REVIEW OF RECORDS
As with any medical procedures, a record review from past attempts is critical. It is important to review the embryology reports and look at the images of the uterine lining. Sometimes this review alone will reveal that an egg donor or surrogate might be the best options.
It is intuitively obvious that being in good general health should impact on pregnancy rates. Frustratingly, most of our female patients are in good health, and even more maddening is seeing so many women in with poor health habits with several children in hand. Despite this paradox, when it comes to IVF, there are some health issues that have shown to impact on success rates.
The most obvious and often neglected one is weight. There are numerous articles showing that high BMI’s adversely affect pregnancy outcomes when either partner is overweight. We work with nutritionists who help patients lose weight fairly quickly through low-carbohydrate diets. A frequent dilemma we see is women approaching 40 who have a high BMI. Understandably, they feel pressured to get pregnant quickly and do not want to wait until they lose weight to conceive. In these cases, it may be worth considering freezing embryos and putting them back after the weight loss has been achieved.
Alcohol intake is another obvious issue. A recent paper showed that if either partner imbibed more than 4 servings of alcohol a week prior to their IVF cycle, this significantly lowered fertilization rates. Most couples undergoing IVF voluntarily give up all alcohol intake. This evidence supports avoiding alcohol as much as possible during treatment.
Although there are few studies validating the value of supplements, the following are reasonable: Pre-natal vitamins, Co-enzyme Q10, extra folic acid, DHA, and Vitamin D, if blood levels are low.