Food Freedom and Fertility Podcast

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.

Sophia and Lily jump right in and talk about their inner nerds and how easy it is to fall "down the rabbit hole" when digging in to juicy nutrition research. First order of business is Folate vs. Folic acid. What's the difference and what's the big deal? Well first off, folic acid is synthetic folate. If you're a nerd like us, you may know that folate comes in many forms in food. Folic acid never comes in food and it can actually block 40-60% of the population from using folic acid! Not only that, it can block you from absorbing the good stuff from your food. NOT ONLY THAT, but the gene mutation that makes this happen is called MTHFR. That stands for methylene tetrahydrofolate reductase… but let it be known it can be a real MTHF**R when it comes to absorbing nutrients. So… why is folic acid added into food anyway? Short answer… it's cheap. Food manufacturers and supplement companies don't want to cough up the dough for the good stuff. Of course, you can avoid it all by simply avoiding refined grains and cereals! Done and done. Sophia and Lily then debunk crazy nutrition myths in regards to pregnancy and conception nutrition. Myth #1 - Eat fortified cereal for a healthy baby Truth #1 - You can't find the same amount of nutrients in refined grains as you can in whole, let alone in comparison to other whole foods. The #1 indicator of poor nutrient intake is high intake of refined grains. Eating a lot of bread, crackers, and pasta means you're eating less fish, eggs, berries, and greens. Not to mention the impact that refined foods have on your blood sugar. Myth #2 - Cereal is a breakfast food Truth #2 - grains in cereal are primarily carbohydrates. Mixing cereal with milk or yogurt only increases the carb load. Mix in some fruit beyond that and you're looking at one sitting that consists of ½ the carbs you need for the whole DAY! Physiologically, everyone who eats a meal like this will see a massive blood sugar spike. Research shows that when you start your day with a carb rich breakfast, you will eat more food and have stronger hunger signals for the whole day! Eating a fat and protein rich breakfast does the opposite, even if the fat/protein breakfast has more calories than that of a carb rich breakfast. Mental health issues can also be abated by eating a protein and fat rich breakfast. It primes your brain to be happier and more balanced all day long! Whereas a carb rich breakfast is greatly associated with higher anxiety and deeper depression all day long. High carb breakfasts also include fruit smoothies! There are fewer things on planet earth that will spike your blood sugar more quickly than liquid fruit on an empty stomach. If you want to have smoothies on an empty stomach, it needs to have 20+ grams of protein and 10+ grams of fiber while containing less than 20g of carbohydrates. And honestly, a smoothie with that profile doesn't usually taste that good. Sorry to say but this includes that fancy bag of protein powder from your best friend's MLM affiliation. Protein powders that taste sweet but are low in carbs contain artificial sweeteners. None of which are tested on fetuses or pregnant women. Though we do know that these sweeteners cause birth defects in mice so… let's just say no to them for humans too. Myth #3 - Eating only plants is best Truth #3 - Listen, we understand all the arguments for and against consumption of animal products. We respect people's choices. We never argue against people's ethical and religious objections. However, there are significant nutrient gaps that strict vegan and vegetarianism can create. If you don't eat animals, nutrients aren't available in adequate quantities and concentrations to support fertility, pregnancy, and breastfeeding. These nutrients are choline, glycine, vitamin K2, iron, zinc, omega 3, and B12. Even if you eat these nutrients in a veggie-based way, you won't be able to absorb them. The same goes for vitamin A. Even if you eat lots of beta-carotene, you can end up with deficient vitamin A without eating animals. Supplements can help, but even great supplements don't always have the right ratios, forms, and amounts of these nutrients to nourish the baby and the mother well. It's not the same thing to take algae-based DHA, versus getting it from animal foods. We are just scratching the surface as far as what women need while TTC and pregnant. Look, there's a difference between knowing what's best and choosing to eat plants-only because of your own preferences and eating plants only because you believe a lie that eating animals is bad for you. Nutritionally, it's just not true that plants alone are best. However, we meet women wherever they are at, without judgement, and help them do what's best for their lives as a whole. Listen up though. When we say "plant based", we are talking about the challenges of a vegan and vegetarian diet in pregnancy. We are not talking about NOT eating plants. We highly recommend that women eat lots and lots of plants! In fact, we recommend that you make your diet MOSTLY plants! We just know, from research, that eating animals and animal products in addition to plenty of plants is the best way to feed your body for fertility and pregnancy. Even though some people have seemingly been ok through a plants-only pregnancy; it's just not best. But here's some good news for ethical vegans! Bivalve shellfish like oysters, clams, and mussels have no central nervous system and therefore do not feel pain. Plus, they are generally very sustainably grown and harvested. Many vegans decide to eat these foods while TTC or pregnant to boost their nutrition. Myth #4 - Artificial sweeteners are better for you and they help prevent gestational diabetes by keeping sugars low Truth #4 First off, this is the dumpster fire equivalent of nutritional advice. YOu might expect that eating something that provides no calories or sugar would be superior to something that does contain sugar and calories. However, it turns out our bodies aren't so easily tricked. When it comes to artificial sweeteners, you actually can still raise your blood sugar in a similar way to as if you were eating/drinking sugar! This is due in part to how our bodies react to strong sweet tastes, and also due to the fact that these sweeteners greatly affect the bacteria in our digestive systems. Sucralose, or Splenda, is one of the worst offenders on our gut bacteria. Sucralose also really affects thyroid function! Eww! Thyroid function is also really vital to healthy fertility before you get pregnant, and vital to your baby's brain development after you've gotten pregnant. There are also studies linking consumption of artificial sweeteners in pregnancy to childhood obesity! Women who consumed artificial sweeteners on a daily basis had bigger babies, and their children were almost twice as likely to develop obesity during childhood. These sweeteners prime your taste buds and brain to crave more and more sweetness, which makes you in turn want to eat more sugar! We are fans of laying off the sweet flavors and letting your taste buds adjust back to nature. Myth #5 Low carb diets are dangerous in pregnancy - 56:00 Gestational diabetes means carbohydrate INTOLERANCE in pregnancy. That means carbohydrate intake needs to be adjusted according to what your body can tolerate. With that said, we don't have a lot of data on SUPER low diets during pregnancy (less than 40g of carbs per day), but Lily does recommend swapping higher carb foods for more nutrient-dense foods that has a higher nutrient-to-carb ratio. Unlike most health professionals, Lily is not afraid of ketosis or ketones in pregnancy. In fact, in all mammals, pregnant bodies use fatty acids and ketones MORE READILY than carbohydrates as fuel. Though this is a different conversation than we are having here, it's worth noting that eating low carb is certainly not something to be afraid of. As dietitians when we put the MOST nutrient dense foods into a woman's diet we find that she is eating at minimum 70-90g of carbohydrates per day. If you try to pull a daily diet lower than that, you start to cut out healthy foods to get to that point. Plus, we have to use our bodies and brains when planning diets for pregnant women. Meaning, in the beginning of pregnancy women usually have food aversions, taste changes, and appetite variations. It's really hard to be low carb at the beginning of a pregnancy! As far as fertility goes, the same rules apply. Limiting your intake of high carbohydrate foods and swapping them out for more nutrient dense foods boosts your ability to make healthy hormones. Swapping out leaner proteins (chicken breast) for the fattier and more nutrient-dense cuts (chicken thighs) can get your body ready to house a healthy baby. However, going through heroics to force down your carb and protein intake in order to induce ketosis has not been shown in research to help fertility or pregnancy. These kinds of diets are not supported by research and they're largely not sustainable. Let's also keep in mind that what a lot of people call "low carb" or even "keto" is simply limiting refined carbohydrates and sugar while focusing on veggies and protein. We are all for diet changes like that! True low carb diets (less than 50g per day) or true ketogenic diets are very different from what your neighbor is describing as she eats a lettuce-wrapped burger with a side of sweet potato.

Welcome back, listeners! Today we are having a chat with Lily Nichols, a kick-butt registered dietitian nutritionist who wrote Real Food For Gestational Diabetes and Real Food For Pregnancy. Here we learn about Lily's work and research, her history as a dietitian, and get a nice sample of the wisdom and expertise she has to bring to women who are trying to get pregnant. This episode starts off with Lily sharing with us her experience with the prenatal dietary guidelines. To sum it up: she's not impressed with mainstream guidelines. Now she writes about how to actually feed yourself well while trying to conceive or pregnant, in spite of the messed up guidelines. If you don't know what these guidelines are, Sophia clues you in. Basically RDA and other guidelines, like the ones you find on the back of a food container, are based on what is the minimum amount someone must consume to prevent a major deficiency. The research is done on adult men, and there is no consideration taken for women or people of other races or ages. Boo! Lily promotes using REAL food to meet your nutrition requirements. She defines real food as unprocessed food made with simple ingredients, as close to nature as possible. Specifically, not processed in a way that removes nutrients. This means not stripping grains of their fiber to make them "refined. Not skimming the fat off of dairy, and not removing the skin or fat from poultry. You get more nutrition when you eat all the parts. A lot of food in the American diet is not really "food". Artificial sweeteners, thickeners, stabilizers, preservatives, etc. are made by food scientists to be "safe" to eat, though it's not necessarily healthy. When we define REAL food, we are talking about what builds your body up with good nutrients, versus how much of a chemical or additive you can consume before it starts doing major harm. We also want to emphasize whole foods vs. isolating specific nutrients in a lab, and then trying to separate them from the rest of the food. To clarify, we are NOT anti food science here on the FFF podcast! We know scientists have been involved in our food supply for centuries, and that a lot of the work they have done has been amazing! We are about food FREEDOM and fertility, meaning not limiting every food or only eating certain things. We just promote a natural diet of real food. There are very few foods that are 100% of the time a bad idea to eat, and according to Lily that list is limited to: refined carbohydrates and sugars and trans fats. That's pretty much it! So, what is it about all this "real food" stuff makes it helpful for women who are TTC? Lily says that all the ways that the primary factor is that increasing the provision of micronutrients in the diet. These nutrients play a strong role in hormone balance, detoxification, egg quality, regulating cycles, and more! Food is powerful, and getting yourself in a healthier place with better nutrient stores can help your body get ready for a pregnancy. Sophia shares her experience at Bastyr University with helping the school adopt an omnivorous menu, and Lily shares how Bastyr School of Midwifery now uses her books as a part of their curriculum! How cool is that? In fact, both of Lily's books are now available as book studies for dietitians worldwide to get their continuing education units! Lily shares a bit of the praise and criticism she has received about her books. Pro tip: anyone giving anything a 1-star review on Amazon is generally someone who did not even read/use the product they're reviewing. Good to know! It's no mystery that on this show we are fans of informed consent. Traditional nutrition guidelines are built around the average consumer being too stupid/distracted/disconnected to make good choices. Information is deliberately withheld to keep from confusing people or making things "overly complex". I am sure this applies to some people, but we believe our audience (that means YOU!) is interested in learning, growing, and making their own choices. Lily details in her books what research shows is BEST when preparing for a baby, but it's not hard and fast rules. When you're empowered with knowledge, you can make whatever choices work best for you, your lifestyle, and your personal beliefs and preferences. Lily reveals some tidbits she wishes she could have added into her books. One major one is a study on vitamin D. Women who have serum vitamin D levels over 40 have a significantly reduced rate or preterm birth! Boom! On this show, we are big fans of vitamin D, as both Caitlin and Sophia recommend their patients have vitamin D levels in the 50's and 60's. If you have pale skin, you can get vitamin D from the sun more easily! If your skin is dark, you're going to have a harder time making it on your own without a supplement. Finally some good news for you folks who burn easily. A major thank you to Lily Nichols, and thank you for listening!

Today we learn about progesterone, pregnanediol and the home-test kit Proov with Dr. Amy Beckley. Amy shares her story about trying to conceive, confronting the medical community, and developing a test that puts power back in women's hands. Amy does medical research and is a PharmD, so she was no dummy when it came to what was going on in her own body. Unfortunately, the doctors she began working with did not see things the same way. After a miscarriage and IVF, Amy found a doctor that was willing to work alongside her on her journey. She began using progesterone supplement medications including Prometrium and Crinone. She had her progesterone tested on day 21 of her cycle, knowing full well that not all women ALWAYS ovulate on time. **PSA** NOT EVERY WOMAN OVULATES ON DAY 14 EVERY MONTH** This means that a day 21 progesterone doesn't always reflect your body's real progesterone potential. Ovulation is more than just releasing an egg. Yes, it does include the releasing of an egg, but healthy ovulation also supports and prepares the body for pregnancy. Progesterone is an important part of that. It is possible to ovulate, and then have something called "luteal phase defect" where your corpus luteum DOES make enough progesterone… just not for long enough. This can make it to where the embryo does not implant properly due to a drop off in progesterone too early. This is what Amy experienced when she was in the midst of her fertility struggles. Hence the progesterone medications we mentioned earlier in the episode. This is why Amy and her team invented Proov! Proov is a home-based urine test that measures progesterone metabolite in your urine. Amy recommends using her test by checking your "implantation window". That's the period of time about 7-10 days AFTER you ovulate to see if you are still making enough progesterone to support a pregnancy. Amy recommends measuring progestoerone with the PROOV strips during the implantation window for several cycles in a row to get some real data as to how your body is functioning. Amy's PROOV test is the ONLY test that works this way! This test is not designed to replace doctors, but instead to allow women to have better guided questions for her doc, and to get her in sooner when there is a problem. Insert: PROOV urine test. Ta-da! A positive PROOV test means your body made enough progesterone to support a normal pregnancy. It doesn't ONLY check whether or not you ovulated, but whether or not you sufficiently ovulated. If you're not making enough progesterone at the right times, it's not a sufficient ovulation to sustain a pregnancy. Until the embryo implants and the placenta begins making progesterone of its own, the pregnancy depends on the progesterone made by the mother's corpus luteum for survival. Amy's pregnancies were ending because her corpus luteum didn't make progesterone for long enough. Diet has a HUGE impact on progesterone production, but not everyone has time or capacity to make diet changes while trying to manage these fertility struggles. It can take up to a year to get your body back to hormonal balance! Some women just don't have that kind of time. Some women prefer to use progesterone medications while beginning diet and lifestyle changes. Birth control pills are different from natural progesterone. We recommend using natural, micronized progesterone that is bio-identical. These are words you can use with your doctor when discussing what medications to consider. Use an oral or intervaginal medication and NOT a skin cream. Using a skin cream takes up to 10 days to work, too long for women trying to get pregnant! The creams are good for menopause, but not good for women who are of reproductive age. So, what else does progesterone do besides support a healthy pregnancy? Should women who are not currently TTC or women who have completed their families care about progesterone? Amy gives us a resounding YES! In fact, PMS symptoms are often experienced because of what Amy describes as a "progesterone crash". Meaning, the progesterone your body makes drops off way too quickly before your period starts. This is often what causes headaches, acne, and bloating pre-period. Depression and anxiety are linked to low progesterone. Low energy can be linked to low progesterone too. Perimenopausal symptoms are often a result of low progesterone. Caitlin and Sophia both have nice rants about birth control pills. Enjoy that. So, what are some food solutions to progesterone malfunctions?? I'm so glad you asked. Seed cycling. We did a whole episode on this! Give it a listen Inflammation in your body - for Amy it was dairy. She needed to lay off the dairy and it caused her many issues. Maybe go through a guided elimination diet to see what is mucking up your system Zinc - a building block for hormones B6 - another important nutrient for hormone production Healthy Fats - hormones are made of FAT! If you don't eat enough fat you won't be able to build hormones. Here are some of Amy's herbal recommendations: Vitex - also known as chaste tree berry. She recommends women take it all cycle long to support a strong LH surge before ovulation and enough progesterone post-ovulation DIM - diindolymethane. This especially helps women who have low progesterone due to high estrogen. WARNING! This can make your symptoms worse if that's not your specific problem. DIM is made from cruciferous veggies like cabbage and brussels sprouts. Caitlin and Sophia recommend that you add more of these kinds of veggies into your diet for many reasons. Remember, taking the wrong thing can make symptoms worse. Not to mention waste your time and money. There are a lot of fertility supplements out there, and it's easy to get overwhelmed. It's important to work with a professional when dealing with these substances! Now let's talk about progesterone and STRESS, aka Cortisol! We believe that the menstrual cycle is the 5th vital sign. It's the last in line of vital functions, so your body steals things from your menstrual cycle in order to keep the other vital organs functioning. Reducing your stress by having a better mindset about stress and conception helps your body cope. Stop "trying to relax", it's a paradox! Instead, start to see stress in a positive light and a valuable part of your journey. PROOV test is also working to educate consumers about progesterone. In our world, there is nothing better than helping people achieve a healthy pregnancy with a happy baby. The success stories really warm our hearts. If you have a success story, we want to hear it! Seeing those positive pregnancy tests is so worth it! PROOV test also lets you pinpoint ovulation. If you have any questions, you can use their contact list on the test to reach out and ask a professional, or you can use their private facebook group. Really the only way to know when you ovulate is to test. If you REALLY don't know, you can start with PROOV strips on day 18 and keep testing and testing and testing until you get a positive. Amy also recommends you get some regular ol' ovulation test strips that measure LH surges and use those. They're cheaper. However, some women with PCOS often do not ever test positive on LH ovulation strip. For those women, Amy recommends you go with checking your cervical mucus. Start testing about 7-10 days after you've had that rich, egg-whitey, slippary mucus to see if ovulation in fact DID occur after all. I mean, even if you don't have PCOS, knowing your body and having sex when you have the fertile mucus, versus just waiting for the LH surge. Sometimes you just get tired of having sex on command and peeing on all these strips! Cervical mucus is your best friend when indicating ovulation. The strips are just meant to supplement your knowledge of your own body. The PROOV test is designed to be used like a pregnancy or ovulation test. However, PROOV is different because a positive test has only one line, while the negative has two lines. This is the opposite of pregnancy and ovulation test strips. It sets it apart! Amy recommends you test your first morning urine, just like a pregnancy test. Progesterone is fat soluble, so you make it in the day and metabolize it at night. This means that your urine test in the morning will give the most accurate result. If don't get 3-4 positive test days in a row, it's time to bring these results to a professional and talk about treatment options. You can buy these strips on Amazon, of course, but you can also buy it through the PROOV website. Amy is smart, if you didn't know that by now. She works with Amazon so you can read real, honest reviews! How cool is that?? If you want to buy through the site, use discount code PROOVIT for a 10% discount! You can also sign up for the newsletter to learn all kinds of cool stuff about progesterone! Even if you order through Amazon, you still want to get on this newsletter chain! Thanks for listening!

In this episode we compare and contrast the 3 top of the market ovulation/tracking wearables! The 3 we review today are TempDrop, Ava Bracelet, and Ovusense. Spoiler: Ava is Sophia's favorite and she's an affiliate so you can get a $20 discount by mentioning the name Sophia Pavia at checkout, or by clicking this link: But before you decide, let's talk about TempDrop. TempDrop: Measures temperature only. However, it measures the nuances of your temperature over time so it does more than a regular drug-store thermometer. It accounts for things like sleeping in a room with AC or a fan, sleeping under a heavy blanket, etc. Measures your lowest temperature while you're sleeping, so no need to set alarms and temp at the same time everyday That makes it a good option for shift workers, nursing moms, and women with irregular periods (hello PCOS and HA!). Lets you use other apps, not just their own proprietary app, so you don't have to abandon whatever other app you've been using if you have a lot of data there. Gives you lifelong access to your data, even if you stopped using the device Take 14 days to begin to show trends, but give it up to 60 days before relying on it as a means of TTC or TTA No charging! Battery does need to be replaced every 6-9 months. Worn on upper arm near armpit Pricing Basic: 1-time fee of $160, NO returns but does include 12 month warranty Confidence: $199 includes 1 year returns and 24 month warranty Freedom: 1 year returns 36 month warranty, extra battery, and care plan Ava: Measures 5 parameters of fertility Basal Body Temperature & temperature nuances Resting Heart Rate Sleep duration & quality Heart Rate Variability Breathing Rate NOT water resistant, and a replacement isn't free (learn THAT the hard way) Family and fertility positive, not marketed for women who are TTA or on hormonal BC (but Sophia used it to avoid pregnancy for a while anyway) Learns your cycles, one by one. Accumulates data over time and gets more accurate the more you use it Takes 2 full cycles before fully effective Synchs to it's own app, where you can also store other cycle info (spotting, CM, cervical position, etc) It's a bracelet you wear around your wrist at bedtime and synch via bluetooth in the morning Has a super nifty built-in vibrating alarm, to wake you up but nobody else Untested for PCOS - but Sophia loves it for PCOS anyway Shows all the parameters of fertility, so I can see more than temperature for my clients Stress and sleep are key for PCOS fertility success, and being able to track resting heart rate, breathing rate, sleep quality, and heart rate variability is SO HELPFUL in seeing ways to support PCOS outside of blood sugar control and nutrition Annoyingly, the app logs out randomly and makes you log back in. Who remembers passwords these days anyway? Has a great referral program and also a very helpful blog! Pricing: Basic: $279 includes bracelet itself and access to blog + community Plus: $299 refund if you're not preg in 1 year and free ebook Premium: $359 refund if you're not preg in 6 months and ebook Ovusense: You sleep with it IN YOUR VAG! Yes, you read/heard me right. Shove it in, ladies! Tracks temperature only, like TempDrop Predicts the DAY of ovulation, not just a "fertile window" Does this by predicting progesterone levels Tracks even if your cycles are irregular or if you have anovulatory cycles (PCOS, HA, etc.) You have to use their app, and you have to pay for that access every month Pricing $129 for 2 months of device + online synching system $299 for 12 months $499 for "pro" and 12 months of device + synching program Month-to-month is $35/month This pricing model can be challenging if it takes you more than a year to conceive, or if you want to use it for multiple pregnancies. Plus… you wear it in your vag. If you're a night pooper, this would NOT be right for you. Overall, the Ava Bracelet is Sophia's fave, but each one really depends on the user and her preferences! Each one works differently, and from what we can tell each one works well. Sophia is just a data nerd so she loves Ava. Choose for yourself! Happy wearing (or shoving)!