Preparing for A Healthy Pregnancy
It seems like the Monday after Thanksgiving might be a good time for a reminder about what to think about BEFORE you try to become pregnant. It's never too late to start new habits for a healthy pregnancy and make more conscious decisions about your lifestyle.
CT fertility specialist Dr. Mark Leondires, Medical Director of Reproductive Medicine Associates of Connecticut (RMACT), talks about the choices that we can make when we are considering having a baby. As he advises below in the blog that he wrote for the Norwalk Patch, 90 Days Preconception: Habits for Optimal Fertility and a Healthy Pregnancy, better to think ahead. Of course you want to make healthy choices when you are trying to conceive; even better though if you know ahead of time. Ninety days ahead of time, according to Dr. Leondires, can make a real difference.
~ Lisa Rosenthal
CT Fertility Specialist Dr. Mark Leondires On Optimizing Fertility
However, instead of jumping immediately into a treatment plan, I believe in treating the whole patient. My partners and I find that patients are most likely to successfully get pregnant when their physical and mental health is at its best.
Patients should consider their health and lifestyle habits 90 days before conception. This is about more than fertility health. This includes nutrition, mental health, stress management, physical activity… all of it affects a person’s fertility and, upon conception, it affects the health of mother and baby.
Some of our patients are able to get pregnant simply by changing their lifestyle habits – without assisted reproductive technology. As little as a 5 percent reduction in weight can lead to more regular ovulatory cycles, improved insulin sensitivity and an improved chance of pregnancy. Sometimes patients are too lean and their hormonal balance can be restored with weight gain.
Preconception Health Tips - A Checklist
Here are examples of how to improve lifestyle habits (and therefore improve fertility while decreasing the risk of birth defects) from the preconception health checklist that we use with our patients at Reproductive Medicine Associates of Connecticut (RMA of CT).
- Eat a balanced diet that exemplifies the USDA’s balanced plate full of vegetables, fruit, whole grains, lean protein, heart healthy fats
- Test for risk factors: hemoglobin A1c, vitamin D, blood pressure, cholesterol – these are simple tests that can be performed by your family doctor
- Start to take prenatal vitamins (800 mcg of folic acid)
- Drink water (not soda and minimize caffeine).
- Boost important vitamins and minerals: calcium (dairy, leafy greens), folic acid (citric fruit, fortified breads, lentils), iron (spinach, beans), omega-3 (low-mercury fish such as salmon)
- Limit alcohol
- Quit smoking
- Avoid exposure to environmental risk factors (e.g., gardening chemicals, cleaning products)
- Lower caffeine intake to less than 150 mg per day, which is equivalent to two 8 oz cups of coffee
- Try to get to a healthy weight and body mass index (BMI)
- Be physically active with low impact activities such as swimming, walking and restorative yoga
Mental Health & Partner Relationship
- Identify stress management method (e.g., yoga, meditation)
- Communicate with your partner about your dreams of a family
- Identify your network of friends and family – and consider talking to them when you are stressed
- Talk to a professional when going through extreme challenges or making life-changing decisions
- Consider support groups with other fertility patients. RMACT has monthly free support groups for fertility patients
- Check your health insurance. Is family planning covered? Are there restrictions (e.g., age)?
- Schedule a preconception visit with your OB/GYN and be up to date on PAP smear and mammogram
- For women: FSH and/or AMH, which are simple blood tests that help guage ovarian reserve; hysterosalpingogram (HSG), which is a non-invasive test to check the fallopian tubes and uterus
- For men: schedule a semen analysis, limit alcohol, quit smoking, work towards a healthy weight
Simple lifestyle changes have the power to improve fertility and the health of the baby. Sometimes assisted reproductive technologies are still needed for a couple to get pregnant. But improving a couples’ health (yes, the woman and the man) doesn’t have a downside. Best of all, many of my patients like being proactive – this is something within their control.
Reproductive Endocrinologist, Dr. Hurwitz Discusses a Link Between Folic Acid and Autism
PathtoFertility is a blog dedicated to educating and supporting men and women experiencing infertility challenges. Board certified reproductive endocrinologist, Dr. Joshua Hurwitz at Reproductive Medicine Associates of Connecticut (RMACT), brought an article to my attention last week that he thought would be good to share here, on our blog.
The article, which was published in the Stamford Hospital's Newsletter, refers to an observational clinical study, discussing findings about folic acid and the diagnosis of autistic disorder. The authors of the study are quick to point out that this study does not link folic acid taken four weeks before conception and eight weeks after conception to Aspbergers or PDD-NOS (pervasive developmental disorder-not otherwise specified). To read more about the study itself, click here.
The authors and the comments from other clinical professionals highly recommend replicating this study with an eye towards a causal link between folic acid and the diagnosis of autism. The study authors go on to discuss other factors that they were able to eliminate as possible causes for the increased diagnosis of autism for those women who had not taken the folic acid for the four weeks prior and eight weeks post conception.
Prenatal Vitamins are Still a Must for Preconception
A good, healthy diet, as well as pre-natal care may factor into the results, but do not appear to negate the substantial results showing in this study about the importance of folic acid during preconception. Starting a good prenatal vitamin while in fertility treatment has long been standard of practice at RMACT. If you are trying to become pregnant, whether on your own, or with a fertility doctor, please do seriously consider prenatal vitamins. Preconception is being considered more and more seriously here at RMACT. We are looking at a minimum of 90 days before you concieve.
What can you do in those 90 days before conception?
First, take a prenatal vitamin with folic acid. Check with your health care provider about the dose that they would like to see in that vitamin supplement.
Second, take a look at your food. There are simple adjustments that you can make that will support your efforts to become healthier. We do know that healthier moms make healthier babies.
Thank you Dr. Joshua Hurwitz for bringing this important study to our attention.
We hear so much in the news about what's good and what's not. There's so much contradiction out there. One news report will say, "yes, eat all the .... that you can", while another news report will tell you never to eat that very same thing. It's reassuring to hear from a top fertility specialist what they are reading. It's reassuring to know that they are concerned and aware of the tests being done and the results. So I'm happy to pass this on to you today. Again, thanks to Dr. Joshua Hurwitz, I know a little more that I can share with you. Take the prenatal vitamin with folic acid. And have a happy Wednesday.
Do You Know Your Pre-Conception Basics?
There are some basic pre-conception concepts for women to know before undergoing infertility treatment. For women trying to conceive, these basics are crucial for you to be successful. Timing is important in multiple ways. Are you on top of your pre-conception basics?
9 Things To Know When Trying to Conceive
1. Trying to conceive? How often do you get your period? If you are not sure, start keeping track of it. Write down the first day that you have a full flow of blood before two o'clock in the afternoon. That will count as day one.
2. Know your family history. If you can, ask your mom and your aunts related by blood when they started menstruating and/or when they entered menopause. Ask them about their experiences conceiving a child.
3. If you are trying to conceive, think about pre-conception health. No recreational drugs or drinking. If you smoke cigarettes, get yourself on a plan to stop and then implement the plan.
4. Educate yourself about timed intercourse. Having sexual intercourse at the right time of the month is the make it or break it about becoming pregnant.
5. If you do not have a partner or if your partner is the same sex you are, then you will need a reproductive endocrinologist. The Society for Assisted Reproductive Technology (SART) and the American Society for Reproductive Medicine (ASRM) are the two professional sites that can give you the most up to date information about fertility and conception.
6. Discontinue all forms of birth control. I always hesitate to add this when I'm discussing conception, yet, invariably, someone will say, "oh, yeah!" That means no condoms or birth control of any kind.
7. Keep track of how long you are trying to conceive without any type of birth control, while having sexual intercourse at the correct time (approximately 14 days before you expect your first day of menstruation.)
8. If you have been trying to conceive for one year, under the age of 35, make an appointment with a board-certified reproductive endocrinologist in your area. Check SART for that. If you have been trying to conceive for six months and you are over the age of 35, I encourage you to make an appointment now.
9. Fertility rates drop considerably at the age of 35, that is a fact. Make sure that your chances of conceiving are as high as possible by being aware of your fertility cycle, your lifestyle choice and your age.
Any questions? Lots of questions? Ask us, we'll be glad to help.
Here at Reproductive Medicine Associates of Connecticut, we are so lucky to have Carolyn Gundell, MS, a nutritionist with over a decade of experience working with fertility and PCOS patients in particular. Here, she shares some wisdom about an important grain that can lead to better health and fertility.
Fertile Secrets of Whole Grains–A Quinoa Primer
Are you bored with your selection of whole grains?
Are you eating the same whole wheat toast, whole wheat pasta and brown rice day after day?
Have you tried quinoa, or other whole grains such as bulgur, buckwheat, millet, farro, barley, or steel cut oats?
Have you purchased quinoa and now you are staring at it in your cabinet with no idea how to cook it?
Maybe learning how to pronounce quinoa is more intimidating than the how to cook stage or if you are like me and had a not so successful first time experience cooking quinoa, it may be hard to go back and try again.
Yes, even a Nutritionist can be a bit stymied with the “how to cook” stage.
So I thought I would share a few tips with you.
If we are going to purchase and cook quinoa first learn how to pronounce this powerhouse of a whole grain. Quinoa is a two syllable word and is pronounced “Keen-wah”. If you want to hear an audio version, then google the Merriam Webster dictionary audio link, “How to pronounce quinoa.” You will surely impress everyone with your verbal skills.
Learn a little trivia about “Keen-wah” to add to your dinner conversation
While relatively new to the United States, quinoa has been a staple food in Peru, Chile and Bolivia for over 5,000 years. The Inca Indians consider it a sacred food, refer to it as the "mother seed" or “mother of all grains” and believe that quinoa nutrients improve the quality of breast milk. Quinoa is a nutritional powerhouse. It is a complete protein and high in magnesium, folate (folic acid), Vitamin E (antioxidant), iron and phosphorous. Quinoa is gluten free. This whole grain fits nicely into the fertility meal plan because it digests slowly with a low-glycemic index. This means that it does not spike blood sugar levels, satisfies hunger longer, and great for PCOS, insulin resistance, diabetes, and fertility.
Tips for Selecting/Preparing Quinoa
The “If you can read, you can cook” stage. Quinoa is generally available in prepackaged containers as well as bulk bins. If purchasing from a bulk section, make sure that the bins containing the quinoa are covered and that the store has a good product turnover to ensure its freshness. Store quinoa in an airtight container and will keep three to six months, if stored in the refrigerator. While the processing methods much of the soapy saponins that coats quinoa seeds, it is still a good idea to thoroughly wash the seeds to remove any remaining saponin residue. Run cold water over the quinoa that has been placed in a fine-meshed strainer, gently rubbing the seeds together with your hands. If the seeds still have a bitter taste, continue the rinsing process.
How to Cook and Prepare Tips
To prepare just add one part quinoa to two parts water and stir for about 12-15 minutes. Substitute rice and pasta with quinoa or even use it as hot breakfast cereal with milk, bananas, walnuts and dried cranberries.
Many recipes suggest mixing quinoa with corn or brown/wild rice, low fat cheese, Italian spices, marinara sauce, or vegetables. How about adding ground turkey and stuffing it into baked green peppers? Try combining cooked chilled quinoa with pinto beans, pumpkin seeds, scallions and coriander. To add excitement to your favorite pasta recipe, use noodles made from quinoa. Sprouted quinoa can be used in salads and sandwiches just like alfalfa sprouts. Add quinoa to your favorite vegetable soups. Ground quinoa flour can be added to cookie or muffin recipes. Quinoa is also great to use in tabouli, as a (and wheat-free) substitute for the bulgar wheat with which this Middle Eastern dish is usually made. Quinoa freezes well too. Many recipes can be found on the internet and in cookbooks. A u-tube cooking video and narrative can also be found at www.healthcastle.com.
I welcome your quinoa experience comments.
More at RMACT. How lucky we are to have these wonderful, compassionate professionals offering these programs, free of charge, open to the public. Please, if you are in Connecticut, come and take advantage of these highly educational, interactive seminars.
Nutrition & Pre-Conception Wellness Tools for Fertility Success
Come to Reproductive Medicine Associates of Connecticut for an interactive wellness seminar on genetics, nutrition, The Fertility Diet™ and fertility secrets for preconception, meal planning & shopping.
Healthy lifestyle behaviors will also be addressed. This seminar will give each couple a nutritional edge before you conceive and health tips to support fertility treatment.
Seminars led by Carolyn Gundell, MS & Monica Moore, MSN, RN
Locations: Norwalk Office- 10 Glover Avenue, Norwalk CT, Danbury Office- 67 Sandpit Road, Danbury CT- All seminars are free
Sat Sept 10 8:15 AM Improving Preconception Health, PCOS with the Fertility Diet / Raffle Gifts Free Norwalk
Tues Sept 20th 7:00 PM The Fertility Diet & PCOS / Raffle Gifts Free Danbury
Sat Oct 8th 8:15 AM Nutrition & Preconception Wellness
Tools for Fertility Success Free Norwalk
Tues Nov 8th 7:00 PM The Fertility Diet & Lifestyle for Fertility Success Free Stamford
Sat Nov 12th 8:15 AM Nutrition & Preconception Wellness
Tools for Fertility Success Free Norwalk
Sat Dec 10th 8:15 AM Nutrition & Preconception Wellness
Tools for Fertility Success Free Norwalk
RSVP required. Please call Melissa/Justine to reserve a seat at 203-750-7484.
Please visit our website or call to confirm date, time and/or location as they are subject to change.
Fertile Yoga has changed days and times!
No longer on Saturday. Starting September 1, Thursday night in Norwalk at 5:45. Danbury/Brookfield, Friday night at 6:00, starting August 26.
And of course, Ladies Night In, Thursday night, August 25, Danbury, with Carrie Van Steen and Lisa Rosenthal