The Fertility Sisterhood_ Episode 1_Enviro and Fertility: Audio automatically transcribed by Sonix

The Fertility Sisterhood_ Episode 1_Enviro and Fertility: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Lara Messerlian:
1 in 6 couples struggle with infertility, and we know that the environment plays a big role in how our bodies reproduce.

Carmen Messerlian:
In the Fertility Sisterhood, join me, Dr. Carmen Messerlian, Harvard epidemiologist and fertility expert, and my sister Lara, as we discuss what everyone needs to know about how the food we eat, the water we drink, the air we breathe, and our everyday environmental exposures impact our health and therefore our fertility.

Lara Messerlian:
Now let's dive in and learn how we can clean up our lifestyles not only for ourselves, but for our future generations.

Lara Messerlian:
Welcome to the Fertility Sisterhood. Cleaning up your lifestyle for future generations. 1 in 6 couples struggle with infertility, and we know that the environment plays a role in how our bodies reproduce. The fertility professor, Dr. Carmen Messerlian, Harvard epidemiologist and fertility expert, and her sister, Lara, take a deep dive into what everyone needs to know about how the food we eat, the water we drink, the air we breathe, and how our everyday lifestyle habits and environmental exposures impact our health and therefore our fertility. So welcome to episode one, the environment has everything to do with your fertility. I'm Lara Messerlian. I'm the sister who has been struggling and had struggled with infertility for many years. I've had many miscarriages, many losses, and the last one being extremely devastating, and luckily, I'm joined by my beautiful, wonderful, most talented sister, the fertility professor, Carmen Messerlian. Hi, Carmen, how are you?

Lara Messerlian:
Hi, sister Lara. I will do a little introduction. So I'm Carmen, don't call me Dr. Messerlian or Professor Messerlian, I'm Carmen to the whole world, and I'm a reproductive epidemiologist. I study infertility at Harvard Chan School of Public Health. I love my job, and I love it because I get to understand and study all the factors that we are exposed to in our environment, our built environment, our natural environment, and our social environment, and how all those exposures impact the eggs we make, the sperm we make, the embryos we make, how we conceive, our pregnancies and our most importantly, our children and their health and development across their life course. I'm really privileged to have this job, and the most part of my job is really to take the knowledge that I gained from my research and for my expertise doing these studies and trying to translate that to people's lives, to your lives, so that you can have better outcomes, you can have more empowerment in the information that you have access to, to make healthier choices for yourself and for your partner and for your future family. And it is my utmost privilege and honor to be able to share my knowledge with all of you so that you can make the families that you desire and deserve and ensure that they are healthy for their entire lives as well, so thank you.

Lara Messerlian:
One thing that I found over the years that was interesting to me was I'd go to all my various doctor's appointments, whether it's freezing my eggs or going to IVF, or just going to my regular OB to check out and see what's been going on in my body. They'd, I'd always mentioned that my sister was a fertility expert, and they'd say, how funny and interesting that you struggle with such, what they seem to think was very rare fertility issues and that my sister happened to be an expert in the field. So I felt very lucky to have you guide me throughout my challenges and just throughout my life. And today we're going to cover the five things you need to know about your fertility that your doctor never told you. And I think this is a really great topic because, throughout my course of my experience, there were certain things that you would always talk to me about that I just never got. I just didn't understand that these were issues that I really needed to care about or that they really even affected my ability to have a positive outcome in terms of conceiving and pregnancy. So the first thing that I really want to discuss is, did you know that the chemicals and the straws and cups you drink your iced lattes and your coffee out of can actually impact your ovulation and risk of miscarriage? Well, I didn't know this either when I was trying to get pregnant. I was living in New York City. I was a professional woman trying to get to work every day. I'd grab my coffee every single morning, and I'd rush around, and I'd eat many of my meals out of the house, and this is something you always advise me not to do because it was unhealthy for me, but I didn't get it. I really did not get it. I just thought, how could me getting a cup of coffee to go every day is going to have, how would that have a problem with my ability to conceive and have a baby? Can you tell me more about what is the underlying problems with these cups, and straws, and to-go packaging that affects our fertility?

Carmen Messerlian:
So this is a huge exposure source, what we call, in my field, where you get exposed to things. So food containers and food packaging and straws and cups, anything that's packaged outside of your home, outside of ceramic plate is made out of plastic. If you look at the world, we are surrounded by plastic. Everything that we are in contact with, especially our food, is coated or covered in plastic. So what is plastic, and why is it so bad? We know that plastics contain phthalates. Phthalates is a huge large plastic chemical, industrial chemical, and commercial chemical that is produced in the tens of millions of tons per year across the globe. So why do we care about this? Because phthalates have been shown in countless studies, both animal studies and human studies. Human studies are the ones that I do. My colleagues study animals. And we know that these chemicals, these phthalate chemicals are reproductive toxicants. They're actually labeled as reproductive toxicants. They harm reproductive health, they harm male health, and they harm female health. And how they do that is different depending on who's exposed and when you are exposed, but we have studies that have shown that exposure to these phthalates, certain kinds of phthalates, and the types that we find in the straws and the cups that you get your Starbucks or your Dunkin Donuts coffee from and any kind of straw cup is coated with these chemicals, and these chemicals are not bound or bonded to the actual container. So they leach out into the beverage, especially if the beverage is hot. And even if the beverage is not hot, they leach into the food or into the beverage, and then you drink it, and then your body gets exposed to it, and then it metabolizes it. But what we know is that individuals and women of reproductive age that have higher concentrations of these chemicals when we measure these chemicals in their urine, because that's where we measure them in, the metabolites of these chemicals, individual women who have higher concentrations in their urine have reproductive problems, including higher risk of miscarriage and longer time to pregnancy, difficult ovulation. These chemicals have also been associated with things like PCOS. And in men, we see that these chemicals are associated with the impact male semen parameters. So we see differences in how men produce sperm, the amount of sperm they produce, the quality of the sperm. And in total, we know that phthalates result in diminished fertility capacity among couples. So couples have a longer time to pregnancy. And even if they do get pregnant, they have a higher risk of miscarriage. So overall, these chemicals we should avoid, because we know that the reproductive toxicants, and there are many sources, we named a couple like the straws and the cups that you drink your coffee in, but.

Lara Messerlian:
What about the to-go containers when you get your food, when you get delivery at your house, they often come in these containers. And I always check to see, oh, is this a container made of paper? And if it is paper, does it mean it's more safe, or is it still lined with some sort of plastic? And then when we're talking to-go cups, if I take the cover off, is the cup itself still going to have a lining of some sort of plastic that is going to get into my body?

Carmen Messerlian:
Yes and yes, all yes is to all those things. So just think about a paper cup. A paper cup for it not to leak or a container that you get your takeout in for it not to leak grease or oil or liquid or water or soup, whatever it's in. Like you get your Chinese takeout, right? You get your Chinese takeout is in a cardboard box. The cardboard box has to be leakproof, and waterproof, and oil-proof, and so they coat that cardboard box with a substance that allows it to become water-repellent and not penetrate through the paper. So those chemicals to make that product so useful, to be able to package your food, actually contains chemicals, and phthalates is one of the classes that I talked about, but there are other classes of chemicals as well, something we call p-fas or perfluorinated chemicals, which are stain and water and oil resistant chemicals, again, in your food packaging and your takeout in your container cups, even in the food that you get from the grocery store. So I'm guilty of this because I buy ham and sausages and things that my teenage sons like to eat and cook for breakfast. And every time I have to open up the bacon, or I have to open up the sausages, and they're in plastic, they're on a plastic container, they're air locked, and you have to cut them out, but it's been soaking and sitting in plastic for weeks or days at least. And there's, the sad and terrible thing about it is that these chemicals don't stick to the plastic, they actually are not bonded to the plastic. So they leach out, and there's transference into the food, and there's very little you can do once you consume the food or purchase the food to actually stop yourself from being exposed. The number one thing that we say in my work and when we try to educate people is reduce the amount, you can't reduce, I drank three Starbucks things today, right? So I was exposed three times to Starbucks cuppies. So maybe in my particular case, I'm not trying to have a baby, but if you're someone who's trying to get pregnant, reduce the amount of times you go. So instead of going three times, go two times or one time or bring your own ceramic cup or stainless steel cup to fill it in. And if you really are serious about getting cleaning up your lifestyle, you need to make these types of detox steps to be able to reduce your total body burden, your total body burdens, all the chemicals that you're exposed to every day. You need to reduce your total body burden. And you do that by just reducing whatever you have control over every single day until you can achieve a goal that seems manageable on a day-to-day basis.

Lara Messerlian:
Just one more thing about that. I just also wanted to mention, I think you recently opened my eyes to pizza boxes as well, that we get pizza once a week, and I didn't, it comes in a paper box. Just wanted to make a mention that you, if you can tell me more about that because you know it seems like such a simple thing that most people do on a weekly basis without ever even thinking about it.

Carmen Messerlian:
So this is it. This is it. So I've got teenage sons, and they're in the stage of development where hormones really matter. And so, for me, it's still a concern for their reproductive health because one day they're going to be men that want to reproduce. And so their bodies are developing as adolescents right now, and we're exposing our children and our adolescents and the individuals that are trying to get pregnant to a whole host of chemicals and pizza boxes scare the daylights out of me because we know that the food contact material that they're produced in the cardboard and the lining that the pizzas put on is coated with what we call perfluorinated chemicals. And these are really scary chemicals. They're called forever chemicals in my world because they last in your body for 2 to 10 years. So once you're exposed to them, it's almost impossible to shed your body out of them, and they stay in our environment. So once you dispose of that cardboard box, and it goes to the refill and gets recycled because of the paper, that refilling that recycling process actually upcycles all those chemicals back into the system. So the recycled boxes with recycled paper are actually triple coated with these p-fas, which stay in our environment for hundreds and hundreds of years. They don't biodegrade, they don't break down, they don't, they just, they bioaccumulate up the food chain and end up in the food and in the meat that we eat and the vegetables that we consume because they get put into soil if things are getting recycled, composted. So there's a whole system involved in how these chemicals just keep regenerating into our environment. So P-fas is a classic chemical that we'll get into. So this podcast, we're going to cover all these chemicals in more depth, today we're just going into really quick knowledge things we want you to detox on. So here's an idea. Going to get your coffee? Don't use a straw. Remove the lid and bring your own cup if you can. Those are three things you can do to reduce your body burn. You can't eliminate all chemicals. I can't, and I'm an expert in this space. My children are exposed. I can't do magic tricks to eliminate every chemical in our body. But there are small things you can do just to cut down a little. A little is better than none. And every day, little small incremental changes that you build into your lifestyle will allow you to have a detoxed opportunity for your reproductive health.

Lara Messerlian:
It's funny you say that because I was just going to say the same thing, is that this is an intro to the podcast, and you're going to learn so much more about me as a person and my sister and her science throughout the coming episodes. And this is just a quick intro as to, you know, five quick things that you can learn about and what you can do to make a, hopefully, a larger impact in your life in terms of your fertility health. The next thing I wanted to talk about is getting your nails done. And did you know that getting your nails done can harm your eggs and impact ovulation? Like many women today, I would spend every Saturday at the salon getting my nails done without ever thinking that such a simple act of going to the salon and getting my mani and pedis could have such a significant impact on my ability to conceive a healthy baby. That's point two. It's, I'm guilty of this, and luckily over the pandemic, I stopped getting my nails done, and I stopped doing those regular things that I did every week without ever thinking twice about it. But tell me about a study, I remember, you had mentioned to me many years ago, actually, when you first started telling me to stop doing these things to myself. Tell me about the actual effects of the study, because I found that really powerful, that the levels in my blood actually could be tested and could be proven that there were there was something chemically wrong in my body after getting my nails done.

Carmen Messerlian:
Yeah, so that's such a great point, and I'm guilty of getting my nails done. I got my nails done for Valentine's Day, but it's not something that I do regularly. And the reason why that is, for what you just mentioned is that the nail polish that goes on to our nails contains toxic chemicals. We know that these chemicals are highly toxic. There are a number of different chemicals that have been identified, that there's thousands of chemicals in these products. First of all, they have flame retardants in them. They have another kind of chemical class of flame retardant, that's one class of chemicals. Another class is formaldehyde and camphor and dibutyl phthalate. These are all reproductive toxicants. And we know that they transfer into our bloodstream because there have been studies that have measured pre and post-concentrations in your urine of some of these chemicals. In particular, this study that you're mentioning measured the flame retardant that is significantly found in these products, in nail polish products. And when they looked at women's urine before they got their nail polish and after they got their nail polish done or their manicures done, the concentrations of these chemicals in their urine was seven times higher, approximately ten hours after getting their nails done. So compared to before they got their manicure, their levels increased seven times. So this means that there's, what we call transdermal absorption, so that's a route of exposure. So we have different ways that these chemicals enter our body, and one of the ways is through our skin or through the nail bed. So the nail bed has nail polish on it, and within a few hours, it starts to absorb into the nail bed and into your bloodstream, and then it gets into your body. It gets into your, into the parts of your body that you don't want it, in example, into your ovaries, into your uterus, into your bloodstream. We've detected some of these chemicals in the follicular fluid of women who've gone through IVF. We can actually quantify these chemicals in the follicular fluid when we remove an egg from a woman during IVF, we measured the fluid that comes with that egg, and we've detected these chemicals in the fluid. So it's concentrated in our ovaries, it's concentrated in our eggs, it goes into our bloodstream, it has epigenetic modifications. And we know through this work that both through animal studies and human studies, that higher concentrations of these chemicals in our body results in a higher risk of miscarriage and a longer time to pregnancy for women. In addition to that, we see that men who have higher concentrations, that men are getting their nails done, but men who have higher concentrations of certain chemicals in their bodies have poor semen quality. And so we need to be concerned both for ourselves and for our male partners when we're exposed to some of these endocrine-disrupting chemicals, which is what we're talking about in the grand scheme of the, we talked about a few classes here today, phthalates is one of them, perfluorinated chemicals are, forever chemicals was another one, and now we're talking about flame retardants down in nail polish, among other chemicals, all reproductive toxicants, all associated with a longer time to pregnancy, more complicated histories in their pregnancy, including miscarriage risks and lower semen quality for male partners. So yeah, nail polish and nail salons was not something, if you're trying to get pregnant, something that you should reduce the number of times you go, the frequency of going. If you need to go for a special occasion, that's okay, but I really strongly recommend really just trying to detox your body by avoiding certain types of cosmetics and services that expose you to high levels of these chemicals through these things like nail polish and makeup we talked about earlier today.

Lara Messerlian:
That was the one that really disturbed me. Like, it stuck with me for many years now because it's just something you never would think about when you're at a salon, and you're getting your nails done, you feel really pretty, you feel really good, and you'd never think that hours later that there's still chemicals that are leaching into your body and going into your bloodstream and going even, as you said, into your ovaries. You, it just, the connection is so surreal somehow that you wouldn't even put the two together, right?

Carmen Messerlian:
And these chemicals are also carcinogenic. So even if it had no impact on your reproduction, you're not trying to conceive these chemicals are known carcinogens, and they can increase your risk of all kinds of reproductive cancers, including breast cancer and other types of cancers, ovarian cancer. So we want to be really careful with our exposure just for our bodies across the life course, not just for reproduction, but across our life course, to make sure we are as healthy as we possibly can be.

Lara Messerlian:
Okay, That's really interesting, thank you. So number three, the hours of sleep you get every night and the amount of alcohol you drink each week affect your chances of getting pregnant. Okay, I'm guilty of this one, too. I never knew that my personal choices and my lifestyle had such a significant impact on my reproduction and my ability to reproduce, but when you add up all these small choices, they make a big difference in your overall reproductive and your overall health. I remember also coming to visit me in New York and had, living in, people who live in New York City understand how much the city never sleeps, literally, because there's always noise, there's always light pollution, there's always sirens going off. And I remember you coming to visit me saying, how do you sleep? How is it that you sleep? And you made me get blackout blinds on my windows because of all the light pollution coming into my bedroom. So tell me a little bit about how this actually significantly affects one's ability to reproduce.

Carmen Messerlian:
Yeah, so sleep, sleep we know is associated with a whole host of things. So when we sleep, the benefits of sleep actually allow us to decrease our inflammation. Our bodies produce certain types of hormones while we're sleeping, and these hormones are really protective for our bodies and for our minds, and for our reproductive health, low sleep or not enough sleep results in your HPA axis, your HPA axis is your hypothalamic pituitary adrenal axis, and that's like the main driver of how our bodies regulate stress or one of the main drivers of how our bodies regulate stress. And when we don't have enough sleep our HPA axis gets disrupted, and that HPA axis disruption results in higher levels of cortisol, disrupted cortisol levels across the day, and these things are known to increase our time to pregnancy. So when we have higher levels of cortisol, our bodies can't reproduce, our bodies sense stress. And when our bodies are under stress, our biology tells us it's not a good time to reproduce. So sleeping is really important, both for males and for females, it's not just for females that we're talking about. These studies have shown that too little sleep or too much sleep is associated with differences in our fertility for both men and women. In addition to that, alcohol is something that we need to be careful of as well because it's a social thing to drink alcohol. People do it socially, but they also do it to try to mask sometimes pain. And going through infertility is a painful process, and failed attempts at IVF is also a very difficult process. I have worked that, I've looked at and published looking at the trauma of infertility and how it's experienced as a trauma and how that trauma results in more stress. So it's a vicious cycle where you are infertile, it causes stress, the stress goes up, it causes more infertility, and it's a vicious cycle. And the experience of the loss or the experience of a failed cycle can be very traumatic for women and for couples. And that can sometimes result in us coping through mechanisms that are not super healthy like alcohol or drugs or marijuana, and these things are also not healthy for our reproduction. They diminish our capacity to reproduce, and they increase our time to pregnancy and result in lower chances of successful outcomes and a higher risk of miscarriage. So really modifying your lifestyle to improve your sleep and to decrease the amount of alcohol you take per week, binge drinking is really toxic to your body, but even regular episodic drinking, where you're taking 1 or 2 drinks a few times a week can be harmful to your reproduction. And so, trying to detox your body from alcohol and try to improve your sleep habits could be strategies to ameliorate and improve your chances of successful reproduction for you and your partner.

Lara Messerlian:
Yeah, again, this is something that I never thought about because I would go to have drinks with friends after work at least 2 or 3 times a week. And as I said earlier, when you add all this up, you look at your total lifestyle, you're not thinking, okay, I got my nails done on Saturday, I'm going for drinks every Tuesday, Wednesday, and Thursday night with friends, I'm eating out 3 or 4 times a week. It's, when you add them all up, it ends up being a really significant amount of pressure that you're putting on your body and on yourself. And the other thing that I thought that you mentioned that is really important is the pressure that comes with loss. I know having gone through loss multiple times, the last one being very, very traumatic. I think a lot of women can relate because actually affects your everyday confidence. It wasn't just, oh, I had a loss, and I lost a baby. It was the fact that all of a sudden my confidence, I couldn't go to work and feel good about what I was doing in the office. I had to have a lot of therapy to help me cope with the anxiety and the stress of having a loss. I couldn't perform in my everyday job the way that I would have prior to having these, having the miscarriages, and I don't think that people realize just how deeply it affects your everyday lifestyle, your everyday capability of doing regular tasks that you would have done prior without ever thinking twice about it. I had, I remember going to the office and feeling like, Oh my God, my boss is going to think I'm doing such a terrible job. I'm such a failure, I can't, I can't even do my work. And it wasn't, I didn't even clue in that it was related to the fact that I had just had a significant miscarriage. I just felt, oh my goodness, I'm such a failure, and I can't even do my job every day. And it was even hard facing people in the office and just pretending like everything was okay and normal, but I think a lot of women go through that.

Carmen Messerlian:
Yeah, those are good points, and what we're looking at right now, what my team is looking at Harvard, and what we're studying much more deeply and we hope to do even more work is, we put together theoretical underpinnings of the connection between pregnancy loss and infertility and how that could be experienced as trauma, which is what you just described, and the symptoms of PTSD, actual PTSD that's exhibited following a failed cycle and a failed IVF cycle or a failed natural cycle, or even if you have a success and you get pregnant, a miscarriage, and how that is experienced by the body and the mind, both for the female and male partner, both of them can experience PTSD symptoms, and that PTSD, those PTSD symptoms are actually your HPA axis. Again, the hypothalamic pituitary adrenal axis being dysregulated and being hypersensitive to stimuli and exposures, and not knowing how to integrate sort of the connection between your body and mind and you feel a tremendous amount of stress, anxiety, sleep is impacted, your appetite's impacted. You might be again more prone to exposing yourself to alcohol or drugs to be able to cope with the feelings of loss and isolation and feeling like a failure because now you feel your body has failed you or something's wrong with you. You integrate that as a woman so deeply and trying to understand that and treat the couple holistically in a way that allows them to heal from the loss and experience the loss and integrate the loss in a way that's more holistic and healing for them so that they can move on to the next cycle without the traumatic feelings or the traumatic symptoms that come with that. That's an area that's being developed right now in the space of fertility and requires so much more investment of money and treatment and care and attention for couples that are suffering like this. And we know that there is biological underpinnings to this, and the work that I'm doing at Harvard is showing some of these biological underpinnings. And we need more research to be able to understand exactly how the body-mind connects with respect to fertility and infertility.

Lara Messerlian:
Yes, and I think the mention of the male partners is really important because I know, when I went through the last one, my husband, Brian, he, your brother-in-law, my husband, I think, also had a really significant mental and emotional impact from the loss, and I think his drinking increased significantly after that. And we were having challenges because he didn't know how to cope with the loss of a child that he didn't even carry, for example. And, but the loss was very significant to him, and I think he felt it very deeply, but he didn't know how, what kind of outlet to use, and how to cope with.

Carmen Messerlian:
Men. Harder for men.

Lara Messerlian:
Much harder. It was so hard for him, and I didn't know how to help him through that, even though I was trying to help myself cope with what had happened to us.

Carmen Messerlian:
So for men, it's harder because, A, they haven't experienced it biologically, physically, right? So then they also are experiencing loss through you, so they are mourning and empathizing with their female partner, and seeing you experience that is a loss to them and a pain for them, but then they also mourn the loss of the child. So they have a double, they have a double burden. They have the burden of trying to care for you and feeling for you and empathizing for you, but also their internal thing, which is this baby that I cared for and logged in my heart and wanted, so much is now not there anymore. And so, there's two things that they have to cope with, and even hard for men. We really need to pay much, much more attention to the male partner because we don't appreciate just how much they struggled through the infertility process as we do, and they cope so differently than we do. They don't cope the same way. They don't have the type of support structures or even conversations or even language to be able to use with their guy friends or with their female friends or colleagues or partners to even say, I'm really sad and really hurt, like men have a hard time with their feelings, and we need more attention paid to the male partner because they need care and attention just as much as we do in the process of trying to conceive. And there hasn't been enough focus on the male partner and trying to support him in the process, educating him, empowering him, helping him know how to support his female partner through the process are all things we're working on at Harvard to try to understand better and also educate practitioners and doctors and people working in the space, and developing treatment protocols and prevention tools that allow fertility clinics and individuals to access information that allows the male partner to be integrated. One of the things that I'm very passionate about is really this idea that we're talking about female health and women's health, but we're only as healthy, if we're in a heterosexual partnership, as our male partner. So if we want to focus on women's health, which is my goal in my work, is really, it's about empowering women and helping women achieve their goals and reproduction. We need to make sure that their male partner is as healthy as they possibly can be. And without focusing on the male and making sure he's healthy, it's a limiting factor for a female's health. If the male partner is the weakest link, if he's unhealthy, then we're going to be unhealthy, and if the relationship is unhealthy, then you're unhealthy. If his habits are unhealthy, then there's a chance that your habits are going to be unhealthy. If his body is unhealthy, it'll impact your chances of getting pregnant and having a successful outcome. So really, one of the episodes will focus entirely on the male partner and trying to understand the exposures to men and how we can take care of men as well as women in this reproductive life cycle that we are all experiencing. So stay tuned for that episode.

Lara Messerlian:
Yeah, so after I had my loss, I went through a major, obviously emotional and physical, and everything changed. It was really difficult, but with time I understood how the changes that I needed to make to help myself and help my husband get to a better space, a healthier space. Even though we were very healthy, we exercised, we took good care of ourselves, we were making a lot of bad decisions on the day-to-day. And one area that I really cleaned up was my personal care products, including my shampoo, body lotion, face creams, makeup, all of these contain lots of toxic chemicals that you never really even think about. Many over-the-counter, high-end brands that I was using every day actually were really bad for me. And I started to research this after you kept telling me repeatedly to stop using these products. I started doing a ton of research and looking at really interesting websites like the EWG Skin Deep Database, which helps me make better decisions and find products that don't have these endocrine disruptors. So tell me about how my personal care products and the choices of what I was buying actually, really, even if they were really high-end fancy brands, were really not healthy for me in the long run.

Carmen Messerlian:
So I talked a little bit about sources of exposure, and we'll get into that more in some of the future episodes, but just as a little quick take here, today as the top five things, we're talking about personal care products, one of the number one sources of exposure. So we talked about food initially and the packaging of food and how that's a source of exposure, but what we put on our bodies every single day, how we wash our hands, the kind of soap that we use, the kind of shampoo that we use, the body lotion that we spread all over our skin, the face cream, the deodorant, the.

Lara Messerlian:
Household products.

Carmen Messerlian:
And products and the suntan lotion, how those things, those products contain countless chemicals in them. And sometimes the higher-end ones have lists of chemicals that you, first of all, can't even read them, and I'm a scientist. I don't even know how to name some, but there are classes of chemicals in there that we've studied that we know are toxic reproductive toxicants, and most importantly, that it's we're putting it on our body constantly. So the number of products, personal care products we use every day has been, in studies that I've done at Harvard, has been associated with higher concentrations of these chemicals. We've measured the number of products that someone uses, and then we looked at their urine or blood samples for certain kinds of chemicals, and the more products, the higher levels. So decreasing the number of products, just that alone will decrease your concentration, decreasing the amount that you put on your body will decrease your concentration, but even better than that is trying to find products that don't have those chemicals, avoid phthalates, avoid parabens, avoid phenols like BPA, avoid benzophenone, which is in UV blockers and other kinds of chemical classes that we know that are harmful to your health, but those are the big ones that I look out for. So what do you avoid is, avoid anything with fragrance, anything with scent, anything with color. These are always products that have higher concentrations of phthalates in them, because phthalates, one of the uses that we talked about was it's a plasticizer helps with plastic coating in food packaging, but there's other classes, other kinds of phthalates that use, are used in the manufacturing of these products to adhere the scent and color to the product. So avoid anything scented, avoid anything colored, avoid anything that allows the product to be more emollient, for example. So you need to try to look for products that say no phthalates, no parabens, no phenols. And there are companies that have this, EWG mentioned, the great site, definitely a good place to look for ones that are shown to be less toxic. There's nothing that's absolutely safe except for maybe coconut oil or almond oil or olive oil or and even those there's pesticides in them and stuff, but nevertheless, there are products that have less concentration of these chemicals and are deemed safer, ... not safe, but safer and less toxic. So these are things you can do. Another thing is just avoid putting on makeup. So today, I did put on makeup is have a talk to give in, at 11:30 at Harvard, but if I'm not going to be live in anything, I don't put makeup on because it allows my body to take a rest from those chemicals. And if I was trying to get pregnant, I would avoid putting on makeup as much as possible to allow my body to detox as much as possible.

Lara Messerlian:
And one trick you taught me was that if the product label doesn't specifically say no phthalates, then you have to assume that it's in the product. So they need to specifically say no phthalates, no BPA, no this and no that, and therefore you can trust that the product, doesn't have it in the packaging or in the product itself.

Carmen Messerlian:
Exactly, so we have, the packaging is a whole other story because it leaches from plastic bottle into the product as well, so that's another way.

Lara Messerlian:
Okay, so did you know that the kind of foods you eat and the quality of your diet can have a positive or negative effect on your chances of getting pregnant depending on your food choices and how you prepare them? Okay, I still struggle with this one. I'm really having a hard time cooking my meals after eating out for ten years, but it's something I'm working on each and every day to do more home-cooked meals. So tell me about this.

Carmen Messerlian:
So that's such an important point, and our diet is the number one source of exposure to anything. The food we eat, the air we breathe, the water we drink, those are the three main things that we're exposed to every single solitary day from the minute we're born to the minute we die. And our diet can be helpful. There's so many good things in our diet that we benefit from to improve our fertility and our reproductive health and our general health, but there's also things in our diet that can be harmful. So pesticides have been shown to be associated with fertility concerns. And so one of the things that I recommend, and it's not something that everybody has access to because organic foods and organic products are obviously more expensive and something that we need to correct from a policy point of view that organic foods are not unaffordable to people, it should be accessible to anyone and there should be better standards of how we produce our food in the United States and abroad. But pesticide-free products that have organic labeling are, have generally your pesticides in them. And there are lists of foods that are considered high toxic pesticide food contents, the ones that have high levels of pesticides and numbers, and they're called the Dirty Dozen, you can look them up, and those products are ones that I really strongly suggest that you swap out from conventional to organic to help decrease your body burden of these pesticides. Other things in your diet can be harmful too. We talked about that. So how you prepare your food and the kind of the packaging your foods in can result in exposure to phthalates and other chemicals. So decreasing the number of times you eat out, decreasing your processed food, and processed foods are known to have these chemicals in them. Phthalates, flame retardants, perfluorinated chemicals are all found in the packaging of the food that we purchase that is processed. And during the manufacturing and making of those foods, if you think about a food plan, the food goes through a whole host of steps, and all those steps have plastic in them. So if you look at a manufacturing plant, anything from bread to olive oil to butter to milk to cheese to anything, every single one of those steps in the manufacturing of food is in contact with plastic. So even your olive oil, how do you get olive oil into a jar, it's through plastic tubing, and plastic tubing has DEHP in it or diethylhexyl phthalate, and this is one of the most toxic reproductive chemicals that we know that I've studied in my lab and in my work at Harvard, and people studied all over the globe to be shown to have an effect on your egg quality, the sperm quality, your chances of having a healthy pregnancy, having a miscarriage. These outcomes have all been associated with higher levels of these chemicals in your bloodstream or in your urine. Actually, in this particular case, we measured these metabolites in your urine. So yeah, so our diet, I'm going on a little bit on this one, but your diet is a really important source that can actually be either helpful or can hinder your reproductive health. And so trying to make healthy choices is something we'll talk about in one of the episodes, and we'll get into more details about this. So this is just basically a little teaser today with the top five things that you should know about that your doctor never told you. We're going to be diving deep into each and every one of these topics in the next ten episodes that we'll be airing, and we're so excited to share our insights with you, and our experience with you, and our science with you. And we're super grateful for this opportunity to be here in your lives, telling you more about how the environment impacts your reproductive health and how you can clean up your lifestyle to improve your outcomes and to create a healthy family for you and your future.

Lara Messerlian:
Yes, I think the whole point is some of this can feel really daunting, and I know it felt really scary for me thinking about, oh my goodness, how, I can't control all of these things. There's so many toxins out there. How are they even in all these products, and how can I deal with this? It can really be overwhelming, but I think the point is that there are simple steps that you can take as an individual that can really make a big difference and a big change, possibly even change the outcome that you're looking to achieve when you start to really make some simple yet really effective lifestyle changes. I know I did make these changes, and so hopefully, it'll add a source of information and inspiration for all of you who are trying to conceive and trying to have children. And we want to thank you all for joining us, and we're so grateful that you're here, and we're so grateful for the opportunity. And there'll be more really interesting conversations to come in the future, so stay tuned.

Carmen Messerlian:
Thank you so much for having me, and I'm really excited to be here. And as you just said, the harm minimization or the opportunity to make small incremental changes every single day that allows you to overall make an impact on your health is something that we want to talk about in the future. So thank you so much.

Carmen Messerlian:
Thank you for listening to The Fertility Sisterhood brought to you by Rescripted. We hope it has left you feeling more educated and empowered about the role environmental factors play in our reproductive health.

Lara Messerlian:
If you've enjoyed this week's episode, be sure to visit SEED-Program.org to learn more about Dr. Messerlian's research. To stay up to date on the podcast, follow Rescripted on Instagram and TikTok at @Fertility.Rescripted or head to Rescripted.com.

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