 4 of the women resumed ovulating, 6 experienced a measurable reduction in insulin resistance, and 5 had a decrease in their LH/FSH ratio (this indicates less androgen production). Intake: 1-2 tablespoons per day.

Magnesium

Almonds, cashews, spinach, and bananas are PCOS-friendly foods rich in magnesium. Magnesium deficiency reduces insulin sensitivity and increases nerve excitability, leading to more stress, more tension, and more PCOS symptoms.

Zinc

Zinc is essential for the functioning of enzymes, hormones, and the immune system. A deficiency in zinc can cause a hormonal imbalance and make PCOS worse. Additionally, excessive or unwanted hair growth and alopecia may be improved with zinc supplements.

Inositol

A sugar alcohol chemical compound found in foods like citrus fruits and nuts, inositol is one of the most well-studied PCOS supplements. Most notably, inositol appears to promote ovulation and fertility. Countless studies have shown that inositol supplementation may also improve insulin resistance and decrease male hormones in the bloodstream.

Vitamin B9

Vitamin B9 is essential for women with PCOS who are trying to start a family. To improve fertility, researchers suggest that women who are at a healthy weight should take 400 micrograms of folic acid, and obese or overweight women should take 5 mg of folic acid. If a diagnosis of MTHFR gene has been determined, supplementing with L-methylfolate or 5-methyltetrahydrofolate (5-MTHF). You also can get plenty of folate by eating collard greens, broccoli, cauliflower, asparagus, kale, spinach, and cabbage.

Vitamin D: Vitamin D is a hormone produced by the kidneys.  It is vital to the endocrine system and is a very common deficiency in women with PCOS. Vitamin D and calcium may improve irregular periods and restore ovulation.

Exogenous Ketone Supplements and their Benefits

The term “exogenous” refers to anything that comes from outside the body. Supplements are therefore considered exogenous because they are ingested rather than produced by the body.

Recently, ketones are being proposed as super-metabolic fuel (7) and as discussed above, many studies have examined the benefits of the ketogenic diet. In addition to the studies performed strictly regarding the effect of a ketogenic diet, there are also studies which highlight the benefits of the exogenous ketone bodies themselves. Using ketones instead of glucose for fuel is associated with a number of benefits:

  1. Weight Maintenance

Ketone bodies kick-start your metabolism, which increases the production of superoxide and glutathione, two antioxidants that protect our cells from oxidation.

2. Glucose and Appetite Control

Ketone bodies themselves have been shown to help with glycemic control and hunger hormone regulation, and they act as an anti-inflammatory agent within the body.

3. Physical Endurance

Skeletal muscles have the ability to re-synthesize ATP (energy) from other substrates, including ketones. This is why exogenous ketones can effectively fuel the muscles during workouts. Exogenous ketone supplements specifically provide an advantage since they require less oxygen per mole of carbon to oxidize.

4. Muscle Repair

Research shows that nutritional ketosis can optimize protein synthesis after a workout, helping with recovery and also encouraging more fat oxidation in comparison to carbohydrate metabolism.

5. Neurological Enhancement

Ketone bodies can reduce neuronal loss and improve neuronal functioning. Additionally, they can prevent damage from oxidation in an area of the brain called the hippocampus—the part of the brain directly in charge of memory, emotion, and the autonomic nervous system.

The Alzheimer’s Association calculates 5.3 million cases of Alzheimer’s disease in the US with projections of as many as 16 million cases by the year 2050. With no cure for this disease, researchers are focusing on the positive outcomes a low carbohydrate diets can have on cognitive impairments.

A small study published by Neurobiology of Aging tested 23 subjects with mild cognitive impairments or Alzheimer’s disease. They were each asked to consume an exogenous ketone supplement drink that elevated ketone levels in their body. Researchers found that those with higher ketone levels experienced greater improvements versus those with lower ketone levels.

Conclusion

Polycystic Ovarian Syndrome is responsible for as much as 70 percent of infertility issues in women. In addition to that, it causes frustrating and embarrassing symptoms like acne, male-pattern baldness, anxiety, mood swings, weight gain, and fatigue.

Fortunately, you can combat PCOS symptoms with the right combination of diet, exercise, and lifestyle choices. The ketogenic diet may be one of the best diets for women with PCOS because it reduces insulin levels and insulin resistance.

During the PCOS road to recovery, make sure to consult with a Registered Dietitian, Reproductive Endocrinologist (RE) and/or Primary Care Physician. He/she can order different blood tests that will confirm how well the new diet and lifestyle are working.

References

  1. Moran LJ, Noakes M, Clifton PM, Tomlinson L, Norman RJ. Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88:812–819. doi: 10.1210/jc.2002-020815. [PubMed] [CrossRef]
  2. Huber-Buchholz MM, Carey DGP, Norman RJ. Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab. 1999;84:1470–1474. doi: 10.1210/jc.84.4.1470. [PubMed] [CrossRef]
  3. Yancy WS, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. Ann Intern Med. 2004;140:769–777. [PubMed]
  4. Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med. 2005;142:403–411. [PubMed]
  5. Aydin B, Winters S. Sex Hormone-Binding Globulin in Children and Adolescents. J Clin Res Pediatr Endocrinol. 2016 Mar; 8(1): 1–12.
  6. Mavropoplos J, Yancy W, Hepbum J, E Westman. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study. Nutr Metab (Lond). 2005; 2: 35.
  7. L Gupta, D Khandelwal, S Kalra, P Gupta, D Dutta, and S Aggarwal. Ketogenic diet in endocrine disorders: Current perspectives. J Postgrad Med. 2017 Oct-Dec; 63(4): 242–251.

 

 

Views herein are those of the author and do not represent CNY Fertility on any official behalf. 

26
Dec

Improving Your Fertility Naturally

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At CNY one of the most common questions, people ask on a daily basis is what they can do to improve their fertility “naturally.” The answer is the same whether that is for intercourse or in preparation for treatment.  The short graphic below sums up just about everything we recommend individuals take and remember that sperm make 50% of any embryos genetics and also play a part 50% of all cases of infertility so it is important that men, as well as women, consider the following to improve their odds of a successful pregnancy. The following should be done for 30-90 days prior to any treatment when possible. 

For those of you who don’t like easy to follow charts, here’s a nice paragraph for you.  For women, we recommend a high-fat low carbohydrate diet (B.E.B.B., Keto, or paleo if the other two are not suitable for you), CBD, Ovavite, Theromega, Ovasitol, Vitamin D (if lower than 30), DHEA (unless you have PCOS). For men, we recommend a high fat low carbohydrate diet, CBD, conception XR, theromega, Ovasitol, Vitamin D (if lower than 30), and NeoQ10. You can buy the CBD here at shop.cnyfertility.com and the others for a slight discount here: https://services.theralogix.com/landing/cnyfertility/ with the PRC: 113205

*B.E.B.B. Is Dr. Kiltz’s Keto Bacon, Eggs, Butter Beef – the high-fat ultra low carb diet for optimal fertility enhancement (oh and did we mention Dr. Kiltz’s Ice cream is A OKAY!). For information on a more moderate keto google Maria Emmerich or buy one of her books on Amazon.

**CBD is a natural anti-inflammatory supplement that CNY has been pioneering to help improve fertility outcomes. Full spectrum, with less than .3% TCH, but loaded with over a dozen cannabinoids that synergistically provide the greatest effect is best.  Those subject to random drug tests for work should opt for THC free CBD isolates.  Buy yours at shop.cnyfertility.com.

***For more information on fertility supplements visit: cnyfertility.com/nutritional-supplements. To order your theralogix supplements head to services.theralogix.com/landing/cnyfertility and use PRC code 113205

****LDN, HGH, HCG and Clomid are prescription medications. LDN reduces inflammation, clomid, HCG, and HGH improve egg/sperm quality. Please contact us through your patient portal to have these medications ordered for you in advance of treatment.

9
Nov

How To Deduct the Cost of IVF

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23
Oct

The Ultimate Guide to Choosing Your First Fertility Treatment

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Asking yourself, “should I do an IUI or IVF as my first fertility treatment?” What about starting with a more natural timed intercourse? One of the most common questions people ask when they first begin doing their research on infertility treatment is, “what fertility treatment should I start with?” While many presume it’s always best to start with the least intervention possible, that’s not always the case.

It’s a great question and while every situation is unique and you should consult with your own personal fertility specialist, we’ve asked one of our Board Certified Reproductive Endocrinologists, Dr. Edward Ditkoff, to answer a few questions and help get you started.

Timed Intercourse

Q:  What is one situation in which you recommend pursuing timed intercourse as an initial treatment option, and why?

A:  “As long as the female has a normal ovulatory cycle, her anatomy is normal, the sperm count is normal, and they have not been trying to get pregnant for a long time, I think it’s a suitable way to start fertility treatment. Typically, the older the patient, the less time you would recommend pursuing timed intercourse. But if they’re younger, under 30 years of age, everything seems to be normal, and they haven’t really tried to get pregnant yet, I think that’s a good first option. “

Q:  What is one situation in which you recommend AGAINST timed intercourse as an initial treatment option, and why?

A:  “I would not recommend timed intercourse in an older patient who should be more aggressive. I would not recommend timed intercourse for a woman 37 years of age or older attempting to conceive on their own for a year or so unsuccessfully.  Otherwise I don’t really think we are helping these patients conceive as efficiently as they should, which I would think they’re interested in since they’re seeing a fertility specialist.”

IUI

Q:  What is one situation in which you recommend pursuing IUI as an initial treatment option, and why?

A:    “One situation in which I would recommend pursuing IUI as an initial treatment during initial fertility treatment attempts, is if the female pelvis is anatomically normal with or without an ovulation issue. Insemination can be used with women who ovulate normally as well women who don’t.  As long as there’s adequate sperm from their partner or from a donor.  Typically, I would not recommend IUI if the patient, upon initial consultation, has been attempting to conceive for a long time with a male partner who has a normal semen analysis.”

Q:  What is one situation in which you recommend AGAINST IUI as an initial treatment option, and why?

A:    “If a patient has tubal disease, that’s one situation in which I would recommend against IUI. The reason would be, if the fallopian tubes are blocked, the insemination would be ineffective and conception would not occur.  If the tubes are partially blocked or open and diseased, that would increase the risk of an ectopic pregnancy.  Obviously, I would not recommend IUI if the male factor is severe enough that there is not sufficient sperm.  Specifically, if the total motile sperm count is less than 10 million sperm.  In the past, we used 2 million motile sperm as the cut-off, but these days, we generally use 10 million.”

IVF

Q:  What is one situation in which you recommend pursuing IVF as an initial treatment option and why?

A:  “There are two situations in which we recommend pursuing IVF as an initial treatment option:  (1) if the fallopian tubes are blocked and the patient is otherwise fertile in terms of age, good ovarian reserve, etc. she is an ideal patient to undergo IVF;  (2) if the male partner has a very low sperm count (less than 10 million total motile sperm) with an otherwise normal, fertile female, that couple is also an ideal patient to begin IVF as an initial treatment.  Obviously if the fallopian tubes are blocked then the sperm and egg cannot get together. Similarly, if the sperm count is below 10 million total motile sperm, then the probability of the sperm finding the egg on its own is low as well, even with other fertility treatments such as IUI. IVF is the ideal solution in these cases.”

Q: What is one situation in which you recommend against IVF as an initial treatment option and why?

A:  “Even though I am an IVF doctor and I think IVF has a potential benefit for almost any type of patient if not every patient, there are situations where it is not warranted. For example, for a 23-year old otherwise normal male and female couple who only have an ovulation factor to be concerned about, letrozole or Clomid IUI is a very reasonable initial treatment option to consider. Why? Because they are very fertile and unless they want to preserve their fertility, there is no reason they need to do IVF.  All they need to do is induce ovulation, correct the underlying problem, and pregnancy should occur hopefully within a 3-month trial period.  Regarding cost and invasiveness of treatments, couples most often prefer to be more conservative. This would be one situation in which I would recommend against IVF as an initial treatment option.”

28
Aug

Dr. Kiltz’s Ice Cream Recipe

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Let’s just put it this way – you’ve never had Ice Cream like this before. Quite frankly after trying this pulling out that Ben and Jerries Pint is going to feel like a bit of a shame.

 

Plus . . . IT’S KETO AND B.E.B.B. approved.

 

 

 

19
Mar

CNY Fertility IVF Grant/Giveaway March 2018

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As part of a thank you to all the incredible families and families to be in our CNY Fertility Community we are incredibly excited to announce that for CNY Fertility’s third IVF Giveaway of 2018 we have partnered with Theralogix and Maplewood Suites to bring a more complete fertility care package to the winner of our March IVF Grant/Giveaway.

By partnering with Theralogix and Maplewood Suites we will now be providing the winner of the IVF Grant/Giveaway with a FREE IVF Cycle, all of the FERTILITY SUPPLEMENTS needed for your care, as well as FREE ACCOMMODATION (should you be coming from out of the area).

Now, for the ever so boring but important rules and details:

Eligibility and submission:

  • To enter yourself for a chance to win a the IVF Grant/Giveaway you MUST like the post AND share your fertility story in a comment on the associated Facebook or Instagram Post.  The comment must be at least 4 sentences long to be considered a valid submission. The comment must be related to your fertility journey, TTC, fertility treatment, etc.
    • Please tell as much of your story as possible and try to provide any tips you think others may find helpful.
  • You can submit a comment on both Facebook and Instagram to increase your chance of winning.
    • You can submit multiple comments to each post, but submitting multiple comments on each platform will NOT increase your chance of winning. Duplicate entries will be removed before randomly selecting the winner.
  • The IVF Giveaway Winner will be selected on Saturday, March 31 – submissions due March 30th.
  • Partners (husband/wife/boyfriend/girlfriend/etc) CAN apply.
  • The IVF Cycle CANNOT be transferred to a friend or family member other than your partner/significant other.

What the randomly selected winner receives:

  • One Free IVF Cycle
    • This Includes: Oocyte Retrieval, Intracytoplasmic Sperm Injection (ICSI), Assisted Hatching, Embryo Transfer, and Cryopreservation and storage of Surplus Embryos for a period of one year following the fresh IVF Cycle.
    • What is not included: Monitoring, medications, FETs ($250/transfer), Donor Egg, Donor Sperm, Donor Embryos.
    • You must schedule your initial consultation with one of our CNY Fertility Center locations within 6 months of the completion of this giveaway. You will not be charged for this consultation if your insurance does not provide you coverage. If you are a past CNY Fertility Client you will need to come in for a follow-up appointment within 6 months of the completion of this giveaway.
    • You must start your Free IVF cycle within 1 year of the completion of this giveaway.
  • All Theralogix Fertility Supplements that Dr. Kiltz recommends for the entirety of the cycle corresponding to this IVF Giveaway.
  • A free stay in a Single Queen Efficiency Room (up to 3 people) at Maplewood Suites in Syracuse, NY for your treatment if you are coming from out of the area beginning the day before your egg retrieval and ending the day after your embryo transfer if you are staying for a fresh transfer and beginning the day before your egg retrieval and embryo transfer and ending the day after your egg retrieval and embryo transfer should you be doing a frozen embryo transfer. Blackout dates apply and are subject to change. Current blackout dates include April 6th through the 8th, April 25th through the 29th, May 11th-13th, May 15th-23rd, and June 1st-3rd.
    • Due to the blackout dates, CNY Fertility will be happy to schedule your treatment cycle around these days to the best of our ability to assure you receive the free accommodation as part of this giveaway.
    • Free Accommodation is good for one treatment cycle. Accommodation will not be provided for multiple Frozen Embryo Transfers.

More about our partners:

Theralogix:

CNY Fertility Center has chosen to partner with Theralogix® to offer a comprehensive line of evidence-based, independently tested and certified nutritional supplements. Theralogix supplements have been approved by a Medical Advisory Board comprised of nationally reputed physicians and scientists after a detailed review of the most recently published scientific data. Speak with your CNY Fertility specialist to learn more or head to https://services.theralogix.com/landing/cnyfertility/ to buy yours today at a slight discount through CNY Fertility.

Maplewood Suites:

Maplewood Suites is our premier hotel partner providing accommodations for our out of town clients in the Syracuse area for only $99/night. As included in all of their stays, Maplewood Suites provides our clients with free transportation to and from the airport, CNY Fertility, and between any entertainment/restaurant/etc and the hotel (not from one entertainment location to the next) within 5 miles of the Hotel.

Additionally, Maplewood Suites provides complimentary breakfast, afternoon snacks, 24/7 Starbucks coffee, and two free drinks (non-alcoholic during your treatment at CNY) per day from their restaurant lounge.

 

 

*No Cash Value for any of the winnings

*CNY Fertility is not responsible for upholding any of the partner gifts/giveaway offerings.

*The winner must have no outstanding balance at CNY before starting their free cycle.

28
Mar

A Uterus Fit for a Shutterfly: A Story of Single Parenthood, IVF, and Infertility

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I have enough pictures of my uterus to make a Shutterfly book.  It would be a mid-length Shutterfly book, absent of any color photography, and debatably artistic.  Not sure this a Shutterfly book anyone would want to put on their coffee table or would want for grandparents day, but regardless, I have at least 18 quality photos to make a book happen.

A Shutterfly book of uterus pictures is one of the unique upsides I have found since I belly flopped into the baby-making pool.

Here’s me in a nutshell.

I am 39.  Not old in the big picture of things, but basically somewhat hag-like in the fertility realm.  Advanced maternal age they call it.  I sometimes picture my eggs sitting in rocking chairs eating oatmeal, listening to show tunes.  It makes the idea of having old eggs a bit more emotionally manageable.

I’m single.  Super-single.  I think my last “quality” date was in 2010, and the only reason that date made quality status is because he turned out to be an excellent beer pong partner.

In this life I have known of only a few true things; that all clowns are creepy, that Jordan Knight was the superior New Kid on the Block, that if I made it to the Price is Right stage that I would walk away with both showcases, that I want my last meal to be a Dairy Queen Blizzard, and that one day I wanted to have a child.

It surprised me that one day would sneak up on me so quickly.

I come from a family that appears to be reproductively gifted.  My dad is one of 9, my mom is one of 12, and I am one of 5.  I was really banking on this family history to lead me into the reproductive promise land.  Much like Pinterest made me believe I could paint the aluminum siding of my 2-story house with only a paint sprayer and a 6ft step ladder, my family history gave me the false confidence that me and my eggs had all the time in the universe.  8 failed pregnancy tests later, evidently that is not the case.

When I started to muse to myself that maybe it was time to get cracking on this family making notion, I had a chat with my girly bits doctor.  I wanted to get her thoughts and to share with her my “plan”.  My “plan” was to get my mind wrapped around things, save a little money, and then in March, when it was super convenient for me, start trying.  After listening and absorbing my thoughts, my doctor told me to take my plan, roll it up tight, and then slap myself in the face with it.

If I was serious about spawn, she recommended to start trying immediately.  That was a little more than I expected to hear on a leisurely fact-finding mission. I needed to act, and I needed to act now. Much to my surprise, you don’t do this type of thing at your girly doctor.  You need a fertility specialist, loads of blood work, some super personal selfies, and a bunch of money to set on fire.

You also need to call your parents and explain to them how you have been thinking about getting knocked up by science.  All of these things are somewhat daunting and happen in rapid succession in my experience.

Calling my parents was…something. My mom was supportive, hesitant but supportive.  Insistent on a Catholic donor, but supportive. My dad was quiet, and quiet is not what I expected from my feisty Arab father.  I expected some rage, a truckload of disapproval, and a threat on my life. What I got was quiet. After the quiet came the, “Maybe if you wore more makeup, or went to the gym…there’s nothing wrong with you!” This felt a lot like he was calling me fat and ugly, but really it was him telling me that anyone would be lucky to be married to me.  I chose to find the rainbow in this conversation.

After a lot of sobbing on my part, my father gave me his blessing to make myself happy. So, I happily went through the process of selecting a donor.  Much like with my dating life, my preferences are very simple; tall, white, smart.  Shockingly, searching through a donor catalog to find these attributes was easier than it has been while dating for 24 years.

I would like to say that I knew I had found my donor when the skies opened up, a light beamed down from above, and an angel got its wings.  In reality, I read in my donor’s profile that his favorite movie was the South Park film.  That clinched it for me.

I ordered up a small vial of my donor for the low, low cost of $475 per vial, which does not include the $225 in shipping and handling.  Once, I happened to be at my doctor’s office at the time of my donor’s delivery.  I took a selfie with the package, partly for the hilarity and partly to show my kid a picture of me with his or her father.

In the days ahead I peed on ovulation strips and took my temperature until it was time to go in for the big show.  An insemination is about as romantic as it sounds.  It’s held in a well-lit, candle less room, no lobster dinner, and is conducted by a kindly nurse who makes small talk about the curve in your cervix and the total motile sperm provided by your donor.  Once the deposit is made, you are left to wait…and wait…and wait.  I have been waiting now for almost a year.

In a year I have spent about $15,000, cried more tears than I knew my face had in it, learned that I was stronger and weaker than I thought I was, and that support isn’t always what you think it is.

Each month for a year I have mourned a baby that never was.

That’s been really tough.  Mourning a fictitious baby.  Each month you have to treat yourself like you are pregnant.  I don’t drink, I abstain from caffeine, I avoid jumping on trampolines.  Each month you behave like you are a vessel of life, until your body reminds you that you are way less vessel and much more a PMS Chocolate Monster.  It’s probably the cruelest thing about the process.

Through this odyssey, I have lost lifelong friends who don’t approve of my decision.  People who used to call me every day on their way home from work I think have lost my number.  I have a closet full of baby hand me downs that I can’t bear to open.  Every time I pop a prenatal vitamin I feel like a sham.  I have felt alone and unrelatable.  I have felt jealous of strangers in the Cracker Barrel with pregnant bellies.  I have wondered if this is all a punishment for something I did or did not do.  My 92-year-old grandmother has begged me to not do this, and to go to the Catholic orphanage and get a cute girl baby.

I wish I could say that there have been numerous moments of joy and hope along the way, but anyone who has gone through this would call me a liar.  In an effort to make graham crackers into s’mores, I have tried to find the upside when I can.  Where the joy has been absent, I have found comfort instead.  When hope seems to be empty, you find a small muster of strength under a couch cushion.

For each friend who has abandoned me, I have a friend who has gone to every doctor’s visit with me, has listened to me cry and rage for hours, a friend who against her better judgement, has given me hormone shots in my ass.  If that isn’t love, I don’t know what is.

This process is pretty cruel and pretty exhausting, but what’s the alternative?  To throw my hands up in the air and do nothing?  To concede on a life that I have always wanted?  To return all the pants I bought with elastic waistbands?  While probably the least expensive alternative, it’s not the most reproductive.

While I am down, hanging on the ropes, with a pretty good gash to my soul and spirit, I think I have 10 rounds in me.

My fertility specialist has told me it’s time to move on to IVF.  Moving on is costly, and stressful, and costly again.

Moving on means more needles, and hormones, and doctors visits, a needle in an area where I don’t what needles, and a more full-time 2nd job.  It means spending $30,000 of money I don’t have.  Moving on means, I have a chance to succeed and a chance to fail.

Moving on means I could replace my Shutterfly book of uterus pictures with a book featuring my baby.

So on, I move.

 

Written by: Angela

18
Apr

Client of the Week: Katie Tamez – A Proud Fertility Fighter

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We knew it wouldn’t be easy to start our family as I had multiple surgeries to remove scar tissue and endometriosis.

When I was 15, I was diagnosed with Poly Cystic Ovarian Syndrome. During my last surgery in November 2016, both of my Fallopian Tubes were removed. They were blocked and heavily damaged and at this point were causing more harm than good.

Though I knew it was the right thing for my body, I fell into a bit of a depression. Any hope, no matter how little, of us having a family naturally was gone. My ob/gyn surgeon had recommended CNY Fertility to us and a month after surgery we had our first consultation with Dr. Corley.

We began keto and prepared for our first egg retrieval. I knew being depressed about the situation would not help my body prepare, so I began blogging and sharing our story through social media.

Infertility and IVF was taboo. No one talked about it, but once I started the conversation I started getting messages from friends asking for advice on trying to convince. The silence was breaking!

In February 2017 we had our first retrieval with Dr. Corley and ended up with 7 beautiful frozen embryos! Due to lack of insurance coverage after retrieval we had to put transfer on hold. It wasn’t our exact plan but we needed to save money to continue.

While we took some time off, we still continued to spread awareness and in October I was honored to do a TV interview with a local news station about IVF. At this point I knew I wanted to do more; not just for us but for all families going through infertility treatments.

So, I started contacting local, county, and state government leaders in New York asking why there wasn’t more coverage for families going through this. In March 2018 we finally began to prepare for our first frozen transfer. I was also invited back to the news station to give an update on our story and give some insight to NYS looking to move forward with infertility coverage.

We hope within the coming weeks we can travel to Albany to meet with government leaders in person and spread further awareness. But that will be on hold for a few weeks as we transferred our first embryo on April 3, 2018 with Dr. Kiltz and Great news!!

Our beta 4/13 was 349.89, on 4/15  it was 710, and our beta on 4/17 2003!!! We are 4 weeks 6 days as of today, the 18th. We did an ultrasound and saw a gestational sac!!

We love CNY so much. Without CNY Fertility we never would have gotten to this part of our journey. You guys, the nurses, doctors, and staff at both CNY Fertility and Healing Arts have become like family to us, helping our baby come home!!

And I still can’t wait to meet Chris at the capital in a few weeks! Even though we are pregnant we will still continue to fight with you guys and get better healthcare coverage for everyone!