In vitro fertilization (IVF) is a sophisticated reproductive technology designed to assist individuals and couples struggling with infertility. The IVF process involves several critical steps: ovarian stimulation to increase egg production, retrieval of mature eggs, fertilization in a lab setting, embryo culture, and the transfer of viable embryos into the uterus. IVF is particularly beneficial for addressing severe male-factor infertility, tubal factor infertility, and cases of severe endometriosis. Success rates for IVF can vary significantly based on factors like the woman’s age and embryo quality. Potential risks include ovarian hyperstimulation syndrome and complications during pregnancy, like gestational diabetes. Nutrition plays a vital role in enhancing reproductive health. A diet rich in antioxidants, B vitamins, vitamin D, and omega-3 fatty acids can support egg and sperm quality. Lifestyle factors, including maintaining a healthy BMI and avoiding smoking and excessive heat exposure, are also crucial for optimizing fertility.

While we at Chiyo are passionate about nutritional solutions, please note that this information is for educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. 

 

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In vitro fertilization (IVF) is an amazing feat of modern reproductive technology, offering hope for many individuals and couples who face the emotional and physical challenges of infertility.

The journey to parenthood can sometimes feel overwhelming, filled with uncertainty and heartache. Understanding the intricacies of IVF, from the initial stages of ovarian stimulation to the final transfer of embryos, is crucial for those seeking to navigate this complex process.

In this article we’ll break down what IVF is, who it’s suited for, how the procedure works, and how diet and nutrition can help support egg health and optimize your chances of success in the complex IVF process.  

Let’s get into the details and gain a more holistic understanding of IVF.

 

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IVF 101

What Is It?

In vitro fertilization (IVF) is a complex process involving ovarian stimulation, oocyte retrieval, fertilization, embryo culture, and embryo transfer — used to help individuals or couples achieve pregnancy. [1] It is commonly used for couples experiencing significant issues with sperm quality (severe male-factor infertility), tubal factor infertility, severe endometriosis (where other treatments may have failed), and after multiple failed cycles of intrauterine insemination (IUI). [2-4]

The effectiveness of IVF varies based on several factors, including patient age, duration of infertility, BMI, previous pregnancy history, cause of infertility, number and quality of oocytes and embryos, and optimal laboratory conditions. Live birth rates per cycle for IVF range from 5% to 32% depending on these factors. [5]

 

When Is It Used?

IVF may be a suitable option for several specific infertility situations:

• Severe male-factor infertility: IVF with intracytoplasmic sperm injection can overcome significant issues with sperm quality. [2]
• Tubal factor infertility: IVF bypasses the fallopian tubes entirely, making it suitable for women with tubal blockages or damage. [3]
• Severe endometriosis: IVF is often preferred for severe cases of endometriosis where other treatments have failed. [3]
• Failed IUI cycles: IVF may also be considered when multiple IUI cycles have not resulted in pregnancy. [4]

 

How Does IVF Work?

IVF is a multi-step process used to assist individuals or couples with infertility. The steps of IVF are as follows:

1. Ovarian stimulation: The woman undergoes controlled ovarian hyperstimulation using gonadotropins to increase the number of available eggs. [6]
2. Oocyte retrieval: Mature eggs (oocytes) are retrieved from the ovaries using a minimally invasive procedure that uses ultrasound imaging to help guide a needle into the ovaries. [7]
3. Fertilization: The retrieved oocytes are fertilized with sperm in a laboratory setting. This can be done through conventional insemination or intracytoplasmic sperm injection, where a single sperm is injected directly into an oocyte. [6-7]
4. Embryo culture: The fertilized oocytes (now embryos) are cultured in the laboratory for several days, typically until they reach the blastocyst stage (5-6 days). [7]
5. Embryo transfer: One or more embryos are selected and transferred into the woman's uterine cavity. The remaining viable embryos can be cryopreserved for future use. [6-7]
6. Post-procedure: Patients are often advised to rest briefly after the procedure, although extended bed rest is not necessary and does not improve IVF outcomes. [8-10]

These complex steps require the coordinated efforts of physicians, nurses, molecular biologists, and embryologists for a successful outcome.

 

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Difference Between IVF and IUI

IVF and intrauterine insemination (IUI) are both fertility treatments, but they differ in when they are used, how they work, and their cost-effectiveness. IVF is a more invasive procedure and involves several steps.

IUI is a fertility treatment that involves placing sperm directly into a woman's uterus to facilitate fertilization. This procedure is commonly used for couples experiencing:

• Unexplained infertility (IUI is often used as a first-line treatment for couples with unexplained infertility)
• Mild male-factor infertility (where semen parameters like sperm count, sperm motility, and semen volume are slightly below normal but not severely impaired)
• Cervical infertility (where the cervical mucus may be hostile to sperm, preventing them from reaching the uterus)
• Irregular ovulation (dysovulation)
• Mild to moderate endometriosis [11-13]

IUI may be more cost-effective than IVF for certain conditions. Studies have shown that IUI offers similar pregnancy rates to IVF for specific indications like unexplained fertility and mild male-factor infertility, but at a significantly lower cost. [2, 14]

 

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Factors Impacting Success

Several factors affect the success of IVF outcomes, including:

• Age: Female age is a critical factor, and success rates are significant higher before the age of 35. [15-17]
• Body Mass Index (BMI): Being underweight or overweight are both associated to lower success rates compared to those with an average BMI. [15]
• Previous pregnancy history: A history of previous pregnancies, especially live births, is associated with higher success rates. [15, 17-18]
• Number of oocytes retrieved: A higher number of oocytes retrieved is generally associated with better outcomes, although very high numbers may not always correlate with higher success. [16, 19]
• Embryo quality: The shape, structure, and developmental stage of the embryos transferred are crucial factors, with high-quality blastocysts showing better implantation and pregnancy rates. [15-15, 19]
• Number of embryos transferred: Transferring more embryos can increase the chances of pregnancy but also raises the risk of multiple pregnancies. [20-21]
• Use of Preimplantation Genetic Testing (PGT): PGT may reduce risk of miscarriage due to chromosomal disorders. [21-22]

 

Risks and Potential Complications

IVF is associated with several risks and potential complications for women undergoing the procedure. These include:

• Ovarian Hyperstimulation Syndrome (OHSS): This is a serious complication of ovarian stimulation, characterized by symptoms ranging from mild abdominal discomfort to severe complications like thromboembolism and renal failure. The incidence of OHSS can be as high as 23 cases out of 1000 women undergoing IVF. [26-27]
• Gestational Diabetes Mellitus (GDM): Women who conceive through IVF have a higher incidence of GDM compared to those who conceive spontaneously. The prevlance of GDM is 43% in IVF pregnancies compared to 10% in spontaneous pregnancies. [31-32, 77]
• Pre-eclampsia: IVF pregnancies are associated with an increased risk of pre-eclampsia, with a prevalence of about 6% in IVF pregnancies compared to 1% in spontaneous pregnancies. This hypertensive disorder can lead to significant maternal and fetal morbidity. [29-30, 76]
• Bleeding and infection: These are potential risks associated with the oocyte retrieval process. Although not common they can occur and may require medical intervention. Prevalence of bleeding during oocyte retrieval is about 0.06% for severe intraperitoneal bleeding to 2-3% for vaginal bleeding. The prevalence of infection is approximately 0.3% for post-operative infections. [26, 28, 72-74]
• Injury to organs: During oocyte retrieval, there is a risk of injury to surrounding organs such as the bowel and bladder, although this is relatively rare, with a prevalence of about 0.1%. [28, 75]
• Placenta previa: There is an increased risk of placenta previa in IVF pregnancies, which can lead to complications like bleeding during pregnancy and delivery. There is a prevalence of about 3% in IVG pregnancies compared to 1% in spontaneous pregnancies. [29, 32, 78]
• Postpartum hemorrhage (PPH): There is a higher risk of PPH in IVF pregnancies, potentially because of the higher incidence of multiple gestations (pregnancy with more than one fetus) and other pregnancy-related complications. Studies indicate that PPH is between 2 and 4.5 times more common in IVF pregnancies than in spontaneous pregnancies. [29-30, 79-80]

 

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For Her: Nutrition for IVF & Egg Health

 

Nutritional interventions can significantly impact egg health and improve IVF outcomes, particularly through an antioxidant-rich diet and a focus on key micronutrients such as folic acid, vitamin D, and omega-3 fatty acids. Important to note: egg quality improvements take a minimum of three months to be impacted by nutrition, because it takes three months for an egg to mature .

B Vitamins: Nutrients in the B vitamin family — like B6, B9 (folate) and B12 — play crucial roles in IVF and egg health by supporting DNA synthesis and repair. Vitamin B6 helps to maintain optimal levels of homocysteine, which is important because excess homocysteine is associated with infertility. [62] Folate is essential for DNA synthesis and repair, and higher levels of B9 are associated with improved IVF outcomes, including higher live birth rates. [63-64] Vitamin B12 supplementation has also been associated with higher clinical pregnancy and live birth rates in women undergoing assisted reproductive technology. [62][65] Sources of B vitamins include:

• Spinach
• Liver
• Asparagus
• Legumes
• Beets
• Avocados
• Brussels sprouts
• Whole grains

Inositol: Other B vitamins, particularly myo-inositol, supports healthy ovulation by promoting estrogen production and increasing follicular sensitivity to follicle-stimulating hormone. [81-82] Sources include:

• Citrus fruits
• Brown rice
• Almonds
• Lentils

Zinc: Zinc supports IVF and egg health by enhancing antioxidant defenses, maintaining DNA stability, and improving oocyte (egg) maturation and embryonic development. Zinc helps to reduce oxidative stress, which is essential for maintaining oocyte quality. [66-68] It also supports the structural integrity and function of oocytes, and is involved in the regulation of reproductive cell cycles and ovulation. Zinc deficiency can reduce oocyte quality, leading to compromised embryonic development. [69-70] Zinc supplementation during in vitro maturation (often used as part of an IVF procedure) has been shown to improve mitochondrial activity and boost the quality of blastocysts. [66,71] Sources of zinc include:

• Beef
• Pork
• Chicken
• Oysters
• Lentils
• Chickpeas
• Pumpkin seeds
• Cashews
• Almonds
• Quinoa

Vitamin D: While the role of vitamin D in fertility is still being explored, sufficient levels of vitamin D are associated with better reproductive outcomes. Vitamin D supplementation has been shown to improve endometrial thickness and embryo quality, which are critical for successful implantation and pregnancy. However, the benefits are more pronounced in individuals with vitamin D deficiency. [37-38] Sources of vitamin D include:

• Shiitake mushrooms
• Beef liver
• Cod liver oil
• Egg yolks

Anti-inflammatory fats: Fats including omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential for reducing inflammation and improving oocyte quality. Increased intake of omega-3 fatty acids has been linked to better egg health and higher live birth rates in women undergoing ART. These fatty acids help in maintaining cell membrane integrity and reducing oxidative stress, which are vital for egg health. [36, 39-40] Sources include:

• Salmon
• Mackerel
• Sardines
• Anchovies
• Flax seeds
• Chia seeds
• Walnuts

CoQ10: Coenzyme Q10, also known as ubiquinol or CoQ10, is an antioxidant that the human body naturally produces. Supplementation of CoQ10 may enhance ovarian response to stimulation, particularly in women with diminished ovarian reserve or poor response to previous stimulation protocols. CoQ10 has been suggested to improve mitochondrial function in eggs, potentially enhancing their quality and increasing the chances of successful fertilization and implantation. [34] This is particularly important because egg cells (oocytes) have the highest amount of mitochondria, compared to other cells in the body. [45] Sources of CoQ10 include:

• Beef
• Pork
• Chicken
• Sardines
• Liver
• Peanuts
• Sesame seeds
• Parsley

Lifestyle modifications: Maintaining a healthy BMI (and avoiding smoking) are critical lifestyle factors that can improve IVF outcomes. Obesity and underweight status are associated with poorer reproductive outcomes, and weight management through diet and exercise can enhance fertility. [33]

 

For Him: Nutrition for IVF & Sperm Health

 

Nutritional interventions can significantly improve sperm health, which is crucial for IVF success. Key nutrients and dietary patterns have been shown to enhance various sperm quality, including concentration, motility, and morphology. Important to note: it takes an average of 3-4 months for sperm to mature and be influenced by nutrition.

Omega-3 fatty acids: Supplementation with omega-3 fatty acids has been shown to increase total sperm concentration and motility. Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), help reduce oxidative stress and inflammation, which are detrimental to sperm quality. [41-42] Sources include:

• Salmon
• Mackerel
• Sardines
• Anchovies
• Flax seeds
• Chia seeds
• Walnuts

Antioxidants & Minerals: Antioxidants such as selenium, zinc, and coenzyme Q10 (CoQ10) have been shown to improve sperm health. Selenium and zinc supplementation can increase sperm concentration and motility, while CoQ10 has been shown to enhance sperm count and morphology. These antioxidants work by minimizing oxidative stress, which can damage sperm DNA and cellular structures. [41-42] Sources include:

• Liver
• Oysters
• Shellfish
• Beef
• Turkey
• Eggs
• Sardines
• Broccoli
• Brazil nuts
• Black beans
• Lentils
• Cashews

Carnitines: Carnitine supplementation has been associated with improved sperm motility and morphology. Carnitine play a role in energy metabolism, which is essential for sperm motility and overall function. [41-42] Sources include:

• Beef
• Pork
• Cod
• Chicken breast
• Avocado
• Eggs

Vitamin D: Adequate levels of vitamin D are beneficial for sperm motility and overall semen quality. Vitamin D receptors are present in sperm, and its active form has been shown to promote sperm motility and fertilization capacity. [44] Sources include:

• Shiitake mushrooms
• Beef liver
• Cod liver oil
• Egg yolks

Dietary patterns: Similarly for women, adherence to a Mediterranean diet, which includes high intakes of vegetables, fruits, whole grains, fish, and olive oil, has been associated with better sperm quality. This diet is rich in antioxidants and anti-inflammatory nutrients that support overall reproductive health. [42-43] 

 

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Before IVF: What to Avoid

For Her:

When trying to conceive or preparing for IVF, women should watch out for:

• Smoking
• Drinking alcohol
• A significantly low BMI
• Exposure to environmental toxins like pesticides and heavy metals
• High stress levels (this one’s tricky, we know!)

Avoiding these factors when preparing for IVF can help improve your chances of successful conception. [33, 46-53]

For Him:

When trying to conceive or going into IVF, men should avoid:

• Smoking of any kind (including marijuana)
• Drinking alcohol
• Excessive/high heat near the scrotum like saunas or hot tubs

These factors have been shown to decrease sperm parameters which could inhibit fertility outcomes. [33, 54-61]

 

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Conclusion

As you navigate the challenging journey of IVF, taking care of your overall wellbeing can have a real impact on the outcome. A holistic approach that prioritizes nutrition not only supports your physical health but also nurtures your mental and emotional resilience during this trying time. A diet rich in vital nutrients can enhance both your egg health and your partner or donor’s sperm quality, fostering more optimal conditions for conception.

With a whole-body approach you’re setting the stage for both physical and emotional strength, ultimately enhancing your chances of achieving the family you dream of.

 

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FAQs

What is IVF?

IVF, or in vitro fertilization, is a process that helps individuals or couples achieve pregnancy through a series of steps, including ovarian stimulation, egg retrieval, fertilization, embryo culture, and embryo transfer.

Who is a good candidate for IVF?

IVF is often recommended for those facing severe male-factor infertility, tubal factor infertility, severe endometriosis, or for couples who have not succeeded with multiple IUI cycles.

How does the IVF process work?

IVF involves ovarian stimulation, oocyte retrieval, fertilization in a lab, embryo culture, and transferring one or more embryos into the uterine cavity.

What is the difference between IVF and IUI?

IVF is more invasive and involves laboratory procedures, while IUI places sperm directly into the uterus. IUI is generally less costly and is used for fertility issues like mild male-factor infertility, cervical infertility, dysovulation, or mild to moderate endometriosis.

What factors influence IVF success rates?

Key factors include female age, duration of infertility, BMI, previous pregnancy history, the number and quality of eggs and embryos, and laboratory conditions.

What are the potential risks of IVF?

Risks include ovarian hyperstimulation syndrome (OHSS), bleeding, infection, and increased chances of pregnancy complications like pre-eclampsia and gestational diabetes.

How can nutrition support IVF success?

A nutritious diet rich in antioxidants, folic acid, vitamin D, and omega-3 fatty acids can improve egg and sperm quality, enhancing the chances of a successful pregnancy.

How long does it take for dietary changes to affect fertility?

For women, it takes about three months for egg quality to be influenced by nutritional changes, while for men, it typically takes 3-4 months for sperm to mature.

What should women avoid when preparing for IVF?

Women should avoid smoking, alcohol, low BMI, environmental toxins, and high stress levels to improve their chances of successful conception.

How can antioxidants improve sperm health?

Antioxidants like selenium and zinc can reduce oxidative stress, enhancing sperm concentration, motility, and overall quality.

 

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