Women who exercise during pregnancy may increase their chances of having a natural birth.

Source: Good News For Pregnant Women Who Love To Workout

There is a much disputed claim that ‘injury’ to the lining of the uterus — whether inadvertent or deliberate — increases the chance of embryo implantation and thus the chance of pregnancy in certain groups of women having IVF.

Source: Endometrial scratch appears beneficial in couples trying to conceive

Too often people take for granted how special each conception and birth is when it occurs naturally. There are so many events that need to occur and so many factors at play that the opportunities for failure and misadventures are vast. As a specialist whose main job it is to help people overcome infertility or prevent yet another pregnancy loss, we need to create a unique plan for each patient/couple. In order to do so, we must take a few steps to better understand and organize their journey. I begin by categorizing the key factors into one of the four “P’s”: the patient, the partner, the passenger and the placenta.

  • The Patient–this special designation refers to each woman that decides to become pregnant. Her role is paramount in the success of the process. She not only contributes the egg but also 280 days of around-the-clock care. During pregnancy, a woman provides her developing baby with each calorie, every breath of oxygen, and countless nutrients while maintaining a protective, safe environment. Think about THAT that next time that you celebrate Mother’s Day. During a fertility evaluation or an assessment for Recurrent Pregnancy Loss (RPL) we focus on the patient’s overall health/wellness. We assess her ability to produce an egg. And we evaluate her anatomy–uterus and tubes–for their ability to provide a safe haven
  • The Partner–refers to male’s ability to fertilize an egg. This is why the male fertility evaluation is so simplified in comparison. Although we hope and expect for the partner’s full participation in raising the child; until birth their physiologic role is quite limited. This is the reason that male fertility evaluation centers on the semen analysis. More recent studies are now validating that simply observing sperm under a microscope does not rule out male contributing factors to infertility or miscarriage. But this simple test does identify most male factor problems.
  • The Passenger–is a unique designation for each individual embryo that successfully implants and grows to become a fetus. Given that each egg and sperm represents a distinctive shuffling of the DNA of the person that they came from–their union represents another opportunity for individuality. Unfortunately, many of these unions are flawed from the beginning. Depending upon the severity of that flaw, they may fail to grow beyond a specific point in development. As a general rule, the earlier that failure occurs; the most severe the genetic anomaly. Studies have shown that typically, failed pregnancies come from flaws in the egg but sometimes it can either be from the sperm or an event that occurs shortly after conception. With today’s technology we cannot correct any of these genetic abnormalities but we can often identify them when they occur. One proven strategy has been to select embryos that are free of major additions or deletions of DNA prior to placing them into a woman’s uterus.
  • The Placenta–is the connection that a developing fetus has with the woman carrying the pregnancy. It is through this vascular organ that a fetus receives all of its calories, oxygen and nutrients. It is also through this structure that all waste products are removed as well. But the placenta is not a just filter; it is a vital organ that also regulates a woman’s physiology throughout her pregnancy. It performs this function by producing most of the hormones that control a pregnant woman’s physiology. The placenta also regulates her immune system. Aiding a placenta to meet the needs of an ongoing pregnancy is something that steer the course of pregnancy; but only if the Passenger and Patient are healthy.

In closing, the process of becoming pregnant and delivering a baby is extremely complicated.  There is rarely a single explanation for why any individual/couple is not achieving success. The best path for a successful outcome is to fully evaluate the situation in an organized fashion. Creating an organized plan helps assure that details were not overlooked. Through greater understanding, it is possible to create greater success as well as realistic expectations.

 

Mothers may play a huge role in the childhood obesity epidemic, thanks to a possible defect in some obese women’s DNA.

Source: Even When You’re Pregnant, Eating Junk Food Is A Bad Idea: Study

Men, got fertility issues? Smoking marijuana may affect sperm size and shape, minimizing the likelihood of egg fertilization.

Source: Smoking Pot May Cause Male Infertility

Can a hormone be partially behind the childhood obesity epidemic?

Source: Childhood Obesity Hits When Levels Of This Hormone Drop

Whole Grains

Writing about nutritional choices is tricky. One author recently compared our dietary choices as being like our own personalized religion. We’re all born into certain dietary patterns. Then as we grow, we either accept or modify these choices based upon our own belief as well as our own personal preference. Unfortunately today, many of the fad diets are like dietary cults—people not only want to make their own choice but they encourage others to embrace their decision as well. Unfortunately, most of these popularized diets are based upon scientific rhetoric. They often use encouraging language and small bits of science (often taken out of context) to try to create a compelling message. They want you to join them. As a scientist and a as a physician, I find this troubling because it often has a negative impact upon the care of my patients. For example, let’s consider gluten.

 

Gluten is a combination of proteins found in wheat, barley, rye, oats and various other grains. It has become a very prominent part of our diet because these proteins help dough to rise and retain their shape in baked goods. Although gluten has been vilified by some recent nutritional gurus; many foods that contain these proteins have major health benefits. These whole grain foods are attributed with a lower risk of developing obesity, diabetes, heart disease and various types of cancer. It is estimated that about 1-2% of us may have a true allergy or autoimmune disease (Celiac disease) as a reaction to these proteins. So let’s consider the possible health benefit for the other 98% of the population.

 

Gluten is also a prebiotic. Prebiotics are the nutrients necessary to help the healthy bacteria thrive within your body. A common reason that many people today are taking probiotics is because their diet is not providing these healthy bacteria the nutrients that they need to survive. However, taking a probiotic is not sustainable without feeding these healthy bacteria so they can thrive. There is also evidence that gluten can be an immune booster.

 

Natural Killer cells (NK cells) are part of your body’s immune system. Despite their ominous sounding name, they serve a sort of security role. They are responsible for identifying and eliminating dangerous invaders like virus infected cells and potential tumor cells—they keep you healthy. Ironically, they also serve a critical role in promoting pregnancy. When functioning properly, they enhance the ability of an embryo to implant and thrive. New studies are now demonstrating that gluten can actually facilitate healthy NK cell activity. Whatever the reason, there is convincing evidence that gluten containing whole grains are associated with higher pregnancy rates in patients that are trying to conceive.

 

Patients undergoing IVF provide a unique opportunity to study interventions in a closely monitored setting. Recently, the impact of eating whole grains was investigated at Harvard University as part of the Environment and Reproductive Health (EARTH) study. In this study they were tracking whole grain content by following the diets of women going through IVF treatment. They found that women that were eating more whole grains had a higher pregnancy rate and a higher live birth rate (53% vs. 35%) than those eating little or no whole grains. In fact, at least one serving per day of a whole grain food was able to boost the odds of success by about 33%. Another recent study that was looking at comprehensive dietary patterns and success during Advanced Reproductive Treatment (ART) found that women eating whole grain cereals had about a 30% greater chance of fertilization and early embryo development and an almost a 60% greater chance of becoming pregnant. Finally when researchers measured the urine for a marker of whole grain food consumption in a healthy population of fertile women they found that those eating more gluten containing foods took fewer months to conceive naturally. Taken together, it seems that we should encourage women that are not truly allergic to gluten to eat more whole grain as part of their fertility boosting diet.

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