Without a doubt, I had the highest level of success that you can have when doing IVF – that is a healthy baby. Although by some standards, my journey was one of the shorter ones, taking seven cycles of injecting medications to get there, at the time it felt anything but short. Even with that final successful round, we had poor egg numbers, poor fertilization rates and ended up doing a day two transfer – cause with only one embryo at day two, it is ‘better in than out’, right?
To sum it up, I thought there was far more luck than science involved in helping my daughter come into the world.
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Over the course of our IVF journey, my medications had been adjusted (mostly up), protocols switched around (and then back again), immunofactors treated (not entirely evidence based, by the way) and different laboratory techniques used (ICSI anyone?).
These are all pretty standard practices over the course of several IVF cycles. In fact, it’s actually kind of G rated. A lot of women can probably add in their the use of embryo glue, endometrial scratching, preimplantation genetic screening, assisted hatching and many, what can often be considered as ‘experimental’ add-ons into their IVF journey.
So why over the three or so years that I was on the fertility rollercoaster didn’t anyone at my fertility clinic tell me about the possible impact of diet on an IVF cycle? Or take alcohol intake seriously? Or even casually mention how there is a small but significant body of evidence that discusses the influence of environmental toxins like BPA on egg quality, fertilization and pregnancy rates?
Don’t get me wrong, I’m not all hippee woo woo in my approach here. Eating a diet with the perfect level of wholegrain carbohydrate can’t unblock your fallopian tube and avoiding chemicals isn’t going to be the answer for the couple with extreme male factor infertility. But for the ‘average’ couple doing IVF could making some significant, but to be honest pretty easy and cost effective changes, be enough to make an average cycle a great cycle? Could it be the difference between a negative or a positive result come testing day?
Women who do IVF have often heard about eating pineapple (there really isn’t much evidence to it), and even acupuncture (evidence is mixed but if you are going to do it, throw your all into it. A session here or there probably isn’t worth the time or money). But this is mostly from biased, non-evidence based chat rooms. What we don’t really hear about is the study that found drinking less than a cup of soda a day was associated with a 12% decrease in live birth rates1. How about another study that said that it found a 32% difference in IVF success rates depending on how much red meat a woman ate2? And what about the study that looked at sleep and found that even getting the optimal amount of sleep every night was enough to cause a 9% difference in IVF success rates3. Why aren’t we talking about how soy can play a positive role in IVF? Yes, positive! Why aren’t our doctors helping us to figure out if dairy foods are really as bad as what they are made out to be?
Medications and protocols are an essential part of the IVF cycle. Until proven otherwise, our doctors should have our every respect and trust and they do their best with the knowledge of our medical history, their clinical experience and not to forget all those years of training.
So why aren’t they telling us about these lifestyle changes that could possibly bring us a bit closer to that take home baby?
Maybe it’s just because of lack of time we aren’t having these conversations. When you have 20 minutes with your doctor to discuss why your last cycle didn’t work and what you are going to change for next time, discussing the pros and cons of farmed or fresh salmon isn’t high on the agenda. I get it, there are more important things to discuss with the person being paid thousands of dollars.
Maybe it’s because the body of evidence supporting these lifestyle and diet changes is still growing. It’s still an emerging area of interest. But if you consider the negative consequences of eating organic vegetables only for it to ultimately be proven NOT to be linked with IVF success rates (despite the earlier, promising data that is appearing now), aside from a slightly lighter pocket, the negative consequences are pretty much non-existent, right? The medical professionals oath of ‘first do no harm’ is pretty safe here – especially when you compare it to exposing women to some pretty impactful medications during an IVF cycle and some pretty invasive diagnostic tests.
Maybe the fertility industry just doesn’t think diet and lifestyle changes really make a difference to IVF success rates. But when you look at the latest research being published in some very respectable journals, you can’t keep just ignoring that. Especially if you are prepared to give the latest IVF scientific technique a go.
The sceptics among us will say that it comes down to money. Fertility clinics don’t make money from women making nutritional changes or avoiding environmental toxins and they certainly stop making money when we are successful and get that take home baby. But I don’t think that is it. The fertility specialists I have been involved with have appeared to be empathetic, caring and have a genuine interest in seeing me succeed. Plus, fertility clinics could always become more holistic and incorporate (and charge for) university qualified dietitian’s and nutritionists into their practice, similarily how some clinics have acupuncture on site. Word would soon travel among the well connected IVF community about this, especially if success rates increased, which would in turn improve their bottom line.
Having these conversations isn’t about fat shaming, or nutrition shaming or any sort of shaming. It’s not about making someone feel guilty because they snuck in an extra biscuit at morning tea time. It is about empowering women and providing them with the knowledge so that they can make the most informed decision. It’s about helping women to become their own best advocate and to get the most out of their cycles. After all, at the end of the day, no one cares as much as you do if you get that take home baby.
Before going in to the fertility clinic to conceive baby number two I was adamant that I was going to leave it less to luck and more to science. Long before I went back to see my fertility specialist to try to conceive baby number two, I started researching, blogging and implementing all the lifestyle and diet changes I could find good evidence for. Because if it took three more years to conceive my second baby it wasn’t going to be because any stone was left unturned on my side. I was one of the incredibly lucky ones and by the time I sat down in my fertility specialists rooms to plan my next cycle, I was unknowingly pregnant. Again, not everyone will have to good fortune and who knows if when it came down to it the lifestyle and diet changes really made a difference. It’s just one of those things we will never know. But it certainly didn’t hurt.
1. Machtinger, R., Gaskins, A., Mansur, A., Adir, M., Racowsky, C., Baccarelli, A., Hauser, R. & Chavarro J. (2017). Association between preconception maternal beverage intake and in vitro fertilization outcomes. Fertility and Sterility Oct 3. pii: S0015–0282(17)31911–8. doi: 10.1016/j.fertnstert.2017.09.007. [Epub ahead of print].
2. Braga, D., Halpern, G., Setti, A., Figueira, R., Iaconelli Jr, A. and Borges Jr, E. (2015). The impact of food intake and social habits on embryo quality and the likelihood of blastocyst formation. Reproductive BioMedicine Online 31 30–38.
3. Basin, G., Wang, E., Gregory, K., Barlow, G., Simmons, C. and Pisarska, M. (2013). The risk of adverse outcomes in pregnancies conceived through assisted Reproductive Technologies (ART). Fertility and Sterility. ASRM Abstracts 100 (3) Supplement S466.