The Deed of the Mothers is a Sign for the Daughters

The Bible is the greatest shaper of Jewish identity. The first movement towards the creation of a unique identity occurs in the Book of Genesis. In the beginning, there is the universal: the creation of the world and humanity as a whole, without division into identities. However, very quickly, starting with Chapter 12, the Book of Genesis turns to the particular, with the commandment to Abram, “Go forth from your country, from your kindred and from your father’s house.” Break away from your family and become an independent identity.
In the Book of Genesis, the boundaries of what will eventually become Jewish identity are clarified. Isaac and Jacob are in; Ishmael and Esau are out. Although all are members of the same family, they have different identities and different destinies. At the end of Genesis, the boundaries are closed: all of Jacob's descendants, the tribes and their genealogy, are part of one identity group, independent of their deeds. However, they are still just a family - seventy people.
In the Book of Exodus, the family’s unique identity is translated into the unique identity of a nation. This is the essence of Exodus—the formation of a nation. Of course, this is not merely a description of the past, but instructions for the present and future. This is the meaning of “The Deed of the Fathers is a Sign for the Sons” or in the words of philosopher Friedrich Schelling, “the mythology of the nation is its destiny.” And so, the reading of the weekly portion of the Torah - which in recent years has engaged not only the religiously observant, but also the secular Israeli - is likely to serve as a sign post for our present conduct and our planning of the Jewish future. The upcoming weekly columns, over the course of the Book of Exodus, will deal with this topic.
The family established the land of Canaan as the home port of its identity, deep and secure. However, at the end of the Book of Genesis, the family “descends” to Egypt, the place which represents a clear alternative to Jewish identity. Indeed, the central question is: Why does most of the biblical drama, beginning with this week's portion and continuing until the end of the Bible occur outside the land of Israel—in Egypt or in the desolation of the desert? Why do only very few of the Torah portions take place in the land of Canaan (and even in those few, there are recurring descents out of the country)? We will return to this question in later columns.
In any case, the first event in the family’s transition to nationhood is demographic growth. It is hard to conceive of a more detailed and impressive description of demographic growth than the opening verses of the Book of Exodus: “And the Israelites were fertile and prolific; they multiplied and increased very greatly, so that the land was filled with them.” If this had been the normal growth pace, Pharaoh would not have been concerned that “the Israelite people have become much too numerous and strong for us.” Indeed, a simple reading of the text teaches that the Israelites in Egypt were not enslaved for economic exploitation, as is commonly thought, but to prevent the growth of the group/population
What is customarily called the “natural rate of increase” was all but natural. In contradiction of plain logic and the pharaonic plan, slavery failed as a means of birth control. On the contrary. “The more they were oppressed, the more they increased and spread out.” The Midrashic description articulates this in characteristic manner: “The women would give birth to six at a time!” A simple calculation illustrates that ordinarily, in such a brief period, a group of seventy people could not multiply “naturally” so quickly as to constitute a demographic threat to an established, developed nation, the leader of the world at that time.
The first to herald our becoming a nation is none other than Pharaoh. He brands us, “the Israelite people” and calls the women “Hebrew women”. When a sociological phenomenon is given a name, it becomes a fact. Anti-Semitism arrives in the world together with recognition of the nation’s existence. Ancient Egypt was similar to both medieval and twentieth-century Europe: hatred of the other, for no reason (or more precisely — an imaginary reason), brings the leaders, then and now, to the extreme solution of enslavement and poverty, which is then replaced with an even more extreme solution: annihilation of the Jews. Pharaoh commands “all his people”: “Every boy that is born you shall throw into the Nile.” A few verses after the nation’s creation, all Jewish baby boys are exposed to the threat of death from everyone around them solely because of their Jewish identity. And what really happened? “And the people multiplied and increased greatly.”
The biblical choice of describing the initial shaping of Jewish identity with a demographic event seems obvious, since the existence of a large population is necessary (albeit insufficient) for the creation of a nation. However, it is not all that simple. Look at today’s European countries whose "natural rate of increase" is so low that their populations are dwindling.  To maintain their economy, they must allow mass immigration from African and Muslim countries, which in turn, endangers the preservation of their identity for future generations. Perhaps, the demographic expression of the struggle for identity in our generation is the main story of the global era.
This is also a compelling contemporary Jewish story: the rate of natural increase in the state of Israel is the highest of all OECD countries by an astonishing amount (3.1 children per family and increasing in Israel versus 1.7 on the average and decreasing by other OECD members). In Israel, the demographic response to the Holocaust that annihilated one third of our people can be seen and heard in maternity wards with more beds than anywhere in the West. The predictors of gloomy demographic developments that would dwarf Israel’s Jewish majority have been proven false. This is not coincidence but rather, a noble expression of, “The Deed of the Mothers are a Sign for the Daughters.”
It is fascinating to discover that not only the “Hebrew women” guarantee our future, but that the state of Israel also participates in this effort in a major way. Couples challenged by infertility have the best chance in the world to have a non-spontaneous pregnancy. The funding of IVF ( In Vitro Fertilization )  in Israel from public monies is the most generous of anywhere and the relative number of IVF treatments per capita is the highest in the world. The state of Israel is the "Shifra and Puah" (the two midwives named in Exodus) of our generation.

Professor Yedidia Stern is President of The Jewish People Policy Institute and a professor of law at Bar-Ilan University. His wife, Dr. Karen Friedman, is the founder and director of Gefen Mind-Body Fertility Organization and the Hadassah-Rimon Center, non-profits that provide emotional and wellness support to fertility challenged women in Israel.

Translated by Felice Kahn Zisken

Unlock your fertility potential - Part 3


Nutrition and Fertility

To be honest I have been a little daunted by writing this particular blog installment. Writing about nutrition and fertility is a monumental task. There is a lot of information out there, not all of it is clear or well researched, and some of it is controversial.
However, on the other hand, improving the quality of the fuel you put into your body is one of the easiest ways to improve fertility. What you eat forms the building blocks for optimal egg development and a healthy uterine lining - both of which are essential for conception and a healthy pregnancy.
Last week we discussed hydration. In this week’s blog about nutrition I’ve decided to focus on three specific food-related actions you can take right now to help improve your fertility. This is not a comprehensive nutritional plan but it certainly is a great place to start.

#1 Cut out down on sugar. Period.
I recognize that this is not a very popular recommendation but it is possibly the most important one. Maintaining stable blood sugar without spikes and dips might be the single most important fertility habit that you can implement.
Research is beginning to show that low intake of sugar is essential for both egg quality which affects the quality of the embryo, and for endometrial function which allows the fertilized egg to implant and for a pregnancy to develop.
The dangerous impact that elevated sugar has on fertility - specifically egg quality - has been shown in research done on Rhesus Monkeys. The researchers created two groups of monkeys. One group was fed low doses of sugar for 6 months, and the other received a regular monkey diet (without this additional sugar). Then both groups were put through a mock IVF cycle. Here’s what happened: 86% of the eggs that were retrieved from the monkeys who didn’t consume sugar matured and were of good quality. But only 18.5% of the eggs taken from the sugar eating monkeys were good quality. That’s a huge difference! And the sugar-eating-monkeys ate less sugar than many women consume.
The results from the Rhesus experiment might explain other research done on the connection between carbohydrate intake and blastocyst health in humans. In a recent study IVF patients with failed cycles who switched to a low-carbohydrate, high-protein diet and then underwent another cycle increased their blastocyst formation rate from 19% to 45% and their clinical pregnancy rate from 17% to 83%.
In fact, as a result of the study, one of the authors of the study now requires his IVF patients to maintain a diet of 25 percent or more protein and less than 40 percent carbohydrates for three months prior to beginning in vitro fertilization treatment.
So cutting sugar is important for fertility, but how do you do it?
I recommend starting with cutting out processed sugar. Just stay away from processed foods with added sugar in them (for example cakes, cookies, muffins, granola bars) and instead turn to fresh whole fruits, nuts, seeds and vegetables.
Which brings us to the next rule...

#2 Aim to eat at least Five Vegetables a day
We are constantly being told to eat vegetables - so I’m sure this comes as no surprise. In fact the American Cancer Society advises eating at least five servings of fruit and vegetables per day for good health while the Harvard School of Public Health goes even further recommending nine servings of fruit and vegetables each day.
Why are vegetables so important?
Vegetables are high in nutrient content - they pack a lot of power in their punch. They are loaded with vitamins (like A and C) and minerals (like potassium and magnesium) that contribute to cellular growth and the maintenance of good health.
Vegetables also contain substances called antioxidants. Antioxidants are extremely important in helping our bodies fight the cellular damage that occurs on a day to day basis. Antioxidants can help prevent diseases like heart disease, stroke, and diabetes.
But antioxidants are also connected to fertility (surprise, surprise!) The oxidative stress that antioxidants fix is associated with conditions like endometriosis, PCOS, and unexplained infertility. It is believed that antioxidants can benefit fertility through mechanisms such as improved blood circulation in the uterine lining, decreased insulin resistance, and improved mid-cycle fertile cervical mucus. So ingesting foods that are high in antioxidants could boost fertility.
Be sure to choose richly colored vegetables. The different colors are really flavonoids which are naturally occurring pigments that give the vegetables their enticing color and that have antioxidant or cell-protecting qualities. Yellow and orange vegetables such as carrots, sweet potatoes, and pumpkin are rich in carotenoids that supply your body with vitamin A. Red fruits and veggies like tomatoes have lycopene. Blue and purple vegetables and fruit are high in phenolic flavonoids which are potent antioxidants so be sure to include red cabbage, purple onions, blueberries and the like. And green vegetables have the added benefit of including nutrients such as calcium, iron, and folate. Folate is extremely important as it supports healthy cell division (important for egg quality) and it promotes proper fetal growth and development to reduce the risk of birth defects such as spina bifida.
Vegetables are also high in fiber. Fiber helps create the feeling of being full - which helps when we are trying to cut down on sugar. Fiber is also important for maintaining bowel regularity and health which allows for body detoxification. Ensuring that our bodies get rid of waste is actually an important way to support balanced hormones by allowing our bodies to get rid of the metabolic waste after it breaks down the hormones.
In 2007 Harvard researchers evaluated data from the famous Nurse’s Health Study which collected data over a number of years from over 18,000 women. In this 2007 study researchers examined the relationship between carbohydrate intake and fertility and they published their results in a book called “The Fertility Diet”. They concluded that a diet high in fiber (and low in trans fats) provides the best nutrition to optimize fertility. So eat lots of vegetables!
Lately the Mediterranean diet is getting a lot of publicity for its ability to enhance fertility. The Mediterranean diet is based on the traditional foods that people used to eat in countries like Greece and Italy around 1960. This diet focuses on eating lots of vegetables, fruits, nuts, legumes, whole grains, seafood, and extra virgin olive oil.
A recent study examined if adherence to the Mediterranean diet (MedDiet) is associated with better IVF performance. They discovered that in women under age 35 a Mediterranean diet made a huge difference. Women who had the highest score on the Mediterranean diet score were around twice as likely to conceive and give birth than women with low scores. The study concluded that eating a Mediterranean diet may help increase the chances of a successful pregnancy and delivering a live baby for women undergoing IVF treatment.

# 3 Eat (organic) Eggs
There is a traditional Chinese saying: “Eat as many eggs as you can afford for a smart baby.”
It seems like they were right. After many years of eggs getting a bad rap they are once again reclaiming their well-deserved respect. In reality eggs are like a superfood.
They are packed with macronutrients like protein and fat and micronutrients (vitamins and minerals) like B2,5,12, Vitamin A and selenium. Eggs actually contain small amounts of almost every vitamin and mineral required by the human body including folate which we know is important when preparing for pregnancy. They also contain the amino acid choline which improves follicle quality and like folate helps prevent neural tube defects and aids in brain development.
We know that eggs have cholesterol. But that’s good. Our bodies need cholesterol to manufacture sex hormones which is important for fertility. Cholesterol is also important for healthy brain development. To that end your body produces cholesterol every single day! But eggs can actually improve your cholesterol profile since studies show that the cholesterol in eggs raises the “good” HDL cholesterol in the body and transforms the “bad” LDL cholesterol into a less dense version which is relatively harmless.
While all eggs are egg-ceptional I recommend organic free-range eggs. These eggs are laid by chickens who are usually cage free, are allowed to feed from the land, and don’t receive hormones or antibiotics. In addition to supporting an industry with good values, you will get more nutrients since organic eggs are actually more nutritious than conventional ones. While all eggs contain similar amounts of protein, research shows that organic eggs have more vitamins and minerals. For example one study found that organic eggs have three times more omega-3 fatty acids, 40% more vitamin A and twice as much vitamin E.
So start your day with eggs - remember - most of the nutrients are in the yolks so make sure to eat them too!

So here’s the plan:
1) Cut out sugar
2) Eat at least five vegetables per day - preferably different colors
3) Eat (organic) eggs

Unlock your fertility potential - Part 2


Part 2 - Hydration and Fertility

Fundamental Pillar #2: Nutrition
The second fundamental pillar of fertility is nutrition. Now I know that nutrition for fertility is a huge topic, too much to write about in a blog post. So I will give you a condensed version with easy action items that you can implement starting today.
This post will discuss hydration which for most of us is easier to do. The next post will address food so be sure to stay tuned.

You may be wondering - why is she talking about hydration. Why is that important? How is what I drink and how much I drink related to fertility?

Water is the liquid of life, without it we would die. Up to 60% of the human body is water! Your blood is 85% water, your kidneys and muscles are 80% water, your brain and heart are around 75% water, and even your bones are watery - with 30% water.

In fact the rule of three for survival states that humans can survive for three weeks without food, three days without water, three hours without shelter and three minutes without oxygen. Our bodies, in a sense, need water more than they need food.

Yet many people are dehydrated. They either don’t drink enough water or they don’t drink it frequently enough throughout the day. Some people drink a lot but they drink the wrong drinks. For example, caffeinated drinks like coffee or soda can be dehydrating and can sabotage your water drinking efforts. The biggest signs that you’re dehydrated include inability to sweat, dry skin, bad breath, dark urine, and urination less than six times a day.

So water is important for your overall health. But how is it directly connected to fertility?

First of all, water keeps all of your organs and cells functioning properly including the reproductive cells (egg, sperm) and reproductive organs (brain, ovaries, uterus, testes, thyroid). This is extremely important for fertility. The egg is filled with fluid - and that fluid is made of water. Think about it - your eggs (and the man’s sperm) are made out of water. So to make healthy eggs you must drink water.

Secondly your body makes cervical mucus which changes throughout the menstrual month. Prior to ovulation the cervical mucus becomes very stretchy (like an egg white) and as you get closer to ovulation your body makes more of it. This stretchy mucus is supposed to help the sperm travel up towards the uterus and then to the fallopian tubes for fertilization. The more hydrated your cervical mucus is the more easily the sperm can travel through it. Studies have found that thick cervical mucus with low water content is the most difficult for sperm to penetrate. Without enough water the cervical mucus that balances vaginal pH can become too acidic and this change in pH can harm the sperm. Having little to no cervical mucus can be an indication that you’re dehydrated.

Finally, your cells need water for proper cell division and metabolism. This affects proper development of the fertilized egg into a blastocyst and its ability to implant in the uterine wall. And the cells in the uterine wall must be properly hydrated for implantation to be successful.

For men, semen production and semen volume can be reduced by not drinking enough water. If semen is thicker due to dehydration, sperm may have trouble swimming. So make sure your husband also follows the instructions below.

So how much water should you drink?

Unfortunately, using thirst as a strict guideline isn’t so reliable since people are busy throughout the day and don’t always register their body’s messages.

You can use your urine as a guide. The color should be pale yellow like lemonade. If it is a deep, dark yellow then you are probably not drinking enough water. If it is colorless, it might mean that you are drinking too much water which can cause salts & other electrolytes in your body to become too diluted. A healthy person urinates on average about 6-8 times a day. If you haven’t urinated in many hours, that’s an indication that you’re not drinking enough

A general rule of thumb for water intake is to drink 33 milliliters per kilo of weight per day. That’s roughly 2 liters per day. Remember - if it is hot out - you need to increase your water intake.

The next important factor is the timing. It is important to space the drinking out throughout the day so that your body can absorb the water slowly. If you drink it all in one shot - you run the risk of having much of the water excreted in your urine and not be absorbed into your cells and tissues. In addition - time your water intake so that you finish your allotted amount by around 7 pm so that you won’t need to wake at night to go to the bathroom.

Tips for proper hydration:
● Start your day with a large glass of water to rehydrate. You breathe out a small amount of water every time you exhale when you’re sleeping. If you sweat at night, you’re also losing water.
● Set recurring water break reminders on your phone.
● If you're not a big water drinker, here's a suggestion that some find helpful. Fill up a big cup of water every morning. Then set an alarm on your phone to go off every two hours during the day. When it beeps or buzzes, or sings (whatever you have your alarm ringtone set to), that means it's time to refill your water glass. Is that glass still full from the last time you filled it? Drink up!

Remember - if you’ve been drinking less than optimal for a long time your body has been in survival mode, not thrive and create-a-baby mode. It may take some time to slowly rehydrate.

Optimal fertility starts with the basics – water being the most critical ingredient to life. Make it a daily habit to drink enough for your reproductive needs and make sure your partner drinks too!

Supplements to Boost Fertility and Support Healthy Pregnancy

Pnina Klinger, Chinese Medicine Practitioner (Dip. Ac)
This email address is being protected from spambots. You need JavaScript enabled to view it. 

Women often ask me what supplements they can take in order to increase their chances of conceiving and support a healthy pregnancy. Below are some suggestions, however before taking any supplement, (with the exception of folic acid which is recommended for every woman trying to conceive) please speak to your doctor as to whether it is right for you.

1: Folic Acid
Folic acid is necessary to take before and during pregnancy as it can help increase your chances of becoming pregnant and can help prevent birth defects of the baby’s brain and spinal cord. Folic acid may also protect the baby from low birth weight, poor growth in the uterus and miscarriage. Before conception (at least three months before) and during the first trimester of pregnancy, 400mcg of folic acid should be taken every day. During the second and third trimesters of pregnancy 600mcg of folic acid should be taken every day. Breastfeeding mothers need 500mch of folic acid per day. In addition to taking folic acid as a supplement, here are some natural sources of folate: fortified breakfast cereal, lentils, spinach, beans, beef liver.

2: CoQ10 Enzyme
Research has found that the CoQ10 may improve fertility in both men and women. It has been recommended that men with sperm related problems take CoQ10 to improve sperm concentration, density and mobility. Today there are studies that suggest that CoQ10 could be important for female fertility as well. There are different theories as to why and how CoQ10 may improve egg quality, but what we do know is that the amount of CoQ10 naturally found in the body decreases with age and studies suggest that women with low ovarian reserve or those over 40 who are trying to get pregnant may benefit from 300-600mcg CoQ10 supplement. In pregnancy it is recommended to stop taking the supplement as its effect in pregnancy has not be studied. It is best to consult with your doctor in order to determine if CoQ10 could be helpful to you.

3: Omega 3 Fatty Acid
Omega 3 fatty acid has been proven to help fertility as it helps regulate hormones, promote ovulation and increases cervical mucus as well as the flow of blood. Our bodies cannot naturally make Omega 3 fatty acid so we must rely on gaining this nutrient either through diet or supplement. Women trying to get pregnant should take 650mcg of Omega 3 every day. Once pregnant, it is best to switch to a pregnancy Omega 3 formulation which contains higher amounts of DHA for fetal brain health. Natural sources of Omega 3 are fish oil and flax oil. It’s important to mention that Omega 3 can slow blood clotting and increase the effects of anticoagulants like coumadin so best to consult with your doctor in order to determine if Omega 3 could be helpful to you.

Women with low ovarian reserve or women over 40 may benefit from taking a DHEA supplement as it may help improve the quality of the eggs. Ideally DHEA needs to be taken 16-20 weeks before IVF. Studies have found that women with low ovarian reserve (low AMH and low follicle count) often have low levels of DHEA and testosterone. By supplementing with DHEA it is possible to raise both AMH levels and follicle count thereby improve the quality and quantity of eggs retrieved. DHEA is a hormone precursor and should not be taken without talking to your doctor.


Login Form

Login Window