9 Myths and Facts About Boosting IVF
When you're investing incredible amounts of time, money, and psychological capital into an IVF cycle, you want to do everything you can 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 could make you feel guilty if you don't do it. We explored the Internet and then polled experts to get the facts on what can actually improve your chances, what could lower your success rate, and what is nothing more than a bunch of nonsense. Keep reading to find out.
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:
- 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, all of which can act like an IUD in the uterus and prevent implantation.
- 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.
- 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.
- 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.
- Are any of my health habits going to affect our chances of success? Your doctor should evaluate the medications, supplements, and herbs you're taking, along with any alcohol or recreational drug use.
One more thing you can do to increase your odds of success: Get 7 to 9 hours of sleep a night. A study by Korean researchers found that women who sleep to 7 to 8 hours per night are more likely to have a successful IVF cycle than women who sleep more than 9 or less than 6 hours a night.
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 with those who returned to their usual routine. Another study found that even a short period of bed rest (about 10 minutes) isn't helpful either. "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 so
A study published in the March 2014 issue of Human Reproduction followed 401 couples who were trying to conceive. Researchers analyzed two stress biomarkers (alpha-amylase and cortisol) in women and discovered that those with high levels of alpha-amylase were twice as likely to be at risk of infertility. Based on the research, scientists believe stress can contribute to infertility, though it's not necessarily a direct cause; other factors (like low sperm count and quality) could contribute to it.
"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," says Alice Domar, Ph.D., executive director of the Domar Center for Mind/Body Health, which specializes in helping women with infertility through complementary therapies.
A more thorough study of stress and its role on IVF success is still needed.
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? Dr. 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, Dr. Domar also considers yoga and massage to be benign because 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.
Trying to get pregnant? Follow our expert's advice to side-step potential problems to boost your chances of conception.
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: The evidence looks good, but be careful.
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.
Further studies have confirmed the fact that melatonin may be useful in infertility treatment. A 2014 review of nine studies in the Journal of Ovarian Research believes that melatonin has the potential to be a treatment for fertility. But the research also cautions that "melatonin use in infertility treatment still lacks adequate evidence to recommend routine use." Bottom line: Talk to your doctor, and don't start taking melatonin without your doctor's knowledge or approval.
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 Dr. 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. 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 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. It's also important to get enough vitamin D each day. A 2014 study of 335 women found that vitamin D deficiency was possibly related to poor IVF outcomes. Although more research is still needed, implantation and pregnancy could be less likely to occur in women with adequate vitamin D levels.
Maintaining your weight within a certain normal range is also important. "You don't want to go into an IVF cycle morbidly obese, overweight, or seriously underweight," says Dr. 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 varies, 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," Dr. 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.
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