Looking after your fertility whilst on lockdown

Andreia Trigo, RN BSc MSc
Founder of Enhanced Fertility Programme, Enhanced Fertility Programme

COVID-19, Emotions and Support

Looking after your fertility whilst on lockdown #IVFWEBINARS
From this video you will find out:
  • What is fertility health?
  • What are the main stressors during the lockdown?
  • How to manage personal wellbeing (physical, mental and social wellbeing)?
  • How to eat healthy food and be active?


Coronavirus lockdown and looking after your fertility

Looking after your fertility whilst on lockdown

Fertility Health

According to the World Health Organization, it is defined as a state of physical, mental, and social well-being and not merely the absence of any disease. It is not only about eggs, sperm, and uterus

It is also said to be related to the enjoyment of a satisfying sexual life as well as having the freedom to decide how often reproduction is considered.

Main Stressors

  • Physical wellbeing

One of the most significant aspects that can potentially affect your well-being is nutrition. Because of lockdown, the lack of access to fresh known products and an evident reduction in physical activity are also said to be harmful aspects as these are known to alter fertility. In the same light, fluctuations in weight due to alterations in the former aspects are stated to be harmful. In addition, toxins that can be easily found in hygiene products are notoriously detrimental and to be avoided.

  • Mental wellbeing

The alterations in daily routine may cause feelings of fear and anxiety as an unstable routine life can be difficult to cope with due to changes in work habits. Sleep pattern disturbances are also known to affect fertility as well. Finally, the lack of personal space in living spaces along with global reproductive uncertainties are mentioned as equally deteriorating mental well-being.

  • Social wellbeing

According to the nurse, social distancing and isolation are also considered to be detrimental as feelings of frustration may arise due to the well-known circumstances.

Thought-feelings-actions-results – strategies

It is said by Andreia that whatever a person is feeling always has its origin in a thought. This is believed to trigger a certain feeling and thus an action and future results.

1. It’s OK not to be OK

The first strategy implies the acknowledgment of what you are feeling for a better understanding that it is normal to have anxiety and fears as a response to an abnormal circumstance because it is a coping mechanism of human behavior that should not be restricted.

2. Let go of what you cannot control

The second strategy is fundamental to understand that in most cases the feelings of anxiety and fears arise because of attachment to circumstances that cannot be controlled.

  • Predict what will happen
  • How long this will last
  • The actions of others
  • If others follow rules of social distancing

What can be controlled? It is indicated that focusing energy should be relied on these strategies:

  • How do I respond to circumstances that cannot be controlled
  • My attitude and my thoughts
  • Own social distancing
  • Amount of news consumption
  • Finding fun things to do at home

3. Start the day with fertility priming

It involves the practice of mindfulness entails the approaching of a healthy mindset to cope with any challenge that might come day by day through self-affirmation.

4. Introduce short pauses

It implies the allowance of short pauses in daily routine for a greater appreciation of what is happening at the moment. It is also highly encouraged to make a list of elements that can be perceived whilst having a pause.

One thing I can see ____
One thing I can hear____
One thing I can feel ____

4. Healthy eating

This strategy is said to be one of the most significant for proper well-being.
Avoidance of takeaway meals is encouraged along with a willingness to cook homemade meals at home including seasonal products if possible. Also, adopting a mindful eating habit that encompasses trying new recipes and the addition of unprocessed food is highly recommended.

5. Keeping being active

Regardless of the impossibility of going outdoors, it is essential to be active physically, which can be solved through many channels such as looking for exercise video routines on YouTube. Also, adopting an activity that results in a feeling of accomplishment, pleasure, and meaning is fundamental.

6. Organize your environment

This strategy is also said to involve the removal of distractions from the environment along with an approach of getting rid of items that are no longer useful. Furthermore, the importance of allowing oneself to optimize your time by breaking a task into small pieces is also considered to be effective in the long run.

7. Time for work, others, and yourself

Andreia mentioned the importance of having a routine, and remembering good sleep hygiene, as well as separating work from living space. It is a balance between work duties and time for oneself and others

- Questions and Answers

I got primary hypogonadism will affect my fertility?

Yes, it will. It can affect your fertility, but this is not something that you can resolve with behaviour or lifestyle, unfortunately, so for this one, you need to go to a fertility specialist.

How long do you recommend to wait if I have had three-five IVF cycles already?

I don’t know your specific circumstances, but if you had three cycles that haven’t worked, we need to look at the reasons why these cycles haven’t worked. We need to look into it. If it was a transfer and it hasn’t progressed to developing into a baby very early on, there is no reason why you should wait. But I think instead of just going ahead very quickly you need to go back to the drawing board and see the reasons why it has happened.

How to cope with this situation, as the clock is ticking I won’t be more fertile than I am now. To be honest, I will be less fertile. But today the treatment is not possible, and nobody knows when or if we get back to normal.

Unfortunately, I’ve been hearing that every day from so many people and that is one of those situations that we need to let go because we cannot control how long this will last. I mean, you can’t focus on things that you’re not in control of. It might last longer than a month or two. We don’t know. The fact that you’re not becoming more fertile is also a fact of life, part of being a woman, and we know that as years go by we become less and less fertile. But what I would like to focus on, instead of focusing on the things that you cannot control, is the fact that IVF has helped many people and it has helped many women who are over 40. So if it has worked for them, maybe it will work for you. Who knows? So instead of choosing the things that you cannot control, think of all the things that are in your favour and think of all how IVF can help you. What you can do to be successful. All the strategies that we’ve been talking about today: the healthy nutrition, sleeping adequately, having a good routine. All of these things will cause that your body is healthy and ready for the protocol to work. It’s ready to carry a pregnancy to term. You will be in your peak state. Those are the things that we can focus on, that we can work on. And that would be my suggestion, to switch from what you cannot control the things that you can control.

What are your thoughts on dairy and egg quality? 

It’s a great question, and there’s so much talk about it. There was a very large study that was run by Harvard University, and they looked at fertility for women and men, and what aspects mattered when it comes to nutrition. And one of the things they talked about was milk and the fact that switching to whole milk when trying to conceive seemed to be better. Now, they don’t understand the reason why because full-fat milk whole milk has way more fat than the milk we usually drink, semi-skimmed milk, but they just noticed that people who were drinking whole milk were were more fertile. So they cannot explain that. A possible explanation that they have theorized is that whole milk is less processed, so if we are living eating less processed food, it tends to be better for our fertility. That is the current evidence that we have is whole milk in fact to conceive and when you get pregnant then switching to the normal milk.

What are your thoughts on caffeine? How do you know what is too much exercise?

Caffeine is controversial. Some studies say that caffeine affects fertility, but then other studies say it doesn’t make a difference, and the question is how much caffeine is too much. There is no consensus on this topic, so my advice is usually to minimize it. If you feel that you need to have one coffee a day, then that’s fine, because there is not a high-quality study that has said 100% it affects fertility or 100% it doesn’t. It’s just all about minimizing. And if you feel you can live with it, it is fine. If you feel you can, have a decaf or tea sometimes instead of it and just remember that caffeine is not only in coffee, we also have caffeine in chocolate. Caffeine is also present in soda drinks. If you can minimize in any way, it will be super helpful for your fertility. In terms of exercise, that’s another great question. What research has found, is that doing too much exercise is not helpful. But what is too much. Too much would be anything strenuous. So if you are training, let’s say you if you are a personal trainer, and your job is to be in the gym doing exercise all day, that will be too much. If you are trying for a marathon or if you are doing high-intensity boot camp training all those things are too much. When it comes to fertility, we are talking about doing much softer exercise. You can still do cardio, you can still run but just do not run to a marathon. You can still do yoga. In terms of men, men should avoid hot yoga, that’s one of the things. Trying to do more moderate exercise and avoid that strenuous or very intense exercise seems to be the thing that affects fertility. And in terms of men, if we think about men who do a lot of exercises and who then take a lot of steroids to build on those muscles steroids affect male fertility immensely. That is one of the key things to avoid.

What if my partner doesn’t want to go for egg donation we already had three failed attempts with own eggs our best chance is egg donation. How can I convince him? 

It’s a common problem, and sometimes it’s the partner who doesn’t want to go ahead with egg donation, sometimes it is the woman who doesn’t want to go ahead with egg donation, and this is something that happens all the time. People feel differently about what treatments to try, how long to try them for, so having this problem is common and normal. You are not alone, and the first advice would be to speak with a counsellor or a psychologist to explore the reasons why your partner doesn’t want to go ahead with egg donation. What are his fears? Is he afraid that he won’t be connected to the child? Is he afraid that the child will not look like you, the mother? What are the fears that are behind his fear of not wanting to go ahead with egg donation? Having these middle term or having a counsellor or psychologist moderating this conversation might be really helpful. It is not a matter of convincing him, but it is just about maturing ideas. Sometimes something that is not an option for me right now becomes an option a few months down the line, and this is very common when it comes to egg donation. At the beginning of the journey, I might not be able to try it, but in the end, my mind is so open to alternative options. If I think, maybe I don’t mind trying it because I learned more about fertility, I learned more about what it is that I want. Do I want a child to be similar to me? Do I want to experience pregnancy? Do I want a family? What is it that I want and what is the solution that will bring me closer to the goal that I want?

What are your thoughts on supplements like coenzyme 10?

That is one of the supplements that has been proved to work. Definitely, that’s something that you can try, and it might improve egg and sperm quality so yes definitely give it a go.

How long before a collection should I take it?

We usually say that it takes three months to get your body ready. Taking these supplements is one thing. Another thing is, being careful about your nutrition choices, and being mindful about the toxins that you’re putting in your body through makeup, creams, and so on. You should be mindful about the toxins in your environment like cleaning products that you used to clean the house. All of these things together, if you do them for three months, that’s the ideal time for you to see an effect on the quality of your eggs, the quality of your sperm and making sure you are on top form for fertility treatment to work.

I know you are working as a nurse. Is it okay for you to share how you cope with what’s going on nowadays? 

I’ve been helping out the NHS here in the UK once a week. It’s just so overwhelming to see so many people suffer from coronavirus because people are actually dying and, for me, it’s really hard to go through a 10-hour shift and see all these people go through this challenging situations and then having to come home. I just need to talk about it so I talked with my husband, and he’s so patient he listens to me. It just allows me to vent. These situations serious, and it just breaks my heart seeing people having their life cut short, dying before their time. Seeing elderly people, not being able to to be with their family in their last moments or family not being able to say their goodbyes. All of these situations absolutely break my heart. But I feel that as a nurse I need to do my bit, and then my way of coping is just coming home, talking to my husband and then just staying at home minimizing the amount of time I need to go out just doing my bit to prevent the coronavirus from spreading and that’s it. Staying focused and positive is really the only thing that we can do.

Is it true that soda drinks, even sugar-free ones, are really bad for fertility?

Soda drinks are one of the worst things for fertility and not because they include sugar, but because they have caffeine as well. Soda drinks are bad, and the largest study that I was talking about from Harvard University says the best drink you can have for fertility is water. Drinking plenty of water, one and a half litres a day and avoiding soda drinks is the best choice. They are highly processed. They are not natural, they contain additives, they have plenty of sugar, even if they say there is none added there is always a small percentage of sugar replacement products. They also have caffeine which is not good for fertility. Additionally, those drinks are not good for so many other aspects of health. So the water is best.

Do you think after castor oil packs are good for fertility?

I’m not sure what castor oil packs are. I’m always reading new research on what works and what doesn’t work and you need to be really careful when there is a study that says that something is really good for fertility, because we need to understand how many people was this tested on, what results were they looking at. Sometimes people are reading the news or very low-quality studies, and they don’t think they may not be credible. I haven’t come across any kind of approach that uses this technique [castor oil packs] to improve fertility in Western medicine. I haven’t read any high-quality study showing it works, so it’s not something that I usually recommend. Our body is very good at detoxing by itself. We don’t need to do any such things. If you think about it, for example, you’re eating good-quality food, you are using all these good products on your body and in your environment, you don’t need to detox. There is nothing to get rid of. If you’re eating a lot of bad foods and processed foods, your body needs to untangle those foods to find the minimal nutritious content in them, so it has a lot to get rid of. But if you are eating healthy and if you’re using products that are low in toxins there is no reason why you need to to do anything. It’s not something that I believe has been proven to be beneficial, using that castor oil on your body.

How much animal protein should a woman consume daily for good egg equality?

What the research studies have shown is that eating a lot of protein is not good for fertility. I come from a Mediterranean country, and we usually have protein as the centre of our meal, and then we have some eggs, some vegetables and some carbohydrates. And what this big Harvard study identified is that people who eat less animal protein tend to be more fertile, so one of the best advice we’ve been giving is to start having less protein and when possible switch to vegetable protein. Eating less protein and replacing some animal protein with vegetable protein seems to be better for fertility.

Is soy good or bad for fertility?

There is some evidence that soy is not very good because it messes up with our estrogen. If if you don’t want to drink normal milk, one of the things that you can do is instead of drinking soy milk, which is particularly a problem for men more than women, you can have almond milk or rice milk. Those are perfectly good options that tend to be a bit better. It’s always about the actual balance.

What is your advice about the best treatment for Hashimoto when it comes to fertility? 

You will need fertility advice by a specialist doctor, and I don’t think it’s something that you can deal with regular advice and just get pregnant without having this specific advice. I think you need to contact the doctor for this one. Check with your doctor to make sure you will get the best possible answer, and of course, all kinds of tests will need to be done just to see what is the best solution for you.
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Andreia Trigo, RN BSc MSc

Andreia Trigo, RN BSc MSc

Andreia Trigo is a multi-awarded nurse consultant, author and TEDx speaker. Combining her medical experience and her own infertility journey, she developed unique strategies to help people undergoing similar challenges to achieve their reproductive goals. Her mission is to improve accessibility to fertility care and support worldwide at minimal cost to populations. She is also The Founder & Director of Enhanced Fertility Programme, the evidence-based programme that improved help for fertility, currently in use by several clinics and patients worldwide.
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Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.