May 17, 2024 • 48 mins
** Welcome to Season 5 of the Fertility Conversations Podcast. This is Episode 14 of this season.
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In this latest episode of Fertility Conversations podcast, Sarah, a seasoned nutritional therapist specialising in fertility nutrition, offers in-depth insights into frozen embryo transfers. Delving into critical concerns such as optimal diet, required tests, and vaginal microbiome, she recommends a personalised approach over a one-size-fits-all strategy.
Sarah brings her expertise on nutrient and dietary shifts for fertility, discussing fascinating topics such as the pros and cons of dairy products, the need to lower caffeine intake, and the importance of promoting blood flow with beverages like hibiscus and ginger tea.
With an emphasis on a balanced diet and a healthy vaginal microbiome, Sarah outlines the crucial role of supplements and diet in fertility. She sheds light on common misconceptions found online, and explores the emerging field of the vaginal microbiome and its relation to fertility. She suggests testing and follow-ups depending on the results, and shares how to handle potential roadblocks like the presence of strep B.
The podcast ends with a useful discussion on recommended supplements and diet, invaluable for anyone preparing for a frozen embryo transfer.
This eye-opening conversation is enriched by case studies and hardline supplement recommendations, leading listeners into a comprehensive understanding of fertility, diet, and microbiome health. Tune in to unravel the labyrinth of fertility information and learn how best to navigate your fertility journey amidst today's information overload.
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To connect with Sarah, do reach her on instagram https://www.instagram.com/sarahtrimble24/
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This is a podcast that shares stories of fertility & Infertility in Africa & all across the world.
Representation Matters. Our stories matter. Our stories help others feel less alone.
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If you would like to share your story, I would love to hear from you. Please email me at: fertilityconversations@gmail.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to another episode of the Fertility Conversations podcast.
One of the areas of concern for people exploring or looking to do frozen embryo
transfer is that, you know, what should I be eating? What should I avoid?
Should I be doing further testing, maybe things like vaginal microbiome testing or not?
(00:21):
So people just want to ensure that they have the right information and well
prepared before going for that frozen embryo transfer. So which is why it's
great to have you here today with us, Sarah, to come answer many of our questions.
I'll do a brief introduction about you and then we can go into the questions.
Sarah's joined us before a few episodes before talking about importance of nutrition
(00:44):
and impact that it can play in our fertility.
But today we want to speak more about frozen embryo transfer,
how to prepare and also to ensure that the vaginal microbiome is all in a good
place before doing that transfer.
For and as you said to me in the private conversation also she noted
that that's also important for people that are trying to conceive without
(01:05):
fertility treatments so it helps for everyone
looking to conceive regardless of the option you see you're opting
for so sarah is a nutritional therapist with
nearly 20 years experience working within complementary health industry she
has a nutritional therapy practice in belfast northern ireland and she also
supports individuals from around the UK and around the world looking to improve
(01:29):
their health with dietary and lifestyle changes.
Today, like I said earlier, she'll be answering one of our questions about getting
us ready for conception.
So welcome, Sarah, and thank you so much for being here today.
Thank you for having me again, Ola, having me back to talk about some things
that we didn't get covered the last time. Exactly.
(01:50):
So I wonder if you just want to tell us a little bit about yourself i noted
some of the information from your bio but if there's anything else you want
to add before yeah i just i'm obviously as you said nutritional therapist i
love helping people sort of support overall health but obviously i have a specific
interest in supporting couples.
Improve their fertility reproductive health and support
(02:11):
them through all different stages of the fertility journey
whether that be trying to conceive without
assistance or assisted conception such as IVF and looking at how different dietary
approaches and focusing on different areas of your diet nutrition can support
those different stages be it sort of prior to sort of IVF,
(02:35):
maybe supporting egg and sperm quality,
and then going through the different stages, then possibly how you might then
approach frozen embryo transfer,
what might change, what different areas you might need to focus on at the different
stages of the IVF process.
So that's a really interesting area where there's quite a lot of really good
research on how nutrition can help.
(02:56):
So for me, that's really interesting and sometimes just very
straightforward simple changes for diet
specific supplementation maybe one
or two tests can really help ensure
success in frozen embryo transfer because you know it's such an important factor
(03:16):
to look at you know it can be expensive very expensive if you're self-funding
so you want to optimize your chances of that frozen embryo transfer being successful and there are some
very simple and straightforward things you can do to improve
that so that's a it's a really interesting area for me
wonderful and that's i mean we love that to to
(03:38):
know more about the simple things we can do and
the changes that we can make when trying to
prepare for frozen embryo transfer so some of the things firstly is that how
long before the frozen embryo transfer should we start making these changes
like the dietary changes supplements yeah well i mean ideally most people People
(03:58):
would have made dietary changes prior to embryo collection because,
you know, you would have been making a lot of positive dietary changes to ensure good egg quality.
Prior to egg collection and embryo development.
So a lot of those changes would still be relevant for an embryo transfer.
(04:19):
So we always say three months prior to embryo collection,
egg collection, you want to be ensuring you're following good dietary practices
that are going to ensure good egg quality,
such as an antioxidant rich diet, which we talked a
lot about in the previous podcast you know avoiding sugar
for example and refined carbs so those
(04:39):
changes really still stand so i really just say to
people keep going with those changes you should meet
those changes three months prior to egg collection just keep
going with that really positive you know
approach to your diet in between egg collection and frozen
embryo transfer but for example for someone
who has had their embryo collected a long time ago maybe
(05:00):
they've had a break from ivf for various reasons understandably it can be very
stressful going through IVF some people like to give themselves a bit of a break
now and again they've maybe had a hard time take a few months to just kind of
you know decompress not worry about it sometimes that can be really healthy mentally,
so again you'd look at again another three month period at least prior to frozen
(05:24):
embryo transfer to make sure you're in a very healthy place nutritionally.
Okay, we aren't basically focusing on factors such as egg quality,
but still there are other factors that we want to focus on in the body that
it can take up to three months to see positive changes there.
Generally, in all areas of nutritional therapy, you're talking about a period
(05:47):
of three months to see lots of real positive positive change in specific areas
so you know that three-month period still generally stands,
so you know but instead of maybe focusing on egg quality we would be looking at things like.
Enhancing your nutrient levels you know those important nutrients that are really
important to pregnancy because ideally at the end of the frozen embryo transfer
(06:10):
you know you're going to have a healthy pregnancy so be looking at making sure
you've got enough of those nutrients that that are really important for healthy pregnancy.
Omega-3 fats, vitamin D, zinc, selenium, iodine, really key for women, really important one.
So maybe making sure you're focusing and getting enough of those from your diet,
but also using high quality fertility supplements that's going to make sure
(06:32):
you've got enough of those.
I forgot to mention folic acid, foliate, for example.
So again, three month period, making sure you've got healthy levels of those
that are going to be both maybe be conducive to transfer, but also then support
a healthy pregnancy making sure your body's in a really good place.
You're also going to look at foods that support circulation,
a really important area because that's going to be delivering nutrients to your
(06:56):
your cervix for implantation,
nutrient levels, oxygen, making sure you have a lovely kind of womb lining that's really healthy so.
All these foods and nutrients that support circulation and we're also looking
at foods and nutrients and an approach that reduces inflammation because if
there is sort of an imbalance in your levels of inflammation in the body that
(07:20):
can interfere with the chances of,
implantation conception so it's a big big picture but you know and i've answered
it's taken me a long time to answer your question but generally yes three months
ola yeah thank you and i mean The information you provided is really helpful
because that's part of the concerns and what we worry about.
And so three months, as much as possible. Now, in terms of what we should be
(07:43):
eating and not eating, one of the concerns is that should we be taking,
I mean, we know that they say reduce coffee, but can cappuccino every now and
then, can that have any negative impact?
And, you know, obviously contains milk. milk some
people say that milk has inflammatory attributes or
(08:03):
not so well what are
your thoughts definitely the inflammation side of things is a very important
one and you know for the important thing and the important thing to understand
with this sort of i say it's a bit of a misconception that dairy can be pro-inflammatory
is that dairy can be pro-inflammatory for some people if they they are sensitive
(08:23):
to it, but not everyone is.
So for everyone to go out and cut out dairy, I don't agree with that approach
because that's sort of a one size fits all approach to nutritional therapy,
which, you know, your nutritional, you know, the nutritional approach for you
should be very individual.
You know, everyone's needs are different.
So, you know, Ola, for example, you might be sensitive to dairy products.
(08:46):
I might not be, you know, for me, you know, Dairy products, therefore,
would be a very important source of important nutrients like iodine, which I mentioned.
Dairy products are a very important source of iodine in our diet,
which is a really important nutrient for healthy conception and healthy pregnancy in women.
And a lot of women are deficient in iodine. So for me, that's quite a problematic
(09:08):
message to say dairy products are proclamatory.
Avoid dairy when you're preparing for conception.
You know, whenever I'm working with a client who is preparing for conception,
frozen embryo transfer, and I suspect there may be a dairy intolerance for maybe
certain reasons that might kind of red flag it to me, or maybe there was a history
(09:31):
of dairy intolerance as a child.
They have eczema or some other condition like eczema
skin condition or maybe they have IBS
I will generally test for a food sensitivity to determine whether it is present
and it's only really under that circumstance that I am happy to then go ahead
(09:51):
and say let's cut out dairy but at the same time if I'm working with a client
and I've recommended cutting out dairy I will be making
sure that I would be meeting any nutritional gaps from cutting out dairy with
either supplementation or dietary changes to make sure that we're not missing
out on important nutrients like,
you know, iodine B12 that they might be getting from dairy products in their diet.
(10:17):
So yeah, I have a bit of an issue with, you know, some of this messaging that,
you know, dairy is pro-inflammatory, avoid dairy.
You know, for some people, yes, but that could be 25% of people.
The other 75% of people could easily continue with their dairy consumption.
So for me, that's a really important area to understand. And then moving on to caffeine.
(10:39):
My attitude towards caffeine is that you don't want to take any caffeine after
a frozen embryo transfer.
So basically at any point that you could be pregnant, avoid all caffeine and
in the run-up to frozen embryo transfer i think it's important to be,
significantly reducing your caffeine intake from all sources
(11:00):
because if you're drinking five cups
of coffee a day that can deplete nutrient levels
it can be a stressor on the body leading to like adrenaline
release so you know
you want to be definitely looking at maybe reducing it down
to one maximum two caffeinated cups
of coffee or tea a day so that your caffeine intake
(11:22):
is significantly low because beyond that could be leading to you know depletion
of key nutrients in the body on the other hand though you also want to look
at what your caffeine free alternatives are and the quality of them as well
so if you're choosing decaf coffee or decaf tea it's important
to look at organic decaf tea, organic decaf coffee.
(11:45):
Because if you aren't choosing organic decaf coffees and teas can be sources
of kind of chemicals because they use chemicals to decaffeinate them if they're not organic.
So it's really important for my clients.
I would source and recommend organic decaf tea, organic decaf coffee or,
you know, naturally, naturally decaf.
(12:07):
You know teas like for example red bush tea or something like that
right instead of you know going to
starbucks and asking for their coffee for example
might not be the best thing to do when you're trying to
kind of support your your reproductive health
good to know thank you for sharing that
and really helpful again because you're further reiterating
(12:29):
the point that nutrition should be personalized
and we shouldn't just reach off stuff off the internet and
just say that what's up for that person then i should be doing the same
but because everyone is different so really important
you know i always think there is a lot
of nutritional advice out there and it
can be overwhelming and it can be very difficult to then you know
(12:50):
figure out what applies to you out of all this information
i always just think you know anyone who's
handing out nutritional advice online if they are
sort of promoting this kind of one size fits
all message like oh everyone should avoid dairy for me
that would be a red flag you know I would never put up
a post on Instagram saying everyone should avoid dairy so you
(13:12):
for me that's a red flag about their advice and about more credentials really
you know so that's always a kind of a good approach to take you know yeah good
to know thank you and now in talking about avoiding certain teas and the the decaps not to take,
what can we take?
I mean, in terms of like, if there are teas that might help to actually.
(13:37):
Help to aid with frozen embryo transfer before or after?
Yeah, well, definitely one tea that's excellent is actually hibiscus tea.
Hibiscus is a flower that you can then make into a tea.
It's got quite a mild flavor, like really quite pleasant. For people that maybe
don't really like herbal teas,
it would be a really good option because it doesn't have a strong flavor.
(14:00):
Her hibiscus would be really excellent. It actually enhances blood dilation and blood flow.
And that's a really important consideration around embryo transfer,
that you want to enhance blood flow to the reproductive organs to support nutrient delivery,
oxygen delivery to the womb for promoting healthy implantation.
(14:23):
So generally, these foods that enhance blood flow, like hibiscus tea,
I generally recommend clients increase those in their diet.
Sometimes the whole way through their new their fertility journey
but also specifically in the two weeks before frozen
embryo transfer and the two weeks after having lots of
these foods that are promoting blood flow healthy blood flow is
really going to help um there is some
(14:44):
kind of research on the topic so hibiscus tea would be
excellent um if you live in a hot country it
can be made into like an iced tea you know just make it up and let
it cool it's quite pleasant and you know with ice so if you
think you know drinking three cups a day which is
what i would recommend three cups of hibiscus tea a day if you think drinking three
cups a day oh wow be problematic you can
let go cold another herbal tea that would be quite beneficial would be ginger
(15:08):
that's also really good at promoting circulation it's a natural anti-inflammatory
as well so that would be another nice one but but kind of top recommendation
would be hibiscus tea good to know thank you for sharing and of course you mentioned
earlier as well about supplements.
There's certain supplements that we should be exploring or considering for an embryo transfer?
(15:29):
Yeah well generally like a good quality fertility multi should be you know you
should have been taking it for a few months before embryo transfer anyway especially
to see the benefits but you know a good quality one that is going to be providing
you with kind of minerals such as zinc for example iodine so obviously preparing
for preparing the body for a healthy pregnancy.
I would also recommend a really good omega-3 fat supplement again omega-3 fats
(15:56):
have have lots of benefits for fertility health.
Some that would be specific around frozen embryo transfer, such as promoting
healthy circulation, good blood flow around the body, omega-3 fat.
Also naturally anti-inflammatory, so increasing your omega-3 status.
In the run-up to embryo transfer and then obviously during pregnancy is very very important.
(16:18):
And you know when you're trying to conceive and also during
pregnancy it is recommended that you avoid too much
oily fish in your diet because oily fish can actually
be a source of toxins such as heavy metals so
you're it's recommended the guidelines are really
no more than one serving weekly because in excess of
that could be a source of heavy metals so for my
(16:40):
clients i generally recommend that they don't
have any more than one serving weekly so we do have to then look at an omega-3
supplement and a high quality one that has been screened for heavy metals not
a not a bargain basement and there's some specifically that you recommend or
you're right a specific brand which which is really good.
(17:02):
It's called Bare Biology. It's all screened for heavy metals.
So that's a really good company. And they do some products specifically for
kind of fertility and pregnancy. So they're really, really excellent.
So you really have to look at a quality supplement for your omega-3 sources
of your diet during pregnancy because you can't eat an abundance of oily fish.
(17:24):
So that's a really important one. And then vitamin D,
really important for showing increased
chances of implantation and conception I generally
would recommend vitamin D testing and then using
that test result to determine a good vitamin D supplement
make sure you're going into pregnancy with really healthy vitamin D levels
(17:44):
as I said vitamin D has very important role
in the body in controlling inflammation and supporting
immune system balance which can help support conception
so vitamin D another one I
would recommend sort of but I do I do generally say start with testing find
out what dose you need and then move on from there and lastly another supplement
(18:05):
that has been shown to be quite positive would be coenzyme q10 which is there's
some clinical trials that indicate that it can sort of thicken and endometrium
lining which can then support healthy.
Implantation but always follow guidance from maybe your
consultant or your doctor with with dosages some people
can recommend very very high dosages of coquetel which i
(18:26):
don't agree with necessarily you know so
I've seen some people maybe be on like 600 milligrams 700 milligram
I don't think that's always necessary for everyone so you know a moderate dose
of CoQ10 and that can really really help and again just maybe maybe two months
of that can be could be enough to really um support implantation as well so
(18:47):
good to know thank you for sharing that really helpful.
And of course, you know, another aspect when you're trying to prepare for a
frozen embryo transfer on Google, there's always the conversation about,
eat lots of beetroot, take pineapple core right after transfer.
And which one of these is actually reality?
(19:10):
And I mean, backed by evidence, which one should we be avoiding?
Well, definitely the beetroot one would be my main recommendation.
And again, linked to the hibiscus, because in the beetroot and hibiscus,
it's the same compound or similar compounds that have a similar effect on the body.
They enhance something called nitric oxide which helps to
(19:31):
dilate our blood vessels and support healthy blood flow around the body so
you know in the same sort of vein as
recommending hibiscus tea i do also recommend things like eating
beetroot yeah so purple foods like beetroot can really help with this nitric
oxide so beetroot blueberries pomegranate all your blackberries or what about
(19:51):
the purple cabbage yes it's also i mean as much as you can of these purple foods
they're also very potent antioxidants,
so they're not going to do you any harm either in that respect.
So all this can really help, but some people maybe make beetroot soup or drink
a glass of beetroot juice or eat a small beetroot daily in a salad or something like that.
(20:13):
And again, at the very least, doing that two weeks before transfer and two weeks
after can really, really help.
But again, these foods are going to be beneficial throughout your reproductive journey.
Good blood flow to the reproductive organs means good oxygen delivery,
good nutrient delivery through reproductive
organs. So they're going to be beneficial the whole way through.
But yes, for example, if you don't like them a lot, just focusing on the two
(20:37):
weeks, there's actually a berry called the Escapa berry, which is related,
kind of similar to the blueberry.
And you can buy a lovely powder made from that berry.
And you can add a good porridge or smoothies or something. And I recommend that
a lot with clients as a way to kind of get this in,
you know, get their purple foods in every day because it's a really easy you
(20:57):
can actually it comes in a powder form and you can make it into a cold drink
or a hot drink it doesn't have to be added to food so it could be made into
like a cup of tea or something and that's a lovely way to get this purple food
in every day which I would use a lot with clients.
And is that a specific brand as well or it doesn't matter? It's
a specific brand but it's actually the berry itself is called the Haskap berry
it's from Scandinavia and then the brand is Haskapa and they make a powdered
(21:19):
form that you can buy and you know it's very handy because you've got it there
in the cupboard you know if you run out of fresh blueberries or you run out
of fresh beetroot it's always there so you can make sure similar to the hibiscus
tea you know you can have it in the cupboard,
you know the whole day the whole time doesn't go off you
know so thank you for sharing of course
speaking more about frozen embryo transfer with the foods
(21:41):
as well there is sometimes the concern should
we eat only warm foods or cold foods again
this is stuff on the internet but it's a common on question and
concern for people preparing for frozen embryo transfer
so does really matter should we not anything cold while you're yeah i've i've
heard that at least as far as i know i think that might be an approach kind
(22:02):
of recommended by you know traditional chinese medicine so it wouldn't be something
i personally trained them but i can maybe understand the you know the the.
The sort of the thinking behind it that if you're
eating lots of cold foods your you know your
body's maybe like your digestion is cold and then your body has
to divert a lot of you know blood flow to the
(22:23):
digestion maybe away from the reproductive organs or something like that and
you know i do think that in an approach to fertility health i mean a combination
of complementary therapies like maybe a traditional chinese approach under nutrition
you know it can they can all be beneficial and they can work together as well.
So whereas it might not be sort of the top of the list of recommendations,
(22:46):
I would give a client, I can understand where it's coming from.
And I do generally recommend, you know, for clients, like I'm a fan of acupuncture to support fertility.
And I think that works quite well together with the nutritional approach.
So thinking of like keeping warming and, you know, because the idea is in traditional
Chinese medicine that you keep your womb warm and, you know,
lovely like circulation to the womb.
(23:06):
So I can see where it comes from. So I don't think there's anything wrong.
I do think that, you know, it would be taking it a bit too far to think,
oh, you don't eat any cold foods, you know, like maybe, you know,
because it can be great to have a salad, you know, a lunch, you know, a meal.
But maybe if it was like if breakfast, lunch and dinner, everything on your
plate was cold, that might be a bit too much or you're drinking lots of very
(23:28):
cold water or, you know, iced drinks and iced, you know, iced tea,
iced coffee, it might be too much.
So I think, you know, there's probably a bit of a bit of sort of a sense to the recommendation.
So, yeah, maybe just trying to make sure not everything's cold.
You're not exclusively eating cold foods could be beneficial, you know.
(23:50):
Thank you. Thank you for speaking on that. I think it helps a lot of people
just to have a better understanding that, you know, just having a good balance
is the way to go. Yeah, definitely.
Yeah. Apart from diet, of course, another area of concern or worry is also the vaginal microbiome.
So is this really true that this is an area that we should also be paying attention
(24:14):
to as well as the diet? Yes, definitely.
It's a really emerging area of kind of concern in sort of overall fertility
health, specifically when it comes to embryo transfer or conception implantation.
So people might be familiar with the gut microbiome
(24:35):
which is the population of good bacteria that live within our digestive
system and support our digestive system but
we are now beginning to understand that other areas of body our
body have their own microbiomes such as our vagina
and having a healthy population in
our vaginal microbiome is is very important for and we're starting to understand
(24:56):
very important for controlling inflammation in that sort of locally in the vaginal
area and also you know promoting conception so there's a lot of them you know
we're kind of start it's very early days but we're starting to go down the road of research.
Into through the characteristics of your vaginal microbiome
how healthy it is and chances of healthy implantation
(25:18):
healthy conception and kind of early pregnancy it's
a very one real positive is a very straightforward
test just so that you take a vaginal microbiome swab
send it away and you get your results back
relatively quickly and it's also usually something that's quite straightforward
to address if it's out of balance so if for example you do the test and there's
(25:41):
a finding that you have some pro-inflammatory bacteria and we would call them
kind of like the bad bacteria there's too many bad bacteria there as opposed
to the good bacteria that keep of everything healthy,
you know, you can address that. Take action.
You know, either an antibiotic or some supplements, try and get rid of the bad
bacteria and then try and boost the good bacteria.
It is such a crucial thing to be aware of and to support,
(26:05):
on your fertility journey, trying to conceive, but something that is so straightforward
and relatively easy to address that I think it's such an important thing that
we're not really looking at.
And it's not common knowledge, but it is starting to become more widely addressed.
And I think that's fantastic.
Yeah, definitely. So what can we do then to try to support the vaginal microbiome?
(26:31):
Is it something that we should be eating or should we be doing some testing?
Well, definitely. I always start with the testing because you may not have any
symptoms that your vaginal microbiome is out of balance, that you've got bad bacteria there.
You can have high levels of certain bacteria such as strep B and you can have
no symptoms whatsoever.
You can have low levels of good
bacteria and signs that your vaginal microbiome might be out of balance.
(26:55):
Or things like recurring thrush, recurring UTIs, discharge, itchiness in the vaginal area.
Or if you have a history of heavy antibiotic use or have been using maybe some
medications long-term, if you've had your gallbladder removed,
all these things can impact the microbiomes in the body.
(27:17):
And so if that's the case, again, quite a few of those things are red flags
that your vaginal microbiome might be out of balance.
But again, it's really a straightforward area to support if you know what's
going on in the vaginal microbiome.
So it can be supplementation with specific probiotics. So a probiotic is a capsule
(27:40):
that's really filled with lots of.
Good bacteria so a bit like the good bacteria that's
in a yogurt but really if you imagine like huge concentrations of
that good bacteria so you can
take probiotic supplements and but then diet has a
big part to play in maintaining microbiomes around
the body so fermented food such as
(28:02):
like live yogurt and kefir you fermented dairy that
provides good bacteria to the body that can help maintain
a healthy vaginal microbiome so that's another reason why i
don't cut out dairy unnecessarily because you would
be you know reducing your ability to maybe introduce those
really good healthy fermented dairy foods things like
sauerkraut kombucha all these fermented foods are becoming quite trendy but
(28:25):
they have real benefits for our body you also want to be eating like a wide
variety of fruits and vegetables plant foods look after our microbiome and then
it's also important like what you're avoiding so nicotine for example has been shown to
reduce good bacteria levels in the vaginal microbiome.
So if you are smoking or vaping or maybe being exposed to secondhand smoke,
(28:52):
all those things could potentially, interestingly, have a bad impact on your microbiome.
Chlorine in tap water has been shown to have a negative impact.
So we would always want to filter tap water or dry animal water that can have
a really positive impact.
So it's a big picture. i usually say start with the testing some people who
can't afford the testing just like to maybe.
(29:13):
Take a vaginal probiotic supplement which is
another way to you know maybe support and transfer and i would usually recommend
that for at least two or three months prior to transfer to make sure you've
got a healthy vaginal microbiome so lots you can do and really as i said it
depends on the person and their medical history and their background you know
if there's There's been factors that might have affected the vaginal microbiome too.
(29:36):
Thank you. And for that vaginal probiotic, is there anyone in particular that you would recommend?
There's a few different companies that produce supplements. The company that
I tend to recommend the product with is actually the company that can provide
the testing in the UK, which is Envivo.
So they will provide the testing kit and then they also have supplements you
can use afterwards to treat as well.
(29:57):
Okay and so for people that might be listening and wanting to get the test done or perhaps explore.
Further if this is something they need what is
the best way to approach that did they reach out to you or you
have to go through your practitioner and you can just log on and order test
kit yourself because then you would need practitioner support after test results
(30:19):
to sort of get the most out of them so you can contact someone like myself or
you know register anyone who's registered with in vivo as a practitioner and
they can organise the test kit for you.
Okay. And what's the best way to reach out to you? For me, you can reach out
kind of directly to me through like Instagram or Facebook, social media.
And I think you have my contact details.
(30:41):
Yeah, I'll put the details as well. So that is definitely another thing you can do.
I put in the show notes so people can reach out. And in terms of general supporting
probiotic, is there anyone that you would also recommend that people take in general?
Yeah, I mean, there are also very good quality, like, pregnancy probiotics on the market now.
(31:02):
So you can use them prior to transfer.
And then, ideally, throughout pregnancy, you can keep going.
A brand called OptiBac do a really good pregnancy probiotic as well.
So, you know, that's another one that's on the market too that I think is brilliant.
Okay. So basically, I mean, you said for, in terms of diet, supplement,
we should be looking at about three months.
And then the vaginal microbiome as well is something that we should be looking
(31:25):
at. and around the same time and of course get the testing done if there's any
issues and that can be treated with the right probiotics.
And then do they then do another testing after the probiotic or once that initial
testing is done and then you take the probiotic, you're good to go?
I guess the testing follow-up would depend on what was found in the results.
(31:46):
So if you find, for example, you know, just a good example is a bacteria called
strep B and it's often not found in women until maybe...
Sort of they are pregnant sometimes because there is screening for
it sometimes in the later stages of pregnancy but there
is some emerging research indicating that if you have
strep B present it can impact chances of
(32:07):
implantation and could be a risk factor for early miscarriage so
if that was one that you found on the
testing generally the way I would address that
with clients is that I would write a letter to
their GP they would go with the test results to their GP or their consultant
if they're having maybe IVF the consultant and that
they're working with who would then recommend antibiotic to
(32:29):
get rid of the strep B and we would then usually sometimes use
a probiotic as well to protect but generally you do want to check again at a
later stage to make sure that the strep B is gone sometimes you're because you've
had a historic result of strep B being present doctor will then test again your
GP or your consultant so sometimes then you don't have
(32:50):
to test for you know retest for strep b right privately
you're because you're you have had a history of it your doctor will keep an
eye on that sort of during kind
of your pregnancy fertility journey because it could be problematic so you know
just an example of a client that i've worked with who we found that she had
strep b her her ivf clinic that she was working with then were able to prescribe
(33:13):
the antibiotics once they she i forwarded the test results to them with.
A cover letter they prescribed the antibiotics she also used probiotic concurrently
she had her transfer got pregnant but then during pregnancy her her clinic continued
to screen for strep free to make
sure that it didn't come back so and then she could if it did you know.
(33:35):
Antibiotics would be available again so that's just one example i guess it's
quite difficult to note it would really be dependent on what the results showed
when they came back you know.
Right, okay. Yeah. Some, just on a note, like sometimes some bacteria show up
that are maybe slightly different to strep B.
And generally you can keep those bad bacteria under control just simply with probiotics.
(34:00):
So for some plants, it's just enough to just use a probiotic throughout pregnancy
and in the run-up to transfer.
And they just keep going with the probiotic and maintaining a healthy,
good bacteria levels is enough to kind of keep the bad bacteria in check.
So you know that sometimes that's all you have to do really is keep going with the probiotic.
(34:21):
Thanks so much for sharing i think it's really i think
for anyone listening that you really how it does really help to listen to you
speak about the diet and you know things to eat not to eat perhaps certain teas
that can be beneficial and probiotics and of course this really important area
the vaginal microbiome as well and just to stress that as well this is important even if
(34:42):
you're trying to conceive without fertility treatments.
This is something that you should be looking at anyway as well,
regardless of IVF or not.
Yeah, yeah, definitely. I was actually talking to a client about it just a few
days ago, and I said, if I was kind of doing my fertility journey again,
I conceive naturally, I would have tested this.
(35:03):
But, you know, back then, whenever I had my child, it wasn't really as sort of widely available.
Available it was very difficult to find the services but if it was if it was
me doing it all over again this would have been one of the first tests I would
have done you know for myself right thank you for sharing is there anything else that you'd like to.
(35:24):
Share in terms of preparation for frozen
embryo transfer that you might have
come across because again i think for many people there's a lot of information
preparing for retrieval of egg retrieval right you know eat right do this right
but then somehow i think people feel like they can relax and not worry so much
because the embryo is already ready and that it is in a transfer but But of course,
(35:48):
the body still has to be prepared as best as possible to receive the embryo
and hopefully carry on further to a successful pregnancy and birth.
Yeah, 100%. It's also a really important area. And, you know,
you're already in a good place. Fantastic.
You've got a healthy embryo. You've had healthy egg retrieval.
(36:09):
Like that's, you know, you've already kind of overcome one hurdle.
But then you know then you want to switch switch your
focus to you know everything you can do
for making sure you're nutritionally ready for pregnancy
as i mentioned you know it's really important to have
optimal status of certain nutrients like iodine
and which supports your thyroid health in early pregnancy and
(36:31):
you want to have good levels vitamin d you want to have good levels omega-3 so
you want to be making sure you know foliate b12 all those so
again continuing to to support and maintain those healthy
levels with a good you know pregnancy multivitamin
a good quality pregnancy multivitamin looking to make
sure your diet continues to be good as well because you
know if say for example oh yeah you've got a healthy embryo you're
(36:52):
thinking maybe someone goes off the rails and you know i can eat more sugar
now or i can yeah you know again you know try to keep be mindful of those foods
can be pro-inflammatory so you know there's a lot of talk about the Mediterranean-style
diet as being very helpful for egg quality, but it's also really good at controlling.
Kind of inflammation keeping inflammation levels down so you know
(37:15):
all those fruits and vegetables that are rich in antioxidants that
also helps to keep your inflammation levels healthy olive oil
you know lots of all all those really you know nutritious foods it's always
it's also going to help your your ability for conception implantation and then
you know early pregnancy and further on during the pregnancy so it's it's really
(37:36):
important you just have to shift your focus slightly and
think about all these other things that could be relevant
and then can also support you know that that
that next stage of of of
the pregnancy journey essentially so it's
i'm just thinking of anything that i haven't mentioned that could
be kind of relevant it's really as i said you know
(37:57):
focusing in on those key nutrients making sure there's enough and controlling
inflammation so a lot of the nutritional like
a lot of the nutritional guidance that you've probably followed for egg
quality it still stands you know yeah but at
this point it just maybe has different benefits for the
body right thank you for sharing that actually one
(38:18):
question that i forgot to ask was about also talking about the diet and what
to eat because sometimes people say they eat a lot of fiber and that's good
and you have some people that are concerned about there's certain cookies or
biscuits that have a lot of fiber but of course biscuit is still feel.
Sugar yeah sugar so should
(38:41):
that be eliminated or should be significantly reduced
sugar should definitely be reduced because
it's going to be prone to too much sugar it's going to be poor inflammatory and i
also think if you're eating lots of sugar you know for example as snacks
you're kind of missing opportunities to get more nutritious food in as
snacks and things as well you know i'm a big fan of dark
chocolate like a square of dark chocolate like high cocoa content at
(39:04):
least 75% cocoa that actually can
help with blood flow so you know if you did want a sweet treat after
a meal a square of dark chocolate might have actual
benefits at this point but yes there.
Is actually you mentioned their fiber high fiber foods there
is some evidence that they can help you know high fiber diet can help
implantation and can support a
(39:25):
healthy endometrium lining and i guess
whole grains like whole grain oats or brown
rice things like that are actually very nutritious
and the source of maybe nutrients like
vitamin e which are known to help support the endometrium and
actually i don't think we talked about vitamin e vitamin e rich foods
are very good so avocado olive oil olives
(39:48):
nuts and seeds whole grains and from
vitamin e are really important foods as well
and again some research that good lots of vitamin e can
support the endometrium so yeah it's it's
a big picture but you know i love going back to the mediterranean diet because
it kind of ticks all the boxes all right whole grains lots of fruits and veg
no real pro-inflammatory foods herbs and spices which are anti-inflammatory
(40:12):
you know if you're in doubt to go with the mediterranean diet that would be
kind of a really my one takeaway kind of message.
Right. And I think it's also important not to be confused that because again,
talking about the fiber and the biscuits, I think people sometimes you see certain foods that might be.
Originally, not a good idea, but because you see that he has things like,
(40:34):
I don't know, fiber or he has something that you think is good,
then you keep eating it because you think of the fiber as opposed to what it actually is, right?
So a cookie is still a cookie, regardless of the fact that he has high fiber.
I mean, because it's still going to be like a processed food.
Right. you know if you wanted to kind of make your own homemade like low sugar something like flap.
(40:59):
Jacks or something that would be great as like a high fiber snack but
really it should be like kind of whole grains in your
meals or you know at breakfast time is your
best way to get fiber i mean i'm also a huge fan
of beans and lentils as a source of fiber in the diet
and a lot of people don't eat enough they don't like them or
they think they don't know how to cook them and just such a
(41:20):
really great nutritious food when you're trying to
conceive you know and really lots and lots of fiber brilliant
brilliant brilliant food to include in your
diet thank you for sharing that and then you mentioned avocados what
about so you talked about fish oily fish that could be
problematic and you know using taking the supplements
what about salmon is that something that
(41:41):
you can eat on a weekly basis or is that also
categorized as part of the oily fish so
that would count as an oily fish so generally if you are going to have
serving of oily fish one serving a
week maximum less if
you are going to choose oily fish the smaller the fish the better because it's
less likely to have toxins so if you do love your oily fish sardines are a better
(42:04):
option mackerel but again you don't go beyond one serving a week because of
the concerns of possibly heavy metals so white fish you know is a better option because it's less.
Likely to have heavy metals and toxins from the
sea stored oily fish tends to store those toxins at a
higher level so and it's also another reason
why i don't recommend cod liver oil as your source of omega-3 fats because
(42:26):
it comes from the liver of the fish where there could be toxins so really
it is the one place where i say unfortunately getting you you can't get enough
omega-3 from the diet when you're following these guidelines so we do need to
use a good high quality supplement right and thank you for clarifying that because
cod liver oil used to be highly promoted i believe for fertility but now we
(42:48):
should be looking more and omega-3.
Supplements omega-3 for sure that doesn't come from the liver right okay thank you so much,
there's so much to know right so people and again
having someone that is qualified like yourself that
is fully aware what's right and what's not appropriate is really important because
there's so much information out there and oftentimes people are just confused
(43:09):
and not sure who to to reach out for the right information and right support
as they prepare for their fertility for transfers or just trying for conception
without fertility treatments.
So thank you so much for answering all of our many questions and always being
so passionate and focused on raising awareness and supporting people.
(43:33):
It really is helpful because there's so many people that are able to listen
to this podcast and listen to you answering all those questions and feel better
informed and even can reach out to you for more support and guidance as they
navigate their journeys.
Yeah definitely and I just you
know I do think unfortunately you know I do see so
(43:55):
many people you're sitting in front of me for a consultation and
they are so confused with the amount of information it's
it is you know a complete minefield and
you know even I find sort of the amount of information
that's comes through on social media and online
overwhelming and I know how to wade through
it you know and I know how to kind of decipher what to
(44:17):
sort of go with so i can understand
why my clients and people that are out there like trying to
educate themselves are just so confused yeah thank
you thank you so much for coming back here the
second time to talk to you
again to speak to us and to answer many
of our questions about again fertility and frozen
(44:38):
embryo transfer and vaginal microbiome it's
really helpful to have that information and to be able to reach out to you for
further for testing and for support thank you for all that you do look forward
to having you again in the near future yeah that would definitely be something
we could there's definitely other topics we could cover yeah yes definitely
thank you so much for your time no worries thank you.
Welcome to another episode of the Fertility Conversations podcast.
One of the areas of concern for people exploring or looking to do frozen embryo
transfer is that, you know, what should I be eating? What should I avoid?
Should I be doing further testing, maybe things like vaginal microbiome testing or not?
(00:21):
So people just want to ensure that they have the right information and well
prepared before going for that frozen embryo transfer. So which is why it's
great to have you here today with us, Sarah, to come answer many of our questions.
I'll do a brief introduction about you and then we can go into the questions.
Sarah's joined us before a few episodes before talking about importance of nutrition
(00:44):
and impact that it can play in our fertility.
But today we want to speak more about frozen embryo transfer,
how to prepare and also to ensure that the vaginal microbiome is all in a good
place before doing that transfer.
For and as you said to me in the private conversation also she noted
that that's also important for people that are trying to conceive without
(01:05):
fertility treatments so it helps for everyone
looking to conceive regardless of the option you see you're opting
for so sarah is a nutritional therapist with
nearly 20 years experience working within complementary health industry she
has a nutritional therapy practice in belfast northern ireland and she also
supports individuals from around the UK and around the world looking to improve
(01:29):
their health with dietary and lifestyle changes.
Today, like I said earlier, she'll be answering one of our questions about getting
us ready for conception.
So welcome, Sarah, and thank you so much for being here today.
Thank you for having me again, Ola, having me back to talk about some things
that we didn't get covered the last time. Exactly.
(01:50):
So I wonder if you just want to tell us a little bit about yourself i noted
some of the information from your bio but if there's anything else you want
to add before yeah i just i'm obviously as you said nutritional therapist i
love helping people sort of support overall health but obviously i have a specific
interest in supporting couples.
Improve their fertility reproductive health and support
(02:11):
them through all different stages of the fertility journey
whether that be trying to conceive without
assistance or assisted conception such as IVF and looking at how different dietary
approaches and focusing on different areas of your diet nutrition can support
those different stages be it sort of prior to sort of IVF,
(02:35):
maybe supporting egg and sperm quality,
and then going through the different stages, then possibly how you might then
approach frozen embryo transfer,
what might change, what different areas you might need to focus on at the different
stages of the IVF process.
So that's a really interesting area where there's quite a lot of really good
research on how nutrition can help.
(02:56):
So for me, that's really interesting and sometimes just very
straightforward simple changes for diet
specific supplementation maybe one
or two tests can really help ensure
success in frozen embryo transfer because you know it's such an important factor
(03:16):
to look at you know it can be expensive very expensive if you're self-funding
so you want to optimize your chances of that frozen embryo transfer being successful and there are some
very simple and straightforward things you can do to improve
that so that's a it's a really interesting area for me
wonderful and that's i mean we love that to to
(03:38):
know more about the simple things we can do and
the changes that we can make when trying to
prepare for frozen embryo transfer so some of the things firstly is that how
long before the frozen embryo transfer should we start making these changes
like the dietary changes supplements yeah well i mean ideally most people People
(03:58):
would have made dietary changes prior to embryo collection because,
you know, you would have been making a lot of positive dietary changes to ensure good egg quality.
Prior to egg collection and embryo development.
So a lot of those changes would still be relevant for an embryo transfer.
(04:19):
So we always say three months prior to embryo collection,
egg collection, you want to be ensuring you're following good dietary practices
that are going to ensure good egg quality,
such as an antioxidant rich diet, which we talked a
lot about in the previous podcast you know avoiding sugar
for example and refined carbs so those
(04:39):
changes really still stand so i really just say to
people keep going with those changes you should meet
those changes three months prior to egg collection just keep
going with that really positive you know
approach to your diet in between egg collection and frozen
embryo transfer but for example for someone
who has had their embryo collected a long time ago maybe
(05:00):
they've had a break from ivf for various reasons understandably it can be very
stressful going through IVF some people like to give themselves a bit of a break
now and again they've maybe had a hard time take a few months to just kind of
you know decompress not worry about it sometimes that can be really healthy mentally,
so again you'd look at again another three month period at least prior to frozen
(05:24):
embryo transfer to make sure you're in a very healthy place nutritionally.
Okay, we aren't basically focusing on factors such as egg quality,
but still there are other factors that we want to focus on in the body that
it can take up to three months to see positive changes there.
Generally, in all areas of nutritional therapy, you're talking about a period
(05:47):
of three months to see lots of real positive positive change in specific areas
so you know that three-month period still generally stands,
so you know but instead of maybe focusing on egg quality we would be looking at things like.
Enhancing your nutrient levels you know those important nutrients that are really
important to pregnancy because ideally at the end of the frozen embryo transfer
(06:10):
you know you're going to have a healthy pregnancy so be looking at making sure
you've got enough of those nutrients that that are really important for healthy pregnancy.
Omega-3 fats, vitamin D, zinc, selenium, iodine, really key for women, really important one.
So maybe making sure you're focusing and getting enough of those from your diet,
but also using high quality fertility supplements that's going to make sure
(06:32):
you've got enough of those.
I forgot to mention folic acid, foliate, for example.
So again, three month period, making sure you've got healthy levels of those
that are going to be both maybe be conducive to transfer, but also then support
a healthy pregnancy making sure your body's in a really good place.
You're also going to look at foods that support circulation,
a really important area because that's going to be delivering nutrients to your
(06:56):
your cervix for implantation,
nutrient levels, oxygen, making sure you have a lovely kind of womb lining that's really healthy so.
All these foods and nutrients that support circulation and we're also looking
at foods and nutrients and an approach that reduces inflammation because if
there is sort of an imbalance in your levels of inflammation in the body that
(07:20):
can interfere with the chances of,
implantation conception so it's a big big picture but you know and i've answered
it's taken me a long time to answer your question but generally yes three months
ola yeah thank you and i mean The information you provided is really helpful
because that's part of the concerns and what we worry about.
And so three months, as much as possible. Now, in terms of what we should be
(07:43):
eating and not eating, one of the concerns is that should we be taking,
I mean, we know that they say reduce coffee, but can cappuccino every now and
then, can that have any negative impact?
And, you know, obviously contains milk. milk some
people say that milk has inflammatory attributes or
(08:03):
not so well what are
your thoughts definitely the inflammation side of things is a very important
one and you know for the important thing and the important thing to understand
with this sort of i say it's a bit of a misconception that dairy can be pro-inflammatory
is that dairy can be pro-inflammatory for some people if they they are sensitive
(08:23):
to it, but not everyone is.
So for everyone to go out and cut out dairy, I don't agree with that approach
because that's sort of a one size fits all approach to nutritional therapy,
which, you know, your nutritional, you know, the nutritional approach for you
should be very individual.
You know, everyone's needs are different.
So, you know, Ola, for example, you might be sensitive to dairy products.
(08:46):
I might not be, you know, for me, you know, Dairy products, therefore,
would be a very important source of important nutrients like iodine, which I mentioned.
Dairy products are a very important source of iodine in our diet,
which is a really important nutrient for healthy conception and healthy pregnancy in women.
And a lot of women are deficient in iodine. So for me, that's quite a problematic
(09:08):
message to say dairy products are proclamatory.
Avoid dairy when you're preparing for conception.
You know, whenever I'm working with a client who is preparing for conception,
frozen embryo transfer, and I suspect there may be a dairy intolerance for maybe
certain reasons that might kind of red flag it to me, or maybe there was a history
(09:31):
of dairy intolerance as a child.
They have eczema or some other condition like eczema
skin condition or maybe they have IBS
I will generally test for a food sensitivity to determine whether it is present
and it's only really under that circumstance that I am happy to then go ahead
(09:51):
and say let's cut out dairy but at the same time if I'm working with a client
and I've recommended cutting out dairy I will be making
sure that I would be meeting any nutritional gaps from cutting out dairy with
either supplementation or dietary changes to make sure that we're not missing
out on important nutrients like,
you know, iodine B12 that they might be getting from dairy products in their diet.
(10:17):
So yeah, I have a bit of an issue with, you know, some of this messaging that,
you know, dairy is pro-inflammatory, avoid dairy.
You know, for some people, yes, but that could be 25% of people.
The other 75% of people could easily continue with their dairy consumption.
So for me, that's a really important area to understand. And then moving on to caffeine.
(10:39):
My attitude towards caffeine is that you don't want to take any caffeine after
a frozen embryo transfer.
So basically at any point that you could be pregnant, avoid all caffeine and
in the run-up to frozen embryo transfer i think it's important to be,
significantly reducing your caffeine intake from all sources
(11:00):
because if you're drinking five cups
of coffee a day that can deplete nutrient levels
it can be a stressor on the body leading to like adrenaline
release so you know
you want to be definitely looking at maybe reducing it down
to one maximum two caffeinated cups
of coffee or tea a day so that your caffeine intake
(11:22):
is significantly low because beyond that could be leading to you know depletion
of key nutrients in the body on the other hand though you also want to look
at what your caffeine free alternatives are and the quality of them as well
so if you're choosing decaf coffee or decaf tea it's important
to look at organic decaf tea, organic decaf coffee.
(11:45):
Because if you aren't choosing organic decaf coffees and teas can be sources
of kind of chemicals because they use chemicals to decaffeinate them if they're not organic.
So it's really important for my clients.
I would source and recommend organic decaf tea, organic decaf coffee or,
you know, naturally, naturally decaf.
(12:07):
You know teas like for example red bush tea or something like that
right instead of you know going to
starbucks and asking for their coffee for example
might not be the best thing to do when you're trying to
kind of support your your reproductive health
good to know thank you for sharing that
and really helpful again because you're further reiterating
(12:29):
the point that nutrition should be personalized
and we shouldn't just reach off stuff off the internet and
just say that what's up for that person then i should be doing the same
but because everyone is different so really important
you know i always think there is a lot
of nutritional advice out there and it
can be overwhelming and it can be very difficult to then you know
(12:50):
figure out what applies to you out of all this information
i always just think you know anyone who's
handing out nutritional advice online if they are
sort of promoting this kind of one size fits
all message like oh everyone should avoid dairy for me
that would be a red flag you know I would never put up
a post on Instagram saying everyone should avoid dairy so you
(13:12):
for me that's a red flag about their advice and about more credentials really
you know so that's always a kind of a good approach to take you know yeah good
to know thank you and now in talking about avoiding certain teas and the the decaps not to take,
what can we take?
I mean, in terms of like, if there are teas that might help to actually.
(13:37):
Help to aid with frozen embryo transfer before or after?
Yeah, well, definitely one tea that's excellent is actually hibiscus tea.
Hibiscus is a flower that you can then make into a tea.
It's got quite a mild flavor, like really quite pleasant. For people that maybe
don't really like herbal teas,
it would be a really good option because it doesn't have a strong flavor.
(14:00):
Her hibiscus would be really excellent. It actually enhances blood dilation and blood flow.
And that's a really important consideration around embryo transfer,
that you want to enhance blood flow to the reproductive organs to support nutrient delivery,
oxygen delivery to the womb for promoting healthy implantation.
(14:23):
So generally, these foods that enhance blood flow, like hibiscus tea,
I generally recommend clients increase those in their diet.
Sometimes the whole way through their new their fertility journey
but also specifically in the two weeks before frozen
embryo transfer and the two weeks after having lots of
these foods that are promoting blood flow healthy blood flow is
really going to help um there is some
(14:44):
kind of research on the topic so hibiscus tea would be
excellent um if you live in a hot country it
can be made into like an iced tea you know just make it up and let
it cool it's quite pleasant and you know with ice so if you
think you know drinking three cups a day which is
what i would recommend three cups of hibiscus tea a day if you think drinking three
cups a day oh wow be problematic you can
let go cold another herbal tea that would be quite beneficial would be ginger
(15:08):
that's also really good at promoting circulation it's a natural anti-inflammatory
as well so that would be another nice one but but kind of top recommendation
would be hibiscus tea good to know thank you for sharing and of course you mentioned
earlier as well about supplements.
There's certain supplements that we should be exploring or considering for an embryo transfer?
(15:29):
Yeah well generally like a good quality fertility multi should be you know you
should have been taking it for a few months before embryo transfer anyway especially
to see the benefits but you know a good quality one that is going to be providing
you with kind of minerals such as zinc for example iodine so obviously preparing
for preparing the body for a healthy pregnancy.
I would also recommend a really good omega-3 fat supplement again omega-3 fats
(15:56):
have have lots of benefits for fertility health.
Some that would be specific around frozen embryo transfer, such as promoting
healthy circulation, good blood flow around the body, omega-3 fat.
Also naturally anti-inflammatory, so increasing your omega-3 status.
In the run-up to embryo transfer and then obviously during pregnancy is very very important.
(16:18):
And you know when you're trying to conceive and also during
pregnancy it is recommended that you avoid too much
oily fish in your diet because oily fish can actually
be a source of toxins such as heavy metals so
you're it's recommended the guidelines are really
no more than one serving weekly because in excess of
that could be a source of heavy metals so for my
(16:40):
clients i generally recommend that they don't
have any more than one serving weekly so we do have to then look at an omega-3
supplement and a high quality one that has been screened for heavy metals not
a not a bargain basement and there's some specifically that you recommend or
you're right a specific brand which which is really good.
(17:02):
It's called Bare Biology. It's all screened for heavy metals.
So that's a really good company. And they do some products specifically for
kind of fertility and pregnancy. So they're really, really excellent.
So you really have to look at a quality supplement for your omega-3 sources
of your diet during pregnancy because you can't eat an abundance of oily fish.
(17:24):
So that's a really important one. And then vitamin D,
really important for showing increased
chances of implantation and conception I generally
would recommend vitamin D testing and then using
that test result to determine a good vitamin D supplement
make sure you're going into pregnancy with really healthy vitamin D levels
(17:44):
as I said vitamin D has very important role
in the body in controlling inflammation and supporting
immune system balance which can help support conception
so vitamin D another one I
would recommend sort of but I do I do generally say start with testing find
out what dose you need and then move on from there and lastly another supplement
(18:05):
that has been shown to be quite positive would be coenzyme q10 which is there's
some clinical trials that indicate that it can sort of thicken and endometrium
lining which can then support healthy.
Implantation but always follow guidance from maybe your
consultant or your doctor with with dosages some people
can recommend very very high dosages of coquetel which i
(18:26):
don't agree with necessarily you know so
I've seen some people maybe be on like 600 milligrams 700 milligram
I don't think that's always necessary for everyone so you know a moderate dose
of CoQ10 and that can really really help and again just maybe maybe two months
of that can be could be enough to really um support implantation as well so
(18:47):
good to know thank you for sharing that really helpful.
And of course, you know, another aspect when you're trying to prepare for a
frozen embryo transfer on Google, there's always the conversation about,
eat lots of beetroot, take pineapple core right after transfer.
And which one of these is actually reality?
(19:10):
And I mean, backed by evidence, which one should we be avoiding?
Well, definitely the beetroot one would be my main recommendation.
And again, linked to the hibiscus, because in the beetroot and hibiscus,
it's the same compound or similar compounds that have a similar effect on the body.
They enhance something called nitric oxide which helps to
(19:31):
dilate our blood vessels and support healthy blood flow around the body so
you know in the same sort of vein as
recommending hibiscus tea i do also recommend things like eating
beetroot yeah so purple foods like beetroot can really help with this nitric
oxide so beetroot blueberries pomegranate all your blackberries or what about
(19:51):
the purple cabbage yes it's also i mean as much as you can of these purple foods
they're also very potent antioxidants,
so they're not going to do you any harm either in that respect.
So all this can really help, but some people maybe make beetroot soup or drink
a glass of beetroot juice or eat a small beetroot daily in a salad or something like that.
(20:13):
And again, at the very least, doing that two weeks before transfer and two weeks
after can really, really help.
But again, these foods are going to be beneficial throughout your reproductive journey.
Good blood flow to the reproductive organs means good oxygen delivery,
good nutrient delivery through reproductive
organs. So they're going to be beneficial the whole way through.
But yes, for example, if you don't like them a lot, just focusing on the two
(20:37):
weeks, there's actually a berry called the Escapa berry, which is related,
kind of similar to the blueberry.
And you can buy a lovely powder made from that berry.
And you can add a good porridge or smoothies or something. And I recommend that
a lot with clients as a way to kind of get this in,
you know, get their purple foods in every day because it's a really easy you
(20:57):
can actually it comes in a powder form and you can make it into a cold drink
or a hot drink it doesn't have to be added to food so it could be made into
like a cup of tea or something and that's a lovely way to get this purple food
in every day which I would use a lot with clients.
And is that a specific brand as well or it doesn't matter? It's
a specific brand but it's actually the berry itself is called the Haskap berry
it's from Scandinavia and then the brand is Haskapa and they make a powdered
(21:19):
form that you can buy and you know it's very handy because you've got it there
in the cupboard you know if you run out of fresh blueberries or you run out
of fresh beetroot it's always there so you can make sure similar to the hibiscus
tea you know you can have it in the cupboard,
you know the whole day the whole time doesn't go off you
know so thank you for sharing of course
speaking more about frozen embryo transfer with the foods
(21:41):
as well there is sometimes the concern should
we eat only warm foods or cold foods again
this is stuff on the internet but it's a common on question and
concern for people preparing for frozen embryo transfer
so does really matter should we not anything cold while you're yeah i've i've
heard that at least as far as i know i think that might be an approach kind
(22:02):
of recommended by you know traditional chinese medicine so it wouldn't be something
i personally trained them but i can maybe understand the you know the the.
The sort of the thinking behind it that if you're
eating lots of cold foods your you know your
body's maybe like your digestion is cold and then your body has
to divert a lot of you know blood flow to the
(22:23):
digestion maybe away from the reproductive organs or something like that and
you know i do think that in an approach to fertility health i mean a combination
of complementary therapies like maybe a traditional chinese approach under nutrition
you know it can they can all be beneficial and they can work together as well.
So whereas it might not be sort of the top of the list of recommendations,
(22:46):
I would give a client, I can understand where it's coming from.
And I do generally recommend, you know, for clients, like I'm a fan of acupuncture to support fertility.
And I think that works quite well together with the nutritional approach.
So thinking of like keeping warming and, you know, because the idea is in traditional
Chinese medicine that you keep your womb warm and, you know,
lovely like circulation to the womb.
(23:06):
So I can see where it comes from. So I don't think there's anything wrong.
I do think that, you know, it would be taking it a bit too far to think,
oh, you don't eat any cold foods, you know, like maybe, you know,
because it can be great to have a salad, you know, a lunch, you know, a meal.
But maybe if it was like if breakfast, lunch and dinner, everything on your
plate was cold, that might be a bit too much or you're drinking lots of very
(23:28):
cold water or, you know, iced drinks and iced, you know, iced tea,
iced coffee, it might be too much.
So I think, you know, there's probably a bit of a bit of sort of a sense to the recommendation.
So, yeah, maybe just trying to make sure not everything's cold.
You're not exclusively eating cold foods could be beneficial, you know.
(23:50):
Thank you. Thank you for speaking on that. I think it helps a lot of people
just to have a better understanding that, you know, just having a good balance
is the way to go. Yeah, definitely.
Yeah. Apart from diet, of course, another area of concern or worry is also the vaginal microbiome.
So is this really true that this is an area that we should also be paying attention
(24:14):
to as well as the diet? Yes, definitely.
It's a really emerging area of kind of concern in sort of overall fertility
health, specifically when it comes to embryo transfer or conception implantation.
So people might be familiar with the gut microbiome
(24:35):
which is the population of good bacteria that live within our digestive
system and support our digestive system but
we are now beginning to understand that other areas of body our
body have their own microbiomes such as our vagina
and having a healthy population in
our vaginal microbiome is is very important for and we're starting to understand
(24:56):
very important for controlling inflammation in that sort of locally in the vaginal
area and also you know promoting conception so there's a lot of them you know
we're kind of start it's very early days but we're starting to go down the road of research.
Into through the characteristics of your vaginal microbiome
how healthy it is and chances of healthy implantation
(25:18):
healthy conception and kind of early pregnancy it's
a very one real positive is a very straightforward
test just so that you take a vaginal microbiome swab
send it away and you get your results back
relatively quickly and it's also usually something that's quite straightforward
to address if it's out of balance so if for example you do the test and there's
(25:41):
a finding that you have some pro-inflammatory bacteria and we would call them
kind of like the bad bacteria there's too many bad bacteria there as opposed
to the good bacteria that keep of everything healthy,
you know, you can address that. Take action.
You know, either an antibiotic or some supplements, try and get rid of the bad
bacteria and then try and boost the good bacteria.
It is such a crucial thing to be aware of and to support,
(26:05):
on your fertility journey, trying to conceive, but something that is so straightforward
and relatively easy to address that I think it's such an important thing that
we're not really looking at.
And it's not common knowledge, but it is starting to become more widely addressed.
And I think that's fantastic.
Yeah, definitely. So what can we do then to try to support the vaginal microbiome?
(26:31):
Is it something that we should be eating or should we be doing some testing?
Well, definitely. I always start with the testing because you may not have any
symptoms that your vaginal microbiome is out of balance, that you've got bad bacteria there.
You can have high levels of certain bacteria such as strep B and you can have
no symptoms whatsoever.
You can have low levels of good
bacteria and signs that your vaginal microbiome might be out of balance.
(26:55):
Or things like recurring thrush, recurring UTIs, discharge, itchiness in the vaginal area.
Or if you have a history of heavy antibiotic use or have been using maybe some
medications long-term, if you've had your gallbladder removed,
all these things can impact the microbiomes in the body.
(27:17):
And so if that's the case, again, quite a few of those things are red flags
that your vaginal microbiome might be out of balance.
But again, it's really a straightforward area to support if you know what's
going on in the vaginal microbiome.
So it can be supplementation with specific probiotics. So a probiotic is a capsule
(27:40):
that's really filled with lots of.
Good bacteria so a bit like the good bacteria that's
in a yogurt but really if you imagine like huge concentrations of
that good bacteria so you can
take probiotic supplements and but then diet has a
big part to play in maintaining microbiomes around
the body so fermented food such as
(28:02):
like live yogurt and kefir you fermented dairy that
provides good bacteria to the body that can help maintain
a healthy vaginal microbiome so that's another reason why i
don't cut out dairy unnecessarily because you would
be you know reducing your ability to maybe introduce those
really good healthy fermented dairy foods things like
sauerkraut kombucha all these fermented foods are becoming quite trendy but
(28:25):
they have real benefits for our body you also want to be eating like a wide
variety of fruits and vegetables plant foods look after our microbiome and then
it's also important like what you're avoiding so nicotine for example has been shown to
reduce good bacteria levels in the vaginal microbiome.
So if you are smoking or vaping or maybe being exposed to secondhand smoke,
(28:52):
all those things could potentially, interestingly, have a bad impact on your microbiome.
Chlorine in tap water has been shown to have a negative impact.
So we would always want to filter tap water or dry animal water that can have
a really positive impact.
So it's a big picture. i usually say start with the testing some people who
can't afford the testing just like to maybe.
(29:13):
Take a vaginal probiotic supplement which is
another way to you know maybe support and transfer and i would usually recommend
that for at least two or three months prior to transfer to make sure you've
got a healthy vaginal microbiome so lots you can do and really as i said it
depends on the person and their medical history and their background you know
if there's There's been factors that might have affected the vaginal microbiome too.
(29:36):
Thank you. And for that vaginal probiotic, is there anyone in particular that you would recommend?
There's a few different companies that produce supplements. The company that
I tend to recommend the product with is actually the company that can provide
the testing in the UK, which is Envivo.
So they will provide the testing kit and then they also have supplements you
can use afterwards to treat as well.
(29:57):
Okay and so for people that might be listening and wanting to get the test done or perhaps explore.
Further if this is something they need what is
the best way to approach that did they reach out to you or you
have to go through your practitioner and you can just log on and order test
kit yourself because then you would need practitioner support after test results
(30:19):
to sort of get the most out of them so you can contact someone like myself or
you know register anyone who's registered with in vivo as a practitioner and
they can organise the test kit for you.
Okay. And what's the best way to reach out to you? For me, you can reach out
kind of directly to me through like Instagram or Facebook, social media.
And I think you have my contact details.
(30:41):
Yeah, I'll put the details as well. So that is definitely another thing you can do.
I put in the show notes so people can reach out. And in terms of general supporting
probiotic, is there anyone that you would also recommend that people take in general?
Yeah, I mean, there are also very good quality, like, pregnancy probiotics on the market now.
(31:02):
So you can use them prior to transfer.
And then, ideally, throughout pregnancy, you can keep going.
A brand called OptiBac do a really good pregnancy probiotic as well.
So, you know, that's another one that's on the market too that I think is brilliant.
Okay. So basically, I mean, you said for, in terms of diet, supplement,
we should be looking at about three months.
And then the vaginal microbiome as well is something that we should be looking
(31:25):
at. and around the same time and of course get the testing done if there's any
issues and that can be treated with the right probiotics.
And then do they then do another testing after the probiotic or once that initial
testing is done and then you take the probiotic, you're good to go?
I guess the testing follow-up would depend on what was found in the results.
(31:46):
So if you find, for example, you know, just a good example is a bacteria called
strep B and it's often not found in women until maybe...
Sort of they are pregnant sometimes because there is screening for
it sometimes in the later stages of pregnancy but there
is some emerging research indicating that if you have
strep B present it can impact chances of
(32:07):
implantation and could be a risk factor for early miscarriage so
if that was one that you found on the
testing generally the way I would address that
with clients is that I would write a letter to
their GP they would go with the test results to their GP or their consultant
if they're having maybe IVF the consultant and that
they're working with who would then recommend antibiotic to
(32:29):
get rid of the strep B and we would then usually sometimes use
a probiotic as well to protect but generally you do want to check again at a
later stage to make sure that the strep B is gone sometimes you're because you've
had a historic result of strep B being present doctor will then test again your
GP or your consultant so sometimes then you don't have
(32:50):
to test for you know retest for strep b right privately
you're because you're you have had a history of it your doctor will keep an
eye on that sort of during kind
of your pregnancy fertility journey because it could be problematic so you know
just an example of a client that i've worked with who we found that she had
strep b her her ivf clinic that she was working with then were able to prescribe
(33:13):
the antibiotics once they she i forwarded the test results to them with.
A cover letter they prescribed the antibiotics she also used probiotic concurrently
she had her transfer got pregnant but then during pregnancy her her clinic continued
to screen for strep free to make
sure that it didn't come back so and then she could if it did you know.
(33:35):
Antibiotics would be available again so that's just one example i guess it's
quite difficult to note it would really be dependent on what the results showed
when they came back you know.
Right, okay. Yeah. Some, just on a note, like sometimes some bacteria show up
that are maybe slightly different to strep B.
And generally you can keep those bad bacteria under control just simply with probiotics.
(34:00):
So for some plants, it's just enough to just use a probiotic throughout pregnancy
and in the run-up to transfer.
And they just keep going with the probiotic and maintaining a healthy,
good bacteria levels is enough to kind of keep the bad bacteria in check.
So you know that sometimes that's all you have to do really is keep going with the probiotic.
(34:21):
Thanks so much for sharing i think it's really i think
for anyone listening that you really how it does really help to listen to you
speak about the diet and you know things to eat not to eat perhaps certain teas
that can be beneficial and probiotics and of course this really important area
the vaginal microbiome as well and just to stress that as well this is important even if
(34:42):
you're trying to conceive without fertility treatments.
This is something that you should be looking at anyway as well,
regardless of IVF or not.
Yeah, yeah, definitely. I was actually talking to a client about it just a few
days ago, and I said, if I was kind of doing my fertility journey again,
I conceive naturally, I would have tested this.
(35:03):
But, you know, back then, whenever I had my child, it wasn't really as sort of widely available.
Available it was very difficult to find the services but if it was if it was
me doing it all over again this would have been one of the first tests I would
have done you know for myself right thank you for sharing is there anything else that you'd like to.
(35:24):
Share in terms of preparation for frozen
embryo transfer that you might have
come across because again i think for many people there's a lot of information
preparing for retrieval of egg retrieval right you know eat right do this right
but then somehow i think people feel like they can relax and not worry so much
because the embryo is already ready and that it is in a transfer but But of course,
(35:48):
the body still has to be prepared as best as possible to receive the embryo
and hopefully carry on further to a successful pregnancy and birth.
Yeah, 100%. It's also a really important area. And, you know,
you're already in a good place. Fantastic.
You've got a healthy embryo. You've had healthy egg retrieval.
(36:09):
Like that's, you know, you've already kind of overcome one hurdle.
But then you know then you want to switch switch your
focus to you know everything you can do
for making sure you're nutritionally ready for pregnancy
as i mentioned you know it's really important to have
optimal status of certain nutrients like iodine
and which supports your thyroid health in early pregnancy and
(36:31):
you want to have good levels vitamin d you want to have good levels omega-3 so
you want to be making sure you know foliate b12 all those so
again continuing to to support and maintain those healthy
levels with a good you know pregnancy multivitamin
a good quality pregnancy multivitamin looking to make
sure your diet continues to be good as well because you
know if say for example oh yeah you've got a healthy embryo you're
(36:52):
thinking maybe someone goes off the rails and you know i can eat more sugar
now or i can yeah you know again you know try to keep be mindful of those foods
can be pro-inflammatory so you know there's a lot of talk about the Mediterranean-style
diet as being very helpful for egg quality, but it's also really good at controlling.
Kind of inflammation keeping inflammation levels down so you know
(37:15):
all those fruits and vegetables that are rich in antioxidants that
also helps to keep your inflammation levels healthy olive oil
you know lots of all all those really you know nutritious foods it's always
it's also going to help your your ability for conception implantation and then
you know early pregnancy and further on during the pregnancy so it's it's really
(37:36):
important you just have to shift your focus slightly and
think about all these other things that could be relevant
and then can also support you know that that
that next stage of of of
the pregnancy journey essentially so it's
i'm just thinking of anything that i haven't mentioned that could
be kind of relevant it's really as i said you know
(37:57):
focusing in on those key nutrients making sure there's enough and controlling
inflammation so a lot of the nutritional like
a lot of the nutritional guidance that you've probably followed for egg
quality it still stands you know yeah but at
this point it just maybe has different benefits for the
body right thank you for sharing that actually one
(38:18):
question that i forgot to ask was about also talking about the diet and what
to eat because sometimes people say they eat a lot of fiber and that's good
and you have some people that are concerned about there's certain cookies or
biscuits that have a lot of fiber but of course biscuit is still feel.
Sugar yeah sugar so should
(38:41):
that be eliminated or should be significantly reduced
sugar should definitely be reduced because
it's going to be prone to too much sugar it's going to be poor inflammatory and i
also think if you're eating lots of sugar you know for example as snacks
you're kind of missing opportunities to get more nutritious food in as
snacks and things as well you know i'm a big fan of dark
chocolate like a square of dark chocolate like high cocoa content at
(39:04):
least 75% cocoa that actually can
help with blood flow so you know if you did want a sweet treat after
a meal a square of dark chocolate might have actual
benefits at this point but yes there.
Is actually you mentioned their fiber high fiber foods there
is some evidence that they can help you know high fiber diet can help
implantation and can support a
(39:25):
healthy endometrium lining and i guess
whole grains like whole grain oats or brown
rice things like that are actually very nutritious
and the source of maybe nutrients like
vitamin e which are known to help support the endometrium and
actually i don't think we talked about vitamin e vitamin e rich foods
are very good so avocado olive oil olives
(39:48):
nuts and seeds whole grains and from
vitamin e are really important foods as well
and again some research that good lots of vitamin e can
support the endometrium so yeah it's it's
a big picture but you know i love going back to the mediterranean diet because
it kind of ticks all the boxes all right whole grains lots of fruits and veg
no real pro-inflammatory foods herbs and spices which are anti-inflammatory
(40:12):
you know if you're in doubt to go with the mediterranean diet that would be
kind of a really my one takeaway kind of message.
Right. And I think it's also important not to be confused that because again,
talking about the fiber and the biscuits, I think people sometimes you see certain foods that might be.
Originally, not a good idea, but because you see that he has things like,
(40:34):
I don't know, fiber or he has something that you think is good,
then you keep eating it because you think of the fiber as opposed to what it actually is, right?
So a cookie is still a cookie, regardless of the fact that he has high fiber.
I mean, because it's still going to be like a processed food.
Right. you know if you wanted to kind of make your own homemade like low sugar something like flap.
(40:59):
Jacks or something that would be great as like a high fiber snack but
really it should be like kind of whole grains in your
meals or you know at breakfast time is your
best way to get fiber i mean i'm also a huge fan
of beans and lentils as a source of fiber in the diet
and a lot of people don't eat enough they don't like them or
they think they don't know how to cook them and just such a
(41:20):
really great nutritious food when you're trying to
conceive you know and really lots and lots of fiber brilliant
brilliant brilliant food to include in your
diet thank you for sharing that and then you mentioned avocados what
about so you talked about fish oily fish that could be
problematic and you know using taking the supplements
what about salmon is that something that
(41:41):
you can eat on a weekly basis or is that also
categorized as part of the oily fish so
that would count as an oily fish so generally if you are going to have
serving of oily fish one serving a
week maximum less if
you are going to choose oily fish the smaller the fish the better because it's
less likely to have toxins so if you do love your oily fish sardines are a better
(42:04):
option mackerel but again you don't go beyond one serving a week because of
the concerns of possibly heavy metals so white fish you know is a better option because it's less.
Likely to have heavy metals and toxins from the
sea stored oily fish tends to store those toxins at a
higher level so and it's also another reason
why i don't recommend cod liver oil as your source of omega-3 fats because
(42:26):
it comes from the liver of the fish where there could be toxins so really
it is the one place where i say unfortunately getting you you can't get enough
omega-3 from the diet when you're following these guidelines so we do need to
use a good high quality supplement right and thank you for clarifying that because
cod liver oil used to be highly promoted i believe for fertility but now we
(42:48):
should be looking more and omega-3.
Supplements omega-3 for sure that doesn't come from the liver right okay thank you so much,
there's so much to know right so people and again
having someone that is qualified like yourself that
is fully aware what's right and what's not appropriate is really important because
there's so much information out there and oftentimes people are just confused
(43:09):
and not sure who to to reach out for the right information and right support
as they prepare for their fertility for transfers or just trying for conception
without fertility treatments.
So thank you so much for answering all of our many questions and always being
so passionate and focused on raising awareness and supporting people.
(43:33):
It really is helpful because there's so many people that are able to listen
to this podcast and listen to you answering all those questions and feel better
informed and even can reach out to you for more support and guidance as they
navigate their journeys.
Yeah definitely and I just you
know I do think unfortunately you know I do see so
(43:55):
many people you're sitting in front of me for a consultation and
they are so confused with the amount of information it's
it is you know a complete minefield and
you know even I find sort of the amount of information
that's comes through on social media and online
overwhelming and I know how to wade through
it you know and I know how to kind of decipher what to
(44:17):
sort of go with so i can understand
why my clients and people that are out there like trying to
educate themselves are just so confused yeah thank
you thank you so much for coming back here the
second time to talk to you
again to speak to us and to answer many
of our questions about again fertility and frozen
(44:38):
embryo transfer and vaginal microbiome it's
really helpful to have that information and to be able to reach out to you for
further for testing and for support thank you for all that you do look forward
to having you again in the near future yeah that would definitely be something
we could there's definitely other topics we could cover yeah yes definitely
thank you so much for your time no worries thank you.
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