ICLW (quite a bit late)

Well, I’ve been meaning to write a post welcoming whoever came over for ICLW for the past 4 days, but my schedule has been nothing short of insane so nothing got written and worse, ICLW commenting did not get done.  I’ve had a lot of people who just jumped in there with the last disjointed, introduction-less entry and commented, I thank you for it.

Still, better late than never: To sum up my blog, I’m somebody who thought she would have absolutely no issues in the baby making department.  2 pregnancy losses later, I’m one hell of a lot tougher, and I think a whole lot wiser too.  Since I’m a scientist that studies how the body works for a living anyway, I’ve come a good way in understanding reproductive biology, and I’ve tried my best to share that knowledge with everybody.  I discovered I was Vitamin D deficient after my second loss, and intense reading on the subject of deficiency of this hormone in various disease states, including infertility has made me a very vocal advocate on the topic of testing for this, and making sure you have normal range blood levels, with a large portion of my blog being dedicated to this subject.

Sharing of knowledge aside, I’m awed at what a source of emotional support the blogsphere has proven to be. While nobody else in real life wants to spend more than 15 minutes listening to you, here, you have a network of people from all over the world, genuinely invested in everybody’s journey and willing to spend hours cheering others on, or crying with them in the horrible times.  Women going through infertility just a scant 10 years ago did not have this resource, yet, we today, do.  When we think about the unfair hands we are dealt, that is something to remember.

In other news, I'm gearing up for the next try. I finally got my act together and went to an endocrinologist.  I was lucky to find one at NYU with really good reviews, and thankfully, he more than lived up to them. He listened to me,  he was well versed on the topic of anti-thyroid antibodies and their potential role in pregnancy loss, as well as the studies (not terribly convincing, but still plausible) looking at correlations of higher levels of TSH during pregnancy and IQ of the resulting children. He was willing to re-test everything, which included the PCOS hormones (Testosterone, DHEAS, AMH, and LH), the thyroid hormones (TSH T4, T3) and the Anti-TPO/anti-thyro-globulin antibodies. I had a whopping 10 vials drawn, and I'm eager to find out what it will show. 

Detailed post on the PCOS + thyroid condition coming , but I have to say again what I will reiterate there- when you get your thryoid tests done, look at that TSH value.  The old normal range for TSH was about 0.4-4 mIU/ml, now  it seems to have been revised  to 0.3-3 mIU/ml, with studies suggesting being over 2.5 is bad in pregnancy.  If TSH  over 2.5 (but still in the normal range),  demand a test for anti-thyroid antibodies. Anybody who is TTC, with infertility issues, is best off maintaining their TSH at  around 1-1.5. 

Its a simple no-risk treatment that only asks that you take some amount of thyroid hormone (which is perfectly safe as long as you do not take too much) and get frequent monitoring done, and it *may* fix an issue which is kind of an ill-understood and murky threat.  I am of this opinion, my current RE is not, but thankfully, this endocrinologist definitely is.  My thyroid during pregnancy will be in good hands.

Meh

For the last year, I've taken immense comfort in the fact that my luteal phase (LP), which was teetering on the edge of being classified as LPD, in both my cycles of conception, had changed greatly after I became Vitamin D replete.  It used to be a short 11 day one, and after I got my  D3 levels up and above 30 ng/ml, it has been a healthy average of 15 days, over 13 or so cycles.

Since Vitamin D increases both estrogen and progesterone and has been shown to regulate the menstrual cycle, its a logical thing to assume that taking vitamin D was responsible for this change.  Heads up on this link, it also talks about a subject I've long neglected in this blog, the effects of Vitamin D on male infertility. Its really something to take into consideration, for all affected parties.

Then, just as I'm about to start a cycle where I AM planning to TTC, I get my period 2 whole days early, giving me a 13 day LP. Occasionally something happens that seems entirely counter intuitive, and this is one of them. This past cycle seemed glorious looking. Lots of estrogen evidenced by crazy amounts of fertile CM, really high progesterone, evidenced by really high BBTs and crazy breast tenderness. Then why on earth did my endometrium give up the ghost 2 days early?  Ironically, based on the 2 progesterone symptoms (BBT and breast tenderness), I think my progesterone did not drop fully till day 16, but my period began 2 days early anyway.

Ugh, Ugh, Ugh. The next time I wanted to TTC, I wanted it to be in a very pretty-looking natural cycle with no issues, since that is all I have to go on. Now I kind of feel like I'm at the mercy of a celestial prankster, determined to mess with my head.

Anyways, if this cycle does not look like sh.it, I should be having an IUI on March 6th or the 7th, if nothing changes.  God, the thought of something changing and me having to make a decision whether to go with a crappy cycle or not is making me nervous already-- all the Should Is/Should'nt Is are starting up.

Adding to the pressure, I got really good news, but it makes when I conceive important-  My brother is getting engaged (!!!) and his fiancee wants to get married in December. Uhmmmm...also my due month, if I do get knocked up now. I definitely cannot attend a wedding when I'm nearly full term, not in India anyway. My parents are looking to pushing the wedding to late January,  which would be just on the edge of ok if all goes well, and as planned, but if not, its going to be a a bit of a pickle.  I did not forsee having to attend a wedding with a baby in tow---I really wanted to keep human contact to a minimum for the first few months of my child's life- that was going to be the best part of doing this in India, wherein no daycare would be needed. To have to attend a wedding, which in India is a 2 day long, giant communal affair, with 100s of germ-laden individuals running around the place and to try to devise a way that only 10 or so people get to handle/be in the same room as my baby...whee.  The thing with plans, you never see the potholes coming.

But...really, this is small stuff. Should remember not to sweat it All issues can be surmounted, you just roll up your sleeves and do what is necessary.   My brother is getting married---that is the part to celebrate!

Psychologists are no fun

Most REs have a policy that anybody using donor sperm has to go see a psychologist first.  My REs in CA had the same policy, but I skillfully (and forcefully) wiggled out in each case, there was no way I was going to spend 300 bucks out of pocket for an issue I had already researched by myself.

No dice with NYU's practice, I had to go see one. So I went, plonked down 350 dollars, but was given a reimbursement form and was told I'd get my money back.  So no pain there, but cannot say the same for the actual visit.

You definitely get your money's worth, I nearly spent 2 hours with her.  Every time I really have a conversation about using donor sperm, about doing this by such a non-traditional route, I start crying. But then, I also cry everytime I read that page in Love Story when Jennifer tells Oliver she has cancer,  and I cry everytime I see that animal shelter ad when they play that song, "In the arms of the angels" and all the animals look at you with those melting eyes. Just remembering that ad can make me cry. To sum up, any emotion (sorrow, empathy, anger, just any strong feeling) instantly triggers my lacrimal glands.

As a result, what was expected to be an easy conversation with rational and had depth, stayed a  conversation with rationality and depth, except I cried for about 30 % of it, intermittently and sporadically. The emotional response does not piss me off, but the tears do.  It pisses me off that I had to redo my eye makeup. It pisses me off that I had to take painkillers and sinus decongestants just to ensure that I did not have a blinding headache for the rest of the day. Argh.  Among the things I wish I could change about myself, this is in the top 5.  When you are in the midst of making a strong argument, you want to appear cool and collected. If  the topic under discussion pushes my emotional buttons, I'm usually bawling while trying to make a point.  Its SUCH a liability. My brother once accused me of turning on the waterworks as a way to get the upper hand, but that is not true- I have the opposite issue, I cannot figure out a way to turn them off.

Anyway, the psychologist covered a few interesting points about donor sperm and having THE conversation with your kid and all that fun jazz. I'd talk about it now, but it has to wait for later because I'm going to watch a pretty silly movie with two smoking hot men (Tom Hardy and Chris Pine)---the perfect end to a day like this! Update: The movie (This means war) is deeply silly and abandons logic at many points, but I recommend it none the less, the eye candy more than delivers, and its also very funny in multiple bits.Successfully took my mind off my afternoon, yay.

Another post on AMH, AFC, and Vitamin D

Biology is complicated.  X sets off Y which sets off Z. Z  can positively or negatively regulate X or Y, and any or all of them can be regulated by A, B, C, or D.  It is a crazy, multi-layered, mind-boggling system in other words. Yet, when perfectly balanced,  perfect health results.

Trying to understand it is like trying to untangle a Texas-sized jumble of wool, yet we solider on gamely, trying to do exactly that. After I took Vitamin D, a number of things changed: my antral follicle count went down, and my luteal phase got longer.  In this post, I wanted to talk about certain studies which may offer explanations for the first.  

After my second miscarriage, it came to light that I may have certain presentations of PCOS: primarily, a very high antral follicle count (AFC), and high levels of the hormone, DHEAS.  My AFC was consistently very high (30 and 34 when measured by 2 independent operators over 3 months apart).  Between these two counts, we also found out that, paradoxically, my AMH was low. I realized that this might be because I was vitamin D-deficient, and indeed, after increasing my Vitamin D, my AMH also went up 4-fold.

One of the things that concerned me from the getgo was my high AFC. Another TTCer (Tiara), who had one pregnancy loss, also presented with a high AFC. Her doctor, in what may have been a very prudent move, put her on metformin, which is supposed to combat insulin resistance.  She was alarmed that, the next cycle, her follicle count dropped sharply, but that IUI resulted in a healthy, beautiful baby girl.  Interestingly, her anecdotal finding of decrease in AFC after start of metformin correlates with this study, which also showed a drop in both AFC and AMH after starting metformin.  Nobody knows how metformin accomplishes this,  but its main mode of action appears to be combating insulin resistance.

Vitamin D also helps to correct insulin resistance, although a lot of studies seem to think it mainly helps that subset of women who are overweight because of PCOS (I don't belong to this subgroup).  Nonetheless, because Vitamin D and metformin share this property, I was hoping my AFC would go down. The conversation I had where I tried to explain this to my nurse, so I could just have an AFC recount ordered, was kind of funny, although, on the whole, a firmly closed mind does not amuse me in the slightest. 

Anyway, I turned out to be right in predicting the result, though I think I was wrong in the mechanism behind it. My AFC went down from 32 (average of 2 cycles) to around 16 ish (average of 2 cycles).  People have said that AFC can vary with different cycles,  and this is true, but in my case the variation, if nothing has changed, is less than +/- 5.

For the longest time I presumed my drop in AFC was *probably* because vitamin D did something similar to metformin. Recently, somebody left a comment on Dr. Malpani's blogpost on AMH , that gave a really smart, and plausible alternate explanation. Apparently, AMH has this really interesting property- it inhibits recruitment of primordial follicles into the pool of developing (or antral follicles). This property of AMH provides an explanation why women with PCOS, who usually have higher AMH levels, may hit menopause later, because the recruitment of primordial follicles is lower, and hence their ovarian reserve lasts longer.

Coming back to my case, in addition to a *maybe* case of PCOS,  I had an additional confounding factor of Vitamin D deficiency (though this is also shared by around 40 % of women with PCOS). If everything in the previous paragraphs is considered correct, the broad possible explanation is this- when I was vitamin D deficient, my AMH was low because this gene needs to be 'turned on' by Vitamin D.  Once my Vitamin D levels went up, my AMH level went up. Over time, that increased AMH decreased the recruitment  of primordial follicles, so my AFC went down.

My numbers are still respectable, my total AFC is now around 16. God knows what this means but 16 is a reassuring number. However, even if you do have PCOS and your AFC goes to a number you don't like, I would hold off the alarm. One should remember this: quantity does not necessarily equal quality. This is best exemplified by women with PCOS who make a TON of eggs in an IVF cycle, and the majority are not good quality. So, on the whole, for women with PCOS,  the moral of the story is, both metformin and vitamin D have a good chance of helping you. I had the option to take metformin, but I chose not to do it, thinking that just Vitamin D would be enough.  It looks like I may be right, I hope the facts bear it out eventually.

I'll end on this note- while the role of vitamin D in pregnancy is open-shut good, its role in fertility itself is a bit murky. Overall, being deficient is bad for you.  But a few studies show that going too high may also be non-optimal, especially if you have endometriosis....you can read an entire review on the role of Vitamin D in female reproductive states here.   I'd say, while trying to get pregnant, maintaining your blood levels at around 30 ng/ml seems like the best course. After you get pregnant, your vitamin D requirements are going to rise- making sure you are taking enough to maintain around 40 ng/ml  may be best.

What makes for good eggs??

Here is a question that my brain has circled, poked and prodded, with little resolution, for a while.One RE's blog pointed out what seemed like basic common sense- your menstrual cycle is the best indicator of the quality of eggs you are producing in it. The more estrogen you make (indicator: egg-white cervical mucus or EWCM production) and the more progesterone you make (indicator: length of luteal phase), the better quality eggs you are likely to have. While this can obviously applied to natural (or medicated) normal cycles, it can also be extrapolated to IVF cycles, atleast the pre-ovulatory phase. If your estrogen goes up and you are making scads of EWCM, its a good sign.

Unless something changes in my physiology, my cycles never change, and are predictable to the hour, down to the time of the day that my surge begins. Its bloody spooky. This reliability makes for detecting any changes very easy.

When I was Vitamin D deficient, I had two patterns.

In the first, I ovulated at day 16- In these cycles, my surge would always start around noon on day 15. My OPT would be negative at 9 am, and be positive after 1 pm. I don't know if this regularity sounds remarkable to others, but it was to me.  In these cycles, I also seemed to have less EWCM, and my luteal phase was a short 11 day one.  This was the cycle pattern in which both my pregnancies were conceived.  Putting 2 and 2 together (in an unscientific, hand-wavy manner) I think my cycle pattern indicated that these may not have been the best quality eggs. And I lost both pregnancies.

The second pattern, was a day 20 ovulation, with more EWCM and a 13-14 day luteal phase.

After I began Vitamin D, mad coincidence or not, everything changed. 

• For the first 6 months, Day 16 ovulation disappeared, almost all ovulations were at day 20 or 22, with good quality EWCM in almost all of them.
• My luteal phase increased in length, with the minimum being 14 days, and the maximum being 16.
• My antral follicle count reduced in half, going from 30 to around 16, which was a welcome (and somewhat anticipated) change.
• 3 months ago, things shifted again- I now had a brand new day of ovulation, day 18.  The unwelcome part was, my EWCM almost disappeared completely. I felt like I had progesterone effects even in the pre-ovulatory phase, because my CM was very thick. This makes no sense, I know, but I still don't know what to make of it.
• My luteal phase continued to be long, averaging 14-15 days.

One of my fellow bloggers, ThePortofIndecision had commented that after taking coenzyme Q10, she had good quality EWCM for the first time in years and she has what looks like a perfect, viable pregnancy finally (YAY!!) after multiple losses.  Based on that and what a few other people had said, and in a mad quest to find my lost EWCM (ha), I started taking Coenzyme Q10.  I'd taken this once  for a single cycle 2 years ago, but had stopped it after I found that it delayed day of ovulation by 2 days.

My first cycle back on CoQ10, I expected to O on day 18. Instead, just like the last time I'd taken it, my ovulation day got pushed back 2 more days (!!!!) and thank god, I got a good amount of EWCM.  So I'm sticking with it for the next cycle, and I'll be very interested to see if the changes repeat again. I'm praying the EWCM will stick around.

It is striking that both CoQ10 and Vitamin D have produced such changes in my cycle. I don't know what these changes mean (they look good, for the most part) but nobody can say what really indicates good eggs, though you can speculate away. So while I don't what to make of any of this, I figured faithfully cataloging all of this here cannot hurt. While we cannot take anecdotal findings seriously, we cannot dismiss it out of hand either.

Why hello 2012...or Que Sera Sera

From one angle, 2010 was possibly the worst year of my life thus far. I spent almost 5 months of that year pregnant, with nothing to show for it but two traumatic pregnancy losses.  From another angle, that year was actually not wholly negative. My losses changed me in positive ways. They showed me how much I could endure and still be ok, they made me realize that looking at the small picture only suffocates you, you have to take life in stride or you just end up floundering. I don't think any other sort of misfortune could have taught me these life lessons THAT effectively. It also bought discoveries that helped me and other people, such as the Vitamin D thing.

2011 was the year I healed and shed bad habits that had built up over the past decade, and was just wholly positive. I learned to just live life, and enjoy the simple things while NOT biting my nails to the quick trying to envision the end of this fertility odyssey.

2012 is the year I have to say, once more into the breach. Giant ULP. Its when , I sincerely hope, that I don't get tested on the lessons I learned in 2010. But if I do, I want to get through it with relatively well.   Being in contact with the ALI community has taught me so much- I've seen so many stories of horrific periods of infertility and  repeated pregnancy loss ultimately culminate in happy endings. It can take years. We have no effin idea whats around the bend, and trying to predict it is a fool's errand.

About the guy- that is a no go. I met him a 4th time after my week on the high seas (which was just heavenly by the way). I have no idea what his long term goals are, but in the short term, he, like the majority unattached guys in NYC I've met, just wants to jump my bones, and like the rest of them, after a point, can't seem to get past that item on the agenda. Seriously, moving here has not been good for my opinion of the opposite sex. I've met just TWO nice guys (who were sadly, unexciting) or interesting pigs, or just plain pigs. UGH. Anyway, coming back to this guy, he had a very good chance to tell me about the fact that he was still married, but did not take it. Its kind of sad to see a 37 year old guy with two babies at home chasing after women like that is going to solve every single problem he has. Anyway, that one evening extinguished any feelings I had very effectively. I was a bit sad the next day- not because I knew there was no chance I wanted anything with him, but because my respite from the frightening reality looming in front of me was up. Single motherhood has its own share of uphill battles, but you combine it with the possibility of recurrent pregnancy loss, it is quite a prospect to contend with. 

Anyway- this was not meant to be a negative post, but it ended up sounding like one.  But I'm neither negative nor nor positive. My attitude simply is--Que Sera, Sera. No matter what happens, I'll be ok. My IUI comes up early next month.

I have some sciency stuff to discuss- that can wait for another post! Happy 2012 everyone! I hope it only brings you all good things.

Also- its International Blog Delurking week. I see people from all over the world here, I'd LOVE to hear from you!

Some birthday gift

So I got the date for the vial used in IUI # 2, where my second pregnancy ended because of a chromosomal number defect, *maybe* because of crappy swimmers, and not any issue with me.

That vial, which may have been so very ill fated, was collected on my birthday. Of all the 365 days in the year, my birthday. I do have vials from other dates, but ironically, the one collected on that day has the highest counts.

So the date weirdness continues---the first bit was where the astrologer predicted that it was safe for me to get pregnant only after a particular date. That date was the day my baby's heart stopped beating, one year before.

My brother argues that its just random probability, you can ALWAYS find make some connection between 2 random things. One part of me knows exactly what he is talking about and tends to agree with him, that I should make absolutely nothing of it, but the more fanciful part of me just can't let it go. Which feeling would you predominantly go with, were you in my shoes?

Need advice (post on male aneuploidy)

I'm about 2 months (maybe) from my next IUI and soon, I'll have to make arrangements to ship my donors swimmers over to my new clinic. That brings me to an question that has been brewing in my head for almost a year now.

My second pregnancy loss was because my child had Turners Syndrome, she had only one X chromosome but lacked the other (either X or Y) which determined gender. Whether it was the egg that came without an X chromosome, or a sperm without an X (or Y) chromosome haunts me.

The genetics counselor I met with told me that in Turner's syndrome, 70 % of the time,  its the sperm that turns out to be the culprit. Still you can't say. There are times I kick myself that I did not pursue this question further, I had the means, I could have probably sequenced my DNA and the baby's DNA, that might have provided the answer.

Give that in a healthy, fertile male, only 2 % of sperm have numerical chromosomal errors, if it had been a defective sperm, you can say it was either random, colossally bad luck, or the universe really, really did not want me to have a baby at that point.

What worries me is: what if it was from a bad day, where the frequency of chromosomal errors was higher that average? This fear is kind of baseless-- studies have compared aneuploidy rates in men with male infertility (which my donor has absolutely no risk of suffering from, he seems to be really good in this department)--- aneuploidy rates are about 18-24 % in men with different kinds of male infertility and 2 % in normal controls.

So though there is not much basis for it, I'm wondering whether I should check that all my donors vials are from the same day, and if possible, use a different day's lot, though a) this might require a lot of digging and b) might even mean added expense. Rationally, I know there is no real need for this, but the niggling fear remains. What would you do?

We know nothing and can control nothing-- the question is- to what degree do you make peace with that...or...how far do you go to try to control the uncontrollable?

Vitamin D and melanoma

In response to my last post, both Jem and Oak asked the very relevant question about how one treads the fine line between getting Vitamin D from the natural source (the sun) when you are at risk for melanoma.

I think the first question one should ask is, do I have an elevated melanoma risk?  I should add, from those discussed in the link, the strongest is a family history of melanoma.. If you do have elevated risk, then yes, you should be very careful and avoid the sun. I would look into what is IN the sunscreen you use though-quite a few products are filled with carcinogenic crap. I highly recommend using the cosmetic database to see which brands are safest.

Also, another interesting thing - a lot of studies show that a Vitamin D deficiency seems to provide higher risk for multiple cancers, including melanoma.So its kind of a vicious cycle if you think about it. IMO, it provides a great explanation for why the melanoma risk is surprisingly high in the black population.

People with melanoma risk factors should be definitely advised to minimize their UV exposure and get their vitamin D through supplements.

However, I don't think advocating it for the entire population, on a constant basis, is that great an idea. If you are going to spend 5 hours on the beach, yeah, sunscreen is a good idea, but all the time you step out? Let me put it this way, everybody needs vitamin D, but only a subset of the population is at increased risk for melanoma.

But I digress--my post was not an advocation of going sunscreen-free as it was an essay on how such a large proportion of the population has come to be Vitamin D-deficient and the many, many dangers of it.  A Vitamin D-deficient mother is herself at risk for pregnancy complications, postpartum depression etc, and her child is at an increased risk for autism,schizophrenia, depression, cognitive disadvantages, diabetes, autoimmune disease, fibromyalgia, various cancers---its freaking scary!!!!

The moral of the story really was, it is very hard to get enough vitamin D from sun exposure in our modern day lifestyle---so check your D levels and supplement if you have to. Although I advocate trying to spend more time in the sun if you do not have melanoma risk (mostly because its what mother nature wanted us to do and our constant deviation from her set plan sometimes ends up being really bad), its amazing how many people who actually get a decent amount of time in the sun ARE deficient and end up supplementing. For many of us, there is no way out, and so far, nobody has been able to come up with any data showing taking  around  2000-4000 IU Vit D daily may be bad for you.

Vitamin D- Its not just about fertility : Part I

Nothing fascinates me more than the workings of the human body. How it evolved to be what it is today is mindboggling. Nature is pretty darned amazing in utilization of resources- while designing an intricate system, you need multitasking. Vitamin D (which is a hormone, not a vitamin) is the ultimate multitasker. Its receptor is almost universally expressed on every tissue in the body. It is strongly involved in regulation of the immune system, the brain, the kidneys, your thyroid gland, bone development, your metabolic pathways, the list is endless.

When you look at evolution, you realize nothing ever happens without a purpose. Nature plugged vitamin D as an important regulator/processor into so many pathways, she also realized you need a good system to make it, wherein you would not be dependent on external sources for it.  So it came about that every time you go into the sun, you made vitamin D.

Vitamin D is also one of the two things (the other is folate) that has probably governed the evolution of skin color. Life probably originated in Africa, and the intense levels of sunlight there destroyed folate (so tanning beds are a bad idea during pregnancy:)). So dark skin evolved, to protect folate. Although this acted as a barrier in the production of Vitamin D, the ample sunlight there created a harmonious balance. When people migrated to colder climates, with weak sunlight and long months of winter, they were making far too little of an important metabolite. This was probably the driving force behind evolution of light skin.

But we started to change. Not only we migrate far away from the places that we were designed for, but we started wearing clothes. That did not cause that much damage IMO, still because 200 year ago, people were still spending plenty of time outside, they walked places or they rode on horseback in good weather, they got out a lot because they did not have so much to do indoors.

In the past 30-40 years, our bad habits have really piled up. We've also let go of some of the old ways of life. In India, a common practice would be to give babies an oil massage and then let them sleep in the sun, fully naked,  for a little while. I asked my mom about this the other day, probably nobody in the cities, with our new lifestyles, does it anymore. We built big buildings with far too few windows where we spend the day, we invented cars so you spend very little time outdoors getting from point A to point B, we invented video games that kids stay indoors playing all day, and probably the worst offence, we started using sunblock by the bucketload, which almost totally blocks vitamin D production. We are literally, in the worst cases, almost completely shutting down our Vitamin D3 supply route. We did start supplying it in our diet, but the amounts were not high enough.

We messed with what nature intended. And what the research shows is, some of us have been paying for it in ways we are just starting to understand. Vitamin D deficiency is linked to Type I diabetes, Type II diabetes, rheumatoid arthritis, other autoimmune disorders, thyroid disorders, bone deformities, fibromyalgia, depression, chronic pain syndromes, autism (!!!), PCOS, obesity--the list goes on and on and on.

Importantly, other than a lack of time spent in the sun, the two other big risk factors for vitamin D3 deficiency is dark skin and obesity- this website talks about the latter.

I'm going to post a comprehensive list of what diseases its involved in a while- but in the meantime, it is bloody important to be vitamin D3 replete during pregnancy. This website does a good job talking about it.


http://www.vitamindcouncil.org/news-archive/2009/pregnancy-and-gestational-vitamin-d-deficiency/

I totally believe the theory proposed herein of a maternal vitamin D3 deficiency 'imprinting' the baby so he/she has a much higher risk for other diseases later in life. Please spread the word- post it to Stirrup Queens, talk about it on facebook, tweet it, whatever. We don't know what the end result will be of any woman being Vitamin D3 deficient during pregnancy (a lot of times, the effect is probably minor), but if you can prevent even one child from developing asthma, schizophrenia, diabetes or autism later in life, its worth it.