Posts

25
Jun

Nutrition for Fertility: High Fiber Foods

by

Consuming high fiber foods is important for all people; but it is especially important for those who have PCOS and endometriosis and who are trying to conceive a child.
Fiber helps the body to properly regulate blood sugar levels. Stable blood sugar levels boost fertility because of the balancing effect on the hormone production. Simple carbohydrates or sugary treats with little or no fiber which have a high glycemic index cause blood sugar levels to plummet. This, in turn, can greatly interfere with estrogen production.
PCOS causes insulin resistance and makes it hard for your body to deal with sugar. The body takes it and converts it to fat—usually right around the middle, and it can happen very quickly. Adding more fiber to your diet can help you to reduce your weight which is often a challenging issue with those with PCOS. For those who are struggling with PCOS, eating high fiber, low glycemic carbs will make you feel full for a longer period of time, helping to curb those cravings that sneak up on us.
In women with endometriosis, the growth of the uterine tissue can form outside of the uterus. Often, it can be in the bowels. Hormonal imbalances further contribute to the growth of this tissue. So, following a diet that is high in fiber will serve to balance these hormones, and can result in less formation of uterine tissue.
Here are some great high-fiber, low glycemic foods to eat:

  • Beans and legumes
  • Raw nuts and seeds
  • Winter squash
  • Whole grains
  • Cabbage
  • Apples
  • Apricots
  • Chickpeas

Eating fiber also reduces inflammation and helps to eliminate the excess hormones in the body. When added with the proper amount of fluid intake, fiber will ‘remove’ through the bowels the extra estrogen and stops it from going back into the bloodstream.
Acupuncturists at each of our CNY Fertility & Healing Arts Centers are available to offer Nutrition Consultations. Please feel free to contact us to discuss this further.
Syracuse:
195 Intrepid Lane, Syracuse, NY 13205
315.671.5755
Albany:
38A Old Sparrowbush Road, Latham, NY 12110
518.724.5750
Rochester:
2244 East Avenue, Rochester, NY 14610
585.244.1280 ext. 2

24
Jun

Syracuse Endometriosis Support Night with Special Guest

by

heartbellyOn Wednesday, July 2nd, we are welcoming Heather Guidone, Surgical Program Director of the Center for Endometriosis Care and Vice President of the Endometriosis Research Center to our center for night of support for clients facing endometriosis.  At our Syracuse location, Heather will share her personal experiences with endometriosis, as well as many educational and support resources for clients facing similar challenges.  Lisa Stack, our Support Coordinator, will highlight some the support available at our center, and we will have plenty of time for discussion and questions.
If you are new to the diagnosis of endometriosis, or you have been coping with this for some time now, this will be a fantastic night of support for you!  We will meet from 5:30p-7:00p on Wednesday, July 2nd.  Please use the CNY Healing Arts entrance and the hostess will direct you to the kitchen.  To RSVP or if you have any questions, please email Lisa: Lstack@cnyfertility.com or message her directly within the Patient Portal.
For more information on endometriosis, please be sure to to read this article written by Heather for our site, and the recording of a teleworkshop we did together last year.
For all of our fertility support offerings, please check our CNY Fertility and CNY Healing Arts calendars.  Please let us know if you have any questions, and we look forward to hearing from you during these sessions!
One last note, did you know that we started  new Private Facebook Fertility and Pregnancy Groups for current clients?  We also have groups for Secondary Infertility and Pregnancy Loss. Here, you can find a safe and secure space to share with other women and men facing similar challenges.  You can get immediate support and feedback!  If you are interested in joining, please message Lisa Stack within the Patient Portal.
 
{{hrule}}
If you are interested in a more private one-on-one support situation, Lisa Stack is our CNY Fertility Center Support Coordiator, she offers her services as a lay support person and can be contacted by email at lstack@cnyfertility.com if you are not yet a client or via the Patient Portal if you are a current client.
Request Consultation or Appointment
If you are a new patient and would like an initial fertility consultation, in-office or over the phone, please visit this link and fill out our New Appointment Form or call us toll free at 800-539-9870.

29
Jan

The Fertile Secret: Nutrition for Fertility – Spices

by

spices and fertilityWhen following a fertility diet, something you might consider is to spice it up!  Using certain, ordinary kitchen spices may be helpful on the journey toward conception.
Variety is the spice of life and adding a variety of spices to your diet helps to shake it up.  Try adding different spices to your food as a substitute for salt or sugar.  It’s beneficial for most people to cut down on their salt and sugar intake. By cutting down salt and sugar, we can help reduce our blood pressure and stabilize blood sugar.  Spices also offer a great opportunity to add antioxidants and other beneficial nutrients to our diets without adding extra calories!  There are other benefits as well.
For women who are challenged with endometriosis, adding Curcumin which can be found in the spice turmeric (and gives the spice its beautiful, bright, yellow color) can decrease inflammation.  It is a member of the ginger family.  Adding Tumeric to recipes can stimulate the blood flow and helps to regulate menstrual flow.  Poor blood flow throughout the reproductive organs can result in endometriosis and cysts.
Eating foods flavored with the spice Cinnamon can bring relief for women with PCOS because its properties help to regulate insulin levels and blood sugar.  Once the blood sugar is stabilized, PCOS symptoms often start to improve.  Just a half a teaspoon per day can be beneficial.  Eastern belief has it that adding cinnamon and other “warming” foods to the diet can help the body prepare for childbirth.  This concept uses the idea that cold foods make the body work harder, which in turn makes the energy go into warming the body, instead of healing the body.
Garlic powder is another excellent anti-inflammatory spice that can help with ovarian cysts and endometrial tissue, as well as adding a great deal of flavor to dishes!
Request Consultation or Appointment
If you are a new patient and would like an initial fertility consultation, click here to request a phone or in-office visit, or call us toll free with your questions at 800-539-9870.
If you would like to learn more about nutrition for fertility our acupuncturists at CNY Healing Arts Wellness Center would be happy to schedule a consult and conversation with you. Visit our website for more information.

13
Oct

Using Laparoscopy to Help Diagnose Unexplained Infertility

by

One of the most challenging aspects of infertility care is helping couples understand why they have not yet become pregnant. About 20-30% of couples will have no definitive diagnosis after completing a standard infertility evaluation[r1] . In today’s fast-paced treatment paradigm, some patients prefer to move forward with treatment without further clarification. Although oftentimes appropriate, this strategy should not be applied to every patient/couple. Laparoscopy and hysteroscopy are minimally invasive, out-patient surgeries [r2] that can provide a diagnosis and sometimes even offer improved pregnancy rates if scar tissue or endometriosis is found and treated at the time of surgery.
Women with infertility are about eight times more likely to have endometriosis than women that have been pregnant. Treatment of endometriosis can not only reduce pain but also improve pregnancy rates as well. In fact, a large, randomized meta-analysis[r3] of the available research found that treating endometriosis was associated with about a 60% increase in the chance for a successful pregnancy. Additionally, if there is scar tissue preventing the egg from reaching the fallopian tubes this can also be identified and treated. So consideration of diagnostic surgical procedures can be beneficial. The challenge is in deciding which patients should pursue this option further.
A more recent study [r4] investigated the usefulness of these diagnostic surgical procedures from a financial perspective. They found that laparoscopy was cost-effective in improving pregnancy rates/outcomes based upon many factors including the potential impact of endometriosis. Finally, they also found that undergoing diagnostic surgery was associated with a lower rate of patients “dropping out” of fertility treatment before becoming pregnant. This suggests that having all of the information available prior to treatment is preferred by some couples experiencing infertility. In summary, if you are having trouble conceiving and want more information, minimally invasive surgery may be your best next step.
[r1]Link to http://jama.jamanetwork.com/article.aspx?articleid=197367
[r2]Link to http://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/minimally_invasive_surgery.pdf
[r3]Link to http://www.ncbi.nlm.nih.gov/pubmed/12519555
[r4]Link to http://www.fertstert.org/PhoenixWeb/PhoenixServlet/article/S0015-0282(08)01236-3/fulltext

Robert Greene, MD, FACOG
CNY Fertility Center
e-mail me at rgreene@cnyfertility.com
Call our toll-free number at 800.539.9870 or request a consult here.

24
Aug

Eating to Reduce Symptoms of Endometriosis

by

Diet may play a key role in reducing and relieving symptoms of endometriosis. Whenever possible, always choose the most natural state, whole, organic foods—and a variety of them! Some excellent sources that may help to provide relief are:
Vegetables and Fruits. Eating raw or lightly steamed vegetables is preferred. Organic is best. If using non-organic vegetables and fruits, peel them to remove the pesticides which may contain dioxin (which can increase estrogen levels and contribute to the symptoms of endometriosis).
Some of the greatest vegetables for endometriosis are from the cruciferous vegetable category! These vegetables are the powerhouse players of veggie nutrition. They can help to eliminate excess estrogen from the body which is found in women with endometriosis and help to improve the immune system. Here are some examples of these ‘cruciferous incredibles’: Arugula, Bok Choy, Broccoli, Brussels sprouts, Cabbage, Cauliflower, Collard greens, Kale, Kohlrabi, Radishes, Turnips, and Watercress.
Dark, leafy vegetables contain B vitamins. These help the liver to excrete the excess estrogen, and help breakdown circulating estrogen in the body. These veggies also help to relax muscles in the uterus.
Healthy Oils. Omega 3’s aid in reducing inflammation and possibly slow the growth of endometrial tissue. Try adding these to your diet: olive oil, flax seeds, walnuts, and cold water fish. Healthy oils prevent the prostaglandins that stimulate contraction and cause pain.
Fiber. Help to aid in digestion and the elimination of toxins from the body. Oatmeal, legumes, brown rice are good choices.
Iron-rich foods. Green, leafy vegetables, dried apricots, sunflower seeds are great sources of iron that helps with deficiency sometimes caused by the heavy bleeding and fatigue that occurs with endometriosis.
Mix and match! For example, try a salad made with arugula, top with a homemade oil dressing; add some cauliflower and seeds on top!
Request Consultation or Appointment  
If you are a new patient and would like an initial fertility consultation, click here to request a phone or in-office visit, or call us toll free with your questions at 800-539-9870.

21
Aug

Endometriosis

by

Endometriosis occurs when the inner lining of the uterus grows outside of the uterus. The lining can then attach itself to other areas such including the ovaries or the fallopian tubes. As well causing issues with fertility, this is often a painful condition.
There is no known cause that can be pinpointed for this painful disorder; however, there have been possible theories including:
• Hereditary factors
• Retrograde menstruation (period travels backwards through the fallopian tubes into the pelvis where they attach and grow
• Immune disorders
For many women, endometriosis can interfere with many aspects of their lives. Besides infertility issues, here are just some of the symptoms of endometriosis:
• heavy and/or irregular periods
• painful intercourse
• painful bowel movements
• urinary pain or difficulty
• abdominal pain
• backache
Sometimes if necessary endometriosis can be diagnosed (and treated) using laparoscopy. Laparoscopy is a minimally-invasive surgical procedure. Although there is no known cure for endometriosis, there are several treatment options, such as medications, that can be discussed with your health care practitioner.
Maya abdominal massage and acupuncture may help with blood flow to the reproductive organs and alleviate pain by eliminating toxins in the system. Herbal formulas and dietary changes may also be beneficial when treating the pain associated with endometriosis. Yoga can help to control weight gain and bloating that goes hand in hand with endometriosis. Yoga’s poses can also help to increase blood flow to the reproductive system and help to stretch the muscles in the back.
When endometriosis affects fertility, there are several options that can be discussed with one of the physicians at CNY Fertility Centers in Syracuse, Rochester, or Albany.
Request Consultation or Appointment
If you are a new patient and would like an initial fertility consultation, click here to request a phone or in-office visit, or call us toll free with your questions at 800-539-9870.

19
Jul

Laughter for Fertility

by

“What soap is to the body, laughter is to the soul.”
~Yiddish Proverb
Researchers in South Korea (H. J. Chung, et. al) investigated the effect of laughter therapy on the stress and anxiety that infertility patients often have to deal with. They recruited 40 patients undergoing IVF and all of them were given pre- and post-tests measuring stress levels. Half of the subjects were then provided laughter therapy. The patients in the laughter therapy group saw significantly reduced scores on the depression and anxiety scores.
In other research, the Oxford Conception Study showed that women with high concentrations of the stress indicator alpha amylase in their blood were less likely to get pregnant than women with lower stress hormones. Therefore, adding some humor to your day may be beneficial during the fertility process, especially when receiving fertility treatments.
Along with reducing stress, laughing can also help to:
*Relax the whole body
*Boost the immune system
*Release endorphins or the body’s feel-good chemicals which can even help relieve pain!
*Improve the function of blood vessels and increase blood flow
While every day may not be a “rolling on the floor laughing” kind of day, just adding a little bit of comic relief throughout your day may help with fertility as well as lighten your heart.
Ways to “pop” some humor into your day:
*Read a funny book, cartoon, or collection of jokes or quotes
*Listen to a humorous audiobook while you’re taking a peaceful walk
*Get together with a friend that cracks you up
*Download a song that makes you laugh on your phone or audio device
*Watch a movie or a sitcom that you find hilarious
*Install a photo that makes you giggle on your computer’s desktop or portable device
*Do something that pushes you outside of your comfort zone and makes you laugh
Request Consultation or Appointment
If you are a new patient and would like an initial fertility consultation, click here to request a phone or in-office visit, or call us toll free with your questions at 800-539-9870.

18
Jul

Diagnostic Hysteroscopy: Risks, How to Prepare & What to Expect

by

What is a Hysteroscopy?
Hysteroscopy is a procedure that makes it possible to look inside the uterus without an abdominal incision.   A small tube is inserted in the vagina, through the cervix and into the uterus so the inner surface of the uterus can be examined.  The uterus is filled with a solution of normal saline to expand and visualize the inner walls of the uterus.

Why is a hysteroscopy being performed?
Hysteroscopy is an excellent evaluation tool used to evaluate the endometrium and look at the inside lining of the uterus.  It provides an accurate diagnosis of fibroids or polyps or any other abnormal conditions of the uterus.
What are the risks of a hysteroscopy?
There are risks to any procedure.  Although the risks with a hysteroscopy are rare, they may occur in 3-6% of women and it is important you are informed of these risks.

  • Fluid overload-too much fluid absorbed in the blood from the uterus
  • Changes in the balance of water and salt in the blood
  • Fluid collection in the brain (cerebral edema) or the lungs (pulmonary edema)
  • Injury to the lining of the uterus including puncture of the uterus (perforation) and bleeding or hemorrhage
  • Infection


How should I prepare for the procedure?
One hour prior to the procedure please take 800mg of Ibuprofen orally.   You may eat or drink what you like.  There are no restrictions. Arrive at the office ½ hour prior to the scheduled procedure.  You may empty your bladder upon arrival to the office.  You will have blood drawn for a pregnancy test upon arrival to the office.
What should I expect after the procedure?
You may have mild cramping that feels similar to menstrual cramps. You may continue to take Ibuprofen for any cramping, following the instructions on the bottle. You may have slight vaginal bleeding or spotting that may last for a week: Use peri-pads for any vaginal discharge.  Do not use tampons.
Notify the office of any of the following abnormal symptoms:

  • Fever or chills
  • Heavy vaginal bleeding more than one maxi pad per hour
  • Severe abdominal pain not controlled with ibuprofen administration.
  • Severe nausea, vomiting, or headache
  • Refrain from intercourse for one week.

You may be able to visualize the actual procedure while it is being performed.  The doctor will discuss the results of your test with you.  A normal test means no abnormalities were found.  An abnormal test means there are abnormal tissue growths, fibroids, scar tissue, areas of active bleeding, or other abnormal conditions within the uterine cavity.  Further surgical procedures may be advised and discussed at this time.
Our goal is to make this as easy as possible for you and your family.  Please call us at 315-469-8700 (Syracuse) or 518-690-0700 (Albany) with any questions or concerns regarding your hysteroscopy.
Stacey Dicerbo, RNC
CNY Fertility Center, Latham, NY
sdicerbo@cnyfertility.com
866.375.4589 (toll free)

 

19
Jan

Gums and Gremlins: Endometriosis Research Update

by

Gums and Gremlins: Endometriosis research update.
This information is provided for couples who are trying to conceive and have an interest in endometriosis research. For further information on this complex disorder see the information on this website and link to www.endometriosisassn.org. The association has a focus on research into dioxins in the environment and the link to this disorder. This article is provided by CNY Fertility Centers in Rochester, NY, Syracuse, NY and Albany, New York.

International findings from endometriosis research were grouped into the February 2009 issue of Fertility and Sterility, the journal of the American Society for Reproductive Medicine.   Perhaps the most innovative came from China. Levels of Gremlin 1, an oddly named chemical antibody, were found to be elevated the blood of women with endometriosis. This is a highly specific test which relates to growth of small blood vessels such as occur in the endometrium. It is hoped that this could develop into a biomarker for the disease which is a common cause of infertility. Currently only laparoscopy is definitive in diagnosing endometriosis. Other biomarkers are being explored but have not proven to be specific. Sha G et al. Elevated levels of gremlin-1 in …patients with endometriosis Fertil Steril 2009; 350-37.

In a study of interest from the University of Michigan, the link between two diseases which involve inflammatory processes were explored. The odds of having gingivitis inflammation of the gums were 57% higher than normal if a woman had endometriosis. Both diseases involve altered immune response. Interestingly preterm labor is among several disorders associated with gingivitis. Further, women with endometriosis and gingivitis have increased incidence of other autoimmune diseases such as asthma, lupus, and multiple sclerosis. The term global immune dissociation has been used. Kavoussi SK et al Periodontal disease and endometriosis Fertil Steril 2009; 91:335-342

A team for Florence Italy explored the reduced immunity which allows endometrial cells to implant in the pelvis in women who have endometriosis. It is normal for cells shed form the endometrium to travel out the tubes and into the pelvis during menses. In 5-20 % of women, there may be an immune defect in the peritoneal cavity which allows those cells to grow. It has been shown that the endometriosis patients have decreased natural killer cells and T cells. A special messenger peptide called CXCL10 has been found to be low in the blood and abdominal cavity in women with endometriosis. Galleri L, et al Low serum … CXCL10… in endometriosis. Fertil Steril 2009;91:331-334

Perhaps the reduced immunity which allows endometriosis to occur also predisposes to gingivitis and other disorders.
Editor, Joe B Massey MD

11
Sep

Reproductive Dysfunction

by

Hi this is Dr. Rob talking about reproductive dysfunction, infertility, the inability to conceive and recurrent pregnancy loss. All these things affect our ability to conceive and deliver a healthy baby.

A 20% delivery rate per month is normal. After one year it may drop down to the 5-10% per month range and after two years it may drop to 1-5% per month range, but it doesn’t drop to zero! Keeping at it, I’m finding, is the key to all of this and I believe that stress, anxiety and fear are some of the major causes of reproductive dysfunction.

I believe in treating the patient as a whole entity, not just treating their reproductive organs. The mind, body and spirit play a huge role in each person’s day to day wellness and quality of life. Incorporating things like yoga, meditation, acupuncture, and maya abdominal massage are some steps from eastern treatments which work toward healing and normal reproductive function. Certainly it’s also important to look at western medical treatments for things such ovulation failure, pelvic adhesions, endometriosis, tubal factors, uterine factors such as uterine fibroids or intrauterine adhesions and diminished ovarian reserve from age factor infertility. All these can all affect egg function and implantation.

Let us not forget the male and sperm factors. There are two important halves to healthy reproductive function, and sexual dysfunction for many of us, can begin with the very basic inability to come together at the right time. There may be an inability to deposit sperm in the right place. There is also the question that if the sperm is properly placed, is the semen of normal count, motility and function?

In reality it all comes down to function, even though everything looks normal, regular cycles every 28 days, a normal hysterosalpingogram that documents that the fallopian tubes are open and the uterus is normal. A semen analysis that documents that there are at least 20 million sperm with 50% motility and the morphology is fantastic and normal. It’s all about the function of our organs (including the brain!), and the gametes. With unexplained factor (idiopathic) infertility there are unknown components preventing conception. It could be a genetic or chromosomal issue, a immunologic factor or a hormonal issue. We can treat these all with eastern and western treatments. We should start with the mind in all of these. With visualizing exactly what we want, we want – a baby, a family. There is an instinctual natural drive for these things. We do harbor fear, anxiety, worry, regret, guilt and judgment. Through yoga, meditation, acupuncture, massage, herbs, support group, connecting positively with other women and sharing stories, often sharing our pain, we can let it go.

I believe that journaling each and every day, a simple five minute journal entry, is helpful. Just write down how you are feeling. Then continue with working on the positive mantras of the day with meditation, which is really important. It can help. Studies by Ali Domar, of the mind body institute at Boston IVF have shown an increased success for patients who included a mind-body-spirit regimen with fertility treatments. Randine Lewis has shown with eastern treatments, significant improvements in outcomes that often do not require shots or pills or surgeries, both for the male and the female.

The fertility evaluation should start with sharing your story with your practitioner, whether it’s a Reproductive Endocrinologist, an OBGYN, family doctor or a Traditional Chinese practitioner. Share your story, or even if it’s with your partner or friend, share your story. There is guidance, there is assistance there.

Some blood work may be important for both the male and female. Patients may benefit from testing hormone levels, looking at immunologic factors, karyotyping and chromosomal factors. Performing a hysterosalpingogram to look at the fallopian tubes and uterine patency can add to the diagnostic picture. A pelvic ultrasound can be performed to look at the uterus, ovaries, ovarian reserve and fibroids. Additionally a laparoscopy and hysteroscopy could be recommended. These are operative procedures to look into the woman’s pelvic organs and uterine cavity. Through these procedures we are able to look for adhesions which may affect the transport of the egg and sperm. Both hysteroscopy and laparoscopy are out patient procedures, often done in the office.
Endometriosis is an infertility factor which we believe is the implantation of the glands from the endometrial cavity, either coming directly out of the fallopian tube or just spontaneously growing on the reproductive organs, causing inflammation and scar tissue and sometimes diminishing ovarian reserve. Via the laparoscopy, endometriosis and adhesions can be removed and increase a couple’s odds of delivering a baby.

It may be that the cycles are regular, the fallopian tubes are open and the semen analysis is normal. It may be as simple as trying a few timed clomiphene citrate cycles with intrauterine insemination, which will bump your delivery rate from about 1-5% per cycle to 5-10% per cycle. There are some side effects from medications. Clomid has an anti-estrogenic effect and can often cause some emotional upheaval, some depression, anxiety, PMS type symptoms, or premenstrual syndrome.

There are many options available to couples experiencing infertility, both invasive and non-invasive, Eastern and Western, and each offers some benefit to the patient guiding them closer to parenthood. I believe that doing something is always better than doing nothing, especially when trying to create a family. For more information about any of our services you can call CNY Fertility Center and CNY Healing Arts and speak with our highly knowledgeable staff.
Have a spectacular day!
Dr. Rob