Fertility Health · 2020-04-13 · Guide to Fertility Health Page 8 If you’ve been trying to get...
Transcript of Fertility Health · 2020-04-13 · Guide to Fertility Health Page 8 If you’ve been trying to get...
We still don’t know
everything about the effect
of COVID-19 on fertility,
pregnancy and childbirth.
Despite these uncertainties,
your nutrition and lifestyle
choices both before and
during pregnancy can have
a long-term impact on
both you and your future
baby’s health.
Fertility Health
What You Need to Know, Including Information on COVID-19
Contents
There is currently no evidence that COVID-19 infection reduces the fertility
of men or women or affects the health of your baby. Many IVF clinics have
temporarily stopped performing fertility treatments, to facilitate greater
social distancing, to reduce the use of medical resources needed elsewhere,
and because the treatments themselves could potentially increase the risk
of infection.
Even with all of this, it is important to remember that if you’re trying to
conceive naturally, it is never too soon to begin preparing for your baby.
As soon as you and your partner decide to start trying, prepare your body
for a healthy pregnancy by eating a balanced diet, taking a high-quality
preconception supplement and maintaining an overall healthy lifestyle that
includes daily moderate exercise. In this eBook we will discuss:
COVID-19 and Fertility
Pregnancy and COVID-19
Things to Do Before You Get Pregnant
Healthy Lifestyle Habits
Nutrients Needed in Your Preconception Prenatal Vitamin
How Fertility Changes as You Get Older
How to Maximize Male Fertility
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Guide to Fertility HealthPage 3
COVID-19 AND FERTILITY
Male Fertility
Unlike the Zika virus, there is no current evidence that
COVID-19 can cause birth defects by infecting sperm.
Although no studies have yet been done to check the sperm
count of men who have had a prior COVID-19 infection,
there are some theoretical concerns. One small possibility
is that the virus itself could cause possible damage to the
testicles, resulting in lower sperm counts. The other concern
relates to reduced sperm production that could result from
a prolonged high fever.
For these reasons, if you are trying to father a pregnancy,
and you had COVID-19 in the past, it would be best to have
a semen analysis done.
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Female Fertility
Women with symptoms of an active viral infection (i.e.
fever, body aches, cough, shortness of breath, diarrhea,
etc.) should avoid trying to conceive until fully recovered.
While there is no direct evidence that conceiving while ill
with COVID-19 would harm the pregnancy, any condition
with high fever should prompt a temporary delay, until the
fever is gone.
Although more research is underway, there is no current
evidence that a past bout of COVID-19 will affect a
woman’s ability to conceive.
TO TRY OR NOT TO TRY?
Unless you or your partner currently
have COVID-19, there is no clear
medical reason to stop trying to
conceive. Especially for women in their
mid-30s or older, a significant delay may
reduce your chances for conception.
For some women, there may be
logistical or situational reasons to
postpone. For instance, in the months
ahead, as the healthcare system
struggles to deal with COVID-19, access
to routine obstetrical care may become
more limited.
Finally, while there are no studies to
suggest that pregnant women are more
susceptible to COVID-19, more research
is needed.
Guide to Fertility HealthPage 4
PREGNANCY AND COVID-19
Does pregnancy make you more susceptible to COVID-19?Pregnant women may be more susceptible to some viral infections
because of the normal changes that occur in heart and lung function
during pregnancy. However, a report issued by the World Health
Organization in February 2020 examined the records of 147 pregnant
women with COVID-19 in China. It concluded that pregnant women
were not more likely to develop severe disease.1
Can COVID-19 be transmitted to the baby during pregnancy?Several studies have shown that coronaviruses do not appear to cross
the placenta. A recent study showed no evidence that COVID-19 is
transmitted to the baby during pregnancy.2 Although one recent study
has shown that transmission is possible from an infected mother to
her baby during a c-section, the affected babies in the study all
recovered quickly.3
Can a COVID-19 infection during pregnancy cause birth defects?A recent Chinese study did not show any increased risk of birth
defects. However, the study was small, and all the women had
COVID-19 during the third trimester.4 The effect of having COVID-19
early in pregnancy has not yet been determined.
What happens if I get COVID-19 while I’m breastfeeding?Studies have not found any evidence that the COVID-19 virus is
present in breastmilk.5
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THINGS TO DO BEFORE YOU GET PREGNANT
Looking for some quick and easy recipes to jump start your fertility? The recipes in this eBook contain fertility-friendly ingredients such as whole grains, healthy fats, full-fat dairy, and vegetarian sources of iron and
protein.
Whole Grain Walnut Cannoli BowlThis quick breakfast includes whole milk ricotta, whole grain cereal and healthy fats in the walnuts, a perfect way to start your day with foods to help improve fertility.
Preparation Time: 3 minutes Cooking Time: 30 seconds Serves: 1
1/3 cup whole milk ricotta cheese 2 tablespoons chopped walnuts 10 dark chocolate chips ¾ cup bran cereal with raisins
1. In a bowl add the ricotta cheese, top with walnuts and chocolate chips, sprinkle cereal over the top.
2. If desired, heat on defrost in your microwave for 30 seconds to warm
slightly.
EAT MORE:
Colorful fruits and vegetables.
Whole grains such as quinoa, oatmeal, brown rice, and whole grain
pasta, bread and cereal.
Healthy fats such as olive oil, walnuts, almonds
and avocados.
Whole milk or full-fat yogurt and cheese.
Whole eggs (the yolk is rich in choline).
Vegetarian sources of iron. These include spinach, beans, legumes,
prunes, raisins, and cashews.
EAT LESS:
Food and drinks with added sugars such as sweets (cakes, cookies,
candy bars) and soda.
Fried foods
ALSO:
Replace a serving of meat with a vegetarian source of protein every
day. These include beans, lentils, legumes, quinoa, nuts, seeds and
nut butters.
Drink plenty of water every day.
Whether you decide to start trying now, or delay for a few months,
there are steps you can take to prepare your body for pregnancy.
Start today by following these healthy eating tips.
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RECIPES
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As soon as you start thinking of having a baby, it’s important to eat a balanced diet of healthy foods and to take a preconception vitamin.
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HEALTHY LIFESTYLE HABITSIn addition to eating a healthy diet, follow these lifestyle tips to
improve your fertility and promote a healthy pregnancy.
If you need help, see a registered dietitian.
Stop smoking.
Stop drinking alcohol.
Limit caffeine found in coffee, tea, chocolate, soda and
“energy” drinks.6
Do moderate exercises, such as brisk walking, for at least 30 minutes
five days per week.7
Achieve a healthy body weight. Being overweight or underweight can
cause irregular menstrual cycles and can impair ovulation and reduce
your chances of getting pregnant.7
Egg Sandwich with Mashed Avocado and Tomato
This filling meal hits so many of your fertility food goals. Egg yolks are rich in choline, an important nutrient for brain and neural tube development. It includes whole grains in the bread and healthy fats in the avocado and olive oil too.
Preparation Time: 11 minutes Cooking Time: 7 minutes Serves: 1
1 egg 1 dash black pepper 2 slices whole grain bread ½ avocado 2 teaspoons olive oil 1 dash salt 1 small tomato, sliced
Directions:
1. Coat a skillet with cooking spray for the fried-style egg.
2. Heat the egg on both sides until cooked through, sprinkle with pepper.
3. In a bowl, mash the avocado with the olive oil and salt.
4. Toast the bread and spread with the
avocado, fill with the egg and tomato.
Fertility-Friendly
RECIPES
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NUTRIENT AMOUNT PURPOSE
Folate 600 -1350 mcg DFE
To promote healthy neural tube development.8
Vitamin D3
50 to 100 mcg (2,000 to 4,000 IU)
To promote healthy vitamin D levels for fertility.9, 10
Iron 18 mgTo maintain adequate iron stores and to prevent anemia.11
Iodine150 to 220 mg
To promote normal thyroid function and a healthy pregnancy.12-14
Choline100 mg to
550 mg
To promote brain and neural tube development.15, 16
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RECIPES
NUTRIENTS NEEDED IN PRECONCEPTION Take a high-quality preconception vitamin that contains at least the
following nutrients:
Black Bean and Vegetable Quinoa
Quinoa and black beans are vegetarian sources of iron, which is helpful for your fertility. This gluten free meal can be served warm or cold, and is filling too! Top with your choice of avocado, cheddar cheese, sour cream, tomatoes, or salsa for even more flavor.
Preparation Time: 15 minutes Cooking Time: 35 minutes Serves: 4
1 teaspoon olive or canola oil 1 small onion, chopped 1 cup chopped red, orange, and/or yellow 3 cloves garlic, chopped ¾ cup quinoa 1 ½ cups vegetable broth 2 teaspoons ground cumin ¼ teaspoon cayenne pepper A dash of salt and ground black pepper 3/4 cup frozen corn kernels Two 15-ounce cans black beans, rinsed and drained ½ cup fresh cilantro
Directions:
1. Heat oil in a saucepan over medium heat; cook and stir onion, pepper, and garlic until lightly browned, about 10 minutes.
2. Mix quinoa into onion mixture and cover with vegetable broth; season with cumin, cayenne pepper, salt, and pepper. Bring the mixture to a boil. Cover, reduce heat, and simmer until quinoa is tender and broth is absorbed, about 20 minutes.
3. Stir frozen corn into the saucepan, and continue to simmer until heated through, about 5 minutes; mix in the black beans and cilantro.
DID YOU KNOW?
According to the Centers for Disease Control and Prevention,
45% of pregnancies in the United States are unplanned.17
Folate is essential in early pregnancy when many women may not
know they are pregnant.8
Your preconception vitamin should contain 600 - 1,350 mcg DFE
of folate.
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If you’ve been trying to get pregnant for six months to a year but haven’t had success, it is time to speak to your doctor.
Roughly one out of eight couples in the U.S. will have difficulty getting pregnant.18
Although there are many things that affect the ability to have a baby, the most common factor is increasing age.19 As we get older, our egg quality declines. This decrease in quality can prevent a woman’s eggs from being fertilized and also increase the risk of miscarriage
There is hope, though. The good news is that there are things you can do to improve your ability to get pregnant and to have a healthy baby. Studies suggest that certain nutrients can help improve your egg quality.
In addition to a preconception prenatal vitamin that contains enough vitamin D, speak to your doctor to see if these additional supplements may be helpful for you.
NUTRIENT AMOUNT PURPOSE
Coenzyme Q10 (CoQ10)
200 mg, 3 times a day (standard CoQ10), or 125 mg, 2 times a day (CoQ10 with VESIsorb for enhanced absorption)
To promote healthy egg quality. 20, 21
DHEA
25 mg, 3 times a day Take only if recommended by your doctor
To promote egg quality and optimize ovarian reserve.22
Inositols
2,000 mg myo-inositol plus 50 mg D-chiro-inositol, 2 times a day.
To promote healthy egg quality. To promote regular menstrual cycles and ovulation if you have PCOS.23-26
Melatonin 3 mg. Take at bedtime.To support healthy egg quality prior to IVF.27, 28
HOW EGG QUALITY CHANGES AS YOU AGE
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There are supplements you can take to
improve your egg quality, which will
increase your ability to get pregnant and
improve your chances for a healthy baby.
Guide to Fertility HealthPage 9
MAXIMIZING MALE FERTILITY
Male infertility factors affect about 35% of all couples who are
trying to get pregnant.18 Roughly 1 out of 20 men will be affected
by male infertility.29
Some of the common reasons for male infertility include infection,
blockage, and high levels of oxidative stress in the semen.
Antioxidants, including certain vitamins and minerals, can help
combat oxidative stress and maintain healthy sperm.30
If you’ve been trying to conceive for 6 months to a year without
success, see your doctor to find out what you can do to improve
your chances.
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30-80% of male fertility concerns are thought to be due to the damaging effects of oxidative stress on sperm.30
Guide to Fertility HealthPage 10
SUPPLEMENTMAY PROTECT SPERM AGAINST OXIDANT DAMAGE
MAY INCREASE THE NUMBER OF SPERM
MAY IMPROVE SPERM ABILITY TO SWIM
NOTE
Vitamin C 30 • • •Vitamin E 31, 32 • •Vitamin D 33, 34 • Promotes healthy vitamin D
and testosterone levels
Selenium 35 • •Lycopene 36 • • •Zinc 37 •Folic Acid 37-39 •
Coenzyme Q10 40-42 • •
Increases sperm density and improves sperm morphology (shape)
L-Carnitine 43 • • Provides energy for sperm
Certain Nutrients Can Help Improve Male FertilityIn addition to following a healthy diet and lifestyle, speak
to your doctor to see if these additional nutrients may be
helpful for you.
NUTRIENTS FOR MALE FERTILITY
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Antioxidants may improve the quality
of sperm by reducing oxidative stress.
Guide to Fertility HealthPage 11
1. The World Health Organization. Available at: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. Accessed: March 24, 2020.2. Chen et al. Lancet. 2020; 395(10226):809-815.3. Zeng et al. JAMA Pediatr. 2020; doi:10.1001/jamapediatrics.2020.0878 [Epub ahead of print].4. David A. Schwartz. Arch Pathol Lab Med. 2020; doi: 10.5858/arpa.2020-0901-SA. [Epub ahead of print].5. The Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancybreastfeeding.html. Accessed: March 24, 2020.6. Signorello and McLaughlin. Epidemiology. 2004; 2:229-39.7. ACOG Committee. Obstet Gynecol. 2015:126(6):e135-42.8. MRC Vitamin Study Research Group. Lancet. 1991; 338(8760):131-7.9. Wagner et al. Am J Obstet Gynecol. 2013; 208(2):137.e1-13.10. Wagner et al. J Steroid Biochem Mol Biol. 2013 136:313-20.11. Gautam et al. Medscape J Med. 2008; 10(12):283.12. Delange. Public Health Nutr. 2007; 10(12A):1571-80.13. De Escobar et al. Public Health Nutr. 2007; 10(12A):1554-70.14. Hollowell and Haddow. Public Health Nutr. 2007;10(12A):1532-9.15. Shaw et al. Epidemiology. 2009; 20(5):714-9.16. Shaw et al. Am J Epidemiol. 2004; 160(2):102-9.17. The Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/reproductivehealth/contraception/unintendedpregnancy/index.htm. Accessed: July 1, 2018.18. Resolve: That National Infertility Association. Available at: www.resolve.org. Accessed: July 6, 2018.19. The American College of Obstetricians and Gynecologists. Female age-related fertility decline. Available at: https://www.acog.orClinical-Guidance-and-Publications/Committee-OpinionsCommittee-on-Gynecologic-Practice/Female-Age-Related-FertilityDecline. Accessed: July 6, 2018.20. Bentov et al. Fertil Steril. 2010; 93(1):272-5.21. Bentov and Casper. Fertil Steril. 2013; 99(1):18-22.22. Gleicher and Barad. Reprod Biol Endocrinol. 2011; 9:67.23. Artini et al. Gynecol Endocrinol. 2013; 29(4):275-9.24. Genazzani et al. Gynecol Endocrinol. 2008; 24(3):139-44.25. Constantino et al. Eur Rev Med Pharmacol Sci. 2009; 13:105-10.26. Papaleo et al. Fertil Steril. 2009; 91(5):1750-4.27. Nishihara et al. Gynecol Endocrinol. 2014; 30(5):359-6228. Batioglu et al. Gynecol Endocrinol. 2012; 28(2):91-3.29. Showell et al. Cochrane Database Syst Rev. 2014; (12):CD007411.30. Akmal et al. J Med Food. 2006; 9(3):440-2.31. Geva et al. Fertil Steril. 1996; 66(3):430-4.32. Suleiman et al. J Androl. 1996; 17(5):530-7.33. Lerchbaum and Obermayer-Pietsch. Eur J Endocrinol. 2012; 166(5):765-78.34. Blomberg Jensen et al. Hum Reprod. 2011; 26(6):1307-17.35. Moslemi and Tavanbakhsh. Int J Gen Med. 2011;23(4):99-104.36. Gupta et al. Int Urol Nephrol. 2002; 34:369-72.37. Irani et al. Urol J. 2017;14(5):4069-4078.38. Wallock et al. Fertil Steril. 2001; 75(2):252-9.39. Wong et al. Fertil Steril. 2002; 77(3):491-8.40. Balercia et al. Fertil Steril. 2009; 91(5):1785-92.41. Nadjarzadeh et al. Andrologia. 2014; 46(2):177-83.42. Safarinejad et al. J Androl. 2012; 188(2):526-31.43. Lenzi et al. Fertil Steril. 2003; 79(2):292-300.
REFERENCES
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Guide to Fertility HealthPage 12
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