Posts Tagged ‘Naturopathy and Supplements’

The importance of selenium for NZ infertility patients

Saturday, October 23rd, 2010

It’s a known fact that New Zealand soils are seriously deficient in selenium, a trace mineral our bodies need. When I went to see a fertility naturopath, she immediately put me on a bunch of supplements including Vitamin E with Selenium. Apparently eating two Brazil nuts per day will provide you with enough Selenium, so it’s considered generally sensible advice to either eat those or take a supplement.

Here’s another angle on the selenium connection from a kiwi woman from a farming family:

I have had a couple of people PM me about using selenium and I thought others may be interested.

Firstly I make no promises, this is completely unscientific and I dont want to give people false hope.

We are described as unexplained infertility. Our fertility specialist has always said there is no medical reason why we cant conceive naturally. Of course 5 years later, 6 IVFs and lots of heartache you stop believing this. Though we did manage 3 pregnancies that ended in miscarriages following IVFs.

So a few months ago after our last miscarriage my mother sat me down and said I needed to take selenium. I am not one to take things without good reason so rolled my eyes and said ‘yeah yeah thanks mum’. However she told me a story about how 20 years ago on her sheep farm she was told to put selenium on her pastures. (My mother farmed for years on her own after my father died so everyone was keen to tell her what she should do). She says that as a direct result of that her lambing percentages increased by up to 15%. There is plenty of research out there to say NZ soils are selenium deficient and selenium assists in animal health and fertility. Anyway I did some research about selenium assisting human fertility and couldnt find anything other than assisting in male fertility (which has never been a problem for us).

Anyway we both started taking it (I thought we had nothing to lose) and the rest is history. We were about to start our 7th and last IVF, and had our names on the egg donor list when I discovered I was pregnant….naturally. Unbeleivable. Never before had this happened. And touch wood it is still going okay.

So read into this what you want. Who knows if the selenium was the factor that changed things. It might be just luck!

Interestingly since we have started to tell some of our farming friends about our pregnancy we have had a few tell us about how they use selenium for their animals’ fertiltiy.

I suggest if anyone wants to take selenium you should check with your fertility specialist (I didn’t, but then I never thought it would work either). I have since mentioned to my fertility specialist, fertility nurses, midwife and obs and all have given me that ‘yes well we’ll let you believe that’ look! There being no research doesn’t help but who knows…worth a try anyway.

We took 100mcg of Red Seal Selenium ACE purchased from the supermarket for about $12 for 40 tabs and took one a day each. Just a note of warning that selenium is very poisonous if you take too much.

Interesting, huh? Food for thought – and possibly food for fertility!

We all know there are no silver bullets in this game, but it many ways it’s about trying to get all the stars aligned so we have the best possible chance. So, here’s one more star that couples struggling with infertility might bring into alignment to see if it helps eliminate one more obstacle. Another for the “won’t hurt, might help” file.

We’ve had multiple losses – what should we be asking about?

Wednesday, October 14th, 2009

“We seem to have no trouble getting pregnant, but we’ve had several first trimester losses.” Or, “We put back good-looking embryos every time, but they just don’t stick.” If this sounds like you, here are a few ideas you might want to discuss with your doctor.

Miscarriages can be caused by any one or more of the following factors:

  • structural
  • hormonal
  • immunological/autoimmune
  • environmental
  • genetic

Let’s start (as the drs often do) with the fairly basic hormonal tests. One of the first that’s included in a fertility workup is testing progesterone in the luteal phase. Most drs order this for CD21 (Day 21 of your cycle), but actually you should really have it done at 7dpo (7 days past ovulation). Of course, 7dpo=CD21 if you ovulate on Day 14 of your cycle, but if you usually ovulate late or early, or if it’s unpredictable, you might want to track your ovulation using BBTs (basal body temperatures) and go at 7dpo. If your progesterone (P4) levels aren’t high enough, you may need progesterone supplements (like utrogestan pessaries) after ovulation (O). Some specialists believe this is a VERY common problem with older women and that if you’re over 40 and ttc naturally you should take P4 after O every cycle.

Another important one to test early, especially if you have any family history or tend to feel tired a lot, is thyroid conditions. Hypothyroid (underactive thyroid) does pop up reasonably often as a cause for conception and sometimes miscarriage problems and is easy to test for. You can ask your GP for this if you’re not seeing a specialist.

If you’re ttc naturally you should also check whether you have a luteal phase defect, i.e. once you ovulate it takes fewer than 12 days for AF (your period) to arrive. You can usually figure this out by charting your basal body temperatures (BBTs) – and a really good site for learning how is Fertility Friend. Again, if your LP is too short, this can be easily fixed with progesterone support after O.

There’s a panel of blood tests you can ask for that are used to diagnose some of the possible causes of “recurrent pregnancy loss” (RPL) or “recurrent implantation failure” (when those embies just don’t stick). Broadly speaking, they cover three categories of issues – autoimmune issues (your body may be rejecting embryos as foreign bodies), clotting issues (not sure the exact mechanism for this, but if your blood clots too much, this makes pregnancy loss more likely – some clotting issues are caused by autoimmune problems) and some genetic issues. Here’s the list that we were sent for, and I think it’s a pretty typical list for New Zealand (some countries like the States seem to test for half a dozen kitchen sinks, several of which aren’t available in NZ):

  • Coagulation screen
  • Thrombophilia screen
  • Autoantibody screen incl.
  • antithyroid antibodies,
  • anti-gliaden antibodies
  • Factor V Leiden
  • Karotype
  • MTHFR mutation
  • Anticardiolipin antibodies
  • Lupus anticoagulant
  • … and a karotype for DH (who gets off easy, as usual).

Probably the next logical step is to get either a saline sono (ultrasound during which they squirt saline solution into your uterus to help them see better) or an HSG (similar, but it’s an X-ray procedure where they shoot iodine dye into your uterus and can also check whether you have blocked tubes). Either of these should tell you whether you have any structural issues in the uterus that might be preventing you from achieving or holding onto a pregnancy. Examples include uterine polyps, fibroids, scar tissue, and an unusual shaped uterus. The most likely issues can often be treated with some fairly minor surgery.

The main environmental causes of miscarriages are not usually tested for, but things you should look around you to check your exposure. Some to keep an eye out for include lead, mercury, organic solvents and ionising radiation. Other more common culprits like cigarettes, alcohol, coffee and other drugs should be cut right out (or, down as much as possible) while ttc. Some naturopaths will do things like send a sample of your hair for analysis for heavy metals, which can highlight things you are exposing yourself to without knowing it. They also advise avoiding those forms of radiation and related exposure that we are not often aware of. These include long-haul flights (which expose the body to as much radiation as a full-body X-ray, or so they say) and keeping a cell phone in your pocket right next to your ovaries – think about it!! Well, who knows which of these various things are real causes, but if you want to make sure you try everything you can to prevent another loss, you’ll probably do what I did and take the ideas pretty seriously.

But what if my specialist won’t run all these tests?

This is quite a common comment from a lot of women/couples dealing with RPL (recurrent pregnancy loss). It may be frustrating, but there is another way to look at this. OK, you may not be able to test for the entire kitchen sink, but maybe you can ask your specialist to consider treating you as if you did have several of these issues going on but they just may well be undiagnosed. That may sound nuts, but there are actually quite a few low-tech options you can ask about that many doctors will agree fall into the “won’t hurt, might help” category. These include:

  • low-dose aspirin (usually 100mg/day) – addresses clotting issues
  • high-dose folic acid (4-5mg/day) – helps prevent neural tube defects
  • progesterone support (usually Utrogestan pessaries) after O on every cycle you are ttc
  • low-dose estrogen support after O too (2mg estradiol valerate, for example)

If you’re doing IVF, each cycle is a bit more high stakes, so you may be able to push for a bit more of a kitchen sink approach. Some other things that people are often allowed to try even if there hasn’t been a definitive diagnosis of a particular cause for repeated losses/failures include:

  • progesterone shots instead of (or as well as) the pessaries – for after egg collection
  • a low-dose steroid such as Dexamethasone – to address any undiagnosed immune issues
  • Heparin shots – Heparin is a blood thinner, so this also addresses clotting factors

Finally, don’t forget that there’s good evidence that acupuncture improves pregnancy and live birth rates for patients undergoing IVF – and good reason to believe this is also true for couples trying to conceive naturally or with IUI. Click on the category Acupuncture and Chinese Medicine in the left-hand column to see more posts on this topic.

What low-tech things can we do to increase our odds?

Saturday, October 3rd, 2009

Maybe IUI and IVF aren’t an option for you and you’d like to try and increase your odds generally while ttc naturally. Or maybe you’re gearing up for – or in the middle of – IUI or IVF treatment. Or on one of those interminable waiting lists!

Is there anything you can do NOW that can help improve your odds?

Yes! There are a number of things you can do to get your bodies readier and more likely to succeed than they currently are for conception and pregnancy. Many of these take several months or more before you see the full benefits, so remember, it’s never too early to start AND it’s never too late to start because every little bit helps! If you’re on a waiting list for IVF (or waiting to get on one!!), this is a fruitful way to make the most use of your time.

Things men can do to improve sperm quality

Let’s start with the guys, for once! Get them out of those briefs and into boxers for starters, and no long spa baths or sweaty bike rides!! Sperm don’t like being overheated. Guys are also supposed to get their BMIs in a healthy range – usually quoted as 19-25, but bear in mind the number can be misleading if you are athletic and carry a lot of muscle. A hilarious recent example is that about 25% of the All Blacks are considered obese and the rest are ALL overweight!

There are also a bunch of supplements that are known to improve sperm quality. Here’s the list that was recommended to us by a naturopath:

  • a multivitamin called V2000
  • CoQ10 100mg (the more bioavailable gel type)
  • Vitamin C 1000mg/day (twice a day if he had a cold)
  • Vitamin E 200mg w/Selenium
  • Flax seed oil 2000mg I think
  • zinc complex (at night)
  • L-carnitine 500mg

I’ve also seen several people also recommend Vitamin B complex and folic acid (800mcg). And most naturopaths would also advise giving up smoking (anything!!), cutting right back on drinking and cutting out coffee (even decaf) if at all possible. Tea is better, green or herb/fruit tea even better.

Does it work? Well, after our IVF#3 failed my DH was so disappointed he went on “vitamin strike” for 3 months. By the time we tried IVF#4 his count had dropped from 90mil/ml to 18mil/ml. After that, no more vitamin strike!!! 😉

What can women do to improve their odds of conception?

The clinics will give you a few basic tips here – cut RIGHT down on coffee and alcohol, stop smoking and other drugs, exercise moderately three times a week, and aim to get your BMI between 19 and 25 to maximise your odds. [However, bear in mind that BMI is a bit overly simplistic for some body types, e.g. very tall women or those who carry a lot of muscle.] Click here to access Fertility Associates’ advice on boosting your fertility.

Acupuncture and Chinese herbs can also be a great way to prepare yourself for IVF. As you can see from this summary of research on acupuncture and fertility, it can be used to treat all sorts of conditions, from endometriosis, PCO/PCOS and sperm counts/quality to advanced maternal age, high FSH and poor eggs. For more information about how and why it works in general and for various conditions, find related blog posts by clicking ‘Acupuncture and Chinese Medicine’ under Topics (in the left column of this page).

What about supplements for women? Well, there is a huge and overwhelming range available depending what diagnoses you are struggling with, so probably the best advice is to see a good fertility naturopath to help you pick out the best mix for you. Having said that, here are a few that seem to be recommended in many/most cases, from what I can tell …

  • a good multivitamin
  • folic acid, at least 800mcg, but if you’re ‘older’ or have had multiple losses or implantation failures, ask your specialist to prescribe you the 5mg dose
  • Vitamin C 1000mg/day, twice a day when you have a cold
  • Vitamin E with Selenium
  • Coenzyme Q-10 (aka CoQ10) 100mg, preferably the more bioavailable gel caps
  • Fish oil or flax seed oil, 2000-4000mg/day
  • zinc complex
  • iron supplement if your levels are a bit low (ask your GP to test)

For an additional truckload of ideas, follow this link to read about low-tech things women can do to increase the chances of conception. And if you fish around that site you will find a lot more info about low-tech methods for couples and some of the basics of conception (most of which you’ll already know, of course). Unfortunately their tips for guys was down when I last checked, but I’ve emailed them about it and will add a link to this blog if it comes back online.