Boosting Your Fertility for IVF
Infertility is defined as the inability to achieve a clinical pregnancy after 12 months (or six months if you are 35 years or older) with regular unprotected sexual intercourse. If you are currently struggling or have struggled with your fertility in the past, you have likely completed a battery of test as well as completed further investigation including trans-vaginal ultrasounds, hysterosalpingogram (HSG), Saline infusion sonography (SIS) and likely discussed the possibility of ovulation induction medications like Clomiphene, as well as procedures including intra-uterine insertion (IUI) and ultimately In-vitro fertilization (IVF).
IVF involves the use of gonadotropins (injectables) to stimulate the ovaries to produce multiple follicles and eggs. The eggs are then retrieved from the ovary while the patient is under sedation. The eggs are then fertilized in the laboratory and matured for 3-5 days. Once mature, the embryos are graded on their quality, which is decided upon by the number of cells and overall structure of each embryo. After the embryos have been graded, only the healthiest embryos are transferred back into the uterus for implantation. Most clinics will limit the embryo transfer from one to two embryos to reduce the likelihood of twins and multiple births. An embryo that has developed to 5 days and has reached the stage known as blastocyst is considered to have the best chance of success in implantation.
So, as you can see, IVF requires multiple steps and can cost on average $12,000 per cycle. So, what if there was a way we could improve your chances of pregnancy naturally along side these fancy treatments? A way to improve your odds that you may need less medications, less cycles and ultimately get pregnant faster? As a naturopathic physician specializing in hormone health and fertility, I have seen impressive results in patients undergoing integrative fertility treatments.
What is Integrative Fertility?
Integrative Fertility is a term I use with my patients to explain collaborative team- based approaches to fertility. I believe that we are better together, which is why I collaborate with fertility and reproductive endocrinologists to provide patients with synergistic modern medicine and natural medicine approaches to fertility.
Can Natural Medicine Really Help My IVF treatment?
100% yes, but don’t just take my word for it, check out the research. In a recent meta-analysis that investigated 7 trials with 935 women, the use of a supplement known as Myoinositol increased clinical pregnancy rates in infertile women undergoing ovulation induction for ICSI (intracytoplasmic sperm injection) or IVF- ET(in vitro fertilization embryo transfer). The study also reported that Myoinositol may improve the quality of embryos and reduce the unsuitable oocytes and reduce the amount of required ovulation stimulation drugs. Myoinositol, is just one example of how natural and modern medicine can work in a synergistic fashion.
The Influence of Diet
If there is one thing you can do today to boost your fertility for IVF, it would be proper nutrition. Studies have investigated and noted strong evidence that healthy preconception dietary patterns (including fertility boosting foods) among BOTH men and women of reproductive age had a beneficial effect on fertility. Which means, optimizing your nutrition for you AND your partner is critical for conception.
Specifically, we encourage a diet rich in healthy fats, high quality lean proteins and one pound of organic vegetables per day.
BMI (Body Mass Index)
Having a healthy body mass index (BMI), is not about fitting into a certain pair of jeans or looking a certain ways. In fact, when it comes to IVF success rates, a BMI above the normal range (under 25 is considered normal) was an independently negative prognostic factor for IVF cycle cancellation as well as reduction in oocyte and embryo count. In other words, working on correcting your current BMI can single- handedly increase your rate of success with IVF. This is why if you are currently struggling with an elevated BMI (a BMI above 25), I highly recommend consulting with a naturopathic physician or dietician who can help improve your BMI to enhance your chances of a successful pregnancy. Although in this scenario I am discussing normal BMI for IVF success, this also applies to women struggling to conceive naturally.
Obesity in men has also been shown to reduce sperm quality and fertility, which is why I highly recommended both partners be properly guided for adequate BMI.
Exercise and Fertility
Moderate regular exercise, which is defined as at least 30 minutes of moderate intensity physical activity per day (brisk walking, short run, yoga, pilates), can improve fertility both naturally as well as with artificial assistance, including IVF. While studies show that exercise boosts female fertility, it is important to note that a large amount of very high intensity exercise may actually reduce fertility and the chance of having a baby with ART (assisted reproductive technology, like IVF). So, it’s a good idea to avoid very high intensity exercise while trying to conceive.
Toxins and Fertility
During our daily life, we are exposed to a variety of chemicals from the water we drink, the food we eat, the air we breath, the places we live and the products we use. In fact, according to the Environmental Working Group (EWG), a survey of more than 2,300 people, showed that the average adult uses 9 personal care products each and every day, with 126 unique chemical ingredients. Not only was the number of chemicals we are exposed to significant, but one in every 13 women are exposed to chemical ingredients that are known or probable reproductive and developmental toxins, linked to impaired fertility or developmental fetal defects. The biggest problem with the personal care product industry is that it is not well regulated. The current safety panel for the personal care product industry, known as the Cosmetic Ingredient Review, approaches each safety assessment as if consumers were exposed to a single chemical at a time. Not only should we be concerned about the chemicals in our products, but other countries including many European countries and Canada have banned 1,300 chemicals from personal care products and cosmetics, while the US, on the other hand, has only banned 11, leaving consumers fending for themselves when it comes to product safety.
Although it can be nearly impossible to eliminate ALL toxic chemicals from your environment, here are a few ways to help reduce your exposure to the worst hormone disruptors:
Avoid the EWG’s Dirty Dozen list of Hormone Disruptors:
Fire Retardants (found on most furniture as well as many car seats)
When it comes to reducing your exposure to hormone disrupting chemicals and unnecessary pesticides, going organic is a must. It is, however, important to understand how to choose organic products and what to look for when you are shopping. First, it is important to note that marketing companies have upped their game to entice you to buy their particular “organic” product, however it you do not see a USDA organic label, don’t buy it. The USDA (United States Department of Agriculture) is the department of the United States government that provides strict guidelines for organically listed products. Second, if finances are a concern and you are unable to convert your entire grocery list to organic products, at least buy the following 12 products as organic. The EWG provides a list each year known as the “Dirty Dozen” list which lists the food that contained the highest amount of pesticides that year. Click here to download the 2019 Dirty Dozen list. Screen shot it for your reference or print it out and bring it with you when you shop.
Acupuncture and IVF
Acupuncture, which has been used in eastern medicine for hundreds of years, can help boost your success from IVF. In fact, data from a recent study shows that pregnancy rates increased by 17% for women who received acupuncture (compared to those who did not). Research has specifically demonstrated that acupuncture before and after IUI and embryo transfer may significantly improve pregnancy rates by increasing blood flow to the uterus, regulating hormone balance, reducing stress and improving male sperm count. Fertility acupuncture can:
Increase the possibility of IVF success by improving diminished ovarian reserve markers
Balance hormones leading to regular menstrual cycles
Improve pregnancy outcomes in patients with a history of recurrent pregnancy loss
For the best results, I recommended undergoing weekly to biweekly acupuncture treatments 1-2 weeks prior to IUI or embryo transfer. I also highly recommended acupuncture the morning of your embryo transfer as well as shortly after.. For my patients, I coordinate their treatments to perform their treatments at their fertility clinic whenever possible. The treatment is 20-30minutes in duration and involves acupuncture points that help dilate the cervix, making the insertion of the embryos easier. We also use points that are specifically used to reduce stress as well as relax the uterus, which can decrease the frequency of cramping and contractions noted during the procedure. Once the embryo transfer is complete, we focus on acupuncture points to stimulate blood circulation to the uterus to nourish the newly implanted embryo and to improve the rate of successful implantation. 24 -48 hrs after the procedure, I typically recommend my patients return for an additional treatment focused on reducing uterine spasms and cramping often associated with IVF and IUI procedures.