In this episode 52 protocols
▶ 22:50 Use Unscented Products Behaviors “using unscented products, especially with children, is a really important thing because we want to make sure that their lifetime exposure to some of these things, especially during critical times, is much less.” ▷ 22:58 Use Unscented Personal and Household Products Diet “And so you'll see people recommend things like your laundry detergent, you know, what's sensor in your laundry detergent, the shampoo and conditioner are a big one, and the soaps that you use on a day-to-day basis in your house or the oils you put on your body.” ▷ 23:12 Avoid Lavender Oil on Babies Behaviors “Lavender is huge because there's this whole community of people. They want to rub lavender oil on their baby's feet and help them sleep.” ▷ 24:59 Choose Lower-Toxin Diapers Behaviors “There's definitely companies now which are promoting and talking about, you know, traditional diapers that they are making sure have less toxins in them. And I always think anytime you can decreased toxin exposure to a child is going to be very important.” ▷ 32:28 Track Menstrual Cycle Predictability Behaviors “So what I tell patients is, in general, your period should be less than 35 days apart. And you should be able to look at a calendar and with your finger, put a finger on the date and within a couple days of accuracy, be able to predict when your period's coming.” ▷ 33:27 Get Evaluated for Shortening Menstrual Cycles Behaviors “But the person who comes to see me and says my periods have always been 28 to 30 days but now they every 24 I just figure it no big deal I have red flags going off everywhere because I now really concerned that potentially their ovarian reserve has dropped to a point where we are starting to see clinical changes.” ▷ 40:51 Get AMH Testing Behaviors “If we draw it, I always say this, AMH may be up to 30% lower in somebody who is on the birth control pill. So we can still draw it, and if it comes back in the normal range, we feel good.” ▷ 41:09 Use Alternative Contraception Before Repeating AMH Testing Off the Pill Behaviors “Are we going to stop the birth control pill for a period of some months, use alternative contraception if you don't want to be pregnant, and then repeat this test to see if this is a true low?” ▷ 43:39 Avoid Testosterone if Trying to Preserve Male Fertility Behaviors “Somebody who's been on testosterone will tell the brain, the brain doesn't know it's from your taking it. It says, hey, we have plenty of sperm. We're good. We don't need any more... therefore, you're no longer making new sperm.” ▷ 56:53 Avoid Smoking Cigarettes Behaviors “Smoking cigarettes actually gets into your vault, decreases the number that you have. You have a higher chance of going into menopause earlier. And it increases the risk of having abnormal chromosomes, which is what we really think about when we think about egg quality.” ▷ 58:10 Avoid Vaping Behaviors “vaping definitely has chemicals that looks like it's associated with poor success rates and IVF cycles... We know that it not good for getting pregnant We know that it not good for sperm” ▷ 59:04 Avoid Cannabis Behaviors “things like cannabis right decreases sperm production decreases sperm motility changes sperm morphology, the shape of it, changes the DNA, increases the fragmentation of the DNA.” ▷ 1:02:07 Limit Alcohol Behaviors “So certainly if you enjoy alcohol, it should be something that is done in moderation, one or two drinks a week at the most, and you should not do it at all once you find out you're pregnant.” ▷ 1:07:57 Remove Progesterone IUD 3–6 Months Before Trying to Conceive Behaviors “So I do tell people if they have a progesterone IUD to get it removed three to six months before they want to get pregnant, use some other form of contraception, but give their body time to make sure they have that regular period pattern back.” ▷ 1:09:38 Avoid Depo-Provera if Planning Pregnancy Soon Behaviors “So that is a contraceptive option that I tell people to discontinue a year and a half to two years before they want to get pregnant, which sometimes people don't know that yet.” ▷ 1:21:02 Get Evaluated for Clotting Disorders if Family History of DVT or PE Behaviors “if anybody in your family has ever had a DVT, so a deep vein thrombosis, so a blood clot in their leg, or a pulmonary embolism or a PE... you should 100% get worked up for clotting disorders.” ▷ 1:21:21 Avoid Oral Birth Control if You Carry Factor V Leiden Behaviors “if you have something, like you carry factor V, you should no longer take the birth control pill. And specifically the pill, because it's an oral pill and how it's metabolized in the liver is actually what is causing the change in those clotting factors” ▷ 1:27:25 Get Antral Follicle Count Ultrasound Behaviors “what you see outside the vault, and that is called an antral follicle count or an AFC, it's an ultrasound-based measurement of how many eggs you have outside the vault at one point in time.” ▷ 1:35:27 Consider Egg Freezing if You Want Future Pregnancy Behaviors “The same question should be, well, do you want to be pregnant at some point? And if so, should you consider freezing your eggs or getting this blood test checked?” ▷ 1:53:33 Freeze Sperm Before Vasectomy Behaviors “If you're going to get a vasectomy because you are choosing that you don't want to have kids... If you're going to get a vasectomy go free sperm first.” ▷ 2:22:45 Prioritize Sleep Behaviors “Sleep is probably the number one thing that people don't do that does impact their reproductive hormone system and therefore can impact egg and sperm quality because sleep is when you have cellular repair and when you can drop your inflammation levels.” ▷ 2:24:37 Eat Fruits and Vegetables Diet “Diets high in fruits and vegetables are good for you... Fruit is not bad. Fruit got this really bad reputation.” ▷ 2:25:01 Eat Whole Grains Diet “Grains, so whole grains, especially that your body, you know, provide a lot of great fiber.” ▷ 2:26:03 Eat Full-Fat Dairy Diet “what we do see is that if you're going to have dairy, have the real thing, the processed dairy, the skim milk, that actually decreases your fertility.” ▷ 2:27:05 Eat Healthy Fats Diet “fat comes in so many important forms. avocados and oils and nuts, dairy, meat, fat and cholesterol are the backbone for all hormones” ▷ 2:27:58 Tofu Diet “Tofu does not negatively impact fertility, even in men. In fact, it can improve it because it does have some antioxidant-like properties, lots of iron.” ▷ 2:28:07 Eat Fish Diet “when it comes to fish, fish are fantastic sources of healthy fats and omega-3 fatty acids, which are very crucial in the reproductive process... So the general recommendation is three servings per week.” ▷ 2:29:03 Avoid Raw Seafood During Pregnancy Diet “And raw seafood, correct? No sushi, no sashimi. Well, when you're pregnant, correct. And that's mostly because of the risk of infectious disease that can cause severe brain development and other issues.” ▷ 2:29:44 Avoid Processed Meats Diet “I mean, obviously, I think we can all come to the agreement that processed meats are not good for a variety of different reasons. In addition to being carcinogenic, those toxins do negatively impact fertility.” ▷ 2:30:19 Eat a Plant-Forward Diet Diet “I usually tell my patients I want them to eat a plant-forward diet. That doesn't mean no meat, but I say, look at your meat servings. I don't want it red meat every single day.” ▷ 2:32:35 Avoid Added Sugar Diet “I think sugar is the last thing I just didn't mention, but added sugar and artificial sugars are bad for you.” ▷ 2:32:52 Avoid Artificial Sweeteners Diet “Stevia itself hasn't been studied as much as the other ones, things like sweet and low and all of those. But what we do know is that they cause inflammation inside the body. And then they also can cause a stress reaction and they can cause higher rates of miscarriage” ▷ 2:33:59 Avoid Being Very Underweight or Calorie Restricting Behaviors “Similarly, being, you know, very underweight and calorie restricting, we all know is really terrible for your reproductive system and can cause the brain to totally shut down ovulation because it senses that you can't have a pregnancy.” ▷ 2:37:55 Prenatal Vitamin Supplements “Certainly, you know, a prenatal vitamin, which has folic acid, we all know that folic acid is really important to prevent neural tube defects, but it's also important in cell division and how the ovary is growing follicles and growing eggs.” ▷ 2:38:50 Vitamin D Supplements “I usually say a thousand international units of vitamin D is not going to be harmful in anybody. It's going to be helpful for most people.” ▷ 2:39:15 Omega-3 Fatty Acids Supplements “Omega-3 fatty acids, also extremely important in, one, being anti-inflammatory, but, two, brain development of a fetus. So most prenatals now actually do have those omega-3 fatty acids in them. But if they don't, I recommend a patient take those.” ▷ 2:40:23 EPA Supplements “What would you say is the dosage cut off... one to two grams per day of the EPA form... Do you think there's a upper limit?... I tell people a gram.” ▷ 2:41:40 CoQ10 Supplements “So I usually recommend if you're trying to get pregnant and you take CoQ10, a dose of 200 milligrams three times a day.” ▷ 2:43:12 L-Carnitine Supplements “We use a gram of L-carnitine with a gram of vitamin C for our male patients who have any abnormal sperm parameter.” ▷ 2:43:12 Vitamin C Supplements “We use a gram of L-carnitine with a gram of vitamin C for our male patients who have any abnormal sperm parameter.” ▷ 2:43:16 Multivitamin Supplements “kind of what we consider the sperm enhancement protocol. And so- And just that? That with a multivitamin. So those two with a multivitamin and CoQ10.” ▷ 2:43:34 N-Acetylcysteine Supplements “those who have endometriosis fall into a unique category where inflammation is so high that usually it's a different environment where we recommend L-carnitine, N-acetylcysteine, vitamin C and E.” ▷ 2:43:34 Vitamin E Supplements “those who have endometriosis fall into a unique category where inflammation is so high that usually it's a different environment where we recommend L-carnitine, N-acetylcysteine, vitamin C and E.” ▷ 2:44:40 Myo-Inositol Supplements “Myo-inositol is probably the one that really is doing the work in PCOS... For myo-inositol, 2,000 milligrams.” ▷ 2:48:57 Maintain Healthy Behaviors for 90 Days Before Conception or Fertility Treatment Behaviors “we already know the sperm cycle is about 90 days. And the eggs... start lining up, getting ready to exit the vault and become more susceptible to the things you're doing in that 90-day window.” ▷ 2:55:21 Avoid Intercourse During IVF Stimulation and Until Next Period After Retrieval Behaviors “So typically I usually say it's from like day five of your stimulation... until your next period comes. So that's usually about a three week time period where we want you to abstain from intercourse.” ▷ 3:17:55 Avoid Toxins to Potentially Delay Menopause Behaviors “trying to live a lower inflammatory life and getting sleep and avoiding toxins of which you can is some of the best that you can do to try to naturally prolong when you'll go through menopause” ▷ 3:18:28 Treat Endometriosis Behaviors “But so do things like endometriosis, especially if it's not being treated in any fashion... it's that inflammation associated with endometriosis that's really causing these women to have low ovarian reserve and go into menopause early.” ▷ 3:19:51 Hormone Replacement Therapy Behaviors “So we, as a community, you know, of doctors, especially OBGYNs, really recommend hormone replacement therapy in women who are going through menopause. And the key here is to initiate it right at the beginning.” ▷ 3:20:32 Estradiol Supplements “the estrogen that we try to replace in this time period much more mimics estradiol. We have estradiol pills. You can have vaginal inserts. You can have patches.” ▷ 3:20:59 Progestin Supplements “And you can't have unopposed estrogen without reaching the risk of endometrial cancer. And so that's why we need to have some progestin.” ▷ 3:21:58 See a Clinician if You Go Into Menopause Early Behaviors “I tell all of them, hey, if you don't freeze your eggs or I never see you again, you're going to go through menopause early. And when you do, I want you to go see somebody. I don't want you to just ignore it and suffer with these symptoms”