Food Freedom and Fertility Podcast

Dr Carrie Jones Podcast Episode    On today’s episode we have Dr. Carrie Jones, a naturopathic doctor and the medical director at Precision Analytical’s DUTCH test - AKA the Hormone Doctor herself! She loves to empower women to understand more about their bodies so that they can advocate for themselves. We dive in with Dr. Jones to talk more about what women can do that struggle with estrogen dominance and endometriosis, since so many women suffer from these conditions and no one ever prepares us how to navigate them.    Many times we find women who are diagnosed with endometriosis face multiple dead-end suggestions by their doctors: 1) suck it up and move on; 2) go on birth control to treat symptoms; or 3)... get pregnant. Well- we know these are not ideal solutions to our problems. Many women go years without getting a proper diagnosis and therefore suffer from crazy symptoms for far too long, just to get tossed birth control as the end-all-be-all solution. Does this sound all too familiar?!    In this episode, we discuss how endometriosis should properly be diagnosed, how it can disrupt the TTC process, foods that can help estrogen detox, and natural techniques to detox our livers of estrogen. We also review the mechanism of how soy is linked to estrogen, the hidden beauty of castor oil, and how valuable unpeeled organic carrots can be.    Dr. Jones discusses estrogen detoxification in depth; the 1st and 2nd step happening in the liver and the 3rd step happening in the kidney. In the liver, phase 1 and phase 2 rely on veggies like broccoli, kale, unpeeled organic carrots, and brussel sprouts to detox optimally (cruciferous veggies).  Magnesium, zinc, and choline are also essential to detoxing in the second phase within the liver. She elaborates on the mechanism of why these veggies aid estrogen detox. The third step in the estrogen detox process occurs in the kidneys and hydration helps this to run efficiently. So - make sure you are having regular bowel movements every day! We discuss more about staying hydrated, having a regular peeing schedule, and Dr. Jones’ favorite electrolyte powders.    Have you ever wondered why you might feel bloated, have a ton of gas that could clear out a room, or have heartburn after a meal? Have you ever wondered how autoimmune diseases caused by gluten intolerance are formed? Dr. Jones shares with us techniques like how simply chewing your food completely with your mouth closed can really enhance digestion, absorption of nutrients, and prevent autoimmune diseases.    Lastly, Dr. Jones discusses common patterns she sees on a DUTCH test that indicate estrogen dominance or low progesterone production with regards to endometriosis. She also talks about what an ideal cortisol, melatonin, and glutathione pattern should look like throughout the day on DUTCH test results.

What if we told you your mindset has a lot to do with your fertility? This might be a shocker for some of you! Today’s episode we dive into what a healthy fertility mindset looks like and how that affects your overall fertility journey. You don’t want to miss this episode as we connect the physical aspect of becoming pregnant to the mental side of BELIEVING you CAN become pregnant!    Although we are practitioners helping women bring home a healthy baby, we are still human and have our own doubts. In this episode, we share our own stories about how we struggled internally with the mental olympics of believing we could become pregnant despite our own personal obstacles. First of all - take a step back and tell yourself you ARE a person that can do hard things. You do believe in yourself. You are taking steps to shift your mindset...after all, you are taking ownership of your life and listening to this podcast!    You do not wear a badge that defines your struggles. You do not wear a badge that says “Hi, I’m infertile.” No...you are YOU!  Talk to yourself like you’re talking to your best friend. Is the first thing you think about your best friend is “oh...she is infertile..” ..No! It’s likely more along the lines of, “She is strong, beautiful, and she WILL become pregnant.” It’s as simple as that. Begin to speak to yourself in a kind and gentle way. Simple techniques to begin developing this healthy fertility mindset are:    Inclusion vs Elimination: add in foods and nutrients that your body needs instead of removing things that you love! How can we add in more foods and nutrients that will enhance your diet/overall health? Can you add two cups of veggies to your dinner, and still have cheese sprinkled on top? How can you add more colors to your plate?  For example: Make a taco bowl with anti-inflammatory spices like turmeric, add grass fed ground beef, bell peppers, and black beans (healthy fats, lots of protein, micronutrients) and STILL include mac and cheese as a small topping to still enjoy the foods you love without making it the focal point of the meal Honor your body. Have the pasta dinner if you want a pasta dinner. Just learn to be strategic about adding things in that can better serve your fertility journey! You don’t have to take away your favorite foods...but begin to think about how certain foods will serve or take away from your fertility journey.  Focus on YOUR progress, not HER progress. In the world of social media, it’s easy to judge your behavior and habits and compare your progress to others. This will do nothing but make you feel inferior to others and isolate you. What works for someone might not work for you, so remember you are an individual and don’t let others’ journeys distract you.  Celebrate each other's victories and stay on your own journey.  Build positive patterns. Look for consistency and improvement in these small habits - adding in more colorful vegetables, possibly changing habits in your sex life, or going to bed 15 minutes earlier to get more sleep. Little by little these small actions will add up. You don’t need to strive for an A+ in “Fertility Nutrition”… we are just trying to accomplish a goal, so remember to find joy in life while still implementing small, consistent healthy habits.  When an obstacle comes up, like you miss a spin class, pivot and try something else. Take your dog for a longer walk or do a YouTube exercise video. Stay on a “winning” path! If you go to a birthday party and eat cake, pivot and make a healthy choice following that. Let setbacks set you up for comebacks! Don’t let these small things snowball into huge unhealthy habits. Be flexible.  Don’t let things you read or hear on social media dictate your behavior. Listen to your body and let that be your guide. If you see someone post about eating more seeds, don’t force them down your throat if you hate them just because they tell you they are the key to fertility. If someone talks about how good spin class is for your health, don’t kill yourself to make it to that 7am class if you feel run down. Make these habits fit for your individual lifestyle to honor your cravings, energy levels, and mood.  Focus on your own continued growth, not your past mistakes. Setbacks are a part of the growing process! Let them prepare you for comebacks. If you ate that chocolate cake you swore you wouldn’t, learn from it. Look at the details of your day leading up to that choice...were you hydrated? Were you in a bad mood? Did you go grocery shopping starving? How can we better prepare you for next time to not make the same mistake? Mistakes are great propellers to help you grow. YOU WILL NOT BE PERFECT, MISTAKES WILL HAPPEN!  Celebrate improvements - in your cycle, in your hormones, indications for ovulation, insulin/sugar cravings, etc.  Every step that you improve is worth celebrating and worth being excited about even though you haven’t reached your ultimate end goal of becoming pregnant. You are getting closer and closer to reaching your goal, so enjoy every step of the way!     Remember to enjoy and celebrate the small victories along the process. There needs to be JOY in your journey. You can do all of the things - take the courses, have sex, buy the tests, but if you struggle with developing this healthy mindset, don’t hesitate to see a therapist. Your mind is part of your body and it’s just as important to nurture and invest in your mind as it is your body. 

In this episode, we are honoring pregnancy and infant loss awareness month. Caitlin and Sophia are digging in deep about this topic with OBGYN and Reproductive Endocrinologist Sasha Hackman, MD. While we know this may seem like a downer, this is purely to inform all of you about statistics, where pregnancy loss is most common, and how we can try to stop this from happening. We all realize most people don’t feel comfortable talking about this, but if this has happened to you, this is NOTHING to be ashamed about.  This is something that happens frequently. You are not alone, you do not need to keep your feelings to yourself, and you are not a failure. In this episode we are trying to educate more people to know how to approach situations like these, become more informed about miscarriages, to open up the conversation and how to hold space for someone who has gone through a pregnancy or infant loss.   Sasha starts talking about how women in early pregnancy can tell the difference between normal discharge or if they are having a pregnancy loss. She says that unfortunately, sometimes a miscarriage can be completely asymptomatic so many women do not find out until they go in for an ultrasound. Some symptoms do include cramping, vaginal bleeding, spotting, low back/ pelvic pain, and sometimes more. The symptoms are very nonspecific and can lead to stress especially with a woman who has had a miscarriage in the past. Truth be told, spotting is not necessarily normal when pregnant, but it is common. If you are having bleeding or spotting, there is a really good chance it is completely benign and will still lead to a healthy pregnancy! Additionally, discharge can be very normal and does not indicate a miscarriage at all.    We had a question about what normal HCG values would be for women before their first ultrasound, around 4-6 weeks pregnant. Sasha explained how HCG should be doubled, or at least increased, after the first few days. Sometimes women only see a 20% increase and will still have a healthy pregnancy. However, the typical minimum cut off where they are absolutely confident about a healthy pregnancy is 53% or more.    Sasha dives into telling us what the main cause is for early pregnancy loss. She say by far, the main cause is genetic abnormality. With technology now, they can do something called a “Microarrye Test” that doesn’t require them to culture a tissue, but instead, they can ID small, little deletions rather than chromosomal duplications or lack of entire chromosome. They have distinguished that at least 75% of pregnancy losses are because of chromosomal abnormality. This is practically nature’s way of removing and absorbing pregnancy that eventually would not result in a relatively healthy child. That being said it doesn’t make this loss any easier.   We asked if someone has experienced early pregnancy loss, what would be the medical model of care, when should they do extra testing, and do they have to experience multiple pregnancy losses before going through diagnostics. Sasha said that technically, there should be 2-3x more losses before you start evaluation. However, it is all patient orientated. If a patient wants to get tested after one loss, that’s great. If a patient has had over 3x miscarriages, doesn’t want any tests done at all, and still wants to try to get pregnant again on their own, then that is totally fine, it’s her autonomy. She describes her role as a reproductive endocrinologist and how they see pregnancy as a very sacred thing that doesn’t come easy to many people. They understand that one loss is too many and they want to see how they can prevent another loss. In this case, they will always do a workup for their patients. This mentality is how they (and us as dietitians) are trying to handle medicine now. They are trying to shift away from paternalistic mentality where the doctors just give recommendations based on past evidence. She says everyone’s body is different, so this “old school” way of thinking needs to get thrown out the window. It should always be about the patient and what they want. Catering to their needs can make a world of difference.    Frequency of pregnancy loss, you ask. Well, Sasha gives us a very descriptive answer on what is really going on in terms of how many miscarriages are happening. Even though this is a “loaded question”, the general number of pregnancy losses would be 12-15% of clinically recognized pregnancies (pregnancies actually recognized by an ultrasound). However, if you were to actually count, a lot of the miscarriages happen before that first ultrasound or before the couple even knows they are pregnant. If you were to combine the clinically recognized pregnancy losses with the clinically unrecognized losses, the incidence rate would be around 30-60%. This HUGE range depends on multiple factors such as age and pregnancy history.  If under 30 years, and you have already had a live birth and/ or abortion your changes of miscarriage is LOW at a 4-6%. Generally, if you are under 30 years of age, your chances are only 7-15%. If 35-39 years old, your risk is about 30% and if you are over 40 years, your risk is about 35-50%. If you have a history of pregnancy loss your risk for reoccurrence is about 25%. With each miscarriage, the risk will go up slightly and will usually plateau at 50%. Yes, this seems high, but there is STILL a substantial chance of a live birth! Sasha also says that there is not really a difference in natural conception, IUI, or IVF in terms of miscarriages. Pregnancy loss really just depends on medical and pregnancy history, and age. And unfortunately, age is the biggest prognostic factor and is NOT a modifiable one (say what?!).    Some other reasons why someone might miscarry other than genetic factors is Asherman’s syndrome, developmental abnormalities, translocation of chromosomes, and well as other disorders. Asherman’s syndrome is when some women develop scar tissue within their uterus which can be caused by a history of abortion or miscarriages and need a DNC or any other type of instrumentation of the uterus. This can increase risk of scar tissue, poor vascularization, and the risk of miscarriage. Probably the developmental abnormality of the uterus that increases the risk of miscarriages the most is called a septum. With this septum, there is not enough vascularization to support a pregnancy, which can easily be fixed by removing the septum, the procedure being minimally evasive, and a patient can go home after. Although not as common, the translocation in one of the parent’s chromosome, meaning two pieces of chromosomes switch in both parents’, causes chromosomal abnormalities which can lead to a miscarriage or having a child with a developmental disability. IVF with genetic testing is a good option for parents having this issue. Clotting disorders, endocrine disorders (poorly controlled diabetes), thyroid disease, luteal phase deficiency, PCOS, and age can also increase the risk of a pregnancy loss. These are known things that will increase risk before going into a pregnancy so Sasha always want to tell these patients to not get pregnant until they can optimize their conditions first so they can decrease risk of miscarriage in the future.   Chemical pregnancy versus miscarriage? Sasha explains that a chemical pregnancy is an actual pregnancy with the presence of HCG, but there is nothing in the ultrasound to show sac is being formed. On the other end, there is something called a “blighted ovum” meaning that there is a gestational sac present but no embryo present. Both of these conditions are considered spontaneous abortions. Again, with all of these conditions, whatever they may present as, women should not be ashamed with themselves because IT IS NOT THEIR FAULT.    Does obesity increase risk of miscarriage? Sasha tells us that studies have shown that once you are in the range of obesity it definitely increases the risk. There is a huge correlation there. Sometimes even very mild weight loss, even 5% of total body weight, will show improved outcomes in pregnancies. This is when it is important to remind women it is not just the weight that matters, it is their overall lifestyle. Being dietitians, we had a few things to say in regard to obesity and pregnancy. We want to tell our listeners that if you are a woman of a larger body size are not eating things that are helpful for fertility, that it is possible to change the way you are eating into a way that DOES support fertility. This will make your fertility completely transformed but your body size does not have to change. This is why the "just lose weight" statement from doctors is not realistic or the issue, we need to talk about how to change the diet and lifestyle with the nutrients that are going to support a healthy baby. Sometimes this will result in a natural weight loss. What we want is to get your hormones under control, blood sugar more regulated, thyroid supported, digestion under control, and stress and inflammation reduced. Sometimes body size will change and sometimes body size will not. Your chances of having a healthy pregnancy will be dramatically increased but it will not always impact your body size.     Let’s say you are experiencing a loss in pregnancy. What can you expect in terms of medical intervention, managing it on your own, and how long should you wait before seeking medical care? The best practices are giving the women the option between 3 interventions. Do nothing. Sit and wait to see if your body will take care of it on its own. Advantage: is there is minimal risk. Downside: if it doesn’t happen right away, you may be waiting several weeks to actually complete the miscarriage and even then, it might not happen, and intervention would be needed.  Medical intervention would involve medication like Misoprostol where it can be given orally/ vaginally. Downside: cramping is really intense. Advantage: avoid having to go into surgery. Another medical intervention would be having a plastic tube inserted into the uterus which would suck everything out. Advantage: all products of conception can go for genetic testing so you can get a better answer (especially now with “microarraye” testing) which really helps with closure for patients. Surgery: if you are experiencing hemorrhaging of if you develop an infection.    What is an ectopic pregnancy and how would someone know if they are having one?  Ectopic pregnancy is different than a miscarriage because the embryo is actually implanted outside of the uterus. There is medication to manage an ectopic pregnancy if the woman is stable, but if unstable, then surgery would most likely be needed. You can tell if its ectopic when you go into doctor’s office and the HCG levels are fairly low compared to what is expected. Also, if the HCG levels are high, then they wouldn’t be rising as quickly as it should. The suspicions would either be a miscarriage, ectopic pregnancy, or sometimes it can even turn into healthy baby. (Wouldn’t it be nice if we could scoop up the ectopic pregnancy and plant it in healthy uterus???)   If someone has an early pregnancy loss, how long can they wait until they can start trying again? What about a further- along pregnancy loss (around 27 weeks)? Sasha says that for an early pregnancy loss the answer would be to start trying whenever you are emotionally and physically ready. Generally, she tells her patients to go for whenever they want, but it might be helpful to wait until they have their next period. For a further along pregnancy loss, also called a fetal demise, you really just want to give months for physical and emotional recovery and grieving. However, she really recommends looking into why this may have happened and if there is something specific that can be changed, then you want to work to see how you can change that and try to reduce risk for the next pregnancy.    Sasha explains that trying to prevent a miscarriage can be tough because the majority of the time it is chromosomal. Sometimes it can be stress related, which no one knows for a fact, but why they believe in this is because there is one intervention for recurrent pregnancy loss that’s called TLC (tender love and care). This is when they will bring patients in for weekly ultrasounds (or really whenever they just want it) to reassure them that their pregnancy is still viable and ongoing. Studies have shown that the live birth rate with this intervention is significantly higher. (Wow!) There is something to be said about constant reassurance, really being there for a patient, and allowing them to get as many ultrasounds that they need. This treatment may help you if you have been through a pregnancy loss more than once and might be scared it will happen again. Reassurance that everything is okay will reduce your stress. Staying active, staying distracted, including lifestyle interventions like proper sleep, mindfulness, mediation, eating whole foods, and doing things that make you feel good, will help you enjoy your pregnancy more, as well as taking care of your mental health and your growing baby.   To end on a happy note, to any woman who has gone through a miscarriage/ recurrent loss, the chances of you holding a baby in the next pregnancy is 70%. THAT’S HUGE. Just remember that and that will help bring you back some optimism.

*Trigger Warning* - It’s a story about labor and birth!   Here we dive in with Cohost Caitlin Johnson, RDN to hear about the birth of her sweet little girl! Caitlin answers all my questions about her birth prep, the birth itself, and the postpartum period.   Caitlin’s prep: She and her husband did a Bradly birth class before her first baby was born so BJ (Caitlin’s man) could get all the juicy deets on what to expect and what to do when his baby was being born. This time around they were already prepared from the last baby!   Red raspberry leaf tea and a nutrient dense diet were Caitlin’s nutrition prep for this birth. Dietitians have a hard go when it comes to early pregnancy nausea. Caitlin was no exception. It’s hard to talk about food all day for work when you feel like you could gag at any second.   Caitlin also upped the protein and sodium to combat low blood pressure and a family history of preeclampsia. She also altered her supplement and herb routine since she had SUCH a struggle nursing her first baby Fiona. Turns out there is a link between PCOS and nursing struggles!   Home birth was the option of choice for Caitlin and her husband. However, we DO want you to know that even though Caitlin chose that, we DO NOT think EVERY woman needs to birth that way! We don’t think you need to quantify your choice, so you choose whatever is right for you. What it comes down to is doing whatever makes you and your family feel safest. For Caitlin, that meant having her baby at home.   Early in the week before Fiona was born, Caitlin had a visit with her midwife. The midwife offered some cervical work to get the baby moving, but Caitlin decided that wasn’t right for her. Instead, later in the week she decided to see her acupuncturist! The acupuncturist also suggested that perhaps Caitlin get the cervical treatment done with her midwife later in the week. As the week rolled on, Caitlin decided that she was ready to bring the baby along, so she decided to tell the midwife she was ready to have her cervix swept.   The midwife spent a lot of time explaining the process of a cervical sweep to Caitlin, and it was great. Caitlin and Sophia are both BIG fans of informed consent, and they believe women should be informed of the risks, benefits, and procedures involved with any medical intervention. Lo and behold, the sweep opened Caitlin’s cervix a bit more! She then went on a walk with her neighbor, had dinner, and around 8:45 she began having real contractions.   Soon thereafter, labor was in full swing! Caitlin’s family set up her birthing tub, and soon thereafter the labor got really intense! This phase was called “transition”, meaning the baby is now low in the cervix, approaching the birth canal, and it’s almost time to push! Fun fact, this is usually when mamas start feeling the “I can’t do this” or “give me the drugs!” feeling. It feels bad, but this is actually good!   The midwife came back, and saw that this baby was coming quick! Caitlin was really feeling intense labor feelings, so the midwife suggested that she break her water and then try some new laboring positions. Up out of the tub she came, and tried a few positions before deciding sitting reverse cowgirl on the toilet was the way to go.   A few pushes later, Caitlin decided that birthing a baby in the toilet was not the deal, so she waddled back to the bedroom with the baby’s head about to crown. The next push, the baby FLEW out, head to toe, and the midwife caught her! By the way, it was 2:40am and Caitlin went into labor at 8:45p, so it was less than 6 hours from start to finish (this is Sophia’s dream, by the way!)   Baby is born, and for a second there they thought it was a boy! Side note, babys have pretty swollen genitals when they’re born. After a second look, the midwives announced with joy that Fiona, a beautiful baby girl, had arrived! Caitlin decided to do a delayed cord clamping, in case you’re interested, because that can help baby have more time to start breathing in case that’s a concern.   Then that was that! They cut the cord, Caitlin delivered the placenta (eventually), began to nurse her baby girl, and life continued! The placenta was huge (common with PCOS pregnancies) but caitlin’s was extra huge since she had a big blood clot attached to it. 

Here comes a special one! This episode features fellow dietitian Ayla Brammer, owner of Boston Functional Nutrition and creator of Full Circle Prenatal! Caitlin and Sophia both use this prenatal for themselves, and recommend it frequently in their private practices.   Ayla shares the roots of her practice and how she came to be the powerhouse dietitian she is now. She also works in pregnancy and preconception, but her passion is working with couples when they are first starting their journey to become parents.   Ayla shares her thoughts on one of the most common pieces of fertility advice shared by OBGYN and RE docs alike… “Lose weight before you get pregnant”. Of course we hate this blanket advice and don’t see it as helpful to women who want to be moms; but Ayla takes it a step further. Rapid weight loss is never a good idea, but when you’re trying to become pregnant, it’s even harder on your fertility systems. Our fat reserves can contain toxins and other dangerous compounds that we do not want to be rapidly circulating throughout our bodies. Remember that one tree in Ferngully, that had the weird evil smoke in it? Fat stores can be kinda like that.   Though some women do see some positive changes when their weight is stabilized, all 3 of us dietitians see the preconception period as a time to fill your body with nutrients, vitamins, and minerals with the right foods; not slashing and restricting everything in the name of weight loss. Our focus tends to be more on how to get your nutrients absorbed and kept, versus how to make your body smaller in order to somehow change your fertility.   Ayla explains some of the functional lab testing she uses in her practice. She’s an advocate of a comprehensive vitamin and mineral assessment to show patterns and gaps in the way your body is processing what you eat. This can also reveal stressors, genetic abnormalities, and other anomalies that impact your ability to get pregnant. Hormone and stool tests are also important tools to getting your body ready for pregnancy.   The girls talk about their pregnancies and nutrition choices while pregnant for a while, so if you’re not ready to listen to a pregnant story, skip from 17:30-22:30.   Ayla lists her 3 favorite foods for the preconception period! Ayla’s fertility curry - lots of veggies, protein, and nutritive spices Stinging Nettle Leaf Tea - very high mineral and easy to drink! Sophia’s husband isn’t a fan of her giant bag of nettle leaf taking up space in the cupboard, but it’s great for you! Liver - we all love/hate it. It’s so nutritious, but the taste is rough. Hide this food in meatballs, meat sauce, burgers, taco meat, etc. A little goes a long way.   If we are losing you on the liver, you’re not alone. Each one of us grew up on pizza and freezer waffles, so it was hard for each of us too! Please don’t try to just eat boiled liver. We want you to enjoy your food, and not choke down whole mouthfuls of liver. Start by hiding little 1oz portions of liver in ground beef dishes.   On to Ayla’s specialty creation: Full Circle Prenatal Vitamins!   The Full Circle prenatal is the best on the market for most pregnant women. One of the things that sets it apart is the Vitamin D content. This is slightly controversial, but Ayla made this leap since she is an RD and really sees the importance of Vitamin D in pregnancy. Vitamin D is vital for ovulation as well, so taking a prenatal like Full Circle while TTC is a great idea. PCOS sister especially need to test and treat their Vitamin D levels, as none of us have ever seen a PCOS patient who also have adequate levels of this vital nutrient!   Full Circle also has much more iodine than other prenatals. Ayla shares that this was a deliberate choice to put her vitamin in line with the optimal supplement in pregnancy recommendations from most major medical associations. A huge number of women don’t get enough iodine, especially when women aren’t eating dairy. Iodine isn’t only important for pregnancy, but it’s important for thyroid function in the preconception period and for postpartum. Iodine can also be found in fish and seafood, even sea vegetables like nori and other seaweeds.   Choline is another star of these kick-butt prenatals! Some folks are taken aback by the 8-capsule dose of these prenatals, but the reasons the serving size is what it is is for choline. If you look at other prenatals, you’ll see only a fraction of the amount that you’ll find in Full Circle. It’s a bigger nutrient, so it takes up more space. 95% of women aren’t consuming adequate choline; and it’s vital for fertility too. Choline is needed heavily for the processes of early pregnancy and to develop healthy eggs for quality ovulation. Yet another reason why we here at the FFF podcast looooooove Full Circle! Choline can be found in food too; mainly in beef liver and egg yolks. However, you’d need to eat a TON of egg yolks to get everything you need in preconception and pregnancy without supplementing with a product like Full Circle.   Ayla then touches on why her supplement isn’t “real food” based. Listen, we are dietitians and OBVIOUSLY we stake our careers on using food as medicine… yet here we are recommending a prenatal that isn’t made entirely from real food sources. Heres why:   Concentrated and dried veggies don’t give you that much nutrition per volume. A concentrated and dried spinach leaf gives you a teeny amount of nutrition compared to actually eating real food! When you buy green food powders or food based pills, you’re getting only a very small amount of fruits and vegetables per dose. Full Circle’s goal is bioavailability - what will your body absorb and use? Often, the “real food” version won’t give you enough of what you need or can absorb. Ayla hand-picked each nutrient in this supplement to ensure you’re getting enough of what you need, and in forms that can be readily absorbed.   Full Circle also does not contain iron, a controversial choice! Ayla explains this choice through explaining the variable iron needs during preconception, pregnancy, and postpartum. Not all women need iron, while some need a lot of it. Iron also has a lot of side effects and poor absorption in supplement form. Iron also can limit your absorption of other nutrients, and vice versa. Ayla chose to leave this nutrient out so that the rest of the nutrients can be absorbed well. If you need additional iron, it needs to be either eaten in food or taken at a different time of day from your prenatal vitamins.   Ayla gets a lot of questions and scrutiny for this choice, but she stands behind it. Developing this product has been very difficult, but Ayla is so proud of what she has created. Caitlin and Sophia are certainly glad she’s braved this world since they both take this supplement themselves.   So now the burning question on everyone’s mind… Why NOT a gummy?? Ayla explains that in order for gummy vitamins to be tasty, they skimp on nutrients while loading up on sugary syrups and flavors. Not conducive to actual preconception health! If you compare any gummy vitamin to Full Circle Prenatal, you’ll see just what we mean.   Ayla shares a message of hope; so many women get empowered and find their fertility through better nutrition and getting to the root causes of issues. If you’re feeling like you’re on the conveyor belt at your fertility center, it’s time to reach out to practitioners like Ayla, Sophia and Caitlin!   A big thanks to Ayla for stepping into the challenging supplement market, making a great product, and coming onto our show to share all her goodness!   If you want to try Full Circle Prenatal for yourself, use the code FFF10 at checkout for an exclusive 10% discount!

PCOS is treatable! Here’s how to start:   Personal Baseline: What do your labs say? What symptoms are you dealing with? Have you had any imaging done? These are all the first things to start looking at when it comes to PCOS. It’s important to note that while Caitlin and Sophia love working with women with PCOS, and we have many years of experience, we are dietitians, not doctors. We don’t diagnose!   So what to do with nutrition:   Balance blood sugar Make sure that there is a higher quality and quantity of protein at each meal and snack “Quality” means it’s not inflammatory and provides more protein than it does any other macronutrient. Examples: meat, cheese, nuts, and seeds Most women with PCOS tolerate high protein dairy products like greek yogurt, cottage cheese, and cheese! SOME women do have fewer symptoms when they eliminate gluten and dairy, but it’s not the magic answer to PCOS management that it’s often believed to be Not everyone needs to be dairy free! Veggies, fruits, nuts, and seeds are your best sources of fiber! Pro tip: artichoke hearts have a ton of fiber! Fiber is great at filling your plate and filling your belly! You’ll find that you get to eat a lot of food while managing your PCOS Eating real food, vs. a protein bar or shake will keep you full for longer. It will help you slow down and feel full, versus slamming down a protein bar in under a minute To succeed, you have to eat enough to feel full! Fiber and protein are keys in making that happen FIBER! Starting your day with nutrients and blood sugar balancing protein! Even though it might seem like a lot of calories to have 3 egg scrambled with spinach and feta, a slice of toast with nut butter, and with a cup of coffee; you will feel full for so long and it will keep your blood sugar steady for hours! Swapping sweet for savory when possible. Eating sweet makes you crave sweet! It’s not your fault, its PCOS! Eating the right fuel first thing in the morning will keep your cravings at bay. Breakfast Try cronometer.com! Plug in what you’re eating and let’s look at your vitamin/mineral/fiber intake in a day! Sometimes you can be eating “healthy” but missing key pieces for PCOS fertility Take a peek at your protein/carb ratio! Typical American diets can have way more carb to protein than is helpful for PCOS fertility Check out your current nutrition status Keto, Atkins, and other super restrictive diets are not needed to boost fertility with PCOS Food is slow medicine; sometimes it takes several months of eating right to balance your cycles and get pregnant! You need to do something that can be sustained long term, not another crash-diet plan. Sustainability Supplements Remember to check with your doc!! Some of these supplements can interact with medications or are contraindicated for certain medical issues. Is there insulin resistance present? How about high testosterone? Or high stress? How’s the thyroid? That’s where we start to dig into what supplements can help. We recommend myo-inositol and not d-chiro. PCOS ovaries can make too much d-chiro, so we are careful not to exacerbate that Inositols Helps improve insulin sensitivity and can boost egg quality, plus helps you make great cervical mucus NAC Another powerful blood-sugar/insulin supportive supplement Berberine Wherever you live in the world, most of us are vitamin D deficient. As levels of vitamin D rise, insulin resistance lowers! It’s also important for maintaining a healthy pregnancy! Vitamin D Support egg quality and improve insulin resistance Zinc Common mineral of deficiency in PCOS, helps with gut health, insulin resistance, and ovulation Magnesium You don’t want to wait until you’re pregnant! Start on a quality prenatal ASAP! (And stay tuned for our episode on prenatals dropping soon!) Prenatal We’re here for the omega-3’s! Omega-3’s are essential fatty acids that are vital for reducing inflammation and supports your body in building new tissues. Eggs, endometrial lining, and babies are all new tissues your body grows! DHA/EPA are the omegas you want! Don’t be seduced by algae oils! They don’t have the same DHA/EPA ratios as fish-based supplements Fish oil Movement and Exercise Sleeping 6-7 hours vs. 4-5 hours is a game changer for PCOS Blackout curtains or a sleep mask can help you stay asleep longer. Here is a link to Sophia’s fave sleep mask Meditation apps and sleep stories can help you quiet your thoughts and get into a deeper sleep Blue-light blocking glasses can help if you’re using screens prior to bedtime Sleep environment is key Sleep and stress management Many times women with PCOS have been told to lose weight in order to get pregnant, that they’re total exercise junkies! All that effort can be misplaced when it’s cranking up your stress hormones and stressing your immune system If you’re dreading your workout and coming up with every excuse not to go, find something else! Keep your own body in mind - if you’re 280 pounds, putting weights on your back and trying to squat is only going to put more strain on your body. Bodyweight exercises can be a lot more helpful! Cardio isn’t always the answer. Strength training and resistance workouts can do wonders for building muscles and changing insulin Find something that you like Stretching and breathing can lower your stress and help your body relax. Quality ovulation is dependent on your body feeling safe enough to become pregnant. Lowering stress hormones can be a big key in this Yoga Exercise Check out Caitlin's program: Find Fertility with the PCOS+ Method. 

Who wants to hear all about PCOS and fertility??   Well you came to the right place! In this episode, Caitlin and Sophia dive in to the #1 most common cause of fertility struggles in women: PCOS   So… what is it?   PCOS is an endocrine problem, meaning it is a hormone imbalance. It used to be thought of as a gynecological problem, but as science has advanced we now know PCOS goes beyond female sex organs.   Dietitians like us actually cannot diagnose PCOS, though both Caitlin and Sophia often have women come to them for fertility help, and when we send them back to their doc for some testing it’s discovered that they DO have PCOS.   PCOS is diagnosed using certain criteria (Rotterdam Criteria), and it’s more of a culmination of signs and symptoms. The symptoms your doctors typically look for are:   Cystic ovaries - ovaries with multiple cysts diagnosed with ultrasound High androgens - Testosterone, DHEA-S, Androsterone, etc. elevated higher than normal for women Excess body hair Male pattern baldness Lack of/delayed ovulation - your cycles are very irregular and ovulation is rare or absent   Caitlin was a mere teen when she was diagnosed with PCOS, and when she innocently asked her doc what this meant, his cold reaction was “PCOS is the #1 reason women can’t get pregnant”. Which, by the way, is a HORRIBLE thing to say to anyone, let alone a teenager!   **If you only take one thing away from this episode, let it be know that PCOS is NOT an infertility diagnosis! If left untreated, PCOS can certainly impact fertility; but PCOS is very treatable! This diagnosis does not mean you will never be a mom!!!!!**   Treating the factors that influence PCOS greatly increase your chances of getting pregnant!   So, what if you simply suspect you may have PCOS?   Cycles longer than 35 days Acne Hair loss Body hair growth Difficulty losing weight Excess weight around your belly How does PCOS affect fertility?   If you’re ovulating every 28-30 days or so, you’ll have roughly 12 chances to get pregnant in a year. If you, someone with PCOS, only ovulates every 50-60 days, you will have far less chances to get pregnant in a given year.   Why does this occur?   Almost always, the root cause of PCOS has something to do with insulin resistance. In simple terms, this means your body doesn’t manage your blood sugar well. Insulin is a hormone that moves the sugar/fuel in your blood into your body’s tissues and cells. Insulin resistance is where your body stops listening to the message of insulin, requiring your body to crank up the volume on insulin to get the job done. This causes ovaries to get overstimulated, increasing testosterone and other male hormone levels; causing many of the symptoms of PCOS   Brains are greatly affected too. Your brain has glands that make hormones that control ovulation. In healthy bodies, your brain makes a surge of luteinizing hormone (LH) and follicle stimulating hormone (FSH) just before ovulation. In bodies with PCOS, these hormones kick into high gear far too frequently as your body tries and tries to ovulate. This is why it’s so helpful to get lab work done so we can address exactly what is happening with each of these hormones.   Brains also make a hormone called prolactin. When prolactin is at its best, it helps nursing moms make milk for their babies. Part of the overstimulation of the ovaries and brain that come with PCOS cause your brain to make too much prolactin. High prolactin is good if you’re nursing a baby because it also tells your ovaries not to ovulate, since your body is still sustaining the life of the baby you’re nursing. However, if you have PCOS and your prolactin is too high, this hormone holds off ovulation and makes it harder to become pregnant.   Estrogen is also higher in many women with PCOS. This, again, can be because your body is trying and trying to ovulate. Estrogen can also be too high due to excess body fat, a piece of the cruel cycle of PCOS. Estrogen being too high is particularly problematic when it comes to the hormonal rhythm of ovulation. When estrogen dominates other hormones (like progesterone), many of the symptoms of PMS/PCOS are amplified. Migraines, cramps, anxiety, heavy bleeding, etc. are all symptoms of high estrogen to progesterone.   The last noteworthy hormone of PCOS is cortisol, the stress hormone. This hormone causes blood sugar to rise and thwarts the function of insulin, making your body naturally more insulin resistant. This is great if you’re in the midst of a bloody battle; not so good if you’re overwhelmed by the daily stress of life. While we cannot change the stressors that occur in your life, we do help each of our patients manage stress and react to stress differently.   These hormones are why both Caitlin and Sophia both do functional hormone testing as a part of their practices! We want to target your specific symptoms and root causes! No two women are the same, and there is no way to say simply by looking at symptoms what each of your hormones are doing.   This is also why advice from medical professionals that sounds anything like “lose some weight” is so infuriating! It’s not only unhelpful, but it’s psychologically damaging. Remember, one of the symptoms of PCOS is excess weight in the midsection. So, it’s not helpful to be told the very symptoms you’re there to address is same as the treatment.   ** Cue Sophia rant about doctors telling women to lose weight **   Another great test to run is an insulin assay. This includes a 2 hour glucose tolerance test and measuring insulin markers like the Homa-IR test   These labs we all mentioned are tests that Caitlin and Sophia use all the time in our practices! However, this is not a comprehensive list of all the hormones and tests to look at with PCOS. Even if you have done all this testing, and you still can’t figure out what’s up; don’t give up! There are more stones to overturn and Sophia or Caitlin are poised and read to help you get some answers!   What could happen if you go to the OB/GYN and say you want to get pregnant with PCOS Get a full panel of labs on varying dates of your cycle Your doc might give you Metformin (glucophage) and are told to come back in a few months if you’re not pregnant Your doc might also give you Clomid (clomiphene) or letrozole to try and trigger ovulation   You might also be simply told to lose 10% of your bodyweight… which is not helpful, as we’ve established.   Stay tuned to next week’s episode where we talk about REAL LIFE SOLUTIONS to PCOS fertility struggles! Tune in and be amazed.

If you are interested in trying this test for your family, use our FFFpodcast15 code to get 15% off your entire shopping cart from YoSperm.com What is fertility like from your man’s perspective? Our guest Eric from Yo Sperm gives his insights into at home sperm testing, in office semen analysis, and the male mind when it comes to fertility testing. This is one of our most valuable and interesting episodes yet! Yo Sperm is an at-home semen test. It’s fully private and works with your smartphone, revealing sperm count and motility from the privacy of your own home. The kit costs far less than a laboratory analysis, and can be repeated over time to see how your man’s semen changes. Not to mention you can forgo the clinical experience and crusty issue of Hustler from 1998. Eric from Yo Sperm talks about the benefits and drawbacks of at home semen testing, as well as options if your results come back as abnormal. Though Yo Sperm is not a replacement for a full clinical semen analysis, it can be a great place to start! You can order the kit yourself anytime, no need to wait 6-12 months for your doc to give you the go-ahead. The system works remotely with 100% privacy and confidentiality. Your results are even compared to other men who have fathered children. This episode then goes into the heart of the matter. WHY are so many of our male partners obstinate about getting a semen analysis? What makes men so reluctant to do this simple test, when women’s fertility testing is so much more expensive and invasive? Eric dives in and gives us a man’s perspective on why this is such a big deal for some men. While semen quality is NOT a reflection on masculinity or viability as a man, it IS a reflection of your overall health. Addressing semen quality issues can bring nutrition and lifestyle issues to light! Semen quality is not static. Your partner’s semen quality can change drastically with proper nutrition, exercise, and lifestyle changes. Even if your results aren’t amazing, don’t fret! There are so many things we can do to impact the quality of your man’s semen! Heavy hitters that impact semen quality are: Obesity/body composition Processed food/fast food Alcohol Tobacco Cannabis Testicular temperature (think cyclists, horseback riding, and working for hours in high heat) Anabolic steroids Testosterone replacement therapy Hair loss treatments and medications Stress Illness The Yo Sperm results page also gives recommendations about nutrition, exercise, and sexual health! All of these things can impact your semen quality, and even though there is no dietitian or doctor reviewing the Yo Sperm results, these recommendations are generally safe and effective for most healthy men. So, what about when it is time to bring some doctors and clinicians? Eric goes into the details of how semen analysis labs measure things like semen volume, DNA fragmentation, motility, sperm progression, morphology, shape, etc. Yo Sperm only gives a baseline analysis, and anything more nuanced needs to be done by a medical professional. Fertility is nuanced, and we want you listeners to feel empowered that there is a lot that can be done with nutrition and lifestyle to boost fertility and improve chances of conception. So how do you get your hands on one of these sweet Yo Sperm tests?? Ebay, Amazon, and directly through Yo Sperm are online options to get this test. Plus they ship internationally! Anyone, anywhere can test their semen quality and begin finding some answers. If you are interested in trying this test for your family, use our FFFpodcast15 code to get 15% off your entire shopping cart from YoSperm.com

Again, we know the audio quality on this episode is less than our usual. It should be back to easy listening next week. Thanks for your patience.  We have a MAN on the show! Our first man on the FFF podcast is Sophia’s husband, Louie. In this episode he shares the hilarious and honest details of sperm collection! NOTE: The audio on this isn’t the best, but we PROMISE you it’s worth it for how funny and informative this episode is! Louie opens by sharing with us WHY he went to the sperm cryopreservation bank in the first place. Since he is active duty military and deploying to combat zones, our local San Diego cryobank does a great service to active duty families by discounting their cryopreservation services! Unfortunately, military members tend to be guinea pigs, and sometimes years and years down the line we find out that the meds/exposures/chemicals/etc actually harm fertility. Military members are exposed to toxins, radiation, and dangerous situations that can damage your ability to reproduce. Sophia and Louie decided to take advantage of this wonderful program and store some of Louie’s goodness before he left on deployment. For them, it was like an extra layer of insurance making sure that there would be healthy sperm available set aside in the event that something catastrophic occured to Louie while in the line of duty. First thing first was to run some tests on Louie to make sure his reproductive system was healthy. Cryobanks want current info on HIV/STI tests, as well as other things. Louie HATES blood draws, and he recommends doing he blood draw a few days in advance to reduce added stress on the day that you make your sample(s). For him, the stress of a blood draw really impacted his ability to climax and produce a sample. Of course he pushed through and made it happen in spite of the looming needle-poke, but it wasn’t easy! Listeners, we CANNOT STRESS THIS ENOUGH: test your semen early! Things happen, and it’s not always possible to make a quality sample on the first go! Sophia and Louie had a looming deployment date and didn’t discover the cryobank benefits until just before Louie had to leave. So, they were on a tight deadline that put added stress on Louie. If that is NOT your situation, go as early as possible in your TTC journey to ensure plenty of time to spread things out and get the best possible sample! It’s important to note that before you go in to make your sample, you need to abstain from sex or anything that could result in ejaculation for 2-5 days before you go to the cryobank. You also need to avoid any hot baths/jacuzzis/sauna/etc. As well as trying to avoid stressful situations. Stress greatly impacts your semen quality and volume. This can put an extra pressure on men! When you’re TTC, it’s all about whether or not the man can orgasm. Women can get pregnant from sex whether or not they climax, but if the man doesn’t orgasm and ejaculate; no joy. The clinic we went to was a fully functional urology office! Turns out this clinic is also the urologist for the local men’s penitentiary! Louie was busily focused on his paperwork while a parade of shackled convicts were streaming through the lobby. Sophia was VERY uncomfortable, but thankfully Louie never looked up from his paperwork and was totally oblivious. The sample collection room was clean… but it made you feel dirty! There was a creepy recliner that was made of some kind of material that could be easily wiped. Also, a stale collection of pornographic magazines from the late 90’s. Important to keep in mind: the skin of the penis must be sterilized with wipes, and absolutely no lubricant, lotion, salvia, or vaginal secretions can be present. Though Sophia initially went into the sample room with Louie, this ended up not working out when Sophia had to run down to the truck and get Louie’s headphones.  Other recommendation: bring headphones! The walls are THIN in these cryobanks, and it’s hard to reach climax when you can hear doors opening and closing, clinicians talking, and other distractions. This is all mixed with the fact that you’re told again and again to “try and relax” because samples are greatly affected by stress. Miraculously, Louie was able to make a sample while Sophia was running down to get the headphones! After the sample was produced, the clinician analyzed the quality and told Sophia and Louie about it in the most AWKWARD way possible! Lo and behold, Louie’s sperm were healthy and his semen quality was stellar! Praise the Lord! Next, you have to decide what you want to do with the sample. For instance, samples that will be used for at home insemination or IUI are processed differently than samples destined for IVF. Because Sophia and Louie didn’t have time for extra samples, they decided to preserve the sample for IVF, since the sample was only enough for 1 IUI vs. 4 IVF cycles. After ALL of this, Sophia and Louie found out they could have done a home collection! Facepalm. If you’re like them, and you prefer the comforts of your own home, do the dang sample at home! As long as you can get it to the clinic within an hour, your sample can be successfully collected at home and used. Something important to note is the legal side of cryopreservation. If you are using the semen right away, or simply analyzing it to see if babies can be made from that sperm; it’s not an issue. If you’re freezing it for future use, a lot of other legal factors can arise. It could be worthwhile to sit down with your lawyer and go over the paperwork prior to the sample to sort out any issues that could arise down the line. Again, that’s only if you’re planning to freeze the sample for future use like Louie and Sophia. In this episode especially, we take plenty of time to laugh and make silly comments about fertility, sperm, and masterbation. We do this because fertility struggles are HARD! We believe that laughter is medicine, so though we fully embrace the sorrow and anguish that can come along with struggling to conceive, we want to make the process more enjoyable by finding ways to laugh. 

Sperm Quality -    Hang with us, the audio quality of this episode isn’t our best, but we have great information for you.    We all know that sperm is essential to creating a baby. This episode is all about helping your partner have the healthiest sperm to contribute to the party.    About 13% of the population has fertility struggles. About 30% of the cases of infertility are estimated to be male factor infertility. Could be too small of numbers, can’t swim, weird shape, genetic issues. Reflux, sperm not going into the urethra in ejaculate, but spilling back into the vas deferens, obstructions.  Female factor infertility can be unexplained infertility, anovulation, insufficient progesterone, eqq quality issues, immune system issues, blood clotting issues.     How would you know if it is a female factor or male factor or both? Get seman analysis done to rule out if something is going wrong. Sperm count, motility, morphology, and volume of ejaculate.    Sperm count - how many per unit volume Motility- Are they moving normally? Morphology -percent of sperm that have normal shape   Sperm count has dropped 33% over the past 50 years worldwide. The y chromosome is also shrinking, what?!   Have no fear listeners! Diet and lifestyle can have a huge impact on sperm quality.   Cantaloupe is shown to help increase sperm over-all quality. Across all studies, fruit and veggie intake , especially leafy greens. It’s not shocking as we return to whole foods, that sperm quality improves.   Higher exposure to pesticides affected sperm quality in a study. Don’t let this discourage you from eating fruits and vegetables. Eating conventional fruit and vegetables will always trump eating a bowl of sugary cereal for a snack before bed. When possible consider the clean 15 and dirty dozen when making decisions on organic versus conventional grown produce.  Everything but the bagel recipe knock off.  Yummy on eggs.    Food prep may be the key to help intake of snacks and meals that are healthier for sperm quality.    A lot of the vitamins in veggies are better absorbed when eaten with fat, so don’t be afraid to saute in oil, add cheese on top, or some avocado on the side.    High fat processed meat products are good to limit in the diet. Sourcing good quality meat, eating nose to tail, eating organ meats, can be very helpful in consuming enough vitamins. Organ meat consumption offered better concentration, better morphology, better sperm count, better motility, and ejaculate volume in studies. We know eating organ meat is something that is pretty abnormal in modern cultures, but getting back to eating more “nose to tail” - making use of all of the animal that you can, will improve health factors for both fertility partners.    Liver has a lot of iron and zinc, both very helpful for sperm quality.   Most people don’t even know how to source liver. You can source liver at: https://grasslandbeef.com/ (US Wellness Meats). We are NOT SPONSORED by them. You can also ask a local butcher or find at a local health food store like “whole foods”. I like to buy it frozen, then grind in my food processor, and save in 1-2 tbsp servings.    Cooking at home can help you save money and get better food than you will have at the drive-thru.    Fish - in and of itself is healthy. Can have some pollutants to the table. The omega-s are healthy for sperm. So try to source quality fish when consuming it while trying to conceive.  43:40   Milk and dairy are controversial topics. The research shows that high fat dairy has benefits in terms of fertility for females. It is suggested that high fat dairy intake might be related to sperm quality, and skim milk might be better. May not be beneficial to be drinking milk period. Having things like cheese on veggies, yogurt, cottage cheese could be good options.    Alcohol can have a negative effect on sperm quality. Decreasing drinking and especially binge drinking can help improve sperm health parameters.    Tobacco, chewing, smoking, even vaping will all negatively impact sperm quality. This is a great opportunity to help improve sperm quality, and overall health for a new dad. No better time than now to kill the tobacco habits.    Sugar and sugar sweetened beverages are not great for sperm. Obesity and extra weight are also negatively impacting sperm health. Decreasing intake of sugar, sodas, desserts will help impact sperm health.    If erectile dysfunction is something is affecting your ability to even have sex or have an ejaculation, it’s important to see your physician to get help with that. There is no shame in getting assistance when needed.   Supplements can be supportive. Antioxidants can be helpful to protect sperm from oxidative damage. Fish oil or omega-3 can be helpful to add in. Adaptogenic herbs can also be helpful during stressful times like ashwagandha.