Tuesday, October 4, 2016

Bridget Jones’s Baby – is having a baby over 40 good or bad?


I’m quite excited Bridget Jones is about again and she’s having a Baby; more importantly it’s a hatrick for me adding to the 2 other films, plus it’s the best one yet and ‘bang on’ so to speak in terms of what is happening right now with women in the UK who want to have babies.

Hopefully having a baby over 40 is going to be the hottest thing in town soon  (maybe I’m exaggerating this a little). I’m not sure if Bridget’s surprise conception was down to the fact that she thought she wasn’t capable of having a child over 40, so stopped trying with contraception,  or something else.

For me having a baby over 40 is always something I celebrate in my line of work! As a fertility Nutritionist I’m inside an ‘ older mum bubble’ , where anything is possible, however when I venture out and meet people ( which I occasionally do!)  its almost whispered that its ‘not right’ or that ‘it’s a bit of a worry isn’t it?’ In fact having a baby at 40  seems almost as taboo as a teen pregnancy according to ‘ word on the street’!  Thankfully this is beginning to change, and lets hope in some small way Bridget will have helped in this quest!

The message that you are almost irresponsible even trying over 35 is plastered everywhere. It is even worse if you are over 40 as when you start trying it all seems to become more scary as are the messages about potential birth defects, miscarriages, and if by some miracle you have the child,  then there is the issue that they might have development issues and there is more chance of autism. The list goes on, and the stories I have heard about how it’s not a good idea to try after 37, are enough to age your eggs overnight and sew your own bits up! If it’s not enough hearing this from GPs or IVF clinics, the media coverage on this is certainly relentless, something that is repeated almost weekly in the many columns of broadsheets and tabloids. 

As a Nutritionist this whole issue of  ‘ old eggs’ and the ‘geriatric mother’ (as was mentioned in Bridget Jones’s baby)  gets me very riled up as its one of the fastest growing age group of women I have coming through my door in the last 2 years and its one I’m getting results with, despite the fact they are ‘ past it’ according to those in the know! This is anecdotal to my practice, but lets take a look at this more closely…

For the first time in decades women over 40 have now taken over the teen pregnancy rate. How’s that for a statistic? A more sombre statistic that ‘its not safe to have a baby over 35’ seems to be hitting home as this age group accounts for the largest amounts of abortions of any other more recently.

Also if we look back a few decades to the 1920s, being an older mum was more accepted. Many were even giving birth when grandmothers and 42 years old was a time when many stopped adding to their families.
 
Today,  an interesting statistic is  that many women in their 40s are also first time mums.  The UK Office for National Statistics figures show that pregnancy rates for over-40s are doubling and in the last years,  this has gone from  only a mere six per 1,000 to now
14 conceptions per 1,000.

Only recently an article in the London Standard mentioned that London is leading the charge for women giving birth to babies over 45. So there is definitely something going on out there with women not giving up or even coming into motherhood later on in life.

In fact, the true statistics about female fertility are far less scary than we are led to believe. Women do lose a lot of their eggs by 30, but that still leaves them with many tens of thousands, when only one is needed to make a baby. Something many ladies are not told in IVF clinics where  egg donation is offered if over 37, or if they have been trying for over 6 months.
 
Other scaremoungering comes from of all places the  journal Human Reproduction. But if you take a closer look at this article in 2004 the  statistic were drawn not from modern day but from birth records from 1790-1830.  When correct me if I’m wrong, there was no access to modern health care or nutrition and many were possibly only living to 45 anyway, so actively avoiding Sex. So no…. ‘
Bridget Jones, wanton sex goddess, with a very bad man between her thighs!’ there!
 
The truth is everyone is different and if you  put in the work and follow a healthy lifestyle, diet and stress levels are managed appropriately, you just may well have the fertility of a 20 something!

In my view Fertility isn’t always age specific and there might actually be some truth in what I talk about daily that diet and tailored intervention  improves fertility at any age. A study in 1995 conducted by Surrey University and Foresight with over 300  couples ranging from 25-45 years old gave couples with previous infertility and miscarriages a tailored dietary and supplement programme over 2 years. During this time 81% of them went on to have healthy babies http://www.zestnaturalhealth.co.nz/preconception-care-and-fertility/how-effective-is-preconceptive-care/  similar studies are also being conducted by Foresight and also the University of New England.

Lord Robert Winston seen as a one of the grandads of modern fertility talked recently in a daily mail article about women’s
fertility being sound until around 45, which might have raised a few eyebrows. I can’t corroborate this empirically but share his view, as do see a heck of a lot of women who are getting pregnant these days over 40.

I believe in fertility in older women wholeheartedly, as my own grandmother was part of this ‘gang’ and had my mum when she was 37. This isn't an isolated incident and its shown to happen time and time again, defying the naysayers. Thankfully many I work with don’t give up, but to be honest with all the media attention about ‘Britain facing an infertility time bomb’ it can be very hard to cut through the negativity.

As always Bridget Jones is ‘On trend’ as it has been right from the first film! Let's hope it starts a ripple effect, where ladies feel they don’t have to feel old and ‘past their sell by date’ when trying over 35,  or worry about the issues with their ‘ageing eggs’ Hoorah for Bridget is what I say and as Daniel Cleaver would say ‘ Hello Mummy’!

Monday, September 5, 2016

Back to school – another reminder of your empty house, or the start of deficiencies that lead to fertility issues?

Yes its that time of year again when all the offers and retail are uber hell bent on selling stuff to parents to equip them for school/nursery/ college etc. However like the new year and Christmas it’s a time of year that makes many who are on a difficult fertility journey sad. Another reminder that you are years behind on this happy moment of taking a photo of your little one against the door in their new school uniform and another time where you can’t get involved with all your friends who are now pushed into a whole new routine and change of life.


When it comes to food it’s a time I normally become a ranting nutritionist (don’t get me started on Halloween and Christmas) as it is a time where ‘ packed lunches’ become king, and a hoard of vile candies, chocolates, flapjack like concoctions, waxed small processed cheeses and flabby white bread ham sandwiches are thrown at you, which will leave anyone nutrient deficient let alone a child!( I know some of you make healthier choices, but sadly its hard with retailers making it oh so easy to eat crap!)

My point is, that the deficiencies start as early as preteens. I’m seeing so many ladies now who were overweight and showing signs of hormonal dysregulation at as young as 10 when we went through a detailed consultation.

I see fertility issues as a deficiency in most cases, where there isn’t enough ‘raw ingredients’ to make good hormones, or at worse too many high processed carbohydrates that have caused the hormonal issues, and I can almost pinpoint when it started to happen. With teens this can present when the body starts to show dysregulation with acne, painful periods, putting on weight and having mood swings. Which contrary to popular belief aren’t a normal part of life when your hormones start to show their face!  Like menopause hormones need at least 10 years to regulate when they start, so that means if a girl starts her period at 12 it won’t be until 22 that she is really normalising and coming out the other side! This is exactly the same for menopause. Sadly in the medicalised and ‘ fix it’ society we live in we see things like heavy periods, acne and pain as something to ‘ turn off’ rather than look at the root  cause and this( ie poor diet and environmental stressors)  So many of the ladies I support are put on the hormonal contraceptive pill to ‘ regulate the period’ Newsflash – the pill doesn’t ‘Regulate’ your period, it mimics pregnancy hormones, and invariably  puts your body to sleep in terms of hormones. Many are even unaware that the ‘ bleed’ they have isn’t actually a period, its is a withrwawal from the hormone bleed! When many of these ladies  start to think about babies that is when  they come off the pill and find they have oestrogen dominance and the same issue comes back again they had at 16!

PCOS is the number 1 cause of infertility now. This is something new I’m seeing in the last 4 years. Prior to that it wasn’t top of the list. There is a genetic predisposition to PCOS, but as the saying goes ‘ genetics loads the gun and the environment pulls the trigger’ ie it may be in the family but you can exacerbate this by the choices you make food wise and stress also makes this worse.


Its not all doom and gloom though, as this can be fixed. I see this time of year always as a new beginning. You may not have a child right now, but why not start to look at September as the start of your new term or semester? Add in some changes to your diet and seek out someone who can guide you. I really don’t know what I would do if I wasn’t a nutritionist, as the food isles and marketing behind food is so relentless.  This makes it nigh on impossible to make these ‘ healthy choices’ yourself. Worse still its made even more impossible to attain by the rise of the ‘ Green smoothie goddesses’ on places like Instagram!  With correct guidance and support your body might just be back on the right tracks for Christmas!  
 

Friday, June 10, 2016

Natural Killer Cells - are we being pulled into the hype?

I see a lot of clients and have over the past few years been increasingly aware of the area of reproductive immunology. Like most the starting point for this was the book ‘ Is your body baby friendly’ by Dr Alan. Dr Alan Beer is the man behind the whole area of reproductive immunology and the originator of the ‘Chicago protocol’. He set up his clinic as a pioneer and he was instrumental in the fertility world with regards to looking into the immune system as a causative factor to multiple miscarriage and failed implantation. As a result, many IVF clinics started looking at Cytokines, the bodies ‘war’ machine and as I like to call them the ‘ Special forces’ or more commonly know - Natural Killer Cells.
What are NK cells and how are they relevant to pregnancy?
Natural killer cells are under normal circumstances a natural and healthy part of the immune system. They are there to eliminate anything harmful that could cause a threat to your body. They are a type of white blood cell that provides a rapid response to infected cells and go to task particularly if they are needed in the case of tumours that start to form but equally get in there with viruses, parasites and bacteria.
When we get pregnant, NK cells need to get the signal to ‘ power down’ - after all although it is the most natural thing in the world  to be pregnant, it is essentially 50% foreign DNA. At the time of pregnancy (and normally the first 12 weeks) the brain needs to give the signal to lower the natural defences of the body, a situation that can understandidly confuse things. It must be really hard for the body's immune system to ignore what looks like a pathogen starting to develop, via the uterus, as during this early time - implantation starts a whole chain reaction where it then starts to establish its own blood supply!
What should happen before an expensive blood test for NK cells
If you have had multiple miscarriages or grade A eggs at IVF and your partners sperm has also been verified as good with no DNA fragmentation, then the next step for me is always a hysteroscopy. This procedure involves taking a biopsy of your uterine lining and the results will show if there is unusually high NK cells. For me this is the most effective way to establish if NK cells are invasive and could be causing miscarriage.
What normally happens…
If you are working with a progressive IVF centre, they may after 3 or more failed IVFs or miscarriages, send off for a raft of blood tests, which cost a pretty penny!
What you need to know before ordering or letting your reproductive specialist lead on some very expensive tests is the difference between blood NK cells and uterine  NK cells. Another thing to keep in mind which takes it a little deeper is you should know is that NK Cells are deemed Bright NK, Super Bright and Dim NK cells http://www.jimmunol.org/content/181/3/1869.full.pdf
..’During implantation, CD56bright NK cells are reputed to play an important role whereas CD56dim NK cells are mostly negatively associated with reproduction'.
In a few studies they found that the proportion of the uterine CD56dimCD16+ NK cells was significantly lower in IVF patients as compared to the controls (6.9 and 13.7% ) The proportion of CD56bright NK cells  was no different between IVF patients and controls in the uterus (28.8 and 33.5%) This data indicated a shift in the ratio towards the beneficial CD56bright NK cells and away from the harmful CD56dim NK cells…’http://molehr.oxfordjournals.org/content/10/7/513.full
In peripheral blood there is no shift in the CD56dim/CD56bright ratio
Blood NK cells are very different to uterine NK cells leading some experts to conclude that “measuring any parameter of NK cells in blood is not useful in trying to understand the cause of reproductive failure” http://humrep.oxfordjournals.org/content/early/2015/12/05/humrep.dev290
The important thing to keep in mind when you have had multiple miscarriages is that the you need to know a little more about these new tests before proceeding to the next stage and what inevitably can then involve more costs. It is my view that a biopsy is the only way to confirm high NK cells which may be causing some issues with implantation and growth of the baby.



Wednesday, February 17, 2016

Vitamin A ~ is is safe in pregnancy?

The new year has started off with a bang! Lots of clients who have been working with me for 3 months or more are now pregnant – Yay! As most are new mums a few have got in touch about Midwives and Drs misconceptions and concerns about vitamins and minerals, as this is where the medical community start to get involved. One of the concerns is about Vitamin A and its ability to cause birth defects; so let me respond and shed some light on this.


I have looked into this issues myself quite thoroughly and the research links I have cited below mention that the research is over 30 years old in regards to the potential causes of birth defects. I will say that again.... In time frame only 18 cases have been cited where this has caused deformities. 

I’m sure you are aware that any adverse reaction to drugs need to be reported.  All medicines are reported under the medical misuse category.

Drugs cause death and other health conditions by the hundreds of thousands annually. vitamins don't cause death http://bit.ly/1Ogey41  We don’t have anything for supplements to report on this, but as always if anything does show ‘Teratogenicity ie potential for birth defects it has to be reported as such.

A basic look into drugs commonly used to help women conceive and to help those with sticky platelet, such as Aspirin have far more potential to cause birth defects, http://www.mayoclinic.org/drugs-supplements/analgesic-combination-acetaminophen-salicylate-oral-route/before-using/drg-20069948 and not to mention fertility drugs that many use unwittingly without looking into the small print, that can also cause deformities and also death. http://www.drugs.com/pro/clomid.html  My point here, is many of my clients are getting all wound up about something, without looking into the issues more closely, and colleagues in the medical profession are making a point of issuing notice on Vitamin A without also mentioning that drugs, many of them used in fertility circles, have far more of a chance of giving ladies birth defects,  And those were taken at the correct dosage!

Of the 18 reported cases over the last 30 years who had babies with deformities all of the women in regards to Vitamin A took over 25,000IUs of Vitamin A, which exceeds the RDA on this by an exponential amount. As always the devil is in the detail. Most  supplements will show 2 forms of Vitamin A – the one that can cause more damaging effects at high levels  is retinol only and not a mixed between Retinol and beta carotene,  which is what most supplements have in them.

It is worth noting also in this instance that Natural Vitamin A ( retinol) is found in high doses in organ meat, such as liver. Which up until the 1970s was consumed and readily available. Many children, like our parents who, were born after the war were given cod liver oil daily, to ensure they didn't have deficiencies. This form of fish oil has a much higher form of Vitamin A.

One of the sources of this information is NHS choices website. In this website, which I find extremely unhelpful and very uniformed it says things like ‘ you should be able to get all you need nutrients from your diet and don’t need any extra vitamin A’. Also rather unhelpfully in the article they put the measurement in Mgs not IUs, which is the standard international unit used to measure Vitamin A, so right from the start shows a fundamental misunderstanding about vitamin A.  http://www.nhs.uk/Conditions/vitamins-minerals/Pages/Vitamin-A.aspx

In terms of its use in pregnancy it is vital and essential nutrient and the most important and well known role of vitamin A is in relation to eye function. Vitamin A is necessary to prevent drying of the eye ( Xerophthalmia) and corneal changes. It is also used for retina function. 500,000 people lose their site each year due to vitamin A deficiency. Vitamin A levels are also inportant in thyroid health as it is needed for the uptake of idone and is required for thyroid hormone triiodothyroxine (T3) to bind to intracellular receptors. 

Vitamin A is needed in pregnancy for:  - Growth, Immunity, epithelial tissue maintenance and during cell proliferation, ie foetal growth!

I work with many clients and look into deeper analysis of fertility issues and pregnancy complications and one area I am fascinated in is Epigenetics. Many people who have polymorphisms in their BCMO1 gene have an issue converting beta carotene into retinol. So I welcome the use of mixed vitamin A for them in a retinol base, as they will have a problem converting Beta Carotene in the body http://www.ion.ac.uk/blog/anonymous/tue-2014-06-17-0954/are-you-converting-enough-beta-carotene-vitamin-55-people-may-not  Many of the studies on the populations in the human genome project also had the potential for poor eye sight also so were really in need of vitamin A, should the gene express.

I ask questions about eyesight as part of my consultations and also look at this from a family health position, as there is the potential here also to pass this on to off spring! One anecdotal thing I’m noticing much more than when I was a child is that there seems to be a huge amount of kids with glasses at a young age. I only remember a few in my whole school growing up, so I’m wondering if reduced amounts of vitamin A in pregnancy are a result of this?

WHO recommendations. More recent than 1995 http://www.who.int/elena/titles/vitamina_pregnancy/en/
American Teratology Society information on Vitamin A http://www.teratology.org/pubs/vitamina.htm


On a personal note. I have used many American supplements for the last 8  years of working with women all of which have mixed vitamin A around 5000IUs and I have confidence on these levels of Vitamin A.  I have worked with hundreds of ladies and so far no issues with this, with my recommendations!

I hope this helps you to make a more informed decision about vitamin A and its use in pregnancy and preconception.

References

2.Teratogenicity of high vitamin A intake. N Engl J Med. 1995 Nov 23 ;333(21):1369-73 
Wiegand, et al. 
3.Safety of vitamin A: recent results. Int J Vitam Nutr Res. 1998;68(6):411-6. Rothman, et al. 
4.Teratogenicity of high vitamin A intake. NEJM. 1995 Nov 23;333(21)1369-73. 3. Miller, et al.
5.Preconceptional vitamin A use. Reprod Toxicol. 1998 Jan-Feb; 12(1)75-88 

           
    

Monday, September 28, 2015

OvuSense a new Fertility Monitor that works (part 2)

I have been promising this review of OvuSense  for a while but I wanted to hang on - to really put it to the test and last month it didn't disappoint. 

As you may remember in Part 1 I got the monitor some months ago and was trailing it alongside BBT charting. Last month things really turned a corner with using this.

I was ill for a few days and my basal body temp went up to 37  degrees randomly right before I begin the phase just before ovulation. Temps stayed highish for a few days during this time, as I was fighting something off which never materialised ( cold for an hour, cold sore and achy bones) 

In my own predictions this would put me to ovulation on day 13-16, a prediction also confirmed by OvuSense to  around the 5th August. I have posted the pictures below but it’s a real example of how OvuSense, as it follows core temps, will show the real dates of ovulation in unison with natural progesterone in the body.









Ovusense  is in fact, according to its trails 99% accurate in detecting ovulation. As already mentioned Ovusense uses core body temps to predict ovulation. One of the biggest bonuses though using core temps, is that it can predict any cycle and for women who have periods only a few time a year -  this is valuable knowledge. The other bonus is if the temps stay low, then its time to trot off to the doctors to look at progesterone as this maybe why you aren’t getting pregnant as levels are just too low!  This is something that Ovusense picked up with me this last cycle, as its been a pretty stressful month with lots of things going on for me and as mentioned in previous articles if cortisol is high i.e. stress it will actively steal progesterone from your body! 

Below is an example of my normal cycles where I have good progesterone which was also confirmed by blood tests.

As OvuSense will pick up ovulation when temps rise, it is an amazing resource for Women who are diagnosed with Poly cystic Ovarian Syndrome (PCOS) Timing is everything with trying for a baby and you get a 24-72 hour window, depending on sperm health. Also  if you only ovulate 3 times in that year, you bet you are going to want to get busy having sex when you need to if you aren't cycling regularly!  

I have a lot of clients who suffer from PCOS. It a condition that 1 in ten women suffer from and something I have been supporting a lot in the last 10 years.  I'm pretty passionate abut this condition and I volunteer on a Facebook Forum sponsored by Ovusense for PCOS Women that has over 6000 members. I have to say the forum is an amazing resource. The ladies who support it Laura and Lucinda who work for OvuSense respond and support a whole raft of technical issues and also brave emotional support and give encouragement when ever possible. Kate Davies also supports the ladies and comes from a background of nursing via her own company Your Fertility Journey. Kate has over 20 years of specialist knowledge in Fertility and gynaecology. and support the ladies who have an Ovusense monitor with a free consultation with her; for others a 15 mins sessions is offered for free. OvuSense also have women so passionate about the monitor that they give up their free time as admins to help out and support the running of this page. The balance on the forum is great and its more of a support network than anything else where those who have bought OvuSense can post up charts and others ask advice on BBT charting and also diets and supplements. ( that’s where I come in where I can!) If you have PCOS and are curious I’d say jump in and join! 










All in all out of all the monitors I have tried, for £295 you can’t go wrong with Ovusense. They also offer monthly plans to pay so its affordable! It is in its early days as a fertility monitor and there are some teething probs like faulty monitors now and then. But to be honest, many monitors out there do also have these issues. It is a hefty piece of machinery in terms of packing a punch with what it has to do daily!


When I had a sensor that stopped working this was courier out the next day and it didn’t cause any disruption to my cycle. This is something also reported on the Facebook Forum. I haven’t seen one bad comment about the teams commitment to sending out and replacing equipment if not working. Everyone loves the OvuSense team as they get straight on it if there is an issues!

In the future OvuSense may also be used as contraceptive! In the meantime I wholeheartedly endorse it as a fertility monitor to help women who want to get pregnant! In fact speaking of that OvuSense have had 50 pregnancies since the beginning of 2015! Pretty good going I'd say! 

I have now been using it for over 6 months and  can say with some assurances I know how it works and look forward, every morning to seeing the little blue monitor building my picture and letting me know when I’m in my fertile window and when I’m not! 
What’s not to love about that as a woman and how amazingly empowering is that? As a Fertility Nutritionist it makes my job easier and it helps me to support clients where I can who use it. I look forward to the day that Ovusense is in high street Chemists alongside other things like OPK kits and Clearblue fertility monitors, leading the way and giving modern women one less thing to worry about in terms of their fertility!


Disclaimer: OvuSense gave me a fertility monitor for the purpose of this review

Friday, September 11, 2015

Ovusense the Fertility Monitor that works! (Part 1)

A study done in Australia in 2013 by the Journal of advanced nursing found that 13% of Australian Women were unable to define their fertile window in order to support conception. This lead researchers to identify that ‘ poor fertility awareness’ is one of the contributing factors to infertility. This figure is I’m certain not just a reflection of Aussie women, but in fact also emulated all over the western world.  In my experience when I start working with women and talking to them about their own fertility knowledge this  figure seems more like 40%!

There are many other reasons for fertility issues and as a nutritionist I'm passionate about turning this over and uncovering how to bring your fertility back into balance again by changes to lifestyle, dietary suggestions and supplementation when possible.

Times definitely are a changing and I often think that my job wouldn't have been around some 50 years ago! Amazingly only a few generations ago women would have been eating foods that were right for them and seasonally based food -  this would have helped their fertility immensely. We weren't travelling huge distances, stress was less and we had more of a community to give us the support we needed from a female perspective and we learnt about our bodies through our sisters! Women back then also just seemed to know the signs and how to effectively predict and track their fertility throughout the month unlike today.  In the olden days this information was passed down from women to woman and in many traditional societies becoming a woman and knowing you can create life is a right of passage. In today's modern life where we have an app for everything, fertility is bundled up in this world . This is not a bad thing in itself as women of younger generations are learning from technology about fertility now, and we have online communities to support our issues! In other words we no longer sit round the campfire sharing knowledge as we look to the internet and technology for fertility awareness.

As a modern girl ( I hope) I try to keep up with technology and as part of my job I teach and coach women on fertility awareness. Over the years I have also tried many devices that identify your fertile window. This has included the clear blue monitor ( persona) and using ovulation predictor kits.  I also used the OvuCue for a while which I quite liked which is based on predicting ovulation based on your saliva. I’ve also tried looking at saliva ferning patterns. You name it I’ve tried it to help my clients and myself!

The most consistent method over the years I have used, is to look at body temperature as a marker of definition between follicular and luteal phases. Before testing your HcG levels, raised body temps are a real indication of pregnancy as high levels indicate a good level of progesterone, which is something that sustains a pregnancy and a hormone that will naturally raise your bodies temperature once you have ovulated. In this 2 week wait from ovulation to menstrual period, progesterone will stay high regardless of pregnancy, but will increase steadily if pregnancy occurs in the feedback loop from brain to the endocrine and reproductive cycle.

I love using BBT charting to see where I am in my cycle. It is a fabulous tool! I have to admit I am a prolific Basal Body Temperature charter in fact ‘ Hello my name is Angela and I’m addicted to BBT charting’  I have been doing this for the last 7.5 years.  Funnily enough I found out my parents also used this method to conceive all 3 of us Heaps! It’s a great method, its been used for years by so many people  and is coupled together with other methods that look at other signs of fertility like cervical position and cervical fluid to shows that your body is ready to release an egg from a follicle and that ovulation has occurred.   When I first started working with Natural Fertility Expert and Andrew Loosely who uses this method readily he was amazed how many BBT charts I had ‘under my belt’.

When it comes to supporting my clients I do walk the walk in regards to understanding fertility and your body. I have also been known to use my own charts in consultations in order to show women what to look for in terms of fertile signs in the female body. However the one thing that throws this picture into a loop is that it relies on taking a reading orally and when you are ill the picture is then out of whack as it records basal body temps which will remain high if your immune system is fighting something off!  I didn’t know how to remedy this, and if you were ill, well when it comes to this, its something to work around as a practitioner!

Until Ovusense…. I was introduced to this fertility device around a year ago. I met Robert Milnes the CEO of Ovusense UK and Kate Davies a specialist nurse brought in from her own practice Your Fertility Journey to support them at the Fertility Show in London 2014. I was at the show as part of the Natural Fertility Expert(NFE) team. This device followed the principals of BBT charting but it used core body temperature! Which made my ears prick up. This would mean that illness would not affect the reading.  When I heard this - I was hooked and approached them to trial  the device on myself this year.  Which they agreed to do and sent me out a monitor and sensor in the post as soon as we had agreed I would be trialing it! I was delighted to be trialing something which showed such promise - Hoorah bring on the temps! As a comparison – even though it isn’t as such - I used it along side the BBT charting also.

How does it work?

The monitor arrived a few months ago and weighed very little ( handy for taking it on holiday!) It also looks like very much like a mini computer, which will hold all the data you input into it. It comes with a sensor, which I think looks like a giant sperm.. or a tampon which you insert into your vagina every night. You do wash this before and after use every day and is made from the highest grade medical material so nothing sticks to it germs wise I’m guessing!














Starting the trail

You only start using the sensor after your period ends for hygiene reasons, so I waited until this was over and started using the device on day 6 of my cycle.  Apparently as the sensor is inside you it will take a temperature every 5 mins while you sleep. In reality when I mention this to some people they are horrified- but It was actually more comfortable than a scratchy tampon ( which I don’t ever use fertility peeps)



You ‘wear’ it overnight – or for at least a few hours for enough readings to be taken. When you wake, thankfully you don’t have to lie there like a corpse while you take your temp like BBT charting and you can get up immediately! Bonus if you already have kids and they wake up in the night or at 6am and bam,  You’ve lost your BBT window to take your temps!  You then take the sensor out wash it and place it back on its cradle and press the down arrow for the data to be transferred! The monitor will then use algorithms to predict your fertile window each month and after using it for 2-3 months this becomes eerily accurate as it begins to see a pattern. This pattern fitted exactly to my cervical fluid patterns also which made me feel more confident from the outset
.  

The good thing about OvuSense – (well there are lots actually) - is it gives you a ‘Fertility Window’


 which is really handy as if you are a long term BBT chart user, you know there is never a window and as useful as it is you can miss your window if your body is ‘ off’ that month! Also OPKs can be unreliable in my view as can surge a few times in the month particularly if you have PCOS! It occurred to me that this device had many uses from a fertility perspective not least as is invaluable if you are using a sperm donor as it will give you a day or 2 notice. If getting pregnant via sex, it also means you have that prior knowledge that you have a day or 2 to get ready! I do also recommend you use other methods alongside this like cervical position and cervical fluid as this just gives you the ‘green light’ when you are already in the race with OvuSense.

I will go into more detail in part 2 about the Facebook Page that supports this app and what Ovusense picked up that my Fertility Friend didn't which was very exciting!

Thursday, March 19, 2015

B Vitamins and PCOS

Today I'm really excited to talk to you about a group of vitamins really vital for female health useful for ladies particularly with hormone dysregulation, PCOS and weight issues.
The B vitamins are very important in helping to improve the symptoms of PCOS. In nature if we get a balanced diet we get lots of the B vitamins in things like Meat, Fish, Eggs, Milk and green leafy veggies. If you want to have them in one source ie a vitamin, Its really important to make sure you have these vitamins in a combined formula as they all work together on different elements! 
Vitamins B2, B3, B5 and B6 are particularly useful for weight and maintaining and managing it. One of the B vitamins - Vitamin B2( riboflavin) helps to turn the food you eat via fat, sugar and protein to the energy we need to survive(its also the one that turns your wee bright yellow!)  B3 another vitamin, s an important co-factor in supporting glucose tolerance factor (GTF), GTF is something  that allows your body to keep an eye on blood sugar . It needs vitamin B3 to help this process, almost like food for your GTF! Vitamin B5 is also important as it helps your body metabolises fat, so important if you are overweight and need to lose weight to qualify for fertility support!  B6 is also marvellous as it supports proper hormonal balance and may be one deficiency present if you suffer from PMT. It helps to maintain blood sugar, oestrogen and also progesterone and helps in mood regulation via serotonin. Many women with PCOS have deficiencies in this and also low progesterone, so worth topping up your levels with B6 in this case. B6 is also part of a ‘gang’ with B2 and B3, that will help your body to make and move thyroxine, needed for normal thyroid hormone production.
Let’s not forget folate B9! Many of you maybe on folic acid for your fertility as this is the basic component of many B complex vitamins. However I like to super charge my ladies and always go for the superior version of folate called Methlyfolate. Folate is such an important substance, its not just needed for helping to prevent Spina Bifida and Neural tube defects, its needed for all our cells to replicate which happens hundreds of thousands of times a second in our bodies, so vital for health, not just to get it in supplement form but in natural forms through leafy greens!



Folate works in conjunction with B12 also a co-factor and together they help to reduce a substance or by-product of methylation called homocysteine. This can have implications of cardiovascular issues if too high and homocysteine can creep up if taking metformin, without replacing both B12 and folate in the diet.
Deficiencies in these vitamins can happen easily if you have an inflammatory condition like PCOS, so having a great combined  B vitamin will enable the body to maintain balance more easily so it can do its job!
B12 is an important vitamin and many people are deficient in this mineral. It is found in lots of foods such as Meats, fish and dairy, so often vegetarians can become deficient in this vitamin,  particularly people who don't eat a healthy diet. B12 together with folate is really needed by the body to help cell replication and DNA, which we need constantly as cells die and are replenished. When we eat protein B12 is released and is then further broken down by something called intrinsic factor which helps B12 to get absorbed into the blood stream. You need good levels of Hydrochloric acid for B12 to be released so for many this may be the issue of constant low B12 despite supplementation. So taking some cider vinegar in war water before food helps with stomach acid support.  B12 becomes deficient in the body by using metformin, so it really important to take this to help red blood cells and oxygenated blood travel round the body. Thorne Research Basic B has a super absorbable B12 called Methylcobalamin in it, which is an excellent version of B12, and one of only 2 I recommend together with Adenosyl cobalamin and Hydroxocobalamin. I'm not a fan of the standard  B12 forms you see in most supplements – Cyanocobalamin. I’ll be honest it isn't my favourite form as it uses cyanide as a binding factor instead of more natural forms. It is a very small amount and we do have naturally occurring cyanide in some food, however I like my B12 without a side order of poison personally!  So if you, like me, are not into this, always read the labels of supplements to see what’s in them and if possible go for active b Methylfolate.
The B vitamins are also essential for the liver , which has 2 phases. The first one processes substances such as hormones and toxins and metabolises them – B vitamins particular B2, B3, B6, B9 and B12, are important at this stage. The second stage is where these substances are ‘ conjugated’ . B vitamins do their thing at this stage also and help the liver to get rid of  excess and old hormones so they can be eliminated by the body. If you have PCOS its more than likely you have an excess of oestrogen, so this is where B vitamins can really help your liver!
Here a diagram to show how well absorbed methylfolate is in the body compared to folic acid as well as where B12 and Homocysteine come into things as we break the vitamins down via food and supplements for the body to use.
Many ladies with PCOS I’m working with are having great results combining this supplement with Inositol which also helps regulate blood sugar via the insulin receptors. It also works on the liver to support its function and in trial has supported reducing higher FSH and reducing oestrogen. In trails particularly for IVF this has helped egg quality and also improved outcome in IVF. There are also loads of studies on using Inositol for PCOS.
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8.    http://www.ncbi.nlm.nih.gov/pubmed/21463230 
9.    http://www.nejm.org/doi/full/10.1056/NEJM199904293401703 

10.  http://www.ncbi.nlm.nih.gov/pubmed/18854115 
11.  http://www.ncbi.nlm.nih.gov/pubmed/18854115 
12.  http://www.ncbi.nlm.nih.gov/pubmed/18854115