Food as medicine: Beetroot + watermelon juice to assist embryo implantation
Could a daily fresh juice help with implantation?
That's the idea researchers started with to investigate how a daily juice of beetroot + watermelon + ginger might affect embryo transfer outcomes - specifically, would it affect endometrial receptivity and implantation?
The Study
In an abstract published in Fertility & Sterility, a small group of 296 women undergoing ICSI cycles were recruited. These women were randomised into a control group (no intervention), or treatment group (daily beetroot, watermelon, ginger juice from the day of transfer through to their pregnancy test). These groups had similar maternal and paternal age, maternal BMI, number of follicles, number of eggs retrieved, number of mature eggs, fertilisation rate, blastocyst number.
Results were adjusted for potential confounders such as age, BMI and endometrial thickness.
✴︎ The implantation rate in the juice group was 24.2% vs 17.8% in the control group
✴︎ The pregnancy rate was 41% vs 21.6%
That's pretty significant.
However, it was a small study and was only presented as an abstract, not a full peer-reviewed paper, so results should be interpreted in light of this.
Another of the study's findings was a 0% miscarriage rate in the juice group - this is a bit jaw-dropping! A lack of any background miscarriages does make me think this is all too good to be true...
But…if our philosophy is to 'Do no Harm', then a fresh juice every day is definitely a safe, (delicious), harm-free intervention to try, and it might just make all the difference...
Why this might work?
I talk about it all the time, a healthy egg & sperm cell contributes to a vital and robust embryo for transfer. But as many of you IVF ladies know, an embryo transfer doesn't automatically = a pregnancy. Implantation failure is still a great unknown in IVF, potentially related to uterine abnormalities, immunological issues, hormonal imbalances, clotting disorders, infection...each affecting endometrial receptivity.
A healthy and hospitable uterus is required for implantation to occur.
Trying to influence uterine vascular health and circulation might be one way to improve embryo transfer outcomes. Think of some of the medications prescribed after a transfer that are also working to optimise endometrial circulation and reduce uterine inflammation - aspirin, clexane, progesterone, prednisone*
And that's where this juice comes in...
Beetroot, watermelon and ginger all contain compounds that affect circulation and (anti)inflammation.
Beetroot
Beetroot is high in dietary nitrates.
No, this isn't the same as the nitrites from processed meats.
When we eat dietary nitrates in leafy greens or beetroot, our body uses them to make nitric oxide (NO).
NO causes our blood vessels to dilate, stimulating them to expand and increase in blood flow. And what comes along for a ride with this increased blood flow?…more oxygen to our cells, tissues and muscles, and more nutrients.
Your uterus is a muscle, and the inner endometrial lining is highly vascular, full of capillaries and spiral arterioles. Each spiral arteriole provides blood supply to 4 -9mm2 of your endometrium.
It's hypothesized that optimising endometrial blood flow might improve the endometrial receptivity to an embryo. That the endometrial lining becomes, well, a super cosy and juicy place for that embryo to nestle!
Watermelon
Watermelon is a rich source of a variety of nutrients, including antioxidants like lycopene, b-carotene, lutein + zeaxanthin, as well as folate and flavonoids.
It's also one of the richest sources of the amino acid L-citrulline.
L-citrulline naturally increases our L-arginine levels (another amino acid), in a more reliable way than supplementing with L-arginine alone (supplementing with L-arginine can cause dietary upset and results in a 'spike' of arginine rather than sustained release).
And then, this is the magic...in turn, L-arginine improves the body's nitric acid production, with all the associated benefits to vasodilation as listed above.
Are you as bedazzled by our biochemistry as I am…?
Ginger
Ginger has long been known to be systemically anti-inflammatory and a circulatory stimulant.
It's also a very energetically warming spice. I love using it therapeutically in liquid herbal mixes to 'warm up' a constitutionally 'cold' person. To get their blood moving. To stoke their digestive fire.
Our food and drink can be therapeutic too! There's something a bit special about a spicy chai with ginger, or a bitey ginger tea, or a warming dahl with ginger.
I love the inclusion of ginger in this juice not only for the anti-inflammatory and circulatory effects of its active constituents, but also the warming energy it adds to the juice.
🌈 Colour
I'm incredibly motivated by a colourful diet and the colour of our foods. Eating a wide variety of colours means you're also reaping the benefit of a wide variety of antioxidants and vitamins and fibres. You're also eating the energy of those colours.
“I’d rather count colours than calories” ~ me x
This juice, this womb elixir is red. Like, red, red, red. Make it and see.
As you're drinking it, it's so easy to visualise your own red and rich endometrial lining nourishing your newly transferred embryo. And I think that's a pretty potent medicine too.
The red colour of this juice reflects the 'root chakra'. This chakra is all about survival and stability and support.
Think about how this might apply to you during the two-week wait after your embryo transfer. Can you look to your network to provide support during this time? If this is lacking, put your own supportive structures in place. Anchor yourself.
☾ Set boundaries - say 'no' when you need to
☾ Consider asking for time off work or a flexible working arrangement if you feel it would help you.
☾ Do some batch-cooking prior to your transfer, so you've got warm, nourishing, wholesome food to grab
☾ Stock that fridge and pantry
☾ Sleep, meditate, go out, rock on...you do you
Feeling safe is also part of the our root chakra. It's a root, or basic, need.
But it can be hard to feel safe in your body when you're moving through fertility treatment. It's easy to distrust or lose faith in your body. That's ok. For the 5 minutes you're drinking your womb elixir, soak up that red energy and visualise its effects.
Recipe
1/2 beetroot
Small slice of watermelon
Ginger to taste
Blend together, adding enough filtered water to achieve the consistency you like
Note:
Blend, don't juice, this way you also get the benefit of all that fabulous fibre for your gut flora - you lose this when you juice.
I found this combination to be Very Sweet for me. So I added some tahini. Delicious.
* This juice is safe to drink alongside any of your post-transfer medications
If you have any questions about how to support your IVF cycle, embryo transfer, or your fertility, please make an appointment with Jacintha to discuss.
If you’re interested in using food as medicine, you might also like:
Additional references
Dahia, V, The Alchemy of Amino acids, 2019
Halpern G et. al, Beetroot, watermelon and ginger juice supplementation may increase the clinical outcomes of intracytoplasmic sperm injection cycles, Fertility and Sterility, 2019, 112(3), e3-
Hoffman, R, Why nitrates and nitrites in processed meats are harmful – but those in vegetables aren’t, The Conversation, 2021 Nov 11, https://theconversation.com/why-nitrates-and-nitrites-in-processed-meats-are-harmful-but-those-in-vegetables-arent-170974
Rogers, P, Structure and function of endometrial blood vessels, Human Reproduction Update 1996, Vol. 2, No. 1 pp. 57–62
