Fertility and Diet
As I walked from the elevator at my usual 7:00 am, I glanced through the waiting room and something caught my eye: a pregnant woman on the cover of Newsweek captioned by “Fertility and Diet.” “ Oh no,” I said to myself. “Here come about at million questions!” So I figured I would read the article and take the time here to go through some things; beat you to the punch.
According to the article, diet the recommendations are aimed at preventing and reversing “ovulatory infertility.” This goes back to my blogs on PCOS. Therefore if you already ovulate regularly, the diet issue does not apply to you.
It appears that women with better diets had more regular ovulation. Brilliant. Lets start with carbs. The article shows that carbs are fine, but women who ate more “healthy carbs”, such as brown rice, pasta and dark bread, whole grains, beans and vegetables, and whole fruit, ovulated more than those who loaded up on white rice and potatoes. Sounds familiar. For any medical well-being issue, the message is the same.
Trans fats can make you fat. Brilliant. A diet higher in trans fats usually means the diet is lower in the good things mentioned above. This concept can also be applied when examining that plant protein may be better that animal protein.
The milk and cream issue requires a little more analysis. There are 2 types of women who do not ovulate: those that are starving themselves, and those who are eating a bit more that they should. The article does not always make the distinction clear. The point is that if a woman in not eating, milk and ice cream will help her ovulate. Increasing caloric intake, through whatever means necessary, can jump start ovulation. However, if someone is overeating to start with, milk and ice cream may not make a difference, unless she starts to substitute some of the bad food with yogurt and cottage cheese, which will lead to weight loss.
Exercise is good. Brilliant.
To be perfectly clear, I agree with everything they say. Proper diet is a good thing. Potential pitfalls here are that women may feel that by taking an extra hit of salmon per week will feel they can lick their fertility problems, and not get the help they need until they are older. If you are not getting pregnant, eat well and see the fertility doctor. If you are 32, overweight and don’t ovulate much, it’s ok to get on a program, lose weight over 6 months, start to ovulate, and avoid Mr. M.D. If you are 38, ovulate regularly and decide to modify your diet for 6 moths before seeing the doctor, I think you may lose too much valuable time. Do both.
In addition there are reasons for non-ovulation (we call it anovulation) other than those related to weight and diet. Problems with the thyroid, pituitary and adrenal glands can also contribute. Therefore, if you are not ovulating, you are better served by a basic simple workup. If everything is ok, at least you know, and then you can make a decision on how to proceed.
Admittedly, I am jealous that some researchers reported on things we already knew, published a book, and got on the cover of Newsweek. Brilliant! But I am happy that by reinforcing some basic principals people can be healthier, and some more women will get pregnant. We all have experienced that some people process a message better when it comes from the press as opposed to from their doctor, spouse, mother ect.
As usual, see the disclaimer blog.
Thank you,
Dr. Licciardi
According to the article, diet the recommendations are aimed at preventing and reversing “ovulatory infertility.” This goes back to my blogs on PCOS. Therefore if you already ovulate regularly, the diet issue does not apply to you.
It appears that women with better diets had more regular ovulation. Brilliant. Lets start with carbs. The article shows that carbs are fine, but women who ate more “healthy carbs”, such as brown rice, pasta and dark bread, whole grains, beans and vegetables, and whole fruit, ovulated more than those who loaded up on white rice and potatoes. Sounds familiar. For any medical well-being issue, the message is the same.
Trans fats can make you fat. Brilliant. A diet higher in trans fats usually means the diet is lower in the good things mentioned above. This concept can also be applied when examining that plant protein may be better that animal protein.
The milk and cream issue requires a little more analysis. There are 2 types of women who do not ovulate: those that are starving themselves, and those who are eating a bit more that they should. The article does not always make the distinction clear. The point is that if a woman in not eating, milk and ice cream will help her ovulate. Increasing caloric intake, through whatever means necessary, can jump start ovulation. However, if someone is overeating to start with, milk and ice cream may not make a difference, unless she starts to substitute some of the bad food with yogurt and cottage cheese, which will lead to weight loss.
Exercise is good. Brilliant.
To be perfectly clear, I agree with everything they say. Proper diet is a good thing. Potential pitfalls here are that women may feel that by taking an extra hit of salmon per week will feel they can lick their fertility problems, and not get the help they need until they are older. If you are not getting pregnant, eat well and see the fertility doctor. If you are 32, overweight and don’t ovulate much, it’s ok to get on a program, lose weight over 6 months, start to ovulate, and avoid Mr. M.D. If you are 38, ovulate regularly and decide to modify your diet for 6 moths before seeing the doctor, I think you may lose too much valuable time. Do both.
In addition there are reasons for non-ovulation (we call it anovulation) other than those related to weight and diet. Problems with the thyroid, pituitary and adrenal glands can also contribute. Therefore, if you are not ovulating, you are better served by a basic simple workup. If everything is ok, at least you know, and then you can make a decision on how to proceed.
Admittedly, I am jealous that some researchers reported on things we already knew, published a book, and got on the cover of Newsweek. Brilliant! But I am happy that by reinforcing some basic principals people can be healthier, and some more women will get pregnant. We all have experienced that some people process a message better when it comes from the press as opposed to from their doctor, spouse, mother ect.
As usual, see the disclaimer blog.
Thank you,
Dr. Licciardi
posted by Dr. Licciardi at 6:06 AM
20 Comments:
Hi - thanks for creating this blog. I am not sure how the "ask a question" part works, but could you talk more about Lovenox and APA, ACA and NK? Thanks.
Well said. I was thinking very similar things as I read the article. It's basically common sense - eat well and exercise - which is what health experts have been telling us for years. Btw - I love your blog!
Thanks a lot for your blog! I would like to ask you about genetic abnormaities and miscarriage. I recently had a triploidy (69XXY) miscarriage. From what I read it mostly due to double fertilization (dispermy?), is this an issue with the sprerm? or with eggs, allowing double fertilization?
Thanks a lot for you answare.
Dear Dr. L,
For those of us immersed in the world of IF, this diet is nothing new. Many of us have been following it for years, based on several studies and books that proceeded the study.
I certainly respect what you wrote, that this is basically nothing new to you and you were aware of most of the info that was studied.
I have been a patient at NYU for over three years and not one RE has mentioned diet or exercise.
I hope you share your knowledge with the other doctors you work with. Now that would be brilliant!
I love your blog and am a very regular reader. I suffer from PCOS, on my own I ovulate maybe every other month, and I suffer from mild hirituism. Except of course mild is enough to be annoying. I am on metfomin and waiting on a sperm analysis before starting fertility drugs. I am also on the thin side, 5'5" and 128lbs. I think that diet is important and in extreme situations like being severely underweight or overweight it can have a significant impact on fertility. But it also seems to me that lots of these articles that point to things like a woman's diet or a woman's stress level are also placing "blame" on the woman for her fertility issues. "Well if you changed you diet you could get pregnant." or "If you'd just stop stressing you'd get pregnant." As if we don't blame ourselves enough. As if, most of us wouldn't give our right arm to get pregnant. The truth is most women's lifestyle has very little do with their fertilty issues. Most of us that have been struggling with this for awhile don't smoke, don't drink, eat organic etc. etc. If a woman suspects her fertility is impaired instead of wasting time with "quick tricks" go to the doctor and get a real diagnosis. I am all for some medical assistance because what I have PCOS is a medical condition and a bad diet is not to blame. BTW- I'm pretty sure my PCOS is genetic since I have a sister that suffers as well. Thank you so much for your blog! You expertise as a doctor is well complemented by your common sense.
Hello! I am currently struggling to balance humor with fertility issues in my blog, carrottopsaregreengenius.blogspot.com. I would love for anybody to stop by and commiserate! Thanks so much for all of your great info.
This magazine caught my eye too at a bookstore the other night. I grabbed it and planned to buy it, but then the frugal side of me made me glance at the article first. I'm glad I did. I ovulate on my own and eat well and exercise already, so I put the magazine back. Those authors should be ashamed of themselves, as they're taking advantage of infertile women by passing off common sense as new findings. Thank you Dr. L for your work.
Yeah, I read that article and thought that it was essentially useless.
Can you comment on the utility of metformin in women who already ovulate? I'm on month 2 of metformin and Cycle 1 of Clomid/IUI.
BTW, anyone is welcome to check out my IF blog, too. http://destinationbaby.blogspot.com
:) Sarah
What about alcohol and caffeine? We husbands want to know how much we can drink of each and still make sperm that will fertilize eggs. I've read several conflicting reports about each, and was told by my own infertility Doctor that caffeine is actually good for sperm, so I should drink more of it. Any thoughts?
Thanks for reviewing the article. I've sent this along to several of the family and friends that sent me the article. I also did not like that the article did not mention male factor.
I still continue to read your blog, Dr. L and I still thank you for being kind enough to share your thoughts and knowledge with us. If anyone cares to check out my blog, I'm at http://maybebaby-jtp.blogspot.com/
Feel free to comment as I'm lacking there. *blushes*
Thank you for your blog on donor eggs. I am 39yo, have one ovary and one fallopian tube. Concieved 1st child at age 35 naturally and as a surprise. We have been trying since Jan 07 to concieve 2nd, using fertility drugs and IUIs, and I have just begun to explore IVF and interviewed two REs. I met the 2nd RE two weeks ago, and he discussed using donor eggs and also doing a banking cycle. His discussion on donor eggs alarmed me, but I kept thinking of what you said in your blog. Thankfully, I found out yesterday we are pregnant...conceived naturally again...no IUI or fertility drugs. How's that for devine intervention?? Thank you for your time given to this blog and for the important information you impart to us all.
I finally became pregnant at age 33 after beginning the Atkins Diet - a regiment I began to promote weight loss, not fertility. I never assumed there might be a correlation between the two.
Interestingly enough, however, although I had been following Atkins for only a few months prior to my pregnancy, and had lost about 20 pounds at the time, I have joked ever since my preganancy that Atkins (the diet, not the doctor -lol) made me pregnant. While following Atkins, I took a multi-vitamin and tried to add exercise whenever I could. Once I learned that I was pregnant, I stopped following the Atkins' regiment, of course, and ate a healthy well-balanced diet throughout my healthy, full-term preganancy. After reading your recent article I see that there may be a grain of truth to my Atkins quip insofar as insulin control is concerned. Maybe the Atkins diet was the catalyst for my pregnancy.
My son is now 3 years old, and an absolute blessing. The best gift I have ever received in my lifetime.
What are normal progesteone levels? I have been on clomid for three months and no luck.. the first month my progesterone dropped to 13, the second month at a higher dose it came back up to 20 and the third month it was 36. I am still not pregnant but wanted to get an idea if clomid is really for me.
Is a BMI of 20 really necessary to get pregnant?
Do you think that it's best to have a balanced diet with whole grains, or to do a low carb diet if you have PCOS and are not significantly overweight? Also, what about the information from McDougall about a low-fat vegan diet reversing type II diabetes? Could this work for PCOS as well?
I want to ask, too, what you thought about the idea that PCOS may be a secondary result of an autoimmune condition, or gluten intolerance (celiac)?
Here is a link about how PCOS and infertility can often be linked to gluten intolerance:
http://www.bellaonline.com/articles/art1507.asp
I would also like to know what role alcohol and caffeine plays in all of this for us males?
i loved what you wrote about fertility and diet. i tried for 2 years to get pregnant with the help of clomid [which was horrid], femara, and adding fat to my diet. i am a recovering/somewhat anorexic whom did a lot of damage to myself over the past 8 years. i have osteopenia, that i just found out, and i finally did actually get pregnant. unfortunately, i miscarried after only about 5 weeks. it's hard to understand how much of what exactly you need a day. i eat about 1200 calories of good carbs [etc wheat bread, fruit] and just 1 cup of coffee a day [i try to limit the caffeine] and drink lots of water. the only thing is that i get very little fat. i just don't know how to do it ..
anyways sorry to write so much .. i'm sure you don't even have time to read most of these comments but i really enjoy your blog.
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