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Caitlin Whyte: When you and your partner decide to have a baby, you can boost your odds of being parents to be by knowing the do's and don'ts of fertility. Here to talk about how to boost your fertility. Naturally is Dr. Allison Rodgers, a Reproductive. Endocrinologist at Fertility Centers of Illinois. This is the Time to Talk Fertility. Podcast. I'm your host, Caitlin Whyte. So I don't know about you, but in quarantine, I've definitely been indulging in some comfort foods, but I understand that what you eat impacts your fertility. What should we know about that?

Dr. Rodgers: So it's really important during a fertility journey to have a normal weight. And some people are overweight. Some people are underweight and either being overweight or underweight actually can impact our pituitary gland, which is in your brain. And it impacts the way the pituitary can talk to the ovary. And that can impact your ability to ovulate normally, also important to know that toxins that we consume. So when we think about toxins, we think about, you know, BPA from plastics, we think about preservatives, food, dyes, all of those things can interfere with a successful pregnancy. And it's not just one thing, right? It's not just cutting out dairy or cutting out gluten or something like that. It's not that, in fact, it's really about sort of living the best life you can live, decreasing processed foods, increasing plant intake, and just being the healthiest person you can be.

Host: Now, is it true that there are fertility boosting foods?

Dr. Rodgers: Well, so I think that when we think about things that are good for fertility, right, we want patients to be consuming normal amounts of folic acid to help with spinal cord development once they get pregnant. And it's important to have that in your system before we think about things like calcium and iron to help you have a good amount of blood. And those are really important to have in your diet, either with a prenatal vitamin in addition to sort of a diet. I think all antioxidants, so we think about these sort of super foods that have lots of vitamins in them, lots of C's and B's, and those are good foods from an antioxidant perspective to sort of consume. And now I think there's some myths out there, right? So one of the myths is that if you eat pineapple core, it's good for fertility or raspberry tea, for example, there's no studies on that. So what I say is, I mean, pineapples fantastic, but pineapple core, it's just like, no, they're eating a branch or something, you know a stick.

I think that if you like eating certain healthy foods, great, I think that you should try to incorporate fresh fruits and vegetables. I usually recommend organic as much as possible to try to limit the amount of toxins on our foods, because that's where a lot of toxins come into our foods, even things like grains, right? We think about fruits and vegetables being organic, but even grains. So, you know, wheat you're eating oatmeal or something like that, but it's not organic. Then it's sprayed with pesticides. And, you know, those are all little areas where toxins can get in to your diet. So I think that there are really no true fertility boosting foods, but eating a healthy diet, limiting, processed foods, eating sort of more of those, what we call whole foods and increasing sort of fruit and vegetable intake is a really good idea. I also think about trying to eat the rainbow. So, you know, different colors typically have different vitamins. And so it's good to sort of, you know, if you can't do it in a day, try to do it in a week, you know, eat some red things, some orange things, yellow things, green things, blue or purple things, and really try to eat your rainbow with fruits and vegetables, not just like Fruit Loops, you know.

Host: So what you eat and what you weigh, obviously go hand in hand. But I didn't realize that the extra weight can impact fertility potential in men and women. Let's start with the women. What should we know about extra weight?

Dr. Rodgers: So increased weight for anybody increases the amount of estrogen in your system. And estrogen can affect your cycles and can affect the way your pituitary communicates with your ovaries. So I think that it's just important to know that women who are overweight tend to have lower ovulation, lower hormone imbalance, so they have more imbalance and it makes it harder for them to conceive because of the hormone disturbances that the extra weight can cause.

Host: And how about men?

Dr. Rodgers: So for men, we know that increased estrogen from fat cells also can affect sperm quality. And when we think about the fact that men who are overweight often can have issues with decreased sperm function or quality, the other thing to think about for men is if they're really overweight, sometimes the testicles get overheated. We think about things like excessive bike riding, or sitting in a bath or hot tub or sauna all the time as creating extra heat, but obesity can also create extra heat for the testicles. And then sperm can not be produced quite as perfectly when it's exposed to high temperatures.

Host: Now, when it comes to stress, of course, this has been a stressful time for most people nowadays, how can that impact fertility?

Dr. Rodgers: So stress is incredibly prevalent. I think everyone's stressed out, especially now with everything going on in our world. So there's a lot of things that you can do to reduce stress. Sometimes I talk to people who are just so focused on their job, their fertility journey, there are other kids that they have them, that they forget to take care of themselves. And I think sometimes as working women and working moms for whatever, you know, when we're going through this journey, we sometimes put ourselves last. And it's important that we really put ourselves first in terms of just taking the time to take care of yourself. So exercising, I definitely recommend patients try out acupuncture. I really like meditating. There's a good app called Calm, also Headspace. Those are good meditation apps, and we're not talking about meditating like you sit in a pretzel and say, um. This is just sort of mindfulness. Right?

We think about meditation and sort of mindfulness and debriefing mindfulness. And these apps have a variety of different links of meditations that you can do them from five minutes to an hour. And, you know, usually I do them pretty much every day. And I usually try to stick with about 10 to 15 minutes. Cause I feel like that's good for me, but there's a lot that you can explore on there that can help patients through this journey. There's some very good fertility apps that can help with sort of mindfulness and stress reduction. They're developed these two apps, one for men, one for women developed by fertility psychologists. The one for women is called Fert Key Calm and then the one for men is Fert Key Strong. I love these apps. I try not to be offended by the fact that the men's one is strong and the women's one is calm. They probably just needed the cute names for them, but they're great. They sort of give you tools. So somebody asks you a question that is triggering question. If you're invited to a baby shower, sort of all the things we think about. If you're waiting to get blood results back sort of tools can help you through the journey.

I also really think that yoga can be really helpful for all kinds of reasons. And actually some studies that were including one that was done in our facility show that, you know, that may help pregnancy rates. Then, you know, you got to imagine that when you're, you know, stretching and everything, it can really increase blood flow to the pelvis. And I encourage patients to do fun things by themselves and also do some fun things with their partner if they have one. So I think a lot of times life can get stuck in a rut and all that kind of stuff. And I think that it's important to go do something silly and fun, right? Whatever it is. Obviously we're a little bit limited here during the pandemic, but, you know, go for a walk color picture together. I mean, there's all kinds of things you can do that don't take interacting with the people outside the two of you. And so I think those are some things that sort of homework for the new patients to help manage stress.

Host: Now you mentioned exercise as a good way to help with stress, but when it comes to exercise for people who are concerned about their fertility, I mean, is there an amount that they should aim for and is there any exercise people should avoid?

Dr. Rodgers: So those are great questions. So the recommendation for women in general, or all people in general is to do about 75 minutes of intense exercise per week, or 150 minutes of moderate exercise. So intense exercise is if you are like huffing and puffing and could not talk, you know, you're not like huffing and puffing. We've all done that, right. Cannot have a conversation. Moderate exercise is you're slightly out of breath but could still talk to somebody. And you know, usually I'll tell you for me, when I do my elliptical, I would call it moderate. When I get on my Peloton, I do intense class. That definitely would be more intense. So those are just guidelines. I think that while you're doing treatment, it's important to talk to your doctor about your case and what's going on because as the ovaries get large with high impact exercise that can twist on themselves. Now, things like a stationary bike or walking typically is very low impact and should not impact fertility journey a whole lot.

What I would say is that people who run excessively can sort of shut down their pituitary because just like weights, you know, a high weight or low weight can stress the pituitary gland. So can excessive running and running seems to be a particular exercise. You know, somebody could go on the elliptical for an hour, a day or whatever, but if they're running for the same amount of time, that a lot of people's pituitary just has a set point. And if you exercise above that set point, you know, their Pituitary just sort of shuts down and stops ovulating. Now I will tell you why patients who have a set point of four hours a week, but most patients it's around seven hours a week. So you really, you know, need to just make sure you're not overdoing it, but you want to also stay in shape and have your muscles and bones be strong for all the reasons why that's important in terms of bone health and cardiovascular health.

Host: Here's a question that really sticks out to me when it comes to drinking alcohol. We've heard so many things, you know, to drink nothing at all to maybe a glass of wine is good at night. How does alcohol affect fertility and what is the quote unquote safe amount to drink during this time?

Dr. Rodgers: Yeah. So what I typically will recommend, and the recommendation is that after ovulation, you should not be consuming any alcohol. And in fact, some organizations have gone so far to say that if you're not on birth control, you should not drink at all. So I think that most of my patients who are going through fertility treatment, don't know exactly when they are ovulating. So typically I recommend no alcohol after ovulation sort of between that time of ovulation and period. And then before that we know that the more alcohol you drink, the lower your success is. So the recommendations are for general health, for men not to consume more than three alcoholic equivalents in a 24 hour period. And for women to not to have more than two in a 24 hour period and an alcoholic equivalent would be a can of beer one-on-one and a half ounce shot of liquor or a five to six ounce glass of wine. And so you think about some of these delicious Martini's and now most of us are at home, maybe making our own Martini's or maybe not going out. But I think that, you know, you go to a restaurant and you order a fancy mixed drink, sometimes those have four or five shots in it for just that one drink. So it's certainly important to sort of really think about what you're doing and sort of try to, obviously sometimes there's special occasions, a wedding or whatever, but you know, it shouldn't be something that is happening all the time.

Host: We'll go to a different type of beverage. Now how about our daily cups of coffee? Where does caffeine come into the fertility equation?

Dr. Rodgers: Most of the signs have shown it's important to try to stay under 300 milligrams of coffee a day. So an average eight ounce coffee has about a hundred milligrams of caffeine. I typically recommend patients stay under a 20 ounces of coffee a day, and that is like one Venti. So I certainly have patients who drink a lot more than that. I have recommended maybe switch to half caf or have their one cup and then switch to decaf. So certainly the more decking for both men and women, the more caffeine you drink, the lower, the chances of success. And I don't know if we totally understand why that is. Caffeine of course is a stimulant and it affects a lot of different things, including blood flow and other effects on the body. So I don't think we totally know why this happens, but certainly it's been shown. And then the question is sort of, I don't think this has been flushed out is that because people who are drinking more coffee may have different lifestyle choices and there's other things affecting that we don't know. So really recommend staying under 300 milligrams a day.

Host: Of course, we all know smoking cigarettes and vaping are bad in general, but how do they specifically affect fertility in both men and women?

Dr. Rodgers: So this is a great question. Smoking will dramatically reduce a woman's chance of success with fertility treatment. So if you look at women who, who are doing IVF, their chances are actually cut in half if they smoke. And this is, you know, also it's not good for, to be exposed to secondhand smoke. So, you know, I certainly have patients who come into the office and they don't smoke, but maybe their partner smokes. And boy, you can tell, they smell very smoky. And I think that people don't realize when they're living with it, maybe the effect of the secondhand smoke. Now a lot of people who are, you know, have partners who smoke, maybe their partners will smoke only at work or outside, which is really honestly the deal for them to stop smoking totally. But I, you know, it's hard when you can only control yourself. So smoking is a hard habit to quit. You know, there is an app that I really like called Craving to Quit, and it's a mindfulness app that can help patients quit smoking. And it's just the more, you know, we were talking about sort of about toxins, right? Smoke interferes with estrogen receptors and people who smoke, lose eggs quicker. They have a higher chances of ectopic, pregnancies and lower chances of being successful. So, and then for men, it can affect sperm quality. But I mean, everyone who's listening who smokes, this is not the first time I'm hearing it bad for you. I'm right. I mean, everyone knows it's not good for you.

Host: Yeah. Yeah. And how about a different kind of smoke? We're seeing cannabis becoming legalized everywhere and CBD is gaining popularity. How do these substances affect fertility?

Dr. Rodgers: One of the things that we see is that there's a lot of just mixed literature on this, but just like anything else, you know, smoking anything, igniting plant substances and inhaling the fumes of that will cause cancer regardless of nicotine or nothing or marijuana. Right. And I think that it's important that if you're going to use cannabis, that I would recommend edible only, it's important know also with edible only that it takes a long time to get it in your system. So sometimes people will take it and then they don't feel like it's working. So they take more and then they sort of take too much, typically during a fertility treatment, I recommend not doing any cannabis, but if that's not an option, I would definitely would recommend edible only.

Host: So we've gone over all these ways of different eating we can do to boost fertility. How do supplements factor in, are there things that men and women should consider taking?

Dr. Rodgers: So that's a great question. And this is definitely one I would recommend you talk to your particular doctor about, about your case and what may be good for you. I think that there is some evidence that some supplements can help. Listen, you are born with all the eggs you are ever going to have and they get damaged through time and supplements are not going to fix damaged eggs. Right. But what supplements do the idea is they sort of help promote the growth of the healthy eggs. And so some of the supplements that we think about for women include things for egg quality things like Kochi 10, something like Maya would not to tell the brand name is pregnantude, melatonin, and DHEA. Sometimes doctors think that, you know, that that particular hormone is a adrenal hormone that can some patients it's not good for. So those are all things that potentially could help eggs, and for patients with PTOS, Myolenopithol certainly has been shown to be helpful, but there are certain people who shouldn't be taking it. So I certainly would recommend you talk to your doctor about it. If there's any supplements that may help you on your journey. For men who have semen analysis issues, you know, abnormal semen analysis, if there's issues with the quality of the sperm, not quantity necessarily, but qualities, how they're shaped. Then a lot of times fish oil and Kochi 10 can be helpful as well. Those are antioxidants. And again, it's certainly something that I would recommend you talk to your doctor about to make sure it's right for you.

Host: So now that we've applied all of these changes to our lifestyles, how do we know it's working?

Dr. Rodgers: Yeah. So if you're someone who is underweight or overweight or overexercising, and your periods are irregular because of the stress on your body, you may see your periods regulate. And I think that's really, you know, an important piece. The other thing I think that it's important to sort of know is that we measure success ultimately by a successful pregnancy, right? Sometimes there's other things going on that require more than just lifestyle changes of coolers, but success is the best max triggered by a successful pregnancy.

Host: Great. Dr. Rogers, is there anything else that you'd like to add?

Dr. Rodgers: Well, I think that, you know, little changes can add up and the lifestyle changes are hard when you are in the habit of whatever it is eating more than your body needs or over exercising for stress management or smoking marijuana or any of these things. Right. I think that all of these lifestyle changes are hardest choices, but it's sort of the combination of sort of pick your [inaudible] like if it's hard. And, you know, by making these difficult lifestyle choices, you can make your fertility journey more successful. And these little changes can add up, and it's important to sort of just know that you have to have kindness to yourself and patience with yourself that you're doing everything that you can be doing, and you're not going to be able to do it all. So you should be proud of yourself for the choices that you're making, little bits at a time. And I would encourage patients to just keep going until they're successful.

Host: Well, Dr. Rodgers, just chock full of information. Thank you so much for your time today. That was Dr. Allison Rodgers, a reproductive endocrinologist at Fertility Centers of Illinois. If you enjoyed this podcast, find more like it in our podcast library and be sure to give us a like and to follow if you do. This has been the Time to Talk Fertility podcast. I'm your host, Caitlin Whyte. Stay safe.