Treatment Overview: Lifestyle, Supplements and Medical Therapy

Welcome to another episode here on our fertility content blog. I hope you're liking this blog. Today we're going to begin the next series of episodes. So if you guys have been following along, you'll see that at first we started with just the new patient consult, the normal menstrual cycle, just trying to kind of establish what's normal. Then we moved into testing. We also published about fibroids. Now we're going to move into treatment. So when I'm talking to my patients about treatment, I always talk about the three armed approach or three sort of specific and individual important areas.

The first one is the actual medical therapy, and that is gonna be tailored to each individual case. And that may include surgery, it may include medications, it may include IUI, it may include IVF. We're definitely gonna chat about all of that. But that'll be individualized and that'll be what we're doing in the office together.

The second one is supplements. And so trying to navigate this world of supplements and what is good, what is not good, what should you be taking, what should you not be taking.

And then third is the lifestyle piece. And if you follow me on social media, you know that I talk a lot about lifestyle because it's something that we have control over. And in the world of infertility and the fertility journey, there's really a sense of a lack of control. So having the ability to really take ownership and accountability of this piece of your care, I think is super important and super empowering for you as a patient.

So let's start there. Let's start with lifestyle. When we talk about lifestyle, most people initially go to nutrition, weight loss or weight gain, foods, etc. And that is super important. We definitely want to make sure that we're eating a well-balanced, nutritious diet, the common sense things you want to try and minimize your exposure to sugar and flour, but really trying to eat well-balanced, nutritious meals. Now, for those who maybe need to gain weight or need to lose weight, I definitely encourage you to work with a nutrition professional. So whether that's a nutritionist, or registered dietitian would be preferred, but somebody who can really help you navigate that journey to your individual case. In the same way that I'm a fertility specialist, they're a food specialist. And there's several really, really great resources out there. So nutrition is a big piece.

Exercise. Now I know I'm guilty of this. And we know that if you do less than 5,000 steps daily, that's actually classified as sedentary. So take a look in the mirror. Have you really done more than 5,000 steps a day? If you haven't, that's definitely something that you wanna start incorporating into your life because we don't wanna be sedentary. We wanna make sure that we're, as a colleague of mine says, that we're loving our body with movement. We wanna love our body with movement, make sure we're keeping those bones and joints moving. There's so many benefits to exercise, including benefits to general health that may impact your fertility. So definitely wanna make sure you're incorporating that.

Now the third one that not a lot of people talk about is Sleep. So sleep is actually considered one of the pillars of health. We know that there is so much regeneration of tissue, of neurons, so much healing, so many hormone changes and things that occur during our sleeping hours that that's really important. We see higher rates of irregular cycles, higher rates of infertility in night shift workers. There really is a real risk to patients who are not getting adequate sleep. So if you suffer from sleep disorders, from insomnia, those are all things that could be contributing to your general health and as a consequence of that to your fertility. So you definitely want to make sure that you're exploring that and actively treating it if indicated.

The next thing I'll talk about is work exposures. So there has been some literature to show that people have certain environmental exposures. I mentioned night shift workers earlier. Another classic one is hairstylists who work in a hair salon, my firefighters, long distance truck drivers. So there's certain work exposures to toxins that could potentially impact fertility. And that's something that you wanna just identify, be aware of, not everybody can quit their job, but potentially taking precautions or measures to minimize your exposure.

The last thing that I'll talk about is stress management. Particularly now in a post-COVID world, all of us are very, very stressed. They say that we have the most technology, we have the most access that we have ever had in our history, and yet we are the most unhappy that we have ever been in our history. We know, in that context, we know that at baseline, the typical average American adult is stressed. When you add infertility on top of that, that is only going to exacerbate and worsen those stress levels. Now the impact, because I get this question a lot, the impact of stress on fertility is a little bit difficult to tease out because there's not a really clear objective way to measure that. But we know that if you can manage your stress better, that you're more likely to engage in the treatment, you're more likely to continue the treatment after a negative outcome, and at the end of all of that, because of your continued treatment, you're more likely to be successful. So stress management is super important.

And stress management looks different for everybody. For some people, that is exercise. For some people, that is individual counseling with a therapist or a psychologist. For some people, that is couples counseling and doing that regularly to really navigate the feelings that each person is going through individually and how that's impacting their relationship. For some people, that may look like group support. Resolve, which is the National Fertility Association, it's a nonprofit organization. They have a great network of online support and in-person support regionally. And then also potentially things like acupuncture, massage, meditation. Meditation is a great one and definitely not used enough. Yoga. I mean, there's so many things that can be incorporated for stress management. So whatever that looks like for you, you really want to make sure that you, number one, acknowledge that the infertility journey is stressful; and number two, that you're proactively taking measures to combat that, okay, to balance that out.

Again, the effects of this are not necessarily to improve fertility, but to improve your experience in the infertility journey and how you navigate that infertility journey.

So we've talked a lot about lifestyle. If you have any additional questions about lifestyle, definitely let me know. Other common things that people ask about alcohol, try to minimize alcohol as much as possible. Tobacco, same thing. We know that nicotine has a direct impact on sperm and eggs. So definitely want to eliminate that, not minimize, eliminate tobacco. And then the third thing that people ask a lot about is caffeine. And caffeine, generally speaking, if you're drinking one 12-ounce cup of coffee a day, it's appropriate. You can continue to do that. Obviously, you're not going to be doing the triple venti shot espresso, but a normal 12-ounce cup of coffee has been shown to be fine. And actually, some people would argue that's probably safe in pregnancy as well.

So that's with regards to lifestyle. We're going to move on to supplements. And again, each clinic, each fertility provider is going to have a little bit of a tailored approach here. So in terms of supplements, I really want you to be talking to your individual fertility specialist because they're really going to navigate or help you navigate based on what their clinical experience is, what their belief or interpretation of the data is showing. Most patients are recommended to be taking a prenatal vitamin and that prenatal vitamin to have folic acid.

Now, there are some suggestions that for patients who have a low egg count, potentially doing DHEA, doing CoQ10, there's some mixed data on that. For patients who have PCOS, the newer data suggests that inositols like myoinositol and d-chiroinositol may be beneficial. And then there's a whole host of other ones. So I'm not going to get into each and every one. I want you to talk to your provider about what they specifically recommend in their clinic. But at least know that at minimum you should be doing a prenatal vitamin, you should be doing folic acid, and the other ones you want to be talking to your doctor about.

Hopefully this blog entry has been helpful. This is just dipping our toe into that treatment piece.

Stay tuned for the next blog entry. We'll be talking all about the medications that we use in the fertility journey as far as treatment is concerned. And we'll also be talking about the IUI procedure. See you next week. Bye-bye now.

*This content is intended solely for educational purposes and is not to be construed as medical advice. For personalized recommendations concerning your specific healthcare needs, kindly consult with your healthcare provider.