The simple guide to improving your fertility in preparation for care at CNY Fertility Welcome to CNY Fertility, My hope is that we can be helpful, and I want you to know that the CNY Fertility team is here to assist you in every way possible. Through decades of clinical experience, CNY Fertility has discovered that our external environment often creates a hostile internal environment that causes inflammation and leads to infertility. Inflammation and the subsequent infertility it causes are pervasive opponents that are best treated with a multi-pronged approach that can incorporate dietary changes, nutritional supplements, pharmacological immunology, mind-body and "eastern" therapies, along with surgical interventions for both males and females. The origin of inflammation is best understood through the recognition that we are unknowingly placing an excessive amount of these environmental toxins into our bodies in the form of fruits, vegetables, fiber, and lean meats. We don’t realize that they are all converted to simple sugar and that plants have defense systems too. They are foreign particles to the human body and cause a constant inflammatory response. Excess glucose causes glycation and fermentation in the belly, creating heat, methane gas, alcohol, acetyl aldehyde (similar to the compost pile in your yard that steams with a foul smell), which are destroying the gut and sending this destruction throughout the entire body - including the ovaries, testes, and all reproductive organs. To learn more about how plants can damage our bodies and reproductive systems, I highly suggest reading the following articles: Phytochemical Mimicry of Reproductive Hormones, Dietary Pesticides, and Poisonous Plant Research. In my opinion, when it comes to food, less is best. By not putting certain food groups into your body in excess variety and frequency, you allow your body to heal and do what it naturally wants to do. Fasting and intermittent feasting is my solution. By eating once or twice a day at most and allowing 12 to 24 hours between feedings, you allow the body time to rest and digest. The B.E.B.B.I.S. Food Plan - bacon, eggs, butter, beef, and ice cream (Kiltz’s ice cream), pronounced “babies”, is one of those “opposites” that I have seen so many clients embrace with incredible success. Maria Emmerich is our keto food guide. We recommend following her and considering having a one-on-one coaching session via her website. Still, modern medicine is a great complement to the natural healing and wellness practices that have been with us for thousands of years. I recommend adding some level of an immune protocol (see below) which may include Intralipids, Lovenox, Prednisone, Low-dose aspirin, and Plaquenil to your treatment. Some more aggressive treatments may include IVIG or Humira. We often recommend 3.0 to 4.5 mg of Low Dose Naltrexone (LDN) a day. LDN is known as the “miracle drug” because of the way it simply reduces inflammation. To further assess your fertility, a laparoscopy and hysteroscopy can be done to look for intraabdominal endometriosis and scar tissue that may be impeding your fertility due to the inflammation in and around the ovaries, tubes and uterus. This is a silent disorder and can be present without you knowing. Often the only symptoms are infertility, miscarriage, or failed implantation. Additionally, the use of donor eggs, sperm, embryos or gestational surrogacy may assist your journey significantly. CNY Fertility’s donor team is happy to discuss these options with you further if desired. Attached to this document is a quick reference guide with links for more information on all of the things I recommend for preparing your body for fertility treatment. I have seen many clients adopt some of these recommendations and call the following month to cancel their treatment because they became pregnant naturally. If this happens, it is important to stay on the inflammation-reducing plan. There may also be other treatments we can recommend to reduce the chances of miscarriage and premature delivery. Your faith and belief in a positive outcome will guide you and help you on the way. Keep the faith! Know and imagine you are already fertile and a beautiful child is coming into your life. Seeking fertility specialized counseling or joining support groups like that offered at The Fertile Spirit can be very helpful. Yoga for fertility in person at our centers and online at Fertile Hope Yoga, can be another great way to improve fertility. Join a supportive community and foster the belief in a positive outcome. If you have not read The Secret by Rhonda Byrne, you should check it out. My book, The Fertile Secret is also a good resource. Please visit CNY Fertility’s website for blog posts and information on lots of fertility topics, and take a look at our Family Building Guide. Thank you for sharing your journey. I look forward to helping your dreams become your reality.
Dr. Robert Kiltz 315-416-9872 (cell) www.cnyfertility.com
Ideally begin 30-90 days prior to the start of treatment
Preparing for Treatment: for Everybody The simple dietary and supplement guide in preparation for treatment at CNY Fertility.
Women
Men
Kiltz's Keto/Carnivore + One Meal a Day (OMAD) See Dr. Kiltz's Keto for Fertility Cookbook. Peak Prenatal, VivoMeg Fish Oil, Ovarian Bloom, and Immunoglobulin IgG supplements by Molecular Fertility. CBD can also be helpful. Low Dose Naltrexone LDN 1.5 to 4.5 mg per day HGH 6-24 units per day (for low egg reserve or poor quality) or Somaderm gel/ Serovital/Ovarian Bloom+ for OTC form Light Exercise Only: Yoga / Tai Chi / Walking. NO HIGH INTENSITY EXERCISE
Kiltz's Keto/Carnivore + One Meal a Day (OMAD) See Dr. Kiltz's Keto for Fertility Cookbook. Male Preconception+ and VivoMega Fish Oil. Immunoglobulins IgG and CBD may also be helpful. Low Dose Naltrexone LDN 1.5 to 4.5 mg per day Clomid 25 mg per day (may help sperm production and function) hCG 250 units per day (may help sperm production and function) Human Growth Hormone (HGH) 6-24 units per day or Somaderm gel/ Serovital/Ovarian Bloom+ for OTC form Light Exercise Only: Yoga / Tai Chi / Walking. NO HIGH-INTENSITY EXERCISE No Saunas, hot tubs, or other modalities of excessive heat
SHOP SUPPLEMENTS
SHOP SUPPLEMENTS
LDN and HGH are prescription medications that can only be prescribed by your local provider or by CNY Fertility after your consultation.
LDN and HGH are prescription medications that can only be prescribed by your local provider or by CNY Fertility after your consultation.
Helpful Resources
Sample Stimulation Protocols IC
IUI
IVF
FET NS
Natural Stim
Oral Low
Letrozole or Clomid with trigger
Mini
Letrozole 10 mg x 5 d fsh 150 x 10 d antag/hcg 10k trigger FSH/hCG
FSH/Menopur
Low
100-200/20
25-125/75
antag/hcg lupron trigger
Standard
300/20
225/75
antag/hcg lupron trigger
Moderate
400/20
250/150
antag/hcg lupron trigger
High
600/20
450/150
antag/hcg lupron trigger
Super High
900/20
450/450
antag/hcg lupron trigger
FET Medicated
Estrace/Progesterone
antag/hcg lupron trigger
Sample Immune Protocols (in addition to stimulation protocol) Start 30-90 Prior to Treatment Cycle Nutrition: Kiltz’s Keto/Carnivore, One Meal a Day (OMAD), and Supplements (F: Peak Prenatal, VIVOMEGA, Ovarian Bloom, Immunoglobulin IgG | M: Male Preconception+, VIVOMEGA) + Light Exercise: Yoga, Walking, Tai Chi. etc. No high-intensity exercise. Medications: LDN and HGH (with levels 3 and 4)
LEVEL 1 Kiltz's Keto + OMAD + Supplements + light exercise LDN 3-4.5 mg Aspirin 81 mg qd* Prednisone 5 mg bid Antibiotics - Doxy 100 mg PO BID x 3 or 5 d Clindam 2% Vaginal Cream: 100mg/1 at bedtime x 3 days Antihistamine (Claritin - 10mg am / Pepcid 20 mg / Benadryl 25 mg)
LEVEL 2 Kiltz's Keto + OMAD + Supplements + light exercise LDN 3-4.5 mg Aspirin 81 mg qd* Prednisone 5-10 mg bid Antibiotics - Doxy 100 mg PO BID x 3 or 5 d Clindam 2% Vaginal Cream: 100mg/1 at bedtime x 3 days Antihistamine (Claritin 10mg am / Pepcid 20 mg / Benadryl 25 mg) Intralipids 100ml 20% qwk Lovenox 30 mg qd*
LEVEL 3 Kiltz's Keto + OMAD + Supplements + light exercise LDN 3-4.5 mg Aspirin 81 mg qd* Prednisone 10-15 mg bid Antibiotics - Doxy 100 mg PO BID x 3 or 5 d Clindam 2% Vaginal Cream: 100mg/1 at bedtime x 3 days Antihistamine (Claritin 10mg am / Pepcid 20 mg / Benadryl 25 mg) Intralipids 100ml 20% qwk Lovenox 30 mg bid* Neupogen 60 mcg qd Plaquenil 200 mg qd/bid or Prograf .5-1mg bid hCG Booster 250 PRP/hCG/ Neupogen wash HGH 6u, Somaderm, or Serovital
*Aspirin and Lovenox only to be started after Egg Retrieval or with FET
LEVEL 4 Kiltz's Keto + OMAD + Supplements + light exercise LDN 3-4.5 mg Aspirin 81 mg qd* Prednisone 15-20 mg bide Antibiotics - Doxy 100 mg PO BID x 3 or 5 d Clindam 2% Vaginal Cream: 100mg/1 at bedtime x 3 days Antihistamine (Claritin 10mg am / Pepcid 20 mg / Benadryl 25 mg) Intralipids 100ml 20% qwk Lovenox 40 mg bid* Neupogen 60 mcg qd Plaquenil 200 mg qd/bid or Prograf 1mg bid hCG Booster 250 PRP/hCG/ Neupogen wash HGH 6u, Somaderm, or Serovital IVIG 20-40 grams q4wk Humira 40 mg x 2 q2wk
Check List of preparatory nutrition/supplements, lifestyle factors & enhancement treatments. Prep: Kiltz's Keto/Carnivore + One Meal a Day - look at doctorkiltz.com or ketoforfertility.co for full advice and start immediately Female Supplements: Peak Prenatal, Vivomega, Ovarian Bloom, Immunoglobulin IgG, Broad Spectrum CBD, and serovital, Male Supplements: Male Preconception+ & Vivomega. Also consider Immunoglobulin IgG, Broad Spectrum CBD, and serovital. Light Exercise: Yoga / Tai Chi / Walking. NO HIGH INTENSITY EXERCISE Meditation / prayer / positive vision practice Acupuncture/massage to improve blood flow to reproductive organs LDN, low dose naltrexone, anti inflammatory, 1.5 to 4.5 mg per day, night best HGH 6u, Somaderm, or Serovital per day pre stim or with stim or transfer (with levels 3 and 4) Level 1: Everything Above + Aspirin 81 mg qd - beginning after retrieval or with start of FET Prednisone, 5 mg bid - start of cycle or before Antibiotics - Doxy 100 mg PO BID x 3 or 5 d Clindam 2% Vaginal Cream: 100mg/1 at bedtime x 3 days Antihistamine protocol (claritin - 10mg am / pepcid 20 mg / benadryl 25 mg) Level 2: Everything Above+ Prednisone, 5-10 mg bid - start of cycle or before Weekly intralipids, 100ml 20% may be given to 12 weeks or longer Lovenox 30 mg qd, beginning after retrieval or with start of FET Level 3: Everything Above+ Prednisone, 10-15 mg bid - start of cycle or before Lovenox 30 mg bid - beginning after retrieval or with start of FET Plaquinil 200 mg qd or bid OR Prograf 0.5 to 1 mg bid Neupogen 60 mcg qd - with stim or with transfer preparation hCG sq boost 250 qd PRP (platelet rich plasma)/hCG (Human Chorionic Gonadotropin) wash Level 4: Everything Above+ Plaquinil 200 mg qd or bid OR Prograf 1 mg bid Humira 40 mg x - 2 weeks prior to start of cycle and again at start of cycle IVIG 20-40 grams - starting after retrieval q 4 weeks Additional Add-ons to Any Protocol if Applicable: Endometriosis/Adhesions/Myoma/Empirical: Hysteroscopy/Laparoscopy, D &C (scratch), ERA, ReceptivaDx, Orilissa 150200 mg qd, and letrozole 5 mg 1-3 months or lupron 1-3 months PCOS: 500 mg to 2000 mg metformin per day Male Factor: hCG 250 boosters, clomid 25 mg, keto, LDN, supplements, slow down, cool down
V 6-3-22