If you are just starting out with in vitro fertilization (IVF), we know you may feel both extremely hopeful and wildly overwhelmed! Below are some tips based on recent research on how to increase your chance of IVF success, what to avoid leading up to and during IVF, and which steps people find particularly difficult during the IVF process.
The information presented in this article is intended for informational purposes only. It is not, and should not be considered, medical advice. The content is based on research studies related to increasing the chances of success with IVF. Individuals should always consult with qualified healthcare professionals for personalized advice based on their specific medical conditions and circumstances.
One of the difficult things about IVF is that so much is out of your control, such as your infertility diagnosis, your age, and your ovarian reserve. However, there are steps that you can take on your own that have been shown to increase your odds:
CoQ10 has been shown in some small studies to improve the percentage of eggs that mature and decrease chromosomal abnormalities for parents above 38 years of age (1). You may consider taking CoQ10 in the months leading up to your ovarian stimulation cycle.
Ensuring that you’re getting enough folate before and during the early months of your pregnancy reduces your chance of your fetus having neural tube defects (2).
Eating a healthy diet improves your overall health, which likely improves your outcomes (3).
Having a low or high BMI may affect IVF success. Eating well and exercising can help bring you into the “normal” BMI range before starting IVF.
Studies have shown that acupuncture directly before embryo transfer may be associated with slightly improved outcomes (4).
You may also consider more intensive steps to improve your chance of success with IVF. These include:
This test takes a few cells from the outer layer of a blastocyst-stage embryo (an embryo ready for transfer) and tests those cells for chromosomal abnormalities. While this test doesn’t improve your overall chance of success with IVF, it does improve the likelihood that you will transfer an embryo that will lead to a live birth by identifying the embryos with the best chance of success.
If you have a diminished ovarian reserve or are of "advanced maternal age," you may not have enough mature and/or high-quality eggs for IVF to be successful. In that case, you could consider using donor eggs or embryos to improve your chance of success.
If you had a discouraging first cycle of IVF, you may be heartened to know that recent research shows that patients tend to have better outcomes on subsequent cycles.
While it’s hard to change your environment, you may consider steps to reduce your exposure to elements that may affect your chance of success with IVF.
Air pollutants such as nitrogen dioxide and ozone have been shown to reduce live birth rates for IVF patients (5).
Endocrine disruptors such as bisphenol A (BPA) may decrease antral follicle count, fertilization rates, and overall IVF outcomes (6).
For both people providing eggs and sperm, alcohol use has been shown to increase the chance of miscarriage (7).
Smoking may reduce your live birth rate during IVF (8).
The most difficult part of IVF depends on you and your body. However, below are some of the parts of IVF that people have identified as particularly difficult:
There’s a LOT of waiting during IVF: waiting to start ovarian stimulation (the first phase of IVF), waiting for appointments, and waiting to hear test results, including the number of mature eggs, fertilization rate, how many embryos reached the blastocyst stage, PGT, and the pregnancy test. For patients who experience a miscarriage, there’s also waiting for your hCG levels to go down so you can do another egg retrieval or transfer an embryo. All of this waiting can be very difficult, especially if you aren’t prepared for it. It’s important to lean on your support system during these waiting times, and to find positive ways to occupy your time and mind.
Ovarian stimulation is the first phase of the IVF process during which the ovaries are stimulated with hormone medications to produce multiple follicles (small sacs of fluid in which eggs grow). It's an intense period of time that some people describe as feeling like a part time job! During ovarian stimulation, you may need to get off work to go to monitoring appointments, travel to and from the clinic multiple times a week, undergo multiple blood draws and intravaginal ultrasounds, self-administer injectable hormone medications, track your test results, and manage your medications. While your clinic can help you with some of these steps, a lot of the work may fall on your shoulders. Fortunately, Alife has a patient app to help you manage this phase of the process (and the rest of your IVF journey.)
Some patients experience ovarian hyperstimulation syndrome (OHSS) after egg retrieval, an uncomfortable and potentially dangerous condition that may occur if you developed a large number of follicles (more than 20) and/or had high estrogen levels before the trigger shot (the last step of ovarian stimulation) was administered. During OHSS, fluid builds up in the abdominal cavity. The symptoms include bloating, constipation, reduced urinary output, and abdominal pain. While severe OHSS is rare, occurring for only ~1% of IVF patients, mild OHSS occurs for about 1/3rd of patients. If you suspect that you are experiencing OHSS, you may consider contacting your clinic.
Depending on your body and your clinic, you may need to take progesterone supplements before embryo transfer. There are several ways to administer progesterone: intramuscular injections, subcutaneous injections, or vaginal gels or pessaries. It may be difficult to tolerate the injections or the medication, especially since you may need to take the medication for about 6 weeks.
If you are concerned about any of these steps or are experiencing discomfort, you should talk to your clinician. They may be able to anticipate issues, suggest alternatives, and help you through the difficult parts of the process.
Ma, L., Cai, L., Hu, M., Wang, J., Xie, J., Xing, Y., Shen, J., Cui, Y., Liu, X. J., & Liu, J. (2020a). Coenzyme Q10 supplementation of human oocyte in vitro maturation reduces postmeiotic aneuploidies. Fertility and Sterility, 114(2), 331–337. https://doi.org/10.1016/j.fertnstert.2020.04.002
Lumley, J., Watson, L., Watson, M., & Bower, C. (2001). Periconceptional supplementation with folate and/or multivitamins for preventing neural tube defects. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd001056
Optimizing natural fertility: a committee opinion. (2022). Fertility and Sterility, 117(1), 53–63. https://doi.org/10.1016/j.fertnstert.2021.10.007
Smith, C. A., Armour, M., Shewamene, Z., Tan, H. Y., Norman, R. J., & Johnson, N. P. (2019). Acupuncture performed around the time of embryo transfer: a systematic review and meta-analysis. Reproductive BioMedicine Online, 38(3), 364–379. https://doi.org/10.1016/j.rbmo.2018.12.038
Conforti, A., Mascia, M., Cioffi, G., De Angelis, C., Coppola, G., De Rosa, P., Pivonello, R., Alviggi, C., & De Placido, G. (2018). Air pollution and female fertility: a systematic review of literature. Reproductive Biology and Endocrinology, 16(1). https://doi.org/10.1186/s12958-018-0433-z
Machtinger, R., & Orvieto, R. (2014). Bisphenol A, oocyte maturation, implantation, and IVF outcome: review of animal and human data. Reproductive BioMedicine Online, 29(4), 404–410. https://doi.org/10.1016/j.rbmo.2014.06.013
Klonoff-Cohen, H., Lam-Kruglick, P., & Gonzalez, C. (2003). Effects of maternal and paternal alcohol consumption on the success rates of in vitro fertilization and gamete intrafallopian transfer. Fertility and Sterility, 79(2), 330–339. https://doi.org/10.1016/s0015-0282(02)04582-x
Lintsen, A. M. E., Pasker-de Jong, P. C. M., de Boer, E. J., Burger, C. W., Jansen, C. A. M., Braat, D. D. M., & van Leeuwen, F. E. (2005). Effects of subfertility cause, smoking and body weight on the success rate of IVF. Human Reproduction, 20(7), 1867–1875. https://doi.org/10.1093/humrep/deh898
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