The Fertility Sisterhood_Episode 9 - Sleep and stuff: Audio automatically transcribed by Sonix

The Fertility Sisterhood_Episode 9 - Sleep and stuff: 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:
Hello, everyone, and welcome to this week's episode of the Sisterhood Fertility podcast. I'm your host, Lara Messerlian, and I'm joined by my co-host, Dr. Carmen Messerlian, my sister. And we're here to talk to you today about, it was originally going to be a sleep episode, but I think we're just going to talk about a couple of different things that we thought were important, because this last week, a couple of things happened that I thought were of interest and I thought it'd be good to share. So I don't know, do you want to talk about sleep first, Carmen? And then just kind of get into a natural conversation about things?

Carmen Messerlian:
Yeah, I mean, I'd like to share some information about sleep and how important sleep is to both men and women with respect to basic parameters around fertility. I think that's something that our listeners probably would love to have some information on because we kind of neglect our sleep. And then, once we're done talking about sleep, we can move on to other questions related to quality of life and related to sort of how to get pregnant and how to work together as a couple. And couple's health, I think, is a great area to start, after we, yeah, why not?

Lara Messerlian:
So, let's talk about sleep. One thing that I have to say is, now that I have a daughter, and you know, there's a lot of women out there and couples out there that are probably trying to conceive a second child after having a first child. Sometimes, you're having a hard time on the first go, like I did, sometimes people have success the first time around, and you know, they're having a hard time the second time around, which I think happens to a lot of people. Like, for me, I got no sleep last night because Olympia woke up in the middle of the night and decided she was hungry, and I had to get up and feed her, and take care of her, and rock her, and, you know, it took like from 3 to 4 a.m., probably, I was up doing all that mommy work. And I thought, wow, you know, if you're trying to conceive like as a mom and as a person in general, even before I was a mom, like I was living in New York, as you know, and there was a lot of noise pollution, and my sleep quality was really, really low.

Carmen Messerlian:
I was so mad at you for not having.

Lara Messerlian:
Light pollution and sleep-like noise pollution, like I never slept, you never got a good night's sleep, and obviously, as a parent too, you never get a good night's sleep. So, in general, I think that sleep is a really important thing to be on top of. I think it's such a healthy thing when you have a good night's rest, but so few of us actually put that into a deliverable. Like we say that it's important, but we don't actually deliver on it. So, tell us from a scientific side, why is sleep important when it relates to fertility, of course.

Carmen Messerlian:
I want to bring up a couple of things because, just going back to the time that you're trying to get pregnant back in New York City, and I'd come and visit you from Boston, and I'd sleep in your condo that was, you know, in a beautiful area of Manhattan. And you're living in Manhattan, you had no blinds that filtered out the light, and even if you're lying down in bed, you had all kinds of light coming into your room. And there's a couple things that we need to discuss, which is, A, the amount of sleep, and B, the quality of sleep, and C, your circadian rhythm and how important light coming in at night, how disruptive that is to your circadian rhythm. And so, even if.

Lara Messerlian:
I guess there would be cell phone light, too, because like some people have their cell phones right next to their bed.

Carmen Messerlian:
Yeah, so there are three things I'd like to cover, which is, A, the amount of sleep and how what we know about that, and two, the quality of the sleep and how you can measure that, and three, just exposure to blue light and other sources of light during the day or during the night, and your circadian rhythm and how that impacts your reproductive health. So a couple of things that I think matter here is, too much or too little sleep is not good, so, both ends of the continuum, it's like more like a U-shaped curve is what we call it. So there's sort of a window of sleep that is really healthy, and if you're getting too little on one end, or too much on the other end, you're in the unhealthy range. And so the more common scenario is that we see women and men getting not enough sleep, professional people especially, but all kinds of people working shift work we know has tremendous impact on our health. And one of the things that we've been able to measure in the last 5 or 6 years, there's been quite a few studies looking at shift working and quality of sleep and how that impacts our reproductive health. So one of the things that we measure in women is their antral follicle counts or the number of follicles that they produce in a cycle in an ovulatory cycle, and we've seen that women who have poor quality sleep, especially women in their 30s, mid-30s, that was where the effect was strongest, we saw that they had lower number of antral follicle counts in that cycle. And so that doesn't sound like a big deal because if you have fewer follicles, as long as you have one, you can ovulate, but actually, the number of follicles that are produced is a marker of your ovulatory potential. And we want to ensure that women have the highest production of follicles in each menstrual cycle because one of those follicles will mature and rupture and become and, you know, ovulate, and so you can get pregnant. And so if you have fewer, you have a lower chance, and also, the level of hormones that get produced in that cycle is lower. So, we want to try to aim to have 7 to 9 hours of sleep, that is the general range of what is recommended, but it's also very person-specific. So some people feel very rested after six hours, some people feel very rested after 9.5 hours. Really, it's about your own barometer around this.

Lara Messerlian:
I'm a nine-and-a-half kind of person.

Carmen Messerlian:
We can fool ourselves

Lara Messerlian:
Before having a child.

Carmen Messerlian:
Yeah, we can fool ourselves and say, Oh, I feel great after six hours, but you're actually in a sleep deprivation state. And that does impact what we've talked about before in this podcast, which is your hypothalamic pituitary adrenal axis and how you produce cortisol, and your HPG axis, your hypothalamic-pituitary-gonadal axis, is linked to that, so how your body produces things like follicle-stimulating hormone, which then tells your ovaries to make eggs. So those things are all linked with your cortisol levels. And like I said, sleep allows you to produce cortisol at night so that when you wake up, you feel rested, and if you don't produce enough, you don't feel rested, and if you produce too much, you feel stressed out. So there's delicate balance, and sleep is one of those things that allows your body to modulate your hormonal axis. So really important.

Lara Messerlian:
Can I ask a question? Because I'm really curious, it's so interesting. So, you know, we go to sleep, and our brain produces the cortisol, but the cortisol, being part of your endocrine system, tells your ovaries and tells your body to produce the cells and the follicles needed to create life, and so if you're imbalanced, your body might not be producing the right amount or the quality that we need to support life or to create a child, and so therefore, you could potentially have a loss. Is that correct?

Carmen Messerlian:
That's a good question. I don't know if we've studied sleep and miscarriage risk. I'd have to look at the literature. I have not myself, I mean, I think it's a really good question. Your question is like, does poor sleep result in.

Lara Messerlian:
Well, it could be poor sleep. And, you know, as we're saying, it's compounded by the fact that we might have other exposures. We may have this, we may have that, like we might be using the wrong products, and then, if you are adding sleep on top of that and your brain is not actually producing the correct amount of hormones and cortisol, then your body is not being able to be in its optimal state to sustain life.

Carmen Messerlian:
Correct. I think what you're leading into is an area that's extremely important in the work that I do, which is one of the reasons why I'm working so hard on complex exposures and what we call mixtures of exposures. And when we talk about mixtures, we're not just talking about mixtures of chemicals, but mixtures of different predictors of what impacts fertility. And it's not, you know, we're complex people, we're organisms that have, like you said, sleep and diet and chemicals and product use and exercise and tobacco exposure and stress exposure and mental health. There's so many variables, so many predictors, and how these things interplay in an individual and how they interplay between the couples, what really matters. And so what you're saying is if you have high burden of exposure to these phthalates and these chemicals that we talked about in earlier podcast, and then also have low-quality sleep where you're not able to regulate cortisol and regulate the inflammation that might be caused by these chemicals or caused by poor diet or caused by stress. Then you have a complex profile of risk factors that could result in longer time to pregnancy, higher risk of miscarriage, more failed attempts in IVF treatments. So I think what you're leading into is really important, which is it's not just one factor, it's a complexity of factors, and balancing and optimizing your health around these factors is what we're trying to say in this podcast. And what we're trying to educate and teach individuals and couples is that, I always say like, there are things you can control and things you can't. You can't control your genetics, that's set, but a person's particular genetics may be better or worse at regulating stress or regulating inflammation, some of that biologically programmed, and you might be more sensitive to inflammation when you don't sleep. Some people have a higher buffer, some people have a lower buffer; that could very well be genetic, but you need to sort of understand the individual piece that you bring into there. So if you wake up in the morning and you don't feel well, you feel low energy, you feel tired, you feel like you need to turn to the caffeine more, that's a sign that you're not getting enough sleep, versus waking up and feeling energetic, feeling motivated. You might need coffee still, but you don't need three cups, you might need two or one. These are markers of how you feel. How much energy do you feel? How much does your body feel aligned with itself? And sleep is important in terms of how we manage stress. Like you said, sleep is when our bodies produce cortisol and allow us to have that optimal level throughout the day, and cortisol is important because it manages inflammation also.

Lara Messerlian:
Which is really important for miscarriage, because I also experienced that where there was inflammation. I had positive ANAs, I think which was potentially like have inflammatory disease and stuff like that, and that was increasing like risk for miscarriage. This is all related, basically, because your brain is producing whatever, and then your body is reacting, and it creates like a hostile environment in one form or another where you're not able to carry something through.

Carmen Messerlian:
So many different pathways. So the pathway could be through inflammation of the uterine lining, and inflammation in the uterine lining does not allow for a healthy implantation. So that's one mechanism. Inflammation could also result in, if you have a lot of inflammation, you might not be able to ovulate and ovulate healthy egg. There might be too many inflammatory biomarkers that result in a lack of even fertilization. So there's different places where there could be failure, and inflammation can also, chronic inflammation can also result in poor reproductive outcomes. So you can end up seeing more higher risk of things like PCOS and endometriosis. So PCOS is polycystic ovarian syndrome, and endometriosis is where you have endometrial tissue growing outside of the uterus conditions that have been associated with inflammation and chronic inflammation, and chronic stress results in chronic inflammation, chronic inflammation results in these reproductive gynecological diseases that are causes of infertility. So they're all part of the pathway, and sleep is a way of managing our stress, and sleep is a way of managing our mental health. And we have to think of the long-term plan around sleep. It's not like, Oh, I got a good night's sleep last night, I'm good. It's how have you been sleeping in the last month? It's how have you been sleeping in the last week, two weeks, three weeks, four weeks? It's not like I slept well tonight, so tomorrow night I don't have to sleep that well, and it's okay. It's, we need to have patterns that are healthy, that cause inflammation. It's variable during the day, but you're at a level that is, you know, in like weeks that could be indication of high inflammation, and so to get that down, you need to keep your sleep and your stress levels low over.

Lara Messerlian:
A long period of time. We'll have to say that's the main reason why I left New York, because I'm like, I can't take the lack of sleep anymore, after ten years. I'm like, even living in a beautiful apartment, like, there's still always noise and pollution. And I'm like, I just can't do this anymore. I need to not hear sirens. I need to not hear the noise. Yeah, I remember now if I hear a siren, like my spidey sense is just like cringe because I'm like, I can't take the sound anymore. Like, it was just too much for me, and I couldn't, it's really why I left. Like, I couldn't take any more. Like, it was like an assault on my entire body and my entire system so.

Carmen Messerlian:
That you're not, so even if you are in bed and you're exposed to noise and your noise pollution or sound pollution and light pollution, those things have been associated with inflammation and poor regulation of cortisol in studies. And so we also see people who have those kinds of exposures have higher risks of not just infertility, but also things like cancer, things like cardiovascular disease. So circadian misalignment is really, really important as a risk factor for infertility through the pathway of inflammation and cortisol and other pathways as well.

Lara Messerlian:
So how does it affect men then? Because like we're talking about follicles for women.

Carmen Messerlian:
So the endometrium and the follicles, so the follicles is the ovary, and the endometrium is the uterus. So both of those things could be impacted directly through sleep.

Lara Messerlian:
We've shown that, what they call a hostile environment, because I've heard that before with my own pathway where they're like, Oh, you just didn't know you had a little hostile environment for conceiving. ...?

Carmen Messerlian:
That is the ovulating, beautiful eggs, and if you have very high inflammation in your uterus, there's not going to be successful implantation, or there's going to be a higher risk of miscarriage, and I think that's why you're on some anti-inflammatories during, you're on prednisone, I think. And people who have underlying conditions like autoimmune diseases, people who have just chronic stress, previous history of trauma, mental health, etc., etc., can have high inflammatory biomarkers in their system which make the environment hostile. So, if you have a lot of inflammation, your body's not going to be too keen, that little embryo is, not be too keen on implanting in that space that feels hostile. That's a word that's used to say, like it's not cushy and warm. It's a high-stress environment.

Lara Messerlian:
Yeah, it's a high-stress environment.

Carmen Messerlian:
Yeah, so.

Lara Messerlian:
What about men? How does it affect men? Like we're talking women mostly, but how does this affect men in terms of their sleep? Because as we spoke in the last podcast, there are 50% of bringing life to the table, and more than just healthy sperm, we want healthy men. So how do men and their sleep patterns affect their sperm, or their ability to help us conceive a child?

Carmen Messerlian:
We talked about different parameters around men last episode, and we have a very strong focus in our society or in medicine even around, oh, we got to check the sperm quality. That's one marker, it's an important one, clearly, but like I've said before publicly, it takes one sperm to make a baby. It doesn't mean that if you only have produce one sperm, you'll have a baby. You need many, many millions of sperms to conceive, but the point is that quality sperm is important, but there are other factors in Men's Health that we need to be concerned about, and those also include inflammation and those also include testosterone, hormonal levels, and the HPA, HPG axis of the man, and how he regulates his stress hormones impacts the sperm quality and the sperm parameters, but also impacts what we talked about last time is the epigenetic markers on that sperm that get registered information into the embryo that tells the embryo to develop or not. And so even if you fertilized an egg and there's a little embryo that's formed, that embryo may not be sustainable for life if there's markers on the man's sperm that tells it, this is high inflammation, risky environment. Other markers that get triggered into that embryo development that make it abort, make it not continue its development. So we need to be as concerned about men's sleep because we know, through studies, it impacts his sperm parameters. So quantity of sperm, the number of sperm that count, the concentration, the volume, the motility, these things have been found to be affected by poor quality sleep and can impact your ART or IVF outcomes. But even if you do conceive and fertilize and implant, it could result in higher risks of failed cycles and failed pregnancies. Studies have also shown that it impacts birth weight and live birth rates, so men's sleep can impact the outcome of that child's, that fetus's development. So they could develop to be smaller in gestation and can impact even, like we said, miscarriage rates.

Lara Messerlian:
Can I? Because this fascinates me. So basically the men's epigenetic cargo that's in his sperm, so basically, there's not just the DNA, but the coding on the DNA that tells the life how to form and how to develop. So it could be like, talk, like as if you're coding a computer. So it could be like you're coming along in the code, like, let's say you're coming along.

Carmen Messerlian:
... the recipe.

Lara Messerlian:
Think of it like a recipe. Okay, let's talk recipe.

Carmen Messerlian:
You thought, okay.

Lara Messerlian:
Right, so you're going through the recipe, you're putting in all the ingredients, the sperm is coding with the, or mixing with the egg and all of the recipe to date, which could be like three months in, the recipe is fine, but in three months time, there could be a break in the recipe, which is incorrect. Let's say it could be in the sperm or it could be in the egg, but let's in this scenario, talk about the sperm, because that's what we're discussing. So that rich epigenetic cargo recipe could have been broken, let's say three months in when it gets to a certain point of the development, and that's why it could possibly reach the outcome of a miscarriage or a miscarriage.

Carmen Messerlian:
End of, yeah, so that's a great way of conceptualizing it. It's very dynamic, it's very dynamic. So now you have embryo environment, so if the baby's been developing for three months.

Lara Messerlian:
Let's say it's been developing healthy for three months and it's been fine and then all of a sudden, three months, around three months, or you've passed that first trimester and, you know, something happens and you miscarry and you don't know why, and you've done all the checking, and let's say on the women's side, it seems like it was fine. Could it be possible then, scientific, is that epigenetic cargo there was maybe a fault in the recipe at that point and it could no longer continue with the?

Carmen Messerlian:
Yeah, so I'll tell you how it works. It's like just for background for the listeners is, so when sperm and egg, I know you guys can't see my hands and I'm gesturing, so when sperm and egg are about to fuse in the fallopian tube, prior to that, the sperm DNA goes through a process of demethylation and the egg goes through a process of demethylation, and then it gets re methylated and then it fuses.

Lara Messerlian:
What's methylation?

Carmen Messerlian:
So the signatures that we talked about, there's different kinds of epigenetic signatures and one of them is methylation and how certain sites on the genome get a little methyl group added to it. And so you add methyl groups or you take methyl groups away, so taking them all off the DNA signature or the DNA recipe, as you call it. So basically think of the recipe in a cookbook and think of like little variations. So it says you can put between half a cup.

Lara Messerlian:
A dash of salt, but you know, you put a little extra salt or something.

Carmen Messerlian:
Dash of salt is a great example. So a dash of salt could be 10 grains or it could be 20 grains, right? That could be a dash. So the book says a dash and your body might register a dash as 20 grains or it might register the dash as 10 grains, and how many grains go in there is basically the epigenetic signature. So the epigenetic in this case, we're talking about DNA methylation. The point is that the egg and the sperm demethylate and re-methylate at the time of pre, just before it fuses, but also when it's used, as there's a complete erasure of the entire epigenetic information on the egg and the sperm when their DNA fuses and becomes, from 23 chromosomes that each egg and sperm contributes then there's 46, the entire genome gets erased, all the markers get taken off except for certain one of them imprinting genes, but that's a whole other topic, and then gets re-methylated in a very specific fashion that remethylation is basically the information from the original egg and sperm that gets told and.

Lara Messerlian:
Fused together somehow.

Carmen Messerlian:
That embryo to say to.

Lara Messerlian:
This is new.

Carmen Messerlian:
This is how this recipe should be read. This is how this embryo should be read. So now we have the cookie recipe for chocolate chips, right? We're making chocolate chip cookies, you can make it, I can make it. Your recipe says, put a dash, and my recipe says, put a dash, and my dash does 30 grains and your dash is 5 grains. There's a difference, right? So two different babies, one's got five grains of salt, one's got 30 grains of salt. How that number of salt, little speckles get put in their brains, get put in there, is the methylation information or the epigenetic information. And so yours might taste more salty than mine, a tiny bit more salty than mine, right? Same idea. That information that gets transferred in from the egg and the sperm into the embryo tells the embryo how to form how certain genes should be turned on and turned off. Now, what you're talking about is like three months in. Yes, that would have been programmed very early on in the pregnancy, like right from the, what we call the blastocyst stage, which is very, very early embryo development, but that information gets carried on over time. But then there's new information that gets added. Now you've got the prenatal.

Lara Messerlian:
Environmental information too.

Carmen Messerlian:
Well, no, like what do you mean?

Lara Messerlian:
With new information from the actual coding from the actual sperm and egg.

Carmen Messerlian:
... is kind of like a base level, but then the baby's developing in the mother's tummy. The mother might be drinking alcohol every day, for example. So now new epigenetic information is being registered into that embryo to be like, Oh, this is weird, maybe I should turn this gene off now because it seems to be needing a different kind of modification. So it's not, my point is that whatever happens in that early stage of re-methylation, demethylation, re-methylation, or the recipe gets read into the embryo is one part of it, but it's constant. It's constant, we're biological organisms and those cells are dividing at an accelerated rate and millions of copies of DNA are being registered and read and replicated over and over again to make an embryo, and every single one of those cell divisions allows an opportunity for information to be changed or transferred. So when you say miscarriage, it's not just one thing. It could be many, many things. And one thing could be the fatal flaw that results in a loss or it could be many, many things added together, together end up being as a.

Lara Messerlian:
So, for example, some of the epigenetic cargo could be not in line with the recipe, so to speak. But then when you add a hostile environment because you haven't been sleeping and have a high-stress job and you're not, you know, maybe resting and your husband is also, has his own daily stressors and etc., etc., and then maybe you have exposures through some of the products you're using, you know, it creates a recipe, a bigger recipe of like, okay, this is maybe not heading in the direction that you initially wanted because you have too many variables that are heading.

Carmen Messerlian:
Not optimal.

Lara Messerlian:
That are not optimal, exactly.

Carmen Messerlian:
So there could be a fatal flaw in the coding. There could even just be a genetic flaw like aging of eggs causes what we call aneuploidy, so older women have more aneuploidy in the DNA coding of their eggs, and that can program for loss because it's not, the DNA is not conducive to continued development of the embryo. So that could be a fatal flaw, but there could be, like what you just said, a number of different factors that, maybe it's the initial recipe that got registered with some risk factors for miscarriage. And then like you said, then you have high burden of phthalates, and poor sleep quality, lots of inflammation. That inflammation reaches a certain level that then results in a trigger to miscarry the pregnancy. So there's many things. The point of this story, though, is as follows is, what we've been trying to say in this podcast the whole time is that it feels so overwhelming to have, Oh my God, I've got all these things I've got to do, but do, we're, always think of focus on the things you have some control over. Focus on changing one thing, or two things, or three things, or four things, as many things as you can focus on that you're able to do will be working towards optimizing and improving your outcome. So you might already.

Lara Messerlian:
Even preconception and post-conception, like that was going to be my next question to you is like, okay, so how do we move forward from that and how do we make sure that we're doing things that, because I get overwhelmed just talking about this stuff. So how do you move forward in a way that's healthy, so?

Carmen Messerlian:
I can't keep my own kids healthy, so they're like taking cologne and eating the boxes every day, and eating out of box every day, and all.

Lara Messerlian:
I know, it's, it can be overwhelming, right? So, I guess maybe you just need to stick to the basics. Like we were saying, detox, decrease exposure to the amount of chemicals or that your, products you're using. Make sure you're getting a good night's sleep, try to reduce your stress, try to meditate, and quiet time.

Carmen Messerlian:
... to get pregnant, like just because you get a positive pregnancy test doesn't mean you can go back to sleeping poorly and using all these products, maintaining that from the preconception period months ahead of time while you're preparing to get pregnant, while you're trying to get pregnant, and then after you get pregnant, maintaining those changes, those healthy lifestyle habits. And the goal is just to do a little better than you did the day before. And maybe today you don't feel like changing your, maybe you have some specific event and you want to put on makeup. So today is not a day where you're going to take your makeup off, but tomorrow is, it's Saturday, and tomorrow.

Lara Messerlian:
Shampoos, and lotions, and household products like.

Carmen Messerlian:
Diet.

Lara Messerlian:
You know, I think it's really important to like realize again, and we've talked about this in previous podcasts, but it's not just one source of exposure to makeup, so to speak, because a lot of people don't wear makeup, but they're using really bad lip gloss, for example, like 100 times that are like the.

Carmen Messerlian:
Lip gloss, even though don't wear makeup and ... the stuff on.

Lara Messerlian:
Which is like, you know, a lot of it is really not good for you, or deodorant, or shampoo, and conditioner, and hair products after that, and then slathering lotion all over your body that's scented with something. And you're.

Carmen Messerlian:
Exactly.

Lara Messerlian:
SPF, and you know, you're using.

Carmen Messerlian:
All of that.

Lara Messerlian:
You're using chemical products in your household to do cleaning and your laundry soap. And, you know, so you have to decrease exposure to all of these items, try to get a good night's rest consistently over a long period of time, decrease your stress, try to do, you know, going for walks and meditating and like just low, not low-pressure activities because, you know, I know a lot of women want to continue running, and men, they do a lot of high energy activities while they're conceiving and having a child or pregnant, but you know, that's something you talk to your physician about. But I think going for a walk or just communing with nature and being outside and just take it down a few notches so you're not in front of a TV or a screen or just, back to the basics somehow for a long period, for like a fair amount of time so that you can just have a baseline of like peace and calm.

Carmen Messerlian:
This goes back to the tenting, the camp we did three years ago with dad. It's like, that period of time seemed so stressful because dad was dying, but at the same time, like we, and you specifically, because you're trying to get pregnant, everything went from a thousand, and New York City, Manhattan with your light pollution and your noise pollution and your perfumes and your lipsticks and your nail polish.

Lara Messerlian:
Eating out every day and drinking with friends.

Carmen Messerlian:
On visits and going out and eating out and doing some drinking.

Lara Messerlian:
What a beautiful time in my life.

Carmen Messerlian:
Right? Well, not really, because guess what? Your body was.

Lara Messerlian:
I mean, it was fun while it lasted. But, you know, I really wanted to have a family.

Carmen Messerlian:
Your body was under extreme stress and under extreme, like burden of exposure and burden of chemicals and burden of stress, and inflammation. And we'd been trying for years to get pregnant, like you were living a really, a lifestyle that was not conducive to reproduction. And then you had too, like a month of a whole cycle of sleeping in a tent, in the pitch, dark in the back, in a wooded area, no access to any products, zero, so you had to get rid of everything immediately. It was like a shock to your system going from high to none, and then just meditating and doing, we didn't do much except we're hanging out and chit chat and eat some fruits and.

Lara Messerlian:
The peace and quiet was amazing.

Carmen Messerlian:
And there was no noise anywhere, we're living in the woods. Like you had a whole cycle of that, and then the next cycle, you got pregnant.

Lara Messerlian:
I know. How amazing is that? But I also have to say, because it does also, which we spoke about this, like I finally also had really let go and gave up, and told my husband like, okay, it's okay. Like we're okay.

Carmen Messerlian:
Yeah, but it's him too.

Lara Messerlian:
Like there was an internal thing where we're both like, surrender to this, and then it happened.

Carmen Messerlian:
... surrendering to it, and you're living in New York, you wouldn't have gotten pregnant.

Lara Messerlian:
No, I agree.

Carmen Messerlian:
So it's not that you surrender.

Lara Messerlian:
No, no, no, it was the whole combination, was like a mix of, like, perfect, divine timing.

Carmen Messerlian:
That's what we're trying to say around the whole thing is like the holistic health is what we're after. It's like optimizing your overall health, it's not one thing like sleep or chemicals, it's the overall health that we should be after. It's the overall health of you, overall health of your male partner, and then the couple's health, which is what you're focusing on, is like your alignment with your partner on the goal and your wish for the baby and your ability to sort of practice letting go. And, because letting go is okay, it's such a hard thing to tell when to let go. It's really taking the stress off your body of all, right? It's the fact that you are letting go. Letting go is like not feeling like you're, it's not stressful anymore. It's like, I let go means.

Lara Messerlian:
I surrender to the stress of it all. I was like, I just can't anymore.

Carmen Messerlian:
When you let go.

Lara Messerlian:
I did, physically, on every level. That thing when dad was dying turned out to be an amazing blessing somehow because, like, it created the, and the pandemic for that matter, because it created the optimal scenario for me to actually conceive a child. I let go in terms of the products, in terms of the chemical exposure, the noise, the sleep, like on every single level, and then internally also was like, I just, I let go. And it just all kind of came together for me at the very last moment of my ability to actually.

Carmen Messerlian:
Yeah, because you were really.

Lara Messerlian:
... I was, yeah, finally, and I had a lot of health concerns with fertility, so it was really like my last chance, and somehow, it happened.

Carmen Messerlian:
We had disease already in addition to and.

Lara Messerlian:
No, no, no, I'm kidding.

Carmen Messerlian:
But diagnoses, things that you're treating like your prothrombin, you know, the stuff around your mutation or I've had the same one, the prothrombin, gene mutation, the MTFHR mutation, things that put you at risk for infertility, some other underlying gynecological stuff. Those things all put you at risk for infertility, so you already were considered infertile or subfertile, add that to age, add that to stress.

Lara Messerlian:
Exposures, and stress, and sleep.

Carmen Messerlian:
So you optimize your environment, which is what the podcast is about, is about cleaning up your lifestyle, cleaning up your environment. And when we talk about environment, we talk about, for me, that's the total environment, the social, the natural, the built environment, your relationships, social, your built environment, the things that you're exposed to that are fabricated in your home, the products that you use, that's the built-in the natural environments, the, you know, the food and the water and the air. All those things, if you can choose better, and choice, again, I always feel guilty saying choose better because some of us can choose to not have noise and some of us can't, right? And some of us can choose our jobs, and some of us can't, so we talk about shift work. Shift work has been associated with reduced fertility. Some of us don't have choice if we do shift work. Some women are nurses or people who have to work night shifts and companies as cleaners, and they don't have a choice to leave their jobs, they won't have employment. So choice is, in quotation marks, whenever I use it, but where you do have choices, you may not have choice over your job, but you might have choice over your product, so you might have choice over the air quality in your house, or the water quality with the filter, or your diet, how you prepare your food.

Lara Messerlian:
You do have your stress management, like what you do in your spare time. Like are you sitting in front of a screen, or maybe you're taking that your quiet time to actually meditate and get centered and have peace and relaxation in your day-to-day as opposed to continuing in a high-stress pace like what I did, which is not the way to do it, but.

Carmen Messerlian:
Well, some women have no choice. They live in Manhattan, they want to get pregnant, right? And that's their life. And their partners live there and work there, and they work there and live there, so how can you live in that environment and optimize your health? And those require changes, like you got those black blind, those shades on your number, you got those, those black shades, and people can afford them. You get them on Amazon, I know my son bought them the other day, they're like big, heavy drapes that you basically could tape up on top of your curtains, and you could take them down. I think you have them in your house in California when you were there, those big drapes, so to blackout, to black out your room. So blacking out your room is a great idea because it avoids any type of light contamination or light pollution in your room. So even if you live in New York, you can do that, that's something you can do that's.

Lara Messerlian:
Or wear, what about wearing earplugs? If you're sleeping so that you block out the noise, it's not very comfortable. But yeah, the light at least, you'll get used to the earplugs more than you do the noise.

Carmen Messerlian:
Yeah.

Lara Messerlian:
Imposing on your.

Carmen Messerlian:
Yeah.

Lara Messerlian:
Noise pollution.

Carmen Messerlian:
... about a lot, but we know that noise pollution causes circadian disruption and sleep disruption and causes inflammation and causes issues around, I don't know any studies particular on fertility. I'd have to look that up, but we've not done them, it's something that I'm interested in studying. But you know, noise, you want to reduce noise pollution, light pollution, both of those things and increase your exposure to the things that you said, which was green space, blue space, water, ocean, lake, green space, trees, flowers, gardens. All of those things have been shown to result in health benefits, and mental health benefits, especially in stress reduction is the pathway probably.

Lara Messerlian:
Sounds really nice. I try to do that in my day-to-day anyway because, you know, life is busy, and you just have to make it a priority. Otherwise, it never becomes one. You have to make it a priority. So let's summarize then. I think, yeah, do you think you're great at summarizing?

Carmen Messerlian:
I'm leaving you summary.

Lara Messerlian:
You're great at the scientific stuff, so that's great. I love listening to it. I think it's fascinating.

Carmen Messerlian:
I get lost in the weeds. I can't see.

Lara Messerlian:
Yeah, no, no, it's brilliant. I love it. So to summarize, it's really important to get a good night's rest and to reduce your stress. If you don't have enough sleep, it actually disrupts your circadian rhythm, it disrupts your ovulatory, but your cortisol levels could change, which could actually result in a more, quote-unquote hostile environment in your body because you potentially could have increased inflammation and other issues that could potentially have problems for you if you're trying to conceive, and that's both for men and for women. So if you're living in a big city and there's a lot of light pollution and noise pollution, try to decrease that to your best ability by covering your windows and making sure light doesn't come in at night. Leave the cell phones and everything in the kitchen so there's no blue light in your room or noise that's coming in, like emails popping off in the middle of the night, which is really annoying. And also do things that you can do, even if it's just simple things like wearing earplugs to get rid of the noise pollution because it becomes an assault on your entire being, an entire system when there's light pollution, noise pollution, when you're in it, you don't realize, but when you actually jump out and you're in a peaceful environment where it's green space and quiet, you start to realize, Oh, my God. How was I living that way? It's so intense. So try to increase your time in quiet space, green space, blue space with water. Try to reduce your stress, increase your sleep, and not only just do that. We're not doing it for one day, we're doing it consistently. So we're making it more of like a habitual change and a lifestyle change so that it becomes part of how we live, not just a short-term fix. So we're not saying we got one good night's sleep, so I'm good to go for the rest of the month; we're going to be doing it for, hopefully, consistently for a long period of time, pre-conception and post-conception. So you do it before you get pregnant and you're trying to get pregnant and continue doing it while you have, you know, once you are successful and you and you have a positive pregnancy test, it's also something you should keep doing consistently all the way to the end. And I think that sort of sums it up for today.

Carmen Messerlian:
That was great. I love your summaries. One thing that I thought of when you were talking, you did such a great job summarizing. Thank you for doing that, but it's napping. We didn't talk about napping like, we don't have to talk about napping.

Lara Messerlian:
Do people nap anymore?

Carmen Messerlian:
But nap.

Lara Messerlian:
It sounds like such a nice thing.

Carmen Messerlian:
I nap after I meditate for a little bit, but like, napping is a good way of catching up on your sleep, like even a 20-minute nap in the daytime. Not too late in the day, but napping is a way of maybe doing a little catch-up sleep and can really regulate your stress hormones and your cortisol levels and.

Lara Messerlian:
Well, it's actually been shown that people are actually more productive when they take naps. Remember, like some companies are actually promoting people to take little quick cat naps and stuff like that, little nappies. When I was pregnant the first time, when I had the loss and I was in New York, there was a place I was working in the Rockefeller Center, right at the Rockefeller Center, and there was this place that I used to go to, it was like a club in the center, which was great, and they had these nap pods. And so the first trimester, I was so exhausted, I would actually, I wouldn't tell anyone in the office, I would quietly go over there and get into this nap pod, and I'd sleep for like my lunch break or something, and.

Carmen Messerlian:
Why should you have to ...?

Lara Messerlian:
I think, like, I couldn't tell anyone. I just like, it's fine, you know, it's it's also like kind of like a no-no. Like you're supposed to be so productive, right? Like, I wasn't going to be like, okay, bye, everyone, I'm going for my nap.

Carmen Messerlian:
Yeah, but people.

Lara Messerlian:
So I would just, like, quietly hide and go for my nap.

Carmen Messerlian:
Knowing how much, how many benefits come from good sleep, and how it regulates your stress, and how much more productive people are after they've had proper sleep and or naps, workplaces, really encouraging them to adopt more practices around this, where this is not weird taboo stuff that you're napping, that it's actually beneficial to the workers and the workforce. So that was a good example of.

Lara Messerlian:
Yeah, I loved doing it because my body needed it so badly.

Carmen Messerlian:
Yeah, so yeah.

Lara Messerlian:
So I guess that's it for today. Thank you all for listening, and I hope you found this inspirational, and informational, and educational from my sister's side and inspirational, hopefully from my side, but her too. She's so brilliant. So hopefully, it's inspirational to you. Yeah, well, you know, as we always kind of joke, I'm the ... and you're the science. So yeah, we bring our own little part to this podcast. Have a wonderful week everyone, and thank you for listening. We're super grateful, and we look forward to speaking to you and speaking to everyone and hearing from everyone next time.

Carmen Messerlian:
Yeah, reach out at @DrMesserlian, my Instagram handle. If you want to learn more about the work that I do, you can find me on LinkedIn or find my linktree. Look up my SEED-Program.org, we have a number of resources on there, and all the papers that I've published, most of them have links on there so you can access them, and please send me a message if you have any questions.

Lara Messerlian:
Speaking of your papers, this is a total aside, but I was looking you up because I was looking at your H index number. Good job, sister, you have a lot of citations and a lot of research that you've conducted, and it's brilliant, it's amazing. I'm so proud of you. We're just at the tip of the ice too. You're just like, young, and you're just kind of youngish. We're still young-ish.

Carmen Messerlian:
Well, the company, the science, which you are helping me with as well is, I think, have a huge impact on a global scale in terms of how couples conceive, and I'm really excited about launching that later on this year, and I'm telling people more about it, and it covers all these topics that we've been covering in this podcast and turns it into actionable solutions that couples can.

Lara Messerlian:
Yeah, most importantly, it's not just, and this is why like the art and science of all this, it's not just us talking. It's like, you've got all the research and the background and the decades of studies that you can rely on, that you've done and conducted yourself in your own lab and through your relationships with other professors that you bring to the table that is not just like, Oh, my fertility doctor told me to have sex every day. I've actually heard an acquaintance of mine who said that their fertility doctor told them that it was a myth to, like, skip a day. And I'm like, Well, I'm not the scientist, but like, I'm just following the research, and the research and the science says it's better if your body takes a day off for the man, that he produces better quality sperm that's more potent. So there's a lot of information out there that isn't actually correct, that is actually more myth-oriented, like have sex every day or as much as possible to have a baby. Well, that's actually scientifically incorrect. So I'm grateful to you because you're actually bringing the science to the table, which is the years and decades of studies that say, this actually works versus this doesn't work, and this is exactly why it works versus why it doesn't work, and not just opinion-based information that one person claims to have. It's a big difference.

Carmen Messerlian:
But we're doing an evidence translation into scalable solutions is what I'm after with my work, my science, and my research, and the product that we're developing in the company. And you're right, evidence is very important, science is very important. We don't have the answers to everything, but we have the answers to a lot of things. The things that we do know, we should share and help people make those decisions very accessible. And then learning more through data collection and having big data and understanding that data in a way that allows us to answer questions like blue light and green light, light exposure, and sound pollution. We don't have any information on that meditation. How does that impact reproductive outcomes? The better and more data we have, the more questions we can answer and help couples have successful outcomes. And the goal is to have healthy babies, and, you know, that's what we're trying to do in our arms. Yeah, have healthy sperm, healthy eggs are a goal, but the goal is to have a healthy baby and to have that baby grow up to be healthy across its life course, and that's why these things are so critical. And that's why the podcast we named it Cleaning Up Your Lifestyle for Future Generations, it really is about the health of your offspring, the health of your baby, and what you do before you conceive that baby will impact his or her health across life until it becomes an old person. And everything that you do before your pregnancy will impact your child's health and how it conceives its child and your grandchild.

Lara Messerlian:
No pressure.

Carmen Messerlian:
No pressure. That's why it's so important what you do. It's pressure, but guess what? The preconception period is an opportunity, a window of complete control. Whereas once you get pregnant, everything's set, you can't really change anything then. So that's why I'm so passionate about the preconception period and holistic health in couples, because it's the window in time when you can build good healthy habits and change your lifestyle to optimize your outcomes.

Lara Messerlian:
Awesome. Speak to you soon.

Carmen Messerlian:
... Ciao!

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: