Come meet one of the authors of The Fertile Kitchen Cookbook and learn about optimizing your health and fertility.
Enjoy sample foods from the book’s recipe collection and get your copy signed!
All of my fertility patients get this book free; so if you’ve not gotten yours, give me a buzz!
When:Saturday December 11th @ 1PM
Where:Book Passage, 51 Tamal Vista Blvd., Corte Madera, CA
This post was authored for the Fertile Kitchen website and I’m sharing it here as well!
For more information on Nutrition for enhancing fertility, I highly recommend
http://fertilekitchen.com/ and co-authors Cindy Bailey and Pierre Giauque of the The Fertile Kitchen Cookbook.
This book is an integral part of my program for all of my fertility patients
As an acupuncturist and herbalist in Mill Valley, CA specializing in fertility, I often receive questions about how acupuncture helps women struggling with infertility. Recent research shows that women undergoing fertility treatment who receive acupuncture have improved reproductive outcomes. In the last 14 years, there have been many publications and studies on acupuncture in scientific, peer-reviewed journals. Two of the best-known studies were done in 1996 by Stener-Victorin and then by Paulus, et al in 2002.
The Stener-Victorin study showed that the resistance of uterine artery blood flow reduced following electro-acupuncture. This mechanism is of great value in allowing for an egg to implant more easily. The Paulus study showed that In Vitro Fertilization (IVF) patients treated before and after embryo transfer demonstrated improved pregnancy outcomes.
Since 2003 the acupuncturist, Diane K. Cridennda, and reproductive endocrinologist, Dr. Paul C. Magarelli, MD, PhD have conducted 5studies combining acupuncture and ART (Assisted Reproductive Techniques). Their amazing research shows that with acupuncture, poor prognosis patients are more likely to fall pregnant, have lower miscarriage rates, fewer ectopic pregnancies, fewer multiple pregnancies, and more take-home babies than without acupuncture.
The research also shows that women have a greater sense of active control and involvement by adding acupuncture to their ART. Acupuncture will add an estimated 15% more pregnancies to an IVF series, which can make the difference in couple creating a family. Reducing miscarriages, ectopics and multiples is precious to a woman’s health and reduces health care costs and risks.
We know that acupuncture improves how the brain communicates with the reproductive organs and we also know it helps regulate stress hormones and induces relaxation. Acupuncture also increases nutrients and blood flow to the uterus and helps to balance hormones. All these elements are important to conception.
I do hope that providing some insight into the research and science behind using acupuncture in conjunction with ART has been helpful. In my practice women consistently share with me that acupuncture helps them weather the side effects of IVF medications more easily, calms their mind and spirit, and gives them a sense of well-being amid what is a storm in life when falling pregnant is a challenge.
Karen Reynolds specializes in the treatment of both male and female fertility, women’s health, and functional endocrinology. Drawing from her 22 years of experience as an ICU RN, she makes extensive use of lab testing, acupuncture, Chinese herbs, antioxidants, dietary changes and nutritional supplementation to optimize health, wellness and vitality for the amazing women and men who she has the great honor to treat.
If you have questions, please feel free to contact her at:kreynolds@balancerestored.com or at 415.381.8500 Ext. 4.
by Karen Reynolds, L.Ac., M.S., R.N.
Welcome to Part III of the Thyroid Fertility Connection.
In Parts I & II, I discussed the typical signs and symptoms of Hashimoto’s
disease, hypothyroidism, the biophysiology of these instances, and some helpful lab tests used to evaluate your thyroid function.
This section will give you some practical nutritional and supplemental tips to support your thyroid function and in turn your fertility.
As I’ve noted in Parts I and II, one of the biggest, life long practices, which benefits your fertility health, your immune system and your thyroid health, is to cut gluten out of your diet. The amazing and wonderful thing about our modern world is there are so many quality, gluten-free alternatives easily available. One of my patients recently traveled to Nigeria and she even found gluten-free bakeries and alternatives there! Next time you are in a restaurant, ask if they have a gluten-free menu. You may be surprised to find that more and more establishments are providing gluten-free options. One local pizzeria in my town even has a gluten-free pie and gluten-free beer.
I love Tinkyada brown rice pastas. These products are readily available online and in most health food stores. The consistency and flavor is practically seamless compared with traditional wheat based pasta.
Next I want to discuss some basic and inexpensive supplements that benefit everyone not just women seeking to fall pregnant. However, if pregnancy is your goal, this is important.
A majority of today’s population is Vitamin D deficient. We tend to think of Vitamin D as necessary in the body for strong bones. This is true. However Vitamin D is vital for immune health, reducing inflammation, and helping to regulate how certain genes are activated or inactivated in the body. How does this affect you and your fertility?
As I discussed in Part I, Hashimoto’s disease of thyroid is an autoimmune disease.
Autoimmune issues of all types are greatly influenced by challenges to the immune system and levels of inflammation in the body. Having adequate Vitamin D in your body will temper autoimmune flares, support your immune system and help to lower inflammation. In essence it will allow your system to go about the business of baby making as opposed to putting out fires. Acupuncture, which is my specialty, is also known to reduce inflammation and improve immune status. Combining acupuncture with diet and life style changes greatly enhances your fertility.
In my acupuncture fertility practice, I routinely check and monitor Vitamin D levels. This is easy, inexpensive and vital for your health. The Vitamin D council recommends maintaining a serum Vitamin D level of 50-80ng/L and supplementing each day with 4,000-5,000 IU/day of cholecalciferol. Avoid ergocalciferol as studies show that it is not effective in raising Vitamin D levels. For more information, see www.vitamindcouncil.org.
Listed below are some foods naturally highest in Vitamin D. You can incorporate these selections into your daily diet to improve your Vitamin D intake.
Mushrooms, potatoes, spinach
Vitamin D fortified orange juice
Soymilk
Herring catfish, mollusks oysters, salmon, halibut
Col liver oil, sardine oil.
My recommendations for my patients diagnosed with Hashimoto’s disease include
daily:
Vitamin D supplementation
Fish oils
Glutathione (topical cream)
Superoxide dismutase (topical cream)
Gluten-free diet
Note: You can also get vitamin D from sunshine. Twenty minutes in bright sunshine (without sunscreen) yields about 10,000 IU. However, if you are at high risk for skin cancer or have fair skin, this is not a good option. Check with your dermatologist for concerns about the sun’s harmful effects on the skin. I have found that most people don’t get enough sun exposure and require supplementation.
I have greatly enjoyed sharing this information and I look forward to providing you with future posts. In my acupuncture clinic, I specialize in the treatment of fertility of both men and women, women’s health, and functional endocrinology. More of my fertility patients have thyroid issues than those who do not; so this is a treatment passion of mine. Drawing from my 20 years of experience as an ICU RN, I make extensive use of lab testing. I also utilize acupuncture, antioxidants, dietary changes and nutritional supplementation to optimize health, wellness and vitality for the amazing women and men who I have the great honor to treat.
If you have questions, please feel free to contact me at:
Balance Restored Center for Integrative Medicine
600 Miller Avenue
Mill Valley, CA 94941
Ring: 415.381.8500 Ext. 4
See my blog for additional information:
The reality around donor egg/fertility issues is that YOU need a village.
If you are reading this article, it is likely that you are approaching the donor selection process already having experienced multiple heartbreaks with fertility and with your desire to create a family. You have undoubtedly heard the phrase: “It takes a village,” with respect to the rearing of children. The phrase is often applied to the more mundane or infuriating, aspects of life as well. The reality is that YOU need a village. You need a team of support solely and expressly for you. I want to stress that this is an endeavor in which bearing its solitary weight does not serve you, your child to be, or your family to be. Cultivate and use your village and allow it to nourish and ground you. Your team can consist of many individuals and specialties, which you personally find helpful.
Here I will share with you some members to consider placing on your team. The goal is for you to move through weighty decisions in a supported way, which is pertinent, individualized, and unique to you.
I have developed this article with input from prospective parents, from other parents who have already experienced successful IVF technologies, and from health care practitioners actively participating in teams assisting with family building. It is my greatest hope that this will provide for you some valuable information on your personal journey toward becoming a parent. Here you will find some food for thought and may review some general considerations to assist with your experience.
A lonely process with no guidebook means you must create your own guides
Being on the path of egg donor selection is likely overwhelming.
As an acupuncturist and RN specializing in fertility/reproductive health for men and women, I often witness this struggle. One of my fertility patients aptly described it as a lonely process with no guidebook. By comparison, when you purchase a car, for example, you can conduct exhaustive research. Magazines like Consumer Reports offer the non-partisan, objective facts, as well as a plethora of specialty books and periodicals for the buyer. Moreover, the road to selecting an egg donor is every bit as expensive as purchasing a $30,000 automobile. But unlike choosing a car, it is a private topic about which you may prefer not to solicit input from family and friends, involving something more precious than all things with which money is typically considered—a baby.
The decisions are many and weighty AND you will get through them.
Yes, you do have many decisions ahead of you. It can be all consuming to sift through these and weather the emotional charges associated with them. Remember: you will get through this time. One of the best ways in which to make your way is to create your team of support.
Who might be on your team?
Medical doctors
An Acupuncturist
A Psychotherapist
A Fertility Coach
A Lawyer
A Financial Planner
A Licensed Insurance Agent
Conventional and Traditional Medicine
You will of course require established relationships with your doctors including an Obstetrician and Reproductive Endocrinologist. This is a conventional medicine must.
What you may not readily know is that conventional medicine and traditional Chinese medicine–including acupuncture, Chinese herbs and nutrition–work synergistically to improve pregnancy outcomes. Choosing an acupuncturist is key to weathering stressors and keeping your body tonified, strong, resilient and in prime condition for the many steps ahead.
Acupuncture has been scientifically found to:
Acupuncture is one part of a 3,000 year-old complete system of medicine.
The process of acupuncture involves insertion of very fine, flexible needles into
acu-points on the body. Needles are sterile, used once, and disposed immediately following treatments. They are delicate, much like a cat’s whisker, and are not hypodermic needles in form, function or sensation. Acu-points located along specific pathways are chosen according to your body’s unique needs. Most of my patients fall asleep during treatments due to the deep relaxation treatments generally induce.
Are you concerned about the education and credentials of your acupuncturist?
Knowledge of training should put you at ease. Acupuncturists licensed in California are legally recognized as primary health care providers and are licensed herbalists as well. California acupuncturists are trained in 4-year masters degree programs, which total more than 3,000 hours of graduate studies. At websites such as the California Department of Consumer Affairs Acupuncture Board www.acupuncture.ca.gov, you can research Oriental medicine, practitioners and verify licensure. Please also see the American Association of Acupuncture and Oriental Medicine (AAAOM) www.aaaomonline.org and www.AcuFinder.com websites to research specialties and topics of interest. Many insurance companies cover acupuncture and I personally have a billing service which makes it easy to facilitate use of your coverage.
Donor selection and you: mentally, emotionally and spiritually.
In addition to combining conventional and traditional forms of medicine, remember to take good care of yourself mentally, emotionally and spiritually. This aspect of your team involves choosing a psychotherapist and a fertility coach. I clinically observe that my fertility patients who actively pursue therapy and coaching move through challenges more easily and with greater senses of well-being and peace. Additionally I want to stress that therapy and coaching work synergistically with acupuncture. For example, I frequently use acu-points to address key emotions pertinent for the individual.
Ahead of you there are emotional wrestling matches amid donor research and selection. Support both your body and soul at this time. Donor selection and fertility stressors have the capacity to impact you, your primary relationship, your physical, mental and emotional health, your family dynamic, your career progression, and your finances, etc.
With choice comes complexity
Never in history have people been able to make the decisions that the wonders of technology afford us today. However, this blessed opportunity brings about choice and choice ushers in complexity. It does not translate to an easy process. You need emotional and spiritual support. Seek it. Discussion with trained, compassionate, and mature professionals is invaluable.
Psychotherapy
Psychotherapy and drop-in support groups prove to be exceptionally healing for my patients. At Balance Restored Center for Integrative Medicine in Mill Valley, we have three psychotherapists on-site. All specialize in fertility and family therapies. Dr. Ellen Hammerle, the head of our Psychotherapy department, offers rare expertise to persons in the process of family building at each of its many levels. Ellen is a licensed Marriage and Family Therapist (MFT #32398) and holds a doctorate in clinical psychology. The current emphasis of Ellen’s work is on the integration of Western Psychology and spiritual wisdom teachings; of body, mind and spirit. The application of these tenets is pivotal for fertility and post-partum support groups. Please see our News Blog at www.BalanceRestored.com for postings re: our available support groups.
Fertility Coaching-creation of your life plan
Coaches are fabulous for co-creating with you your desired life plan. Keep in mind that this can be important time for you to nurture other dreams in addition to that of having a baby. Plans keep you moving forward even when emotions run high and tend to cloud activities. A coach will help you define your needs and goals. With support and compassion, a coach will monitor your progress and keep you accountable to your goals. There are coaches who specialize in fertility challenges and even those who draw from personal experience of the various paths of IUI, IVF, donor selection, surrogate selection etc..
I would like to refer you to www.FertilePerspectives.com, a website created by coach, Merideth Mehlberg ACC. Merideth draws from more than 15 years experience in the business world having functioned as a product manager, business analyst, and project manager. She is the author of the book: The Power of Plan B: How Infertility Can Transform Your Life. From her solid, analytical skill set, she coaches her clients to dream big while creating plans with manageable steps toward those dreams. Being herself a survivor of what she aptly calls the “fertility maze”, Merideth brings to you support to promote creation of your passions, focus, and life goals. You can reach Merideth at mer@fertileperspectives.com or 510-864-0249.
Psychotherapy vs. Coaching-drawing distinctions
You may wonder about differences in psychotherapy and coaching.
Psychotherapy is like looking into your rear view mirror of your life. You see behind you what you have already passed and also that which has influenced your experience of your journey. There are profound life experiences in your rear view mirror, which mold how you move forward to present and future endeavors.
Coaching is like looking through the windshield of your car to the path ahead of you and deciding how you will navigate that unfolding road.
Both specialties are important: your past and your future.
Fertility challenges are not your fault, nor are they a measure of your worth
Interestingly I find that sometimes clients are reluctant to invest in their spiritual and emotional health in this most trying of times. It can feel indulgent when so many other resources in their lives are being dedicated to fertility processes. Some women share with me that they feel as though they have failed or let themselves or their mates down to find themselves struggling with fertility challenges. What I will share is that you are experiencing a situation of intensity for which you must give yourself every ounce of compassion and utmost credit. You always deserve to be treated well, to be loved and honored and to be supported in your journey.
Legal, Financial, and Insurance advisors on your team
A wise teacher of mine once said: plan as though for all eventualities, then live with joy as though life will unfold perfectly.
Independent of those of your fertility clinic or other agencies, it is wise to hire your own legal, financial and insurance advisors. These professionals protect and educate you. While the realms of law and money might trigger stress or anxiety, it is always preferable to operate in a well-informed and educated manner. It is money well spent.
Know your responsibilities as well as the donor’s responsibilities and review the plans for possible scenarios such as donor back-out etc. In my practice I find some clients who do not want to consider undesirable possibilities. In contrast, other clients focus so very much energy upon the scary “what if” scenarios that much precious energy is lost. A place in-between is most in balance. It is wise to plan in case bumps in the road occur and then set about choosing the best possible plan for you.
Options to Investigate
•Shared risk programs available at some clinics. These are programs in which you prepay for multiple cycles at a discount, and there is a refund available if you do not take home a baby following care.
• Tax breaks may be available to you.
•Donor/Recipient accidental health insurance.
Honor yourself
There is a 5 Element Acupuncture saying that the each person who enters our doors is the likes of which we shall never again see. Each person is unique, special, and sacred. You are unique, special, and sacred. Honor yourself in this process and create your village. I wish you well in your journey and selection. If I can be of help, please feel free to contact me at: kreynolds@balancerestored.com or Phone: 415.381.8500 Ext. 4.
All rights reserved. Karen Reynolds, L.Ac., M.S., R.N. 2008
Be well!
Karen Reynolds, L.Ac., M.S., R.N.
Balance Restored Center for Integrative Medicine
600 Miller Avenue
Mill Valley, CA 94941
Phone: 415.381.8500 Ext. 4
Talk on Eating for Fertility
Aug. 12, 2010, San Francisco – Special Event at Greens Restaurant:
At this special event being hosted by fertility specialist and patient educator, Dr. Danielle Lane of Golden Gate Fertility, and sponsored by MDR Pharmaceutical, featured speaker Cindy Bailey, co-author of the Fertile Kitchen Cookbook (www.fertilekitchen.com) will give an information-packed talk on how to change your diet to optimize fertility and share strategies and tips for successfully building healthy eating and cooking into our busy, daily lives.
All attendees receive a handout of local organic resources and goody bags which include a copy of our book.
When: 5 – 6:30 pm, Thurs., Aug. 12
Where: Greens Restaurant, Fort Mason, Building A, San Francisco, CA 94123
RSVP: Seating is limited, so respond ASAP!
To RSVP, call 415-893-0391 and ask for JODI, or send an email to Cindy at info@fertilekitchen.com with “Event at Greens” in the subject.
The Thyroid Fertility Connection and Hypothyroidism, Part II of III
by Karen Reynolds, L.Ac., M.S., R.N.
Thyroid hormones literally impact every cell of your body. It is no surprise that when your thyroid gland is stymied, getting pregnant can be more difficult. Unfortunately, thyroid dysfunction is a poorly understood health issue which directly impacts both male and female fertility. This article will give you some basics on the biology of hypothyroidism–the condition in which your thyroid gland doesn’t produce enough of certain important hormones–and why it impacts your ability to fall pregnant.
Many women have an understanding that sluggish thyroid function can manifest as extreme fatigue, feeling cold all of the time, and loss of scalp or eyebrow hair. However here are some additional significant signs and symptoms, which are less commonly discussed but are vital to your reproductive health.
Do you have any of these?
Male specific signs and symptoms:
Female specific signs and symptoms:
Heartburn, bloating, and gas: why do you have these and why does it make a difference in your fertility? The hormone gastrin is necessary to make Hydrochloric acid (HCl) in your stomach. You need HCl in order to kill parasites, prevent food poisoning and prime your lower gastrointestinal tract to complete the digestion of foods. Sometimes women think of stomach acid as a bad thing; but in reality an acidic environment is needed in the stomach for healthy digestion.
If you have hypothyroidism, the amount of gastrin your stomach makes is decreased. This leads to less efficient digestion and can show up as bloating, heartburn and gas.
Without adequate HCl the lower organs of digestion, such as the pancreas and gall bladder, are not adequately signaled to do their jobs. Evacuation of your bowels can slow down and this can lead to overgrowth of yeast and bacteria in your intestinal tract. All of these wrenches in the gears of digestion drastically impair the amount of nutrients absorbed by your body. Mal-absorption can lead to inflammation and infection. Low-grade intestinal infections are typically and easily overlooked. If this sequence of digestive patterns occurs, your body will focus its energies upon survival as opposed to baby making.
At the risk of sounding like biophysiology class topic, let’s talk about how your thyroid and liver function impacts your fertility. The liver is the largest organ of your thorax and is the powerhouse of processing and eliminating hormones, medications, environmental chemicals and food matter. You may be familiar with some laboratory levels drawn for assessing your thyroid. These can include, but are not limited to, the following: Triiodothyronine (T3) and Thyroxine (T4).
Your thyroid makes both T3 and T4. Roughly 93% of the hormones produced by your thyroid are T4. Roughly 7% of the hormones produced by your thyroid are T3.
The clincher is that your optimal cell functioning requires the T3 form. The conversion of T4 into T3 happens primarily in your liver and some conversion occurs in your intestinal tract too.
It makes great sense that if you liver is overwhelmed with other jobs of detoxification, or if your liver is not receiving enough T4 from your thyroid, or if there is an infectious process in your gut, your cells may not be getting the basic levels of thyroid hormones they need for optimal functioning. Remember your body’s rule of thumb is that it is most fertile when all other nutrient and energy producing processes are humming along in perfect order. It’s all connected.
So now that we’ve talked about mechanisms of action in your body, let’s talk about mechanisms of action for you to take to improve your fertility.
Get evaluated.
It is necessary to get a full metabolic blood chemistry panel work up and have it analyzed by a qualified MD, Endocrinologist or an Acupuncturist specializing in endocrine issues. I do such assessments daily in my clinical practice in Mill Valley, CA. Benefits an Acupuncturist can bring to you are multifaceted. For example, I can order lab work at significant discounts compared to unspecialized labs, community hospitals, large corporation labs, or HMO’s. Additionally, acupuncture has the ability to reduce stress hormones, detoxify, improve circulation and reduce inflammation.
Maintain stable blood sugar levels by eating breakfast, eliminating inflammatory foods, and eating every 2-3 hours. This is not just a message for diabetics. Erratic blood sugars cause a cascade of biophysiological events, which ultimately impact your fertility.
Eat breakfast. Your brain needs nutrition even if you do not feel hungry in the morning. If it’s difficult for you to eat in the mornings, begin by taking only several bites at time. It doesn’t matter if you nibble for an hour to get a breakfast portion consumed. An optimal breakfast has a high quality protein, a low-glycemic grain and a small amount of fat. Two fried eggs over quinoa with several slices of avocado is an ideal combination to stabilize blood sugar for hours. Cold, gluten-containing cereal is not your friend in fertility. Cold beverages, juices, and dairy are all items which dampen and challenge digestion.
Eliminate inflammatory food items from your diet-the main one being gluten. Even if you are not gluten sensitive, gluten is a highly inflammatory substance. It is like throwing gasoline on a fire. If you have inflammation in your system, there is already a fire burning. Help quench it by choosing gluten free selections such as rice, quinoa and potatoes.
Eat every 2-3 hours and make sure you have some protein with your snack. Always eat carbohydrates with some protein otherwise you’ll experience a spike in your blood sugar followed by a crash. If you after eating a portion of carbohydrates, you feel drowsy, fatigued, or you crave sweets immediately, you have gone over your personal carbohydrate tolerance. That is a crash. Experiment with smaller portions of carbohydrate and larger portions of protein.
Remember you have a glorious, wise human body and you have the power to educate yourself about your fertility and life choices!
Stay tuned for Part III of the Thyroid Fertility Connection!
Thank you, be well, and Namaste.
If you have questions, please feel free to contact me at:
Balance Restored Center for Integrative Medicine
600 Miller Avenue
Mill Valley, CA 94941
Ring: 415.381.8500 Ext. 4
See my blog for additional information: http://karen-reynolds.com
What you need to know about the infamous Semen Analysis
by Karen Reynolds, L.Ac., M.S., R.N.; Mill Valley, CA.
A semen analysis, often colloquially called a “sperm count”, is not used only to count sperm. It also evaluates sperm production (quantity) by the testis, assesses how the sperm are moving (quality), and examines secretions of the genital tract. A semen analysis does not singularly determine a man’s fertility. Many additional factors must be reviewed and considered. From the standpoint of processing of semen samples: not all labs are the same. In my fertility acupuncture practice, I have stopped sending my patients to larger, unspecialized laboratories, such as those in community hospitals or large corporate labs. This article reviews pros and cons about the types of options available and important considerations for collection for the most accurate results. At the end of this post, I have additionally listed some definitions and terminology.
Semen samples are best processed in an “andrology” lab. Such labs are generally associated with Urology or Reproductive Endocrinology offices. This is important as a semen analysis is a time-sensitive procedure that requires a certain level of technical expertise to perform accurately. Processing by an andrologist is inherently superior for multiple reasons. Firstly, an andrologist has advanced training and skills in assessing semen samples and extensive experience in proper handling. Secondly, dedicated andrology labs typically have state of the art equipment with more accurate counting chambers and more formal analytical methodologies. In unspecialized lab settings, semen specimens frequently are relegated to the least senior technician on site, or to the technician available at that moment. For that reason the specimen may be handled and processed by less experienced individuals.
A study published in The Journal of Human Reproduction in 2000 showed marked variability in the same semen samples analyzed at different facilities. Results for the same semen specimen ranged from a count of 3 million sperm/ml to 492 million sperm/ml. Erroneous results can be emotionally devastating, can cause unnecessary stress, can change the course of medical care, and are wasteful.
In other words: your semen analysis results from an unspecialized lab might tell you that Elvis is in the building but it won’t go into detail about how many cheeseburgers he’s eaten or how well his hips are swiveling. Yes, this is a campy analogy, but I’m sure you understand my point. If you are going to the trouble of spending time and money to produce a sample, you want it to accurately reflect what is going on with your sperm production.
Additionally I strongly encourage men to schedule the semen analysis in conjunction with a complete medical history and examination by an experienced Urologist. Beyond the natural drive to father a child, each man needs to be evaluated for a disease processes that may cause an abnormal semen analysis, or for mechanical issues or genetic pre-disposition which might affect not only semen quality but his health in the future. Currently it is accepted that infertile men can have higher rates of testis and prostate cancer after the diagnosis of infertility is made. Unfortunately, the male infertility evaluation is sadly lacking in current conventional practice as the focus has tended toward the women and Assisted Reproductive Technologies (ART). Please remember: a semen analysis alone is insufficient to inform a couple whether male infertility is
a) curable,
b) caused by an important health condition, or
c) a risk factor for later disease development.
Another vital consideration is your comfort level and how you are treated. At a Urology office such as The Turek Clinic in San Francisco, CA (www.theturekclinic.com) you will find professional staff, a quiet, private setting and a seamless process for appointments. You can literally show up at 8AM and be completely done well before noon. In those few short hours the semen analysis is collected and processed. The results are interpreted for you the same day by Dr. Paul Turek, and a comprehensive history and physical exam is completed during a consultation hour. It is commonplace to need to meet on-site with Dr. Turek only once and follow ups can be scheduled per telephone, in the comfort of your home or office. Your time will not be wasted and you’ll come away having had a hassle-free, thorough, reliable exam and testing process.
The Turek Clinic
Blog: www.TurekonMensHealth.com
55 Francisco Street #300
San Francisco, CA 94133
(415) 392-3200
I hope this article is helpful for your journey to fatherhood and having a family. In my acupuncture clinic, I specialize in male and female fertility, women’s health, and functional endocrinology. Drawing from my 20 years of experience as an ICU nurse, I make extensive use of lab testing. I also utilize acupuncture, dietary changes and nutritional supplementation to optimize health, wellness and vitality for the amazing men and women who I have the great honor treat.
Below are important considerations for obtaining your semen sample as well as some additional information regarding terms you may see on your results.
If you have questions, please feel free to contact me at:
Balance Restored Center for Integrative Medicine
600 Miller Avenue
Mill Valley, CA 94941
Ring: 415.381.8500 Ext. 4
See my blog for additional information:
Semen samples require specific steps in collection and transport. Here are some important directions to assure accurate results.
•Due to religious or personal beliefs, masturbation for sample collection may not be an option for all men. In this case, inquire with your MD regarding use of a Milex sheath or a Silastic Sperm Collection device. These specialized condoms are non-toxic to sperm, yet allow for effective collection.
•Abstain from ejaculation for 2-4 days prior to semen collection. Longer or shorter periods of abstinence will impact your results.
•Consult with your MD regarding appropriate lubricants for use during collection. Most lubricants are toxic to sperm or otherwise impact the specimen.
•Collect in a sterile container-obtain this from your MD.
•Make sure the entire ejaculate volume is collected. All is necessary for an accurate test.
•Samples must be kept at body temperature. Place the sample in a shirt pocket to maintain the temperature.
•Deliver the sample within 1 hour to your testing lab.
•Always check with your lab facility to be certain other requirements are not necessary.
World Health Organization Limits of Adequacy for Semen Samples (1999)
Volume >1.5 ml
Concentration >20 million/ml
Motility >50%
Morphology >30%
Forward progression 2 on a scale of 0-4
Semen Analysis Terms and Definitions
Density= how many million sperm per milliliter of semen fluid.
Motility= the percentage of sperm with any movement
Morphology= pertains to sperm shape and physical characteristics
Forward progression= quality of sperm movement rated on a 0-4 scale
The Thyroid Fertility Connection and Hashimoto’s Disease, Part I of III
by Karen Reynolds, L.Ac., M.S., R.N.
Elizabeth is a hardy, healthy small business owner known for her creativity, drive and sense of humor. In the last 2 years she has fallen pregnant easily; but has had 3 miscarriages, each early within the first trimester. Her medical doctor had attributed her pregnancy losses to advance maternal age. Following the last miscarriage, she began noticing that her energy level seemed inordinately high, even after 12 hours of hard work. She also began spontaneously losing weight. This pleased her; but it was peculiar that neither her diet nor activity level had changed.
Next she started experiencing heart palpitations and feeling as though her insides were quaking. Friends and family dismissed it as anxiety, overwork and stress, though Elizabeth is not an anxiety prone woman. These symptoms culminated in awakening one morning with double and blurred vision and a headache so severe that she could not drive or function.
It turns out that Elizabeth has Hashimoto’s disease-an autoimmune disease of the thyroid. Autoimmune means that the body attacks itself or identifies its own tissue as foreign. It is important to realize that with Hashimoto’s disease, women can have fluctuating bouts of BOTH Hyperthyroid (fast/overdrive) and Hypothyroid (slow/sluggish) symptoms.For some women, the symptoms change rapidly from week to week.
Hashimoto’s disease is complex with regard to how it disrupts fertility and can contribute to recurrent miscarriage. During hypothyroid bouts, the disease impacts progesterone production. During hyperthyroid bouts, the disease imparts extreme inflammatory stress and temperature dysregulation. The matter is further complicated by the fact that some women have the commonly checked TSH blood level (Thyroid Stimulating Hormone) registering within “normal” ranges; yet they do have Hashimoto’s disease. For your review below are listed typical Hyperthyroid and Hypothyroid symptoms.
Hyperthyroid Symptoms
Heart palpitations, heart racing
Agitation
Anxiety
Nervousness
Feeling like your interior of your body is trembling
Insomnia
Loss of weight without diet or activity change
Hypothyroid Symptoms
Marked fatigue, despite getting enough sleep
Unable to lose weight, even with a strict nutritional intake
Gaining weight, even with a strict nutritional intake
Poor concentration
Memory loss
Hair loss/thinning: on scalp, body, and genitals
Loss of outer edge of eyebrows
Extremely dry skin
Dandruff
Constipation despite fiber, fluids, and over the counter medications
By the time Elizabeth saw me for acupuncture, she was physically and emotionally drained.
I was stunned to find that nowhere along her course of evaluation were blood levels for antibodies drawn. This is a must. Labs called Thyroid Stimulating Hormone Antibodies (abbreviated TSH Ab), had been drawn to rule out Graves Disease. These were indeed negative for Elizabeth; but she still had Hashimoto’s.
There are two basic and inexpensive antibody blood tests, which should always be checked when there is a question of thyroid disease or Hashimoto’s. In my practice, I routinely order these markers. My patients pay $29 for each test plus a $7 lab draw fee.
Thyroid Peroxidase Antibodies abbreviated TPO Ab.
Thyroglobulin Antibodies abbreviated TGB.
Elizabeth had extremely elevated numbers of both Thyroid Peroxidase Antibodies and Thyroglobulin Antibodies. Conventional medicine does not typically recognize steps, which autoimmune patients can actively take to attempt to quench the inflammation that occurs within their bodies due to autoimmune thyroid issues. This may be one reason why antibody draws are often not completed. The conventional medicine tack that is frequently taken is that the thyroid will eventually be burned out, so to speak, by the body’s repeated autoimmune attacks. Then the woman will simply be on thyroid hormone supplementation for the rest of her life.
What about the woman’s body, mind and spirit weathering the extremes of these overdrive states? What about the physiological impacts to a woman’s overall health during these flares? Any woman who has ever experienced this phenomena will tell you she wants options.
In addition to seeking medical care and acupuncture, here are some things you can do to take care of your own thyroid if you have or suspect you have Hashimoto’s disease. By following these self-care measures, you can assist your body in more optimal hormone regulation and reduction of inflammation, so as to improve your chances to fall pregnant.
First of all: see your MD and Acupuncturist. Have the appropriate labs assessed and interpreted to determine the function of your thyroid.
Cut out gluten from your diet-FOREVER.
This is a strong statement, I realize. There are voluminous amounts of evidence that gluten is akin to gasoline on the fire of autoimmune issues. Sometimes my patients will say to me “Can’t I just have a slice of birthday cake once a year?” Please note: one exposure to gluten revs up your immune system for up to 8 months. One slice of birthday cake could have long standing impacts to your thyroid, causing a flare. An autoimmune thyroid flare can in turn cause your body to attack your thyroid. You have power within your habits to attempt to preserve your thyroid’s function. Avoiding gluten is one power you can exercise. I will have more information on gluten and how it affects the thyroid in Part III of this series. Complex carbohydrates that are OK to include in your diet are potatoes, rice, quinoa, and wheat-free oats.
Avoid iodine supplementation and avoid iodated salt.
This may seem counter intuitive. From a biophysiology standpoint, iodine stimulates increased production of Thyroid Peroxidase (TPO). For a woman who has antibodies (Thyroid Peroxidase Antibodies TPO Ab) to her own TPO, this surge of TPO can cause flares. Sea salt is fine. Cook your own food as much as you can.
The other iodine warning is to avoid, if possible, scans requiring use of intravenous iodine based dye. Patients generally must sign consent for the iodine contrast dye to be used. Chemically flooding your system with an iodated dye can do exactly the same thing as iodated salt. However a contrast dye injection is in far greater quantities and infused directly into your blood stream. With any testing procedure, you all must weigh the pros and cons. Actively consider these with your MD, should it be necessary for you.
Increase antioxidants in your diet and with supplementation.
We often hear about antioxidants associated with warding off cancer or used in anti-aging protocols. If you have Hashiomotos disease or suspect it, your body will use antioxidants to quench that flaming fire of inflammation caused by the autoimmune response. The great thing is that antioxidants are abundant in green leafy vegetables, they are widely available as supplements, and there is plentiful information about them on-line. Cindy Bailey’s fabulous book The Fertile Kitchen Cookbook models a diet naturally high in antioxidant rich foods to nourish your body. Additional information on antioxidants will be provided in Part III of this series
In my acupuncture clinic, I specialize in the treatment of fertility of both men and women, women’s health, and functional endocrinology. More of my fertility patients have thyroid issues than those who do not; so this is a treatment passion of mine. Drawing from my 20 years of experience as an ICU RN, I make extensive use of lab testing. I also utilize acupuncture, antioxidants, dietary changes and nutritional supplementation to optimize health, wellness and vitality for the amazing women and men who I have the great honor treat.
Stay tuned for Parts II and III of the Thyroid Fertility Connection!
Be well and Namaste.
If you have questions, please feel free to contact me at:
Balance Restored Center for Integrative Medicine
600 Miller Avenue
Mill Valley, CA 94941
Ring: 415.381.8500 Ext. 4
See my blog for additional information: