Transcription:

Deborah Howell (Host): More and more couples are turning to fertility experts to help them have the best chance of conceiving. In this episode, we'll dig into some DIY tips to boost IVF fertility treatment success and, in so doing, deepen our understanding of the fertility process.

Joining us today to share these DIY tips, with us is Dr. Elie Hobeika, a board-certified reproductive endocrinology and infertility specialist at Fertility Centers of Illinois.

This is the Time To Talk Fertility podcast. I'm your host, Deborah Howell. Welcome, Dr. Hobeika.

Dr Elie Hobeika: Thank you for having me back.

Deborah Howell (Host): Great to have you back. Before we jump into all of your DIY tips, can you share how making these changes can help patients achieve success?

Dr Elie Hobeika: The optimum goal of fertility treatment is to achieve a live birth. And each of these DIYs that we will discuss optimizes the chances to get to that goal at a single or multiple aspect of the fertility journey.

Deborah Howell (Host): And then while smoking has decreased in popularity, it's still a very hard habit to break. How can quitting cigarettes help with treatment?

Dr Elie Hobeika: Smoking is one of those habits that can affect negatively every single aspect of the process of conceiving and delivering a child. It accelerates the loss of eggs in women and causes an earlier age of menopause. So quitting smoking preserves your ovarian reserve for longer. Smoking decreases the response of follicles to medication and decreases egg quality, maturity, and their ability to be fertilized and later on the ability of the embryo to implant and lead to pregnancy.

On the other side, it increases the chances of miscarriage. I cannot stress how important it is for smokers to stop smoking in order to reverse at least partially those implications.

Deborah Howell (Host): Great advice. Now, vaping of course is much more common and is commonly believed to be less harmful than cigarettes. Will quitting vaping help with fertility?

Dr Elie Hobeika: There isn't a whole lot of data on vaping, but what we prefer is not to be exposed to any potential toxins. And this is why we would recommend that individuals quit vaping as well.

Deborah Howell (Host): Got it. Now that cannabis is legal, it's also more common. How can quitting cannabis help with fertility?

Dr Elie Hobeika: Cannabis have been shown to affect negatively chances of pregnancy in women, even if edibles are used. Hence, I would recommend individuals also to quit cannabis as well.

Deborah Howell (Host): All right. Now, there are a lot of differing opinions on alcohol. What parameters should patients stay within for optimal fertility?

Dr Elie Hobeika: You're right. A lot of my patients feel it's a must to quit every form of alcohol use. However, we know that minimal alcohol consumption does not decrease the chances to conceive. Minimal alcohol consumption is defined for men between six to seven servings a week and, for women, between two to three servings a week. So it's important to mention though that the consumption of alcohol is preferably decreased during an IVF cycle and should go down all the way to zero when the pregnancy test is positive.

Deborah Howell (Host): Perfect. All right, let's talk about our beloved caffeine, coffee and tea. How does it impact fertility and the possibility of pregnancy loss?

Dr Elie Hobeika: Similar to other toxins, caffeine decreases egg quality and success rates with treatment and it also increases the chances of pregnancy loss. Consumption is allowed as long as there's under two cups a day or 200 milligrams of caffeine per day. And it is okay to continue that even throughout pregnancy. Just be aware that caffeine is not only found in coffee and maybe found in tea and other energy drinks as well.

Deborah Howell (Host): Got it. That's really good news. Now, a very touchy subject, but it is one of the single most important lifestyle factors when it comes to fertility, body weight. How can achieving a healthy weight improve fertility?

Dr Elie Hobeika: So increased weight or obesity is defined as a body mass index of 30 kilograms per meter squared or higher. The adipose tissue or the excess adipose tissue that is present is hormonally active and acts against individuals trying to conceive or undergoing treatment in various ways. It decreases the response of ovaries to medication, the growth of follicles and the amount of eggs retrieved, their quality and their development, as well as their chance to attach. So it is very important also to maintain a healthy body weight.

Deborah Howell (Host): Got it. Weight can also be viewed as a very binary topic. You either lose it or you don't. But you advise that losing any weight in patients that are overweight can help, right?

Dr Elie Hobeika: That is true. I typically tell patients not to gain any more weight, so if they cannot lose it, make sure not to gain anymore. But losing 5% to 10% of body weight has been shown to improve outcomes significantly and it is encouraging for patients to hear that.

Deborah Howell (Host): And what kinds of foods should people aim for?

Dr Elie Hobeika: It has been clearly shown that a Mediterranean-based diet has been associated with improved chances of pregnancy. Those diets mainly consist of consuming fish and seafood as main source of animal proteins and relying mostly on plant-based sources of fats. Those are the fats that you can get from avocados, olive oil, nuts and peanuts.

Deborah Howell (Host): Got it. Now, is eating organic something that patients should be thinking about?

Dr Elie Hobeika: Organic foods mean pesticide-free foods. And it has been shown that pesticide residue is associated with poor embryo development, lower implantation rates and higher miscarriage rates. So eating organic is definitely something patients should consider.

Deborah Howell (Host): So I know that buying exclusively organic food is something that's really just not accessible to everyone. How can patients find a middle ground on this?

Dr Elie Hobeika: You're right. It's actually very hard to convert completely to organic foods, but individuals can always wash well and peel fruits and vegetables to try to get rid of all the pesticide residue. They can also avoid eating foods that have a high pesticide residue and those are known as the dirty dozens and includes strawberries, kale, peppers, to name a few, and they can find a list of those online as well.

Deborah Howell (Host): Got it. Okay. Because it's kind of hard to, you know, wash each blueberry and each strawberry thoroughly. So yeah, just while you're trying to conceive, maybe stay away from it, right?

I also saw a new study on burritos from Taco Bell and Big Macs from McDonald's and their negative impact on fertility, through plasticizing chemicals, including phthalates. What are your thoughts?

Dr Elie Hobeika: Actually. Any food that is highly processed, such as fast food gets exposed to a lot of toxins. Phthalates are found in wraps and containers. They are known to be endocrine disruptors, which means that they intervene with the function of hormones in our body and we know that your production is highly hormonally dependent. So this is how having those foods will affect negatively the chances of conceiving.

Deborah Howell (Host): And doctor, there aren't chemicals in just fast food, there are chemicals in all sorts of household products and even cosmetics. How can these chemicals impact fertility and what should patients avoid?

Dr Elie Hobeika: The same concept that applies to food applies to household products and cosmetics. Some chemicals present in those products are also endocrine disruptors. They have not only been linked to infertility and miscarriage, but also to cancer as well. The Environmental Working Group's Skin Deep database is a good resource for patients that will tell them which products are clean to use. And I encourage patients to look into their shampoos, their shower gels, and soaps. The half-life of these products is so short, so it makes a big difference for patients to stop today and switch to cleaner products.

Deborah Howell (Host): Sure. Okay. A big factor. Stress is something that's really hard to measure and can be problematic to try to lessen with factors like work and taking care of a home, not to mention infertility is stressful. How can reducing stress help achieve better outcomes? And what should patients do?

Dr Elie Hobeika: The stress of infertility actually has been found to be equivalent to the stress of having cancer or a cancer diagnosis. It's a very important factor, but unfortunately it is not measurable and neither is its impact on outcome. Nevertheless, there's no doubt that decreasing stress is beneficial and this can be done by cognitive and behavioral therapy, acupuncture, and mind and body exercise.

Deborah Howell (Host): Great. And let's talk about supplements. Now, what supplements and doses can help men and how do these supplements boost male fertility?

Dr Elie Hobeika: To give you the short answer, none of the ones marketed have truly been shown to be beneficial for men and actually some are harmful. So I would suggest that men should only be taking supplements if their doctor recommends something specific.

Deborah Howell (Host): That is very interesting. So what supplements and doses can help women and how do they help?

Dr Elie Hobeika: Some supplements that women can use are a daily prenatal vitamin that contains at least 800 micrograms of folic acid or more. Lifestyle modifications are much more variable than a supplement that women can take, so make sure you're doing whatever's right for your body.

Deborah Howell (Host): Also, when it comes to supplements, I know that some can help, but there's also a lot of bad actors in the supplement industry. How can patients vet a particular product?

Dr Elie Hobeika: Supplements are products that are not regulated by the FDA. So I encourage patients to go to third-party verified sources, such as Consumer Labs that can truly tell them the purity of the supplements that they are taking.

Deborah Howell (Host): Good advice. How do vitamin D levels impact fertility and how can boosting them help?

Dr Elie Hobeika: Increasing treatment success by correcting vitamin D levels have been mostly shown to be beneficial in women with PCOS. However, low vitamin D levels are associated with poor pregnancy outcomes. So we try to optimize it for all women before they try to conceive.

Deborah Howell (Host): Excellent. Now, aside from all these changes, patients need to understand what to look for in a clinic and IVF lab and physician before making their choice. And it's a lot to take on and understand in detail. Let's start with a physician partner. What should patients look for?

Dr Elie Hobeika: I encourage couples to look at a physician who is board certified in reproductive endocrinology and infertility. But most importantly, a physician that they feel comfortable with that is open to hear their questions and concerns and available to answer any that may come up along the way. The treatment journey may be stressful, may be long, and you need to make sure you have a good companion along the way.

Deborah Howell (Host): And then in an IVF lab?

Dr Elie Hobeika: Choosing the right clinic is as important, if not more, as choosing the right provider. No matter how good your doctor is, if your embryos eggs and sperm are not handled well, your success rates will still not be optimal. I advise couples to look into clinics that have a long track record of success and have a high volume.

I'm very privileged to work with a lab who was part of the birth of the first child in the midwest and a lab that enables me to make such a big difference to the patients that I'm treating.

Deborah Howell (Host): Oh, that is just wonderful. Well, Dr. Hobeika, we can't thank you enough for being with us today and for letting us learn all these DIY tips to boost success during IVF treatment.

Dr Elie Hobeika: Of course. Thank you for having me.

Deborah Howell (Host): That was Dr. Elie Hobeika, a gynecologist and obstetrician at Fertility Centers of Illinois. Find out more about the services FCI provides for patients by calling (877) 324-4483 or head over to fcionline.com to schedule a telemedicine appointment with one of our physicians. And if you enjoyed this podcast, you can find more like it in our podcast library, and be sure to give us a like and a follow if you do. This has been the Time to Talk Fertility podcast. I'm your host, Deborah Howell. Have yourself a terrific day.