BEFORE IVF

WHAT IS IVF?

In vitro fertilization (IVF) is a highly specialized process where eggs from a woman and sperm from a man are put together in a controlled environment to enable them achieve fertilization outside the body and form an embryo(new life). The resultant embryo is then transferred back to the woman’s womb with hopes of implantation taking place and pregnancy beginning.

WHEN TO OPT FOR IVF ?

Indication for IVF includes:

▪️Prolonged infertility

▪️Increasing age of couple

▪️Severe male factor infertility

▪️Tubal blockage/malfunction causing female factor infertility

▪️Single motherhood using donor sperm

▪️ Failed fertility treatments using other methods.

So IVF is almost like the last bus stop for fertility treatments.

 The process seems pretty straightforward; eggs are collected from the woman, sperm collected from the man, both put in a conducive environment, fertilization occurs and embryo put back in the womb… Pregnancy begins!

Its not as simple as it sounds though. Sometimes this process can fail resulting in no pregnancy after transfer to the womb. This is due to failure of implantation.

WHY CAN IVF FAIL?

As we must have realised, three important factors are at play for the process of IVF; the eggs, the sperm and the womb. If there’s a problem at any of these points, the process can end in failure.

What problems can arise at these points?

▪️Poor quality sperm: Sperm with poor quality can lose their motility strength, have fragmented tails, damaged or abnormal chromosome or poor enzymes needed for penetration of the egg. The process of fertilization is very complex and is championed by the sperm cells. Damaged sperm cells become non functional and unable to achieve this all important task.

▪️Poor quality eggs: while a poor quality egg can be fertilized if sperm is good, the eventual stages of division and growth may be truncated due to the poor quality. Age can affect eggs adversely as the spindle which holds the chromosomes in the cell are prone to easy fragmentation in older women, so increased age is a stronger reason to build quality of eggs.

▪️Poor womb environment: The journey of IVF ends in the uterus(womb). When the womb environment is compromised therefore, the chance of achieving implantation reduces as well. Maximizing an optimal womb environment therefore is key to the success of IVF.

▪️Poor technique: The environment where the IVF procedure takes place is also very complex and controlled. Alterations even in the slightest way in terms of temperature, humidity, lighting, etc can alter the viability of the embryo. Also the grade of drugs used is very important. So it is very important to use a center where all the conditions are optimal. Many centers now are upping their game as the market for IVF is increasing. It’s important still to check that everything is done to standard in the center you choose.

▪️ WHAT CAN WE DO TO PREPARE FOR IVF?

So we have mentioned how IVF can fail. What causes the compromise of the egg, sperm and womb? What can we do to optimize them?

Let’s find out….🧐

 1️⃣ Eat Fertility enhancing foods: Our diet is our major source of nutrition. Eating nutritious foods helps improve our health. Eating fertility enhancing foods therefore improves the quality of eggs and sperm the bodies produce. Foods low in fat, high in protein, iron, magnesium, calcium, potassium, zinc, etc helps improve the quality of the Reproductive cells. Caffeine, nicotine, sugar and alcohol are known to make eggs resistant to fertilization. Alcohol actually reduces the chances of success by 50%. More plant based foods (Mediterranean diet) in the preparatory phase of IVF have been known to improve the chances of success at the procedure, so fresh fruits and vegetables, lean protein like fish and poultry, whole grains, beans, lentils, low fat milk, healthy fat like avocado, olive oil and nuts all play a role in improving quality of cells produced. Avoid red meat, flour, processed foods, excess salt and spices.

2️⃣ Manage stress: Strenuous exertion should be avoided. Clear your schedule 1-2months before the procedure so you are not under any pressure. Avoid strenuous exercises as well. If you do intense work outs, you may want to replace it with moderate activities like yoga, swimming, walking or hiking. Too much exercise can thicken the womb and make it more difficult for implantation. It also reduces blood flow to the womb as the other muscles involved in exercise will require more blood. We want all the blood the womb can get for this process. Don’t stop exercising all together however.

You can have sex to help relieve tension, but practice shallow penetration or outercourse to prevent irritation to the cervix.

 Socialize when you can. Practise stress relieving activities like

• meditation

• massage

• reading a book

• starting a journal on the process

• taking warm baths

• going to movies

• taking pictures to keep memories of the time

• taking a vacation.

Whatever works for you, find a way to relax.

3️⃣ Stock up on high quality supplements: If you are ready for IVF, then spare no cost in taking high quality supplements. We cannot get everything from food, especially in this environment where a lot of the things we eat already have some of their nutritional components compromised. Folic acid, fish oil, vit E, vit D, Beta carotene, zinc, are very important supplements that must be available during this process. Ask your doctor to prescribe the best for you (At L.O.V.E. FOUNDATION, we have all your supplements needs covered).

4️⃣  Avoid EDCs: we have talked a lot about endocrine disrupting compounds(EDCs) and their impact on Fertility health. We have taught here how they bind to receptor sites and prevent natural processes. The sperm binds to certain receptors on the egg to achieve fertilization as well as other hormones. Avoiding these compounds totally up to 6-8weeks before the actual cycle for IVF will go a long way to ensuring success. The compounds implicated are;

•Formaldehyde

•Parabens

•Benzophenols

•Triclosan

•BPA

•Phthalates etc.

They are found in things like nail polish, cosmetics, moisturizers, some soaps, canned/processed foods, plastics, fragrances, perfumes. Also  drugs(especially NSAIDS, antidepressants, steroids, thyroid drugs, drugs containing estrogen and progesterone, chemotherapy, etc). Talk to your Doctor if you are on any medication.

5️⃣ Sleep: sleep 7-8hours every night weeks preceding the cycle of the IVF. Sleep has a close correlation to fertility as we have learnt before. It helps ensure that hormones are balanced, relieves stress and keeps the body functioning optimally. This is not the time for excessive night vigils.

 6️⃣ *Have a medical review by an obs/gynae:* it is important to visit a doctor to do a general review of the system, different from the fertility center if possible. This will be fresh eyes on your system away from the bias of having settled for the procedure. They might identify one or two things requiring attention before the procedure proper. Nothing should be left to chance.

7️⃣ Detoxify: Rid the body of accumulated toxins which can interfere with the success of the procedure. Talk with your Reproductive Health counsellor to best guide you on this process. Identifying your detox need and getting the best kit for you makes a whole world of difference.

8️⃣ Commit to the process: Have a positive mental attitude to the whole process. Ensure you have closure before signing up for IVF; this means that you have understood why you are not conceiving naturally and have accepted the assistance IVF is to provide before embarking on the process. Do all you are advised to do. Cooperate with the clinicians. They are there to help. Pray and commit the entire process to God (if your faith accepts IVF) and be sure to have tackled any spiritual issue if present. Ask God for guidance and help.

Having done all these, hope for the best. The chances are improved, but remember, there is no 100% guarantee from the doctors. Your faith will have to see you through. If it fails, don’t be discouraged to try again.

We must note however that statistics show that failure of IVF after 3 attempts likely means that other attempts after it will be likely yo fail too.

After two attempts, you might want to take a break and review the entire situation; from the center used, to the environmental conditions around you, the lifestyle changes made, have you done all that is required? Most importantly, what is God saying concerning the situation? You might need to make a few changes before trying again.

WHAT YOU SHOULD KNOW ABOUT IVF

IVF is an intense, emotional medical process. There are about seven stages to the entire process

 STAGE 1:

The first 2 to 4weeks to the cycle to be used is recommended to make all the lifestyle adjustment we mentioned earlier. I personally recommend 4-8weeks of preparing your body on the minimum. If it can be more, better. This is because I don’t think all those processes should be rushed. They should happen gradually so the body is properly adjusted and it becomes almost routine for you as well. All these is to keep you at your most optimal health. The facility will also do a debriefing of the procedure at this time. You should also get some emotional support at this time. Talking with a counsellor at this point is very important.

 The facility will also carry out tests at this stage in preparation for the process proper. If everything is good, we wait for the period. If not, a few things in terms of treatment might need to be done.

 ⭕ STAGE 2:

This is from day one of the cycle to be used for the procedure. Once the menses starts, you report to the facility for commencement.

⭕ STAGE 3:

From Day 3 to Day 12 of cycle. This is almost 2 weeks of injections to stimulate the ovaries to produce more eggs than usual. This is a vital step. The preparations given to the body will play out here to determine the quality of eggs to be produced. These injections also cause heightened emotions and may result in mood swings.

⭕ STAGE 4

The pregnancy hormone (HCG) is administered at this point to help the ovaries release the eggs.

 ⭕ STAGE 5:

36hours after the HCG injection is administered, you have to go in for the actual harvesting of the eggs. Sperm can also be collected at this point if a donor is not being used. There must be abstinence 3-4days before the sperm is collected to allow for ‘a full harvest’. After this, another set of injections with progesterone which prepares the womb for implantation and reduces the risk of miscarriage. At this point, the eggs and sperm cells are put together in a specialized controlled environment.

 ⭕ STAGE 6:

Transfer of embryo follows about a week later. This is a non invasive painless procedure. At this stage, it is in God’s hands as we wait for implantation to take place and pregnancy to commence.

 ⭕ STAGE 7:

9 to 12 days later, a blood test is done as well as scan to check for success.

The two weeks preceding a test feels like forever. There are no symptoms to confirm a success or suggest a failure within this time. The only thing guaranteed to tell the results is a test.

SYMPTOMS THAT CAN BE FELT DURING THE TWO WEEKS OF WAITING ARE:

🔹 Bloating

🔹 Cramping

🔹 Sore breasts

🔹 Tiredness

🔹 Nausea

🔹 Light bleeding

🔹 Increased urge to urinate

🔹 Increased vaginal discharge.

🔹 Indigestion/constipation

🔹 Headaches

🔹 Anxiety

🔹 Hot flashes

🔹 No symptoms at all.

All or any of these are possible but do not necessarily mean anything. Pregnancy can bring about any of these symptoms, but they can also be as a result of the hormones given during the process.

 To help relieve these symptoms, you can do any of the following:

• Dress light

• Have warm showers

• Stay hydrated and cool

• Exercise (walk, swim, yoga)

• Sleep more

• Socialize

• Take healthy snacks

• Practise stress relieving activities as earlier mentioned.

If you are considering IVF, start now to prepare. We wish you the very best in this journey and encourage you to keep your head up. You can do this!😊