Nutritional Support for IVF

The preconception period continues to gain recognition as an ideal opportunity to optimise the health of the prospective parents. It is well understood that a healthy lifestyle and good nutrition influences the quality of egg and sperm and thereby increases the chances of a successful pregnancy. Likewise nutritional support is essential during IVF cycles to ensure healthy embryonic development.

Recent data from national health surveys indicate that the general population’s nutritional intake is suboptimal and virtually everyone suffers to some extent from deficiencies of essential vitamins, minerals and trace elements.

A preconception Mediterranean-type diet has been associated with increased success of achieving pregnancy among couples undergoing IVF. This diet is characterised by a high intake of vegetables and good quality vegetable oils, fish, nuts, legumes and low intake of dairy and snacks. A Dutch study showed couples with a high adherence to this diet had a 40% increased chance of pregnancy after embryo transfer.
In comparison, the Western dietary pattern is characterized by a high intake of red and processed meats, high-fat foods, refined grains, and high-sugar drinks and desserts, and is relatively low in fruits, vegetables, whole-grain foods, poultry, and fish. This diet has been shown in animal studies to be detrimental to fertility.

Some important nutrients in the Mediterranean-type diet that may mediate the benefits during IVF include:

B vitamins

• Poor B-vitamin status is associated with early pregnancy loss. The early embryo requires folate to reduce risk of neural tube defects. Availability of B vitamins during the period immediately preceding egg recovery may affect embryo viability after IVF. There is also a positive association between folate intake and sperm quality.
• Food sources: Avocado, Brewer’s yeast, rice bran, oatbran, dark leafy greens (collard greens, mustard greens, romaine lettuce, spinach and turnip greens), sunflower seeds, legumes, lentils, mushrooms, wholegrains

Vitamin D

• Higher levels of vitamin D in body are directly related to vitamin D levels in follicular fluid of egg which are associated with improved ovarian response to ovarian hyperstimulation, high quality embryos, improved implantation and pregnancy rates.
• Food sources: Eggs, fatty fish, butter and cod liver oil. You can also get vitamin D from sitting out in the sun for 10 to 50 minutes per day 4-6 times per week. But absorption is impacted by the darkness of your skin.

Essential Fatty Acids:

• Omega-3 acids have shown benefit on fertility outcome by improving egg quality and their subsequent development into competent embryos. They also help to regulate hormones in the body, increase cervical mucous, decrease miscarriage risk and regulate anti-inflammatory action in the ovulatory cycle and implantation process during IVF.
• Food sources: Flax seeds, walnuts, salmon, sardines, snapper, trout, whiting.

Antioxidants: (vitamin C, vitamin E, zinc, selenium, CoQ10, alpha lipoic acid)
Anti-oxidants have many roles to play during IVF. They manage oxidative stress and reduce impact of reactive oxygen species (ROS), provide gentle detoxification and support gonadal DNA integrity.

• IVF procedures such as sperm preparation and embryo medium may increase ROS and oxidative stress
• Oxidative stress impacts sperm-egg interaction and implantation
• ROS may affect egg maturation, development of the embryo, and implantation
• Zinc is important for ovulation and a recent animal study has shown a positive association with high zinc levels and the increased development of blastocyst in IVF
• High antioxidant dietary intake has been associated with higher sperm numbers, motility and quality
• Food Sources: Colourful fruits and vegetables. Some of the fruits highest in antioxidants are plums, pomegranates, blueberries and strawberries. Eat a rainbow of foods everyday.

For more information see our Diet for Conceiving Well on our website www.fertilityhealth.com.au and for information & support with IVF call the clinic on 9976 5466.

Are we over using IVF?

Originally IVF was developed for women with tubal disease. It was then expanded for use in men with poor semen quality. Now IVF is being applied to other types of subfertility such as mild male subfertility, endometriosis and unexplained subfertility.
Are we over-treating couples who had a reasonable chance of conceiving naturally? Is it equally effective in these conditions? What are the consequences of using IVF? Do the risks outweigh the benefits?

What is meant by IVF?
IVF is commonly used term for Assisted Reproductive Technology (ART) which includes:

• Assisted insemination (AI) or Intrauterine insemination (IUI) – sperm introduced in uterus around ovulation for fertilisation
• In Vitro Fertilistation (IVF) – when egg and sperm are put together in test tube to fertilise prior to transplantation into the uterus
• Intracytoplasmic Sperm Injection (ICSI) – sperm is injected into egg for fertilisation prior to transplantation into the uterus
• Gamete & Zygote Intrafallopian Transfer (GIFT) – gamete (egg & sperm) are introduced into the fallopian tube; less often used

Rising Rates of IVF

• One million babies were born in first 25 years of IVF (1978 – 2003)
• An estimated 5 million babies will have been born to IVF by end 2013.
• 2-3% of all births occurs via IVF in developed countries

Unexplained Fertility and IVF

• More than 90% of fertile couples are expected to achieve conception within 12 months of contraception-free sexual intercourse
• Sub-fertile couples are considered to have a good prognosis for natural conception in 2-3 year timeframe of trying to conceive
• Unexplained fertility accounts for 25-30% couples presenting for IVF, and many of these conceive before treatment. A Dutch study of 500 sub-fertile couples showed 60% conceived naturally after their initial assessment at the fertility clinic.

 

Emerging Risks of IVF

• Multiple pregnancies are associated with maternal and perinatal complications; this is not such an issue in Australia where single embryo transfers are the norm
• Some studies show 50-70% additional risk of preterm birth and congenital anomalies
• Healthy children born through IVF may have higher blood pressure, glucose levels and vascular dysfunction than children conceived naturally. Epigenetic and developmental abnormalities after ART have been shown in animal studies.

Emotional Adjustment to IVF

• IVF is a multidimensional stressor; many couples seeking fertility help, especially IVF are not prepared for the challenges ahead
• The treatment (doctor visits, hormonal changes, daily injections) constitutes the primary stressor and is most likely to evoke anxiety
• The unpredictable outcome of the treatment is another major stressor and more likely to evoke feelings of depression
• Other considerations are the financial burden and the impact on the couple’s marriage

IVF or not IVF?

• IVF has allowed many infertile couples to have a family
• IVF procedures are improving and having increasing success. Although IVF success rates fall away with increasing maternal age
• Some couples will be clinically defined as infertile, that is, unable to achieve spontaneous conception within 12 months of contraception-free sexual intercourse
• However, many of these may indeed be sub-fertile, and just need more time to try for spontaneous conception

Next week: Nutritional Support for IVF
If you would like more information on IVF procedures and support, please call the clinic on 9976 5466.