IVF Factors: Improving the Odds
For many couples looking to start a family in vitro fertilization (IVF) might be the only option. This could be for any number of reasons. Such as reproductive problems on the side of either partner, same sex couples or advanced maternal age. Unfortunately, IVF is far from a guarantee. In women under the age of 35, the chances of a live birth is about 40% per cycle and this rate drops dramatically to 31% and below 20% for women between 35-37 and over the age of 40, respectively. With the average cost per cycle without insurance starting between $12,000-$18,000 not to mention the physical, emotional and mental toll, it is wise to take steps to improve the odds.
Maintain a Healthy Weight
One of the best things women can do to improve their chances of success with IVF, is maintaining a healthy weight. In comparison with normal weight women, over weight and obese women undergoing IVF have been shown to have lower pregnancy rates (20.8% vs 28.3%) and implantation rates as well as increased rates of miscarriage. Overweight and obese women also require more fertility drugs during IVF and have a lower number of retrievable oocytes (eggs) and decreased embryo quality. In general, it has been found that having a BMI between 20-26 is optimal for female fertility. Being at a healthy weight is not just the mom's responsibility, but also dad's. High male BMI can affect fertilization rates because excess body fat leads to increased estrogen and decreased testosterone levels. Ultimately, this has a negative impact on sperm counts, morphology and motility.
Protect your mitochondria
Let's take a trip back in time to your freshman year biology class. You might remember mitochondria as those "little bean looking" organelles found inside cells responsible for respiration and energy. Unlike other cells, oocytes and early embryos are entirely dependent on mitochondria for energy. As we age, oocyte mitochondrial function decreases due to oxidative stress which has an impact on fertility even with IVF. Although we can't turn back the clock, there are nutrients that can help. For example, CoQ10 (especially when combined with DHEA) has been shown to improve oocyte mitochondrial function, follicular maturation and overall ovarian reserve. Therefore, women over the age of 30 who are considering pregnancy should be taking CoQ10 daily. Other mitochondrial protective nutrients include alpha-lipoic acid, melatonin, and DHEA.
I'm not suggesting you should rent a villa in Nice but when it comes to a diet that has been shown to be the most beneficial for fertility, Mediterranean is the way to go. Studies have shown that women undergoing IVF, who follow this diet, increase their probability of pregnancy by 40%. If you are not already familiar, the Mediterranean diet emphasizes healthy fats like olive oil, fish, whole grains, fruits and vegetables and an avoidance of refined carbohydrates and saturated fats. One reason this diet can be so helpful is that it is positively associated with red blood cell folate and vitamin B6 in blood and follicular fluid. Having optimal levels of these nutrients is essential for achieving and maintaining a pregnancy to term. And don't even think of dining alone! This diet actually has the greatest impact when it is followed by both partners as demonstrated by further increases in pregnancy with adherence by the couple.
Have a Clean Start
I probably don't have to remind you that we live in a toxic world, but chances are you might not know that the accumulation of certain chemicals in uterine and ovarian tissues can have a significant negative impact on IVF success rates and fertility as a whole. Let's start with polychlorinated biphenyls (PCBs) a known endocrine disruptor and neurotoxin. Although now banned, it still contaminates many fish, meat and dairy products. In women with high levels of PCBs undergoing IVF, it has been found that the rate of failed implantation is double and the odds of live birth reduced by 41%. Another endocrine disruptor which is still widely used, is Bisphenol A (BPA) found in some water bottles, the lining of food cans, and even receipt paper. Exposure to BPA is related to reduced egg retrieval and decreased uterine receptivity to implantation. Probably the worse offenders are phthlatates, which found in many personal care products and cosmetics. Even at lower exposure levels, phthalates are associated with low oocyte yield and maturation during retrieval, and overall decreased likelihood of live birth or clinical pregnancy following IVF. Detoxification is therefore an essential part of any preconception plan for women trying to get pregnant with or without IVF. It is recommended to start at least 3 months prior starting IVF or other conception methods.