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Fertility & Conception

  1. Where can I find a dietitian who works with infertility? Answer
  2. I was diagnosed with Polycystic Ovarian Disease, told to lose weight and given the pill Answer
  3. My wife has poor egg quality and her fertility doctors say they knoew of nothing that can be done to improve her eggs. Is there? Answer
  4. I want to have more children. Could my diet or my extra weight be interferring with my chances at conceiving? Answer

Where can I find a dietitian who works with infertility?

The Women's Health dietetic practice group of the American Dietetic Association specializes in working with infertility. You can find a dietitian at the American Dietetic Association. Include your zip code or city / state, the type of service you want (individual consultation) and expertise.

Although I certainly agree with you that testimonials are no way to practice science or choose a diet, I'd like to share with you my experiences. Last year, after severely injuring my back, I finally decided to get help to loose weight. I am a 5'4" 34 year old female whose weight began ballooning at the age of 20 with a simultaneous loss in menstrual activity. The number of obese women in my family had convinced me that genetics were the cause (they surely are) and that nothing would ever work. I was eventually diagnosed with Polycystic Ovarian Disease, told to loose weight and given the pill.

Nothing ever worked. I finally stopped all attempts to diet in 1989 after a month at Weight Watchers produced no weight loss and accusations of cheating ("You can't expect to lose, honey, if you don't stick to the diet.") Not only had I not cheated, I carefully and meticulously weighed every bite to avoid errors. I walked a half-hour ever day as well. I was humiliated, sick and frustrated. I checked the diet against a calorie counter and discovered the diet only had 800 calories a day! In 1995, I reached my top weight of 236 pounds and felt terrible.

After my injury last year, I consulted a reproductive endocrinologist (She is both a gynecologist and endocrinologist) to get a handle on my problem. After an examination and a few tests, she told me I am hypoglycemic and have elevated triglycerides and cholesterol. I was shocked, as my diet was high in complex carbohydrates, moderate in fat and alcohol free. She also gave me articles from the New England Journal of Medicine that explain the recent research that Polycystic disease is a symptom of hyperinsulinemia, which is, of course, also the cause of hypoglycemia.

I'm reasonably sure that I am a reactive, rather than a true hypoglycemic. This was last September. I have read everything I can get my hands on, both in print and on the Internet. I am now sure that medical science really does not understand enough about how different body's process food, since no two scientists or doctors can agree. I decided to follow my own philosophy of "moderation is the key." After following the hypoglycemia diet (protein with every bite of carbohydrates, no sugar and B vitamin supplementation), I realized that a chronic headache problem I'd had since childhood was cured. I used to get up to 7 headaches a week. My menstrual period returned; I had been taken off the pill for later testing and sinus problems had decreased 80% to 90%.

I also tried a carbohydrate-restricted diet called "The Carbohydrate Addict's Diet" by Doctors Heller. After the holidays were over, I noticed that only while on the CAD diet had any weight been lost. Since I had only tested that diet for a month, I decided to start it with the new year. In case you are not familiar with this diet, it is similar to Atkin's except that you do eat complex carbohydrates with one meal a day and that meal must be completed within an hour. I believe the purpose is to avoid triggering an insulin imbalance. I don't know how many grams of carbohydrates I am getting per day, but I don't think I am in ketosis. I do not follow the diet quite as strictly as is written, since I have four to six ounces of orange juice every morning and about two glasses of milk during the day.

The results so far have been incredible. I am loosing about one pound per week. I feel much more energetic and can climb my stairs without huffing and puffing (better oxygen uptake?). The most important news to me came last week when the endocrinologist re-tested me, including an examination of my ovaries and told me that I have reversed my cystic disease. All the hormonal and lipid blood levels have normalized as well. I have taken no drugs of any kind. The only significant change in my diet from where it was last summer is the complete elimination of sugar, which I did not eat much of in the first place and the reduction (not elimination) in potato, bread and rice consumption. I've always eaten more than the recommended quantity of vegetables.

At this point I am very comfortable eating three times a day, two restricted meals and one unrestricted meal. I had started on six tiny meals a day, which worked well initially. My appetite seems to be somewhat smaller from where it was before. I do not count or control calories at all. I select low fat meat as much as possible and am using as many soy products as I can for an alternate protein source. No one will ever convince me that this low carbohydrate diet is dangerous or wrong for me. I don't necessarily believe it is the only diet for all people.

I hope that as a few more pounds are lost I can begin exercise to overcome the back problem and strengthen my cardiovascular health. I am only just now finding it possible to do the back exercises prescribed by my chiropractor.

For the first time since early adulthood, I am contemplating the possibility of pregnancy.

I'd be willing to bet that the carbohydrate recommendations for people with insulin problems will be revised downward again, maybe to 30% or 40%. I don't think any diet that completely eliminates complex carbohydrates can logically be healthy, extremes seldom are.

I have the same opinion of super low fat diets. People are starting to notice my weight loss and I feel better than I have in 14 years. I have only lost 15 lb., so I have a long way and a long time to go.

I do believe my story is significant because of the effect on fertility issues. I wonder how many of the overweight women with Polycystic ovaries (half are not overweight) would benefit from the same diet I am on. I now believe that overweight is a symptom, not the disease and only treatment of the underlying disease will ever work.

It's hard to oppose something that shows results i.e. weight loss and reduction of ovarian cysts. I hope that this diet plan you have devised meets your weight and pregnancy goals long term. I am concerned about very low calorie diets and how those calories are divided up (40% carbohydrate, 30% fat and 30% protein), especially if you eliminate whole groups of food or eliminate nutrients like carbohydrate. Your higher protein intake may be responsible for your drop in food intake. The bottom line is, weight loss occurs when you eat less calories than you expend in your daily activities.

I am not familiar with the carbohydrate addict diet, but your food philosophy of "moderation is the key" seems sound nutritional advice. FYI, if you are in ketosis, your breath might have a fruity smell and your urine would test positive for ketones.

If your goal is pregnancy, your nutritional health 2 years before becoming pregnant is most important. It would be impossible to achieve nutritional health by eating a balanced diet on less than 1600 calories per day. I would highly recommend that you take a daily multivitamin that has 100% of the RDA for all vitamins and minerals if your calorie intake is less than 1600 calories per day.

You may not be aware that soy products contain phytoestrogens, which are estrogen like substances. For women, these compounds help regulate and moderate their own estrogen production. For men, these compounds often help reduce prostate symptoms including an enlarged prostate. Soymilk and tofu are particularly high in phytoestrogens. So you're including soy products in your diet may have also caused an improvement in your reproductive organs. You may want to search the Internet for more information about phytoestrogens.

Increased insulin resistance of fat cells can also cause Hyperinsulinemia (high insulin in the blood). Many persons who are very overweight have higher insulin levels in their blood because it takes more insulin to get into an abnormally large fat cell and turn blood glucose into energy. Insulin resistance seems to improve and blood insulin levels fall when people lose weight. Did your doctor explore this cause of your hypoglycemia with you? BTW, you are probably less winded from simple exercises like climbing stairs because of your weight loss.

Sugar and sweets also contribute to elevated triglycerides. Did you read my Triglycerides topic? Starches (complex carbohydrates) and sugar have a high glycemic index, which means that they cause a higher jump in blood sugar than other carbohydrate containing foods like milk, fruit and vegetables.

Carbohydrate from any source will help maintain blood glucose levels and reduce the loss of protein from the body, which can occur when calories and carbohydrates intake is low. Remember, your body can convert body protein into energy far easier than it can burn body fat.

Here is some body fat facts. Fat cells have a large capacity to increase in size by storing more fat per cell. Also, fat cells increase in number from birth through age 10 and increase at different times in life including pregnancy. If you were an overweight child, you are more likely to be an overweight adult who is more resistant to lose weight because you have more fat cells. Fat cells want to stay at least 40% full and if a fat cell drops below 40%, your body will urge you to eat to replenish the minimum fat required by fat cells. Your body is always prepared for a famine and stores fat for that purpose. So if you have more fat cells to begin with, your body can store more fat.

Lastly, testimonials do not replace nutrition science in proving what medical nutrition therapy is recommended for most people. There are many diet plans and supplements out there that have not been tested for effectiveness or safety. Therefore, I recommend nutrition therapy that has withstood the rigors of scientific testing. If medical science and recommendations seem confusing, remember the phrase "practicing medicine" as medicine is not perfect yet and there are many undiscovered treatments or remedies that change with new science.

My wife & I have been told that her "egg quality" isn't good. We were told this recently after a "high tech" procedure was done to retrieve her eggs and fertilize them with my sperm. The fertilization didn't take and we had an "out of the womb miscarriage "according to our fertility doctors. They said this was a result of poor egg quality and that they knew of nothing that can be done to improve her eggs. Is there?

Actually, a woman is born with all the eggs she will ever produce. The eggs ripen at different times from the onset of menses until menopause. Sometimes multiple eggs ripen during one month. Whereas, a man continually makes sperm. I do not know of anything nutritionally that can improve ovum quality, but you could do a Medline search on female infertility or human ovum. Medline is published medical research and may be a bit difficult to read, but worth a try. You could also consult other fertility doctors in your area about egg quality.

As to pregnancy, a woman's nutritional health 2 years prior to becoming pregnant is important as is the mother's weight gain during pregnancy. Would not suggest a weight loss program unless you make sure you get all the vitamins and minerals you need according to the RDA. When you do conceive, check out the Healthy Body Calculator. It calculates a healthy weight gain during pregnancy as well as the additional calories and protein necessary.

I had a baby 20 months ago and haven't been able to lose the 20 - 25 extra pounds since then. I want to have more children. My husband and I have been trying to no avail to have another child. Could my diet or my extra weight be interfering with my chances at conceiving? Should I be eating anything in particular to HELP get pregnant (I know, it sounds like witchcraft, but I've been told that diet DOES make a this true?) I'm afraid to "go on a diet" because I don't want to mess up my ovulation timing....but I WOULD like to lose this weight. Can you offer any suggestions or advice along with answering my previous question?

Body weight and nutritional status of the mother does impact fertility more often when weight is low and food intake (low vitamin and mineral content) is poor. You most likely can lose the 20 to 25 extra pounds without negatively impacting your ability to conceive as long as you lose it slowly (1 to 2 pounds per week) and exercise (30 minutes 3 to 5 times per week). A severe weight loss program (losing too much weight too quickly) could upset your ovulation cycle. Why don't you ask your doctor to see a Registered Dietitian who can plan an individual, balanced nutritious weight loss diet. There are some good suggestions in the Overweight Topic.

There is no magic fertility food.

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