Fertility Foods: Join Hana Feeney on May 30, 2012 at 5:30 pm

Posted on May 15, 2012 by Holly

Dear Patients,

As a dietitian, I feel that it is my duty to increase awareness of diet-related conditions that increase the risk for infertility. No matter the diagnosis or reason for delayed time to conception, attention to a high quality, unprocessed plant-based diet is the key to fertility. Specific food choices may be tailored to your needs, but all couples trying to conceive want to make the very best food choices that they can to improve their odds of conception. Diet and exercise play critical roles in your ability to conceive. Aspects of nutrition and physical activity influence both male and female fertility, so work together as you consider lifestyle changes to promote fertility.

On Wednesday, May 30 at 5:30 pm  at the Reproductive Health Center, I’ll be talking about Fertility Foods; the foods that you want to fill your fridge, freezer and pantry as you are trying to conceive. These are the foods that you want now, before pregnancy, and later, during pregnancy, breastfeeding and raising your family.

Don’t miss this informative and interactive lecture! Call the Reproductive Health Center to sign up for the class, 733-0083. Space is limited so please call soon.

I will be hosting a monthly lecture on a variety of food and nutrition topics. Have a question that you want answered at our next class? Send me an email at Hana@NourishingResults.com.

See you on May 30th!

~Hana Feeney, MS, RD, CSSD

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Pregnancy after tubal ligation? Worth talking about again

Posted on April 2, 2012 by Holly

I think I get about 5 emails a week from people who had tubal ligation surgery and now would like to conceive. It is worth talking about again:

Tubal ligation Reversal surgery can be successful at opening up the fallopian tubes and allowing pregnancy, however, if the tubal ligation was done more than 10 years ago, or if the tubes were cut and burned then success rates are very limited. It was used in the past because in vitro fertilization (IVF) had such low success rates, so it was the best option. Now, however, IVF has much higher pregnancy rates than tubal reversal surgery, is also expensive and has some other benefits. Here are the pros and cons of each.

Tubal reversal:

Pros: 1. if the tubes are successfully put back together then you have an opportunity for pregnancy each month (typical chance of pregnancy per cycle is 15 to 20% depending on your age). 2.You do not have to use any fertility medication to conceive.

Cons: 1. you have a higher likelihood of having a tubal pregnancy (ectopic) due to the surgery, 2. The surgery can cost up to $16,000 and may require an additional overnight stay in the hospital. 3. Tubal ligation reversal is abdominal surgery and the recovery time can be up to 4 weeks. 4. Once you are through with child-bearing, you must use contraception to avoid pregnancy or have another tubal ligation.

In vitro fertilization (IVF):

Pros: 1. much less expensive than tubal reversal (about $9300 including estimation for medication costs), 2. less invasive than tubal ligation reversal (recovery time is one day), 3. pregnancy rates (depending on age) are about 50% per embryo transferred, 4. You will typically have more than one embryo produced from the cycle, giving you multiple chances for pregnancy,  5. once you are done with child bearing there is no need to use contraception.

Cons: 1. fertility injections must be used to produce the eggs, 2. the IVF cycle must be planned in advance.

 In either case,  successfully having a baby will depend on how healthy you are and your age. Women who are unhealthy are less likely to conceive. Women who are over 36 will have a lower chance of conception with either procedure as there is a natural decline in fertility rates after this age. Smokers and women who are not of normal height and weight (so either too thin or obese) have a decreased chance of pregnancy from the start. Additionally, these women also have an increase rate of miscarriage.

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We’re Back with a Guest Blog!

Posted on April 2, 2012 by Holly

Cynthia, a patient shares her views on what it took for her to have a successful and healthy pregnancy….

“Don’t let your diet derail you!

I have been a patient at RHC for 3 years.  I received a positive pregnancy result after my 4th IVF; and after my 2nd egg retrieval, and I owe a great part of my success to the time I took to get my diet healthy.  Time and time again I was told how important diet is to conceiving, and like most of you, I wanted to get pregnant now, and not worry about my diet.  RHC has some great advice about diet that is easy to follow, and I highly recommend it.  Don’t let a year go by, start eating well today.

Basically, you need to give yourself 3 months to let the foods work and for you to adjust to your new diet.  Sure, you will miss some things, but if you want to create the best conditions for a pregnancy, there is not a better time to do it than now.

I ate mostly whole foods –veggies, grains, fruit, cheese and some meat.  I gave up packaged foods for the most part,  eating nothing that your great-great grandma wouldn’t recognize as food.  My meals became pretty simple – meat and a veg, or a veg and a grain.  Snacks were fruit and nuts and cheese.

Coffee? Love it, but give it up. I slowly reduced my intake of coffee to decaf a few times a week to nothing at all.

Diet coke? I gave it up completely, its dehydrating, too many chemicals, plus the caffeine. You can do it, you can do anything for a short period of time.

Wine? Savor it, but only once in a while, you have give it up for the most part during the 3 months.

Water, lots and lots of water. I learned to love hot water with lemon, you will too.

Cold water fish – I ate salmon 2x a week and took fish oil pills the rest of the week. Cruciferous and green leafy veggies like broccoli and kale, one serving a day.

You CAN do it, it’s only for a few months right? I think you will find that you feel better eating this way, and feel good that you are doing absolutely everything you can to create an environment for a healthy pregnancy.  Happy eating!”

 

 

 

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Let’s Talk Turkey

Posted on October 24, 2011 by admin

Halloween is upon us and that means the rush to the Holiday Season is here. As soon as the costumes and candy corns clear the shelves this weekend, Christmas and Hanukkah will be in full force in the stores. If you have been a regular around the Reproductive Health Center, you know that being mindful about what you eat and reducing stress play a critical role in conception and a healthy pregnancy.  So, before you scream, cry and run for the closet, I want to help you cope with “the most wonderful” time of the year.

Let’s talk Turkey. The pilgrims were stressed out, underfed and desperate for company. But let’s face, it the first Thanksgiving was not about gluttony, excess or laying around watching football it was about being thankful to survive the first year in the new world!

To avoid an insulin overload and decrease in fertility, here are my suggestions for a healthy, reduced stress and fertile Thanksgiving:

1.    Don’t offer to have the Thanksgiving dinner at your house. Offer to bring the veggie tray and hummus to the host house (hey, they don’t need the calories either!). Pick the place with the fewest pregnant women attending.

2.    Eat a good breakfast with protein. Have a snack around 10:30 am or so of nuts and veggies and sparkling water. If the dinner is mid-afternoon, then have another low calorie snack at lunch time. Drink water and stay hydrated. This will help avoid the insulin rush and inflammation that comes with it and will  keep you from over eating.

3.    At the dinner, fill your plate as follows: half of the plate should be veggies (no, not the green bean casserole with fried onions and mushroom soup or the sweet potatoes and marshmallows). A quarter of the plate should be turkey, an eighth potatoes with gravy and taste portions of cranberries (unless unsweetened) and stuffing. Remember alcohol consumption is not recommended with attempts at conception (plus, not imbibing will keep you from telling off your promiscuous 3rd cousin who has 3 different baby fathers).

4.    Dessert? A small slice of pumpkin pie with whipped cream, leave some crust please…..and enjoy it, eat slowly!

5.    Now, since you don’t feel like a piggy pig, GO TAKE A WALK. This will reduce your stress and help you to avoid the inappropriate relative who asks the question: “When are you having babies dear?”

6.    Take home only the leftovers of turkey and veggies (they are great for snacks later).

7.    Give thanks for your health and the fact that you are with a partner who wants to have a baby with you! Have an intimate moment and enjoy the only true American Holiday, you will survive the winter!

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Pregnancy loss and thyroid function

Posted on October 18, 2011 by admin

A 2010 article in the Journal of Clinical Endocrinology Metabolism (J Clin Endocrinol Metab 95:E44-E48, 2010) reminded us of how important  thyroid function is in a healthy pregnancy. The TSH and thyroid peroxidase antibodies are blood tests that we require patients to have prior to beginning fertility treatment and again with a positive pregnancy test.

This study evaluated 4123 thyroid peroxidase antibody negative women  with TSH levels under 5.0 mIU/liter who were pregnant (women who were hyperthyroid were excluded from the study). They divided the women in to two groups: Group A had TSH levels under 2.5 mIU/liter and Group B had TSH levels between 2.6 and 5.0 mIU/liter.

What they found was surprising. Group A had a pregnancy loss rate of 3.6% and Group B had a 6.1% rate of pregnancy loss. Statistical analysis showed that this was a signficant difference (P=0.006). There was no difference in the rate of preterm delivery in either group.

This information supports what we have long suspected; it is important that the thyroid be functioning properly and if not, thyroid replacement therapy should be instituted to help prevent pregnancy loss.  We also learned that it is important to institute thyroid replacement therapy with TSH levels above 2.5 mIU/liter.

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Miracle Babies?

Posted on August 30, 2011 by admin

Miracle Babies? They come from good raw materials…..

It seems like ART can create miracle babies where there was no possibility of pregnancy, but the truth is that ART can only make miracles with good raw materials.  Just because IVF and ICSI and PGD can be done, does not mean that they will create life if the eggs and the sperm are not good. Patients are often mislead with stories of conception against all odds, and while these conceptions can occur, they are truly infrequent and miraculous.

So, what can patients do to have the best success?

1.    Listen to the odds your doctor gives you, listen carefully. Good physicians are not going to sugar coat your chances of conception. If you are over 40, are in poor health or if the male partner has no sperm, the chance of conception will be lower or non-existent. Modern medicine cannot overcome everything.

2.    Be realistic about your chance of success and carefully consider what your goals are. If your goal is to have only genetic offspring and adoption is out of the question, then you will not want to investigate options that do not include your own gametes. If, on the other hand, you might be willing to adopt to have a child to nurture and love, then you may want to consider donor gametes as an option for conception. In either case, carefully consider what your chance of pregnancy is and be realistic about your chance of success.

3.    Be in the best health you can possibly be. Good eggs and sperm do not typically come from people who are overweight, underweight, smokers, drug users, couch potatoes, or poorly nourished. I had a patient who appeared perfectly healthy. During the IVF cycle, the eggs retrieved looked like they had been fried. On further questioning, we discovered that the way she controlled her weight was to eat 100 calorie packs foregoing healthy non-processed food because she knew how many calories were in the packs. She was mal-nourished and did not know it. The good news was after 3 months of good nutrition and a visit to the nutritionist, she was able to change this.

4.    Do what you can to control stress and if you are struggling with it, get help! The Mind-Body Medicine program really works and statistics prove this again and again. Patients who complete the program are not only more likely to conceive, they are more likely to have easier journeys on their path to parenthood and have better relationships with their spouses.

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July is Vacation Time

Posted on June 21, 2011 by admin

Dr. Hutchison will be out of the office from Monday June 27 to Sunday July 17, 2011. He will return to the office on Monday July 18, 2011. During this time, the office will have reduced hours. The staff will be in the office Monday to Friday from 9 am to 2 pm to schedule appointments and to answer any questions patient’s may have. If you have an emergency during this time, please contact your OB/GYN. Additionally, for those patients doing IVF cycles, Holly will be away the month of July returning the beginning of August. Randi Weinstein will be available to answer questions. Joan, Joanna and Pamela will also be available to help patients starting cycles for September with birth control pill starts. Be healthy, happy and stay cool the monsoons are just around the corner!

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Office Closed until Jan 3

Posted on December 17, 2010 by admin

The Staff at the Reproductive Health Center wishes everyone a healthy and happy Christmas and New Year. Our office will be closed from December 18, 2010 until January 2, 2011. We will return for normal office hours refreshed and ready to go on January 3, 2011.

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Tubal Ligation Reversal or In Vitro Fertilization?

Posted on September 13, 2010 by admin

If you have had a tubal ligation and have decided that your family is not complete, what are your options for conceiving a child again?

Tubal ligation reversal or In Vitro Fertilization (IVF) are your options.

Tubal ligation reversal can be a successful procedure to reopen the fallopian tubes and lead to fertility, however, it depends on how the initial tubal ligation procedure was performed and how long ago it was. If your tubes were cut or burned (or both) there is not typically enough tube to put back together. If it has been more than 10 years, there may be too much scar tissue.  Tubal ligation surgery is typically more expensive than IVF because it must be done in a surgical center and sometimes can lead to an overnight stay in the hospital. This surgery is not typically covered by insurance and the cost can be up to $15,000. The advantage of the surgery is that, if successful, each month you will typically have a normal chance of conception for your age group. One disadvantage is that you will have to use contraception once you have had the children you want and the incidence of tubal pregnancy (ectopic pregnancy) is higher in women who have had tubal surgery.

In Vitro Fertilization is often the best choice for patients. This is a process where we stimulate the ovaries to make eggs and then remove the eggs from the body, fertilizing them in the laboratory. We then put the embryos back into
the uterus to achieve a pregnancy. IVF is more cost effective (about $8800 including fertility medication) and is less invasive than the surgery for tubal ligation reversal. Another advantage of IVF is that you do not have to worry about
subsequent contraception. With IVF we have the advantage of controlling the number of embryos we return to the uterus and we can freeze additional embryos for use in the future. IVF after tubal ligation is not typically covered by insurance.

Before you pursue either option, you will want to know that you are in good health and that you are having normal ovulatory menstrual cycles. Additionally, you will want to be of appropriate height and weight, with a body mass index under 30.  Also, you will want to make sure that your husband or partner has a normal sperm count. Age is an important factor in your reproductive success. Women over the age of 40 will need to realize that their fertility is compromised due to age alone even though they did not have difficulty conceiving in the past.

Please call our office for specific information about your case and for a review of your operative report. We can help you make the choice that is right for you.

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Diet and Fertility Event

Posted on August 10, 2010 by admin

As you all know, we really encourage our patients to eat a healthy diet. We are amazed by the success some of our patients who are following our recommendations have had.

Please join us for an Interactive Food Demonstration and Discussion with Hana Feeney, MS, RD, CSSD and Mark Woodburn, pharmacists and applied nutrition student.

Wednesday August 18 at 5:30 pm

Exciting new nutrition research, question and answer session, learn about foods that: improve fertility, reduce cravings, control blood sugar, boost energy and manage body weight.

Call the office to reserve a spot at the table: 520-733-0083, $10 for you and a support person.

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