Lifestyle and fertility

That’s a very interesting question because one of the modifiable factors that we talked about today. We can probably do another webinar just on supplements because there are so many and the conditions that each woman or men has that affect their fertility. Some supplements might be better than others and some might be more recommended than others but I can tell you that when it comes to folic acid, the recommended dose is 400. It’s 400 micrograms; not sure if you are confusing milligrams with micrograms but 400 micrograms is the recommended dose. Some people will need a higher dose than that. These are cases, for example, when the baby’s biological father has a neural tube defect and this has to do with a deformity in the spine, if the woman has already had a pregnancy with a neural tube defect or if there is a history in the family of neural tube defects, if the woman has diabetes or if the woman is taking medicines for epilepsy, if any of these conditions are met, she needs to take a higher dose of folic acid which is five milligrams which is so much higher than the recommended dose to the general population. But, again, if she doesn’t have any of this history then she needs to take just the recommend 400 micrograms. It’s really important that she doesn’t take more than what she needs because like I said a lot of people are not able to break down the folic acid into the form that your body can use. If you’re taking too much, it can be accumulated in your system and you don’t want to do that. Vitamin D I can tell you that it’s really important as well. Most people take 1,000 milligrams and that is the correct dose so you can take that. Some countries recommend higher doses than others so there isn’t quite a consensus but I would say that is an average dose for vitamin D and that’s correct. In terms of probiotics, I haven’t found a lot of evidence in terms of trying to conceive. I was just reading about it today but I haven’t found much evidence. I found some evidence for women who are already pregnant, in terms of improving the vaginal bacteria but not in terms of trying to conceive. If you look, for example, at a multivitamin which is a tablet that has already all of these, for example, prenatal vitamins, will already have all of this so you don’t need to buy separate tablets – that’s a possible solution to find the right doses.

I think I’ve answered the question in terms of the doses of folic acid, vitamin B, probiotics. I haven’t found evidence to say that it’s useful. Flaxseed oil, again, I haven’t found any high-quality evidence but again it’s something that I can look into and I haven’t found anything so far.

The person who is donating the egg needs to start taking it before they have the egg collection. We know that eggs and sperm take around three months to mature and become good quality so just if you take it around three months before the retrieval that would be good. In terms of surrogates, the surrogate needs to start taking the folic acid and the vitamin D as well ahead of time, I would say at least a month because she needs to have that good level of folic acid in her system so that when the embryo is transferred and starts developing and the placenta starts developing, she has enough resources of folic acid for herself and for the embryo. It needs to be ahead of time.

That’s a good question. In the UK if you buy supplements, you will have 10 micrograms, if you buy them in Europe, you will have 25 micrograms. If you are living in the UK, you will only be able to find 10 micrograms, if you are buying them online, you will have 25 micrograms. But there is no consistency in terms of universal recommendations on how much vitamin D is required. But again this is a separate modifiable factor that I can talk about. I didn’t talk about it today but it will depend as well on how much sun you are getting. We produce a lot of vitamin D if we are spending some time outside, for example, 10-15 minutes at lunch time going outside with your arms showing just to make sure you are getting the sunlight. Countries that have less sun should take more but again in the UK the recommended dose is 10 micrograms, 10 mcg, and in Europe, there’s a lot of countries recommended 25.

That’s a good question. Vitamin D – it’s something that we haven’t talked about today. In the UK, the recommended thing for everyone even for people who are not trying to conceive is to take vitamin D in the winter months. If we start thinking from September to March, start taking vitamin D and here the dose we have available is 10 micrograms. If you notice, for example, now that we are in lockdown, if we’re not going outside much, then you can still continue taking it even though we are almost in the summer – so that that is currently the recommendation in the UK.

As I said both, folate and folic acid are available in supplement form. If you are eating foods that have been enriched, you are most likely eating folic in enriched rice or cereals. If you are taking it as a supplement tablet, you will find supplements that have folic acid and supplements that have folate. Now some people are not able to metabolize folic acid as easily as other people. Some nutritionists often recommend folate but if we look at all the medical recommendations, if you go on the NHS website, the World Health Organization where other organizations worldwide that are medical, they will not talk about methyl folate, they will not talk about folate and their recommendations are always around folic acid. If you have been recommended a higher dose, the five milligrams of folic acid by your doctor, then I think that’s the dose that you should follow instead of trying to switch or definitely not try and take two supplements because you could be overdosing yourself. If you have that higher dose, stick to the brand and the dose that your doctor has recommended to you and just make sure that you are eating those dark leafy vegetables and get the natural source of folate from there, instead of trying to have a different sort of tablets and which could mean that you could be overdosing yourself.

Here we’re talking about the radiation RF-EMF so we’re talking about having the computer close to you but, for example, if you can limit your work time on the computer to, for example, 8 today but not having your phone next to your computer or the radio next to you, at the same time, or the TV in the same room, so it’s about the devices that you’re using and how close you are to them but as well how many you have around you. So many times we have all these devices around us and necessarily mostly because we are not aware that they can be harmful to us. If you have to use the computer, use it for the minimum time that you need to actually perform the job. We haven’t found any type of time limit that has been identified in these research studies but it’s all about limiting the use of the devices and having them close to you when you need them but further away or turn off the switch when you’re not using them.

That is a great question but again one that I’m not going to answer today because this is part of the other modifiable factors that I have not brought here today. I can tell you that there is good evidence on Coenzyme Q10. The evidence is noted high up in the hierarchy so if we were using a traffic light system, I would say it’s orange, so it’s not green saying go ahead there’s 100% certainty that you need it like folic acid or vitamin D, but it’s yellow, it’s useful in certain circumstances. But, again, I’m not going to talk about it today but I’m more than happy to hold another webinar where we talk about other modifiable factors. There’s so much information and people are so curious about it and it was really hard for me to choose which five modifiable factors I would bring here today but I thought it would be interesting to bring a variety of all of these factors but I’m more than happy to be more thorough in the next webinar.

Vitamin C is one of the most researched antioxidants and it’s good. You can also get antioxidants from dark fruits, for example, blueberries. So getting a mixture of antioxidants from fruits and vitamin C that’s I would say a good amount. Let me just clarify one thing. Antioxidants are good if you are undergoing oxidative stress. Oxidative stress comes not only from food but it comes from your environment, lifestyle, smoking, so the more oxidative stress you have, the more antioxidants you’ll need. The key thing is to minimize our exposure to oxidative stress so that we don’t need a lot of antioxidants. We can take them to minimize the impact and the DNA damage from oxidative stress but if we can minimize exposure then it’s best. If you are pre-diabetic and you choose to take a tablet to deal with that without making any changes to your diet when maybe changing your diet would mean that you wouldn’t need a tablet. Minimizing exposure is as important or even more important than taking antioxidants.

I would say that if you can have your phone turned off at night that would resolve the issue. If you use it as an alarm, I would say having it far away from you and that could actually be quite a good strategy but you because you wouldn’t snooze the alarm, you’d have to wake up, stand up to turn it off so that might be a good strategy to have it far away from you. But turning it off would also be good. In terms of the techie stuff, it’s the more you have, the more exposure you will have. It might be okay for most people but, for example, if you notice that his sperm has DNA problems, if it has a lot of oxidative stress, then maybe those are some of the things that you can reduce. If we’re thinking about the heat exposure that we talked about today, for example, using very tight underwear or tight trousers or having the computer on his lap, that is more important to address that than addressing the radiofrequency stuff. Instead of thinking of all the things that you could do, think in terms of the priority. Are you addressing all the other things and everything is okay and is this the only thing left to change and adjust? Think of ways that you can minimize instead of removing it altogether. I understand it can be very difficult for us to remove all these things that are part of our lives. Change is really really hard. Think of ways of minimizing it, avoiding exposure where you can but not removing it or completely moving to an island in the middle of nowhere – that might not be necessary, just minimizing, doing most of the stuff 80% of the time, not 100%. Otherwise, we’ll go mad.

No, that’s fine. If you think about one of those basic alarm clocks, then that’s absolutely fine that there’s no Wi-Fi, there’s no radiation coming from it so you can have an actual alarm clock.

That’s a good question. If we’re talking about sperm, we know that sperm changes take 74 days so it’s reversible. If you start reducing the exposure to the computer and the phone, it takes 74 days for sperm to be born again all beautiful without changes affected by those factors. If we’re talking about eggs, eggs take about three months since they are very little and then they start growing into follicles so it’s reversible. We have an opportunity with these lifestyle interventions to make a change to our lifestyle, to our habits, to our environmental factors and then see an actual difference in just a few months’ time.

Melatonin – it’s not one of the supplements that we have found of high-quality. The most important thing in egg quality is age. We know that quality starts reducing from the age of 37 and we know that some of the other factors we’ve been talking about can make a difference in egg quality but melatonin is not one of the supplements that we found much evidence for.