Welcome to the latest series of Fertility Foundations, where we speak in depth with expert guests about how to prepare the foundations for healthy pregnancy. This week Sandra Greenbank is talking to Sarah Laver, Nutritional Therapist and founder of The Embryologist Nutritionist, about embryology and improving egg health. 

After working as a clinical embryologist in IVF clinics for many years and seeing couples struggling with their fertility, Sarah was finding it difficult to offer alternative ways to support them on their journey. Through studying psychology and personalised nutrition, she discovered the transformational impact that diet and lifestyle changes can provide, especially when behaviour change is supported. She is now on a mission to share her knowledge supporting those trying to conceive. 

Sarah is a BANT-registered nutritionist and registered Nutritional Therapist, specialising in assisted conception, support and fertility. She’s the founder of The Embryologist Nutritionist, helping couples and single females regain control of their fertility and maximise their chances of a healthy pregnancy. Sarah takes a holistic view of a client’s situation and together they create a bespoke personalised plan that works for them and what they need. 

Listen to this episode of the Fertility Foundations podcast with Sarah Laver here.

Find Sarah here: www.theembryologistnutritionist.co.uk
and on Instagram here: www.instagram.com/the_embryologist_nutritionist

Sarah has produced a free guide explaining the acronyms and terminology you’ll come across in the world of assisted reproduction. You can download a copy here: https://bit.ly/IVF_terminology

Our sponsors for this episode of Fertility Foundations are NeoVos, a UK-based lab that provide at-home health tests and cutting edge analysis. Knowledge is power and in my opinion, you need to always check not guess your levels of Omega 3 and vitamin D so that you can supplement correctly if you need it. I found the novice test really easy to use and affordable. The team at NeoVos have kindly offered Fertility Foundations listeners a 10% discount by using the code FERTILITY at the checkout. Visit the NeoVos website for more information.

Podcast transcript

Sandra Greenbank  00:04

Sandra 0:04 

Hello and welcome to the Fertility Foundations podcast, where we go into detail about how to prepare the foundations for healthy pregnancy. We dive deep into the underlying root causes for fertility issues and natural solutions. I want you to know that you’re not alone and you’re not broken. I hope that by sharing these episodes that will help you move from feeling overwhelmed and lost to feeling hopeful and empowered to take charge of your own path to parenthood, because there are actually lots of things that you can do to help rewrite your own story. 

I’m Sandra Greenbank, nutritional therapist, functional medicine practitioner, coach and educator, specialising in fertility, pregnancy and postpartum health. I’m also the founder of the Fertility Nutrition Centre, where you can find fully trained experts in nutrition, lifestyle and functional approaches to a healthy fertility and pregnancy. You can find more information over at www.fertilitynutritioncentre.org and also book in a free strategy call with one of our experts.

Today I’m speaking to Sarah Laver about what you can do to improve your egg health. After working as a clinical embryologist in IVF clinics for many years seeing couples struggling with their fertility, Sarah was struggling to find alternative ways to support them on their journey. Through studying psychology and personalised nutrition, she discovered the transformational impact that diet and lifestyle changes can provide, especially when behaviour change is supported. She is now on a mission to share her knowledge supporting those trying to conceive. Sarah is a BANT registered nutritionist and registered nutritional therapist specialising in assisted conception, support and fertility. She’s the founder of The Embryologist Nutritionist, helping couples and single females regain control of their fertility and maximise their chances of a healthy pregnancy. Sarah takes a holistic view of a client’s situation and together they create a bespoke personalised plan that works for them and their need. 

Before we get into the interview, I wanted to talk a little bit about our podcast sponsors, NeoVos. They’re a UK lab that provide at home health tests and cutting edge analysis. I personally like the vitamin D and Omega three tests, which are absolutely crucial to get right for anyone trying for a baby. Knowledge is power. In my opinion, you need to always check not guess your levels of Omega three and vitamin D so that you can supplement correctly if you need it. I found the novice test really easy to use and affordable so the NeoVos team have kindly offered our listeners a 10% discount on their website using the code FERTILITY at the checkout. Their website is simply www.neovos.com. All of these details are also in the show notes for you.

Now let’s get into today’s interview with Sarah. Hi, Sarah, thanks so much for joining me on the podcast. 

Sarah 2:47 Thank you, Sandra lovely to be here. 

Sandra 2:49 So you’re one of our wonderful Fertility Nutrition Centre practitioners and all of them have, you know, something amazing and incredible, incredible that they bring to the group and you are you know what a really kind of unusual practitioner in that sense, because you actually have a really strong background from the IVF world. Yep, no, I 

Sarah 3:15 am quite unusual in that respect. I suppose I worked in IVF clinics throughout the UK for 11 years. And yes, my understanding of those laboratory techniques and the sort of laboratory side of everything and the intricate workings of the IVF clinic is is a you know, it’s probably maybe more than than other nutritionists. And I was there day in day out doing the connections, the embryo gradings scene analyses. So I have seen it from that side of the scenario as well. Yeah. 

Sandra 3:54 And so let’s go straight into the talking about egg health. That was the split, which is what I’ve convinced you to come on to talk to me about today. So because that was your job, you were looking after those eggs. Yeah, and making sure that they were kept as healthy as possible and monitoring them and then you know, choosing the right one. So can you tell me can you tell me a bit more about what happens in the lab? 

Sarah 4:19 Yeah. So with the with the collections that are carried out in the laboratory theatre, and there will be a clinician will be carrying out the process and then there’ll be an embryologist next to them as well. And we are looking through the follicular fluid that they train to identify the eggs. And at this point in time, the eggs are surrounded by all their nurturing cells are called the cumulus cells, which is a bit like fluffy fluffy cells around them and that’s how we identify the eggs and then separate them. So at the point of a collection, there isn’t much that you can tell about those eggs. Only a very general idea and it’s either the eggs think I’m back to the laboratory. And if someone was having straightforward IVF, then later in the day, there would be small amounts of a prepared sperm sample placed next to the next to the eggs, where they are in the dishes. And then it would be the next day when you take away those surrounds themselves to see whether the extra fertilised if someone’s having the procedure called exceeds the intracytoplasmic sperm injection when someone might have a lower sperm count or poor morphology, so the embryologist is having to inject the sperm into the eggs, then in order to do that, they have to already strip away those surrounding nurturing cells to be able to assess for the extra mature. And so the same day as a collection that’s under the afternoon. And at that point, when those cells have been taken away, you can get a really good look at the eggs. And you assess whether they are mature, you’re only able to inject eggs that are mature. And you’ll have an idea of the quality as and when we talk about air quality and embryologist would have a different view on what air quality is compared to a wider understanding. So when an embryologist talks about a quality, they are literally talking about what they subjectively see an egg to look like. So that that can vary. Sometimes eggs are quite dark and granular. Sometimes they might have some artefacts within them. So little structures, things called vacuoles. Or refract our bodies, which is a little dark specks. The shell of the egg zone of Mooster might be very thick, it might be sort of abnormally begins in certain places. So it’s those kinds of things that the embryologist would talk about in regards to egg quality 

Sandra 6:57 at that stage. Yes, at that stage. Yeah. And then I know that there’s lots of sort of different tech that can be used and different mediums that dish kept in and you know, there’s a bit of debate about whether, you know, there’s food that can be added, and you know, all of these things. So what happens? What happens then once you’ve sort of assess them? And you know, on that first day 

Sarah 7:24 to see whether they fertilise 

Sandra 7:27 and then use it. Yeah. 

Sarah 7:29 Yep. So the next day so that the day of the collection, they’re either injected or their place with the sperm, whether it’s IVF, or exceed the following days when they are checked, fertilisation techniques have moved on a little bit since I worked for the advisory. So now quite a few clinics use something called an embryo scope, where they are continuously monitoring the development without the need to remove the dishes from the incubator. And so when someone has exceeded that might be the case, because the the X could be an individual for drops. And so they just record or they fertilise and they can then just leave them in the incubator and they just wanted to develop the next few days. If they were from IVF, they will be moved to fresh media where there isn’t any spam around them anymore. And then again, they could be monitored on a daily basis. From that. I mean, that monitoring of everyday developments is altering crazily with artificial intelligence coming in. And yeah, the different techniques that will be brought in the future are brilliant. 

Sandra 8:39 That’s fine, just saying. Yeah, yeah. 

Sarah 8:41 So yes, the culture media isn’t always changed too much. It’s just depending mainly on how they were fertilised in the first place. 

Sandra 8:51 Okay. And so you mentioned that the embryologist will look at quality in one way and then is there like, in your your understanding of this sort of concept of equality? What what is it we’re looking at in terms of when we’re say you’re working from an T’s point of view now? 

Sarah 9:10 Yeah. Yeah. So my understanding I carry now of a quality is so much bigger than what you just see. Because what you see down a microscope doesn’t tell you anything about the DNA. So the chromosomes that hold the jersey material within the egg, it doesn’t tell you anything about those. And the quality of the DNA, the integrity of the DNA, plays such a large role in a whether that egg will fertilise where if it just fertilise how that embryo embryo may develop, would it develop on to a healthy pregnancy? And it’s that quality of the DNA that we can’t assess in the laboratory? By looking down at microscope. There are procedures that you can do when the embryo develops further and biopsy cells. Look at the chromosomes at that point in time that some people do their pre Implantation Genetic screening, the aneuploidy screening, but that is that’s how my interpretation of quality is it’s how how integral the how, what’s the word I’m looking for the just the the integrity of the DNA. And also other structures within the egg, that you can’t assess that a microscope, there are some sort of powerhouses called mitochondria, then these little structures in the minute you can’t see them, but they generate a release the energy that the egg and the embryo needs to develop. And if there’s mitochondria may not be functioning properly, then they may not be able to generate all that energy and embryo development requires a huge amount of energy. And again, that sort of comes under how I understand the term egg quality to mean it’s the quality of those mitochondria and the integrity of the DNA. 

Sandra 11:07 And it’s so important, isn’t it to consider the mitochondria actually does. We every cell in our body has one. And with age, they do begin to function less well. They’re also impacted by things like stress and toxins, your environment, they need certain nutrients. And so it always comes back to everything that we do anyway, isn’t it? You know, in terms of looking at the cellular health of every cell in your entire body? 

Sarah 11:37 Yeah, yeah, exactly. The eggs. And sperm are no different to any other cell. And they do, they do need the nutrients to come that we get from our food, to support them for their efficient functioning, and for their development. Yeah. 

Sandra 11:55 And so I would say the majority of my clients who’ve had IVF, will have been told if they asked the clinic, if there’s something they can do to support their own capital to improve their health, they usually are told that there’s nothing that can be done. And it’s just a case of trying a different protocol, or you know, something else that they would do in the lab that is taken out of your hands in the sense. But what do you do you subscribe to this idea? And I sort of assume that you don’t. But you know, why is it that that’s the situation in clinics? And why do you have a different approach to that? Yes, 

Sarah 12:34 it is something that a lot of people do get told. From an antique point of view, it’s very frustrating. I think why it comes about why people say that is when someone was born biologically female, you’re born with all the eggs that you’re going to have your entire life. And whether it’s from that respect, why some people say there’s nothing you can do the extra already that you can’t, can’t improve them. And those eggs are essentially held in a sort of suspended animation for a certain amount of time. And then every now and then a bunch of them start their final maturation to then eventually in a natural cycle for one to be isolated. And that you know, final stage of maturation is around about three months or there abouts. Obviously an IVF its influence the number of those follicles and eggs that will do that final maturation is increased due to innovation. But in that sort of final maturation period, they are very, very vulnerable at that point of their development. And how an egg grows is it’s it’s, it’s held within a follicle and it has, as I mentioned earlier, these nurturing cells around them. And there’s a huge communication between the egg and those nurturing cells. And these nurturing cells are how the eye perceives its nutrition and receives its nutrients. And you just touched on the fact that yes, and mitochondria need a lot of nutrients to be able to generate the energy. And there is so much that can be done to support that x development. And those final stages of maturation because it is very energy requires a lot of energy required for that. So we want to be making sure that there’s a lot of good nutrition being received by those eggs. Also, the body has lots of processes that undergo are undergoing all the time. And these can generate some inflammation in the body. We have an amazing antioxidant system within our own body, which counteracts any inflammation that that happens, any oxidative stress that occurs from these processes. But sometimes people have higher levels of inflammation, either due to stress in their life, poor diets, their working environments, many many different reasons can infectious illnesses, please Can all raise the levels of inflammation in the body to the point which tips a balance and our own body’s antioxidant defences can’t manage that. And when that happens, there’s a risk to any cells within our body. But we’re talking about x today of that oxidative stress, that inflammation damaging the DNA of the cells, damaging the membranes of the cells, which can then impact and impair that communication between the the egg your site, and its relevant cells. And so nutrition, what someone’s eating, how they live, their life, their lifestyle, sleep, all of these can work towards improving the level of antioxidants within the body, and trying to decrease that level of inflammation. So there are those definitely things that people can do to impact and improve the quality of those sites. And, yeah, this is something that just isn’t considered by speaking very generally here. But by a lot of clinicians, this is something that isn’t really considered to be a benefit. But many studies have shown that, that there is a positive impact from from looking at these things. And especially with sleep, sleep is something that a lot of people maybe don’t think about, but studies have shown when there have been shiftworkers. The disruptions, they’re sort of inbuilt circadian balance, when that is changed and improved. There are improvements in utility and hormonal balance. And that sort of success with IVF. So there are many factors that can be used to improve like health, the definite and 

Sandra 16:53 that makes so much sense with the sleep doesn’t it because we know that melatonin is, you know, sleep hormone, but it’s also it’s a, it’s a great antioxidant, and your ovaries love it. So, you know, and that’s not to say you should go out and buy melatonin and put, you know, put it in artificially, but actually working on making sure that your stress hormones are not suppressing the melatonin and making sure that you’re producing enough by going to sleep at a good time and, you know, focusing on fixing sleep issues, if you have them, you know that that in itself can be really helpful. And also, you know, if you’re looking into sort of genetics, and your genetic, your, your detox potential, for example, and your potential, you know, everyone has a different genetic makeup, and, you know, baseline I suppose in terms of what they actually can and can’t make in terms of endogenous antioxidants. So sometimes you just have to sort of focus on, you know, whatever, whatever it is, obviously, you know, detox mechanism for anti oxygen production, nutrient absorption and all these things, and it’s just sort of one size doesn’t fit all does it 

Sarah 18:05 either. Yeah. Yeah, yeah, definitely. I mean, we are all individual, and we’ve all got unique makeups. And yeah, that’s why working with a health practitioner can really come in to take a deep dive into your own situation and investigate those things if they felt necessary. Then personalised. Your interventions, patients. 

Sandra 18:27 What do you think, though? So what should you do if you’ve been told you’ve had a cycle, you’ve had maybe a couple of cycles, and the clinician says, Well, you know, you’ve just got poor air quality. We’re just have to it’s just, it’s a numbers game. Maybe that’s what they get. That tends to be what they’re told. It’s a numbers game, we’ll try again. What would you say to a person who’s sitting at home now listening and in this exact situation? 

Sarah 18:49 I would say don’t feel despondent. First of all, there are definitely areas that can be investigated and looked at. It’s trying to get out with whether your hormones have been properly investigated, because when there are slight hormonal imbalances, those can have an impact. And it’s not always something that a clinician would do to a very comprehensive look at those investigating your nutrition, your dietary pattern. Potentially, there may be some gaps that need more support, you might need to focus nutrition more on some food groups more than others. There are some potentially conditions like asthma metrio, sis PCOS which can carry a higher level of inflammation. So again, in those kinds of conditions, it might be that more support is needed to be provided through nutrition through maybe extra supplements. And you touched on this genetic side there are different genetic panels that can be investigated. To see again, it’s So how to plan nutrigenomics. So is looking at different variations in someone’s DNA that can be supported through nutrition. So someone potentially doesn’t map relate very well. And methylation is a process that is essential for detoxification, but also for DNA synthesis for growth, to study live regeneration, so it’s really important for all of that. And there are ways that we can investigate whether there are sort of variations of the genes which are impacting next would be the methylation cycle, and therefore we can support them different ways. But I think, sort of general purpose listening to this, it’s, I would obviously say, you know, maybe seek out Health Partners practitioner to give you some guidance. And to sort of identify if there might be an area that could be out of balance, or putting some more focus on what’s actually pointed you, one of the best things you can do is increase your intake of antioxidants. And that the way to do that is increasing those fruit and vegetables that you’re eating, and especially going for a variety of colours. So your listeners undoubtedly will have heard about eat the rainbow. And it’s not just a tap away, saying it really really does carry some some rigour with it, because the different colours that those vegetables have come from the different chemicals for polyphenols, they all have different antioxidant and anti inflammatory properties. So the more colours somebody can eat, the more they’re going to be supporting their body and their antioxidant supply. And you can also by including extra virgin olive oil in your diet that has very good antioxidant properties as well. And we’ve mentioned sleep, but stress is something that I feel everybody nowadays is impacted by stress, it’s something that is ubiquitous, we can’t avoid it. And it’s not telling someone Yes, you just got to stress less, because that’s just impossible. It’s more in my opinion about how you manage stress, and ensuring that you’ve got certain strategies in place that will allow your body to move out of that fight and flight system. When we are racing around, we’re looking at emails where we’re dealing with so many million one things at the same time, it’s important to have time every day, when you try and take yourself out of that and put yourself more the rest and digest in the palm bays. And strategies for one person will be very different to another. But they may include things like reading, meditation, yoga, breathwork. And if you have a stressful job, it might even be when you go to the toilet, you’ll sit there for five minutes and just do some deep breathing, regulate points throughout the day, just little things like that, I think would really, really help improve your levels of stress, which would reduce your inflammation. And along with the other things that I’ve mentioned, and I touched on all of those are going to work towards improving our health. Are those are things that everybody can do. You don’t need to work with somebody working with somebody can fine tune and investigate different avenues. But if we’re not able to work with a practitioner at the moment, then there are lots of things that you can be doing by yourself. 

Sandra 23:36 Yeah. And it’s, you know, you touched on stress. And I think that, you know, I personally just hate telling someone that they have to stress less, or that stress is impacting their fertility. And it’s sort of almost implies that you can think yourself pregnant. But, you know, that’s not what we’re talking about here. And it’s not the avoidance of stress, because stress is a part of life. But actually the study is the very the studies I’ve seen on stress is, you know, does illustrate that actually, it’s not removing the stress as important is actually dealing with it just like you said, it’s finding the ways to deal with it, and whether you know, that’s working with you as a coach, or whether it’s seeing, you know, a counsellor, or joining a yoga class or whatever it is, or even having some CBT if there’s something particular in particular, that’s sort of really difficult in your life, aside from the fertility struggles, of course, but yeah, I think that’s really important message that, you know, we can’t avoid it, but it’s about learning to cope with it better. 

Sarah 24:41 Yes, yes. I mean, it is it’s everywhere around us, and it is just making sure those strategies are in place. And, and yeah, seeking out that extra support from people if you feel it’s necessary. 

Sandra 24:54 Yeah. And so, so you mentioned about you know, the things You can do in terms of eating better and and sleeping better. But what did some of the things that you that we should avoid 

Sarah 25:07 the one of the biggest things for creating inflammation in the body and negatively impacting the account was smoking. So that’s I would imagine when people are going through fertility treatments is something that they may have already addressed as well. But it is imperative to mention, and if there are other people in the house that are smoking, it’s very important to be aware of foods that are potentially negative towards alcohol, is if someone’s having a very high sugar diet, because the morning sort of takes in a lot of sugar, again, high sugar in the bloodstream, can lead to inflammation. And, and that is something that blood sugar balance is really, really important to keep in check. And to be very, very aware of, because we don’t want the sugar to be really high in the blood for a prolonged period of time. Obviously, whenever somebody eats a carbohydrate rich foods, that blood sugar will rise. But it should be done in a controlled way with the body reacting to that without having some very high peaks and low tracks. So reducing the amount of sugar in the diet is one approach to be considering. And sugar isn’t always just in additional sugar, say the chocolate bar, it can be someone’s having what they feel is a healthy drink at breakfast time, like an orange juice, that is the fibres been taken out of the orange. So you’re literally having a big hits of burritos and sugar in the morning. So it’s sort of considering where the sugar might be coming from. And also processed foods can contain different fats and trans fats. And these are things again, that can impact the level of inflammation in the body, and can and can have a negative impact on the facility. So when I talk to people about how to look at that their nutrition and their dietary pattern, it’s really going back to thinking about Whole Foods trying to think of when you go into a supermarket, you’re looking at the fruit and the vegetables stands, you’re keeping away from the freezer section, because that’s normally all packaged and processed, you’re going to the fish and the meats, or the if someone’s vegetarian or vegan, then you’re going to burn the mushrooms and the things like chickpeas and beans, and thinking more about putting your meals together with those foods being the main part and reducing any of the processed foods, anything that has more than about five ingredients or anything on the ingredients label that you wouldn’t be able to just go and pick off the shelf, those are the things to really be avoiding. Because they can all have inflammatory impacts on the body. And inflammation is it just tends to be at the heart of a lot of people’s fertility problems. So it’s really looking at how to limit any of that inflammation. So yes, from a nutritional point of view, those are things to be trying to reduce. And toxins as well. They are within our environment all around us. There are lots of toxins that can impact on hormonal balance. So it’s looking to reduce your exposure to those kind of toxins that maybe a flooded plastic where you might have in the kitchen, plastic bottles, and trying to use things that aren’t plastic and not putting anything passively the microwave or the oven. And that exposure as well. 

Sandra 28:49 Yeah, because they actually can act like the compounds can act like hormones. And you know, it’s not about choosing BPA free plastics, because there’s still other plastics that are not good for us. And they’re just as bad so and also it’s in the air that we breathe, it’s in the food that we you know, it’s pesticides. So, you know, it’s a good idea to try and avoid pesticides, isn’t it, you know, eating organic, if you can, it can be more expensive, but then, you know, the solicited the clean 15 and the Dirty Dozen, which you can just easily Google that helps you to sort of really understand what foods are more important to buy organic instead of actually, you know, for example, apples, I don’t if I can’t find organic apples, I actually just would rather not buy them. Whereas some foods not so important. So you know, just being a little bit more aware of where the toxins might be hiding. Yeah. 

Sarah 29:43 Yeah, that’s definitely great advice. Because yeah, organic food can be much more expensive. So knowing the worst offenders and the ones which are unlikely to be okay is definitely a great place for someone to start. And I think they print a few go and you google them On information, you can even print off little pieces of paper to put it in your purse. And when you’re shopping, you’ve got quick reference guide as well. 

Sandra 30:06 Yeah, exactly. And I think, you know, not only does organic food actually contain less chemicals or less, potentially harmful chemicals, but actually, they tend to also have higher nutrient content as well. So you know, you, they might be more expensive, but you’re getting more value from Yeah. Yeah. And also eating locally, and seasonally does help as well. Because, you know, again, it’s just gonna have more nutrients in it if it’s been picked when it was ripe. 

Sarah 30:41 Yes, definitely. I mean, that’s what we’re recording this in the autumn. And that’s what I love at the moment is the apples are out on the trees. The hedgerows are full of blackberries. And so even just being able to go out and pick things like that, as well as just that I just, I love this one with you, and you can go out and eat seasonally. 

Sandra 30:59 Yeah, you’re right. And actually, another thing that’s in season right now is pumpkin. So it’s about to be and you know that the compound that gives pumpkins to orange colour is beta carotene. And beta carotene is so good for your follicles, aren’t they? 

Sarah 31:16 Yes, yeah. Yeah. And it’s great antioxidant. So, I mean, that’s the thing, if you’re able to grow your own as well, I mean, obviously, it takes time for that, you know, for you to grow your vegetables, but it is something that’s always good to have the back of your mind. There’s no better feeling than going out into your, your little veggie garden and picking some spinach or picking whatever you’ve got. And then you know, that there’s nothing that’s been put on that you wouldn’t want been put on it as well. 

Sandra 31:42 Yeah, I mean, I’m a huge fan of growing my own, and I’ve got my own allotment, and it’s so much fun. I mean, I’m mostly I’m mostly growing weeds, but you know, getting there, just trial and error. So how would you say that your experience as an embryologist has benefited you or informed your work as a nutritional therapist? And 

Sarah 32:05 my training, obviously, I had to learn is that about sperm about embryos, developments, eggs, and and all the techniques involved. So it supports me a lot with my clients, because I can understand the process that they’re going through. And that enables me to empathise with them greatly about their experience and what their expectations can be. And, yes, that’s, it definitely does help me guide them with questions that they might that might come up. And some of that I learned about, you know, how the membranes communicate, and, and a lot of that does involve different nutrients that come through food. And so my brains always thinking, Okay, well, is there something wrong there? Do we need to if something if something’s not fertilised? Or is there some communication issues you need to diet to make sure they’re getting enough of one nutrient or another? And so I think having that knowledge, in depth knowledge of those mechanisms sort of, does make me think a little bit more when I’m looking at someone’s nutrition. But it is having that understanding of the treatments and the directions that the clinic might put somebody in and being able to give my opinion on what may be best, are there any options? Do they have to go straight to xe, is there something else that could be done to improve sperm counts? We’ve also talked in depth about improving our health day, but sperm also are things that can there’s huge improvements that can be made in that respect from the community attrition as well. So it really, I think that’s why the main benefit comes, and how that sort of helps us support my practice. 

Sandra 33:58 I mean, we’re constantly asking you about, you know, clients, reports that we’ve got, you know, obviously always in an anonymized way, but, you know, you can read this reports that sort of a gobbledygook to the rest of us, but, you know, and also, I imagine that you can spot patterns, if someone’s had several rounds of a collection, and then, you know, looking at how that grading has been impacted by, you know, whatever they were doing. So, you know, I mean, I imagine that’s really useful to know, and also, you know, knowing how to coach people what to say to their clinician, as well. You know, how that might be received in the clinic, because, you know, we’re all it can be a little bit difficult to sort of, send your client back with a letter or with a message to, you know, can we put a lot of gear, can we postpone treatment, or can we do this or can we check this, you know, and it’s just sort of having that insider knowledge, I suppose, of the workings of a clinic, 

Sarah 34:53 I think as well, it’s sometimes patients that might be a clinic aren’t given a huge amount of details about their embryo developments, or that there might not be that they’re not given them, but they don’t, because so much is being told to them in an emotionally high state, they maybe don’t take a turn. Yeah. So it’s always ensuring that they ask for help make copies of their notes of embryo development, because there’s a lot that can be gained from seeing how embryos have developed over a number of days in the laboratory, have they slowed down after day three is that development has it continued all the way through to sort of weather changes at any given point in time, because that can all give little indicators because the up to day three of embryo development, a lot of that developments enter the control from proteins and molecules within the egg. But then the combined embryonic genome, which is the maternal and paternal chromosomes really switches on day three. And if there is an issue with that, then you might find that embryo development past a three isn’t as optimal as possible, or the embryos were stopped developing, even. So it’s really understanding what actually has happened, and what that looks like. And so it’s encouraging clients to ask for that information, so that they can understand that a bit more, that might be like that, you need to investigate the partner a little bit more from the point of DNA fragmentation, there could be something there that might be hampering the embryos development. 

Sandra 36:26 I mean, it’s never the effort of one that’s gonna, you know, takes two to tango. And, you know, we’re all always singing from the same hymn sheet there. But, you know, you don’t always have access to the male partner to change it, you know, you might be stuck with using frozen sperm for whatever reason, or, you know, your partner might not be your male partner might not be interested in, in in the treatment. And that’s, that’s okay. But is it true that a really healthy egg can sort of overcome a little bit of what may be an issue in a male partner sperm? I’m sure have heard this. 

Sarah 37:04 Yeah, yeah. So there is the ability sometimes, when the cell divides, that any that maybe don’t have the normal chromosomal arrangement, they can be improved. And, and it can cope that certain amount that the embryo as it develops, can help. I wouldn’t be able to say at what level that is, but there definitely is a point at which the embryo can crowd out, especially the blastocyst as well, it can crowd out any cell that might not be chromosomally normal, should we say? Yeah. 

Sandra 37:43 And I mean, I know that you obviously you love working with women and couples who are preparing for IVF IVF. But I know that you don’t work just with the female partner. And also, you know, the male, just talk to me a little bit just briefly about sperm development. And I know this is a separate podcast in and of itself, but obviously, it’s going to be affected by the same factors as the egg. Yes, 

Sarah 38:09 100%. So again, you have that three months to pick out that sort of bandied around by lots of practitioners. And that’s because the process of sperm production, so men are different to women in that a new batch of sperm is produced every three months. So if someone was to make changes to their lifestyle or their nutrition today, then it’s the sperm that are ejaculated in three months time, that will have benefited from this change changes largely. And as the sperm developing in the testes, they are very, very vulnerable to changes in their environment, just as the eggs were vulnerable to changes around them. And all the factors that we’ve talked about the inflammation, smoking, nutrition, stress, all of those can impact potentially the development of this firm. And that might be that it impacts negatively on the morphology or the shape of the sperm. It might impact on how many sperm are produced and so the concentration of the sperm sample or it may impact on the motility so the number of sperm are moving and the motility was found comes later on said sperm are produced and it’s when they are being held in a holding stage and the epidermis that they gained their motility and so at that point in time, if they are exposed to inflammation or lack of antioxidants or any kind of oxidative stress at that point, that as as the level of oxidative stress exposure increases, and there could be negative impacts on motility as well. And there are many other like you say it’s a whole podcast itself, but there are many other ways that sperm quality may be impacted either through heat exposure in factions through blockages there There are many things. So I know when I work with a male, there’s a huge history taking that goes on to try and identify if there have been any injuries in or in lie. If the female partner we normally investigate for any potential infections in the vaginal microbiome, because if there are, they’re normally passed between the couple of having intimate relationships. So if the female heart was an infection more often than not the male will and vice versa. So yes, there’s there’s a lengthy history taking that’s normally done to try and identify that particular, weaker areas that might be supporting or investigating further, that could be impacting on the sperm quality. 

Sandra 40:40 Yeah, and it’s really important, isn’t it? So I promised I would try and keep you know, more than 45 minutes. And I think that mark, but I just wanted to finally ask about because I know everyone’s sitting and going, what about supplements? So, you know, I want to preface that by saying, you know, never self prescribe any supplements, you have to work with a professional but, you know, there are obviously books and there’s lots of marketing, flying around about supplements and what’s your opinion on supplements? 

Sarah 41:10 Yes, I mean, supplements definitely do have a place to people, like you say, it’s all it should be done on an individualised basis, especially when people have varying health conditions and requirements. I would always suggest, when a woman is trying to conceive, they are always advised to take folic acid or folate. So this has been a hugely debated topic, or should it be folic acid, or should it be meat, our folate, which is the methylated version? And it’s very confusing for people when they are reading about it on Google or being told by their doctor to take folic acid and not knowing what to do? The shortish answer is that the methyl folate is the active form that the body will use. And folic acid will get turned into meat or folate eventually in the body. But a lot of people carry genetic variations that kind of form a bottleneck and slow down that processing. And so somebody they’re taking folic acid might not be having the levels of methylfolate that their body needs. So I would always recommend a female to have a comprehensive prenatal or fertility supplement that contains a methylated folate, not a folic acid, and the recommended levels and minimum of 400 micrograms of methyl folate. So there are a huge array of poor quality Maltese out there. And so again, that’s something that someone might say, Oh, how do I know what’s a good quality multi, but it’s it’s one that has very good levels of different nutrients within it carries the methylated, B vitamins, the nicop, folate and methylated B as well. And that would be a very good starting point for anybody who’s trying to conceive to supplement their diets always focus food first. But having a really good multi is a very good sort of backstop and to provide extra support. And vitamin D is again, it’s something that’s recommended on the NHS, but we should all be supplementing and potentially throughout the year as well, because we’re someone when we can normally get vitamin D made in our skin from the sunshine. But quite often what we will be doing is putting some cream on and then that stops that vitamin D being made. So you might not actually be making much of a smoothie in the summer if you’re using barrier suncream or you’re covering up. But with vitamin D, it’s, you can have too much. So there’s certain nutrients that can become toxic in higher levels, and vitamin D is one of those. So my recommendation would always be for someone to be tested first to test don’t guess, be tested and be advised on the dose of divestment, this would be best for you to take. And then a third supplements that I would potentially recommend to people is an Omega three. So when we discussed diets, I would normally be advising people to be eating oily fish getting their Amiga three fats. The omega three fats are really really important one as an anti inflammatory, but two, they form in the cell membranes, so all our cells in our body will have these fats within them. And when you think about an eggs, membrane and outer sort of shell that’s really important for communication with those nurturing cells. It’s important when the sperm goes to meet the egg, it needs to be flexible, in order to allow the sperm in and for that communication to take place. So you want to be having a good level of Omega three either from your diet, or someone is not eating or doesn’t like what you fish or doesn’t eat fish. They’re looking for a really good quality and maybe three supplements. And it’s important that they’re quality tested, because you can they’re not cost tested, you can sometimes have high levels of heavy metals such as mercury, and then proceeds can accumulate in the fish. So, it is important to be making sure that your supplier is processing all of that products. If you’re not getting that in the industry through your diet, and you can get some of these omega threes from plant foods such as flax seeds, but you, your body has to do a lot of conversion when you’re eating those, and you wouldn’t be eating enough of them to be getting it purely from from that. So is either looking at your oily fishes that your salmon, mackerel, sardines, anchovies, or having a very good quality and the three succulents, which is often the safer way to approach it. So those are really my top three supplements that most people should be able to take from a safety point of view. But again, it is always good to get advice and check with the health practitioner first. 

Sandra 46:03 Yeah, and I suppose that that message changes if somebody is on any type of prescribed medication and medication, that is not the case that is going to be safe for most people. But yeah, I agree with you. That’s kind of like the baseline. And then we sort of pick and choose on top of that. And, you know, the multivitamin, like we there are so many on the market. And you know, there is, again, there’s not one size fits all, you know, we’re always looking for one that’s got more or less iron, or more or less B vitamins or you know, depending on the person, so we always have to still choose but you know, and yeah, I think also making sure that you you’re not getting it from the supermarket or your pharmacy, you’re getting it from an independent health food store. Ideally, if you haven’t got the funds to work with a nutritional therapist who can pick one specifically for you. Yeah. And then obviously, there’s the CO q 10. And the 

Sarah 47:04 list goes on, there are many things but with 10, again, it depends on your age, it depends, you know, on many factors as to what would be recommended, 

Sandra 47:13 much. And again, it’s so expensive nowadays, it was always expensive, but I think it’s just gotten monotonous now. And 

Sarah 47:22 then people because that’s because we’ve Kochi tenants to different forms and sort of form that a lot of people will come across Ubik for known is, is much cheaper than Ubiquinol, which is a form that we would probably recommend. And that yeah, they might be taking a cue turn, and I’m still paying quite a substantial amount of money for it, but it’s not doing as much for them as it could be. It’s just important understand all these things. 

Sandra 47:49 And also, actually, well, I mean, we’re talking about click your turn, but you know, the, actually the Kochi term being delivered to the cell is very much dependent on what it’s suspended in, whether it’s liquid oil, powder, and also the capsule form. So what what, you know, what is it? What is it actually packaged with? And, you know, and again, you get what you pay for generally, and so you have to be really mindful that you’re not buying something that’s actually not even gonna get into yourself, because you’ve not, you know, because there’s products that are actually not, you know, they’re not useful. Yeah, 

Sarah 48:28 yeah, because Kochi tells part volleyball, if it’s not in a linear format, then it’s yeah, it’s gonna struggle to be absorbed efficiently. 

Sandra 48:36 So anyway, so I mean, I personally, I think if somebody is sitting here listening and thinking, you know, my, my, I didn’t have very good experience with my last cycle of my cycle so far. I would encourage them to do what you said, actually get a copy of the files so that they know they can then perhaps book an appointment with you. And for you to review what’s going on in conjunction with them looking at their lifestyle diet, you know, everything that was going on with them. 

Sarah 49:10 Yes, yeah, definitely. The more information someone has about what has happened in their IVF cycle, the better enables recommendations and directions be more tailored. 

Sandra 49:22 Yeah. I mean, that’s not to say that you can only benefit from support if you’ve, if you’re having IVF. I mean, everybody can say everyone could benefit from focusing on that egg health and their sperm health but how can people find you what’s the best way to get hold of you? 

Sarah 49:41 So I’ve got my website which is www.theembryologistnutritionist.co.uk. And I’m also mainly open on Instagram as @the_embryologist_nutritionist and you can find me and contact me through those means. You’ll also find them Link, I’ve got a very handy free download, which contains lots of the terminology and the acronyms that people will come across if they’re having an IVF treatment, which can seem like a completely different language at the time. So if someone is interested in downloading that and can find that on my Instagram profile as well. Okay, 

Sandra 50:21 we’ll put those in the show notes as well. So all of the contact details as well. So yeah, great. Thanks so much, Sarah. 

Sarah 50:28 Well, thank you for having me. It’s been lovely talking to you. 

Sandra 50:35 I really enjoyed this chat with Sarah and I hope you enjoyed listening to this episode. Please like, save, share and rate this podcast if you found that useful, as it helps us reach more people. Also, don’t forget your 10% discount on tests with Neovos using the code FERTILITY at the checkout. And if you’re looking for a fertility specialist to support you, all practitioners can all be contacted over at www.fertilitynutritioncentre.org And they all offer a free strategy call to help you decide on your next steps on your journey. Thank you for listening.