Common Chemicals Not Just Harmful for Baby – Bad for Baby-Making

A recent study of men and women undergoing IVF found that even low levels of some pervasive environmental chemicals are associated with reduced number of pregnancies. In the small sample of IVF patients, researchers adjusted for confounding factors like age, race, and smoking, and found that small increases in blood levels of both mercury and cadmium are associated with reduced rates of clinical and biochemical pregnancies.

[The term “biochemical pregnancy” refers to two positive hCG tests in very early pregnancy, while the term “clinical pregnancy” refers to detection of a gestational sac on ultrasound.]

In the women, slight increases in blood mercury were associated with pregnancy decreases of up to 35 percent, whereas slight increases in blood cadmium were associated with decreases of up to 94 percent. There were no similar effects detected in the men.

So what does this mean for you, if you're trying to get pregnant? Chemicals are all around us, in products, furnishings, and even foods, and you cannot completely avoid every one of them. But there are a few steps that can be taken to lessen your risk of exposure:

• Don't smoke cigarettes or be around second-hand smoke.
  
  
• Avoid certain types of fish that contain high levels of mercury: bluefin and albacore tuna, swordfish, shark, king mackerel.
  
  
• Don't use phosphate-laden fertilizers.
  
  
• Eat only moderate amounts of organ meats, like liver and kidneys.
  
  
• Have your blood tested for toxins. You might also consider testing your soil and, if you have a well, your water supply.

For more details on the study and on the effects of mercury and cadmium, see this Fertility Authority article.

On Women, Bicycles, Sex & Fertility

Here's a topic that you won't hear a lot of reproductive specialists talk about – but maybe they should! A new study in The Journal of Sexual Medicine advises that women bicyclists can lessen their chances for potential sexual dysfunction by changing up a couple of things on their bikes.

How about the seat on your spin cycle?

Women cyclists can experience genital nerve damage if the bicycle seat is higher than the handlebars. This type of nerve damage reduces a woman's ability to detect vibrations, which can then lead to impaired sexual function.

An important point: Sexual dysfunction in and of itself does not equal infertility! But as many of my patients unfortunately know already, trying to get pregnant when there's a fertility problem in the way can be less than pleasurable. So I advise couples to take reasonable steps (and seek related counseling, if necessary) so that enjoyable physical intimacy remains a part of their experience.

Granted, the women studied are competitive cyclists, and most of my Houston Fertility Center patients are not in that category. Bicycling is one of the activities that has been recommended as healthy for women who are trying to conceive, but again, in moderation, since over-activity and extreme weight loss can work against your body's ability to get pregnant.

And if you want to maintain a healthy sexual relationship with your partner through what can be a daunting process, you might also need to adjust your bike seat and handlebars.

IVF? Skip That Last Cup & Croissant

Cut back on the caffeine and saturated fats. It's not new advice. But there's a bit more research now that arrives at the conclusion that too much of these dietary no-no's can get in the way of IVF success.

I know my patients at Houston Fertility Center sometimes feel “up to here!” with the restrictions that they already find infertility and its treatment have put on them. So information like this is not always welcome – but remember, the more data we have on which to base our treatment decisions and techniques, the less likely it is that patients will be required to go through numerous treatment cycles to get pregnant.

In two different presentations, researchers at this year's meeting of the European Society for Human Reproduction and Embryology informed us of these findings:

• Drinking more than 5 cups of coffee per day can reduce your chance of pregnancy from IVF by 50 percent, but the reasons are not clear.
  
  
• The type and amount of dietary fats consumed by a woman seems to impact IVF success. Specifically, chances of IVF pregnancy were lessened in women who had higher intakes of saturated fats because they produced fewer mature egg cells.

The dietary fats study is especially small, and the researchers call for more follow-up. The caffeine-related study, too, should be expanded, but for now, authors of this Danish study of nearly 4,000 IVF patients are suggesting that adverse effects of coffee are comparable to the detrimental effects of smoking on IVF.

The researchers in both of these studies clearly state that there's no need to make drastic changes based only on their findings.

Overall, our patients are admirable in how they heed the warnings of research about lifestyle-based effects on fertility treatment. Whether a woman is experiencing infertility or not, going through a little dietary “clean up” during preconception is a great idea with benefits for mom and baby. 

Obesity Impacts Your Reproductive Health Goals

The topic of weight and fertility is a sensitive one: Years ago, I mentioned patient's concerns about “fat phobic” doctors in a newsletter on “Weight & Fertility”, in which I gave a quick description of how a woman's weight impacts her ability to get pregnant. Now, The Endocrine Society has made available a free, downloadable booklet with more information on the topic.

“Obesity, fertility, and contraception: Disparities Among Women – 3 Perspectives” covers the entire fertility spectrum, explaining how body weight is not just an issue for women trying to get pregnant. Those who are trying to avoid pregnancy are also at risk – for weight-related contraceptive failures.

The booklet is complex and thorough, and offers the professional opinions of a basic researcher, a clinical practitioner perspective, and a clinical researcher. A few interesting points in the publication:

• Higher prevalence of obesity in African American and Latina women is an important factor in racial and ethnic disparities in reproductive outcomes. 

• Obesity adversely alters egg quality, in addition to the endocrine system, and is associated with ovulatory dysfunction and higher risk of miscarriage.

• Donor egg recipients who are obese do not appear to have lowered IVF pregnancy rates.

• Hormonal contraception may fail more frequently in obese women.

Body weight is not merely a matter of fashion, and reproductive endocrinologists are specifically trained and experienced in applying the latest research-based knowledge to the related fertility needs of patients in the clinic.

The staff of Houston Fertility Center and I offer all fertility patients the opportunity to access helpful nutrition counseling, whether it is for weight-loss, maintenance, or weight-gain – whatever is healthiest for their situation and will promote the greatest fertility treatment success.

Lyme Disease – Do you need to worry?

A recent post by Dr. Beth Hartog on Fertility Authority talks about something we don't think of often here on the Gulf Coast: Lyme disease. In the post, Dr. Hartog describes a fertility patient who finds a tick after a hike in the woods and is worried about lyme disease.

Lyme disease is an inflammatory disease that impacts multiple systems in the body. Its cause is infection by a bacterium spread via deer ticks. Humans and other animals are susceptible to lyme disease if bitten by a deer tick. The disease can result in long-term symptoms which can become severe if untreated. Fortunately, treatment with antibiotics upon early detection almost results in a cure. You can find out more about Lyme disease at the American Lyme Disease Foundation website.

What does Lyme disease have to to with infertility or getting pregnant?

As Dr. Hartog explains, treatment of the disease during pregnancy or when trying to get pregnant can be tricky. Some of the medications typically used for Lyme disease are contraindicated – unsafe – during pregnancy.

Lyme disease has spread predominantly from the northeast U.S. and into the Midwest. So do we Texans need to worry about Lyme disease? Not really, according to this prevalence map from the American Lyme Disease Foundation. But there are other tick-borne diseases that are less well-known, some of which are discussed on the Foundation's website. And of course, if you travel to areas of high prevalence and spend time outdoors, you could be at increased risk for Lyme disease. Like some of our staff at Houston Fertility Center, you may find yourself wandering in the beautiful woods just north of the city, and ticks are definitely a possibility.

To prevent contact with or to deal with removing ticks, the Foundation site offers very helpful and specific tips.