Infertility

PCOS

Elevate Fertility: Winning Against PCOS

Beyond "Infertility": Navigating Your Path to Parenthood Summit

https://drive.google.com/file/d/1lx3VXfg56mqhmiZHl2FjHaUU8kyImOvm/view?usp=drive_link

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Great. It's so nice to be here. Yes, I always welcome the opportunity to talk about PCOS. It's a condition that I have. I was diagnosed in my late 20s after seeing many different doctors before officially getting the correct diagnosis. Any time that I have the opportunity to help other people with PCOS, I'm appreciative of it. I love helping people become parents.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes, awesome. That's what we're all about. Helping people become parents. Thank you for joining me today. In your experience, PCOS, like one in two women who struggle with PCOS also struggle with fertility. What are the things that we should focus on if someone has PCOS or suspects that she has PCOS that will help her support her fertility and get pregnant when she's ready?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes. PCOS is the main cause of anovulatory infertility, and what's happening is, the research shows that most people with PCOS do go on to get pregnant. The overwhelming majority of people with PCOS will get pregnant and have babies, but it will take a little bit longer and could be a little bit harder. We see a connection with egg quality. There are tons of follicles there. If they measure somebody's AMH level against malaria, on one level, it tends to be high. There are tons of follicles. It's just that part of the problem is that there are immature follicles, a lack of ovulation, and irregular periods. Helping to restore ovulation and improve egg quality is an area of focus, and that's what I do to help people improve their egg quality. That can be done through food, exercise, supplements, and sometimes medications if needed, and then helping to regulate periods and balance out the hormones a little bit better.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes. Awesome. What kinds of things can we do to maybe break it down into chunks? What are the things that we could do to maybe support ovulation?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes, so ovulation can be supported by eating a healthy diet that includes plenty of whole grains and antioxidants. Antioxidants help to support egg quality. We're talking about omega-3 fats. We're talking about whole grains; we're talking about fruits and vegetables, nuts, and seeds. These are all great foods to include in antioxidants to help support ovulation. Then we can also look at supplements. For example, vitamin D is crucial in supporting ovulation. Most people are lacking in vitamin D; I don't know how many are in Texas, but here I am.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">It's pretty rampant. It's a pretty rampant problem everywhere in the U.S., for sure. I think we just don't spend enough time outside. Yes, we, and even if we did spend the time outside, would need it in our bodies to convert to the active form of vitamin D, which is all that the sun does. Yes, it's just that it's a double whammy.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Knowing your vitamin D level and supplementing with vitamin D can be helpful for ovulation and exercise. Even just walking, believe it or not, doesn’t seem like much, but getting your body moving can support ovulation as well.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes. Okay. Awesome. Then, in terms of exercise, are there any specific exercises that you think are very helpful for women with PCOS or things that they should maybe avoid? Because I feel some people will push themselves, the high achievers that are, and try to do everything. I'm going to spend 3 hours at the gym every day, so I'm curious if you have any tips on what kind of exercises are specifically helpful.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes, absolutely. The recommendation I always give is the kind of exercise that you should do because you're more likely to keep doing it and it'll be part of your routine, whether that's walking or even walking your dog. Ideally, we should see a combination of resistance training, lifting some weights, and some cardiovascular aerobic exercise. But again, whatever you enjoy, there's no need to kill yourself. There is some research out there that shows that it does not help get pregnant. But moderate amounts of exercise, both strength and aerobics, are helpful for fertility.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Lovely. Okay. We talked about the ovulation piece, fruits and vegetables, an antioxidant diet, and eating whole foods, not processed foods, for everybody. Then focusing on movement. I feel there was one more piece around ovulation. Supplements, of course. Are there any specific supplements that you find helpful, specifically for ovulation?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Vitamin D is the key we talked about. Then another one is inositol, specifically Myo-inositol. This is a member or a relative of the B vitamins, and it acts as a secondary messenger to relay signals between your pancreas and your cell receptors. It does help your body use glucose and insulin better. But we're also finding that in the uterus, the follicular fluid is high in Myo-inositol and PCOS, there might be a defect in the ability to use inositol and it’s converted into another, converted from d-chiro-inositol, and we're seeing that's ineffective for myo-chiro, so it's depleting levels of myo, and that's what helps improve egg quality as well as ovulation.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Perfect inositol and vitamin D are also high on the list for supporting ovulation. Then Myo-inositol also helps with egg quality. Let's talk a little bit about depleted egg quality for women with PCOS. With these immature follicles, what can they do to help support this development?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes, a lot of the same strategies. The antioxidants can help with that. Then those supplements, Vitamin D, Inositol; we also see that fish oil, DHEA, and EPA can be effective and certainly as needed for pregnancy, too. These are all keys. We also see that some advanced supplements, like Coenzyme Q10, can also support egg quality. Help makes it mature, and then just overall managing PCOS and the hormones can help with the egg quality in helping those follicles to mature.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes. irregular cycles being one of the key symptoms and outcomes of PCOS. In your experience, it helps to regulate the hormones regulate the cycle so that women with irregular cycles can get more; maybe they don't get to 28 days, but it's 30 to 34 days, a reasonable amount.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes. Eating a balanced diet can be helpful. We also see that getting regular exercise is helpful. Taking those supplements, Vitamin D and Inositol can be helpful. Then just even getting more sleep. We see that lack of sleep can throw off your cycle, and hormones, are certainly important for stress reduction and keeping cortisol down. All of these lifestyle strategies together can be effective. Inositol, though, says there's good data that shows Myo-inositol can help regulate periods, so that can be effective for getting those cycles more regulated.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Awesome. Myo-inositol is the triple win for PCOS, for ovulation, and supports egg quality for regular periods.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Absolutely. There's a lot of good research on what's probably the most well-studied supplement for people with PCOS.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Believe it or not, I find it tricky. I know the research out there is amazing. There are so many studies on this, and I have given it to people, and they're not changing. Maybe helps with their egg quality, but we don't know for sure. I'm curious if there's any tidbits that you find that you're. it works if you do X, Y, and Z.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Inositol doesn't work for everybody. I think 20% of people would take it, and it's not effective, but to know if it is effective, you have to take it consistently. You have to take it at the right dose, and you have to take it for the right amount of time. We recommend at least three months to have those eggs develop, see what happens, and give you time to track your cycle.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Awesome. Then do you have? I've seen all kinds of data on how much Myo-inositol. What's your recommended dose for how much to take per day?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes, everybody is different. I usually recommend the ratio of 40 to 1 Myo-D-Chiro. This is what is in most of the tissues in the body, and some pretty good data shows that's more effective than either taking Myo-inositol or D-Chiro on its own. In this 40-to-1 ratio, the dose comes out to 2,000 milligrams of Myo-inositol and 50 milligrams of D-Cairo-inositol, taken once a day. I usually recommend taking it with food. Take it with breakfast and then take it with dinner, getting that in twice a day for three months and seeing the full effects of any response.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Okay. I love it. In terms of other supplements that you take for PCOS; maybe what do you think about Berberine? I think we get a lot of good results with that one. What's your experience?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes, berberine. It's been around for a long time. I know it's new to a lot of people, but it's an ancient herb. It's always been used for the treatment of insulin resistance and diabetes. It's good for that. The research is mixed as far as how well it helps with fertility. There's some research out there that shows that it does, and then we just don't have enough overall. I feel enough data to show that it's the go-to for people with PCOS. I think it does help a lot of people. It does help with lowering testosterone, and it can help. We see even helping with body fat mass and, again, insulin. The only thing that we don't know is the data on pregnancy. I don't recommend that someone else get pregnant. I do recommend that they stop it because we don't have any.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes. We don't have any safety data on that.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">I want you to say yes.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">After I hear the interestingly large amount of data that we have, I feel there is very little research being done on what's safe in pregnancy. I suspect that a lot of these herbs are perfectly fine, but there are enough herbs that we know that are not. That is not safe in pregnancy; it makes us nervous. I'm, let's just get you off it because you're doing it. Sure. I'll do that for most supplements and herbs because I just don't want to take them.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Why take the risk? Yes. </span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes. Totally. Any other favorite supplements?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">I mentioned the CoQ10. That's always a good one. Resveratrol is another one that's a potent antioxidant that can help improve ovulation and egg quality. I'm just thinking of a good prenatal that's going to help support your pregnancy. I think good prenatal care should have choline in it. It should also have earned a good amount of vitamin D because vitamin D levels in pregnancy get depleted by at least 2,000 international units, which is what I recommend.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">I agree with all of those, and those are hard to find prenatally with decent amounts of choline are challenging to find.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">You don’t need to take a lot of pills and DHEA too. You don't see a lot of supplements, but a lot of DHEA. It's usually separate from fish oil. It's usually a separate pill that's given with the prenatal, and it's just a big pill. You can't just put it all in one package.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes, pretty challenging to find it all in one. It's the right kinds of nutrients, making sure the vitamin D is the D3 and folate, and just all of the things that need to be checked on prenatal are so rare.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Absolutely.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">In terms of tips for PCOS or women who are struggling with this, is there anything else that you want to add to food, lifestyle, and supplements? I think those three pillars are foundational and certainly create the environment for women with PCOS to have a healthy pregnancy. I'm curious if you would add anything else there.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Yes, the only other thing I would add to those main pillars is sleep, because we do see a connection between lack of sleep and infertility and stress management. After all, high cortisol levels can deplete progesterone, and that doesn't help anything.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes. Let's touch on that because I think it's something we can't stress enough. What about the cortisol going up that causes the progesterone to struggle?</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">The adrenal glands produce cortisol, and that can affect progesterone levels. Progesterone is a calming hormone, and you're going to be depleted of it. You have too much of your stress hormone, cortisol, and if you don't have enough progesterone, that's going to affect your ability to get pregnant. Progesterone is produced with ovulation. It's going to affect your ability to implant the embryo.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Awesome. Focusing on high-quality sleep and quality food. Are there any foods that you love for women with PCOS beyond a healthy whole foods diet? If there are any, you must have them.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">I tried this for PCOS. Those are going to be foods that have a lot in them. They have fat. They're going to have protein, and they're going to have antioxidants. I would say salmon is a go-to food that is safe to have in pregnancy, too. Avocados have a lot of good omega-3 fats, and they're an antioxidant. Berries that are dark in color. They have tons of antioxidants. Olive oil. These are all great foods.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Love it. Thank you so much. I love getting other people's takes on what's there; what are the heavy hitters so that for those of us listening in, you can think about whether these foods are in your diet regularly. We don't have to supplement everything. Superfoods can make a huge difference in creating the foundation through food, diet, and not having to have over supplements.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Absolutely. You should be able to get most of your nutrients from food. Vitamin D is an extra one that you need more of. In pregnancy, we do recommend a prenatal that's getting in good-quality foods, which is important. Lots of vegetables, green leafy for the folate.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes, absolutely. Awesome. I love the ease of this plan. Food, supplements, lifestyle and sleep.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Eating should not be complicated. Going to have enough to deal with if enough on their plate or to speak. This is just one way to take the stress off: eat a variety of foods, look at the nutrient quality, and practice good lifestyle habits.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Yes. Awesome. Thank you so much for joining me today. This is lovely, and we will look forward to your amazing tips coming up in our podcast.</span>

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<h6><b>Angela Grassi, MS, RDN</b></h6>
<span style="font-weight: 400;">Thank you so much.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Thank you.</span>

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<h6><b>Aumatma Simmons, ND, FABNE, MS</b></h6>
<span style="font-weight: 400;">Welcome, Angela. It's so great to have you here today. I'm very excited to dive into the world of PCOS, and you just do such a great job educating people who struggle with PCOS. How did you get into this? What brought you into the PCOS world?</span>

https://drtalks-media.b-cdn.net/Summit%20Audio%20Files/2024%20Summits/2024%20-%20Beyond%20Infertility%3A%20Navigating%20Your%20Path%20to%20Parenthood%20Summit/Transcript%20Files/2024_RIS_Angela%20Grassi%2C%20MS%2C%20RDN%20Transcript%20File.pdf

<p><span style="font-weight: 400;">Angela Grassi, MS, RDN is an internationally recognized author, speaker, researcher, and consultant. She is the founder of The PCOS Nutrition Center where for over 20 years, she has been providing evidence-based nutrition information and counseling to help people reclaim their lives from PCOS. Her research has been published in numerous peer-reviewed journals. Angela is the author of several books on PCOS including The PCOS Workbook: Your Guide to Complete Physical and Emotional Health and</span></p>
<p><span style="font-weight: 400;">The PCOS Nutrition Center Cookbook. Recognized by Today’s Dietitian as one of the Top 10 Incredible Dietitians making a difference,  Angela has been the recipient of several awards for Women’s Health and Research. Having PCOS herself, Angela has been dedicated to advocacy, education, and research of the syndrome. For more information visit the PCOS Nutrition Center website, www.PCOSnutrition.com.</span></p>


Angela Grassi

Angela Grassi, MS, RDN

<p>Dr. Aumatma is a double board-certified Naturopathic Doctor &amp; Endocrinologist, in practice for 15 years. Dr Aumatma supports badass power couples to create the family of their dreams, and also trains doctors who want to specialize in fertility. She is the best-selling author of &#8220;Fertility Secrets: What Your Doctor Didn&#8217;t Tell You About Baby-Making”. She is on a mission to help bring healthier babies into the world by creating healthier parents and the planet. Dr. Aumatma has been featured on ABC, FOX, CBS, KTLA, MindBodyGreen, and The Bump as the Holistic Fertility Expert.</p>


Elevate Fertility: Winning Against PCOS

Aumatma Simmons, ND, FABNE, MS

Angela Grassi, MS, RDN

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Aumatma Simmons, ND, FABNE, MS

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Angela Grassi, MS, RDN