When you're investing incredible amounts of time, money, and psychological capital into an IVF cycle, it's understandable that you would want to do everything in your power to make it a success. But you don't want to take up every hour of your day and every little space in your heart with another "must-do" that will make you feel guilty if you don't have time to check it off your list. From eating pineapple to setting up a meeting with a clown, rumors abound as to what you can do to boost your success in getting pregnant. We explored the Internet and then polled experts to get the facts on what might actually improve your chances, what could lower your success rate, and what is nothing more than a bunch of nonsense.
Myth #1: You have no control over the success of an IVF cycle.
Our take: False
The results of an IVF cycle are to a large degree based upon a thorough evaluation of the couple, and there are a number of things your doctor can do before you begin to optimize success rates, says Glenn Schattman, M.D., associate professor at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Medical College of Cornell University in New York City. The problem is, not every doctor or fertility center completes thorough evaluations. So be sure to ask your doctor these five questions before starting any IVF cycle:
1. Is my uterus ready? Your uterine cavity should be evaluated with an ultrasound, X-ray, or hysteroscopy to look for fibroids, scar tissue, or polyps, which can all act like an IUD in the uterus and prevent implantation.
2. Are my tubes clear? Fluid in your fallopian tubes reduces IVF success rates by about 50 percent, says Dr. Schattman. If fluid is present, it's necessary to either block the tubes or remove them prior to starting IVF.
3. Do I have enough eggs? A good ovarian reserve is key for IVF success. Dr. Schattman says two tests can help doctors estimate how many eggs you will get: Blood tests given on the second or third day of your cycle can analyze the level of follicle stimulating hormone, and an ultrasound can determine an actual follicle count.
4. Is my husband's sperm adequate? Dr. Schattman recommends having a sperm analysis done in a lab that also does IVF. That way, the quality of the sperm can be compared with what is needed for IVF success.
5. Are any of my health habits going to affect our chances of success? Your doctor should evaluate the medications, supplements, and herbs you may be taking, along with any alcohol or recreational drug use.
Myth #2: Stick to bed rest after embryo transfer.
Our take: False
There's no need to put your life on pause after the embryo transfer. Dr. Schattman says this idea is an absolute myth. In fact, a study done in Egypt found that women who were on bed rest for 24 hours following a transfer had a lower success rate compared to those who returned to their usual routine. "I tell my patients to go home, have a glass of wine and a nice meal, and return to their normal activities," says Dr. Schattman, who believes that bed rest can actually be detrimental because it prevents normal fluctuations in heart rate and blood flow.
Myth #3: Stress lowers IVF success rates.
Our take: Maybe not
Until recently, many doctors told patients to avoid stress, but that belief was based only on theory, not on facts, says Dr. Schattman. But a recent article in the British Medical Journal looked at 14 different studies on the effect of stress on IVF success. The conclusion? Emotional distress (whether related to IVF, infertility, or other life events) had no effect on the likelihood of getting pregnant. As James Grifo, M.D., program director of the New York University Fertility Center puts it: "Stress is not contraception. If it were, no one in New York would get pregnant."
Alice Domar, Ph.D., executive director of the Domar Center for Mind/Body Health, which specializes in helping women with infertility through complementary therapies, isn't convinced. She believes a more thorough study of stress and its role on IVF success is needed: "We know the number one reason insured people drop out of IVF treatment is stress, so anything you can do to reduce stress might keep you in treatment longer and help you get pregnant."
Myth #4: Acupuncture helps you get pregnant.
Our take: Maybe so
The theory behind undergoing acupuncture during IVF is that it increases blood flow, which may help with embryo implantation. Studies are split: Half show no benefit and half show a significant benefit. So what should you believe? Domar categorizes complementary treatments like acupuncture for infertility into "the good, the benign, and the ugly" and places acupuncture under "good," because "it's cheap, it has no side effects, and there is data to support its efficacy so there is no reason not to try it." At the very least, she says, "It can help you feel more relaxed and optimistic."
Even though there isn't research to back up their efficacy, Domar also considers yoga and massage to be benign since they can also help with your mental state. "If you enjoy yoga and massage and you can afford it," she says, "go for it."
If, on the other hand, adding one more appointment to a busy day will do nothing more than increase your stress level or make you feel like you are failing to do everything in your power to achieve IVF success, Dr. Grifo advises patients to just let it go.
Myth #5: A clown in the recovery room will help.
Our take: Can't hurt!
Did you hear the one about the clown who walked into the recovery room after an embryo transfer? It's not a joke. It happened in Israel, where a study of 219 women found that those who were entertained by a "medical clown" after embryo transfer were twice as likely to get pregnant as those who were not. The lead researcher wanted to test the idea that laughter can help lower stress, and although it was a small study, the researchers are hoping the results will spur other fertility clinics to try out "clown care." "If you want to have an afternoon with a clown, go for it," says Dr. Grifo. "There's no harm. You're not going to laugh your embryos out." Of course, a funny movie might be a cheaper and easier way to go.
Myth #6: Melatonin can help improve egg quality.
Our take: Too soon to tell.
A very small Japanese study in 2010 investigated the idea that melatonin (yep, the same kind we sometimes use to help us fall asleep at night) may improve egg quality by reducing oxidative damage. Researchers looked at the existence of a particular chemical compound that can cause oxidative stress and potentially reduce egg quality. They found that when there were higher natural levels of melatonin present, there were lower levels of the oxidizing agent. Then they recruited 100 women who had failed an IVF cycle because of poor egg quality and gave half of them 3 milligrams of melatonin before their next IVF cycle. The results? Fifty percent of the eggs of the women who took melatonin could be successfully fertilized, compared with only 23 percent of the eggs of the women who did not take melatonin. When the eggs were transplanted, 19 percent of the women in the melatonin group became pregnant, compared with 10 percent in the control group.
Although the study results sound like big improvements, Dr. Grifo cautions that this is a very small study, adding that the pregnancy rates in both groups were actually pretty low compared to success rates achieved at fertility centers in the U.S. Dr. Grifo believes that the researchers could be on to something related to oxidative damage and fertility, but he's "not sure melatonin is the secret to success, and it's too early to say for sure."
Photo by Devon Jarvis
Myth #7: Herbal remedies can help with IVF.
Our Take: False
There's no data showing that herbs are safe to take while you're trying to conceive. "We have no idea how they interact with fertility drugs," says Domar. One study conducted in Denmark found that out of 800 women, those using complementary and alternative therapies (which mostly consisted of herbs) lowered their chance of pregnancy by 30 percent. says Domar. Add to that the fact that many herbs come from overseas with detectable levels of mercury and no guarantee of safety and that some are even inadvisable to take during pregnancy -- herbs are a dangerous proposition. Dr. Grifo agrees: "We don't know about herbs and what their impact is, and some of them affect blood clotting." He advises his patients not to "keep secrets from your doctor. It can have serious consequences."
Myth #8: Special diets can boost your chances of getting pregnant.
Our take: False
There is no evidence that any specific diet (be it eating pineapple every day or never eating gluten) will increase your chances of success. That said, all of our experts recommend following a healthy, balanced diet full of whole grains, lean protein, and fruits and vegetables to maximize your health and the health of the baby you are trying to conceive through IVF. Unless you have a diagnosed medical condition, eliminating certain foods (such as gluten) can actually lead to malnutrition and other health problems, Domar warns.
One thing that has been proven: Maintaining your weight within a certain normal range is necessary for getting pregnant. "You don't want to go into an IVF cycle morbidly obese, overweight, or seriously underweight," says Domar. Women with body mass indices of over 35 or under 20 do experience lower pregnancy rates.
Myth #9: If IVF doesn't work, there is something you could have done better.
Our take: False
In any given cycle, the chance of IVF success ranges, depending on your age and your personal health circumstances. Success rates can be as high as 41 percent, but there's not much you can do to improve that number. "Patients have to realize is that there is very little they can do that will make a difference in terms of the outcome," Grifo says. "But there is a lot they can do in terms of how they feel about the process. What they should understand is that when they are doing IVF, they are doing everything they can possibly do. They should feel really good about that." So keep on thinking positively and ideally you'll achieve IVF success without trying out every myth you hear.
Copyright © 2011 Meredith Corporation.