EPISODE 76 | Interpreting a Semen Analysis with Dr. Paul Turek

Hillary: You are listening to Episode 76 Fertile Minds Radio, and I'm your host, Hillary Talbott Roland.

 

Dr. Turek: I have to say that the more we know about sort of transcriptomics, genomics, metabolomics, and epigenetics, the deeper we dive into the genetics of infertility in sperm, the more that the most basic things matter like lifestyle, choices, diet, and things like that. It's remarkable. It's just remarkable because when I entered the field, we couldn't explain a lot of male infertility. It was really unexplained, a half of it. And then the Y chromosome was found as to have deletions by Renee Reijo Pera, and all of the sudden 7 to 10% of infertility is explainable. So one region of a chromosome and all of the sudden 10% of the field has an explanation. So that the impact of genetics was clear to me that it's gonna be large. And then now we're learning that even on unexplained cases, epigenetic issues loom large, and it's probably more male than you think.

Hillary: If you are looking for holistic wisdom and a plan to reclaim your fertility, to help you create a healthy family for generations to come, you're in the right place. This is Fertile Minds Radio. And that excerpt was an interview with Dr. Paul Turek we did last year. To date, I think it's one of the most important episodes we've done because it really gets into specifics about the rather elusive subject of male fertility. We originally entitled that episode "Is IVF Good for Men's Health?" Because we were joking before recording that it might be one of the only times a male goes to the doctor. If you are one of the many that has had issue getting your man to the doctor, I invite you and your partner to listen to this refurbished episode. Dr. Turek is a wealth of knowledge and a guy's guy. I would say on average, I refer a male client to him weekly to work with him virtually for a second opinion to what exactly is going on with his reproductive health. So, grab your partner and have a listen because after all, it still takes two to tango.

Dr. Turek is actually a world-renowned reproductive urologist. He's probably one of the top three urologists in the world. He has clinics in San Francisco and Beverly Hills. He advises the ABORM board that I'm a fellow of. He graduated both Yale and Stanford University. He's taught at Yo San University. He has countless studies that he's both authored and advised. And aside from being a Western medical doctor that really gets complementary medicine, like Chinese medicine, he's a soulful clinician. He manages to connect with one of the most difficult patient populations- dudes that don't want to talk about their potential fertility issues. The first time that I heard him speak at the International Infertility Symposium, in Vancouver, I was blown away. He was so intelligent and generous with his ideas and research that he was really the first person that made male fertility issues relatable to me. For three years running, he was one of my favorite speakers, and since I wasn't able to attend this year, I had to get my fix, and I invited him on the show. So, I'm sure that you'll be just as enamored with him as I am by the end of this. His ideas are both provocative and backed by science. So, without further ado, welcome to the show Dr. Turek.

Dr. Turek: Hillary, thank you very much. Who are you talking about?

 [laughter]

Hillary: We need to get you a mirror, right? You just listen to that.

Dr. Turek: I want to meet that guy.

[laughter]

Hillary: No, truly, I mean, I think that your generosity with your ideas is and they've been, you know, pretty groundbreaking. Decades ago, you've been in this field since the 90s, and you're really at the forefront. So, I think there's a lot to learn from you.

Dr. Turek: It's interesting, I entered the field because it was a dearth of research. You know, I said, this is a very interesting field, male fertility reproductive urology because it's great surgery. So, it's microsurgery and you have to have a skill set for that, which I found myself drawn to. But then I looked at the science in the field and compared to something like an oncology, there was really very little I mean, it's a very young field. I'm probably the second generation of person in it, you know, in terms of its age. But it's come along beautifully, I think, and it still got a long way to go, though.

Hillary: Yeah, I mean, it's, for eons, it's always been the woman's fault, right? We never even looked at the men.

Dr. Turek: And that's an interesting cultural bent, but what happens is women are generally more proactive about their care, and women also have a cycle to judge their health by and men don't. So that's my next 20 years is where can we get the men's ovulatory cycle? What can we replace that with men that might be just as effective? And is it semen analysis? Is it waist circumference, the fifth vital sign? Is it testosterone levels? There will probably be something coming on board, where we can say, "Hey, and while you're young, be aware that this is where you're headed." 

Hillary: Yeah, I mean, I've heard you advocate several times that, you know, fertility, semen analysis, waist circumference should all be bio-markers for male health and yet the semen analysis is pretty archaic, right.

Dr. Turek: It's about 60 years old, and it had several normal ranges that change every 10 or 15 years. And yeah, I'd say among the things I think about when I see men for infertility, it's probably the least important thing, unless of course it's zero, then it becomes the most important thing.

Hillary: Right, and you just lectured on this at the symposium and you were relating it in the semen analysis to a deck of cards.

Dr. Turek: Yeah, I'd say the blog I wrote is called Reading Your Cards on Turek blog is searched turekandmenshealth.com or Turek blog on Google. I basically took the four components of a semen analysis and view them as cards in your hand in a game of cards and what do they mean independently of each other and what do they mean when you take them as a whole? So, for instance, count, sperm concentration has values, especially if it's not zero, but not predictive value because it varies so much. So, I showed a graph of a man, that was published in our World Health Organization guidelines for semen analyses fourth edition, that took semen samples every week or twice a week from a man for a year, and they were all over the map. The sperm concentrations were all over the map from zero to normal to high and they hovered around 20 million or so but they never really sat there very long. And so, you're really looking at a moving target with sperm concentration because it is a biological process much unlike a glucose level, you know. So, there's a lot of variation between individuals, there's a lot of individual-- each individual varies by season. So, if you look at sperm concentrations, they're basically highest in the winter. I just did an interview for a magazine about this - “why are sex drive so high in the spring?”, and I'd say it's probably because people were stuck-- you know like bears. We've stopped hibernating we're looking upward and outward again, as opposed to downward.

However, sperm counts are highest in the winter and births are highest in the summer. With other animal species, there's a lot of seasonality. Some of you even have ruts where there's no sperm most of the year and there’s only sperm when ovulation occurs once or twice a year, like in walruses. I had a nice paper with Holly Morocco from Six Flags because the walruses, coming from the Arctic, were in Napa, and Vallejo. They weren't reproducing and she figured out that the female was ovulating once a year off-cycle in the fall and the male is rutting in the spring. So, it's an incredible biological process but very different between men and women. So, count alone is you know, it's a moving target. Motility even worse and I think of motility is kind of a toxin light like something's going on when the motility is not normal. That's toxic in some way like pot or social-- how their social habits, alcohol, obesity, things like that. If it's not a huge hit, then you get to the account a motility problem. If it's a larger or longer hit, then you get account problem. It takes more to knock account down than it does your motility and motility recovers faster.

Volume is a third one. And that is probably the most significant one for finding something. If someone has a low ejaculate volume, you will certainly find something if you look hard. So, that is one of those setting stone abnormalities. If the volume is high it's probably meaningless. If the volume is low, you can almost always find something a blockage, something missing and a testosterone problem. Retrograde ejaculation is a list of five things that will always be something on that list. So, that's nice to have something a reference point that matters. And then there's four, progression, which is less relevant. But there's also morphology, which I don't give a lot of credence to, which is firm shape because I always think about walking in a bookstore and finding you know, a book with a really nice cover and then not reading it bringing it home and finding out it's not very well written. I think morphology similar to that. So that's sort of dissecting it out. And you know, I kind of held up the semen analysis as a cube and sort of walked around it and describe what I feel about it. The bottom line is that it has a little relevance to man's fertility. I'd rather know more about his history and physical exam. If the semen analysis shows anything, I mean, a good hot bath will drop you down. If you do hot baths 20 minutes, three times a week for a month, you probably be zero. 

Hillary: Really? 

Dr. Turek: So, it would bounce right back. Yeah. So, it's pretty sensitive marker of things. That's why I like the bound marker concept. Flu season this year was rough because there were several flus. They weren't covered, influenza A wasn't covered well by that vaccine. So, I remember seeing men who had, "Oh, I was yeah, I was feeling uncomfortable for about a week Doc. Took a couple days off headaches and pains, but I didn't have a fever.". But you know, when they have aches and pains, and when they have myalgias, men typically have a low-grade fever. So, I said, "Well, let's look at your semen. It's like zero, right? It's zero. And it was normal two months ago, and it's going to be normal in two months again.” 

Hillary: Yeah, men are so lucky that way, right? They're meant to bounce back.

Dr. Turek: Yeah. And so, the other main concept about the semen analysis is you're meant to run hard. So, the semen analysis is not something men say, "How can I make? How can improve my semen analysis or how can I improve my count?” You run it full tilt. If everything's healthy, you're running at maximum RPM, and all you can do is bring it down. So, it's-- right? So, you’ve given everything so that's why it's valuable because if it's running at half speed, you got to look at why. And usually, you can figure it out. When I entered this field, we usually couldn't figure it out, but it wasn't a lot of conceptual differences going on. But I think with the attitude that why isn't his motility normal? And why is this count low? What is going on in his life? What is he eating? What is he doing? Whether is recreational drug use? What's his lifestyle like? What's his stress like? What's his weight doing? All that stuff matters. And that's really interesting to me. That falls in collusion with other things that we're learning about, for instance, epigenetics. So, the other point of the talk was that the whole story is not on the semen analysis. You have to dive deeper into sperm and look at more of their function, and the two. Morphology does that a little bit, but I'm not a real believer in it. Sperm DNA fragmentation is another measure of quality and performance, sort of, and then sperm epigenetics. Now we know after there's been an essay on the market for about a year to that sperm epigenetics is probably the new evolution. That's how we're evolving. That's what we're handing off to kids. You can have abnormal expression of markers on your DNA because you're obese. If you lose weight, those change on sperm and change the quality so it's quite dynamic, a process. Even on a genetic level or epigenetic level, it's constantly changing, and it makes sense because evolution isn't really a generational thing over 1,000 years. It's really happening every day, and this is the everyday evolution is epigenetics. So my mind is very captivated by the deeper dive with sperm, which appears to be explaining why a lot of unexplained infertility what causes because if you look at a couple to try for a year, and everything looks normal, extensively normal, if you dive deeper in sperm you may find that the genetic issues or sperm fragmentation issues or whatever the next thing might be, but there might not be a next thing because epigenetics appears to be probably the new bottom line, I think.

Hillary: Well, I think, you know, as a TCM practitioner, I feel like I was taught about epigenetics, just with different languaging. You know, our jing in our essence, being affected by our lifestyle, dictating what we passed down. 10 years ago, that seemed like an obscure concept to Westerners, but now you're saying science is actually proving that, right? 

Dr. Turek: Absolutely. I, as an advisor to the epigenetics company, that's my disclosure, I have to say that the more we know about sort of transcriptomics, genomics, metabolomics, and epigenetics, the deeper we dive into the genetics of infertility and sperm, the more that the most basic things matter, like lifestyle choices, diet, and things like that. It's remarkable. It's just remarkable because when I entered the field, we didn't know a lot about, we couldn't explain a lot of male infertility. It was really unexplained, a half of it. And then the Y chromosome was found, has to have deletions by Renee Reijo Pera and all of a sudden 7 to 10% of infertility is explainable. So, one region of a chromosome and all of a sudden 10% of the field has an explanation so that, you know, the impact of genetics was clear to me, it's going to be large. And then now we're learning that even in unexplained cases, epigenetic issues loom large, and it's probably more male than you think. So, it's shifting over from 25% to maybe 50% of unexplained might be male-related and it's not female. So yeah, women might take the hit, but actually men should take the hit. And then if you look at the solutions for that, it's gonna be how you live your life. That's what Eastern medicine does beautifully. We're terrible in Western medicine at lifestyle. 12-minute visits do not get into the details in a medical practice of how a man lives his life. I love it because when I get acupuncturist's referrals, guy with a low sperm count, I've tried everything for six months and it's still low. I generally find something anatomical that I can fix, which is pretty interesting, because everything else is sorted out. The man's stress is under control. His diet's good. He's got a good balance in life, exercising, and all that stuff's handled. And that's the stuff that Western medicine is terrible at, but it all, and so I am a firm believer in the role, the complimentary role of Eastern and Western medicine in treating infertility. It's more powerful than ever and yes, you should hang your hats on epigenetics because that's the value to Eastern medicine as you're making big changes. Those changes are transmissible to other generations. So, they're really important. 

Hillary: So, would you describe, just so that I'm clear and our listeners are clear, you know is when you're talking about epigenetics, when you're talking about the difference between single-gene mutations versus chromosomal gene mutations?

Dr. Turek: Right. So, epigenetics isn't really a mutation story. It's really a… it's the marks on your DNA. So, it's not mutations. It's not chromosomal. It's if you look, so there's blog is called "Epigenetics: The Reason You Are Who You Are", it's the reason a nose is a nose and an ear is an ear, despite the cells being the same. It's a reason why we're different than bananas, even though we share 50% of the genetic material of the banana. It's a reason why, you know, individuals are individuals despite being 99% genetically identical. So, it's not explained in the genes themselves. It's explained in which genes are turned on and which are turned off. So which pages in the book can be read and which pages can't be read if you have different pages that are read differently for each person. So that's epigenetics. It's really the expression and a non-expression of various genes to make different organs and different people and different functions. So, we all have the template of, we all have the whole book, but we don't express the whole book.

Hillary: And so, the test that you helped develop, that's Episona, right?

Dr, Turek: Yeah. And that test tells you if there's a pattern of epigenetic marks on certain genes, that might explain your semen analysis or your fertility. So, it could explain impaired natural fertility. So that might be in, you know, at home, at time the intercourse would fail or inseminations might fail IUI. And then there's another part of the test that looks at the sperm dynamics and interaction with the embryo, and it could explain why IVF would fail. So, sperm can be… sperm are a big contribution to IVF success. We're not talking about fertilizing an egg, we're talking about post-fertilization events. I call it, “dissolving embryos syndrome”. I have a lot of patients who come in, normal semen analysis, normal female evaluation and go to IVF. And their embryos don't make it in a dish. They just dissolve on day 2, 3, 4, whatever and I call it, “dissolving embryo syndrome”. I think epigenetics of sperm, a lot of it drives early embryogenesis, and those genes have to be the right genes have to be working at the right time and if they're not, it's a contribution to failure. Before knowing more about sperm epigenetics, we used to think that about 5% of poor embryo development in IVF might be due to sperm issues. With the development of epigenetics, it's looking like it might be around 45%. So, all of a sudden, in the last couple years, the whole new light being shown on sperm quality as a driver of IVF success, and a lot of epigenetics we know is lifestyle mediated. So, it's all kind of coming together like the Mediterranean diet for health, you know or paleo. It's sort of that kind of collusion of information, it’s all making sense now. 

Hillary: Right. So, what you were speaking about in terms of the dissolving, you know, the embryo, it fertilizes but then they just kind of implode on themselves. You know, I've heard that oftentimes blamed on DNA fragmentation of the sperm, which would be toxicity, right? 

Dr. Turek: Right. Lockshin species and oxidants, right.

Hillary: And so oxidative stress is that's supposed to be around 30 to 80% of the cause of male infertility, right? 

Dr. Turek: Yeah, that's, I mean, it's hard to prove, but that seems reasonable. But this may be epigenetics may be a downstream event of oxidative stress, and the epigenetics predispose you to that. So, it's going to be related somehow. We don't know that relationship yet. I think that epigenetics will assume the field of oxidative stress or be a byproduct of it, or somehow related to it.

Hillary: Okay. But it's not necessarily DNA fragmentation. That's just one thing that can like a symptom that can show up, right?

Dr. Turek: Correct. I think that the downstream event, probably.

Hillary: Okay. So, with that in mind and oxidative stress, and that, you know men are kind of traditionally, not all, but some are poor eaters and, you know, some lifestyle choices… Do you think men should take a prenatal?

Dr. Turek: Absolutely, I mean, the data for prenatals for men, it's sort of pre prenatal, is very strong from the Cochrane Reviews. And that was my talk at IFS a couple years back about should men be on a prenatal. And they did, you know there are about 20 studies done using antioxidant supplements in men. And the nice thing was that they were controlled, and they used IVF, as the result, the IVF findings. That's as about a controlled situation for pregnancies you can get. Funny the big complaint when you do natural fertility studies is how do you know that the- that the pregnancy is his. When you publish a paper it's always the question because you can, how do you know it's his?

Hillary: Right.

Dr. Turek: Very-- I never-- just an odd criticism from editors, but that's what you get. But having an IVF setting is much more controlled, so. They showed about a three-fold increase in pregnancy rates at IVF and a three-fold decrease in miscarriages among women whose partners who are taking an antioxidant supplement compared to controls. And published it, I don't know 2011, and then in the Cochrane Reviews. And then they probably didn't believe it so they did it again with 40 studies, and they came up with the same numbers three years later, maybe 2013. The criticism of all of it is that garbage in garbage out, the studies weren't large and well-powered and they were all small, but they all kind of show the same thing. So, it may not be the best data but the government was so taken by this, the NIH, that they started a Moxie trial. So male antioxidant supplement trial a couple years back, and I was on the review committee called the RMM for that, but I'm not now. So, I don't know what's happened to that trial. But typically, what happens when you try to recruit men to a randomized controlled trial fertility is if they don't accrue very well, so there's a lot of trouble keeping them the men and keep them compliant and getting them to join. So, I'm not sure what the results are. But that's how impressed the government was they're saying, listen, if you're recommending--  if this data is real, then mentioned be on a prenatal, if we de-prove that in a prospective trial, because that's a big statement, because women have been on prenatals for 35, 40 years, for similar reasons, prevent miscarriages and birth defects. And it's been very effective. This is probably as effective. It's probably just as important that men be on a prenatal. 

Hillary: Yeah. And you actually took a step further and developed one of your own. How is that different from what a female would take versus a male?

Dr. Turek: I know it's true. It's doses of things like those a lot of related products and female, there's some in male, more antioxidants. We have some sort of an antioxidant, mineral, herbal supplement, it's organic, and we had one called it's called Essential Beginnings XY, we also have one called XX which is female. The key thing was for both they were had organic fillers. So, you can put a vitamin in anything you want, but your body may not see it. It may not be available to you, and any vitamin supplement can be put on the market saying this is in it, but what are you actually seeing? And so, a cancer nutritionist whose job is to get nutrients into cancer patients who have terrible digestion and habits and you know, because of disease. So, we used very highly organic fillers that are highly absorbed and had great reviews of it. For instance, the iron in the female prenatal, you know often upsets women's stomachs because, you know, gets absorbed pretty quickly and it's kind of iron is heavy on the stomach and you can get upset but the natural fillers are a little more-slow release. So, women were tolerating that a lot better. With men, we add tribulus, astragalus and maca root. Some of the well-established herbals that have the best data and it was all it's more scientific. I'd say it's kind of like a smart vitamin.

Hillary: I love that, that you added the herbs to it especially the tribulus and the maca. 

Dr. Turek: Yeah. And we had L-Carnitine and the usual, you know, and CoQ10 and ubiquinol and things like that, resveratrol, stuff that really made sense.

Hillary: And so, do you like you ubiquinol over CoQ10? Because I know a lot of people look at me, and I try and have them take the ubiquinol instead of the CoQ10. Because it's more cost-effective than the pathway before and all the studies are seemingly done on CoQ10.

Dr. Turek: Yeah, I think a lot of it depends on absorption. I mean, if you get nothing of one of them, it's the other one is better. So, you choose the one you want. It's how it's delivered that matters, right? You can buy all the gifts you want, but if you don't give them to the person who's intended, it's worthless. So, we're all about delivery. In fact, the NIH chose our supplement to model their supplement that they were gonna provide in the trial because they were impressed with the way it was thought through.

Hillary: I agree. I mean, it's definitely complex. What I like most about it is your delivery. You've put all these things together in one pill because if you start trying to make a man take, you know, a handful of pills every day, that's gonna last maybe three days, right? You've got it in one or two.

Dr. Turek: Well, that's another whole problem is compliance with men, I mean, we're thinking a chewable is probably really good, but it's too many calories for 35 to 50 calories a pill, you know, great for kids, probably not good for men, but they probably even toss it up there. You know, because a lot of these antioxidants are water soluble. They don't last very long. So, you do have to dose twice a day. It's hard to do anything once a day with antioxidants and get any persistent levels, you know with vitamins C and E. So, it's complex, but the news is that we've been bought out. It's probably gonna be improved this year, hopefully. And that's all I can tell you. But I'm very excited.

Hillary: That's great. And that's definitely in line with what I've observed about you and your ability to try and make things as easy as possible on the men. You know, your practice model, unless it’s changed, it's a very lengthy questionnaire, but they only have to see you once and then the rest is done by phone, right?

Dr. Turek: It's all Telehealth. So now I can even do, I'm even starting mobile care where I will, I won't even require the guy to come to the office. So, I'm in San Francisco and LA. And they're both pretty heavily trafficked cities. I like the idea of seeing them and IVF programs when they hit the door, because you don't have many opportunities to connect with men ever. So, it's just the way the culture is. So, asking them, I mean it's amazing that they fill out that questionnaire, but that's so valuable. I mean, you'll never get it, you'll never get the information ever again unless there was-- you know the partner says, “get in there and get that done and get in to see him.” You got one opportunity so you got to take maximum advantage of it. Once you've got it, you've seen it, get everything you can done, and try to make that connection with men. Because if you don't, you'll never see him again. I mean, I most of my patients have seen the urologist before can't remember their names. I have a simple thing I say to them, “I want to give you care that's so good that you'll remember my name.” 

Hillary: I think that's great. And I think that's so needed, you know, men don't get cared for. I think that that's You're right. If they're willing to go to IVF like what if you could get them right then and there? Oh, my God, what if you could get them before that? 

Dr. Turek: Right. So before, that is almost impossible, but because they're- they're basically taken care of by their partners, but I am, you know, my bigger mission in life is not cure infertility, it's to have men live longer. You know that the stark fact and the stark truth in America is that the richest man in America lives five to seven years, less than or shorter lifespan than the poorest woman. So, they are certainly under served for a variety of reasons. Some of its self-inflicted, some of that inflicted on them, some of its provider, cultural norms, and but it is a shame that men just have such a short lifespan in America, regardless of their socioeconomic status. It's a little bit about the immortality complex, but my attitude is let's find a bio-marker and then let's engage men because they love numbers, right? So, if you throw them a number, they'll try to fix it, right? The try to get, I'm gonna get that number better, and they'll do things. So, you got to get them engaged. And if you don't show your personality, and you don't commit yourself to them to walk the walk, you're not gonna get them, they have to trust you. 

Hillary: Well, I love your blog for that. I send men to it all the time, or I tell wives just to have their husbands go there, Turek on Men's Health, because it's, you know, like you speak. It's a lot of information in a short time. Like you get to the point. Here, here it is.

Dr. Turek: Nuggets. They're called nuggets. Nuggets, right. I'm aiming at guys, it's 80% read by women, but I want men to just start the blog, and then not- they have to finish it, they can't put it down. That's the idea. Because you know, again, you only have one shot. So, you have to have a hook. It's not written like other blogs. You don't answer the question right away. You bring up some social situation where everyone finds themselves and somehow bring it down to their health.

Hillary: Now, it's definitely interesting in that way, for sure.

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Hillary: So, when I… you're pretty light-hearted physician, right? You've got a good sense of humor and connection, but on one of the years in the symposium, I heard you talk about advanced paternal age and the sobering reality of it. It really made me tune in because I had observed and kind of suspected that there was some advanced paternal age problems and couples in my clinic, but I really didn't have any proof of it. This kind of urban myth, another myth that males can be fathers at any age, which you know, they can. There's been some very old fathers in the course of history, but your work is around the epigenetics and everything is kind of saying, "Hey, there are some issues with advanced paternal age." And I think that that was really illuminating, especially even some of it that pointed and said, "Hey, you know, like, infertility is not always the cause of the woman. There is some issues with advancing age in men, right?

Dr. Turek: Absolutely. So we actually just published a nice review in a journal of assisted reproductive genetics, called reproduction of the genetics in the aging male, and it'll be available open access, probably in a couple months. Alex Yatsenko Y-A-T-Z-- Yatsenko is a geneticist at University of Pittsburgh who co-authored it with me. It's really the most update review on this topic. I think it's pretty legible talks about epigenetics and all the newest stuff to the month. So, it'll be available open access if you search my name on Google, it should come up in about three months. It's pretty dense reading, but it's I think it's concise. So, the issue is, the most interesting thing to me is that advanced paternal age never existed until about 1960, two generations ago. There was no such thing as advanced paternal age because we didn't live that long. So, it's a recent problem to have an advanced paternal age issue. And a lot of the problems that we're noticing arising among offspring is recent, like autism. We think schizophrenia, bipolar, things like that seem to be going up, increasingly. So, there have been associative studies trying to look at epidemiologically at the relationship. There have been correlations between age and neurodegenerative diseases in offspring so bipolar, autism, schizophrenia, dyslexia. And there's some correlations showing up but no biological basis, and it looks like it might be epigenetic. So, the kinds of things you see in advanced paternal age… so what is advanced paternal age? That was the biggest argument on the paper, with the reviewers and the editors. It's what's the definition? And the answer is there isn't really one. Remember, it's a new field because in 1900, we lived 38 years on average. In 1950 we lived 50 to 60 years. 1980 we live 75 years, right? 

Hillary: Right.

Dr. Turek: Very few people 50 to a 100 years ago or older, had any kids at age 40. I mean, the average age of an American male at first child or first paternity is 30 now, used to be 26 about a generation ago. So that's pretty significant. That's a 10, 20% increase in age. So, I think the issues are new and they're large, and we're just learning what they are but as men age the miotic machinery that makes sperm tends to fail. So, you spin out in this monumental stem cell on the testicle, that's the driver of all sperm, you spin out-- you divide that thing once a year for 13 years. You hit puberty, and then you're doing it 10 or 15 times a year. So, you've you schooled up the problem. And then at by the age of 60, the machinery is getting old, and the quality control is getting a little sparse. And so advanced paternal age 40 would be the kind of a general definition, 50 for sure. And that's, you know, that's what we're talking about sort of age 50 and beyond. And if you compare 25 to 50-year-old men, you'll see that there's more miscarriages, there's more early fetal deaths, there's about one-- a little over 10-20% more birth defects, congenital birth defects. And if you go to 60, think of it as a hockey stick shaped curve. It's sort of flat for a while, and then it starts rising dramatically like the blade of a hockey stick. And that probably that position where it changes that flexion point is probably around age 60, where it really starts to go up dramatically in, DNA fragmentation is a classic age-related issue. It's about 3% per year increase over age 40. So, talking 3 times 10 is 30% per decade or 20% per decade change in sperm DNA fragmentation just because of age.

Epigenetically, it changes dramatically. Great study by the Utah Group, Doug Carroll took men who had bank sperm in their 20s, 30s. And then again, got a sample in their 40s, 50s and shut-- and so they had these samples at about 17, 20 years apart. And they looked at the epigenetic profile, and there was a dramatic shift in the in the epigenetic marks on sperm in the same men samples over age, and they all tend to group around the neurodegenerative diseases. So that means you would expect the expression of genes around the diseases we talked about, to be changed, and altered. And so, it's again, kind of coming all together. Chromosomally men don't change that much. That's not one of the systems that fails but yet trisomy 18, and Kleinfelter syndrome XY are two of the kind of hot spots in men that could contribute to issues with kids later in life. And the biggest and well-known, most well-known are single gene mutation. So, when women age they have chromosomal issues. And those are detectable on prenatal testing. And they're also usually lethal, causing miscarriages. So that's good, I guess that they are lethal, it's a quality checkpoints. In men, they're single gene mutations. So, they're just little nicks in the DNA that tend to pass through quality control mechanisms and persist, and come out of an offspring and they're the source of, I would call, highly disfiguring and rare diseases like, retinoblastoma, tuberous sclerosis, and Lesch–Nyhan syndrome, lots of odd sort of diseases. 

And luckily, they don't-- they're not that frequent. They're more frequent and older men, but they're not that frequent in general. So, this stuff, if you look at it carefully, is very, very alarming. And right now we consider about 20% of autism appears to be paternal age related, not all of it. That mean, that's probably a conservative number based on the best science, but it's definitely related. And I always tell men, because when I-- some men bank, their sperm, you know, while they're in their 40's, or 30s, because there's no relationship in the future, near future. And they want to know what they're headed for and you give them this data, and they usually bank their sperm. But I would say, though, that to put in perspective, if you just ask men, "If you have a child with a partner, do you know what the birth defect rate is, you know, the chance of having a birth defect in that baby is, you know, all comers, all ages?", and they usually say, No, they don't know. And it's-- so it's not on their radar. And the answer is about 3%. Is a 3% chance, so men usually don't-- aren't too alarmed below 5%. Once you start getting 5%, 10%, they start taking notice. It's just a risk aversion thing. But that's about the same rate you're seeing with the combination of issues with men with age. It goes from less than 1% to about 3%. So, it runs in the same order of magnitude is birth defects in general. And so, I leave them with that statement because that puts it all in perspective. And then they can decide whether they should need to worry about it or not. There's nothing you can test for with these issues. So, the problem is, you can't do prenatal testing easily. There are no genes identified for these conditions right now. And it's really-- it's an open risk. It's an open faced, what risk. And the other thing is, these are sometimes diseases and adult offspring. So, you won't even see them at birth or early on. You have to wait for a lot of them three to five years, and sometimes up to, you know, beyond purity, to see any issues. So, it's a concern, and it's a new issue. So how you handle it, no one's ever dealt with it before in history.

Hillary: It is a lot to make you think about our biology and what happens as we age for sure. So, bring up what happens later in the offspring and things that you may not even see until much later. And, you know, this kind of makes me think about when I was first learning about reproduction in grad school, and the concept of ICSI of the intracytoplasmic sperm injection where, you know, the sperm is selected and put into the egg during IVF. And I remember just kind of being somewhat horrified like, "Oh, my God, we're taking natural selection out of the process.”, and, “Is this a good idea?" Like, "Do we really know better?" And you know, and now 10 years later, I have, you know, these walking children that are a product of ICSI that probably wouldn't be here without it. And they're seemingly healthy. But sometimes I wonder about, like the long-term implications on their health and their ability to reproduce. And do we have any data on that? Because ICSI hasn't really been around that long, right?

Dr. Turek: Right. There's not much but it was an interesting player, is, when I first entered the field in the early 90s, you know Gianpiero Palermo and Van Belgium - who's now at Cornell started it. And I sat with him in 1998 at a play at ASRM in San Francisco called-- I forgot what it's called. But it was about a woman who was in the lab and got some sperm and got her own eggs out and was ICSI-ing her own eggs. And it was just-- everything that can go wrong with the technique. Was done by Carl Djerassi-- An Immaculate Misconception I think it was called the play. It was premiered at the ASRM in 1998. And I sat with the inventor of ICSI at the thing. It was pretty interesting, but you know, it was an accident. So, there was no science behind ICSI. Someone Gianpiero , and basically and Belgium were doing-- trying to get sperm closer to eggs for male factor issues. Putting them between the egg and the egg shell, and sub-sona insertion and that-- it wasn't working well. And then he made a mistake, and he stabbed the egg. Maybe-- he said he made a mistake. But maybe they he did it intentionally. But he did it four times. And then he just watched those, and they fertilized. And then he told Van, "Start again." That what he had done, and that they gone phone he said, "We're going to have to follow this carefully." So, they have tracked their ICSI kids in Belgium ever since day one. And you know, there's a lot of debate about the health, because you are removing barriers to natural selection. And I had a conference at a resolve meeting where I took all the embryologist from the major programs at San Francisco. I had a minute panel session with a microphone in front of each of them. And I-- the audience was patients. And I said, "Meet the embryologist, because patients want to know who's selecting my sperm. Who's collecting that sperm?"

Hillary: Right.

Dr. Turek: What kind of person is selecting my sperm? What do they believe in? What are they-- You imagine the questions these guys got about, you know, do you have kids? What-- Do you-- Are you religious? You know, it's interesting, how you-- Culturally it's a big change, right? And then, of course, scientifically, what does it all mean? And you are removing barriers. But a couple things impress me that sperm-- that things still work pretty much the same, even by removing those barriers, there's so much quality control in the process, that it's still quite intact. And you can debate whether there are higher birth defect rates with ICSI. But there probably is, but it's probably very small. So, in a point of like, point 1.2% increase, there's probably some conditions that are more likely to occur that are very rare, imprinting disorders and things like that, but again very rare. And we don't know about the unnatural environment of ICSI, because you have to be under a microscope with light and neither of our gametes normally see any light. So, there can be epigenetic alterations. And there's from feeling from power and all those research at UCSF that there might be epigenetic alterations going on. Two, the culture medium is a little unnatural, that kind of stuff. So, sort of much, some of that IVF, but it's constant.

So, the best data out of Belgium recently is men, couples in whom there's male factor with low sperm counts, they now have the sperm counts of the sons, and only about 50 or 60 couples. So, they had IVF exceed for low sperm counts have children, and the boys are now men, and the men have low sperm counts. So, it looks like a lot of the male, low sperm counts in men might be genetic or epigenetic and it's being passed on. That's the ideas a lot of it is being passed on whether you can define the genetics or not. But I've been also impressed on how little is coming-- How little difference we see, for instance, I have cancer survivors with 20 sperm in their testicle after chemotherapy. And published in mobile transplant literature, some of the most extreme cases of being treated and cured for cancer and they have a couple of sperm and you know, those sperm were in testicles that were exposed to lots of chemo and radiation. And those kids have no, you know, no issues and it's pretty impressive. But I think you could of course, long term follow-up is still needed. One of the biggest problems all these studies is birth defect rates. Birth defects are defined differently in different countries. Some of them are defined as, something needing a surgery to fix, some have defined as, you know, an abnormal look. So, it's hard to compare. It is apples and oranges among groups. So, you'll see conflicting data and we know nothing about cancer risk later in life, which is of some concern.

So, it is a bit interesting. I feel the same way as you do and still, and I am working with Demirci, who's a Stanford professor and we just published a paper on using a chip that will allow the sperm to swim under a microfluidic chip to imitate the cervical path that they take going to the cervix, there's grooves in the human cervix. And only really sperm can make it through that cervix, like an obstacle course. So, we're creating an obstacle course like it. And we're comparing the integrity, build quality of sperm before and after running that the gauntlet there. And we're finding that they are, they're better looking, better moving certainly, better looking morphology. They have four to five full, less fragmentation, and they have an epigenetic profile that's altered, probably better favorably. So, it looks like we're able to help reproduce what sperm have to go through to get to fertilize an egg. And when I first saw his data, he's a fluid physicist who just loves sperm, because they have motors on them, like they're little particles with motors on them. And he was publishing physics journals. And I read the things I said, "This guy is such a cuk, I mean, he's publishing all this fluid physics with sperm." And I called him up and got and met him and said, "He's so much fun." But I said, "Look Tom", I said, "You know what you're doing here, you're reproducing the cervical path." And then I said, "This is a path that has been preserved in mammalian species, land and sea from million years." So, for a million years, sperm had to do this work to get to the egg, they don't-- the egg just doesn't sit at the cervix. And as soon as you make it through the cervix, you're in or even closer. You have to go and have human six, eight inches, which is like crossing an ocean. And that's why, you know, 40 million start and 100 make it but there's something about the path. And I said, "And you're making the path." And I said, "I need to be part of this. And I need to help out." So, he had me write the introduction to the paper, about the reservation of the you know, the cervical path issue, the urine path issue for a million years. So, I think they're-- what I'm comfortable-- now they have a product. It's a fertile chip. It's available in Europe. It's now FDA approved in America, as of last month. So, another disclosure, I'm part of that company called DX Now, and they named it Zymotchip Z-Y-M-O-T. Horrible name I'm gonna get it changed.

[laughter]

Dr. Turek: But it's a chip, that's literally a microscope slide, and you put sperm on one and you drop it in, there's no processing, and you pick it up at the other end, 20 minutes later by the clock. And you should have a sperm that is more naturally selected, than if an embryologist did it, you know, at 9 am with a cup of coffee and then in the other hand.

Hillary: I've got a name change for you. I think that you have created the Darwinian Obstacle Course.

Dr. Turek: Yes, that's right. That's the idea. But you know, it's been bothering me for 20 years. Maybe you for 10 or 5, but it's always been a little-- I'm a little bit of a Darwinian but not really. And I'm also religious. So, it's complicated, but--

Hillary: Right. Oh, very much, so yes. Well, and like I said, you know, that it's such a something, I wonder and now we're seeing it and like you, you're saying that there's really not-- Yes, they're passing on this the low sperm count. But to me, that's just information of like, "Hey, son, you might want to freeze your sperm earlier before you have this, you know, the steep increase in DNA fragmentation on top of the low sperm count." Right?

Dr. Turek: That's right, because those things are probably occurring in all men, and may be exaggerated in men with abnormal semen analysis. We don't know.

Hillary: Yes.

Dr. Turek: It's the kind of science I hope the field that had when I joined it, but now it's happening. And I'm glad to be a part of the hard science coming out. Because it has more relevance than ever, I think. You know, for me maybe the treatment for ICSI is not to use it, maybe just go to IVF, right? Maybe IVF, the worry is that it will fail to fertilize. But we're not seeing that. So the whole even Jamie Grifo is work from NYU looking at, if you don't use morphology, which has been a classic reason to do ICSI. Poor morphology means poor fertilization with IVF, so go to ICSI and avoid the problem. If you just don't use that criteria and stick sperm, and without looking at morphology the failure to fertilize rate is 101 and 250. So, it becomes almost noise. So, I don't think that criteria matters. And there's one group at San Francisco that stopped using it and they're doing-- instead of 70 to 75% ICSI nationally, they're doing about 40 to 45%. They don't see failure to fertilize. They don't see that issue at all. So, I think there's going to be a bold move to keep it more natural and IVF is, you know, inseminated eggs and sperm and let them do what they normally do. It's not the cervical path, but it's still a lot of the process. So, I like that concept of maybe going backward a little bit. 

Hillary: Yeah, just you know, we don't know what we know until we know it. And your research is helping us to know those things. And I mean, that chip, that's like the golden ratio basically. If all mammals have that ratio of that six-inch path that we have as humans to the cervix, right? You just kind of recreated that. 

Dr. Turek: Yeah. 

Hillary: That's amazing.

Dr. Turek: Yeah, if you look at-- if you do research, I mean, we did research on the path itself and the micro groups and stuff like that. And he put obstacles in the way and there was this video that was so telling-- I haven't shown it nationally yet, but, and he's a mathematician. So, he calculated in fluid physics, if you put pillars in the way, put obstacles in the way, at a certain distance. If you take a normal shape sperm, morphologic than normal sperm and put it through this obstacle course, it sails through. So just on fluid physics principles, a nicely shaped sperm sails through. If you put it, a sperm has a bent neck or a big head, it'll never make it. So, what's interesting is, I'm not been a big believer in sperm shape as a driver of sperm health, right? A book by its cover. But I am totally convinced that Sperm Morphology matters in the path. Because if it's aerodynamically brilliantly shaped it will do better. So, in the real world, morphology probably matters to success with intercourse and success with IUI, because of shape, not because of nuclear material. But once you get to the, so you know, the more important thing with ICSI nuclear material, because shape doesn't matter that much.

Hillary: It is and that's such a clarification, I think that people need to understand about, you know, their sperm analysis, and then what plans do you have going forward, right? So, if you want to do all natural, but you've got morphology issues, then you know, maybe there is an issue. Especially if you combine that with like cervical mucus production issues, where there's not efven the cervical mucus there to help those sperm get that six inches of the way.

Dr. Turek: Right. And I think, you know, you're talking at the edge of theoretical considerations here, because the study just came out. And these are just my preemptive thoughts about it, so, I don't think you can say anything yet. But if you see these videos, you're going to say, even the mathematical experimental videos, so they can-- he has, you know, videos of mathematically what would happen based on the sperm shape as it goes to the course and then he has the actual, what happens to sperm that are real sperm, but-- and they're identical. So, his mathematical modeling is identical to reality. So I know it's true. But it's just fascinating because it gave morphology new meaning to me. It actually does matter. Because if you're not absolutely perfectly shaped sperm, least in a from a fluid dynamics point of view, you're probably not going to make it.

Hillary: Well, I have to say, this is one of the things I love about you. You publish all this research and you're involved in it yet you are very careful to say, what is theory still and what is-- what is fact, right? 

Dr. Turek: Now, I have a blog on, when does fact become fact, right? It starts out as theory and we published a paper about the semen analysis being a bio-marker for prostate cancer and testis cancer 10 years ago. And, you know, it was an epidemiologic study, and it was large and it was very prominent. It was published in a general medical journal that, you know, men who are infertile have higher rates of cancer later in life, if they have low sperm count. It was based on molecular biology data, and we went straight to epidemiology, which is like the opposite end of the spectrum. And it was done by my fellow Tom Walsh, an epidemiologist and urologist at University of Washington. And, you know, took 10 years. And now I believe it's true. I mean, even though I did the paper, because it's epidemiology, but enough people have reproduced it. And the government is now putting grants out to study the issue, which is a-- for me a bucket list thing. Because, you know, being at the meeting, where we're talking about it and NIH, and they're saying, Dr. Turek inspired this meeting, and like, Oh, that's nicest. So, it's a very nice compliment, but I think, it takes time for theory to fbecome fact. And this is now theory. I think it you know, it's always that way, in science. It could be disrupted at any point. But I think there's enough cumulative evidence looking at the bio market concept and fertility that it's true. I don't know if there's enough evidence that what I'm saying today is true about sperm. But--

Hillary: Well, I'm glad you brought that up, because that ties into our title, Is IVF Good for Men's Health, because I do believe, you know, I kind of look at reproduction and fertility issues. This is what was most fascinating to me. I didn't mean to choose this as a specialty, but it's kind of like almost the ultimate disease, right? If we're put here to eat, sleep and procreate. And there's an issue with that what else could that tell us about our health, right? Especially around chronic disease. 

Dr. Turek: Yeah.

Hillary: And so, the fact that now this work is being used to kind of show you know, again, not fact, but some correlation with later stage cancer being an issue, I think, is huge. Because so many men don't want to do that sperm analysis, but if you can put it in statistics, where you can say, "Hey, this can actually show you how healthy you are inside."

Dr. Turek: Yeah, I mean, I-- every day, on an everyday level, if I see a guy with a normal semen analysis, I know some things are true. He can't be doing too much bad, because it would lower his sperm count. So, he's living a good life, probably. He's, you know, probably got a normal testosterone level, because you can't really generate-- You can't bloom a plant without enough water. So he's got the right combination. So, you can say pretty good things and I-- So knowing what I know, I did a study where men came in and they had normal sperm counts, and the woman had no issues and they were infertile. And they were unexplained. And I said at the end of the visit, based on my complete evaluation that I thought he was cleared, and I said, "I think you're cleared; I don't think you are part of the problem." And that's based on everything I know. And so, most of those couples went home and went online and said, Turek couldn't figure out what was wrong with us. And I got a little upset with that, because I didn't say that. I said, Honestly, I think, look harder elsewhere. I mean, I don't take care of women, and I don't make recommendations. But I said, look in the partner a little bit more and then you'll probably have to go down the path of the technology or to other alternates. But I think you're doing great, and I think you're fine. So, they said that, and I said, yeah, nobody said. So, I put a little-- I put my back into it. And I got USC involved, the resident USC. A year after I met them, I called-- I had this resident call them all up in an IRB, you know, to study. And I had them-- I had him ask a couple five questions. How to go last year? Dr. Turek told you to try harder and this and that. And all these guys had varicoceles and they were doing things and they had toxins and I gave them advice about stuff. I did not give them a pill. I did not operate on varicoceles. I just advised and said, "You know, try this, and you know, maybe an antioxidant supplement, etc." So, it wasn't no care. But it was just basically advice. And I thought they were doing fine. And so, to my surprise, 65% of those couples conceive naturally the year after I met them.

Hillary: Wow.

Dr. Turek: So, they follow the rule. And these are 35-year-old women for a year and a half of infertility and 65% conceive naturally. Another 20% conceived with IUI or IVF. So, at the end of the year 85% had kids or had pregnancies ongoing. And I said, "So it's true." I mean, basically what I said was true. So, I'm writing this up as a paper and I'm not writing as, "See, I told you I was right." I'm writing it as a lifestyle paper. So, all I did really was give lifestyle advice.

Hillary: That's amazing. Somebody needs to show that in the literature, for sure.

Dr. Turek: Yeah, that's going to be hard to publish, because it's hard to publish when-- You're most effective when you don't do anything as a doctor. Or, I'm on a lot of journals. I'm associated or two, I review for 20. And honestly, I know it's not going to be a big hit. It's not a controlled trial. It's not this, it's not that. But if you look at what a doctor is best at doing, sometimes it's just holding your hand sitting there and being at your side and walking the walk with a little more knowledge and giving you good advice. I mean, that's-- 500 years ago, that's what doctors did. And it may have happen today, because if you-- If they're paying the money to see you and you're telling them, you got to eat better, you got to stop smoking, you got to cut down your alcohol, you got to, maybe, stop these pills taking antitoxins and supplement. Maybe it's just the antitoxins supplements, who knows? But that's a tremendous pregnancy rate. And that told me, until I'm trying to publish the papers, you know, a lot of unexplained infertility can be cleared. Men can be cleared of it by a simple evaluation in the office, one visit.

Hillary: I think that's great. And I… it's amazing that you're doing Telehealth. I think that's just going to open it up to even more men. So, you know, if you're listening to this, and you've been trying to get your male partner in to be seen, you know, he makes it as easy as possible. He can do it at home, a persona test, he can see you via Skype or phone, I think that's incredible. There's going to be some, hopefully, some big changes in the ways that males perceive getting a sperm analysis and getting checked out and hopefully kind of treating it like socialized countries where they do it in the beginning, you know.

Dr. Turek: Correct.

Hillary: You can put a dollar amount to it, then they're more up to go, right?

Dr. Turek: Right. And I think it's a lot cheaper to see a man once and get it all done. I mean, I like to package it so that-- So I offer basically free calls for couples to see if it's a good fit. And then you can get the background stuff, and then have them come in and have the first and last visit. And everyone thinks, "Well then that's it. I'm all done with him." No, that's the start of the care. I mean, my cares is all Telehealth. So, I want-- I'm with you to the kid, but you don't have to come see me. But if you want my opinion about stuff or you, you know, you're taking something new, is this medication safe? Those are really good questions. Someone should answer those questions. I just got diagnosed with this, this is what I'm on, Is this safe for-- I've changed so many blood pressure medications from calcium channel blockers to other things, and bam pregnancies occur. It's so, you know, that's the way you have to deal with men. You have to-- they're not women, they're not that good about care on general. And it's a cultural shift. And you have to I think you have to adjust to the way they need their care, and not trying to treat them like everyone else. And, you know, having them travel across two bridges, and two hours to get there. And then for a 15-minute visit, for what you are 20 minutes late. It's not worth it. It's not the way to do it.

Hillary: No.

Dr. Turek: You're hitting productivity or making them weak where they shouldn't be weak, and it's already a problem that's embarrassing. And then if you explain it and-- So I just work with the organism the way it is. That's the idea. To work with the organism. Look at what you have.

Hillary: I love that. And I have one more question for you. You mentioned that you don't always treat varicoceles surgically. So, can you explain to our listeners what the prevalences of those. The cause and how they're treated?

Dr. Turek: Yes. Varicocele are the most common diagnosis in infertility. It's probably 40% of men are trying to have their first child and then can't. It's up to 60 to 80% of men who are trying to have a second child and having trouble. And they're a bag of veins in the scrotum. And they occurred as a result of us standing up in an evolution. So, I think the bloggers call it, What Happened When We Stood Up?

Hillary: Yes.

Dr. Turek: Probably the worst thing that men could have done in life was to stand up, because the varicoceles basically drainage of the testicle, the blood supply to the body. And if you stand up, it goes up hill and your fighting gravity and the veins aren't made for it. So, they tend to go backwards and the blood goes the wrong way. And unfortunately, that blood from the body going down to the testicle the wrong way, is warmer. And that heats up testicles like a hot tub. And I know-- I did the hot tub study and I know how sensitive testicles are too hot-- to heat. But like I said in the beginning, you know, three days a week for a month, you can be zero. So, you can really turn things off. And so, heats up the testicle, affects both sides and causes probably the largest single correctable cause of male infertility. But they're found in 15% of high school athletes. So, it's also a disease of athletic young people, thin people. So that's also important. And so, some of them are pathologic and some of them aren't. And you just-- we don't have a good test to know which is which right now. Epigenetics, maybe a test down the line, but it'd be nice to have a way to figure out in whom it's a problem. I use metabolomics. Initially, I was looking at the metabolomics of the testicle and a grant 20 years ago from NIH, but my co-investigator took all my money and got no data out of it. So, I was kind of burned by that. But that would have been a way to put them in a scanner and see if there's a certain decrease in function of the testicles that much between side to side that might mean there's relevance and then and then fix it and then scan them again and get recovery. So, but right now, if you fix it, you can either fix it non-surgically with radiology or you can fix it surgically with microsurgery, it's probably the best way. It's an hour of surgery. It's pretty quick. Two or three pain pills down for a weekend back to work on Monday on a Friday case. And you just tie off the veins so it doesn't do that anymore. Sometimes men are having discomfort feel better. That's a pretty high rate. And about 70% of the time you'll get improvement and semen analysis, and if primary infertile couple probably we run a 45% pregnancy rate over the next year naturally.

Hillary: That's amazing. All because they just got checked.

Dr. Turek: Right. So, that's the thing that I find when acupuncturists see patients and have screened everything else in their lifestyle, and have perfected them as best they can be, that's what I find. I find a lot more varicoceles, and I have to figure out-- I'm going to work with a postdoc on a doctoral student on how to do that study. Patients referred from IVF programs versus patients referred from acupuncturists. What's the rate of finding correctable causes of infertility in men, I think it's going to be much higher.

Hillary: Awesome. I can't wait to read that and see the video on the mathematics of the fluid of the sperm. I'm such a nerd. That's great.

Dr. Turek: The coolest video it is. It changed my life to see that.

Hillary: Okay, well I will definitely be stocking your blog looking for that then so I can link it to the show notes which is ladypotions.com/episode30. So, people can find you at turekonmenshealth.com for blog work, they can find you at turekclinic.com if they want to schedule something. And they can also get that test on episona.com. And if you're in the San Francisco Bay, you're also part of a free clinic called, Clinic by the Bay. Yes?

Dr. Turek: Yes. We just had our fundraiser yesterday. It was Fiesta themed and raised $200,000 for free clinic for the working poor. It's called Clinic by The Bay. Love to donations on Facebook or social, it's fabulous. Would take care of the working the uninsured, the hard-working people that can't afford insurance in San Francisco, immigrants, Catholic Charities, everything's free. It's fabulous. It's not fertility. It's general medical care.

Hillary: It's amazing. And so they can donate to you on Facebook. And then you're also doing a Facebook Live covering semen analysis a little bit more in depth, right? They can find that on your Facebook?

Dr. Turek: Yeah, a whole series on Facebook Live weekly.

Hillary: Awesome. Well, I'm not going to keep you any longer. I'm so grateful to you. I know you are a busy, busy man. All right, well, thank you so much.

Dr. Turek: Good bye, Hillary.

Hillary: And I'm sure our listeners will enjoy it. Thank you.

 Dr. Turek: Continue doing your good work.

Hillary: So there you have it. IVF could be the best thing for your man's health, if it's what actually gets him into the doctor to be evaluated. What if you could save a ton of money and heartache by being evaluated by a holistic physician, the beginning of your fertility journey? Remember, we are more than our lab test values and our DNA. We are the product of what we think, what we eat, what we are exposed to, even the exposure of the care of our physicians. If you'd like to work together, find me over at ladypotions.com and click on the work with me tab to see options that are currently available. Bye for now.

 

Continue Your Journey- Referenced Studies

Sexual, Marital, and Social Impact of a Man’s Perceived Infertility Diagnosis

 Increased Risk of Testicular Germ Cell Cancer Among Infertile Men

Reproductive genetics and the aging male

Finding the fit: sperm DNA integrity testing for male infertility

Differences in the clinical characteristics of primarily and secondarily infertile men with varicocele

New device selects healthy sperm

Marijuana use and its influence on sperm morphology and motility: identified risk for fertility among Jamaican men.



EPISODE 74 | CONCEIVING WITH LOVE | How to Keep the Spark Alive with Denise Wiesner

Description: Has TTC made your mojo go MIA? There's a book to help you find it! This conversation with Denise Wiesner, a fellow ABORM certified acupuncturist, is packed with tips from the taoist traditions of chinese Medicine to help you forget about conceiving and get back to loving, literally. Trust me when I say you should listen to this episode together and read the book in bed together :)

Announcer: (0:00) Welcome to Fertile Minds Radio. Here, you'll find wisdom for your fertility journey and beyond. Chosen specifically to help you trust your body and elevate your spirit so you can enjoy the process. Join us and see what a fertile mind feels like. Now your host, Hillary Talbott Roland. 

Hillary Talbott Roland: Hey there, Hillary here, your go-to gal for a plan to reclaim your fertility and create a healthy family for generations to come. We have an amazing guest today, Denise Wiesner. She's a fellow acupuncturist and a fellow of the American Board of Oriental Medicine. She's the founder of Natural Healing & Acupuncture clinic in West Los Angeles and she's an internationally recognized traditional Chinese medicine practitioner, specializing in whole systems Chinese medicine and approach to women's health, sexuality, and fertility. She has been at this work since 1994 so she really is a wealth of information when it comes to balancing the body naturally in order to enhance the fertility of a couple all while helping them to keep their spark and loving connection.

Her approach uses a combination of acupuncture, diet and lifestyle counseling, nutritional supplements, Chinese herbs and Daoist breathing and fertility exercises. She has just published a book, Conceiving With Love: A Whole-Body Approach to Creating Intimacy, Reigniting Passion and Increasing Fertility. And she has graciously taken the time out of her busy schedule to come on the show and let you know some tips and tricks to help keep love alive while you are trying to conceive.

Denise, welcome to the show. 

Denise Wiesner: I'm so happy to be here. Thank you so much. 

Hillary: Yeah, I have to say your book is awesome. One of my patients was in Colorado for some IVF procedures and she just hopped on upon the publishing house for Shambala and she texted me and said, "Do you know this book?" And I said, "I don't even think it was out yet."

Denise: Wow. 

(2:00) Hillary: She's like, "It's amazing. You have to read it." So that's why you're here today.(2:00) With all serendipitous act upon one of my patients. 

Denise: That's lovely.

Hillary: I feel like acupuncture isn't one of those careers that every little girl dreams of doing, nor as being a sex therapist I'm really curious, how did you come to this world? 

Denise: Really, in terms of the conceiving, I was having my own issues, conceiving my second child and I went to see a lot of different acupuncturists and I went to a naturopath, a western medical doctor and at the time I was having difficulty breathing, I was having some asthma. They just wanted to work on my asthma and I kept thinking, "Gosh, I just want to make a baby, like don't you want to understand?" So -- 

Hillary: Right.

Denise: And nobody really caught on that I was having some types of -- I was having a thyroid issue. And at that point, I did get pregnant and had to I --  it was a very faint line and it was a chemical pregnancy and I was freezing and I went to my doctor and I was like, "Test my thyroid." And he did and I found out I had low thyroid. That was sort of the impetus for being, for doing fertility.

And then the sexual piece, I might have to clarify, I'm not a sex therapist, but I am a certified sex coach, but I found that I was talking to all my patients who are trying to conceive and it seemed like nobody was having sex and if they were, it was really kind of strained and I would deal with couples and I had mentioned about sexuality and they were like, "Oh yeah, baby-making sex." And then the husband would turn to the wife and the wife would look at me and I just realized there was a whole world of intimacy that wasn't really being addressed in the world of fertility so I tried to marry the two. 

Hillary: I think that's great. I see the same thing in many of my patients, especially if the challenge has gone on for any amount of time in terms of the intimacy. 

Denise: Yeah. 

Hillary: And so often, they're not talking about it. It's like an elephant in the room. 

(4:00) Denise: I think there's just so much shame around the topic of sexuality. Right? I mean, it's a very, very --  fertility is private, which it is for a lot of people, then sexuality is even more private. Nobody has anyone to talk to. I think, people don't know where to go to speak about this. 'Cause you don't want to tell like your best friend that your husband's having problems getting erections so you have to do an IVF, right?

Hillary: Right.

Denise: As we go -- and then you don't -- The fertility doctors, I mean, I interviewed many of them and they're so gracious and wonderful, but they're not really talking about it either. Some are, but their solution is, "Well, we can do an IVF or insemination," and that's sometimes a great solution, but nobody is addressing the underlying problem.

Hillary: Right. And I find that with a lot of the reproductive endocrinologists as the amazing gift that they have to help couples conceive. It's not really holistic in nature. Like they're not looking for the underlying problem. So the quality of life issues, cause if you are having trouble being intimate in having sex before the baby, guess what's going to happen after the baby.

Denise: Right. Right. The baby, it gets even worse. 

Hillary: Right. I think it's brilliant to address that now and we're going to go into some of that in great detail, but your book just does such an excellent job of describing the 5-element theory of Chinese medicine and specifically how it pertains to fertility. I was hoping that you could briefly go through that and why it's important. And this kind of hearkens back to what you were talking about, the acupuncturist wanting to treat your lungs and your asthma or the metal element and you're thinking, "What? Just giving me a baby." Right? 

(6:00) Denise: Yeah, alright. Well, I took a lot of liberties with the five elements because I really decided that there was really nothing on intimacy. So I bridged it with how do we take care of ourselves holistically and how do we equate that into what kind of lover we are, so to speak. Really, just how do we open the dialogue about sexuality, was my biggest point. I started with the center. I did a Daoist model of the five elements where earth is at the center(6:00)and earth is this idea of being present in the body and communication and our digestion and how we assimilate. Right? And so people that are earth types or have an imbalance in this element oftentimes seek the approval of others. And really, they overworry and they overthink. Right? 

No, this is so common with fertility patients. Over worrying, worrying, ''What if it doesn't work? What if I don't have a baby? What if I don't get pregnant with this IVF?'' There's a lot of worrying. There's also this idea of how we show up in our bodies, how we feel in our bodies.  What our diets like, how our microbiome is, the beneficial bacteria of our gut or how the microbiome is in our vagina. 'Cause we have a separate microbiome there. How's the flora and fauna? Do we get frequent yeast infections? Are we eating a lot of sugar? This idea of the earth element really is about being present in the body and communicating and feeling good in our body. Feeling like if we don't feel good in our body, we really probably don't want our partner to see us. We don't want to be naked, right? 

Hillary: Right.

Denise: How do we nourish this element? Then it goes even further in what kind of lover we are. Do we just try to please our partner and we don't really ask for what we need? Because we're a giver. We're an earth Mama. We want to take care of everything, but we don't get our needs met. That could be more than just lovemaking, but how do we feel in our body? That's pretty much just the brief synopsis of the Earth element. 

(8:00) Hilary: You had this quote in there about that I have pertained. I took relevance to the fire element and you said, "Connecting to your heart allows you to trust your spiritual journey of procreation, even when it is fraught with uncertainty, even when you have no idea whether you will ever have a child." I just love that. I was wondering if you can talk about the connection of the fire and water elements, water being reproduction and fire really being our heart center in community and how we connect in community and how we connect and why that's so important. 

Denise: Yeah, in Chinese Medicine as you know, there's this extraordinary vessel called the Chong Meridian. It is this extraordinary vessel that connects our heart energies with our kidney energies or the water element, our reproductive energies. The kidney energies are our reproduction and our sexuality. It's that fire in our loins that says, "Yes, let's make a baby." The element is not working in all its abundance. Because wanting to conceive is that energy. It's like that, "Oof, yes, we love each other. Let's make a baby." But it's also connected to the fire element, which is the spiritual heart, which is love, which is in my book, the heart element. And you know, Chinese medicine also goes to the mind, but it's that beautiful like looking into your partner's eyes and kissing with the tongue, which the tongue opens to the heart. It's deep passion, deep intimacy. This energy connects with the kidney energy, the water element. It's water and fire. They have to be working together. It's love that makes the baby, it's that love energy that drops into the lower burner, the lower energies, the kidney energy that makes us conceive. 

Hillary: But you're right, just wanting to go on and in ourselves, continuing to reproduce themselves. 

Denise: Yeah.

(10:00) Hillary: You mentioned Daoist practices or Daoist traditions, which I think a lot of our listeners are familiar with traditional Chinese medicine if they've listened to the show because we bring it in here and there. But a lot of people aren't really familiar with what Daoism is or what it means and how it relates to Chinese medicine. Could you speak to(10:00) that a little bit just to clarify? 

Denise: Yeah, sure. That's a great question. Daoism is what Chinese medicine came from. The Daoist, way back in the day before Confucianism came into to the planet really connected with nature. They lived their lives according to the rhythms of nature. We have the night time, which is in Chinese medicine, we say the Yin time, the dark time, the feminine time going inside. Then we have the Yang time, the fire element, the sunshine, going outside the male energy. They have this idea like the Tai-chi symbol, the Yin Yang symbol, that black and white circle thing everyone talks about. This idea of having them always in balance of Feminine and Masculine Balance. In the ancient times, they have practices to help create balance, to help live in flow with nature that also created lovemaking. 

They had this idea of feminine. Males are supposed to boil like they're ready to go and females are really slow. This idea of, that's Yin and Yang again, and that idea of creating balance is letting the feminine lead. In Daoism, a lot, the Feminine Energy would lead and there would be, the males would wait for the feminine to be, [let's say] aroused. I'm using sexuality as an example, but it's way more than sexuality. But this idea of cultivating, it was this idea of cultivating our energies. How do we cultivate and balance our energy so that everything is in balance like nature? That forms Chinese medicine, as we know it. 

Hillary: Awesome. Thank you for explaining that for all those that didn't know. I think that's such an important part and that's when people say, "Well, how does Chinese medicine work?" And I say, "It'll get you back in line with nature and your surroundings and that you can go with the flow."

Denise: That a lot better, a better explanation. 

(12:00) Hillary: No, well, I think it's important for what we're talking about that the Yin and the Yang, it's those have become terms that are thrown around, but unless you've studied deeply, like you don't quite understand some of the intricacies and that dig in does lead. And that it is up to the woman to really drive that cart, so to speak. You hear that women? It's up to you to set the stage. It's not a bad thing. 

 Denise: Right. Absolutely. And we do that with just a lot of times showing and communicating and Yin is the receiver. I think that's also really important too, is that we receive. In fertility world that I work in, you probably could relate. Most of the women are doing so much. They're doing everything to have a baby and they just want to do more. Like what else can I do? And sometimes, it's not so much about the doing as it is about the receiving. 

Babie are never achieved. They are received. Sometimes you need to go to the Yin Valley of darkness and be in a place of utter reception.
— Randine Lewis IFS 2017

Denise: Yes, yes. That's very true. So yeah, from that place of receiving is where we drop in.

Hillary: Right. And it's difficult, I think, when you've been- Women that are of childbearing age right now, we're kind of raised in a society of 'try to live in a man's world'. They've kind of indoctrinated themselves into 'go, go, go'. And how very Yang lifestyle. And so, it almost seems foreign when you tell them like, "Hey, you need to slow down." And you are actually guiding this but you need to be a little softer about it. That might help you.

(14:00) Denise: And it's so interesting because of how this affects the relationship because we're talking about intimacy in a relationship as men whereas their Yang nature of like coming and fixing things and being that energy. This could be, we're talking about male-female relationships, but it's often in same-sex too. There's a dominant Yang person or a Yin person or however. It's not just in the heterosexual relationships, but in that Masculine Feminine Energy Dance, which we all do, that males oftentimes in my practice, specifically feel sort of impotent literally on what to do. Because the females are doing so much and they would like to do, but they don't know what to do. And their big job, their big moment is that to like do the ejaculations and so that they get right. And for them, they want to connect too and they want to have intimacy and so they can't fix it and then maybe they have this big pressure on this one moment and then they have, it's difficult for the men as well as the females. 

Hillary: Do you see a lot of men in your practice? 

Denise: I happen to see a lot of men in my practice.

Hillary: That's awesome. 

Denise:  Yeah, it is. And they are amazing and they really tell me so much. They really inform me, they really are open. And I'm pretty impressed with my male patients. 

Hillary: Well, you know, it takes two to Tango, but I think that that kind of 'I'm going to do everything I can and then I don't want to bother my husband', until I absolutely have to model that. I see it happening sometimes as the males, they don't come for treatment as often as they should. I'm sure there's a lot of listeners out there wondering like how do they have that conversation in a tactful way to get their husband on board to come to something like acupuncture if it's foreign to them? 

Denise: Yeah. I think, if they know they're going to have more intimacy with their wives.

Hillary: Yes. Okay. 

Denise: If we're going to get more pleasure out of the whole experience, I bet a lot of men will be down. I mean, like, if that's gonna make their connection better and make their wife happier. I mean, men probably -- Well, yeah, that's what they're about, like taking care of the feminine. Male and male energy is taking care of the feminine energy. I think that, yeah, more intimacy, more connection. I think that's a way to win a man as opposed to(16:00)you might have to take these or that you have to do this. I think men want to have a baby. Most men, a lot of men want to conceive as well and they want their wives to be happy and they want to be connected.

Hillary: Yeah. For sure, but they just don't talk about it ad nauseam like we do.

Denise: That's for sure.

Hillary: Your book has all these amazing Daoist Taoist exercises, I should say, in there for lovemaking. What's a simple one you could share with our audience if they were, say going to practice and be like, "Hey, you'll get more of this perhaps if you go to the acupuncturist."

Denise: I'm going to talk about some really basic things right now. Because it's hard to explain like Microcosmic Orbit Breathing, really [line breaking] instruction reading the book for that. I think what happens with couples is just the simple things go by the way said. Like full body hugs. This idea of, in Taoism or actually, I use some tantra stuff too, where there's the Yab Yum practice where a female will sit in a male's lap and maybe they connect their energy centers with them. But boiling it down, I would ask the questions of, 'when's the last time you had a full body naked hug for a long time? And when's the last time you did eye gazing?' Just really looking at your partner in the eye is so intimate. It's just this idea of connecting energies and then in addition, 'when's the last time you made out?' Connecting the heart energies, the tongue energies. These things, it's just when people are trying to have a baby, it's like, "Okay, come on, let's get down to it." It's that intimacy of connection of deep hugs, deep kissing. And yes, there are lots of Daoist practices, but just breathing together, where we breathe, we just match each other's breath and we just sit there across from each other. Look in the eyes, you could even put a hand on the heart energies and just look at your(18:00) beloved and really look into their eyes. Sometimes, that's just very hard to do because we don't have a lot of time and it's hard to be really that intimate.

Hillary: Well, yeah, because fertility becomes that job on top of your other jobs and you're always giving to-do lists of what to do or at least this is what I observed in some of my patients and they're not slowing down. And that's why the show has a big emphasis on mindfulness. One of the huge reasons I wanted to have you on after I read your book was just what a great job you did of driving home that that's so important to be present. It's so often things, we get away from that. We get into these ruts and I think just looking at one another in the eye, it can bring up so much, but it's stuff that needs to rise to the surface.

I made my husband try the  3-minute hug, clothes on, not to be too TMI, but I said, "Hey, before you leave, we should start just hugging for three minutes." And it's funny because I don't think we make it more than 90 seconds without giggling or one of us saying something and it is like foreplay like you say in your book that is well before the action actually happens later. It's just kind of planting that seed, if you will, for later. And that's been really helpful. I think he really likes this stuff and reading this book.

Denise: I've gotten that from a lot of patients that are even trying to have a baby, that it's really reignited the passion in their relationship. Because there's a lot of great, even if you're not trying to conceive, there's so many great-- Just to bring back the passion for couples cause it's hard to keep it up. Ha, ha. All the time. 

Hillary: Yeah, you're right. 

(20:00) Denise: Yeah, it is. And there's a whole section in my book, Foreplay. Like this idea that it kind of begins in the morning because you do set the stage for what's going to happen. Women, we want connection, we want to be able to feel, it's not just like at that moment. Now we have to perform. It's really like, do we say really nice things to our partner? Do we text them something nice during the day? I mean, what's the communication all day? We're all so busy, sometimes it's hard to do that. 

Hillary: Right. We take that for granted. I think that that's such an important part of the relationship to foster, to be good parents, to have that alive and well before the child gets here. Because man, you need that connection. 

Denise: Absolutely.

Hillary: You need to be unified.

Denise: At its best.

Hillary: Once the baby comes, right? I'm wondering, 'cause you treat a lot of men because this is something that I've been thinking about for quite some time. They had the World Conference on Reproductive Endocrinology where they finally all in a consensus said like, "Oh yeah, this isn't just like a natural pattern that's happening, but men's sperm counts and their motility is falling and at an alarming rate." It was the first that it was this like, grim outlook for humans in terms of reproducing without something like IVF. What do you think about that? Because I know that there was-- I've actually had some male patients bring me the GQ article that was written about it where they were like, "Oh, now I'm listening cause it was in GQ." What's your opinion about why sperm rates are dropping so drastically across the planet?

Denise: I think that's such a good point. And on that note, I had a Reproductive Endocrinologist that was talking and he goes and he said, "Oh, yeah, one day it's going to be like you have sex for recreation. And then you go to the fertility doctor and have your baby." And I thought, "Wow, that's really, that's a sad commentary on our naturalness," so to speak. But I think that what's happening is that we're very out of sync. We have this huge technological broom[?] where everybody's on their cellphones and there's a cell phone in the pocket and we have a lot of environmental problems. I think that we're not even probably aware of the amount of pesticides and like what they have DDD in people's fat tissue and that has to play a role in sperm and eggs. Just the amount of environmental toxins that-- Even if it's not in this generation, we're in generations(22:00) before that it's hard for our bodies to get rid of. I think there's that plus this, you know, sort of in -- There must be some kind of stress level that's happening. But it's not just from the men from now. It's like what happened when they were conceived. Because I'm having all sorts of men right now with very low sperm counts.

Hillary: Right.

Denise: And that doctors don't know why.

Hillary: Right. This unexplained male infertility, I think, is becoming even bigger than unexplained female fertility.

Denise: Really unexplained low sperm, like really low sperm counts and taking all the tests, it's not genetic or we don't know enough about genetics right now to know because there may be are some genetic problems going on. But yeah, I think it's gotta be some type of environmental toxins, as what I'm thinking.

Hillary: Yeah. Have you ever listened to Doctor Zach Bush talks about pesticides and GMOs and how that's affecting fertility?

Denise: No, but I'm sure I would agree because it is and we're only getting worse, we're not getting any better. I wonder sometimes with women and maybe with men as well of hormone disruptors and how they play a role in male fertility as well. I mean, birth controls, how many years older? It's not that old, but women are peeing. We pee out all of our hormones and that goes into our environment somewhere. That urine goes somewhere. 

Hillary: Right.

Denise: It's not-- I think it's in the water. I mean, I know--

Hillary: Right, we can't get it out of the water.

Denise: -- our water isn't tested for that. We don't, we'll test our product. We do, and in my city, they test for all sorts of things, pesticides --

Hillary: Right.

Denise: -- heavy metals, all these good things. But they don't test for hormones. And I wonder if I'm drinking tap water by mistake, I wonder, "Are there hormones in here? I don't know"

Hillary: Right. Or SSRIs or other things that affect fertility.

Denise: Correct. Yes, SSRIs, so many of these medications, I wonder what's in the water I'm drinking.

Hillary: Berkey Filters, if you don't have one,(24:00) grab one. That's what the Peace Corps uses.

Denise: Yeah, we have filters. We have filters, but I'll have to look. I'll have to keep that one in mind. I have a filter in my office and in one of my house, but still, you know?

 Hillary: Do you think the stress aspect is what is keeping the libido low? Because I mean, I asked that in my questionnaires, and I asked if the male doesn't come. There's a part about like, tell me about your partner. That's almost always tracked when there's some fertility issues. I have to wonder if it was the chicken or the egg. When there's fertility problems, which came first?

Denise: Yeah, I'd say like 95% of my women check low libido. It's such an interesting thing for women because I have to inquire much more about what that means. Do they have low libido or is it really not enough time to be aroused because it takes like 20 to 45 minutes for a woman to become fully aroused where all her tissues engorge with blood and she's ready to have intercourse. I don't know that we have that kind of time because of stress, because stress, there's so much stress in life. It's like you come home, if a woman's working, it's like, I know when I come home and my mind is still thinking about things I have to do. It's not really in my body. I'm not feeling my sexy self. I'm not feeling like-- I have to unwind all that and get in the mood. 

And it is. I think we have such a stressful communication and there's a thousand emails I have to look at. And we are going at such a fast pace, it's hard to slow down to get into our body. I do think stress plays a huge role. Then on that note, with males and with females too, like some of the SSRIs actually prevent men from ejaculating. It sometimes prevents women from having an orgasm. We have that level where we're taking stuff for our stress and then it's causing more problems. There's other solutions for that. But I mean, I don't take my patients off their SSRIs, but they're given so easy these days and I think now everyone is given one. (26:00)

I do think stress is a huge, huge problem in libido. Absolutely. It takes time. It takes nurturing. It takes quite. It takes feeling the body just getting touched. It's all those things were sensuousness, it's not just sex, it's just like being sensual with one another, feeling of the senses, cooking, smelling, touching, tasting. That's part of the dance of sexuality. People are so stressed out, they're forgetting about that.

Hillary: Well, don't you think it really comes down to presence though? I mean that's when you involve all of those, your five senses, you're in the moment, right? You're there. You're not answering your email in your head.

Denise: Right. Absolutely. And that's where you were talking about mindfulness. I think that's so important. It's learning how to be here now. As one of my mentor, like not mentors, but spiritual teacher, Ram Dass. His book, Be Here Now. There was a watch, it says, "Now, reminder."

Hillary: Right.

Denise: Oh, yeah. Like, cause my mind does it too. It goes right into the future and I'm worried and I'm like, "Oh no."

Hillary: Yeah, that future thinking. I think, I'm permanently recovering from that. I do. I do love Ram Dass though. I mean, I think, Polishing the Mirror was his greatest book yet.

Denise: I look at him, he's in a wheelchair and he is paralyzed and half of his body and he smiles. He looks you in the eye. I'm sure he has his thing, but I'm always inspired by people who in the face of obstacles and difficulty are able to really fully be present and really fully be there. Even with fertility or whatever is going on, reminder, for myself as well. Be in the moment, be in the moment, drop into the moment.

(28:00) Hillary: Yeah. He talks about that. About how humbling it was when he got sick and he said the people taking care of him and he felt he wasn't the man anymore. He was like, here, I thought I was enlightened. And now I'm down low. I just thought that was such a great part that anybody can relate to, especially with fertility because somewhere in our wiring, I think we get it. That this is the one thing we're supposed to do. When we can't do that, I think it colors everything else.

Denise: Yeah. It's like this feeling of being broken. 'Is there something wrong with me?' Or 'I can't do this thing I'm supposed to do.' I mean, I have women that are really having hard times with it. I'm so much compassionate for that. How do we find a way to enjoy our lives in the midst of struggle. In the midst when things don't go the way we'd like them to. In the midst when we're arguing with our partner, how do we drop into love? How do we remember what's really important? I have this great exercise. I have to share this because Kia Miller, who's a yoga teacher shared it with me and I think it was like Yogi Bhajan, the founder of Kundalini gave it to another Kundalini practitioner. 

And she said, "When you're mad at your partner, you spread your legs, you go upside down and you'd hold hands upside down and you've seen what you're upset about." We get upset about so many things, myself included. What's really, really important is to return to love. It's so important to return to that energy of love, love of self, love of your partner. Love, the love energy that really dictates why we're here. I think what and why we want to have kids.

Hillary: Right. Yeah, I agree. I might try that one with my teenager. He'll be like, "What are you doing?"  But you know, people don't like the emotion of anger. We're scared to sense and feel anger coming at us. If you can lighten it up a bit and still allow your anger, I think that's brilliant. 

 (30:00) Denise: Right. And Chinese medicine talks about that and like the wood element. That we're supposed to feel our emotions and obviously not be abusive with them but to feel them and it's okay to feel anger sometimes if that's the emotion. It's okay to feel all the emotions as long as we don't stay with them forever in a day. 

Hillary: Right. The wood element is also important for feeling orgasm, right? 

Denise: Yeah. Passion, absolutely. 

Hillary: Yeah. So lots of babies are made via IVF now, but I love that you pointed out how one couple had to use donor sperm and then they kind of literally brought it into their own, took it in their own hands into that home because they wanted to have orgasms when they were trying to make this baby out of love.

Denise: There was an amazing same-sex couple that I interviewed. They were incredible. They just told me this story. I was trying to figure out about sexuality in same-sex couples and how it works there. They were like, "Oh, yeah, we had the most sex ever because this man would give us the sperm. He'd leave it for us. And then we put it in and then we knew that an orgasm afterwards is really, really important." We would go to each other one and that -- and they ended up doing IVF. But just the story, the journey of how this baby was made was so great. Yeah, that having an orgasm after a cervical insemination, was really potent for them. Yeah, it's just great. And then having an orgasm, it's a theory. Sometimes if we can, it's really wonderful, but it's not essential. One doesn't have to have one.

Hillary: Right. But it could help, right? 'Cause this is pretty powerful to get that sperm where it needs to go and you're happy at the end of it, even if it doesn't work.

(32:00) Denise: I think, I teach a lot of young women. I have a lot of young women in my practice. And a lot of women don't know even to talk about what kind of orgasm, like having an orgasm. Like one woman was having an orgasm just with a vibrator, but her partner with vaginal sex didn't give her an orgasm. And she was like so afraid. She thought there's something wrong with her. I was like, "Oh, no. A lot of women don't orgasm with vaginal intercourse. Sometimes they need a little extra clitoral stimulation and it's okay to ask your partner for that." Just the mention of all these words, people are looking at me. Just to have that dialogue where we're talking about the clitoris and the penis. I think it's like, "Yes, let's talk about these things because these are important. These are our body parts."

Hillary: Right. I think if you're going to be having sex, you should be able to talk about these things. Okay. Well, I know that we are coming to our place in time. But if you had one piece of advice for a couple that was out there trying to conceive, what would it be?

Denise: I always tell my patients like that and we don't know why this baby wants to come in or when this baby wants to come in. Sometimes your baby could be the future president, it could change the whole course of our country but it wants to be born at a certain time and it's this idea of the love coming together and trusting in the time. I think, timing becomes really scary for people. It's like you don't know when this child wants to come in and we have to do deep trust, we have to do deep love. That would be my advice. Deep trust, deep love.

Hillary: That's awesome. I think that's great. That reminder of we're not in control of time. Well, where can our listeners find you if they want to connect further?

Denise: You can go to my website, which is my name, https://www.denisewiesner.com/ And that's a good place to find me and find about the book. Yeah, that's a good place.

Hillary: Awesome. Well, thank you so much for taking the time to come on the show and to educate our listeners about how to reclaim their intimacy. And for being so vulnerable in telling your story in the book. I think that that really helps the reader to get comfortable with what might be a highly uncomfortable subject for some.

Denise: Yeah. Thank you. Yeah, I appreciate that. I tried to put a little of me in there cause it's hard sometimes for all of us.

Hillary: Yeah, absolutely. It's a much-needed book. I think it's going to help a ton of couples out there. If you're listening, I highly recommend grabbing a copy of Conceiving With Love and reading a little in bed each night and sharing with your partner. I promise you and your partner will be pleasantly surprised about what comes up, pun intended.

If you want a free chapter, you can get a free chapter before you commit. You can do that if you go to the show notes for this podcast, which is ladypotions.com/fmradio/74 or simply search Conceiving with Love on our homepage at LadyPotions.com, that'll take you right to her home page as well. If you're out and about, you don't have anything to write down with, you know where to find it. You can also win a free copy of Denise's book if you follow me on Instagram @LadyPotions4U. You'll find details to come on, how to win a free book.

A huge thank you to all our listeners for giving us your greatest asset of your time and your attention. We truly hope this interview has peaked your interest on how to rekindle the fire. Thank you so much, Denise.

Denise: Thank you so much. You're doing great work. 

Hillary: You too.



3D Book Cover_Conceiving with Love transparent (1).png

Announcer: Thanks for listening to Fertile Minds Radio posted at www.ladyportions.com where you'll find past episodes of show notes and free meditations. If you've benefited from what you've heard, leave a comment or review so it makes it easier for others to find this valuable wisdom. Let's help elevate each other. Thanks for listening. (35:31)


EPISODE 73 | WHAT IS THE BEST FERTILITY DIET FOR YOU?

Description: Today we will be covering one of my personal subjects in life, food! Food therapy has always been part of Traditional Chinese Medicine. It can be really easy to initiate your own healing simply by eating for your current TCM disharmony. I will share with you some easy life solutions and three different approaches that you can start with your very next meal. Food has a lot of ties to our belief system, our past, and emotions we have yet to feel. Changing the way you eat can seem very overwhelming, so today I invite you to just pick a few from these three ideas that suit you and your life.

 


Takeaways

[2:34] This can be a really hot topic for some people. I think most of my patients would rather me ask them who they voted for and how much money they make than for a weekly food journal. The reason why is food has a lot of ties for many of us. It’s got our belief systems all wrapped up in it, this is good, that’s bad, I can never follow a diet, I’ll get fat if I eat that, I’ll feel better if I eat that over there, I’ll eat in secret and no one will know, and so on. And it’s highly tribal and social. Most of us were comforted by food when we were little and as adults in the western world, it is often the center of many social gatherings. So when we start poking at it, and suddenly trying to change the way we eat, it can get a little unnerving.

[5:42] If you do have blood sugar instability and you test positive for gestational diabetes, you could pass that insulin instability down two generations. That’s right, your unborn grandchildren could have trouble with their blood sugar or even PCOS. This is because insulin can compete with your hormones trying to dock in your ovaries, reducing egg quality, or even stopping ovulation. We have the power to affect the health of the next two generations by what we put into our bodies up to one full year prior to getting pregnant.

[6:01] I would rather encourage you to make positive small changes that feel right to you rather than your feeling like your eating is one more thing you have to try and be perfect at. The implications of your DNA occur one full year before you get pregnant.

[8:25] Even a 2% change a day has a cumulative effect. It’s important to start small and adopt habits and a diet that feels positive and nourishing. If you pick what feels right at this stage of the game, you can work with suits you now and always circle back to more of them. If it doesn’t feel good, you are going to make an excuse not to.

[8:39] Pick what feels right for you and your partner, and start small.

[10:24] The first approach is from Daoshing Ni, from his book The Tao of Fertility. He thinks of the menstrual cycle as a season, and there is a systematic way to eat accordingly along with the phases.  This can be helpful to improve egg quality, sperm quality, and your menstrual lining. It might be a bit difficult if you are a creature of habit or have a tendency to grab raw cold food as this is pretty much prohibited on the diet. It is a simple approach that can drastically make a difference in less than three months.

[12:10] The second is a general list of what not to eat, and a meal order solution like Green Chef or Hello Fresh. This is great for the on-the-go person that is working too much or overwhelmed by the idea of shopping and cooking. However, it can get pricey, especially if you cave and order take out when you have organic food sitting in your fridge.

[13:09] Third, is the pattern diagnosis of TCM by symptoms that tell you how to eat based on TCM. This will often help you feel the best the quickest and make your overall constitution stronger helping you to achieve optimal fertility. It can be difficult if both of you have completely different imbalances or constitutions. It’s a win if you love strict rules. It gives a list of don’ts and dos.

[14:20] In the Tao of Fertility approach, you think of your menses as the season of winter. Shedding, ending and contracting. The week after your period is like spring where plants and flowers are budding and blooming, and the ovulatory phase is summer. The luteal phase is akin to autumn, the idea that Earth is filled with activity and where the temperature is beginning to drop as we come towards Winter. During the first two weeks of your “seasons,” you want to incorporate foods that will strengthen your egg quality and energy. This includes grains, high protein foods like eggs, meat, and beans. It’s important the food is warm for digestion. If you feel extra fatigued and weak during menstruation, you want to eat a lot of blood-nourishing foods like bone broth. The second phase after ovulation shifts to leafy green vegetables like spinach, kale, chard, and berries.

[23:15] Build healthy blood through the addition of foods like eggs, avocados, seeds (chia, flax, sunflower, and pumpkin) and nuts (with the exception of peanuts), unrefined coconut, and full-fat organic grass-fed dairy (as long as there is no intolerance or allergy). Healthy blood encourages good circulation to nourish egg follicles and to build healthy endothelial lining. Must of us go out of our way to make our baby's first nursery the best it could be, really though our womb is really baby’s first home, so let's make the most of it!

[25:44] Always choose full-fat instead of fat-free. Often times when they take the fat out, they replace it with sugar and other unhealthy additives.

[26:40] Method 3 is pattern diagnosis of TCM by symptoms that tell you how to eat for your fertility based on TCM. This will often help you feel the best the quickest and make your overall constitution stronger helping you to achieve optimal fertility. It can be difficult if both of you have completely different imbalances or constitutions. It’s a win if you love strict rules and are good at abiding by a list of do’s and don’ts.

[29:22] I go through the patterns of foods and symptoms depending on the body types, symptoms and deficiencies.  You can also download the food quiz here on the website for a further dive into what you should be eating for your specific constitution.

[29:51] In TCM, Chi is translated very loosely to “circulating life force energy.” Kidney Chi deficiency can range from not enough energy, feeling low mood or stagnant, lower back pain, and stale menstrual blood. Foods that are useful in building up the kidney energy include raspberries, seeds, and nuts, venison, and lamb, shellfish and such as basil, fennel, and horseradish.

[32:53] Spleen Chi deficiency can look like changes in appetite, bruising easily, excessive worry, and cramps that feel as though they are bearing down. It can lead to an inability to lose belly fat and water retention. You will want to avoid cold foods, deep fried foods, and dairy. Foods that help are cinnamon, clove, garlic, chestnuts, and all the foods in the kidney yung pattern such as shellfish, roasting chicken or lamb and roasted vegetables.

[36:31] Yin is responsible for moistening and cooling, and foods that rebuild these cooling fluids are things are fish dishes with coconut milk, omelets, sweet potatoes, duck, string beans, fruit smoothies. You want to avoid caffeine, alcohol, sugar and pungent spices.

[39:37] Liver Chi stagnation is basically stress and shows up by being prone to depression, irritability, and possibly nipple discharge which is a sign of high levels of stress and hormonal imbalance.

[41:09] Blood stasis or deficiency can show up as more anxiety or a low pain threshold, numb hands and feet, and fibroids or endometriosis. Foods that help to increase blood and decrease stasis include dark leafy greens, alfalfa sprouts, mushrooms, watercress, barley, apricots, kidney beans, mussels, oysters, tuna, and pate. If you are looking for a fibroids diet or an endometriosis diet make sure you look under the blood stasis category of the dowloadable TCM diet quiz.

 

References:

American Board of Oriental Reproductive Medicine

The Tao of Fertility: A Healing Chinese Medicine Program to Prepare Body, Mind, and Spirit for New Life,
by Daoshing Ni and Dana Herko

Sun Basket

Feed Your Fertility: Your Guide to Cultivating a Healthy Pregnancy with Chinese Medicine, Real Food, and Holistic Living, by Emily Bartlett and Laura Erlich

 

Continue Your Journey:

@ladypotions4u on Twitter

@ladypotions4u on Instagram

photo credit @BrookeLark

EPISODE 67 | IS ENDOMETRIOSIS THE CULPRIT TO YOUR INFERTILITY?

How to Manage Endometriosis Naturally & Enhance Fertility

Description:

Despite having been recognized within medical literature for over a hundred years, Endometriosis remains a very poorly understood condition. In today’s episode, Hillary discusses exactly what it is, why it takes so long to diagnose in the first place, how it can impact fertility, long term implications, and natural treatment options.

 

Takeaways:

[3:15] Endometriosis is an estrogen-dependent benign inflammatory disease. It affects women during their pre-menarcheal reproductive and postmenopausal hormonal stages. It is defined as the presence and growth of endometrial tissue in locations outside of the uterus. Displaced endometrial tissue responds to cyclical hormonal changes, proliferating and shedding outside of the uterus, and the bleeding is then accompanied by inflammation caused by irritation of local tissues such as the peritoneum.

[6:28] The most conservative estimate is that Endometriosis is estimated to affect approximately one in ten women of reproductive age, which is approximately 176 million women in the world. It’s considered one of the most common gynecologic problems in the U.S. and a leading gynecologic cause of both hospitalization and hysterectomy. This may be a conservative number due to the fact that so many diagnoses are missed in teenage girls.

[7:29] Initially, endometriosis was related to retrograde menstruation, but new theories have been launched, suggesting that chronic inflammation can influence the development of endometriosis because inflammatory mediators have been identified elevated in patients with endometriosis. It’s not clear if this is the cause or an effect yet.

[10:26] A few of the factors to developing endometriosis include an early period before the age of 12, short menstrual cycles, a D&C procedure, and a genetic predisposition. One of the main ways to diagnose it is through laparoscopic surgery.

[15:20] Signs and symptoms include killer cramping before or during the menstrual cycle that does not respond to treatment, severe backache, bloating, and chronic fatigue. Additionally, women may experience constipation, swollen abdomen, intestinal gas, depression, and insomnia.

[19:22] Given its association with chronic systemic inflammation and oxidative stress, it’s theorized that there is a link between endometriosis and an elevated risk of atherosclerosis and subsequent coronary heart disease. Interestingly, also epithelial ovarian cancers may be higher in women with a history of endometriosis. In nearly 8,000 women with EOC (epithelial ovarian cancer), women with a self-reported history of endometriosis had three times the risk of clear cell EOC and double the risk of endometrioid and low-grade serous EOC, but no changes in risk of high-grade serous, or mucinous EOC. Again, increased risk of ovarian cancer. And finally, and this is really interesting, women with endometriosis have a very clear increased risk of hypothyroidism, fibromyalgia, chronic fatigue syndrome, other autoimmune conditions in addition to Hashimoto’s, including systemic Lupus, MS, and Sjogren’s, and also atopic disease is also significantly more common in women with endometriosis than women in the general U.S. population.

[25:32] The holistic approach to dealing with endometriosis encompasses treating both the pain and the root cause.

[36:32] A few of the natural treatments include Devil’s Claw, Melatonin, Adaptogens, and Medicinal Mushrooms. Also, it is important to decrease or eliminate foods that cause inflammation such as a high amount of dairy and animal products. One also must detoxify their liver and reduce stress and environmental exposures.

[36:32] A diet similar to the Mediterranean Diet seems to do well for those with endometriosis, as the focus is on healthy fats, lean meats and plenty of vegetables.

[54:38] Other options and treatments include speaking with a professional practitioner about an IUD, acupuncture and getting a pelvic or abdominal massage. Many places will teach you the art of doing the massage technique on yourself so you can administer it on your own time.



 

References

  1. http://www.ncbi.nlm.nih.gov/pubmed/12790847

  2. https://www.ncbi.nlm.nih.gov/pubmed/30781885

  3. https://www.ncbi.nlm.nih.gov/pubmed/30359864

  4. https://www.ncbi.nlm.nih.gov/pubmed/30302765

  5. https://www.ncbi.nlm.nih.gov/pubmed/29873595

  6. https://www.ncbi.nlm.nih.gov/pubmed/29726290

  7. https://www.ncbi.nlm.nih.gov/pubmed/29610611

  8. https://www.ncbi.nlm.nih.gov/pubmed/21111655

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875884/

  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941414/

  11. https://www.ncbi.nlm.nih.gov/pubmed/15727565

  12. https://www.ncbi.nlm.nih.gov/pubmed/15727565

  13. https://www.ncbi.nlm.nih.gov/pubmed/26901277

  14. https://www.ncbi.nlm.nih.gov/pubmed/9660426

  15. https://www.medpagetoday.org/obgyn/generalobgyn/39127

  16. https://www.ncbi.nlm.nih.gov/pubmed/26247027

  17. https://www.ncbi.nlm.nih.gov/pubmed/17007852?dopt=Abstract&holding=f1000

  18. https://www.ncbi.nlm.nih.gov/pubmed/23865123

  19. Porpora M, Brunelli R, Costa G, et al. A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine. Evidence-Based Complementary and Alternative Medicine. 2013; April. Article ID 240702

  20. https://www.ncbi.nlm.nih.gov/pubmed/29944729

  21. https://www.ncbi.nlm.nih.gov/pubmed/30231769

  22. Aviva Romm’s Functional & Integrative Training Program

Disclaimer

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider.If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.




EPISODE 69 | THE FIFTH VITAL SIGN | Lisa Hendrickson-Jack

Master Your Cycle & Optimize Your Fertility

Description:

Lisa Hendrickson-Jack is a certified Fertility Awareness Educator, Holistic Reproductive Health Practitioner, and author of The Fifth Vital Sign. She joins the show today to speak with Hillary about using Fertility Awareness as a primary method of birth control, ovulation as a health marker, important things to know about hormonal birth control, and an evidence-based approach as to how to set ourselves up for success when it comes to our menstrual cycle and fertility tracking. They discuss the realities of the public education system regarding this topic, hear more about her Fertility Friday Podcast, and ways in which women can connect more with their cycle and fertility.

 

Takeaways:

[7:11] Lisa herself didn’t discover fertility awareness until about age 18 or 19, and even after that, there has been very little that has progressed in terms of teaching about menstruation and fertility in the public education system.

[9:12] Woman are often made to feel as though the menstrual cycle is something dirty or a nuisance that must be stopped or contained. Their concerns are dismissed and side effects which can be very serious and painful are diminished.

[12:26] Our ovulation is a marker of our health. In the same way that we have come to learn more about men’s health and their fertility being intertwined, Lisa and Hillary hope the same for the near future regarding ovulation and women’s health.

[15:58] Menstruation is a vital sign of what our body needs, how it is doing and is connected to many layers of health.

[24:54] The hormonal birth control pill stops ovulation to some degree, which dramatically reduces the natural production of our bodies estrogen and progesterone, and affects our free testosterone.

[27:02] Although how it plays out is different in everyone, all women who take hormonal birth control do experience effects in their hormones and organs.

[28:54] It is important for women to be upfront and aware of the side effects of the hormone birth control pill. Depression is a big one, along with mood swings.

[29:41] Research shows that hormonal birth control is associated with a temporary delay in the return of normal fertility. The shot is the worst offender, with other methods falling in after.

[33:56] Some women may hear about the side effects of hormonal birth control and decide it’s not for them, while others decide they will still use it but modify the use. Whatever choice that works best for you is the right one, but it’s important to be informed and aware.

[37:16] Birth control stops your normal cycle and replaces it with a fake one, but it doesn’t address or fix the real root of irregular menstrual cycles.

[45:12] Since birth control shrinks the ovaries, there is an established delay between when we come off birth control and when our body is normalized and fertile.

[52:35] There are many options for tracking our menstrual cycle and fertility. Because there is only about one week out of the month we can get pregnant, knowing this fact alone can be a total game changer.

[60:30] Devices such as wearable thermometers can be very helpful, but nothing trumps fertility awareness and training from a professional instructor. Much like learning to drive a car, it is a one-time investment that can lead to years of knowledge and empowerment.

 

References:

The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility, by Lisa Hendrickson-Jack

Fertility Friday Podcast

 

Continue Your Journey:

@ladypotions4u on Twitter

@ladypotions4u on Instagram

 

Disclaimer *

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

 

EPISODE 59 | COULD YOU BE A CANDIDATE FOR EFFORTLESS IVF? | Drs. Kathy & Kevin Doody

Description:

This week’s episode is all about innovation in IVF. The highly esteemed reproductive endocrinologists, Drs. Kathy and Kevin Doody came on to talk about their process of what they call “effortless IVF” and how it helps couples conceive. The Doodys talk about their clinic in Bedford, TX,  the specifics of their process, and the changes they have witnessed in over 30 years in the field of assisted reproductive medicine. In my opinion, their use of the INVOcell™ helps to make IVF as close to natural as possible. If you are someone that has hit a wall in terms of the all-natural route or is over the age of 35 and looking to check out your options, I highly recommend you have a listen.

To share your own fertility story, please email me at hillary@ladypotions.com. I look forward to connecting with you, as you are what this podcast is all about.

Takeaways:

[2:06] Dr. Kathy is board certified in Obstetrics and Gynecology and subspecialty board certified in Reproductive Endocrinology/Infertility. She has received multiple recognitions as one of Fort Worth's Top Docs, as well as one of Texas’ Super doctors. Dr. Kevin is is board certified in Obstetrics and Gynecology and sub-specialty board certified in Reproductive Endocrinology/Infertility. Dr. Kevin has received multiple honors as one of Fort Worth's Top Docs, one of Texas’ Super Doctors and one of the Best Doctors in America for the last several years. In 2017, Dr. Kevin was recognized with the Resolve National Infertility Association’s Hope Award for Achievement in recognition for his contributions. While Dr. Kevin was serving as president of the Society of Assisted Reproductive Technology (SART), he was instrumental in updating the SART National Summary Data to assist patients in making informed decisions about medical care. Dr. Kevin was also recognized as Microsoft Physician of the Year 2004. And they are married! Which is super cool.

[7:04] Their Center for Assisted Reproduction, CARE Fertility, in Bedford, Texas has an outstanding number of firsts in their location: the first ICSI pregnancy in the geographical area, they were first to successfully implement a blastocyst culture system, first in the world to use the INVOcell™ device in a blastocyst embryo transfer, and even trained the doctor in Virginia who helped the first same-sex couple both carry their baby.

[9:22] IVF, or In Vitro Fertilization, means that the egg is fertilized outside the body. ICSI, or Intracytoplasmic sperm injection, is the placement of a single sperm into the egg. It was invented in Brussels, and the Doodys were at the forefront of its discovery and implementation.

[10:36] A personal happy story! The Doodys had a hand in creating their nephew through ICSI.

[11:11] The INVOcell™ is a plastic capsule shaped like a champagne cork. It is an incubator and allows for the woman to provide the right environment and atmosphere for embryo development. It enters the uterus at the blastocyst stage.

[13:41] Dr. Kathy says it’s important for patients to understand why it makes sense to put the embryo into the body because it reflects what happens naturally in the different stages of ovulation.

[15:30] Part of the quality control is being able to make sure that the egg has normally fertilized, and it does take the place of IUI.

[17:47] The Doodys believe it is better to allow the natural competitive process when you can.

[18:20] Effortless IVF decreases the cost by about 50% and the amount of medication and monitoring that usually come with traditional IVF. The two main factors that are taken into account in a woman are her egg count, which is determined by her Anti-Müllerian Hormone (AMH) levels, and her body weight. The appropriate candidates need to have an AMH higher than 0.8, a body weight less than 190 lbs, and a BMI less than 35.

[23:40] There is a 59% success rate with frozen embryo transfers with no monitoring and transferring only one embryo in patients.

[26:41] The approach is closer to mother nature, as they are able to discern which embryo will transfer successfully.

[30:01] Dr. Kevin explains why the process is so streamlined from a laboratory standpoint, and the minimal interventions that take place in the process.

[33:21] Complex organic systems like variance and the human body is certainly an example of that.

[34:54] The INVOcell™ was founded by Dr. Claude Ranoux, a fertility specialist.

[36:47] This discovery has been a huge win for same-sex couples, as it is opening up new avenues and options for fertilization.

[41:02] Dr. Kathy’s advice for couples looking to conceive, is to realize you aren’t alone, and it is important to be proactive and seek out the options in your area. Dr. Kevin reminds us to not get discouraged, and not to let fear of failure hold you back. It is hard to give up control, and effortless IVF makes the appointments more convenient and less daunting.

 

References:

Fertile Minds on LibSyn

Fertile Minds on iTunes

@ladypotions4u

Center for Assisted Reproductive Care

American Society of Reproductive Medicine

Ep #30: “Male Infertility with Dr. Paul Turek”

Effortless IVF

“Comparing blastocyst quality and live birth rates of intravaginal culture using INVOcell™ to traditional in vitro incubation in a randomized open-label prospective controlled trial”

INVO Bioscience

@CareFertilityUS

 

Continue Your Journey:

@ladypotions4u on Instagram

 Disclaimer *

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 57 | A CONVERSATION ABOUT CYCLING WITH THE MOON | Sharna Langlais

Cycling With the Moon — What Does That Even Mean?

Description:

In this week’s episode, we welcome back the highly credentialed Reiki master and Meditation Facilitator Sharna Langlais, what moon cycles have to do with fertility, how you can work with the moon when it comes to your emotions and energy levels, and what exactly it means to cycle with the moon. We give you a brief history of how we have connected with La Luna over the years, ways to practice that honor and respect tradition of connecting with the moon’s deep energy, and a view of how to navigate the moon’s cycle with grace and ease.

 

To share your own fertility story, please email me at hillary@ladypotions.com. I look forward to connecting with you, as you are what this podcast is all about.

Takeaways:

[5:51] When Sharna talks about the moon with her clients, she also talks about the larger cycles of nature and the solstice energy that comes with releasing and shedding the old to welcome the new.

[7:15] Mercury Retrograde usually happens 3 times a year and is typically a 3-week cycle where Mercury appears to be going backward in the night sky. From an astrological standpoint, Mercury rules communication, travels and thought, and is thought to affect decisions, conversations, technology, etc. Sharna sees it as an opportunity to slow down and get more intentional to reevaluate and repurpose our life.

[13:54] As we cycle more with the seasons and look for the opportunities to connect to spiritual traditions, it even goes further back to times in history where we experienced cultural appropriation for our beliefs and traditions. Sharna would like to reframe “paganism,” not as a demonic and satanic term, but as a way to show that we are aligning ourselves with the elements of nature.

[19:28] Moving ourselves out of fear and into research is a huge element of growth and reclaiming information that was lost and taken away from women, from the structures of power and control.

[23:45] To Sharna, cycling with the moon is about being connected to nature, physical bodies and everything that feminine is about: mystery, chaos, observation, openness. Hillary thinks of it as a time when we are most fertile.

[26:35] White moon is the idea that you bleed at the new or the waning moon, and the period is a time and rest and recovery. The red moon means your cycle follows the full moon, and you are most fertile during the new or waning moon. In ancient times, the red moon cycle was said to demonstrate their creativeness outward, and they are focused on self-growth, mentorship, and creativity. The feminine energy allows us to observe and accept what our body is doing on any different day.

[33:40] One of the first things Sharna recommends to get aligned with the moon is just to observe what it is that is happening with their body for three cycles.

[36:11] In olden times they used to offer menstrual blood to the land and fertilize their plants with it. Sharna finds that the “messiness” itself is a feminine energy and our creative energy at our core. She also recommends charting our cycle, moon gazing and spending time with nature and trees.

[44:54] Sharna says all releases are good releases, no matter how society has told us to be shameful of them.

[48:89] The new moon symbolizes new beginnings, and it begins to wax or become fuller leading to when it’s at its fullest at the full moon. We are usually intention-setting around a new moon, and looking at what we would like to create over the next period. Traditionally, full moon cycles honor fertility and celebrate releasing what is no longer necessary.

full.png


[56:02] When you start to observe how the moon cycles affect your energy and period, it becomes fascinating to watch and plan life changes and interactions accordingly.

[58:53] The more Sharna does energy work, the less she finds herself affected by her menstrual cycle.

[63:07] Moon energy is feminine, and sun energy is masculine. Sharna compares it to a dance of two lovers.

 

References:

Fertile Minds on LibSyn

Fertile Minds on iTunes

@ladypotions4u

Sharna Langlais

Seek Spark Shine

Ep #055: “Could Your Fertility Challenges Be An Unexpected Spiritual Awakening?”

Kissing the Hag, by Emma Restall Orr

Miranda Gray

Ep #035 “Mastering Mindfulness During a High Risk Pregnancy”

Ep #037 “TCM Wants to Help You Conceive”

Sharna’s Full Moon Gathering

Leah Whitehorse

Continue Your Journey:

@ladypotions4u on Twitter

@ladypotions4u on Instagram

Disclaimer * You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.








EPISODE 51 | NATURAL BEAUTY PRODUCTS THAT WON'T WRECK YOUR FERTILITY PT2

Description:

Hillary first opens the show with an amazing keynote from her mentor, the late Ray Rubio from the Integrative Fertility Symposium last year. Ray shares a story about Dr. Shen, and why often times the simplest answer right under our nose is the one that will give us our answers. Then, she welcomes back her friend Katrina to share Part 2 of their top picks for yummy (and effective!) green and clean beauty products.

 Takeaways:

[4:10] Hillary plays a clip of a Keynote from the Integrative Fertility Symposium where her mentor, Ray Rubio, discusses the beauty of using common sense as a practitioner, and a story regarding his mentor Dr. Shen and the fashion icon Chanel.
[14:53] Hillary and Katrina discuss more of Katrina’s top picks!

Dry Shampoo (Katrina recommends putting it in our hair before bed instead of in the morning)

●      Kaia Naturals

●      Captain Blankenship

Shampoo

●      Innersense

●      Avalon Organics

Conditioner

●      Acure Conditioner

Body Wash

●      Aleavia

●      Saje Soap Bars

●      Meow Meow Tweet

Deodorant

●      Agent Nateur

●      Meow Meow Tweet

●      Kaia Naturals

●      Meow Meow Pit Primer

●      Once a week do an armpit detox with bentonite clay and apple cider vinegar mask to pull out all of the old aluminum. Leave it on for about 10 minutes.

Beauty Boxes

●      Beauty Hero

●      Art of Organics

●      Organic Bunny Box (@organicbunny on Instagram)

 

References:

Fertile Minds on iTunes

@ladypotions4u

Ep #049: “Part 1 of Natural Beauty Products Worth Your Money That Won’t Wreck Your Fertility” 

Integrative Fertility Symposium

Parents on Demand App

Disclaimer * You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 49 | NATURAL BEAUTY PRODUCTS THAT WON'T WRECK YOUR FERTILITY PT1

Natural Beauty Products that are Worth Your Hard Earned Pennies & Won’t Interfere with your Fertility

Description:

Today, Hillary and her friend Katrina talk about beauty products and how they could be interfering with your fertility. They list the top ten chemical and ingredient offenders (out of 1,300!) to look out for and avoid, give recommendations on natural beauty product and product lines, and share some practical ways to make small shifts away from slathering ourselves daily in a chemical cocktail. More women are becoming savvy as consumers, and aware of how much of an effect what we put on our body has in with what happens inside of it. 

Takeaways:

[1:37] The United States Federal Food, Drug, and Cosmetic Act (abbreviated as FFDCA, FDCA, or FD&C), has not been changed since 1938. Europe and Canada have higher regulatory standards, and hopefully, the United States will catch up in the close future.

[9:30] Top 10 ingredients we don’t want in our personal care products:

  1. Sunscreen Chemicals. Common Names are Benzophenone, PABA, Avobenzone, Homosalate, and Methoxycinnamate.

  2. Parabens. Parabens are widely used preservatives that prevent the growth of bacteria, mold, and yeast in cosmetic products. Read more on parabens.

  3. Synthetic Colors. FD&C or D&C represent artificial colors. F (food) and D&C (drug and cosmetics).  These letters precede a color and number (e.g., D&C Red 27 or FD&C Blue 1).

  4. Synthetic Fragrance.

  5. Phthalates. The main phthalates in cosmetics and personal care products are dibutyl phthalate in nail polish, diethyl phthalate in perfumes and lotions, and dimethyl phthalate in hairspray.

  6. Triclosan. Triclosan is a widely used antimicrobial chemical found in toothpastes, antibacterial soaps, and deodorants.

  7. Sodium Lauryl Sulfate (SLS) / Sodium Laureth Sulfate (SLES). This surfactant can be found in more than 90 percent of personal care and cleaning products (think foaming products).

  8. Formaldehyde. Formaldehyde and formaldehyde-releasing preservatives are used in many cosmetic products to help prevent bacteria growth.

  9. Toluene. A petrochemical derived from petroleum or coal tar sources and it can be found in nail polish, nail treatments, and hair color /bleaching products.

  10. Aluminum. Used in antiperspirants. Read more on aluminum.

[18:21] Now on to… what to actually use? Hillary’s friend Katrina Hall shares her evolution into natural beauty, and some of the top natural products she finds to be the ones she can trust the most with great results.

[22:55] Katrina’s gateway product was an oil cleanser from the Crude Personal line, and she still uses it to take off her makeup.

 Cleanser

●      Marie Veronique Gel Cleanser

●      Probiotic Skin Cleanser

Sunscreen

●      HYNT

●      Suntegrity

●      Marie Veronique

Foundation

●      Sappho Essentials Foundation

●      Crunchi

  Setting Powder

●      100% Pure Bamboo Blur Powder

Bronzer/ Contour

●      RMS

●      Lily LoLo

Brows

●      Ecobrow

●      Plume

Eyeshadow

●      Lily LoLo

Mascara

●      Tarte Amazonian Clay

●      Harvest

●      Fitglow Lash Serum

Eyeliner

●      ZuZu Luxe

Lip Gloss

●  Sign up for the newsletter & receive 15% off @    Fitglow Lip Serum

Chapstick

●      Zi Zai

Lip Sticks

●      Axiology

Lip Liners

●      Gabriel Cosmetics

●      ZuZu Luxe

References:

Fertile Minds on LibSyn

Fertile Minds on iTunes

@ladypotions4u

Think Dirty

EWG’s Healthy Living App

Parents on Demand App

Crude

thedetoxmarket.com

 

Continue Your Journey:

@ladypotions4u on Twitter

@ladypotions4u on Instagram

 Disclaimer *

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 43 | HOW TO REVERSE PCOS NATURALLY, GET HEALTHY & GET PREGNANT

Description:

September was PCOS (Polycystic Ovarian Syndrome) Awareness Month, so it is only fitting to do an episode centered around this condition. One in 10 American women, which is somewhere around five million women, suffer from symptoms on the PCOS spectrum. Today, we talk about what exactly PCOS is and the root causes, how the diagnosis occurs, the five Categories of Treatment, some myths surrounding it, and how you can go about reversing your PCOS in 9-12 months naturally.

To share your own fertility story, please comment below. I look forward to connecting with you, as you are what this podcast is all about.

Takeaways:

[2:12] Hillary shares her acceptance into the Women’s Functional and Integrative Training Program, offered by Dr. Aviva Romm. This is a huge honor, and Dr. Romm has been one of Hillary’s trusted teachers and an inspiration for shaking things up in the medical world and applying wisdom and evidence-based medicine.

[2:42] Just because something has been traditionally used, doesn’t mean it’s a good idea for us. Hillary gives examples of pharmaceutical debacles from the 1950s up until recently.

[6:52] Hillary recounts her experience with Accutane and the severe side effects.

[8:28] It’s important to know what you are taking, the potential side effects, and whether it is traditional or alternative treatment.

[10:46] How we take care of our bodies in the 12 months prior to falling pregnant has a huge impact on the next two generations. For the first time ever in the United States, children are being born with a lower life expectancy than their parents. And if we are sending down copies two generations at a time of our genes and we’re not teaching people how to ensure that these genes don’t trigger or mutate into various health issues, then we’re not actually practicing preventative medicine.

[12:11] In the U.S., one in 10 American women will have a diagnosis of PCOS at some point in their life, which is the equivalent of five million women. There are about 10 different types that can present and are not what a majority of healthcare physicians think of as PCOS. Usually, they consider it to be someone that’s overweight, with high testosterone, and a 2:1 LH: FSH ratio, and having cysts show on an ultrasound around the ovaries. But in reality, there are so many different presentations that it’s more like a spectrum with women being affected to different degrees causing different symptoms and severities.

[13:43] Although 85% of women affected with PCOS can reverse it naturally, a lot of physicians don’t look at it like it’s reversible.

[16:44] Polycystic Ovarian Syndrome was previously considered a gynecological problem, diagnosed on the presence of polycystic ovarian cysts by ultrasound. Now, it’s actually recognized as a complex endocrine disorder with multiple possible causes and clinical manifestations. Only one of those actually yields polycystic ovaries on an ultrasound.

[18:23] When women begin to understand that it was likely a predisposition was from their mother in utero, based on changes in the food supply, they can have a little more grace and compassion with themselves as well as motivation to try and stop it for the next generation.

[19:23] How is it diagnosed and what are the symptoms? PCOS is a clinical diagnosis and it is primarily diagnosed based on having some or all of the classic symptoms and having other medical conditions being ruled out. While testing the blood on day three, looking at the ratio between LH and FSH, estrogen and testosterone, can certainly be one of the ways that we diagnose PCOS.

[20:31] Traditionally, PCOS was thought to cause weight gain and abnormal hair growth from the excess testosterone, which does happen in one phenotype, but not all.

[21:30] Symptoms of Polycystic Ovarian Syndrome can include any of the following: infertility, irregular periods, lapses between periods for months at a time without being pregnant or breastfeeding, acne, weight gain, unwanted facial hair, hair thinning or hair loss, which oftentimes looks like male pattern baldness in PCOS, and then less commonly, you can have darkening of the skin in the armpits, the back of the neck or the groin. The other aspect to consider is that women with PCOS are also more likely to suffer from depression and anxiety, or they have eating disorders, particularly binge eating.

[23:31] You are 20 to 40% more likely to experience a miscarriage due to the insulin resistance and the hormonal problems that it creates. Oftentimes, there is estrogen dominance and there’s not enough progesterone to actually hold a healthy pregnancy. I do see a lot of chemical pregnancies or early stage miscarriages in women that maybe didn't even know that they had PCOS. But then after we do a little bit of deeper digging we find that they have these symptoms, and then it’s really important to control for blood sugar dysregulation as well as the hormones when they’d go to get pregnant again. Diet becomes super important in those women.

[28:00] You have to understand, the key is getting your blood sugar under control first, and the insulin resistance under control, before you start experimenting with the fasting. In terms of the science behind the diet, low inflammatory, low glycemic Mediterranean diet or a modified ancestral diet, meaning Paleo with lots of vegetables in it, not just all meat, has been the one that has been shown in the evidence to have the most dramatic effect on PCOS. And the bottom line is that most patients with PCOS will respond to a diet that is no more than 80 grams of carbohydrates a day and has about 60 to 90 grams of protein, and the rest being good fat.

[29:59] Vitamin D has been associated with insulin resistance in low amounts. Having your vitamin D tested to see where you’re at is super easy and then supplementing depending on how low you are, with 2,000 to 5,000 units a day, and then re-testing again in 30 to 60 days to see if it’s making a difference on the levels themselves can be really helpful. One of the supplements that Hillary uses when encountering a woman with diagnosed or suspected PCOS is inositol. Inositol comes in a couple of different forms and a lot of the studies that have been done actually show that it’s advantageous to have a combination of Myo-inositol with D-chiro-inositol, at a ratio of 40:1 of Myo-inositol to D-chiro-inositol. The reason for that is, it’s naturally occurring in the body in that ratio. With the Myo-inositol you want to take up to 4 grams a day and the D-chiro you can go up to 1,200 milligrams a day.

[33:19] Another herb or supplement that is used in blood sugar regulation is cinnamon and we use this all the time in Chinese medicine. In fact, the main formula by which most others are based on for treating PCOS is derived from is Gui Zhi Fu Ling Wan.

pcos insulin & HPA.png

[34:03] The second category to consider when treating PCOS is HPA Axis Dysregulation. Now, HPA Axis Dysregulation is the hypothalamus, pituitary, and adrenal axis. One of the biggest things that you can do for yourself is getting adequate amounts of sleep. The most restful hours of sleep for fertility are actually between 9:00 PM and 11:00 PM.

[40:43] Adaptogens are one of the greatest weapons we have, as they regulate cortisol and change our perception of stress. Adaptogens are ginseng, and things like ginseng, Rhodiola, Ashwagandha, licorice, Dang Shen or known as Codonopsis from Chinese medicine, milky oats, Schisandra, also known as Wu Wei Zi in Chinese medicine. Oftentimes if you pick up an adrenal axis formula or some are even named HPA Axis Formula, you will find that it’s a combination of these herbs.

[42:22] The only adaptogen that has been studied specifically for PCOS is licorice. Licorice tends to raise the blood pressure, so if you already have high blood pressure, this is one that you would want to avoid. And in terms of ginseng, even though it’s a great adaptogen, it’s very hot energetically. If you have a lot of symptoms of heat, you’re sweating at night, maybe you’re having hot flashes with it during the day as well. You’ve got red itchy skin, loose urgent bowls, ginseng is not the one for you, you would want something more cooling like Dang Shen. Dang Shen is often substituted for ginseng or Ren Shen.

[46:04] Not only do adaptogens regulate the cortisol, but they also help to regulate blood sugar and insulin.

[48:59] If you aren’t properly eliminating those toxins in your bowel, they circulate back around to your liver which only lessens your liver’s ability to get rid of excess hormones. Making sure that you’re having daily bowel movements and detoxifying to the best of your ability is super important. On the flipside, if the bowels are too loose and you’re seeing undigested food, you’re not absorbing everything that you should be from your food.

[52:46] The other aspect of gut health is leaky gut and that is caused by all kinds of pharmaceuticals, over-the-counter medications, antibiotics, improper gut flora, improper diet, and any major abdominal surgeries, including C-sections. You want to find out if there are any inflammatory food triggers — anything that is causing thinning or permeability of the gut. If you’re intolerant to gluten or dairy and you’re eating it every day, this can build so much inflammation that it eventually thins the lining of the gut, causing toxins to leak into the bloodstream.


pcos gut & toxin.png

[56:41] If you do have histamine intolerance, if you think you’re having an immune response to sperm or you suspect that, that’s part of your infertility, you could include strains in your probiotic that actually help degrade histamine and an overactive immune response, which would be Bifidobacterium infantis (this is found in breast milk), Bifidobacterium longum, and Lactobacillus plantarum. These are helpful as well as soil-based organisms, meaning prebiotics that act as a food source for the good strains of probiotics you are using, as these can help to lower the immune system response.

[58:09] The other category that needs to be considered when you’re cleaning up PCOS and trying to reverse it is environmental toxins and detoxification overload. Oftentimes, this is happening through your skin and beauty products, as well as your foods that are genetically modified and cause what are called xenoestrogens — bad estrogens — to dock in your hormonal receptors. These are huge causes of dysregulation, as are things like BPA, which is found in the lining of cans, so all those cans of tuna and LaCroix that you’ve been consuming thinking that you’re eating healthy, the BPA inside can be detrimental to your estrogen/testosterone balance.

[1:00:57] The last category: Energy production and mitochondrial function. If you are someone that has insomnia and or fatigue, this category is for you. There’s been evidence that’s been accumulating for the role of CoQ10 in the treatment of mitochondrial disorders and infertility for some time now.

References:    Fertile Minds on LibSyn    Fertile Minds on iTunes    Aviva Romm MD    Thalidomide    DES    Accutane    Gaia HPA Axis    Episode 7    Additional Research    Continue Your Journey:    @ladypotions4u on Twitter   @ladypotions4u on Instagram  My Website:  Ladypotions.com    Disclaimer *  You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

References:

Fertile Minds on LibSyn

Fertile Minds on iTunes

Aviva Romm MD

Thalidomide

DES

Accutane

Gaia HPA Axis

Episode 7

Additional Research

Continue Your Journey:

@ladypotions4uon Twitter

@ladypotions4uon Instagram

My Website: Ladypotions.com

Disclaimer * You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 41 | WHAT TCM HAS TO SAY ABOUT YOUR CYCLE | PT 2 Your Period & Aging

 

Description:

Our periods are signs of how we are interacting with our environment, both internally and externally, and a way for us to use certain signals for fertility. Today, Hillary talks about what to stop and consider about your own period, how to change the quality and quantity of your uterine lining, decreasing inflammation to help clotting and cramping, certain foods to build up the blood, and how to turn back the clock in aging. 

Takeaway:

[1:45] The symptoms of your period are not something to be flushed and forgotten. They are your body’s way of telling you that something is out of balance.

[2:36] The amount that you bleed is important and should be a steady flow with 1 or 2 days that are heavier, for a total of about 4 to 5 days. In order for the embryo to be nourished and grow, the lining has to be thick and well-vascularized. One important thing that often gets missed is the shedding of the lining every single month, so you don’t have old blood sitting on top of the lining. If you are a scanty bleeder, it is a good indication that your uterine lining is insufficient.

[5:26] Foods that help build up the blood include eggs with the yolk, clean sources of red meat, full-fat dairy and healthy fats such as seeds and avocado. It is also advised to not over-exercise during this time and resort to light stretching, walking, and gentle movement.

[6:53] The clot that you see in your menstrual blood has been forming way before you have your period. So what’s the problem? Implantation depends on establishing a healthy, thriving blood supply. But the whole job of a clot is to stop the flow of blood! A clotted uterine lining is one that is stale and stagnant. It doesn't have the fresh surface it needs to allow implantation to succeed at a high rate. It is important to stay away from inflammatory foods, and employ abdominal massage, and possibly employ a vaginal steam bath.

[9:29] When you feel cramping, it really is your uterine wall spasming. Severe cramping — also called dysmenorrhea — isn’t just a drag, it’s counter-productive for conception.

[11:07] It is common to have one day of heavy bleeding, but the other days should be more even with bright red blood rather than just one day of intense bleeding then right to spotting. Heavy bleeding can indicate an issue with spleen chi deficiency, where your body doesn’t have enough energy to open and shut the uterus and control the blood flow, leading to a feeling of strong fatigue.

[12:02] Red raspberry leaf may be used to tone your uterus, and then Cramp Bark when you are having your period. Some traditional Chinese formulas that include herbs from blood building and breaking categories.

[13:33] Many factors including diet, stress, environment, and even things we were exposed to while in utero can affect our eggs. Even more so for the eggs in our 120-day queue, for what’s called a germ cell to become a ripe and fertile egg.

Does age really matter when it comes to conceiving?

[15:13] You can turn back the clock. The Chinese had the idea of two ages which we can scientifically prove now using telomeres or a structure at the end of a chromosome. If you are interested in seeing what age you are according to this science, you can order a telomere test.

[16:28] The Chinese had a different take on the Western idea of the advanced maternal age of 35. They say men and women mature differently, and every 7 years for a female and 8 years for a male was a huge transition. Age 27 is when we see the first decline in FSH and AMH, two hormones that collectively approximate what a woman’s ovarian reserve is. There is an even more steep decline at 35, especially in egg quality increasing the risk for miscarriage or birth defect There is hope if you have waited! Egg quality can be positively affected by things like acupuncture, herbs, meditation, proper nutrition, and other various stress reduction techniques.

[18:31] Paternal age matters as well. You can reference a previous episode with Dr. Zev Williams from Columbia for more information on how much paternal age matters when it comes to single gene mutations that can cause things like autism, bipolar disorder, and other mental/emotional disruptions.

[19:02] There are categories of herbs that are said to have been taken by royalty because they were said to help them live forever. Zinc has been shown to help sperm fragmentation, and alpha lipoic acid has been touted to help egg quality in a woman of advanced maternal age when taken 3-6 months. DHEA is a precursor for the other steroids in our body, and studies have shown it helps the quality of the eggs. It is recommended to get your levels tested before taking this, and talk to your provider to see if it’s something to consider.

  

References:

Fertile Minds on LibSyn

Fertile Minds on iTunes

Ep #37 — Part 1

Ep #27 with Dr. Zev Williams

Art of Acupuncture  

 

Continue Your Journey:

@ladypotions4u on Instagram

 Disclaimer *

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 39 | CAN BLOOD SUGARS AFFECT YOUR FERTILITY & PREGNANCY w/ Lily Nichols RDN, CDE

This week, we are joined again by the very knowledgeable (and one of our most popular Fertile Minds podcast guests) Lily Nichols. Not only is Lily a devoted mom, but she is a stellar author and a registered dietitian/nutritionist with a flair for interpreting scientific data and applying it to the modern-day woman. She speaks with Hillary today on her work helping women learn how to prevent or manage their Gestational Diabetes. She also discusses how we test for it, what makes someone more susceptible to acquiring it, and what the long-term complications are for both mama and baby once they are diagnosed with it.

Lily presents a unique approach in helping women manage their diet and lifestyle in her bestselling books, Real Food for Gestational Diabetesand Real Food for Pregnancy.

Takeaway:

[2:13] Lily describes what Gestational Diabetes is and is not. It is a type of Diabetes that develops or is diagnosed during pregnancy. Typically, your body is having trouble processing carbohydrates, causing high blood sugar.

[4:06] Lily uses a hybrid approach when screening for Gestational Diabetes, mixing traditional glucose tolerance tests with discussing their diet and lifestyle choices.

[7:08] Diet and lifestyle are two factors we can be proactive about in pregnancy, as well as in pre-conception.

[8:26] We are seeing that even mildly elevated is an issue, so it’s important women find out early. 49 to 52 percent have either diabetes or pre-diabetes, and most of them have yet to be diagnosed.

[8:50] We want to use A1C readings in pre-conception and in the first trimester and after that look at blood sugars. If A1C has not gone down later in pregnancy, that is a warning sign that something is going on. We recommend getting an over-the-counter glucometer and monitoring your blood sugar at home first thing in the morning and one to two hours after meals to get an idea of how your body responds to specific foods.

DOWNLOAD BLOOD GLUCOSE TRACKER

[12:58] Lily discusses the acceptable levels of fasting and non-fasting blood sugars in pregnant women. We naturally see lower blood sugar levels in a typical pregnancy, along with changes in the significant thyroid and the burning of more fat to send fatty acids to the baby.

[17:32] During pregnancy, if your blood sugar levels are higher than normal, there is a direct line from you to your baby to via umbilical cord. There’s also a physiological reason that women may not feel like eating during pregnancy, to try and push towards ketosis. This makes sense as to why breastfeeding is the best diet ever, as it pulls all the fat to give to the baby.

[22:19] When we have been on a sugar binge and try to come off of sugar, that is happening to the baby the first couple days, so you can imagine how jarring that is until they re-regulate.

[23:34] Even with a diagnosis of Gestational Diabetes, the recommendation of allowable daily carbs is still very high. Lily observed her clients blood sugar getting worse when they followed the protocol and found that a lower level of carbohydrates is ideal.

[27:34] The second part of Lily’s research was looking at ketones and the different part of ketosis. The benefit of the ketogenic diet becoming popular is now there is more discussion on what it means to be in ketosis and what types of ketosis are safe to be in.

[33:39] Lily observes that most women gain their weight in the second and early third trimester and tend to level out unless there is fluid retention.

[36:06] The pancreas is not accustomed to pumping out a large amount of insulin consistently.

[39:11] While it may be annoying and tedious, testing your blood sugar levels daily is well worth it for acquiring interesting data.

[40:41] We discuss the risk factors of how blood sugar issues may affect our children’s fertility and generations down the line. What we may be seeing now may be the epigenetic effect from our low-fat diet from the 1980’s.

[45:21] As you tend to get beyond the 35 and 40 BMI, you do see more pregnancy complications and macrosomia with an epigenetic carryover effect through generations and beyond.

[48:59] People feel like they have acquired a disease, but really your body is adapting to the environment in which it is currently in.

[49:18] Plan of action:

●     Start monitoring A1C & post-meal blood sugars pre-conception, if possible.

●     Pull an A1C in the first trimester and if it’s suspect get in touch with someone like Lily to get it under control. Check out Lily’s books AND video course, or join her Facebook group.

●     Eat real food throughout your pregnancy and a reasonable amount of carbs that works for you.

●     Continue to eat the same way, maybe even more good fats while you are breastfeeding to enhance your breast milk.

●     Bring up your children on the same diet they were exposed to in utero and educate them about blood sugars and food in general so they can affect the next two generations in a healthy way.

 

References:

Fertile Minds on LibSyn

Fertile Minds on iTunes

Pilatesnutritionist.com

http://pilatesnutritionist.com/why-i-drank-the-glucola/
http://pilatesnutritionist.com/i-failed-the-glucola/

Gestational Diabetes Course

California Diabetes and Pregnancy Program

Real Food for Gestational Diabetes: An Effective Alternative to the Conventional Nutrition Approach,
by Lily Nichols

Does Gestational Diabetes Occur in Pregnant Mares?  

Twitter.com/LilyNicholsRDN

Lily’s Instagram

 

Continue Your Journey:

Link to sign up for free 29-day meditation challenge

@ladypotions4uon Twitter

@ladypotions4uon Instagram

Disclaimer * 

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 37 | WHAT TCM HAS TO SAY ABOUT YOUR CYCLE | PT 1 Timing, Length & Temperatures

I was listening to other podcasts as I often do, and one happened to be about the basics of TCM diagnosis. It dawned on me that I have yet to demystify this system of medicine that I love so much.  Today’s podcast is my attempt to explain some basic diagnostic terms in TCM, especially how they relate to your menstrual cycle and your fertility.

I believe that symptoms are God’s gift when it comes to figuring out what exactly is going on in your body. This reigns especially true when it comes to trying to figure out what exactly is happening internally when it comes to your fertility. If you’ve noticed subtle changes in your menstrual cycle in regards to timing, length or amount of bleeding and have wondered if this effects your fertility or how to rebalance it, this episode is for you. If you’ve ever had acupuncture and wondered what the heck your practitioner was referring to when they mentioned you had Kidney Yin Deficiency or Liver Qi stagnation, this episode is also for you. If you have considered getting acupuncture, but never really understood how it could help your fertility, this episode is for you. If you just want to know what your BBT or AVA charts mean through a lease of TCM and what to do about it, this episode is definitely for you. 

 

The Eight Principles (辩证) are:

1. Yin: Yin, along with Yang, is the most general classification for pattern diagnosis and it describes the relationship between the other three pairs of the Principles. Generally speaking, Yin is Cold and the fluids of the body.

2. Yang: Yang, along with Yin is used to describe the relationship between the other three pairs of the Principles. For example, Heat is Yang or the energy / Qi of the body. 

3. Interior: Interior describes diseases that manifest themselves in the Zang-fu organs or deep inside the body, such as Qi, blood, and bone marrow. In menstrual terms, this may mean scanty menses,  late menarche, or erratic cycles in general. 

4. Exterior: Exterior describes diseases that manifest themselves on surface of the body, such hair, skin, nails, and meridians. In menstrual terms, this may mean the symptoms of external pathogen that has invaded the body, like an STD that presents with a rash.

5. Heat: Heat describes the absence of an aversion to Cold. In menstrual terms, it can mean BBTs above 98.2, high temps above 97.2 in the follicular phase that provoke early ovulation, or cramps that do not respond to a heating pad. 

6. Cold: Cold describes an aversion to Cold. In menstrual terms, we see it as low BBT temps, dark blood with pain, or menstrual cramping that responds to a heating pad.

7. Deficiency: Deficiency is used to describe a vacuity in Qi, blood (Xue) or body fluids (Jinye).  In menstrual health we see it as cramping that gets worse as the period goes on, low temps on a BBT, short luteal cycles meaning Kidney Yang Deficiency or short follicular cycles meaning Kidney Yin Deficiency.

8. Excess: Excess is generally classified as any disease that can't be identified as a Deficiency pattern. Usually, it means that one of the Six Excesses is present. In menstrual health we may see it is as STD, yeast infections, bacterial infections,  growths (like fibroids), certain types of PCOS that involve the concept of phlegm and dampness, or even in certain presentations of endometriosis. 

It’s important to decipher if an imbalance is truly excess or deficiency because it will often mean completely different herbal preparations to balance the body. 

 

After a basic diagnosis of the diseases is given via the Eight Principles, the diagnostic continues and focuses on more specific conditions. After evaluating the present symptoms, a person’s condition is further evaluated as to how the specific entities (Qi, meridians, Zang-fu, etc.) are affected. This where we start to get into concepts like stagnation. You may hear about blood stasis or Liver Qi stagnation, where flow is disrupted. We still have to use the above pillars to decide if it stagnated due to deficiency or excess, but knowing what organ it is affecting by asking questions helps us to target the herbal formula to a greater degree and ensure the system is balanced. 

Causes of Imbalances

Traditional Chinese Medicine does not strongly differentiate between the cause and effect of a disease. However, there are three major categories that are considered to give rise to disease. The three major categories of disease causes are:

1. External: Disease caused by the Six Excesses. These have to do with the environment in which we live,  too much cold, too hot of environment, too damp of an environment, too dry of environment. For example; I reside in South Florida and it’s currently August at the time of this taping. It isn’t just hot out, it’s downright slimy. For a male that has worked outside all day, he might be exposing himself to super high temperatures all day long and  that could drastically affect his quality and count of sperm. 

2. Internal: Disease caused the by Seven Emotions or Seven Affects: Anger, Fear, Anxiety, Fright, Grief, Pensiveness, and Joy. These are said to affect the Zang-fuorgans. Constant high stress without a constant relaxation response have been shown to negatively impact sperm and egg health as well as ovulation.

3. Other Irregularities: Disease caused by something that is neither external nor internal, such as having unbalanced diet, damage done by parasites or in this day & age- toxins. In modern day you could think of this as the quality of the food we eat, and what toxins we are exposed to including those we slather on our skin in our beauty products. This is often the one cause of imbalance that we have the most control over. 

Timing Matters and How Do You Time a Cycle Anyways?

Ideally a menstrual cycle (from the start of one period to the next) is 28 days, the same as a lunar cycle. It's not uncommon for cycles to shift in accordance to new moons, full moons, changing time zones with travel, or with extreme stress or changes in diet, but when it comes to your fertility, the length can have a huge impact, in some cases it can decrease your chances of conceiving by up to 50%. 

Length Matters

Length of your cycle as well as how long you bleed for equally matter but for different reasons.  

Three main consequences of shorter cycles include lower egg quality, inability to sustain a pregnancy, and early ovulation.

Temperature matters

Most couples are shocked when they have a miscarriage. They are often even more shocked when they find out the chances of having one for any healthy couple is 30%. The good news is, that by simply tracking your basal body temperatures and waiting to conceive the following cycle after a "healthy" one is detected you can drop your chances of miscarriage to less than 5%.

* healthy cycle means having an average of 97.2 BBT in the follicular stage of the cycle and an average of 98.2 BBT in the luteal cycle, with a mid-cycle ovulation and a luteal phase lasting at least 10 days.

Did you know that you could get the same custom herbal formulas I use with my acupuncture
clients, shipped right to your door? When you sign up for a 3 Month
Subscription, your evaluation is free, a $100 value, and you receive email access to ask me
any questions you have pertaining to your fertility.

Links to take you further

Episode about Cervical Mucus

LadyPotions.com/episode27

Artofacu-stpete.com

https://www.ncbi.nlm.nih.gov/pubmed/16357595

Disclaimer :

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider.If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 31 | REAL FOOD FOR REAL PREGNANCY w/ Lily Nichols RDN, CDE

How to Feel Good, Build a Healthy Baby and Avoid Gestational Diabetes

Description: Today we welcome Lily Nichols, Registered Dietitian, Nutritionist, Certified Diabetes Educator,  researcher and an author with a passion for evidence-based prenatal nutrition and exercise. Lily draws from the current scientific literature and blends it with the wisdom of traditional culture and nature. We talk about the Western expectation of women managing it all directly after pregnancy and giving birth, and Lily’s prescription for healing and self-care. She shares how she began backing philosophy with results and clinical data to author two of her groundbreaking books, Real Food for Gestational Diabetes and Real Food for Pregnancy. She also gives some of her top picks for pregnancy food, embracing mindfulness, and how she feeds her family for months at a time using only two animals. Let your intuition guide you, and then use Lily’s book to prove these decisions with scientifically proven data.

Get the first chapter of Real Food for Pregnancy Free

To share your own fertility story, please email me at hillary@ladypotions.com. I look forward to connecting with you, as you are what this podcast is all about.

 

Takeaway:

[2:26] Lily wrote Real Food for Pregnancy when her son was 10 months old, and she herself was healing from pregnancy and birth.

[3:48] Lily encourages prioritizing food and self-care at all stages of pregnancy, including the preventative stage prior, and the fourth trimester, the postpartum months.

[7:38] It was almost by accident that Lily got into the nutrition field. She was looking for a part-time role in the nutrition field that did not include a hospital, saw an opening for California Diabetes and Pregnancy Program and starting working clinically in Gestational Diabetes. As she implemented the nutrition element of the protocol in the clinic, she noticed a lack of improvement. The common sense side of her observed the current guidelines didn’t emphasize real foods, and were pretty high-carb.

[8:47] Women with Gestational Diabetes are often not able to tolerate large amounts of carbs without elevated blood sugar. These findings led Lily down the path of researching a low carb and nutrient dense diet from real foods. She started using it clinically and knew she was on to something with excellent results. This led her to author her first book, Real Food for Gestational Diabetes. This changed the course of how many viewed their philosophy in the nutrition and pregnancy field.

[14:38] Lily comes at the information from a proactive and informed outcome, not a fear-based one.

[18:12] Lily shares some sample meal plans compared to the current recommended ones, and the breakdown of the ratio between protein, carb, etc.

[21:20] Carbohydrates are in many vegetables and fruits.

[22:07] There is very little nutrition education for MD’s, and much of what they are learning is outdated. One example is the hesitancy for the low carb diet due to ketones in the urine. A ketogenic diet could be a safe option during pregnancy, as a woman’s body often dips into ketosis naturally during pregnancy.

[24:27] Organ meats and liver are the most nutrient dense parts of an animal. Supplying a high amount of iron, choline and B12, Lily supplies recipe ideas in her books on incorporating it dishes, so you aren’t eating a whole plate of just liver.

[35:07] When choosing animal products, Lily is a proponent of choosing the highest quality and best sourced meat. Nothing goes to waste and she encourages families to purchase from a farmer and utilize the whole animal.

[38:57] Even the most culinary-challenged person can develop basic skills to make a flavorful and nutritious meal.

[45:14] Lily gives us some good news — her opinion is that small amounts of caffeine are okay. A lot of the foods that are mentioned to avoid due to food borne illness are also ones that provide critical nutrients. She suggests eating foods sourced from high quality places, and the risk is extremely low. 

[52:58] Eating well is one of the ways we can be mindful in pregnancy. Mindful moments, spiritual self-care and moving our body are also key elements to keep our body aligned through the process. It’s not about pushing and resisting, it’s about being mindful and going with the flow in a gentle. guided way.

 

Continuing your journey:

Lily Nichols Blog

Real Food for Pregnancy- amazon

Real Food for Pregnancy — Get the First Chapter Free 

Gestational Diabetes info and course by Lily Nichols

Real Food for Gestational Diabetes

California Diabetes and Pregnancy Program

@lilynicholsrdn on Instagram

@ladypotions4u on Twitter

@ladypotions4u on Instagram

American Board of Oriental Reproductive Medicine

Disclaimer * 

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 30 | MALE INFERTILITY w/ Dr. Paul Turek

Could IVF Be Good For Men's Health?

Maybe, If That’s the Only Thing That Gets Them to the Doctor to Check Their Overall Health Status!

 

World-renowned reproductive urologist Dr. Turek joins us today. He has been at the forefront of IVF and ICSI since the early 90’s. He shares the latest happenings in both his research and his clinics in San Francisco and Beverly Hills, along with the ways Eastern Medicine compliments Western treatment, his thoughts on prenatals, single gene vs. chromosomal gene mutations, the sobering reality of advanced paternal age and some groundbreaking discoveries that are both provocative and backed by science. He is a soulful and lighthearted clinician and is committed to making things as easy and relatable as possible for his clients.

Takeaway:

[:01] Dr. Turerk advises the ABORM board that I am a fellow of, and is a graduate of both Yale and Stanford University. He teaches at Yo San University and has countless studies he has both authored and advised. The first time I heard him speak at the International Infertility Symposium in Vancouver in 2015, I was blown away. He was so intelligent and generous with his ideas and research and really was the first person that made male fertility issues relatable to me.

[3:01] Dr. Turek explains his comparison of a semen analysis to a game of cards. When the motility is not normal, that is an indicator to him that something isn’t right.

[9:18] The whole story is not all about the semen analysis, but it’s a good way to begin the conversation of man’s habits when it comes to diet, recreational drug use, lifestyle, weight, etc. Dr. Turek is captivated by the thought of going into a deeper dive of the cause behind the semen’s quality and performance.

[11:17] As a TCM practitioner, I feel like I was taught about epigenetics with different languaging, referring to our Jing or essence being affected by our lifestyle dictating what we will pass down. Dr. Turek confirms that science has proven it correct in epigenetic studies that lifestyle really does matter.

[14:02] Dr. Turek explains what epigenetics is, and how he helped to develop Episona, a test for epigenetics and sperm quality through sperm analysis.

[17:15] We discuss how epigenetics may be related to oxidative stress. Oxidative stress is about 30-80% of the cause of male infertility.

[18:05] The data for men taking a prenatal is very strong, and is something Dr. Turek recommends and actually developed a supplement for men. The data is still getting more compiled on this, and the research in the field is still new and emerging. Men are not the easiest subjects to keep engaged in study, however, and he is committed to making it easy and sensible for them to share information and data in his studies.

[25:34] The richest man in America lives 5-7 years less than the poorest women. Dr. Turker has an attitude of wanting to engage men and building their trust so they are part of the solution in making their own health better. One of his main goals out of his career is to have men live longer.

[27:25] Dr. Turek shares the current state of advanced paternal age. Himself and co-author Alex Yatsenko published a review entitled, “Reproductive Genetics in the Aging Male” This is a recent problem, as we haven’t lived this long, people are waiting longer to reproduce and we are exposed to more toxicity than ever, affected our epigenetic expression.

[32:56] Dr. Turek talks about the chromosomal issues that occur in women, vs. the single gene mutations in men. He also addresses birth defect rates differing in other countries, and if low sperm counts are being passed on through generations.

[43:33] Dr. Turek has created what I think to be the first Natural Selection Obstacle Course for sperm .

[54:14] A lot of unexplained infertility can be cleared with a simple visit to a trusted source. Dr. Turek makes it as easy as possible and does virtual consultations. He likes to first see if it’s a good fit, and speak with both partners at the start to select the appropriate care for their situation.

[56:57] Work with what you have. IVF could be good for men's health if that's the only time you get them to the doctor and you work with a responsible physician that views an abnormal semen analysis as a marker for health and goes looking for the cause of that poor semen analysis. 

[60:40] Clinic by the Bay, Dr. Turek’s free clinic, just had a big fundraiser to help people from all walks of life receive medical care.

 

References & Links to Take You Further:

American Board of Oriental Reproductive Medicine

Reproductive genetics and the aging male https://www.ncbi.nlm.nih.gov/pubmed/29524155

Turek on Men’s Health Blog

Turek Clinics

Episona

Clinic By the Bay

Yo San University

@ladypotions4u on Twitter

@ladypotions4u on Instagram

 

Disclaimer * 

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 28 | FERTILITY HOPE IN THE FACE OF CANCER w/ Alice Crisci

MedAnswers with Alice Crisci

Today’s episode is full of hope and maybe even some perspective changers for some of you, especially when it comes to what you can handle at once. Our guest today is Alice Crisci. She is an author, fertility preservation spokeswoman and social entrepreneur, and most importantly, a mother on a mission. Her story is incredible. I talk with Alice about the non-profit she founded, Fertile Action, for fertile women touched by cancer, along with her new app MedAnswers, that seeks to connect patients experiencing fertility challenges, oncology issues, or even genetic questions with industry vetted experts.


Within weeks of her own breast cancer diagnosis, Alice harvested her eggs to protect her opportunity to become a mom after surviving cancer, had a nude photography session, launched Fertile Action and published her first book, Too Young for This. She is a game changer in legislation and technology, and an inspiration for women looking for expert education, support, and courage.

Takeaway:

[3:43] Within a few weeks of her diagnosis, Alice learned about the scariest potential side effect of breast cancer and it’s treatment: infertility. Egg freezing was still considered experimental, and she needed more insurance than just a 2-3% chance. She then realized embryo freezing was a better way to go, and continued down her path to single motherhood and faced with the tough decision of picking a donor, all while dealing with the severity of her current diagnosis.

[9:59] When picking a potential donor, Alice encourages women to be truthful with who they are, and who they see themselves with. Be specific and rule out any health history concerns that matter to you. Alice picked a donor that spoke to her and matched her own internal values, as it was important that her child know the story of both sides having grit and tenacity.

[17:44] Alice is on a private Facebook group with other families that used the same donor that she used for her son, and she calls them his ‘diblings.’ They share anecdotes and stay connected.

[18:20] Due to all the genetic testing that is available, open donorship has become way more prevalent and necessary.

[21:43] Alice developed her non-profit Fertile Action as a way to take on insurance coverage and a fee reduction for women who found themselves in fertility preservation cases. She created a network of discounted fees for cancer patients and found it required a large amount of effort and resources.

[24:39] Alice gives recognition to the legislators who also helped take Fertile Action and their partnered organizations as their cause.

[27:03] Alice has now turned a major part of her attention and focus on the app MedAnswers. This helps to connect those struggling to conceive with seven different types of fertility experts. Digital tools are critical, especially when facing a health crisis and MedAnswers is a way for women to connect with experts while maintaining anonymity.

[33:46] Both Alice and I are big proponents of empowering people with data about their own bodies, and not waiting until it is too late to have information.

[35:49] Alice brings up a very interesting point about sex education benefiting from being more about reproductive health than the current topics of just pregnancy prevention.

[36:08] Alice created a webinar just for Californians when it comes to insurance and the appeals process.

 

References and links to take you further:

Fertile Minds on LibSyn

Fertile Minds on iTunes

American Board of Oriental Reproductive Medicine

Fertile Action

MedAnswers

Dr. Paul Turek 

Alice Crisci on Huff Post 

Too Young for This 

Egg Whisperer

Helix.com

@InfertilityAnswers

 

Continue Your Journey:

Link to sign up for free 29-day meditation challenge

@ladypotions4u on Twitter

@ladypotions4u on Instagram

Disclaimer *

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.

EPISODE 27 | ADVANCEMENTS IN TREATING RECURRENT PREGNANCY LOSS | Dr. Zev Williams, M.D, PhD

Today’s episode features Zev Williams, M.D., Ph.D. He is the Chief of the Division of Reproductive Endocrinology and Infertility and an Associate Professor of Obstetrics and Gynecology at Columbia University Medical Center and is a nationally-recognized clinician and researcher in the area of recurrent pregnancy loss and infertility. Not only is he one of the most brilliant minds I’ve had the pleasure of interviewing, he is incredibly humble, gracious, and passionate about his work. His intentions to help couples overcome recurrent pregnancy loss by building healthy happy families came through so clearly during this chat.

We touched on why miscarriage rates are so high and why the public has false perceptions about it being a rare event. He spoke about how his research has even uncovered a way to find out if the cause of a miscarriage was chromosomal even years after the fact in some cases. He explained the differences in PGD and PGS testing when using IVF and when and for whom it might be highly beneficial. We also spoke about MTHFR gene mutation, and what it really means in regards to treatment strategy and further testing. We even touched on his work with stem cells and the potential they have for one day helping women who experience premature ovarian failure to overcome this devastating diagnosis. He explained new ways to treat endometriosis and preserve fertility and new ways to diagnose PCOS. 

Takeaway:

[1:15] Dr. Williams completed his M.D. and Ph.D. training in Molecular Biology and Biochemistry at the Mount Sinai School of Medicine before continuing to the Brigham and Women’s Hospital/Massachusetts General Hospital for his residency in Obstetrics and Gynecology. After completing his fellowship in Reproductive Endocrinology and Infertility at Weill Cornell, Dr. Williams then did a post-doctoral fellowship in RNA biology in the laboratory of Dr. Thomas Tuschl at Rockefeller University.

[1:45] Dr. Williams has also achieved success in federally-funded research projects in several different areas of study, having received numerous NIH grants to support his work. Currently, as part of an NIH R01 grant, Dr. Williams is engaged with a research project intended to use placental RNA as a screening tool for diseases and complications of pregnancy, to enable early intervention, and to provide insights into disease pathogenesis for things like pre-eclampsia.

[4:35] Dr. Williams works with couples and doctors all over the world, and the research that he and his colleagues find benefits those all over looking for answers on fertility.

[5:16] The PEARL Program that Dr. Williams started stands for Program for Early and Recurrent Pregnancy Loss. It is one of the only centers in the world that is both clinically focused, and a basic/translational research program dedicated trying to understand what causes unexplained miscarriages and trying to find ways methods to prevent them in the future.

[12:22] One of the realities of human reproduction is that is a very inefficient process. Of the eggs that get fertilized, very few result in a live birth.

[19:22] Dr. Williams explains the difference between PGD and PGS testing when using IVF, and who may benefit from these tests.

[26:54] We cover the MTHFR gene mutation and antiphospholipids, and what it really means in regards to treatment, strategy, and further testing.

[32:45] Dr. Williams explains the work on helping the brain to produce its own FSH (follicle stimulating hormones) which is the bodies own version of that hormone compared to traditional injections with his CORAL IVF which is an oral IVF requiring only one shot instead of 30.

[41:23] Dr. Williams shares the new ways to treat endometriosis and preserve fertility and new ways to diagnose PCOS.

[45:27] Diet is, of course, important to overall health, but also very important to pregnancy success. There are some factors that lead to Dr. Williams’ recommending a diet low in carbs and sugar.

[46:12] Egg freezing has become successful, but the challenge is that often women are thinking about freezing their eggs in their 20’s when the eggs have already lowered in quality. And fertilized eggs freeze better than eggs which require a partner.

[49:58] Once you are trying to conceive (and of course through all of the process), make sure to support each other. It’s a tough journey and you want to be going through it together.

Take the Fertile Minds Meditation challenge and see what a fertile mind feels like. Each day you’ll receive access to a 15 minute guided meditation designed to yield more clarity and calm no matter where you are on your path to building a family.

If you are feeling frustrated and wish you could experience feeling more patient this challenge is for you.

If you are finding yourself resentful and want to feel empowered instead this challenge is for you.

If you are feeling lost and overwhelmed with all things fertility and long to be more centered during the process of striving for a family this challenge is for you.

If you’ve wanted to add meditation to your self care routine but had no idea where to start this challenge is for you.

You'll learn how to shift your attention from the future to the present moment helping you to feel more fulfilled and patient with the process, your life, your partner and maybe even God.

You won't know though until you commit to the challenge. I'll be there with you every step of the way, one complete menstrual cycle, until it becomes your new favorite habit. Meditate, Listen, Trust, Repeat

References:

Fertile Minds on LibSyn

Fertile Minds on iTunes

American Board of Oriental Reproductive Medicine

Dr. Zev Williams 

Dr. Zev Williams Bio 

Columbia University Department of Obstetrics and Gynecology  

Efficient Differentiation of Steroidogenic and Germ-Like Cells from Epigenetically Related iPSCs Derived from Ovarian Granulosa Cells

FMR1 targets distinct mRNA sequence elements to regulate protein expression 

Nytimes.com/2015/11/26/health/progesterone-may-not-help-women-with-history-of-miscarriages-study-finds

Huffingtonpost.com/science-of-us/miscarriage_b_8000760.html?ncid=txtlnkusaolp00000592

Wsj.com/articles/solving-the-mystery-of-miscarriages-1434389396

Columbiaobgyn.org/profile/s-zev-williams-md

Ncbi.nlm.nih.gov/pubmed/26000502

Nyp.org/enewsletters/advances/2018/gynecology/2018-Advances-Gynecology-Issue1.html

Continue Your Journey:

Link to sign up for free 29-day meditation challenge

@ladypotions4u on Twitter

@ladypotions4u on Instagram

 

Disclaimer *

You must not rely on the information in this podcast as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website or in this podcast.


EPISODE 25 | USING CERVICAL MUCUS TO PREDICT HIGH FERTILITY WHEN TTC

Fasten your earbuds, as our topic is rarely talked about but very important from everything to our fertility, overall health, and sexual pleasure. We talk about what the difference is between cervical mucus and vaginal discharge, how to keep our environment alkaline, the four types of mucus, ways around a hostile cervical environment, medications that can impair fertile mucus and herbs and practices that can help restore them, and why Mother Nature is all about timing.

Takeaway:

[3:30] CVM is a type of vaginal discharge that signals that high fertility is approaching. There are four types of vaginal discharge that you can notice and they will coincide with the subjective observation of dryness or wetness around the vulva.

Is it Vaginal Discharge or Cervical Mucus? How to tell

 

[4:32} All mucus is a response to the amount of estrogen being produced by the woman’s body. This is why it hopefully begins to increase about 6 days prior to ovulation as the estrogen is rising and peaking.

[6:03] I cover what different mucus consistency means, and how the pH and quality of the cervical mucus need to be just right in order for the sperm to survive their long journey to the egg.

[9:14] Steroids may help stop sperm antibodies, but they can cause huge side effects like adrenal fatigue, especially when used more than once.

[10:32] The four types and descriptions of mucus as they relate to ovulation and the fertility cycle: G-mucus, L-mucus, S-type mucus and P-mucus.

[14:31] Some medications that can impair fertile mucus: birth control, antibiotics, NSAIDs such as aspirin and ibuprofen, antidepressants (SSRI), and the fertility drug clomiphene/clomid.

[20:02] : Water and staying hydrated, exercise that is not dehydrating, Shatavari Root, Dang Kuei, Ashwagandha, Omega 3 supplements, L-Arginine, probiotics with lactobacillus, licorice root, red clover blossoms and vaginal steams.

[26:20] Your cervix changes shape and position with your cycle. The ligaments that support the uterus respond to the peak of estrogen that happens just before ovulation by tightening. After ovulation, the position of the cervix is once again low in the vagina and can be easily palpated.

 

Links or Mentions to take you further. 

episode 23 basal body temp

episode 18 lab values explained in plain english

episode 13- vaginal steams

episode 7- avoiding burnout

EPISODE 23 | WHAT YOUR BASAL BODY TEMPERATURE (BBT) CAN & CAN'T TELL YOU ABOUT YOUR FERTILITY

Description: Today’s episode is going to uncover what your basal body temperatures can and can’t tell you about your fertility. There is a ton of information regarding this topic, so by the time you are done listening to today’s episode, I want you to feel confident and motivated about tracking your BBT and working with your practitioner on what it means for you. We will talk about why you should take your temperature, how to do it and then track it correctly, how to use the different methods to your advantage, and the benefits that come from tracking it.


Takeaway:

[2:14] When it comes to tracking BBTs or what is known as Basal Body Temperatures, I’ve had two main teachers — Jane Littleton and Kirsten Karchmer from Of Conceivable. Both are a wealth of information when it comes to using and INTERPRETING this technique. Fertility charting is an excellent way to gate what exactly is happening all month long, hormonally, in your body.

[2:57] Many times when a patient comes to my office they have done BBT in the past and are fed up either with the stress it causes or they have no idea how to read it. This leads to them wanting to dismiss doing it all, or maybe they have had an MD of some sort tell them that it’s pointless and they should move on to something like IUI or IVF if they want results. I’m here to tell you that’s not always the case.

[4:12] When a woman walks into my office with 3-6 months of charts either on paper or in an app I know in all likelihood she has just sped up her chances of conceiving with Chinese Medicine. This is also a way I know how and when to fine tune her herbs, recommend lifestyle and diet adjustments and even when there is a greater chance of miscarriage after a positive pregnancy test. This gives many women increased peace of mind that they able to keep an eye on the miracle that is unfolding within them without any invasive treatments. The other positive reason I recommend charting your temps is that it can be greatly empowering to understand what is having an effect on your body, like alcohol, caffeine, or even certain foods.

[8:17] Calendar rhythm method: Consists of using past menstrual cycles to estimate the time of your ovulation. When used on its own, this is the least reliable method of birth control. It should be avoided if your menstrual cycles are shorter than 26 days or longer than 32 days.

[8:42] Temperature method. You track your BBT for several cycles by using a very sensitive basal thermometer to take your temperature before you get out of bed each morning. Due to hormonal surges, your BBT goes up right after ovulation.

[9:10] Cervical mucus method. You track the color, thickness, and texture of your cervical mucus to monitor your fertility. Your cervical mucus becomes thinner, slippery, and stretchy when you ovulate. Tracking your cervical mucus will require some practice.

[10:14] I cover how to take your BBT:

  1. Take your daily temperature first thing upon awakening, before any other activity (going to the bathroom, talking on the phone, etc). The exception is 16 seconds of focused breathing referenced in episode 22.

  2. If using a digital thermometer, wait about 30 seconds until it beeps. Keep the receipt and return if you think the battery is faulty.If using glass, leave it in 5 minutes.

  3. You can take your temperature orally or vaginally, but always make it from the same place. Pick one and stay with it.

  4. Try to take it at the very same time each day right when you wake up.

  5. Make sure you get a minimum of 3 hours consecutive sleep before you take the temperature.

  6. If you use a glass thermometer, shake it down the day before.

  7. If you wake up at 5 and then plan to get up at 7, take your temperature at 5, when you wake up. Most digital thermometers will keep the temperature on it until the next use.

[14:38] When charting your temperature, you can use paper or an app. Some that I like are Fertility Friend, Conceivable, and Glow. If the temperature falls between two numbers on a glass thermometer, always take the lowest. Make dots on the appropriate temperature and connect the dots with straight lines. Note events such as stress, or illness in the miscellaneous row. Temperatures taken late should be noted in the ‘time taken’ row. 

[16:36] We cover what BBT tracking can and cannot do. It cannot tell you about your partner’s fertility, nor is it great at predicting ovulation.

[17:50] Don’t freak out if you don’t get every single day. As a practitioner. I am looking for the average in the follicular and the average in the luteal phase. It takes about one season (3 months) of working with someone to make a 50% increase in their chances of fertility.

[19:57] We cover the bleeding, follicular, ovulation and luteal phases and what I look at within each one.

[25:18] If temps are at 98.2 in the luteal phase, your miscarriage chances will drop from 30 percent to 5 percent the following cycle.

[29:16] I go over some patterns that we see in BBT and the phases, and how I as a practitioner use this information to work with the patient.

[34:12] One reason someone wouldn’t want to track their BBT is when they are taking progesterone supplements, as it affects the temperatures and if it stresses you out completely my suggestion is to meditate directly after. And if that’s still too much for you or you travel a lot or you aren’t able to wake around the same time most days due to life constraints I encourage you to check out the AVA Woman.

  

MENTIONED LINKS:

Link to sign up for free 29-day meditation challenge

affiliate link for $30 discount on Ava Temp tracker

Avawomen.com/avaworld/ava-data-means/

Jade Ashtanga retreats- join me this summer and receive one complimentary coaching session prior

 manifest your dream life with davidji retreat- $150 discount coupon code dreamlife2018

Treatment of Infertility with Chinese Medicine, by Jane Lyttleton 

Guide to Cervical Mucus  episode 23

@ladypotions4u on Twitter

@ladypotions4u on Instagram

EPISODE 21 | TAKING A TCM APPROACH TO YOUR DIET TO ENHANCE YOUR FERTILITY

Taking a TCM Approach to Your Diet to Enhance Fertility

Description: Today we will be covering one of my personal subjects in life, food! Food therapy has always been part of Traditional Chinese Medicine. It can be really easy to initiate your own healing simply by eating for your current TCM disharmony. I will share with you some easy life solutions and three different approaches that you can start with your very next meal. Food has a lot of ties to our belief system, our past, and emotions we have yet to feel. Changing the way you eat can seem very overwhelming, so today I invite you to just pick a few from these three ideas that suit you and your life.

Takeaways

[4:56] Many of us have some body image issues, myself included, that we’ve worked really hard to overcome and I don’t want you to get stressed with the idea of cutting things out or calorie counting. That’s not what today’s episode is about.

[6:01] I would rather encourage you to make positive small changes that feel right to you rather than your feeling like your eating is one more thing you have to try and be perfect at. The implications of your DNA occur one full year before you get pregnant.

[8:25] Even a 2% change a day has a cumulative effect. It’s important to start small and adopt habits and a diet that feels positive and nourishing.

[10:24] The first approach is from Daoshing Ni, from his book The Tao of Fertility. He thinks of the menstrual cycle as a season, and there is a systematic way to eat accordingly along with the phases.

[12:10] The second is a general list of what not to eat, and a meal order solution like Green Chef or Hello Fresh. This is great for the on-the-go person that is working too much or overwhelmed by the idea of shopping and cooking. However, it can get pricey, especially if you cave and order take out when you have organic food sitting in your fridge.

[13:09] Third is the pattern diagnosis of TCM by symptoms that tell you how to eat based on TCM. This will often help you feel the best the quickest and make your overall constitution stronger helping you to achieve optimal fertility. It can be difficult if you both of you have completely different imbalances or constitutions. It’s a win if you love strict rules. It gives a list of don’ts and dos. 

[14:20] In the Tao of Fertility approach, you think of your menses as the season of winter. Shedding, ending and contracting. The week after your period is like spring where plants and flowers are budding and blooming, and the ovulatory phase is summer. The luteal phase is akin to autumn, where the temperature is beginning to drop. During the first two weeks of your “seasons”, you want to incorporate foods that will strengthen your egg quality and energy. This includes grains, high protein foods like eggs, meat and beans. It’s important the food is warm for digestion. If you feel extra fatigued and weak during menstruation, you want to eat a lot of blood-nourishing foods like bone broth. The second phase after ovulation shifts to leafy green vegetables and berries.

[25:44] Always choose full-fat instead of fat-free. Often times when they take the fat out, they replace it with sugar and other unhealthy additives.

[29:22] I go through the patterns of foods and symptoms depending on the body types, symptoms and deficiencies.  You can also download the food quiz here on the website for a further dive into what you should be eating for your specific constitution. I RECOMMEND PRINTING IT OUT, MARKING IT UP WITH YOUR NOTES AND REPEATING EVERY 3 MONTHS SO YOU CAN SEE HOW FOOD HAS CHANGED YOUR RESULTS!