Fertility add-ons: Complementary treatments to increase your IVF success
You have tried everything. You’ve tried so many natural cycles that you’ve lost count. You’ve gone through months and months of IUI, coupled with poking yourself with daily needles to coax your ovaries to produce more eggs.
Now your doctor says that IVF is the next step. You are excited but nervous. This is the gold standard of fertility treatment! It has to work! Many patients feel like IVF is the end of the road and that if it doesn’t work, any hope of getting pregnant is gone.
So what can you do to improve your chances of success?
Complementary treatments have become mainstream in all fields of medicine. Particularly in the fertility world, complementary medical practitioners and fertility specialists work hand in hand to help their patients achieve pregnancy.
What complementary treatments are available to you, and how can they maximize your IVF success rate?
We consulted Mary Wong, a traditional Chinese medicine (TCM) practitioner and author, for her input on how complementary medicine can work with conventional IVF treatments to improve success rates. Mary shares her insight below.
Everyone has a friend who conceived after doing acupuncture. A stress-reliever and a way to balance your body, acupuncture involves the insertion of fine needles through the skin to treat various physical, mental, and emotional conditions. In recent years, acupuncture has been shown to help in the treatment of infertility. Acupuncture induces a relaxation response, increases ovarian and uterine blood flow, and relaxes the uterus to increase receptivity. It should not hurt, but rather should lead to calmness and relaxation. In fact, it’s not uncommon to find my patients fall asleep or in a state of deep relaxation during their acupuncture treatments, even if they come in feeling highly stressed.
What’s the evidence?
Many research papers show that acupuncture can increases IVF success rates when performed before and after embryo transfers. Most clinics are willing to accommodate acupuncturists in their schedule so that patients have access to a private space in the clinic where they can have acupuncture done pre- and post-transfer.
Ask your fertility doctor about this possibility. Alternatively, even if you have to do acupuncture outside of the fertility clinic before and after the transfer and there is a bit of a delay, even of a few hours, this could still help your overall pregnancy outcome.
Many patients ask us fertility doctors, “Should I be doing acupuncture more than just before and after the embryo transfer?” While the data suggests that acupuncture done around the time of the embryo transfer is most helpful, doing it much prior to and after can also help significantly. It can get your body used to the techniques and promote blood flow to the ovaries and uterus. Doing acupuncture for three months before your IVF treatment could help to relax you, reduce stress, and improve the ovarian response to fertility medication.
In addition, acupuncture has been shown to help in patients with repetitive miscarriage and also those with nausea and vomiting in early pregnancy.
Many women in our practices see a naturopath or TCM practitioner as part of their fertility treatment and are often prescribed herbs and/or teas to help their hormones and improve their fertility. While we, as fertility doctors, are not opposed to patients taking herbs, we encourage patients to review all medications with their doctor, especially when taking fertility drugs, because many of the drugs could interact with each other, sometimes in a detrimental way. Also, many herbs and teas are not safe during pregnancy, so be sure to discuss these with your fertility doctor.
The natural menstrual cycle is the basis for all fertility treatment, and the healthier and more normalized your regular monthly cycle is, the higher the chances of a successful pregnancy, whether you are trying to conceive naturally or in conjunction with IVF. Certain herbs can help regulate the menstrual cycle and balance hormones. As always, speak with both your TCM practitioner and fertility doctor to see which are right for you. Also, make sure to use herbs that are free of contaminants and heavy metals.
If you search the internet for supplements that can boost your fertility, you’ll find no less than a few hundred iPhone apps to keep track of all the vitamins and supplements you are taking! Which of these supplements actually work? And how safe are they to take?
There is some data to support taking a few key supplements prior to and during your fertility treatment.
Coenzq10 and Ubiquinol
These help to create more energy (ATP) in eggs (oocytes), which helps the chromosomes separate normally and increase egg quality.
Vitamin D reduces the chance of miscarriage and improves overall fertility. Sunshine is a source of vitamin D. Given that we live in a colder climate here in Canada, routine supplementation is recommended. We routinely say to women who are trying to conceive to take 1000 IU per day in the summer and 2000 IU in the winter. Vitamin D can be taken as drops, pills or chews, often in combination with calcium.
DHEA is a naturally occurring substance. The hormone helps to make more estrogen and testosterone, two important mediators in the hormonal cascade in the ovary. DHEA might improve fertility particularly in older women with a severely reduced ovarian reserve. Because DHEA is a hormone, speak to your doctor about whether this supplement is right for you and how long you should be on it while trying to conceive.
This is important in an early developing pregnancy for normal spinal cord development. The recommended dose is 0.4 mg per day, but in women who have a personal or family history of neural tube defects (i.e. failure of the spinal cord to develop normally) or those on certain medications (such as anti-seizure meds) a higher dose, up to 4 mg, is recommended. We recommend starting folic acid up to three months prior to initial attempts to conceive in order to maximize blood levels when pregnant.
Diet and lifestyle
Green shakes, fertility yoga, pineapple, avocado, and cold-pressed juice. The list goes on and on! Patients are willing to eat, drink, and do anything that will help them get pregnant! While all of these things definitely promote a healthy diet and lifestyle, what kind of data actually supports the diet and lifestyle modifications we all do to improve our chances of pregnancy?
Reduced caffeine intake
Many patients will go cold turkey and stop drinking coffee altogether. The truth is that moderate intake is still OK. Up to 200 mg per day (about one tall Starbucks latte!) is considered safe when trying to conceive and when pregnant.
Eliminating toxic habits
Smoking and alcohol are teratogens (substances that can harm fetal development), and stopping both of these before trying to conceive and while pregnant is recommended. No amount of alcohol or nicotine intake is considered safe when pregnant. However, feel free to have that one glass of red wine the night prior to your egg retrieval or when the fertility hormone treatments are making you a bit crazy!
Avoid toxins such as pesticides, phthalates, and Bisphenol A (BPA), often found in food and in skin, makeup, and cleaning products. One simple habit is to carry your own filtered water in a glass or food-grade stainless-steel bottle to prevent exposure to BPA. BPA has been linked to cancer and contributes to fertility challenges.
Laughter goes a long way in your fertility journey as well as in IVF transfer. One study shows that women who were entertained by clowns in the recovery area of an IVF clinic after embryo transfers had an increase in pregnancy rates compared to women who were not entertained by clowns. So, go home and watch some funny movies or read something that will make you laugh and lighten up.
In short, complementary treatments can definitely improve your IVF success rate. The most important thing is to maintain open communication between your fertility doctor and complementary medicine practitioner to make sure they work together to optimize your success!