Deborah Howell (Host): A new year means new possibilities. Fertility Centers of Illinois has the tips you need to boost your chances of conceiving in 2024. In this episode of the Time to Talk Fertility podcast, we'll delve into some lifestyle factors that impact your quest for conception and the ways you can invigorate your family.

This is the Time to Talk Fertility Podcast. I'm your host, Deborah Howell. Joining us today is Dr. Jennifer Hirshfeld-Cytron, who is Board Certified in both Obstetrics and Gynecology and Reproductive Endocrinology. Welcome, Dr. Hirshfeld-Cytron.

Jennifer Hirshfeld-Cytron, MD: Thank you.

Host: Glad to have you back. Let's dive right in. What positive lifestyle choices can someone make to improve their chances of getting pregnant?

Jennifer Hirshfeld-Cytron, MD: I would say there are many things we can do. One guidance that a patient once said to me that I sort of love is that we should live the best forms of ourselves. And we all have a sense of what that means. Really trying to eat optimally, avoiding simple sugars, white flours, avoiding processed foods, getting adequate sleep.

I think for a lot of us, sleep is the thing that we let go of, particularly when life gets busy. But it is an essential piece of conceiving and optimizing your fertility, there's no question. And so sleep and quality of sleep are really, really important as well as movement. You don't have to be training for like a triathlon, of course, and too much exercise could theoretically be a negative, but some type of movement every day, 20 to 30 minutes.

Host: Sounds good. Now you mentioned eating well. Can you tell us the connection between nutrition and fertility?

Jennifer Hirshfeld-Cytron, MD: For both men and women, there are studies that suggest we can improve our fertility by, you know, the way that we fuel ourselves. And so more studies, I would say, impact men. So men are such that sperm recreates and regenerates every three months. So when you make lifestyle changes and something is new of three months from now, you're going to see that benefit, you're going to see that impact.

So having a diet, we think, with whole grains. Avoiding all the things we love, and it was just the holidays, but avoiding the sweets and the sugars and the brownies. Not never, but just less. Trying to make organic choices when feasible, in both produce and dairy and meat choices, the avoidance of sugary beverages and the utilization of lean meats.

And so absolutely can see an improvement in sperm quality. For women, we are born with a fixed number of eggs and I wish we could, but there is not nutrition that will bring us back egg quality. The idea is we will optimize the eggs that remain.

Host: Sounds good. Um, are there foods that are better to eat when you're trying to get pregnant?

Jennifer Hirshfeld-Cytron, MD: I think, again, it's the variety in what we eat. There is this idea that if you eat a large amount of colorful fruits and vegetables, that you get a high antioxidant yield. And I think for many patients, when you're online or you're talking to other people in a similar scenario, or there's quite a few books around this topic, is the concept of supplements.

But supplements will never, ever, ever be able to recreate the quality of nutrition you get when you eat something, and so when you eat there's a different stimulation to your gut. The blood flow is substantial, and you will get in that nutrients in such a more substantial way. And so, antioxidants is something we all think about, and so our diet driven in high antioxidants can be really important.

So colorful fruits and vegetables, high quality whole grains, lean meats. I think those are important pieces, and it doesn't have to be meat, of course. Lean sources of protein. You do not have to eat meat if you're vegetarian or vegan to optimize your fertility. And then it's the avoidance. It's the avoidance of the processed foods, the avoidance of the simple sugars and white flours.

Host: In addition to that, are there any supplements that are beneficial? I'm sorry. In addition to that, are there any supplements that are beneficial for someone trying to conceive?

Jennifer Hirshfeld-Cytron, MD: It's meat, in particular folic acid, that is a part of every prenatal vitamin is an essential supplement. And so folic acid is something that you may not necessarily get in your diet. And folic acid can prevent certain birth defects of spine development. So we believe that it's critical for those trying to conceive that they are taking folic acid, ideally even before you conceive.

That is the really essential one. Other things that are important to supplement our diet would be things like vitamin D. Particularly where we live, or I live I should say, in Chicago. This is the time of year that most of us are low. We are getting minimal sun exposure. Even if you live in very sunny areas, appropriately so, people use sunblock.

So vitamin D is an important piece for health or pregnancy. And then, you know, there is some thought that particularly to optimize sperm quality, and maybe egg quality as well; that we take in these antioxidants. Again, first and foremost, I would try to do it with your diet. But if not feasible, things like fish oil or omega 3s can be important. And coenzyme Q10 or CoQ10 can be another great source of antioxidant in the form of a supplement.

Host: Okay. Now, I'm curious about something else. What's a preconception supplement, and what are the benefits of taking one?

Jennifer Hirshfeld-Cytron, MD: So a preconception supplement is what we think about as like a prenatal vitamin. And so that has the folic acid that I described, and it also just is a wonderful multivitamin. It has calcium and all other nutrients that are just optimal for someone trying to conceive. So it takes a high quality multivitamin and adds additional folic acid.

Host: So you wouldn't add another pill of folic acid to that.

Jennifer Hirshfeld-Cytron, MD: No, the nice piece about it is that it should hopefully minimize what you're taking. So if you take a prenatal or preconception supplement, it should have folic acid and then in some cases even vitamin D and in some cases even fish oil.

Host: Got it. Now, are there some habits that can negatively impact fertility?

Jennifer Hirshfeld-Cytron, MD: Habits that can negatively impact fertility, the worst is the use of any tobacco product, whether it is in the form of a cigarette, or a chew, or vaping, it's unfortunately all bad. Particularly for women, if someone utilizes tobacco or nicotine, and we do fertility treatment, we get half as high of success. And those same individuals go into menopause earlier.

So things we do work half as well. And your ability to conceive is a shorter time frame. So if there's anything I could encourage someone to do is completely stop any form of tobacco and nicotine.

Host: Is this also true for fathers to be?

Jennifer Hirshfeld-Cytron, MD: It is also true, it's probably not as substantial for fathers to be as mothers to be.

Host: Okay. And let's go to a different subject altogether. How does your BMI affect your ability to get pregnant?

Jennifer Hirshfeld-Cytron, MD: So BMI is one measure we have to look at someone's weight in relation to their height. It is by no means perfect, and there's a lot of critics out right now about the value of using BMI, but it's probably something that's very easy to obtain, and therefore it's used quite a bit, and having an quote unquote ideal or normal weight for your height can positively impact your fertility. When you have a higher BMI, meaning that the weight exceeds your height, we can see impacts really more to the health of the pregnancy than the capacity to conceive. So we can see some impacts to conceiving, but that individual is at higher risk of miscarriage, higher risk of diabetes, high blood pressure, and complications of pregnancy.

Host: Fair enough. So, what's a good BMI to shoot for if you're trying to get pregnant?

Jennifer Hirshfeld-Cytron, MD: Ideally, somewhere 18.5 to about 23.

Host: And is there a minimum or maximum BMI for going through fertility treatment?

Jennifer Hirshfeld-Cytron, MD: Yeah, so if we think about on the lower end, so someone whose BMI is less than that recommended range, that, of course, can also impact your fertility. When someone is underweight, it can impact ovulation, it can impact your nutritional status, and therefore the health of the pregnancy. And so there's an optimal time to be pregnant.

In terms of doing fertility treatment, ideally, someone is in that range that I described. But our criteria and most criteria is to have a BMI that's less than 45.

Host: Got it. Now, we see so many advertisements on TV, so let's talk about this. If you have a higher BMI, are trendy medications like Ozempic a good choice if you're trying to get pregnant?

Jennifer Hirshfeld-Cytron, MD: The unfortunate part about Ozempic and that entire category of medication is that they can create birth defects. So it's one of the medicines we actually require someone to stop and wait two months before we attempt conceiving. So I absolutely would not be utilizing Ozempic if you're trying to conceive.

Host: Well, that is very clear. That's a clear answer. Are there environmental factors that can affect fertility?

Jennifer Hirshfeld-Cytron, MD: There are, I think the challenge here is that so much of this is out of our control. I mean, the way in which pollutants in our environment really come are better worth the level of our governmental agencies. And so the challenge of environmental factors is we create a whole list of things and none of us can do anything about it.

So the ones that we can control are having a really high quality air filter in your home. Taking your shoes off before you enter your house. This way you're not tracking in pesticides. On your apps, you'll see when there's low air quality, keep your windows up when you're driving. Try to avoid eating and drinking out of plastic.

The plastics will leach into our food and be detrimental to pregnancy health. And in fairness, your health overall. Try to avoid parabens and phthalates in your beauty products and your cleaning products.

Host: Okay. I'm going to switch subjects one more time because this is so much on people's minds lately. How does mental health play a role in fertility?

Jennifer Hirshfeld-Cytron, MD: I think mental health is something that is a bit more complicated. So the challenge of mental health is it's more a result of than a cause. And what I mean by that is when someone is struggling with infertility or a miscarriage and loss, we see a higher incidence in those patients of depression and anxiety.

Arguably, we see levels of depression, anxiety, and infertility patients on par with a patient that's been diagnosed with cancer. The challenge for infertility patients, compared to potentially a cancer patient, is the way the community comes together. So, many of us can think of a friend or a family member who had a recent diagnosis of a cancer, and there are food trains, and there is this collaboration.

Everyone sort of gets together to help through that time. Infertility, unfortunately, can be a very lonely experience. So it's not that it's the cause of, but because it's substantial, it can actually impact someone's ability to do treatment and stay in treatment. And so therefore it impacts your success because you're not doing treatment, you're less likely for it to work.

So I think with mental health, the awareness that they're so linked, that it's not uncommon if you're struggling with infertility to have depression and anxiety, and that there's support out there. There are therapists that specialize in the context of those with infertility. We have at our facility one.

There are great uh, networks, the Resolve, and ASRM are two, plus our website that has a lot of support and tools for those going through fertility, so you can appreciate that you're not in this alone.

Host: Yeah.

Jennifer Hirshfeld-Cytron, MD: So I think the awareness and the treatment of is the best approach.

Host: So don't go it alone.

Jennifer Hirshfeld-Cytron, MD: Don't go it alone. There's no reason.

Host: How about reducing stress? Does reducing stress really help you get pregnant?

Jennifer Hirshfeld-Cytron, MD: I think it's pretty mixed, and I wish any of us knew ways to reduce stress in the world we live in. If anything, probably it's just more and more stressful as, you get older and world is so complicated. And so instead of reducing stress, I think what's really a more helpful mantra is how do you manage your stress?

So we all have stress. That's an inevitability of life. So if we manage stress proactively. I'm going to use movement and exercise. I'm going to really make sure that I am fueling my body with healthy foods that help me feel good. I'm going to get my adequate sleep. I'm doing those things that's not enough.

I'm going to add meditation. I'm going to add acupuncture. I'm going to add therapy. I think proactively managing our stress is the way to go about it.

Host: Beautifully said. Do you have any other tips or advice for someone trying to conceive in 2024?

Jennifer Hirshfeld-Cytron, MD: I think my advice is really the same vein of do not feel a need to do this alone. So if you have been trying for six months to a year, I would seek assistance with your OB GYN, I would potentially see a fertility physician. There is some baseline testing that can be done to identify factors that would be impacting fertility.

I would also encourage people to get connected with some of the patient efficacy groups related to fertility, so they can share with other people going through a similar experience. But my best advice is to not sit on the sidelines, but to, you know, take control of your health. Get information and find out if there are ways that can improve your fertility with treatment.

Host: Well, doctor, thank you so much for being with us on the podcast today and offering up so many great tips for conceiving. We really, really appreciate it.

Jennifer Hirshfeld-Cytron, MD: Thank you so much for this opportunity.

Host: That was Dr. Jennifer Hirshfeld-Cytron, a Reproductive Endocrinologist here at FCI. If you'd like to schedule an appointment to talk to a fertility specialist, call 877-324-4483 or visit fcionline.com for more info. 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.