The fertile diet and Clomid.

Poor nutrition is one of the reasons why some women can not get pregnant. Such conclusions were made by scientists on the basis of large-scale studies conducted. On their basis, a fertile diet was compiled, designed to increase the ability to conceive a baby.

The fact that the use of a certain set of products helps to get pregnant (we also remind you that clomid copes with this task perfectly) became known in the early 90s. Scientists have developed a special nutrition system after a long eight-year study in which more than 18 thousand women took part. The diet, called fertile, increases the chances of getting pregnant, and also affects the development of the fetus.

By the way, other studies conducted on animals have shown that a certain type of nutrition of parents before conception has a serious impact on the health of offspring.
Of course, when planning a pregnancy, you should not rely only on a diet, but as studies show, it can really increase the chances of conception. But of course, if a woman does not have serious problems like infection, clogged fallopian tubes, or if the cause of infertility is not any irreversible painful processes. What should be the nutrition of future parents?

fertile diet

What foods can not be consumed if you want to get pregnant

First of all, it is important to exclude from the diet coffee and products containing caffeine-Coca-Cola, Pepsi, etc. The fact is that caffeine suppresses the reproductive function of the body. Caffeine stimulates the production of androgens by the liver, adrenal glands, and ovaries. The increased amount of androgens does not have time to turn into sex hormones, as a result, the endocrine balance is disturbed. As a result, there is a lack of ovulation, an incompetent egg or sperm, polycystic ovary syndrome. Nicotine has the same effect.

You should also give up sugar and flour products. After consuming sugar and products with it, the glucose level increases. To reduce it, the body produces insulin, which can cause polycystic ovary syndrome, which is one of the most common causes of female infertility, problems with conception and even carrying a child.

Products with preservatives and dyes are also on the black list, since they directly affect the viability of the egg and sperm cells. In addition, settling in the liver, they disrupt its proper functioning, causing increased production of androgens.

Fertile diet: What does a woman have to get pregnant faster

The diet of the expectant mother should be rich in healthy fats, whole-grain products, vegetable proteins. All these products support the eggs in working condition, contribute to regular ovulation, normalization of sugar levels, and as a result, the onset of a long-awaited pregnancy.

Meat consumption should be reduced in favor of vegetable proteins – legumes, nuts, as well as fish and seafood. The researchers note that the use of excessive amounts of protein can negatively affect the attachment of the embryo to the uterine wall or interfere with its early development.

The diet should also contain a sufficient amount of vitamin E (vegetable oils).

As for dairy products, they should not be decontaminated. When following a fertile diet, it is recommended to consume fatty milk, cheese and yogurt. Dairy products with normal fat levels contribute to the production of a hormone associated with ovulation and fertility.

A distinctive feature of the fertile diet from others is the high level of folic acid. As is known, this acid plays a special role not only in conception, but also in the development of the embryo.

Fruits, nuts and greens are especially rich in folic acid.

Foods rich in vitamin C also contribute to the improvement of reproductive functions in women. In this regard, it is necessary to increase the consumption of citrus fruits, kiwis, apples, pears, wild berries, tomatoes, bell peppers and broccoli.

Experts recommend eating five servings of vegetables and fruits a day: three vegetables and two fruits. One fruit or vegetable is equal to one serving. It is also necessary to take vitamins.

These studies of the influence of nutrition on the probability of conception were conducted by scientists at the Harvard Medical Institute in Boston

Conception: Magnesium and zinc deficiency

Today we will consider the deficiency of magnesium and zinc: the problem of conception in married couples varies widely and has no tendency to decrease in all countries of the world and is 8-18%. Infertility in a married couple can be caused by several reasons, and therefore the diagnosis and treatment of infertility is a difficult and lengthy process. Special attention among the causes leading to infertility, both congenital and acquired, is paid to the connective tissue, which makes up the stroma of all organs and occupies about 50% of the body weight.

Connective tissue dysplasia (CTD) is a poorly studied condition, it has two types that affect the reproductive function. The first group includes diseases with hereditary collagen diseases-collagenopathies. The second group consists of undifferentiated CTD — this is a genetically heterogeneous pathology caused by changes in the genome due to multifactorial influences, which, in turn, can lead to various chronic diseases. The development of both hereditary connective tissue disorders (syndromic forms) and non-syndromic forms is based on mutations of genes responsible for the synthesis/catabolism of structural connective tissue proteins or enzymes involved in these processes, quantitative changes in the formation of full-fledged extracellular matrix components, fibrillogenesis disorders. CTD is a multi-level process, since it can manifest itself at the gene level, at the level of an imbalance of enzymatic and protein metabolism, as well as at the level of a violation of the homeostasis of individual macro – and microelements.

Magnesium and zinc are necessary for the full formation of collagen at all levels. Zinc is a basic element in the synthesis of collagen. The entire connective tissue system is built on it. With a lack of zinc, the synthesis of collagen in the body is disrupted, since zinc takes part in more than 80% of enzymatic processes, plays a major role in the production of DNA and cell division, contributes to the stabilization of the structure of RNA, DNA, ribosomes. Magnesium, in addition to its alkalizing properties, is an integral part of the enzymes involved in the formation of collagen. The effects of magnesium on connective tissue are not limited to collagen and collagenases.

Microfibrils and elastin are the main components of flexible fibers. The degradation of elastin fibers can significantly increase (by 2-3 times) in the presence of magnesium. Its deficiency corresponds to a lower activity of elastases and a higher concentration of flexible fibers. It is proved that the most common effect of magnesium on connective tissue is that the ions are necessary for the stabilization of non-coding RNAs. Magnesium deficiency leads to an increase in the number of dysfunctional transport RNA molecules, reducing and slowing down the overall rate of protein synthesis. Thus, its role is extremely important for the structure of connective tissue, which is one of the main bioelements that ensure the physiological metabolism of connective tissue. Despite the fact that magnesium is widely distributed in nature, its deficiency in the human population occurs in 16-42%.

The aim of the study was to evaluate the quality of the obtained embryos in patients with CTD when correcting the concentration of magnesium and zinc in the blood serum.

Magnesium and zinc deficiency

Materials and methods of research

The clinical study included in the observation group 75 patients with infertility on the background of CTD of varying severity, who were divided before the in vitro fertilization (IVF) program into two observation subgroups: subgroup I (n = 40) did not receive treatment, while patients of subgroup II (n = 5) underwent nutrition correction taking into account macro – and microelements: magnesium at a dose of 1500 mg/day and zinc 20 mg/day for 30 days before the IVF program, in the IVF program and up to 20 weeks of pregnancy. The main indications for IVF were tubal infertility, infertility associated with stage 1, 2 and 3 endometriosis, endocrine infertility associated with the absence of ovulation, and male infertility with mild sperm pathology. The comparison group is represented by 25 practically healthy women who have no problems with conception.

magnesium and zinc deficiency

The patients of the observation and comparison group were comparable in age and social status. The average age of the patients was 33 years with fluctuations from 25 to 45, in the comparison group 27 years. When analyzing morphoanthropometric data, it was revealed that the average height of patients with infertility was 162.5 cm, did not differ from the average height of pregnant women in the comparison group. The body weight of the patients in the observation group was 63 kg, did not differ from the comparison group.

Results and their discussion

From the anamnesis, it was found that every third woman – 21 (28%) had secondary and 54 (72%) – primary infertility. The duration of infertility in a married couple ranged from 2 years to 12 years, on average-6.1 years. 48 (64%) patients were diagnosed with tubal-peritoneal factor of infertility, 30 (40%) – reduced ovarian reserve, 21 (28%) – endometriosis, 3 (4%) – polycystic ovary syndrome. It should be noted that every third patient has a combination of 2 to 3 factors of female infertility.

All patients with CTD who have a female factor of infertility in the IVF program should study the concentration of magnesium and zinc (magnesium and zinc deficiency) in the blood serum and follicular fluid, with a decrease in the concentration of magnesium and zinc in the follicular fluid, treat using magnesium and zinc preparations for 30 days before the IVF program, in the IVF program and up to 20 weeks of pregnancy.

Stimulation of ovulation of PCOS. Part 2.

We continue our articles about pregnancy with a diagnosis of PCOS. You can read the first part here.


In Chile, a plenary session was held in 2002, the result of which was the first summation of data on the use of CC for ovulation induction, including in PCOS. It was noted that CC can be used in PCOS as monotherapy, in combination with gonadotropins, and in case of detected insulin resistance (IR) (using Caro and HOMA indices) — with metformin (MF). The main side effects of CC remain-the risk of multiple pregnancies, ovarian hyperstimulation syndrome and ovarian cancer. Later, studies began to appear in which it was noted that CC is most often ineffective at low doses in women with PCOS and obesity, and at higher doses (> 150 mg) it is often accompanied by hyperstimulated ovarian syndrome. And in such cases, a combination of CC and MF is more effective.

The important question remains, what is the percentage of pregnancy in women with PCOS during CC treatment? It was found that the restoration of ovulation with the use of CC occurs in 80%, and pregnancy-only in 35-40% of patients. The authors themselves associated this with the antiestrogen effect of CC at the level of the endometrium and cervical mucus. In addition, 20-25% of women with PCOS are clomiphene-resistant, and, as a rule, these are women with obesity, IR and severe hyperandrogenism.

Due to the need to discuss issues and summarize data on the treatment of PCOS in Greece, an ESHRE/ASRM consensus was held in 2007, which resulted in a synthesis of the data available at that time. The first-line drug was called CC, the second-line drug was gonadotropins, the next step in case of ineffectiveness of conservative therapy is the surgical method of treatment-electrocauterization of both ovaries (ECOI). The use of MF in women with PCOS should be limited and used only in those who have been diagnosed with a violation of glucose tolerance (HTH). The insufficient number of studies conducted in the field of biguanide use does not give a complete picture of this group of drugs for ovulation induction.

PCOS

In 2009, the data of a comparative study on the use of CC, MF and their combination for ovulation induction were published. The randomized study involved 115 women who were divided into three groups. In the MF group, ovulation was achieved in 23.7%, in the CC group-in 59%, and in the combination of these drugs — in 68.4%, the birth rate was 7.9%, 15.4%, 21.1%, respectively.

Due to the lack of algorithms for the treatment of women with PCOS (taking into account age, anamnesis of the disease, the presence or absence of IR, etc.), the age of initiation of CC therapy is determined individually for each patient. In 2009, Badawy et al. published the results of a study in which they showed that the earlier a CT scan is prescribed in women with PCOS, the more pronounced the follicular growth in the ovaries, the thickness of the endometrium will be and, thus, the percentage of pregnancy will increase.

to be continued…

Stimulation of ovulation of polycystic ovary syndrome

Today we are starting a series of articles about the ovulation stimulation of polycystic ovary syndrome, we are publishing the first part.

Polycystic ovary syndrome (PCOS) is the most common form of endocrinopathy, it occurs in 5-10% of women of reproductive age and accounts for 80%, and according to some data, even 90% of all forms of hyperandrogenism.

The classic picture of PCOS, or sclerocystic ovaries, was described by Stein and Leventhal in 1935 as a syndrome of amenorrhea and enlarged ovaries, combined in 2/3 of cases with hirsutism and in every second case with obesity. However, later it was noted the existence of a wide variety of forms of the syndrome, manifested by a significant variation in the clinical picture of the disease, the endocrine profile and morphological features of the classic syndrome, in connection with which the term “polycystic ovary syndrome”was proposed. In recent years, the concept has been put forward, which has received universal approval, that the clinical manifestations associated with PCOS should be interpreted precisely as a syndrome, and not as a disease, this is a more accurate and specific term.

The etiology and pathogenesis of PCOS are still not fully understood, despite the huge number of studies devoted to this problem.

Ovulation stimulation and the Rotterdam Consensus

The final document of the Rotterdam Consensus (2003) stated that PCOS remains a diagnosis that requires the exclusion of other known disorders that manifest themselves as universal clinical signs of hyperandrogenism, and therefore can mimic and occur “under the mask” of PCOS. While PCOS itself is a syndrome of ovarian dysfunction (irregular menstruation, anovulation, infertility), the specific manifestations of which include not only hyperandrogenism, but also the “polycystic” morphology of the ovaries. Thus, for the first time, an agreement was reached on the need to give an ultrasound assessment of the size and structure of ovarian tissue a significant diagnostic criterion.

ovulation stimulation

According to the consensus, the presence of at least two of the three criteria makes it possible to verify the diagnosis of PCOS after excluding other conditions. Thus, on the one hand, in terms of examination, PCOS remains a syndrome (a complex of symptoms), the identification of which is impossible and unacceptable on the basis of the isolated presence of any single diagnostic criterion. On the other hand, a simple analysis of the pairwise combination of modern criteria allows us to draw a fundamental conclusion about the need for an expanded interpretation of the term PCOS. This is due to the additional inclusion of new clinical forms in its definition, namely: in the absence of another hyperandrogenic pathology, the diagnosis of PCOS is permissible not only in the classical course (a complete triad of signs), but also in the presence of one of three incomplete (non-classical) clinical and instrumental duets.

It is known that PCOS accounts for 56.2% of all forms of endocrine infertility. Currently, it is believed that the main ways to restore fertility in patients with PCOS should be considered assisted reproductive technologies( ART), the purpose of which is not to treat a woman, but to achieve pregnancy in a specific cycle of ovulation stimulation. The concept of ART includes not only methods of in vitro fertilization (IVF), but also conception in a natural way as a result of various methods of ovulation induction.

The leading link in the structure of assisted reproductive technologies in PCOS is the induction of ovulation. For this purpose, various medications are used individually — derivatives of chlortrianisene – clomiphene citrate (CC) and its analogues, combined oral contraceptives, gonadotropins, gonadotropin-releasing hormone analogues, insulin sensitizers, aromatase inhibitors.

The drug of choice for anovulation is considered to be CC, which was first synthesized in 1956 by WS Merrell for contraceptive purposes. Initially, CC was used for endometrial cancer during the preparation of patients for surgery, but during surgical interventions, yellow bodies in the ovaries and secretory transformation of the endometrium were accidentally discovered, which served as the basis for the use of CC as an ovulation inducer, and since 1967, the use of the drug in patients with anovulatory dysfunction began. Is CC a first-line drug for the treatment of infertility in women with PCOS? This question has arisen throughout the use of this selective estrogen receptor modulator, and there is still no clear answer: whether to use it as monotherapy or in combination with other drugs.

to be continued…