How to prepare yourself physically for an IVF cycle ?

Going through an IVF cycle is exciting and very stressful too. You will be tormented by a variety of emotions. You will be happy that you are taking treatment that might give you a much longed-for baby ;  and at the same time , you have to cope with the fear that the cycle may not work! You want to do everything as perfectly as possible , so that you have given yourself the best chance of success. Your mind will be full of doubts and questions , and you are not sure how to find the answers. You may be needle-phobic and scared to death of all the injections you have to take. Did I inject the medicine properly ? Did I take the proper dosage? What if I forget to take my medicines at the right time - will this affect my cycle? What should I eat and what should I avoid? Will the type of food I eat affect my IVF success? What supplements should I take? Where do I find the much needed emotional and intellectual support?  There are so many questions in the mind of first time IVFers. Most of them search for answers to their questions on the internet , and will get lots of different answers - some reliable and some not.  I hope this article will help you to resolve your doubts . This is reliable information because I am a biologist and have gone through several IVFs myself . Good Luck with your IVF cycle and keep reading!

Life style

Life style factors do have an impact on your fertility , whether you are trying to conceive in your bedroom or when you are doing IVF! Preparing yourself physically is important so that you can maximize your chance of conception.

Below are some common life style habits and behaviors which can be modified in a positive way , so that you give yourself the best chance of succeeding in an IVF cycle.

Weight

It is a well-known fact that both obesity and excessive leanness affect fertility. When you decide to go through an IVF cycle , it is wise to concentrate on your body weight and try to bring your BMI to normal. You can calculate your Body Mass Index by using the online BMI calculator. Normal BMI should be within 18.5-24.9 Kg/m².

Obese women need a significantly higher dose of injections for superovulation ; and their egg yield is also reduced when compared to woman of normal BMI. Their chance of pregnancy is lessened; and they also carry a higher risk of miscarriage. Underweight woman also produce fewer eggs when compared to woman of normal BMI ; and their risk of miscarriage seems to be elevated too. These  are documented facts.  Try to bring your body weight to the optimum level before starting an IVF cycle. Even if you are not able reach your ideal weight range, modest weight loss if you are obese (or weight gain if you are underweight) will help in improving the outcome of your IVF cycle. Many women find that signing up for an IVF cycle provides excellent motivation for optimizing their body weight.

A rapid change in your weight can affect your IVF cycles adversely, so if you plan to make changes to your weight , do it gradually and slowly by following a healthy diet plan and exercise. Do not follow any fad diets and starve yourself. Proper nutrient intake is very important for optimum reproductive functions.

Exercise

Exercise makes you feel good physically and mentally. It will help you to lose weight and will also aid in maintaining an ideal body weight. Exercise releases many feel good hormones called endorphins which will help you to have a healthy psyche too. It also increases blood flow to various organs ( thus helping in optimal oxygenation) , including your reproductive system.  However, too much of a good thing can be harmful too. Rigorous exercise (more than four hours of strenuous exercise per week) can negatively affect IVF cycle outcome , Such an exercise regimen can reduce your fat reserves drastically , and this will prevent proper functioning of your reproductive hormones. Yoga and pranayama (breathing exercises)  are excellent.  They keep your body flexible and help in blood circulation. Select an exercise which you feel comfortable with. A good exercise schedule will help to reduce your physical and mental stress greatly during an IVF cycle. Avoid doing any strenuous exercise when you are undergoing ovarian stimulation. There is a danger of ovarian torsion as superovulated ovaries are heavier and larger during this time.

Smoking 

It is a well-known fact that smoking can cause enormous harm to various organs in our body. Smoking affects our reproductive organs too. Women who smoke reach menopause earlier than their non-smoking counterparts. Epidemiological studies have repeatedly shown that women of child bearing age who smoke have higher rates of infertility, spontaneous abortion, ectopic pregnancy, tubal infertility, and intrauterine growth retardation than nonsmokers. Smoking decreases ovarian reserve as well. This reduces  oocyte yield and decreases fertilization rates,  leading to a poor prognosis in ART cycles.  In men, cigarette smoking adversely affects sperm quality and causes damage to the sperm DNA. This can lead to male infertility and has been found to adversely affect IVF/ICSI outcome. Passive second hand smoke is dangerous as well !

Alcohol consumption

There are studies which show that maternal and paternal alcohol consumption decreases live birth rate after IVF .  As few as four alcoholic drinks per week decreases IVF birth rate. Female alcohol consumption was associated with decreased egg yield, and an increased risk of miscarriage.  Many people have the misconception that red wine is OK to consume as it has an anti-oxidant called resveratrol.  While it is true that resveratrol has a positive effect on several health parameters and is touted as an anti-aging agent, humans have to consume a bottle of red wine everyday to ingest the amount of resveratrol which is found to be effective in mice experiments (yes in mice! So the amount of resveratrol needed to produce a positive effect on human health will even be higher). So do not use resveratrol as an excuse for drinking alcohol. Few glasses of red wine cannot give you enough resveratrol and on the other hand it can affect your chance of conception when undergoing an IVF cycle.  Remember, moderation is the key here. If you feel relaxed after a drink , go ahead and have it , but avoid going beyond the stipulated limit. You will feel emotionally better if you stop consuming alcohol during an IVF cycle because even if the cycle fails , you will not blame yourself!

Diet

Healthy food intake is very important for your fertility and a healthy preconception diet increases the chance of ongoing pregnancy in women undergoing IVF/ICSI treatment. A good diet consists of fresh fruits and vegetables, complex carbohydrates, lean meats, dairy products and healthy fats, all in moderate amounts. There are no special foods that can increase your chance of IVF success and there are no foods that can hinder your chances of success (when not taken in excess!). Adding a wide variety of foods to your diet and taking them in the proper amount is very important for your reproductive health. If you search on the internet, you will find loads of advice on which food to take and which one to avoid when undergoing IVF. But I can vouch that all are just nonsense. Look at the women who conceive naturally; do they take any special food or do they avoid eating any particular food ? Then how could come a particular food either increase or reduce your chances of IVF success ? It is widely speculated that reducing caffeine is good and that increased caffeine intake can reduce your chances of IVF success. But I have found no scientific studies to support this notion.  If you are drinking 2 cups of coffee a day I find no valid reason to cut it down but if you are drinking 10 cups of coffee a day , then it is time to reduce your coffee (caffeine) intake. I have seen people avoiding fat as if it is a poison.  Remember, many sex hormones need cholesterol for their biosynthesis.  It’s fine to take healthy oils and fats in moderate amounts. There are some women who need a special diet, for example women with PCOD and women with diabetes because of the insulin utilization issues they have. Such women should talk to their doctor or dietitian and modify their diet accordingly.  But the basic diet rules are:

1)   Do not follow any fad diets.

2)  Include a wide variety of foods in your diet. Add color to your life by adding different coloured  vegetables and fruits.     

3)   Watch your caloric intake.

4)  Limit your intake of refined , calorie dense, nutrient depleted foods  like white sugar, white bread, white rice; and increase your intake of nutrient rich, calorie sparse foods such as  fresh vegetables and fruits.

5)   Remember, moderation is the key!

Supplements

Should I take any supplements?  Of course yes! The most important supplement which every woman who is trying to conceive should take is folic acid. Folic acid is proven to prevent neural tube defects in developing embryo. Taking folic acid can prevent 70% of neural tube defects. So make sure you take a supplement containing at least 400µg ( 0.4 mg) of folic acid at least 3 months prior to starting your IVF cycle. If you are diagnosed with mutation in your MTFHR gene you are supposed to take 4mg of folic acid . If you haven’t started taking it 3 months before, do not panic. Better late than never-so start taking it from today!  The internet is full of long lists of supplements ; and many women who have had IVF babies attribute their success to these.  Sometimes I really panic looking at these lists. From fish oil to wheat grass, there are just too many things to take !  Remember, what is good for the goose need not have to be good for the gander. So do not buy and gulp down supplements just because someone else is using it. Most nutrients can be obtained via a good diet. If you think your diet is not good enough , it is wise to start pre-natal vitamins prior to your IVF cycle.  There are some supplements which are helpful for women with a particular condition, for example, DHEA is a supplement which is found to help some women with poor ovarian reserve. So talk to your doctor regarding which supplements can benefit your particular situation. If taking lots of supplements helps you feel better emotionally ( lots of women feel that pills are good for their health) then please use supplements which are proven not to cause any harm ; and buy these from a reputed pharmacy! Some herbal supplements might interfere with your IVF cycle in an unknown and unpredictable manner. Always let your RE know if you are taking any herbal supplements when undergoing an IVF cycle.