Optimizing Fertility



Guidebook Purpose

The purpose of this guidebook is to provide guidelines and information that will optimize your fertility. These guidelines will help you make an easy transition into a lifestyle that will promote a healthy pregnancy. In addition, the purpose of this book is to promote the Laws of Naturopathic Medicine. These laws are common to many professions of healing and they continue to be worthy of renewed focus as you strive to improve your health and well-being.

First, Do No Harm. Naturopathic medicine uses therapies that are safe and effective.

Support the Healing Power of Nature. The human body possesses the inherent ability to restore health and is only aided by the physician’s role as a provider of supportive therapies.

Treat the Cause of Disease. Naturopathic Physicians seek and treat the underlying cause of disease, where symptoms are viewed as expressions of the body’s natural attempt to heal.

Treat the Whole Person. The multiple factors present in health and disease treatment are considered while treating the whole person.

Prevent Disease through Education. The physician’s primary role is to educate, empower, and motivate patients to take responsibility for their own health.

Prevention is the Best “Cure”. Naturopathic Physicians are preventative medicine specialists who can intervene appropriately to reduce risk and prevent illness.

Before beginning, we offer a note of warning and encouragement. The changes required of you may seem overwhelming at first or too difficult to master, but the satisfaction and joy you will receive after you achieve your goals will be well worth the sacrifice. It will be your personal desires and motivation that produce the results.

The key to success is not to become overwhelmed. Worry less about being perfect and more about being consistent. Striving for perfect eating habits will burn you out in a short time, while consistency will lead to perfection, leaving you feeling satisfied with your personal progress.

Improve your health and you will increase your opportunities for greater happiness. Happiness is a personal journey and requires harmonious alignment of spiritual, emotional, and physical needs. We wish you the best in your personal journey.

Patient Instructions

You are beginning a program designed to improve your egg quality, your uterine lining, and your hormonal balance. The program is based on the most up to date information about reproductive health. Your success with the program will hinge upon your adherence to the dietary principles, exercises, and supportive therapies. You can stay on track by doing the following:

1. Begin any recommended therapies as soon as possible. Ideally, you will have at least 3 cycles to improve your health before becoming pregnant. For many patients, this means getting started right away.

2. If you are running low on a supplement, do not wait to refill it. Try not to discontinue any components of your program before you have given the therapies time to be effective. Some aspects of the treatment will make noticeable difference quickly, while others take time.

3. Return to the office monthly for follow-ups. It is important to evaluate your progress and make any necessary changes to your program.

4. If your dietary recommendations are too difficult, talk to your doctor! Your doctor will usually have a simple solution to make your meals more palatable. We want you to succeed and will work with you!

The Keys to Success

To optimize your results, you need to consider all aspects of your reproductive health. Your body will sometimes limit your ability to conceive if you require nutrients or other support. The keys to success focus on telling your body that circumstances in your life are ideal for bringing a baby into the world. These healthy changes can be maintained throughout pregnancy and nursing. Overall, you may find that you enjoy the benefits of your healthier lifestyle and maintain these changes long term. For now, take changes one day at a time. Focus on doing everything you can to prepare your body to support another human life. That includes nutrition, healthy weight and blood sugar, improve digestion, reduce chemical exposure, work on your mind / body connection, knowing your fertility signals, and improved sleep. These are the 8 keys to success.

1st Key to Success: Nutrition

Nutrition is a vital part of your reproductive health. Make sure your body has the nutrients needed to support a healthy pregnancy. This includes macronutrients (fat, protein, and carbs) as well as micronutrients (vitamins and minerals). We will outline the most vital parts of healthy nutrition in this section.

Fatty Acids

Many people believe that a low fat diet is a healthy diet. This is not entirely true. What is important to focus on is the kind of fats that you are eating. Fat is vital for proper function of the body. You need fat and cholesterol to make cell membranes. You also need cholesterol to make hormones. You need fatty acids to make anti-inflammatory molecules in your body. Consider the fats you eat to be foods for this process. If you eat the wrong fats, you are building your cells with unhealthy materials. The wrong fats feed the inflammatory process in your body. This is especially detrimental in people whose fertility problems are related to inflammatory processes. The right fatty acids are needed for follicular rupture, the key part of ovulation in which the egg is released into the tube.

Omega 3 fatty acids are significantly deficient in the American diet, but are optimal for nearly every aspect of health and well being. Deficiency in Omega 3’s can result in depression, anxiety, heart disease, menstrual problems, and excessive inflammation. Because fish have become such a significant source of toxic exposure in our diet, it is important to make sure you are getting a clean source of fish oil. That means eating wild caught fish about once per week. To get the rest of your fish oil, you should supplement with a high quality oil that is molecularly distilled, tested for purity, and kept temperature controlled. This is one supplement that should be purchased directly from your doctor to ensure quality. Low quality fish oil can be rancid and polluted, which is ultimately detrimental to your health.

Trans fats have been in the press since being added to food labels. The increasing discussion of trans fats is based upon the knowledge that even a very small amount of trans fats in the diet can be significantly detrimental to your health. This may be due to the fact that your cell membranes are being constructed from a synthetic fat that interferes with normal cellular function. Recent studies have shown that even a small amount of trans fats can impact your fertility and cardiovascular health. While current recommendations suggest keeping your consumption below 2 grams, it is better to avoid trans fats completely. Read labels. If you see partially hydrogenated oils or hydrogenated oils, avoid that food. These are synthetic fats. Additionally, read the list below that lists common hidden sources of trans fats. Before you order a meal, think about what kinds of fats are in the food.

Fats to Maximize in your diet—Unsaturated fat

Olive oil canola oil almonds avocado pumpkin seeds

Hazelnuts cashews safflower oil sesame oil fish oil

Smart Balance

Fats to minimize but not avoid completely—Saturated Fat

Red meat butter palm oil

Coconut oil

Fat to avoid completely—Trans Fats and Partially Hydrogenated Oils

French fries breaded foods burritos pizza chips

Granola bars muffins pie pancake mix enchiladas

Shortening popcorn peanut butter deep fried foods crackers

Baked items fast food breads cookies low fat items

Margarine cakes tortillas doughnuts chocolate

*MOST of these are available without hydrogenated oils—check at your health food store

Foods High in Omega 3 Fatty Acids (anti-inflammatory):

Salmon, trout, mackerel, sardines, oils of cold water fish, flax seed oil

Foods High in Monounsatruated Fatty Acids:

Olive Oil, Canola Oil, Almond Oil

Meat with Better Fat Composition:

Make sure you are purchasing organic, grass fed, grass finished beef. This means that the cows have not been corn fed. Stated simply, imagine the fat composition of a human who has eaten corn chips their whole lives. Compare that to a person who has only eaten salad. The animal’s diet makes a difference. As an added benefit, the life of the animal is better under these conditions. For a good price on Grass Fed, Organic meats and eggs, try:



*For more information, see the "Understanding Fatty Acids" link on my website.

FATTY ACID COMPOSITION OF FOODS

oleic Linoleic Arach- alph- eicos- docosa- saturated cholesterol

acid acid idonic linolenic penta hexa fats (in mgs per

acid acie enoic a enoic a 3 oz.)

Atlantic cod 4.0 1.2 - 0.8 12.4 21.9 36 47

Pacific Halibut 25.7 0.9 - 0.3 1.0 7.9 19 35

Lake Herring (fresh) 18.1 4.3 - 3.4 5.9 13.3 25 54

Pacific Herring 16.9 1.6 - 0.6 8.6 7.6 26 81

Mackerel 19.3 1.1 - 1.3 7.1 10.8 34 62

Ocean perch 22.0 9.5 - 0.6 9.3 12.0 18 53

Chinook Salmon 29.1 4.3 - 3.4 8.2 5.9 21 54

Chum Salmon 21.4 2.0 - 1.0 6.7 16.1 20 54

Coho Salmon 18.6 1.2 - 0.6 12.0 13.8 15 42

Pink Salmon 17.6 1.6 - 1.1 13.5 18.9 15 44

Tuna, can in water 17.0 2.0 - 2.0 8.0 21.0 27 35

Rainbow Trout (fresh) 19.8 4.6 - 5.2 5.0 19.0 15 45

Shellfish

Blue Crab 17.6 1.9 - 1.2 13.4 11.0 19 78

Littleneck Clam 10.8 1.4 - 1.6 10.0 14.5 28 57

Shrimp 10.0 2.0 - 1.0 16.0 13.0 - 166

Pacific Oysters 8.5 1.2 - 1.6 21.5 20.2 25 93

Sea Scallops 5.2 0.6 - 0.3 21.3 26.2 26 28

Shark 16 0.3 5.0 - 10* 10* - -

Oils oleic linoleic linolenic EPA DHA saturated cholesterol

Butter 25 2.0 - 1.0 0.0 0.0 70* -

Flax Seed 17 15 - 55.0 - - 13 -

Cod liver 23 2.0 0.7 1.0 9.5 9.5 19 -

Safflower 12.5 79 - 0.5 - - 8 -

Corn 29 54 - 1 - - 17 -

Cottonseed 24 50 - 0.4 - - 26 -

Sesame 46 41 - - - - 13 -

Sunflower 26 66 - 0.3 - - 8 -

Olive oil 82 10 - 0.7 - - 8 -

Soybean 28 58 - 7.0 - - 14 -

Peanut 51 29 2.2 1.0 - - 19 -

Canola 54 27 - 6.2 3.8 3.5 6 -

English walnut 23 55 - 11.0 - - 11 -

Other Foods

Cow milk fat 35 2 - 1 - - 62 -

Human milk fat 42 7 - 0.7 0.6 0.3 50 8 oz=32

Chicken fat 49 17 - 1.0 - - 33 -

Egg yolk 36 11 - 0.2 - - 53 1m=222

Coconut oil 10 2 - - - - 88 -

Palm oil 43 9 - 0.3 - - 48 -

Beef, lean 44 4 - - - - 39 81

Chicken, white 35 19 - 4 - - 29 73

Lard 53 10 - 1.0 - - 36 1T=15

(from Gruger et al. Fatty acid composition of Oils from 21 species of marine fish, freshwater fish and shellfish. J Am Oil Chemists society vol 41 Oct ‘64 . & USDA Handbook, Washington, D.C. Govt Print Office, 1987 #8-15)

Vitamins

Some vitamins are vital to the health of your DNA. As you prepare your body for a baby, you want to make sure that the DNA in your baby is healthy. Recent research has shown that the body has a mechanism for blocking “bad genes”. Genes the promote diabetes, obesity, and other common problems are masked with “methylating agents”. Methylating agents bind to our DNA so the bad genes are not used. What are methylating agents? Methyl groups come from our diet in the form of B12 and folic acid. Many Americans are deficient in both. To protect the health of your DNA and your baby’s DNA, make sure you are getting plenty of B12 and folic acid. It is a good idea to supplement these things unless you are sure you are getting enough. Want to find out if you need more? Track your diet on for a week and see for yourself.

Antioxidants are needed to prevent oxidative damage. Current theories about aging suggest that oxidative damage is responsible for aging cells. Research has shown that antioxidants can reduce free radical damage in the body, including in developing reproductive cells. Some examples include CoQ10, selenium, lycopene, vitamin E, and beta carotene.

Carnitine helps transports fatty acids into the mitochondria. It is can also help regulate immune function. This may be beneficial for those who have an autoimmune component to their infertility.

Most of the time, a high-quality multivitamin is all you need to get the nutrients required for optimum fertility. Drug store brands often have fillers or less active forms of the vitamin. We like Priority One Prenatal to get all of the nutrients you need without upsetting your stomach, however there are other physician grade formulas that are good.

|Nutrient |Benefit |Food Source |

|zinc |Decreases risk of miscarriage |Pumpkin seeds |

|Folic Acid |Methylating agent |Whole grains |

|B12 |Methylating agent |Animal products |

|B6 |Fertility | |

|Lycopene |Antioxidant |tomato |

|Vitamin E |Antioxidant |avocado |

|Selenium |Antioxidant |Brazil nuts |

|CoQ10 |Antioxidant |Oil fish |

| | |Organ meats |

| | |Whole grains |

|Carotenoids |Antioxidant |Carrots |

| | |Sweet potatoes |

| | |Butternut squash |

|Inositol |Reduce insulin sensitivity |lecithin |

|Omega 3 fatty acids |Lower inflammation |Fish oil |

Dairy

Avoid dairy completely while you are trying to get pregnant.

Protein

You need a certain amount of animal protein to get all of the amino acids your body needs. A 150 pound person needs about 70 grams of protein per day. If you exercise a lot, you may need more. 70 grams of protein is about 3-4 servings of protein per day including lentils, nuts, beef, and fish. If you are vegetarian or vegan, you need to make sure you are getting a wide variety of protein sources. Your chances of getting a balanced diet are much better if you eat a wide variety of protein sources. You should consult with your Naturopathic Doctor to see if your vegan or vegetarian diet needs any adjustments.

Complex Carbohydrates

You don’t need to be on a low carbohydrate diet to be healthy. You do, however, need to be sure that you are getting a variety of complex carbohydrates. That means whole grains, whole fruits, and vegetables. If you are not eating 5 servings of fruits and vegetables per day, you are not even getting the minimum amount recommended by the Center for Disease Control.

Experiment with new whole grains like quinoa, millet, brown rice, amaranth, buckwheat groats, wild rice, and steel cut oats. They can be found in the bulk section of Whole Foods. Cook whole grains like rice, using 2-3 cups of water per cup of grain. Boil and reduce to a simmer for 20-40 minutes. In the handout section, you will find recipes that will be helpful as you incorporate more whole grains into your diet.

2nd Key to Success: Healthy Weight and Blood Sugar

Maintaining a healthy weight is vital to your reproductive health. Adipose (fatty) tissue is not just inactive fat. It produces its own hormones that act as signals to the rest of the body. If you are overweight or underweight, your adipose tissue may be sending signals to your body that your health is not ideal for becoming pregnant. If your BMI is not between 19 and 25, you must make some changes. There is a BMI chart in the “handout” section.

Emotional eating is a huge obstacle to weight loss. If you find that you are binge eating consistently, address this immediately. See a counselor who practices EMDR, a form of trauma counseling. If you would rather read a book, try “When Food is Love” by Geneen Roth. Depression and anxiety are often the cause of emotional eating. You may be able to address depression or anxiety with a homeopathic remedy.

Maintaining healthy blood sugar is part of keeping hormone levels normal. When you eat sugar, you blood glucose goes up. When your blood glucose goes up, your insulin levels increase. Insulin tells your body that there is plenty of sugar in your blood and it needs to be converted into a storage form—fat. Storing more fat impairs your fertility. In addition, insulin has an effect on ovarian function. It causes an increase in testosterone production and a decrease in sex hormone binding globulin. This is especially a problem for women with Polycystic Ovarian Syndrome.

If you need to reduce your blood sugar, consider incorporating foods that naturally control blood sugar. These foods include cinnamon, lecithin, lime juice, bitter melon, and buckwheat farinetta. To order buckwheat farinetta, visit orderform.htm. This unique food is very high in inositol and can be used daily to help reduce insulin sensitivity. A recipe for muffins with buckwheat farinetta is included in the handout section.

If your doctor put you on a weight loss program, take this part of your program seriously. If you think this needs to be addressed, set aside a specific appointment for a weight loss program.

3rd Key to Success: Healthy Digestion

Gas and bloating are signs that your food may not be digesting well. This may be due to food intolerances, stress, or an imbalance in your intestinal flora. It could also be a sign of a problem with dairy or gluten.

Gluten is found in most baked goods and all products that contain wheat flour. A significant problem with gluten will manifest as gas or diarrhea following wheat products. If you are bloated constantly, this may be a concern for you. Problems with gluten can interfere with nutrient absorption. It can also lead to decreased fertility. Your doctor may decide that you need to try a gluten free diet while you are trying to become pregnant.

Dairy can also interfere with fertility if you have trouble digesting it. The sugar found in milk and dairy products is called galactose. In most women, after drinking milk, the lactose is broken down into glucose and galactose. The liver turns galactose in to glucose. Glucose is our “blood sugar”. Many women are unable to turn galactose into glucose. When galactose is not broken down, it circulates in the blood. The galactose is harmful to the ovaries and the unfertilized eggs. Development of unfertilized eggs may be impaired by the sugar from milk.

In Traditional Chinese Medicine, dairy products have long been considered harmful to the body. Diary interferes with the flow of “Qi” and leads to “Stagnation”. It creates “damp” conditions in the body. Translated into more Western Medical terms, dairy products increase the amount of sticky, globular proteins in the body’s secretions, making them thicker.

Many people find that a wide range of health conditions are improved from removing dairy from the diet. Humans are the only animals that continue to drink milk after being weaned from their mother’s milk. We are the only species that regularly drinks milk produced by another animal. The proteins in cow’s milk are significantly larger than those found in human milk. Consequently, many people have a difficult time digesting these proteins. In addition, the fat found in dairy products is considered to be pro-inflammatory. That means that the fats are used to feed inflammatory pathways in the body. Feeding inflammatory pathways will contribute to countless disease processes. In fact, nearly every chronic disease plaguing Americans is related to high levels of inflammation. It is no coincidence that we also take in large amounts of animal products, including dairy, that feed our inflammatory pathways. All of that said, moderation seems to be best if you do not have a problem digesting dairy. One serving of full fat dairy per day may improve your chances of getting pregnant.

4th Key to Success: Reduce Chemical Exposure

Research shows that exposure to certain solvents, chemicals, and metals can raise your FSH levels. You may have been exposed to chemicals in the past that are still stored in your fatty tissue. While some people can break chemicals down and excrete them effectively, others are less genetically able to do so. Regardless, it is a good idea to minimize exposure to chemicals. Clean with vinegar and water whenever possible. Paint with non-VOC paint. Avoid harsh cleaning products and buy “natural” versions such as 7th Generation. Do not spray for bugs and weeds around your house. Find alternatives to pest control. Avoid purchasing new carpet or particle-board furniture. To discuss this further, consider reviewing your chemical exposure with your Naturopathic doctor. You may need to undergo a brief cleansing period before you continue trying to get pregnant. This may be inconvenient for you, but ultimately it is the safest thing for the baby.

The EPA indicates that indoor air quality is the most consistent threat to your health. Pollution from carpeting, paneling, cabinets, flame retardants, etc. releases formaldehyde, benzene, and trichloroethylene into the air. You can use a combination of air purifiers and plants to maintain your air quality. Honeywell makes a high quality air purifier.

The FDA recommends limiting your intake of fish to reduce mercury levels and PCB levels. One good source of clean fish is Wild Caught Salmon. For more information, see the information below for more specific information. When purchasing your beef, chicken, eggs, and dairy products, try to buy organic. Even “natural” meats are often given hormones for a portion of their lives. Most animals are fed large doses of antibiotics. Butter is highly contaminated with PCBs. For better quality, try .

Plants that promote clean air:

Mass Cane Pot Mum Gerbera Daisy Warnecki

Ficus English Ivy Marginata Peace Lily

Chinese Evergreen Bamboo Palm Heart leaf Philodendron

Green Spider Plant Janet Craig

Books:

The Nontoxic home by Debra Lynn Dadd

The Chemical Free Lawn by Warren Shultz

Organic Foods / Genetically Modified Foods

One recent study showed that genetically modified corn with the MON810 gene has been shown to reduce fertility in mice. With so little research available about GM food, consider using organic food when possible. In addition to new genetic make—up, conventionally grown food is exposed to a host of herbicides, fungicides, and pesticides. Ever wonder if those harm your fertility? Check out the link to substances below that are known to interfere with fertility:

5th Key to Success: Exercise

Exercise is vital to your physical health and cardiovascular circulation. It is important to remember that the CDC recommends a minimum of 30 minutes of ‘moderate intensity’ activity per day at least 5 days per week. Strength training should also be included two days per week. When you are trying to become pregnant, you do not want to overdo the intensity. Also, avoid intense abdominal workouts that may reduce blood flow to your pelvic organs. Focus on exercise that you enjoy, even if it is just a brisk walk in the park. The Exercises and Activities section has some other physical activities to include after you exercise. Incorporate the things that are the most enjoyable for you. These activities should be relaxing and rewarding.

6th Key To Success: The Mind Body Connection

If you have any doubt about interaction between mind and body, ask a nursing mother about the connection between emotion and milk production. Many will tell you that the slightest amount of empathy or sadness will cause them to lactate instantly even if their baby is not present. Moms may not even notice that they have reacted emotionally until they have produced milk. Emotion causes some unknown neuroendocrine process that immediately triggers the hormonal cascade the ultimate results in milk production. Think of the effect that extreme anxiety and sadness could have on your hormonal balance! While this process is poorly understood, research shows evidence that your emotional state can affect your fertility.

80% of chronic health problems are exacerbated by stress. While under stress, your immune system is suppressed, your blood pressure increases, and cholesterol production increases, stomach acid production increases, and many other problems occur including irritability and sexual dysfunction. Studies about whether anxiety can impact fertility have shown mixed results. However, these studies do not always take into consideration the multitude of ways a person can respond to infertility. Sadness, tension, isolation, anger, exhaustion, irritability, or hopelessness all upset the delicate endocrine balance in the body. Women with a history of depressive episodes are twice as likely to report subsequent infertility than women who are not depressed. Women who have a depressive episode before IVF have a 13% pregnancy rate, compared to those who do not have a depressive episode who have pregnancy rate of 29%. A 10 week program designed to provide psychological support alone has been shown to increase fertility rates within the next 6 months (control 18%--experimental 33%).

Signs of depression

• Loss of interest being with loved ones

• Suicidal thoughts

• Loss of interest in usual activities

• Depression that does not lift

• Agitation and anxiety

• guilt

• Marital discord

• Strained interpersonal relationships with partner, friends, family, or colleagues

• Difficulty thinking of anything other than infertility

• High anxiety

• worthlessness

• difficulty accomplishing tasks

• Difficulty concentrating

• Sleep disturbance

• anger

• Change in appetite or weight

• Increased use of drugs or alcohol

• Thoughts of death

Consider the facts:

• 48% of Women report that infertility is the most upsetting experience in their lives

15% of Men report that infertility is the most upsetting thing in their lives.

This leads to a disconnected feeling in many marriages. The woman wants the man to be more upset. The man wants the woman to be more rational.

• IVF costs anywhere from 10K to 12K, but is only successful 25% of the time

• Couples have a a 15-20% chance of conceiving each month

• 11% of infertile women meet the criteria for having a major depressive episode

• 1/3 of all infertile women are clinically depressed

• Depression associated with infertility is comparable to depression associated with terminal illness.

• Research has shown that being involved in a support system that provides coping skills and communication can significantly improve your chances of becoming pregnant.

7th Key to Success: Know Your Fertility Signals

Cervical mucous

Rising levels of estrogen in the body cause your cervix to secrete cervical mucous. This is the signal that your eggs are developing and that you are fertile. 85% of the time, ovulation takes place on the last day of cervical mucous or the day after the last day. The egg has the potential to be fertilized for the next 12-24 hours. The cervical mucous serves to keep sperm cells alive. Because of the cervical mucous, fertile days include the cervical mucous days and the four days following the mucous. Cervical mucous can keep sperm alive for 3-5 days. This makes it an excellent maker of fertility. Sperm survive in the cervix, nourished by the mucous, until your body releases an egg. Cervical position is also an indicator of fertility. A low, firm, pointed cervix is felt most of the month. During fertile days, the cervix is higher up, softer, and more slippery. It may take up to a month to begin to recognize fertile mucous. Seminal fluids may make it difficult to check cervical mucous. You can try doing several Kegel exercises following intercourse to reduce excess fluids left in the vaginal canal. The best time to have intercourse is the 4th day of the cervical mucous and the day after. The cervical mucous will also keep sperm alive for 3-5 days, so all days of the fertile cervical mucous are fine. Some experts recommend waiting 48 hours to allow your partner’s sperm count to increase.

1. Before urinating in the morning, wipe with tissue to collect any cervical mucous at the vaginal opening.

2. If there is mucous visible on the tissue, pick it up between your thumb and forefinger.

3. Press the mucous between your thumb and forefinger.

4. Slowly separate your thumb and forefinger. Watch the mucous. Fertile mucous should form strands and be the consistency of raw egg. It can also be creamy, milky, or the consistency of thin paste. It is easy to confuse this fluid with fluid left in the vaginal canal following intercourse. Try to practice checking for mucous when you have not recently had intercourse.

5. Write down the days that you have slippery mucous on your calendar.

Temperature

Estrogen levels change throughout the month. Estrogen levels increase after menses and surge in the middle of the cycle. The estrogen surge causes ovulation. It also triggers increasing levels of progesterone. Progesterone’s job is to support pregnancy. Progesterone increases the body’s temperature. Following ovulation, there will be an increase in body temperature. By the time you are aware of the temperature change, ovulation has already occurred. The fertile cervical mucous days are likely to be ending at this time. Because of this, monitoring body temperature is less accurate for finding fertile days. It is helpful for monitoring and predicting the hormone changes that are necessary for pregnancy.

1. Take your basal body temperature each morning when you wake up. Do not get up or move around before taking your temperature. Keep the thermometer next to your bed.

2. Record the temperature on your fertility chart.

Kits

You can buy FSH test kits from a drug store to predict your ovulation. For a more advanced system, you can purchase a conception kit. This comes with predictors as well as pregnancy tests and a special cup. The cup is designed to hold the sperm against the cervix for several hours. This is good for couples with low sperm count or low motility. You can find it at . Pregnancy and ovulation tests can be purchased at bulk prices from many distributors, but the conception requires a prescription. The distributor can provide a physician consultation to obtain the kit if you do not have a prescription.

8th Key to Success: Sleep and Light Cycles

Did you ever think about light cycles and your menstrual cycles? Do you think that menses correlating with the cycle of the moon is an old wives tale? In fact, there is a scientific explanation for the effect of light on fertility. Before nightlights and alarm clocks, women slept in the dark most of the time. The only time they were exposed to light while sleeping was from the moon. The skin on the eyelids is very thin, and the retina still recognizes exposure to light even when our eyes are closed. Many animals in nature have hormonal cycles that are directly related to light cycles. In humans, the relationship is much more complicated.

In some women, artificial light in the bedroom can lead to menstrual irregularities as well as irregularities in fertile cervical mucous. It is believed that this is because of complicated hormonal interactions. Serotonin is produced by the pineal gland during exposure to light. Serotonin is a powerful neurotransmitter that affects mood as well as other neurotransmitters. After dark, serotonin levels drop. This is why many people experience seasonal depression when they are not exposed to enough light during the day. Their serotonin levels get too low. If people are exposed to too much light at night, their serotonin levels stay higher than normal. Serotonin levels never drop off at night. When serotonin levels are high, prolactin levels also increase. Prolactin is the hormone that allows nursing women to make milk. Prolactin is also the hormone responsible for making nursing moms infertile. Increased night prolactin levels, specifically between 1am and 6am, keeps the body from becoming pregnant. This is because a woman who is still nursing frequently throughout the night is still providing a significant amount of nutrients and labor intensive care to the infant. Infertility from prolactin is a protective mechanism to keep the woman from becoming too depleted from nursing while carrying a new baby. Being exposed to light at night triggers that same hormonal response. Prolactin levels increase and fertility decreases. Some women may be more sensitive to this than others.

Light at night( higher serotonin( higher prolactin( decreased FSH and LH

Consider blocking out all of the light in your bedroom. Even cover the alarm clock. Turn off any night-lights and have curtains over the window. You may open the curtains when there is a full moon for some light exposure.

Exercises and Activities

Yoga

1. Tree Pose—Stand on right leg. Place left foot up against right thigh and put hands together in prayer position in front of the heart.

2. Eagle Pose—standing, bend your knees and cross your right leg over the left, tucking the right foot behind your left ankle. Keeping knees bent, raise arms to shoulder level and bend 90 degrees. Cross the left arm over the right, bringing the left palm around to meet the right palm.

3. Hip Stretch—left foot on right knee, left knee on right foot. Rest hands on the floor in front of you, lean forward and exhale.

4. Supine Bound Angel Pose—lie on our back and bring the soles of your feet together. Let your knees drop to the floor. Rest your arms to the side, palms up. Hold for 5 minutes

5. Cat curls—on hands and knees, inhale while arching back toward the floor. Exhale while arching back up toward the ceiling.

Pelvic Floor exercises

1. Sit Comfortably. Find your perineal muscles. These are the muscles that contract around your vaginal opening and anus. These muscles are contracted when you stop urination midstream. Contraction of the perineal muscles is called a Kegel exercise. When driving or sitting quietly at home, practice strengthening this area.

2. Inhale for three seconds while contracting the right side of your perineum.

3. Exhale slowly.

4. Inhale for three seconds while contracting the left side of your perineum.

5. Exhale slowly.

6. Inhale for three seconds while contracting the front of your perineum.

7. Exhale slowly.

8. Inhale for three seconds while contracting the back side of your perineum.

9. Exhale slowly.

This is an excellent strengthening exercise for before and after pregnancy. In addition, this exercise brings Yin, Blood, and Qi to the area. In Western terms, it brings circulation to the area. Increased circulation to an area provides better nutrient deposition and repair to the local tissue.

Acupressure

1. Lie down comfortably on the floor.

2. Place hands over navel area. The acupressure points surrounding the navel correspond to all of the different organs in the body. Stimulating them brings harmony to the body.

3. Find the 3 o’clock position. Gently massage the area next to the navel.

4. Press gently until you feel the tissue underneath your finger change.

5. Move clockwise around the navel until you have returned to the 3:00 position.

6. Some positions may be more tender than others.

7. If this is the case, you will want to press on these areas for a little bit longer.

Acupressure 2

1. Lying on the floor, move your hands down to your pubic bone.

2. From your pubic bone, slide your hands straight out towards your thighs.

3. When you reach the crease, rest your hands there. You should feel your femoral artery pulse.

4. Apply pressure to the femoral pulse on both sides.

5. Notice the difference between each side.

6. Using your fingers, try to apply more pressure to the stronger side and less pressure to the weaker side until the pressure feels equal on both sides.

7. Once the pressure feels equal, apply even pressure to both sides for half a minute.

8. Release the pressure and brush downward on the thighs, feeling the blood flow down into your legs.

Qi Gong

1. Sit comfortably and place your hands over your womb.

2. Contract your perineal muscles.

3. Breath in through your mouth and imagine your breath flowing down towards your hands.

4. Pause and focus your attention on your vaginal opening.

5. Take in another small breath and imagine that it is flowing down through your ovaries to your vaginal opening.

6. Exhale.

7. Imagine that you have flooded your womb with warmth and light.

8. Breath in again, focusing on the warmth in your womb.

9. Take in another breath, imagining this warmth beginning to travel up your spine.

10. Exhale.

11. Take in another breath, continuing to visualize the warmth traveling up your spine until it has reached the top of your head.

12. Exhale.

13. Repeat this exercise again, each time adding more warmth to the womb until you feel relaxed and revitalized. Shake out your arms and legs before getting up.

Lift the Uterus

1. Remain seated.

2. Find your pubic bone

3. Roll your fingers up from your pubic bone until they drop off and sink into your abdomen.

4. This is where your uterus should be.

5. Press in towards your spine until you cannot press back any more.

6. Now you are pressing your uterus. Lift upwards and hold for 33 seconds.

Relaxation

1. Lie quietly and close your eyes. Notice any tension in your body.

2. Start by focusing on your forehead. Feel all of the tension in your forehead. Tighten the muscles in your forehead and squeeze as you slowly inhale. Your inhale should take about 4 seconds. As you exhale for about 8 seconds, gently relax your forehead.

3. Move down to your jaw. Feel the tension. Clench your jaw as you inhale, and relax it as you exhale. Feel the relaxation. Repeat until all of the tension from your jaw is gone.

4. Move down to your shoulders and repeat.

5. Move down to your forearms and repeat.

6. Move down to our fingers and repeat.

7. Move to your chest muscles and repeat.

8. Move to your lower back and repeat.

9. Move to your perineum and repeat.

10. Move to your thighs and repeat.

11. Move to your calves and repeat.

12. Move to your toes and repeat.

Take a deep breath and notice any tension that you still feel. Move back to any areas as needed.

Maintaining Results

Always remember that in Naturopathic Medicine, we treat that cause. That means that what it takes to get better, it takes to stay better. If you improve your health through diet, lifestyle, and supplement changes, you will see results. However, there are no quick fixes. Being healthy is a lifestyle. You will want to continue to eat right, avoid chemical exposure, and supplement. For most women, supplementation will simply be a high quality multivitamin throughout pregnancy. nursing, and beyond. After nursing, you may want to ask your doctor about supplements that can build your strength back up. During pregnancy, you may need homeopathic remedies or dietary consultations to feel your best. After childbirth, you may need to consider treatment for any post-partum depression that you may experience. Keep in mind that you want to stay healthy for yourself and your new family. Do not lose the progress you have made once you have your beautiful baby. Your baby deserves optimal health as well. Babies born into a Naturopathic lifestyle rarely get sick, and when they do they are often treated easily. Ask your Naturopathic doctor about what you can do to give your baby the best start possible.

Patient Handouts

MENU PLAN WORKSHEET



Calorie Count Plus Login ________________________ Password _______________

Daily Needs Calculator:

Age _____ Ht ______ Wt ______ Male/Female

Activity level ____________________

Daily calorie needs for weight maintenance __________

Daily calorie needs for weight loss ____________

Daily calories from: Carbohydrates ________ Protein ________ Fat ________

Carbohydrates _______% Protein _______% Fat _______%

|Category I Vegetables: (serving = 1/2 c.)|Fruit: (serving as indicated) 1 medium apple, 3 |Legumes: (serving = 1/2 c. cooked, or as |

|Artichokes, asparagus, bamboo shoots, |medium apricots, 1/4 avocado, 1 cup berries, 1/2|indicated) Garbanzo, pinto, kidney, |

|bell peppers, broccoli, brussels sprouts,|medium cantaloupe, 10-15 cherries, 2 fresh figs,|annelloni, navy, mung beans, soy beans, |

|cauliflower, celery, raw carrots, |1 whole grapefruit, 1/4 small honeydew, 2 small |split peas, green peas, lentils; 1/4 c. |

|cabbage, chives, onion, leeks, garlic, |nectarines, 8-10 medium olives, 1 large orange, |hummus |

|cucumber, dill pickles, eggplant, green |1 peach, 1 medium pear, 2 small plums, 2 small | |

|beans, tomatoes, lettuce, kale (and any |tangerines | |

|other leafy green vegetables), mushrooms,| | |

|okra, radishes, snow peas, sprouts, water| | |

|chestnuts, zucchini, spaghetti squash, | | |

|summer squash | | |

| |1 serving = approx. 80 cal. |1 serving = approx. 110 cal. |

| |Protein: (serving = 3 oz; should be grilled, |Nuts/Seeds: (serving as indicated) 10-12 |

| |roasted, baked, etc.) Fish, shellfish, poultry, |whole almonds or hazelnuts, 7-8 pecans or |

| |eggs (2 whole or 3 whites plus 1 whole egg), |walnuts (halves); 2 tbsp peanuts, |

| |tofu, veggie burger, lamb, lean roast |pistachios, sunflower, pumpkin, sesame |

| | |seeds; 1 tbsp cashews or nut butter |

|1 serving = approx. 15 cal. |1 serving = approx. 150 cal. |1 serving = approx. 100 cal. |

|Category II Vegetables: (serving = 1/2 c.|Grains: (serving = 1/2 c. cooked, or as |Oils: (serving = 1 tsp.) flaxseed oil, |

|or as indicated) Beets, acorn squash, |indicated) Amaranth, quinoa, brown rice, wild |walnut oil, olive oil, canola (for cooking);|

|butternut squash, cooked carrots, sweet |rice, barley, oats, millet, kamut |all oils should be cold pressed |

|potatoes, yams | | |

|1 serving = approx. 45 cal. |1 serving = approx. 85 cal. |1 serving = approx. 40 cal. |

BODY MASS INDEX CHART (BMI)

|BMI |19 |

|58 |91 |96 |

|Vegetables |

|Frozen Green Peas 39 |Beets 64 |Pumpkin 75 |

|Frozen Sweet Corn 47 | |Parsnips 97 |

|Raw Carrots 16 | | |

|Boiled Carrots 41 | | |

|Eggplant 15 | | |

|Broccoli 10 | | |

|Cauliflower 15 | | |

|Cabbage 10 | | |

|Mushrooms 10 | | |

|Tomatoes 15 | | |

|Chilies 10 | | |

|Low GI |Medium GI |High GI |

|Vegetables (continued) |

|Lettuce 10 | | |

|Green Beans 15 | | |

|Red Peppers 10 | | |

|Onions 10 | | |

|Fruits |

|Cherries 22 |Mango 60 |Watermelon 80 |

|Plums 24 |Pineapple 66 |Dates 103 |

|Grapefruit 25 |Bananas 58 | |

|Peaches 28 |Raisins 64 | |

|Strawberries 40 |Papaya 60 | |

|Apples 34 |Figs 61 | |

|Pears 41 | | |

|Prunes 29 | | |

|Grapes 43 | | |

|Coconut 45 | | |

|Coconut Milk 41 | | |

|Kiwi Fruit 47 | | |

|Oranges 40 | | |

|Dried Apricots 32 | | |

|Low GI |Medium GI |High GI |

|Legumes (Beans) |

|Kidney Beans 52 |Beans in tomato sauce 56 | |

|Butter Beans 36 | | |

|Chick Peas 42 | | |

|Haricot/Navy Beans 31 | | |

|Lentils, Red 21 | | |

|Lentils, Green 30 | | |

|Pinto Beans 45 | | |

|Black-eyed Beans 50 | | |

|Yellow Split Peas 32 | | |

|Breakfast Cereal |

|Natural Muesli 40 |Bran Buds 58 |Cornflakes 80 |

|All-bran 50 |Mini Wheats 58 |Sultana Bran 73 |

|Oat bran 50 |Nutrigrain 66 |Bran flakes 74 |

|Rolled Oats 51 |Shredded Wheat 67 |Coco Puffs 77 |

|Porridge 58 |Porridge Oats 63 |Puffed Wheat 80 |

| |Special K 69 |Honey Cheerios 77 |

| | |Rice Krispies 82 |

| | |Total 76 |

| | |Cheerios 74 |

|Low GI |Medium GI |High GI |

|Pasta & Grains |

|Wheat pasta 54 |Basmati Rice 58 |Instant White Rice 87 |

|New potatoes 54 |Couscous 61 |Instant potatoes 80 |

|Meat ravioli 39 |Cornmeal 68 |White rice 83 |

|Spaghetti 32 |Taco shells 68 |Tapioca 70 |

|Tortellini (cheese) 50 |Gnocchi 68 |Mashed potatoes 73 |

|Egg fettuccini 32 |Canned potatoes 61 |French fries 75 |

|Brown rice 50 |Rice noodles 58 | |

|Buckwheat 51 |Baked potatoes 60 | |

|White long grain rice 50 |Wild rice 57 | |

|Pearled barley 22 | | |

|Yam 35 | | |

|Sweet potatoes 48 | | |

|Instant noodles 47 | | |

|Wheat tortilla 30 | | |

|Bread |

|Wholegrain pumpernickel 46 |Croissant 67 |White 71 |

|Soy and Linseed 36 |Hamburger bun 61 |Bagel 72 |

|Whole Wheat 49 |Pita, white 57 |French Baguette 95 |

|Heavy Mixed Grain 45 |Whole grain Rye 62 | |

|Sourdough Wheat 54 | | |

|Sourdough Rye 48 | | |

|Low GI |Medium GI |High GI |

|Dairy |

|Whole milk 31 |Ice cream 62 | |

|Skimmed milk 32 | | |

|Chocolate milk 42 | | |

|Sweetened yogurt 33 | | |

|Artificially sweetened yogurt 23 | | |

|Custard 35 | | |

|Soy Milk 44 | | |

|Snacks & Sweet Foods |

|Cashew Nuts 25 |Ryvita 63 |Pretzels 83 |

|Peanuts 13 |Honey 58 |Water Crackers 78 |

|Walnuts 15 |Blueberry muffin 59 |Rice cakes 87 |

|Hummus 6 | |Maple syrup 68 |

|Sponge Cake 46 | |Donuts 76 |

|Milk Chocolate 42 | |Scones 92 |

|Oat Crackers 55 | | |

|Nut & Seed Muesli Bar 49 | | |

|Nuts and Raisins 21 | | |

|Jam 51 | | |

|Corn Chips 42 | | |

|Nutella 33 | | |

Cooking with Whole Grains

Blender option

The night before, put 5 different grains (a tsp. or tbs. of each) in your blender and cover well with water. The next morning, turn on the blender and blend well. Then pour into a sauce pan (add more water to get all the grains out) and stir and cook approximately 10-20 minutes on low-to-moderate heat.

Grinder option

In the morning, grind 5 different grains and pour into boiling water you have removed from the flame. Stir and cook on low-to-moderate heat for approximately 10-20 minutes. Any brand of small coffee grinder will work.

Whole Grain Recipes

Five Grain Cereal

An oatmeal style dish with lots more flavor...

10 rounded Tbs. mixed whole five grains (amaranth, quinoa, oat groats, millet, and brown rice)

3 1/2 cups of water

1/2 tsp. sea salt (optional)

Put water and salt in a large stainless steel or corningware pot; bring to a boil. Meanwhile, grind grains coarsely. Stir grains into boiling water; use a whisk to break up lumps. When mixture boils, cover tightly and remove from heat*. Grains will be ready to eat in 10 minutes. *Or continue to cook and stir over low heat until thickened.

Basic Muffins

A great basic for the lunch box. There’re quick, easy and satisfying. Lots of variations.

2 1/2 cups mixed grains, ground well

5 tsp. baking powder

1 1/2 tsp. sea salt

1/4 cup olive or other cold-pressed oil

1/4 cup honey or maple syrup

2 eggs

1 1/2 cups water

Mix well. Do not overbeat. Let sit 5 minutes; add water if too stiff. Pour into well-oiled or paper-lined muffin tins, 2/3 full. Bake until tops brown lightly, about 25 minutes. Cool in pans 5 minutes; remove from tins and cool thoroughly.

muffin variations:

add 1 cup of fresh blueberries

add 1 tsp. cinnamon, 1 cup chopped apple and 1 cup chopped nuts

add 2 mashed bananas

add 1 lb. can pumpkin puree, 1 cup chopped nuts and 1/2 tsp. cinnamon, ginger & cloves

Biscuits

Makes 10-12 biscuits. Oven at 450(F

2 cups mixed grains, ground well

1 tsp. sea salt

5 tsp. baking powder

1/2 cup olive or other cold-pressed oil

2/3 to 1 cup water]

1/4 cup whole wheat or brown rice, ground into flour

Mix first five ingredients with a fork. Let sit; store again; adjust by adding water if it seems too dry. Mixture should clean sides of bowl. Turn onto separated wheat flour and knead gently. Pat or roll flat to 1/2 inch thick. Cut with a 3” biscuit cutter or a large water glass. Bake on UNGREASED baking sheet for 10-15 minutes or until browned.

biscuit variations:

add juice and grated rind of 1 orange; reduce water by 1/4 cup.

add 2 tsp. herbs (any kind) with initial ingredients

Pancakes/Waffles

Makes 10-12 four inch cakes or 4 ten inch waffles - Much fresher tasting than boxed “whole wheat” mixtures

1 cup mixed five grains, ground well

1 1/2 tsp. baking powder

1/2 tsp. sea salt

1/4 cup olive or other cold pressed oil

1 Tbs. honey or maple syrup

1 egg

1 cup of water, milk, or milk substitute

Mix well. DO NOT OVERBEAT. Let sit 5 minutes; add water if too stiff. For pancakes, bake on a medium-hot griddle or frying pan until edges get dull; flip and bake until done. For waffles, bake on a hot waffle iron, oiled only once; follow manufacturer’s directions for baking.

Pancake or Waffle variation

add 1 cup fresh blueberries

add 1 tsp. cinnamon.

add 1 grated apple or 1 chopped banana

Millet Salad

Prepare a quart (or so) of cooked millet (not ground up)

Finely chop garlic, carrots, green scallions, cooked and peeled broccoli stems and chopped toasted pumpkin seeds

Dress with Dijon mustard with seeds and 1 Tbs. (or so) of white miso

Muffins for Healthy Blood Sugar

2 1/2 c. buckwheat farinetta

1/2 c. soy lecithin

1 T. baking powder

1 t. sea salt

4 t. cinnamon

1/2 c. flaxmeal (or fresh-ground flax seeds)

3 mashed bananas

2 T. brown rice syrup

4 1/2 t. stevia plus FOS (spoonable stevia, not the pure extract)

2 eggs

3/4 c. water

3 T. cold-pressed oil

2 t. vanilla

1 1/2 c. blueberries

Mix dry ingredients. Mix wet ingredients, including dry stevia. Add wet to dry ingredients and mix with fewest possible strokes.

Bake at 375 deg. For 25-30 min. Makes 12 muffins.

Smoothie for Estrogen Excess

1 serving of fermented soy protein

1 cup blueberries

1 tbsp kelp

1 tbsp lecithin

1 tbsp ground flax seed

add water and / or pomegranate juice to desired consistency

Congee Recipe--warming

8 cups water

1 cup rice

1 tsp cinnamon

1/4 cup raisins

1 tsp local honey

Add ingredients to a crock pot and allow to simmer overnight. Eat as a breakfast cereal.

Variation: For dinner, use carrots, onions, and ginger instead of cinnamon and raisins.

Personalized Dietary Plan

Breakfast:

Lunch:

Dinner:

Snacks:

Resources

Diet

Free online diet & exercise tracking programs

• caloriecount.

•

• tools/calorie_calculator.htm

Free nutrition information with graphs and nutrition facts of thousands of foods

•

Low glycemic index recipes

• recipes/

Support Is Available, Take Care of Yourself

1. Suicide Hotline

1-800-suicide

2. Crisis Hotline

1-800-273-TALK

3. Johnson County

Mental Health Services:

888-432-4300

4. Infertility Support Group

“When God Says No”

913-832-2031

5. Infertility Help Line

651-659-0333

6. Infertility Help

888-959-0333

heartbeatministry@

7. MEND

Mommies Enduring

Neonatal Death

(888) 695-MEND

Websites:

Angel Mommies

Dedicated to those who've suffered pregnancy loss by providing information and support.

For Those Who Have Had Miscarriages

Support for parents after miscarriage, stillbirth or perinatal loss. There are other miscarriage pages at this site.

Hygeia(tm) . . . An Online Journal for Pregnancy and Neonatal Loss

Support, info and links. Individual stories.
Put together by Michael R. Berman, M.D.

Major depressive disorder in the 6 months after miscarriage.

Abstract of article on depression within 6 months of pregnancy loss.

Misc.Kids Miscarriage FAQ

Support and medical information.

Miscarriage - A Significant Loss

A doctor's essay on miscarriage.

Miscarriage, Pregnancy Loss, and Infant Death

Growth House resourse for grieving. Includes chat room.

Miscarriage: Surviving Pregnancy Loss

Information on grief and recovering, and also medical preparation for another pregnancy.

One Miscarriage, One Man, One Woman

Personal story from mother and father on the loss of their baby.

Personal Stories of Loss

A collection of stories where those who have suffered loss can read and contribute.

Postpartum Depression after Pregnancy Loss

Miscarriage and PPD article by Karen Klieman, MSW.

Psychological Problems after Miscarriage More Common than Once Thought

Acknowledges that mourning is common.

Remembering Our Babies

Official site of Pregnancy and Infant Loss Remembrance Day, October 15th.

Tips and Suggestions for Coping after a Pregnancy Loss (soc.support.pregnancy.loss Grieving FAQ)

Includes FAQ and downloadable booklet "A Guide to Coping with Miscarriage.

Books:

The Zone

Eat Right for Your Blood Type

When Food is Love

Molecules of Emotion

elHeldskljdsf]

OPTIMIZING FERTILITY SHOPPING LIST

Millet

Black Sesame Seeds

Lecithin

String beans

Black beans

Mung bean sprouts

Melon

Blueberries

Seaweed / kelp

Spirulina

Eggs

Asparagus

Flax seed

Red raspberry leaf tea

Wild Caught Salmon

Dr. Alicia Johnson, NMD 816-361-8885

Austrian Study shows GM corn negatively affects reproductive health in mice:

articles/article_15588.cfm

(Austrian Agency for Health and Food Safety)

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