Ready to plan a pregnancy and prepare your body? Join Dr. Carrie Bedient Fertility Center of Las Vegas, Dr. Abby Eblen from Nashville Fertility Center, and Dr. Susan Hudson from Texas Fertility Center as they discuss the obvious and not-so-obvious plans you should make while preparing for pregnancy. The docs discuss everyday exposures like caffeine and diet and how they impact pregnancy. They offer real advice on what medical conditions and medications matter prior to pregnancy and how they impact pregnancy itself. Basics like sleep and exercise affect success, as do exposures to substances like alcohol, nicotine, and marijuana. Tune in for a practical and informative episode to prepare your body for pregnancy! Have questions about infertility?  Visit FertilityDocsUncensored.com to ask our docs. Selected questions will be answered anonymously in future episodes.

Today’s episode is brought to you by Levy and Receptiva 

Episode Transcript:

Susan Hudson (00:01)

You’re listening to the Fertility Docs Uncensored podcast, featuring insight on all things fertility from some of the top rated doctors around America. Whether you’re struggling to conceive or just planning for your future family, we’re here to guide you every step of the way.

Susan Hudson MD (00:22)

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Visit www.levy.health/fdu and use code FDU10 at checkout for 10 % off. Levy Health, decoding your fertility.

Carrie Bedient  MD (01:04)

Hello everyone and welcome to another episode of Fertility Docs Uncensored. I am one of your hosts, Dr. Carrie Bedient from the Fertility Center of Las Vegas. And I am joined by my quintessentially quirky queens and co-hosts, Dr. Abby Eblen from Nashville Fertility Center and Dr. Susan Hudson from Texas Fertility Center.

Abby Eblen MD (01:20)

Hi, everybody.

Susan Hudson MD (01:24)

Hello everyone.

Carrie Bedient  MD (01:25)

And so the question of the day, which we were laughing at as we were thinking about our topic for later is, what is your adult beverage of choice? And just for full disclosure, our topic today is preparing your body for pregnancy. so do as we say, not as we do.

Abby Eblen MD (01:42)

So Abby pointed out, there’s a little irony there, Abby pointed out, that we’re talking about preparing your body for pregnancy, but yeah, we’re talking about our favorite adult beverage. But nevertheless, we want you not to drink it.

Carrie Bedient  MD (01:52)

But nevertheless, so think about all of these, drink them, and then stop.

So Abby, what is your drink of choice being in the South? Is it a mint julep? Is it?

Abby Eblen MD (02:03)

My husband is a big bourbon fan and he’s kind of got me on the old-fashioned wagon, so I like old-fashions. But really my girly drink, I would say, is like a chocolate martini. That’s really my fave.

Carrie Bedient  MD (02:14)

Ooh. Now for old fashions, isn’t there, can’t you choose between more sweet or more sour or bitter? Like do you have a preference there?

Abby Eblen MD (02:21)

Yeah, there’s lots of lots of different versions. I’m much more the sweet for sure. And you can even there’s even a tequila old fashioned to believe it or not. And that’s pretty.

Susan Hudson MD (02:30)

I love tequila. A good tequila old-fashioned is really good. There’s a restaurant in downtown San Antonio that we will need to visit next year for ASRM and they’ve got a pretty darn good tequila old-fashioned.

Carrie Bedient  MD (02:45)

What kind of tequila do they use? Like Blanco or Inejo or what type?

Abby Eblen MD (02:49)

I don’t know, honestly.

Susan Hudson MD (02:50)

It’s just like when you use it with a whiskey or bourbon, old fashioned, you can use whatever you’re willing to pay for. Obviously it’s gonna taste better if you’re drinking something that’s of better quality.

Carrie Bedient  MD (03:05)

I never knew you could do that because tequila is my tequila and gin for the harder alcohols are my drugs of choice but we have a pretty thorough supply of gin because we like to drink gin and tonics because it’s simple and so playing around with, all right, what kind of, is this a lime garnish? Is this orange? Is this cucumber? Is this mint? Is it, you know, what do we put in it? We like to play with that a lot around here, but that’s mostly because it’s simple. But if I’m going out to actually do work on a cocktail, either pear martinis or cucumber martinis are high on my list.

Abby Eblen MD (03:29)

Yeah.

Susan Hudson MD (03:47)

Hmm, interesting.

Abby Eblen MD (03:47)

You don’t like the sweet, sweet girly drinks.

Carrie Bedient  MD (03:50)

I’ve gotten more and more away from them. I mean, when I was in college, it was an amaretto sour, and I thought I was so cool for drinking that and Riesling wine. But since then, I’ve kind of gotten a little drier the older I get.

Abby Eblen MD (03:56)

Yeah.

You’re more sophisticated as you get older.

Susan Hudson MD (04:04)

So I’m a gin and tonic girl when I’m at home or if we’re at somewhere that I, because of the celiac, I have to be real careful about everything that goes in my drinks, because they like to add lots of flavors and different things that may or may not be friendly for me. So gin and tonic is usually safe, but if it’s somewhere nice, I really like a French 75. But again, it’s a gin drink, so.

Carrie Bedient  MD (04:27)

Yeah, those are good too. We’ve got my lemon tree right now is exploding. So I have all this fresh lemon juice. And yeah, it’s pretty great.

Susan Hudson MD (04:36)

Yummy.

Y’all want to do a question? Okay, here’s our question for today. Hey, docs. First of all, what a comfort your podcast has been to me in the last 90 days. After 15 months of trying to conceive, we began fertility screenings. My husband, 33, and I, 29, were shocked to receive his semen analysis, which was zero. A few more tests and genetic screening later showed he is a carrier for cystic fibrosis. Thankfully, I am not. His appointment with the clinic is mid-March. We know that our path forward is IVF. All of my hormones and ultrasounds have come back normal, so docs are optimistic on my end. I believe my AMH is 2.53. Is that good? I would love it to know if you could talk a little bit more about the next steps would be for my husband, i.e. surgeries, and how timing of IVF might happen. Also, what are the chances of success? Husband blood work hormones are all good. Thank you so much.

Abby Eblen MD (06:04)

I mean, I think you’re, I’m very optimistic. It’s really not that your husband, I assume, doesn’t produce sperm. It’s just that his sperm doesn’t have a way to get out through the ejaculate. And so he probably has a really good normal, I won’t say a good count, because they can’t aspirate that much, but his sperm will be really good. And I think if you get the average of 15, maybe 20 eggs, he’s going to have plenty of sperm. I think you’re going to do as well as anybody in their 20s. And most people in their 20s do really, really well.

So I’d be really optimistic. If you were going to one of our centers, we would probably say you have about a 66 % ongoing chance of having a baby in your arms at the end of nine months. So I think your chances are really good. And hopefully because you are young and you’ll make several eggs, the many, several will fertilize and you’ll have several normal embryos. And hopefully you won’t ever have to go back through the major part of IVF again, which is the stimulation part and the retrieval.

Carrie Bedient  MD (06:55)

I would say for him, the things that he needs to do to prepare, really it’s not too much. I mean, it’s the common sense things of don’t sit in hot saunas and hot tubs and jacuzzis for hours on end. And don’t parboil your sperm and eat healthy and get sleep and no tobacco and no alcohol. Nevermind the fact that we just had a discussion about mixed drinks, knock it off, don’t do it.

Abby Eblen MD (07:17)

Hahaha

Carrie Bedient  MD (07:20)

But it’s really all the common sense things. Sometimes they’ll check hormone levels and consider if there’s additional medication that’s needed. But most of the time the production’s good, it’s just accessing it. So it is helpful to have somebody who’s well trained in accessing that sperm with getting it out and having a lab that’s used to working with surgically extracted sperm. That is a little bit of a different ballgame than just a regular conventional insemination where they dump the sperm in and let them go. You can’t do that with extracted sperm. But I would agree with Abby. Your prognosis is really pretty good.

Susan Hudson MD (07:57)

I agree, I think it’s time to treat your bodies like temples, which is what we’re gonna talk about today. Things are very optimistic that when gentlemen have cystic fibrosis or are carriers for cystic fibrosis genes, the thing that we’re really talking about is congenital absence of the vas deferens, which is the connection point that connects where sperm are made and how it gets out. And so…Essentially, he doesn’t have a pathway between the two and so we just need to go upstream, which is usually relatively simple. Most of the time, the guy is going to undergo some conscious sedation, sort of what you’re going to undergo during your egg retrieval, and then they’ll use a very small needle to aspirate the sperm. They’ll know before he wakes up if they have sperm and will be able to give you some hopefully good and reassuring information at that point.

Carrie Bedient  MD (08:54)

Mm-hmm.

Abby Eblen MD (08:54)

Well, I’ll throw in there too, we have a urologist who actually does it in our clinic with the guy awake. He just does local and does it right in our clinic. So it’s a pretty quick, easy procedure and people tend to recover really quickly.

Carrie Bedient  MD (09:01)

Yeah, and we’ve got that set up too. And I would say most fertility clinics, especially in bigger areas, have that available. And to answer your question about your AMH 2.5 is rock solid normal. What we would expect it to be in your age range, you’re good to go there. All right, so treat your body like a temple. When you’re preparing to get pregnant, what do you need to do and how do you need to do it? So pick your favorite subject and let’s go.

Susan Hudson MD (09:30)

I will start. You need to start your prenatal vitamins now. There’s a lot of people who don’t necessarily think about prenatals until they’re actually pregnant. The main reason we’re having you take prenatal vitamins is to build up something called folic acid. Folic acid is important in correct formation of the brain and the spinal cord. If you have low levels going into early pregnancy and sometimes even before you know you’re pregnant, that can have a negative impact. And so usually we recommend you being on prenatal vitamins for about two to three months before trying to conceive. If you haven’t been taking them, start them now. And also make sure you’re getting a good quality prenatal vitamin. Not all prenatal vitamins are created equal.

And so we want to make sure that they’ve undergone adequate testing to make sure that what you’re expecting to be in your prenatal vitamin is there. The most important is being that folic acid. And most prenatal vitamins are going to have at least 800 micrograms. We want to have at least 400, so the 800 is usually a good adequate amount. And start that as part of your regimen.

Abby Eblen MD (10:44)

And I would say too, that preparation for pregnancy for infertility patients may be a little bit different in the sense that we like to check tubes and we like to check your uterus. And so a lot of times we’ll do that through something called a saline sonogram. Essentially what that does is it’s almost like blowing air into a balloon. It opens the cavity up when we put the fluid or the saline in there. It’s an outpatient procedure. It’s not a surgery. You come in and it’s just an office procedure. And essentially, fluid will go inside the cavity, open the cavity up. What we’re really looking for are polyps or fibroids or anything that could irritate the endometrium and make it a little bit more difficult for pregnancy to implant. There’s probably plenty of healthy women that have polyps and get pregnant and do fine, but because you’re seeing us as an infertility patient, it’s like layers of the onion. We wanna do everything we can to optimize your implantation and your pregnancy success. With that same procedure, we’ll also put fluid or air bubbles through your fallopian tube.

There’s also some foam that can go through your tubes, but essentially it’s a way to check and make sure your fallopian tubes are open. Because again, if you’re an infertility patient, we want to make sure you have at least one tube opening because otherwise you wouldn’t be able to get pregnant through more minor office procedures.

Carrie Bedient  MD (11:52)

Considering what you’re putting in your body is very important. Like Susan mentioned with the prenatal vitamins, make sure that you’re on board with that. There are some differences between preconception vitamins and pregnant vitamins. So if you go back to our last couple of episodes, there’s one with Mark Ratner, who’s the CMO of Therologix, where we talk about some of the differences there. So that can be helpful if you’re thinking about supplementation.

Thinking about just the basic foods you put in your body. Really helpful here. And we don’t need you to be super virtuous and never eat a gram of added sugar or any compound that you can’t pronounce the name of. You don’t need to swear off all processed foods or ice cream or everything. In general, avoiding full food groups is…rarely a good plan unless you have a specific diagnosis, like celiac or like some other intolerance there. But Mediterranean diet is, I think, the most mainline reasonable thing to follow because it’s a lot of emphasis on high fiber carbs, on fruits and vegetables, which provide you with antioxidants, which are very protective to egg and sperm.

To lean proteins because babies are made with proteins. And so you have to have that coming in, whether it’s veggie based with your various peas and beans, whether it’s fish or chicken, not to say that you should never have anything like red meat, lamb, beef, whatnot, but being mindful of the balance between those. Mediterranean diet is typically the best go-to that we have.

Pretty decent data about it for a variety of health conditions. There’s not a magical fertility diet. And so when you look at some of the ones that say you need to swear off dairy and gluten and foods that end in P, carbohydrates and anything that you eat after 10 p.m. and before what, like.

Abby Eblen MD (13:43)

Are any of the other weird rules?

Carrie Bedient  MD (13:54)

There’s a ton of weird rules. None of them, I think, I don’t think I’m going down a limb by saying none of them have been proven. There’s some common sense ones, you probably shouldn’t eat the whole pint of ice cream or quart of ice cream if you’re an overachiever like I am, at any point during the day, but it’s a lot of good common sense. Following up with a nutritionist can be really helpful because if you track what you’re eating and then, touch base with a nutritionist a couple of times and show them your list, they can make some really good suggestions for you that are more tailored to your life and your diet that may be really helpful for you, not just preparing for pregnancy, but during pregnancy and after as well, because you want to model all of these good eating habits for those small human beings that you’re trying to create as well.

Susan Hudson MD (14:39)

All right, I’m gonna take another lifestyle factor in nicotine use. So nicotine use, I’m letting you all know it’s bad for eggs, it’s bad for sperm, it’s bad for embryos, it’s bad for babies, it’s bad for you, okay? And so the nice thing is that when you stop using nicotine, those byproducts of nicotine that end up in your body can even end up in the…than the fluid that’s bathing your eggs, those things can go away and you can actually have definitive positive impact on your fertility outcomes, whether it’s eggs or sperm. And so another important thing to know is it doesn’t matter how you’re getting the nicotine. We have lots of patients who come in and they’re like, I have not used cigarettes in years. I’m only using patches or pouches or vaping.

Abby Eblen MD (15:24)

Hmm.

Susan Hudson MD (15:34)

Nicotine is nicotine. It is not good for your body. And so though we know it’s a very hard habit to kick, every other reason in your life that you’re wanting to stop nicotine is a negative one. This is a positive one. And so we know it’s tough, but we really, really want to emphasize that stopping nicotine use is going to have a huge impact on your fertility success.

Abby Eblen MD (15:34)

Yeah. So I’ll springboard off what Susan was just saying. It’s not easy to quit smoking. It’s also not easy to lose weight. And I’m not talking about somebody that’s a few pounds overweight. If you know that you’re really heavy, you probably need to lose weight. Because we know it’s, kind of like Susan said, it’s bad for your baby. It’s bad for you. It may also be paired with some things that may make it difficult for you to get pregnant. So for example, some women that are of normal body weight ovulate regularly, make an egg every month, and can get pregnant pretty easily.

Sometimes is even as little as gaining 10 or 15 pounds can sometimes make it harder for you to ovulate or maybe not ovulate at all. And so it may be harder for you to get pregnant. Once you get pregnant, we know that people that are heavier and it’s not cut and dried at this weight, you’re healthy at this weight, you will have trouble. But we just know the heavier you are, the more likely you are to have complications in pregnancy, things like diabetes in pregnancy, preeclampsia, failure to progress so that you have to have a C-section, complications from the C-section. And so there’s just a lot of things that go along with obesity that make it more difficult for you to have a healthy pregnancy. So I think this is something that’s gonna help you get pregnant potentially and also will make you or help you have a healthier pregnancy and a healthier baby. And that’s what we all want for you. And so that’s why we always talk about weight when we see patients who are, who we think would benefit from weight loss.

Carrie Bedient  MD (17:18)

There’s the flip side of that as well as being underweight. And we don’t want you to be overweight. We don’t want you to be underweight. We want you to be Goldilocks and be just right. And so one of the things that women who have very low body weights, there’s a couple flavors of this, but what we see, would say more often in our practice are the patients who are extraordinarily fit and the patients who are extraordinarily good at restricting their caloric intake to exactly what they need and no more. And what you need varies depending on what stage of life you’re in. When you are going to make a baby, your body is going to draw on all of those extra resources, and that includes fat. So for example, every hormone that you make is based off of cholesterol. If you don’t have cholesterol, nothing’s going to happen. Things like your protein, what you’re taking in, the calcium, all of those things the baby is gonna need an extra supply of. And so when you are starting off either right at the line, right at the cutoff or below that, it makes it much more difficult for you to get pregnant. And it means that you will be the one who suffers when your baby is being made because baby’s gonna get what they need to get.

And it will be at the expense of you. And even though it can be extraordinarily difficult to gain weight when you are used to being a much lower weight or a lower BMI, that’s an important consideration. There are women who have low BMIs where their body is registering it as such of, can’t ovulate, we cannot support a baby right now. Do not release that egg, do not pass go, do not collect $200, do not get pregnant because that is life threatening for mom.

And if mom ain’t happy, ain’t nobody happy. And so the body is very protective of that. And there are women who have relatively regular periods who are very underweight, who still really struggle to get pregnant because their body doesn’t have those extra resources to put into it. And that translates to preparing your body for pregnancy. So not too much, not too little, just right. Go old school Goldilocks on this one.

Susan Hudson MD (19:26)

While we’re talking about weight, think this is an important time for us to talk about the new miracle drugs that are out there, our GLP-1 agonists. So these are the medications that are like Ozempic, Mounjaro, whatever the brand happens to be, or if you’re getting it compounded from your local compounding pharmacy, it is important to understand that these are what are called neuroendocrine modulators, okay? And at this point in time, we really don’t know what the impacts are to an ongoing pregnancy with someone using one of these medications. So it is good medical practice at this point in time and granted, things may change as we get more information and more data, but if you are taking one of these medications, one, we don’t encourage you to get pregnant while you’re taking it. And if you’re planning on getting pregnant, we really want you to be off of those medications for two months. And so I can say that I’ve had some patients who’ve had some amazing outcomes by using these medications to help get to or closer to their goal weight. But with that understanding, hey, we need to stop at this point and then we need to have a washout period and then we can hit the door running.

It may add a little time, but if it’s something that’s needed to help you get to your goal, it’s a great tool, but we also need to understand that we need to use it with balance.

Abby Eblen MD (20:58)

And speaking of medications, while we’re on that subject, it’s really good to assess the medicines that you’re on and probably with your doctor. I’m really surprised at the number of people that will come to see me and they’re young, reproductive age women and they’re on a medicine that we know can cause malformations in the baby, like lisinopril, for example. We don’t want women on that certain medicine if they have blood pressure problems. Now, don’t get me wrong, we need to treat the blood pressure problem. Don’t just stop the medicine, but we need to look through, and this can be with your primary care doctor, this can be with your OB-GYN, but somebody really needs to look through and make sure that none of the medicines that you’re currently taking can cause problems with fetal development. And on the flip side, sometimes there’s medicines that you may need to take proactively. Susan mentioned folic acid earlier. For example, if you’re on seizure medications, we know you’re at high risk for having a baby with a malformation in the backbone called a neural tube defect.

And so by preemptively taking a high dose of folic acid ahead of time, that prevents that problem from happening. And sometimes even women who’ve had a seizure disorder, even if they’re not on seizure medicines currently, benefit from that as well. So there’s certain things like that, that there’s really no way that you would know those things. So I think it would be a really great idea if you’re on medications like that or you’ve had medical problems. And we’ll probably talk about a few more medical problems in just a minute. But if you’ve had those issues, it’s good to schedule a consult visit with your OBGYN or your primary care doctor to look through those medicines and go, hey, I’m gonna try to get pregnant, are these medicines safe? And if not, they can take that opportunity to switch you to different medication at that point.

Carrie Bedient  MD (22:30)

Tagging along with that, let’s talk about medical conditions that impact you during pregnancy. And some of these are ones that you know about, some of them are ones that you do not know about. It’s well worth going to get your basic health maintenance. This means going to see your gynecologist, having an up-to-date pap smear, making sure that everything is normal there and that you don’t need to fine tune anything, talking with your primary care physician, checking your basic labs. Is your thyroid okay?

Is your blood pressure okay? Those are some of the biggest ones that we see impacting women. Diabetes and getting the standard checks there. All of the basic medical stuff that women think, I don’t really need to go to the doctor now, I’m otherwise healthy. There are things that are silent and that are quiet there that you really have to get treated in order to optimize your chances. This doesn’t mean that you can’t get pregnant when you have high blood pressure and diabetes or any of these other thyroid problems, any of these other issues.

But it means that if you’re planning a pregnancy, let’s optimize it in the same way that you wouldn’t go on a 500 mile road trip with a tank that’s got 33 miles to it. Insert things that I may or may not have tried to do in my past. You need to get optimized. So fill up the tank, make sure that the car is clean, the tank is full, the oil has been changed, the tires have been rotated and go because you can exist without those things being done, but your outcome’s gonna be better if you get them checked ahead of time.

Susan Hudson MD (23:52)

With that being said, would also recommend that if you have an existing health condition, whether it’s diabetes or some sort of GI disorder or a history of a heart defect, this is the time to go see a specialist and make sure everything is picture perfect for going into pregnancy. Pregnancy is one of the hardest thing and most dangerous thing most women, especially in the United States, will ever experience.

And so to save a little time and a little effort, it’s like, wow, yes, I have this condition. I haven’t seen my neurologist or my cardiologist. I just get followed by my PCP. This is probably a good time to have one of those more in-depth evaluations of, hey, I know I was born with this heart defect and I haven’t had a problem since I saw my pediatric cardiologist at the age of nine.

But let’s just make sure everything is as good as we expect it to be. Because we want you to get pregnant and we want you to have a happy, healthy pregnancy and baby. But in the end of the day, we want to make sure you’re there to enjoy that baby once he or she comes to bless your life. And so these are really important things to do. And we were mentioning things like diabetes. Understand that even if you have blood sugars that are in the pre-diabetes range, that can have a negative impact on your pregnancy. If you go into pregnancy with a hemoglobin A1C that’s in the pre-diabetes range, your chances of getting diabetes in pregnancy are exceptionally high, and women with gestational diabetes, again, have an exceptionally high chance of developing regular type 2 diabetes. So these are good times to just make, again, treat yourself like a temple, make sure everything is as perfect as we possibly can get it.

Abby Eblen MD (25:47)

And I would say too, if you’re thinking about getting pregnant, and this appears to what I was saying about meeting with your primary care doctor, sometimes we kind of laugh, we’ll see patients in our practice, and it’s almost like I feel like I’m a detective because if I don’t ask the exact right question, I don’t find out that, yeah, I did have cardiac surgery when I was two years old, or yeah, they said I had this congenital condition and my heart makes funny palpitations, but I’ve never been to cardiologist.

Don’t make your doctor try and figure that out. Anything that you think in any of your body systems that anybody’s ever worried about, be sure and tell somebody because, like Susan said, it’s much better to get it looked at and evaluated before you ever get pregnant because once you get pregnant, there’s a lot of invasive testing that we can’t do at that point.

Susan Hudson MD (26:31)

I’m gonna pick on the guys for a minute because when we’re talking about these things, these things apply to you too. I don’t know how many times I have new patients come into my practice and they’re filling out their online history of like their medical conditions and their surgeries and their medications. And inevitably when it says, you have any past medical conditions, they all put no, okay.

And then under medications, the list medications, so I’m like, okay, so you actually do have high blood pressure, you have diabetes, you have chronic pain, you have PTSD, you have all these other things. And then you get to the surgeries, and the surgeries are the ones that crack me up the most because it’ll be like port placement. Okay, and I’m like, so you had a port place. So what was, I had cancer when I was in my 20s, but I had a bone marrow transplant and I’m doing great now. And this has happened to me more than once. If you’re sitting there saying I have no health issues but you’ve had surgeries or you’re taking medications, take a step back and realize that those have been health issues and those are things that we want to make sure are A-OK because they can have huge implications to reproductive success.

Abby Eblen MD (27:45)

So like Susan, for example, what you said about somebody having cancer, if somebody had cancer treatment, like radiation or chemotherapy as a child, why would that impact their ability to have a baby?

Susan Hudson MD (27:56)

Because oftentimes things like radiation and chemotherapy can affect both sperm and egg quality, function, number. And sometimes those things are reversible and sometimes they aren’t. But if we don’t have information about that and you come in and we have really bad egg counts or we have really bad sperm counts and we’re like, well, not really sure. Most of the time this is what we call idiopathic. We don’t have a good reason for something and it’s like, well this did happen to me when I was a kid. Those things are really, really important and so just because you’re not actively being treated for something doesn’t mean that your body hasn’t had a hit in some way from those types of things.

Carrie Bedient  MD (28:43)

Let’s talk about medications that people use that aren’t prescribed. Marijuana is probably the biggest one out of these, but can apply to any drug whatsoever. With that, one thing that I find is that people who are using marijuana in whatever form on a regular basis, including CBD, they’re treating something.

Susan Hudson MD (29:00)

Including CBD including CBD guys

Carrie Bedient  MD (29:07)

And it can be pain, can be anxiety, can be depression, it can be insomnia, it can be any number of things, but you are treating something. And so making sure that you are talking with your doc and making sure your reproductive doc knows about it and your primary doc does too, because it may be something where in the time that you’re trying to conceive, male or female, or carrying the pregnancy or afterwards, it’s worth addressing because you want to make sure you’re optimizing everything.

We don’t have amazing data about what marijuana does from the male or the female side during pregnancy. We think that it probably doesn’t help. Nicotine doesn’t help, even if it’s just coming from a nicotine patch that’s helping you stop. Marijuana probably doesn’t help either.

Abby Eblen MD (29:48)

What about alcohol, Carrie? Do you think that’s a problem?

Carrie Bedient  MD (29:52)

We’re really having this conversation in 2025. The discussion of, let’s go to alcohol for a minute, the discussion of, oh, I can just have one glass of wine. Well, there’s no safe amount of alcohol that’s noted in pregnancy. There are very detrimental effects that are well documented and fetal alcohol syndrome is well known to cause impacts to babies. And, yeah, if you’re drinking a fifth of Johnny Walker every day or vodka or whatever your drink of choice is. Yeah, that’s probably going to have an impact. But we don’t know for the lesser amounts how much it is either. And I remember I have had many patients over over time come in and say, well, one glass is just fine, right? Now that I’m 13 weeks pregnant and the organs are formed and the answer is really probably no. There’s nothing beneficial that it’s giving you and so avoid it.

Susan Hudson MD (30:44)

I’m gonna add a couple of things to the alcohol talk. So in my opinion, if you are post-ovulatory, you are pregnant until proven otherwise. So no alcohol at that point. Number two, guys, alcohol intake does affect your sperm production. I don’t know how many times, again, that it’s like, we’ll go on that initial intake and it’s like, we’re drinking six to 10 drinks a day.

And this is real, and I mean, some of our listeners may be like, that’s an exception. We see this a lot. We see this a whole, whole lot. Well, we really need to test that sperm because those high alcohol intakes can affect how the brain and the testes function together. And sometimes those things are reversible and sometimes those aren’t. And so, guys, when we’re sitting here, kind of lecturing the ladies, we’re also lecturing you too. So bring that alcohol down, no more than two drinks per day for gentlemen. Probably less than that is gonna be helpful, but know that those higher amounts can definitely have a negative impact.

Abby Eblen MD (31:51)

And while we have the ear of your husband, the one other thing that we see very often is a couple that will show up and we’ll find out that he’s taken weekly injections of testosterone, not every day or anything, but that matters, that counts. So testosterone just tricks your brain into thinking if you’re getting it from a source outside of your body, from an injection or a patch or however you’re getting it, your body sees that you don’t need any more testosterone and so the brain doesn’t produce the hormones that are necessary to stimulate the testes to produce testosterone and sperm. I can’t count the number of times when I’ve talked to a male patient, they’re like, well, I don’t really take that much. I’m sure it probably hadn’t really affected my sperm count. And great majority of time when they do a sperm count, they’re not producing any sperm at all. And they’re really shocked about that. Good news is if you stop the testosterone for about three months, you’ll go back to whatever your baseline is now.

If you’re testosterone for legitimate reason, because you have a really low testosterone, the other concern would be maybe there is a testicular problem and maybe you won’t have very good sperm count. But we don’t really know until you’ve been off of it for about three months. So just keep that in mind as well.

Carrie Bedient  MD (32:58)

What do you guys think about sleep and what do you think about exercise?

Susan Hudson MD (33:03)

They are both important. So getting good, restful, and enough sleep, I think that’s one of the biggest things. I think a lot of us walk around sleep deprived. We stay up too late, we wake up too early. Everything else is taking priority and we’re living in a sleep deprived state. And I think that that is definitely something that as you are preparing for pregnancy, when you get pregnant, it essentially like makes you sleepy, so you’re gonna sleep more. 

But when you’re going into pregnancy and you’re not pregnant yet, it’s like, I can keep on going, going, going and pushing and pushing, pushing. And that’s gonna be the same balance as with exercise. We want enough exercise, but we don’t want too much. We don’t want your body to feel like it’s in a starvation or fear for your life type of phase. So it’s not the time to be training for a marathon.

Carrie Bedient  MD (33:56)

If you are always running from a tiger, your body will decide this is not a good time for me to get pregnant right now.

Abby Eblen MD (34:01)

Yeah, and the way you know that is if you stop having a period. I mean, that’s your body. If you’ve had regular periods and all of a sudden you’re training for something and you’re exercising a bunch, that’s your body telling you you’ve done a little too much, that your body’s just not ready and prepared for pregnancy.

Susan Hudson MD (34:17)

I think it is so true that we have to realize that we need to let our body prepare to become a nursery for nine-ish months. And that’s a big job. That’s a big job. When you do become pregnant and you’re setting up your nursery, most people aren’t gonna leave it to the last minute. Some of us kinda did, but you know. It happens, it happens, but it’s ideal if you have some planning time and the same thing goes for your body. Doing some weight bearing exercise is really good for making sure your bones stay strong, making sure your muscles are in shape. And it also helps you be able to carry your pregnancy a little more comfortably. If your muscles are weak and things aren’t as supported by a solid musculature it’s going to take more of a toll on you as you’re going through your pregnancy.

Carrie Bedient  MD (35:10)

All right, any other preparing your body for pregnancy tips that you guys can think of off the top of your head that we haven’t covered yet? I just realized one, caffeine.

What do you tell your coffee drinkers? Or your Diet Coke drinkers? Or your insert mainlining form of caffeine here?

Abby Eblen MD (35:30)

Well, I mean, I think there’s some data that shows if you get more than 200 milligrams of caffeine a day, you have an increased risk of miscarriage. I think it’s hard to really know with pregnancy. I would just say, moderation, just keep moderation in mind. If you’re drinking six cups of coffee day, that’s probably not good. I think one cup of coffee a day is probably fine, but now would not be the time to overdo it if you’re trying to get pregnant or you are pregnant.

Susan Hudson MD (35:54)

I generally recommend less than 200 milligrams a day. Normal cup of coffee has about 120 milligrams a day. Normal sodas and teas have between 35 to 50. Your energy drinks, which I in general think are a bad idea, are all gonna be labeled, but you’re probably about to knock out your entire 200 milligrams right there. Also know if you’re using any type of pre-workout supplement that has caffeine in there, that counts. And so, and this goes for the guys as well as the ladies.

Carrie Bedient  MD (36:23)

Okay, now I’m legitimately asking, have we forgotten anything? Okay, perfect. Well, I hope this was very helpful to our audience as you’re thinking about what to do, what not to do as you’re getting ready for pregnancy and preparing your body. And to our audience, thank you so much for listening. Subscribe to Apple Podcasts to have next Tuesday’s episode pop up automatically for you. Be sure to subscribe to YouTube as well. That really helps us spread reliable information and help as many people as possible.

Abby Eblen MD (36:26)

And visit fertilitydocsuncensored.com to submit specific questions you have and to sign up for our email list. We look forward to hearing from you.

Susan Hudson MD (36:58)

As always, this podcast is intended for entertainment and is not a substitute for medical advice from your own physician. Subscribe, sign up for emails, and we’ll talk to you soon. Bye!

Abby Eblen MD (37:07)

Bye.

Carrie Bedient  MD (37:08)

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