A fun, honest conversation about food, fertility, and women’s health.
The Food Freedom Fertility podcast started when Caitlin’s mom overheard a conversation between Caitlin and Sophia about fertility nutrition. As registered dietitians and experts in their field discussing fertility nutrition and human health, their banter was funny, honest, and insightful.
Sophia and Caitlin both specialize in prenatal, fertility, pregnancy, and postnatal nutrition, and invite you into their conversation about all things food, freedom, and fertility!
Pregnancy Loss with Sasha Hakman MD
In this episode, we are honoring pregnancy and infant loss awareness month. Caitlin and Sophia are digging in deep about this topic with OBGYN and Reproductive Endocrinologist Sasha Hackman, MD. While we know this may seem like a downer, this is purely to inform all of you about statistics, where pregnancy loss is most common, and how we can try to stop this from happening. We all realize most people don’t feel comfortable talking about this, but if this has happened to you, this is NOTHING to be ashamed about. This is something that happens frequently. You are not alone, you do not need to keep your feelings to yourself, and you are not a failure. In this episode we are trying to educate more people to know how to approach situations like these, become more informed about miscarriages, to open up the conversation and how to hold space for someone who has gone through a pregnancy or infant loss.
Sasha starts talking about how women in early pregnancy can tell the difference between normal discharge or if they are having a pregnancy loss. She says that unfortunately, sometimes a miscarriage can be completely asymptomatic so many women do not find out until they go in for an ultrasound. Some symptoms do include cramping, vaginal bleeding, spotting, low back/ pelvic pain, and sometimes more. The symptoms are very nonspecific and can lead to stress especially with a woman who has had a miscarriage in the past. Truth be told, spotting is not necessarily normal when pregnant, but it is common. If you are having bleeding or spotting, there is a really good chance it is completely benign and will still lead to a healthy pregnancy! Additionally, discharge can be very normal and does not indicate a miscarriage at all.
We had a question about what normal HCG values would be for women before their first ultrasound, around 4-6 weeks pregnant. Sasha explained how HCG should be doubled, or at least increased, after the first few days. Sometimes women only see a 20% increase and will still have a healthy pregnancy. However, the typical minimum cut off where they are absolutely confident about a healthy pregnancy is 53% or more.
Sasha dives into telling us what the main cause is for early pregnancy loss. She say by far, the main cause is genetic abnormality. With technology now, they can do something called a “Microarrye Test” that doesn’t require them to culture a tissue, but instead, they can ID small, little deletions rather than chromosomal duplications or lack of entire chromosome. They have distinguished that at least 75% of pregnancy losses are because of chromosomal abnormality. This is practically nature’s way of removing and absorbing pregnancy that eventually would not result in a relatively healthy child. That being said it doesn’t make this loss any easier.
We asked if someone has experienced early pregnancy loss, what would be the medical model of care, when should they do extra testing, and do they have to experience multiple pregnancy losses before going through diagnostics. Sasha said that technically, there should be 2-3x more losses before you start evaluation. However, it is all patient orientated. If a patient wants to get tested after one loss, that’s great. If a patient has had over 3x miscarriages, doesn’t want any tests done at all, and still wants to try to get pregnant again on their own, then that is totally fine, it’s her autonomy. She describes her role as a reproductive endocrinologist and how they see pregnancy as a very sacred thing that doesn’t come easy to many people. They understand that one loss is too many and they want to see how they can prevent another loss. In this case, they will always do a workup for their patients. This mentality is how they (and us as dietitians) are trying to handle medicine now. They are trying to shift away from paternalistic ment
Caitlin's Birth Story with her Daughter Fiona
*Trigger Warning* - It’s a story about labor and birth!
Here we dive in with Cohost Caitlin Johnson, RDN to hear about the birth of her sweet little girl! Caitlin answers all my questions about her birth prep, the birth itself, and the postpartum period.
Caitlin’s prep: She and her husband did a Bradly birth class before her first baby was born so BJ (Caitlin’s man) could get all the juicy deets on what to expect and what to do when his baby was being born. This time around they were already prepared from the last baby!
Red raspberry leaf tea and a nutrient dense diet were Caitlin’s nutrition prep for this birth. Dietitians have a hard go when it comes to early pregnancy nausea. Caitlin was no exception. It’s hard to talk about food all day for work when you feel like you could gag at any second.
Caitlin also upped the protein and sodium to combat low blood pressure and a family history of preeclampsia. She also altered her supplement and herb routine since she had SUCH a struggle nursing her first baby Fiona. Turns out there is a link between PCOS and nursing struggles!
Home birth was the option of choice for Caitlin and her husband. However, we DO want you to know that even though Caitlin chose that, we DO NOT think EVERY woman needs to birth that way! We don’t think you need to quantify your choice, so you choose whatever is right for you. What it comes down to is doing whatever makes you and your family feel safest. For Caitlin, that meant having her baby at home.
Early in the week before Fiona was born, Caitlin had a visit with her midwife. The midwife offered some cervical work to get the baby moving, but Caitlin decided that wasn’t right for her. Instead, later in the week she decided to see her acupuncturist! The acupuncturist also suggested that perhaps Caitlin get the cervical treatment done with her midwife later in the week. As the week rolled on, Caitlin decided that she was ready to bring the baby along, so she decided to tell the midwife she was ready to have her cervix swept.
The midwife spent a lot of time explaining the process of a cervical sweep to Caitlin, and it was great. Caitlin and Sophia are both BIG fans of informed consent, and they believe women should be informed of the risks, benefits, and procedures involved with any medical intervention. Lo and behold, the sweep opened Caitlin’s cervix a bit more! She then went on a walk with her neighbor, had dinner, and around 8:45 she began having real contractions.
Soon thereafter, labor was in full swing! Caitlin’s family set up her birthing tub, and soon thereafter the labor got really intense! This phase was called “transition”, meaning the baby is now low in the cervix, approaching the birth canal, and it’s almost time to push! Fun fact, this is usually when mamas start feeling the “I can’t do this” or “give me the drugs!” feeling. It feels bad, but this is actually good!
The midwife came back, and saw that this baby was coming quick! Caitlin was really feeling intense labor feelings, so the midwife suggested that she break her water and then try some new laboring positions. Up out of the tub she came, and tried a few positions before deciding sitting reverse cowgirl on the toilet was the way to go.
A few pushes later, Caitlin decided that birthing a baby in the toilet was not the deal, so she waddled back to the bedroom with the baby’s head about to crown. The next push, the baby FLEW out, head to toe, and the midwife caught her! By the way, it was 2:40am and Caitlin went into labor at 8:45p, so it was less than 6 hours from start to finish (this is Sophia’s dream, by the way!)
Baby is born, and for a second there they thought it was a boy! Side note, babys have pretty swollen g******s when they’re born. After a second look, the midwives announced with joy t
Prenatal Vitamins and Nutrition with Ayla Barmmer Creator of Full Circle Prenatal
Here comes a special one! This episode features fellow dietitian Ayla Brammer, owner of Boston Functional Nutrition and creator of Full Circle Prenatal! Caitlin and Sophia both use this prenatal for themselves, and recommend it frequently in their private practices.
Ayla shares the roots of her practice and how she came to be the powerhouse dietitian she is now. She also works in pregnancy and preconception, but her passion is working with couples when they are first starting their journey to become parents.
Ayla shares her thoughts on one of the most common pieces of fertility advice shared by OBGYN and RE docs alike… “Lose weight before you get pregnant”. Of course we hate this blanket advice and don’t see it as helpful to women who want to be moms; but Ayla takes it a step further. Rapid weight loss is never a good idea, but when you’re trying to become pregnant, it’s even harder on your fertility systems. Our fat reserves can contain toxins and other dangerous compounds that we do not want to be rapidly circulating throughout our bodies. Remember that one tree in Ferngully, that had the weird evil smoke in it? Fat stores can be kinda like that.
Though some women do see some positive changes when their weight is stabilized, all 3 of us dietitians see the preconception period as a time to fill your body with nutrients, vitamins, and minerals with the right foods; not slashing and restricting everything in the name of weight loss. Our focus tends to be more on how to get your nutrients absorbed and kept, versus how to make your body smaller in order to somehow change your fertility.
Ayla explains some of the functional lab testing she uses in her practice. She’s an advocate of a comprehensive vitamin and mineral assessment to show patterns and gaps in the way your body is processing what you eat. This can also reveal stressors, genetic abnormalities, and other anomalies that impact your ability to get pregnant. Hormone and stool tests are also important tools to getting your body ready for pregnancy.
The girls talk about their pregnancies and nutrition choices while pregnant for a while, so if you’re not ready to listen to a pregnant story, skip from 17:30-22:30.
Ayla lists her 3 favorite foods for the preconception period!
Ayla’s fertility curry - lots of veggies, protein, and nutritive spices Stinging Nettle Leaf Tea - very high mineral and easy to drink! Sophia’s husband isn’t a fan of her giant bag of nettle leaf taking up space in the cupboard, but it’s great for you! Liver - we all love/hate it. It’s so nutritious, but the taste is rough. Hide this food in meatballs, meat sauce, burgers, taco meat, etc. A little goes a long way.
If we are losing you on the liver, you’re not alone. Each one of us grew up on pizza and freezer waffles, so it was hard for each of us too! Please don’t try to just eat boiled liver. We want you to enjoy your food, and not choke down whole mouthfuls of liver. Start by hiding little 1oz portions of liver in ground beef dishes.
On to Ayla’s specialty creation: Full Circle Prenatal Vitamins!
The Full Circle prenatal is the best on the market for most pregnant women. One of the things that sets it apart is the Vitamin D content. This is slightly controversial, but Ayla made this leap since she is an RD and really sees the importance of Vitamin D in pregnancy. Vitamin D is vital for ovulation as well, so taking a prenatal like Full Circle while TTC is a great idea. PCOS sister especially need to test and treat their Vitamin D levels, as none of us have ever seen a PCOS patient who also have adequate levels of this vital nutrient!
Full Circle also has much more iodine than other prenatals. Ayla shares that this was a deliberate choice to put her vitamin in line with the optimal supplement in pregnancy recommendations
PCOS and Fertility: How to Approach Treatment
PCOS is treatable! Here’s how to start:
What do your labs say? What symptoms are you dealing with? Have you had any imaging done? These are all the first things to start looking at when it comes to PCOS.
It’s important to note that while Caitlin and Sophia love working with women with PCOS, and we have many years of experience, we are dietitians, not doctors. We don’t diagnose!
So what to do with nutrition:
Balance blood sugar Make sure that there is a higher quality and quantity of protein at each meal and snack “Quality” means it’s not inflammatory and provides more protein than it does any other macronutrient. Examples: meat, cheese, nuts, and seeds Most women with PCOS tolerate high protein dairy products like greek yogurt, cottage cheese, and cheese! SOME women do have fewer symptoms when they eliminate gluten and dairy, but it’s not the magic answer to PCOS management that it’s often believed to be Not everyone needs to be dairy free! Veggies, fruits, nuts, and seeds are your best sources of fiber! Pro tip: artichoke hearts have a ton of fiber! Fiber is great at filling your plate and filling your belly! You’ll find that you get to eat a lot of food while managing your PCOS Eating real food, vs. a protein bar or shake will keep you full for longer. It will help you slow down and feel full, versus slamming down a protein bar in under a minute To succeed, you have to eat enough to feel full! Fiber and protein are keys in making that happen FIBER! Starting your day with nutrients and blood sugar balancing protein! Even though it might seem like a lot of calories to have 3 egg scrambled with spinach and feta, a slice of toast with nut butter, and with a cup of coffee; you will feel full for so long and it will keep your blood sugar steady for hours! Swapping sweet for savory when possible. Eating sweet makes you crave sweet! It’s not your fault, its PCOS! Eating the right fuel first thing in the morning will keep your cravings at bay. Breakfast Try cronometer.com! Plug in what you’re eating and let’s look at your vitamin/mineral/fiber intake in a day! Sometimes you can be eating “healthy” but missing key pieces for PCOS fertility Take a peek at your protein/carb ratio! Typical American diets can have way more carb to protein than is helpful for PCOS fertility Check out your current nutrition status Keto, Atkins, and other super restrictive diets are not needed to boost fertility with PCOS Food is slow medicine; sometimes it takes several months of eating right to balance your cycles and get pregnant! You need to do something that can be sustained long term, not another crash-diet plan. Sustainability Supplements Remember to check with your doc!! Some of these supplements can interact with medications or are contraindicated for certain medical issues.
Is there insulin resistance present? How about high testosterone? Or high stress? How’s the thyroid? That’s where we start to dig into what supplements can help. We recommend myo-inositol and not d-chiro. PCOS ovaries can make too much d-chiro, so we are careful not to exacerbate that Inositols Helps improve insulin sensitivity and can boost egg quality, plus helps you make great cervical mucus NAC Another powerful blood-sugar/insulin supportive supplement Berberine Wherever you live in the world, most of us are vitamin D deficient. As levels of vitamin D rise, insulin resistance lowers! It’s also important for maintaining a healthy pregnancy! Vitamin D Support egg quality and improve insulin resistance Zinc Common mineral of deficiency in PCOS, helps with gut health, insulin resistance, and ovulation Magnesium You don’t want to wait until you’re pregnant! Start on a quality prenatal ASAP! (And stay tuned for our episode on prenatals dropping soon!) Pren
PCOS: How it Affects Fertility
Who wants to hear all about PCOS and fertility??
Well you came to the right place! In this episode, Caitlin and Sophia dive in to the #1 most common cause of fertility struggles in women: PCOS
So… what is it?
PCOS is an endocrine problem, meaning it is a hormone imbalance. It used to be thought of as a gynecological problem, but as science has advanced we now know PCOS goes beyond female sex organs.
Dietitians like us actually cannot diagnose PCOS, though both Caitlin and Sophia often have women come to them for fertility help, and when we send them back to their doc for some testing it’s discovered that they DO have PCOS.
PCOS is diagnosed using certain criteria (Rotterdam Criteria), and it’s more of a culmination of signs and symptoms. The symptoms your doctors typically look for are:
Cystic ovaries - ovaries with multiple cysts diagnosed with ultrasound High androgens - Testosterone, DHEA-S, Androsterone, etc. elevated higher than normal for women Excess body hair Male pattern baldness Lack of/delayed ovulation - your cycles are very irregular and ovulation is rare or absent
Caitlin was a mere teen when she was diagnosed with PCOS, and when she innocently asked her doc what this meant, his cold reaction was “PCOS is the #1 reason women can’t get pregnant”. Which, by the way, is a HORRIBLE thing to say to anyone, let alone a teenager!
**If you only take one thing away from this episode, let it be know that PCOS is NOT an infertility diagnosis! If left untreated, PCOS can certainly impact fertility; but PCOS is very treatable! This diagnosis does not mean you will never be a mom!!!!!**
Treating the factors that influence PCOS greatly increase your chances of getting pregnant!
So, what if you simply suspect you may have PCOS?
Cycles longer than 35 days Acne Hair loss Body hair growth Difficulty losing weight Excess weight around your belly How does PCOS affect fertility?
If you’re ovulating every 28-30 days or so, you’ll have roughly 12 chances to get pregnant in a year. If you, someone with PCOS, only ovulates every 50-60 days, you will have far less chances to get pregnant in a given year.
Why does this occur?
Almost always, the root cause of PCOS has something to do with insulin resistance. In simple terms, this means your body doesn’t manage your blood sugar well. Insulin is a hormone that moves the sugar/fuel in your blood into your body’s tissues and cells. Insulin resistance is where your body stops listening to the message of insulin, requiring your body to crank up the volume on insulin to get the job done. This causes ovaries to get overstimulated, increasing testosterone and other male hormone levels; causing many of the symptoms of PCOS
Brains are greatly affected too. Your brain has glands that make hormones that control ovulation. In healthy bodies, your brain makes a surge of luteinizing hormone (LH) and follicle stimulating hormone (FSH) just before ovulation. In bodies with PCOS, these hormones kick into high gear far too frequently as your body tries and tries to ovulate. This is why it’s so helpful to get lab work done so we can address exactly what is happening with each of these hormones.
Brains also make a hormone called prolactin. When prolactin is at its best, it helps nursing moms make milk for their babies. Part of the overstimulation of the ovaries and brain that come with PCOS cause your brain to make too much prolactin. High prolactin is good if you’re nursing a baby because it also tells your ovaries not to ovulate, since your body is still sustaining the life of the baby you’re nursing. However, if you have PCOS and your prolactin is too high, this hormone holds off ovulation and makes it harder to become pregnant.
Estrogen is also higher in many women with PCOS. This, again, can
At Home Sperm Test
If you are interested in trying this test for your family, use our FFFpodcast15 code to get 15% off your entire shopping cart from YoSperm.com
What is fertility like from your man’s perspective? Our guest Eric from Yo Sperm gives his insights into at home sperm testing, in office semen analysis, and the male mind when it comes to fertility testing. This is one of our most valuable and interesting episodes yet!
Yo Sperm is an at-home semen test. It’s fully private and works with your smartphone, revealing sperm count and motility from the privacy of your own home. The kit costs far less than a laboratory analysis, and can be repeated over time to see how your man’s semen changes. Not to mention you can forgo the clinical experience and crusty issue of Hustler from 1998.
Eric from Yo Sperm talks about the benefits and drawbacks of at home semen testing, as well as options if your results come back as abnormal. Though Yo Sperm is not a replacement for a full clinical semen analysis, it can be a great place to start! You can order the kit yourself anytime, no need to wait 6-12 months for your doc to give you the go-ahead. The system works remotely with 100% privacy and confidentiality. Your results are even compared to other men who have fathered children.
This episode then goes into the heart of the matter. WHY are so many of our male partners obstinate about getting a semen analysis? What makes men so reluctant to do this simple test, when women’s fertility testing is so much more expensive and invasive? Eric dives in and gives us a man’s perspective on why this is such a big deal for some men.
While semen quality is NOT a reflection on masculinity or viability as a man, it IS a reflection of your overall health. Addressing semen quality issues can bring nutrition and lifestyle issues to light! Semen quality is not static. Your partner’s semen quality can change drastically with proper nutrition, exercise, and lifestyle changes. Even if your results aren’t amazing, don’t fret! There are so many things we can do to impact the quality of your man’s semen!
Heavy hitters that impact semen quality are:
Obesity/body composition Processed food/fast food Alcohol Tobacco Cannabis Testicular temperature (think cyclists, horseback riding, and working for hours in high heat) Anabolic steroids Testosterone replacement therapy Hair loss treatments and medications Stress Illness The Yo Sperm results page also gives recommendations about nutrition, exercise, and sexual health! All of these things can impact your semen quality, and even though there is no dietitian or doctor reviewing the Yo Sperm results, these recommendations are generally safe and effective for most healthy men.
So, what about when it is time to bring some doctors and clinicians?
Eric goes into the details of how semen analysis labs measure things like semen volume, DNA fragmentation, motility, sperm progression, morphology, shape, etc. Yo Sperm only gives a baseline analysis, and anything more nuanced needs to be done by a medical professional.
Fertility is nuanced, and we want you listeners to feel empowered that there is a lot that can be done with nutrition and lifestyle to boost fertility and improve chances of conception.
So how do you get your hands on one of these sweet Yo Sperm tests??
Ebay, Amazon, and directly through Yo Sperm are online options to get this test. Plus they ship internationally! Anyone, anywhere can test their semen quality and begin finding some answers. If you are interested in trying this test for your family, use our FFFpodcast15 code to get 15% off your entire shopping cart from YoSperm.com
Customer ReviewsSee All
Found my favorite fertility podcast!
Caitlin and Sophia’s personalities mix perfectly in these educational episodes. I learn something in every episode, and it’s a great blend of humor, science based info, and hope. I’m a PCOS listener and have tried many popular TTC/fertility podcasts but wasn't crazy about any of them. I’ve listened to almost all of these episodes in 2 days! I’ll continue to tune in and hope you’ll make more episodes regularly!
Love Caitlin & Sophia’s perspective & balance
I have enjoyed listening to the broad range of fertility topics. I have learned A LOT from them, and their presentation of material is very entertaining! Can’t wait for more!
Better without guests
I like the hosts, they are super knowledgeable and have a ton of great info to share regarding nutrition and fertility. I enjoyed the episodes with just the hosts discussing various topics. But, I just listened to the most recent episode/interview with Lily Nichols and the host talked SO much. I wanted to hear more from the guest. I thought it would’ve been more helpful for the host to ask more questions to get Lily talking rather than just fangirling and talking so much.