Lifestyle

When looking to egg quality, the first thing we suggest is that you consider lifestyle.

To some degree, maximizing egg quality is predicated on maximizing your overall health, and the quickest and surest route for most of us to improve our health is to improve our sleep hygiene. That might be as simple as going to bed on time. But, for others, it might be more complicated including minimizing screen time before we go to bed and other rituals that will maximize the likelihood of sufficient sleep. The evidence for cutting out caffeine as it relates to egg quality is poor. That said, most of the literature points to the safety of minor amounts of caffeine, but decreasing fertility with significantly higher doses. Certainly four cups per day of coffee would be too much. We do encourage people to consider limiting themselves to one per day, with decaffeinated drinks to follow.

Of all lifestyle changes, quitting smoking is, by far, the most helpful choice, well beyond any of the supplements that follow. The relationship of alcohol to egg quality is somewhat controversial. Certainly 4 drinks per day is too much. We are not certain if there is a minimum “safe” amount. Fertility can be stressful; if you find yourself tempted by drink too often, please ask for help. There is a controversial association between egg quality and elevated BMI. If your body mass index is over 30, try 5% weight loss, an achievable goal for many, with a potential upside for your eggs.

Acupuncture and Traditional Chinese Medicine

We are not able to differentiate the “best” practitioners of acupuncture. We do not know who has good quality control mechanisms in place, best practices for minimizing cross contamination, or who provides the most efficacious treatments. However, we have had the opportunity to meet with a number of practitioners in the field, all with a special interest in fertility. For those who are interested in trying, I am most supportive of a trial of acupuncture +/- TCM. I would suggest a minimum of 2 months. By six months you should see pregnancy if acupuncture is going to be successful.

Supplements

Supplements should be taken for a minimum of two months; you will find if they are going to work, pregnancy should happen quickly. Six months will be trial enough. Though we remain hopeful that in taking these supplements you will be maximizing egg quality, please be aware that none have been proven in scientific randomized controlled trials to be effective.

The supplements we suggest include:

CoEnzyme Q10
Myo inositol (especially if PCOS)
Melatonin at bedtime unless you are taking thyroid medications
Omega 3 fatty acid
Vitamin C and E (antioxidants)
L’arginine
In our opinion, CoEnzyme Q10 is the most important of the supplements.
If you are only going to take one, take this one.
Dosing, and the “best” supplements for a patient, are individualized at the clinic.

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If you have difficult to control blood pressure, lifestyle changes alone may not be enough and medications become necessary.

We need to make sure that the medications are consistent with safety during pregnancy, which is why we always encourage medications to be arranged before pregnancy occurs.

Increased progesterone during pregnancy often causes your blood vessels to relax during the first and second trimesters. But it begins to rise from 24 weeks onward when you have an additional litre of blood pumping through your body. Which is why it’s so important to manage before becoming pregnant.

A commonly prescribed treatment is Labetalol. It is thought to be safe and does not cause excessive fatigue like some other medications can. Your doctor may begin your dose at 100 mg twice a day and increase, as needed, to 200 mg twice a day.

If Labetalol alone is not sufficient, your physician may add in Methyldopa, or long-acting formulations of Nifedipine, if the former two medications together are insufficient. It is also possible to add in Thiazide diuretics.

Though the evidence of Aspirin’s effectiveness for blood pressure is limited, there is no harm in taking ASA 81 mg daily.

Talk with your physician about your medication options. It may take a little time and adjusting your medication to find the right balance for you.

The post How do I manage hypertension before, during and after pregnancy? appeared first on Fertility.ca.

The majority of pregnant women will experience some nausea or vomiting at some point in their pregnancy. For some women, it’s mild and doesn’t last very long.

The causes of morning sickness is generally assumed to be caused by hormonal shifts in your body and changes in your blood sugar levels that are normal in pregnancy.

But there is a more serious level of nausea and vomiting of pregnancy (NVP) that can have serious health consequences. It’s called hyperemesis gravidarum (HG).

It may be triggered by certain smells, you may experience an increase in saliva, feel fatigued and have an unpleasant taste in your mouth. In addition to feeling nauseous, other symptoms include retching, gagging, dry-heaving and/or vomiting.

HG is serious and can lead to dehydration that may require hospitalization. The first thing you should do is talk to your doctor about your symptoms! Especially if this is your first pregnancy. Be sure to tell them about any vitamin or mineral supplements you may be taking.

NVP can feel extra frustrating if you’ve had fertility challenges prior to becoming pregnant. Reach out to your family and friends for support. When you can eat, make sure you’re making balanced choices. If you feel up to physical activity, do whatever you can. Most importantly, take the time to rest properly – as much as you need.

If you need to talk to someone, you may find the Motherisk NVP Helpline helpful. It’s bilingual and offers help, support and counselling. Know other resources for morning sickness? Let us know in the comments!

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