Please don’t sabotage your IVF cycle

June 11, 2010Carole No Comments »

We live in a modern world in which we can fix our medical problems with a pill or surgery or a treatment. Right?  Yes and No. If you want to optimize the chances of getting pregnant with IVF (or without), there are things that you can do before IVF treatment to help yourself get pregnant.

First. Please don’t smoke. If you do smoke, stop. Right now. The American Cancer Society has an up-to-date list of ways to stop smoking, including some of the newest drugs that act directly on nicotine receptors.

We could always tell a smoker’s eggs in the lab. They just looked, well smoked.  We can’t do much with sick eggs. Kick the habit, wait a couple of months, then come back. You will be saving yourself time, money  and disappointment. Smokers take twice as long to conceive using ART than non-smokers, according to ASRM. The same advice applies to your man. Smoking does not improve sperm. There are many research studies on smoking and semen quality. Some studies show that smoking decreases sperm quantity or quality or both. There are no studies to show that smoking improves sperm.

I know that smokers get pregnant without any help.  If they smoke and still get pregnant, they probably had some extra ovarian reserve or better defenses against the destructive free radicals in smoke.  If you have a fertility problem that seems solvable only by spending $12,000 for IVF, then please for your own sake, don’t sabotage yourself  by smoking. If you can’t do it for yourself, do it for your future kid. Smokers have more difficult pregnancies than non-smokers. Smokers are more likely to have miscarriages. Smoking around kids is terrible for them. Consider stopping smoking as your first act of mothering.

Second, make sure that you don’t have any thyroid problems. Low thyroid function is often undiagnosed or misdiagnosed. Thyroid problems interfere with normal reproductive function. Sometimes, correcting underlying thyroid problems can restore your fertility. Wouldn’t that be great? No IVF. No drugs. No pills.  A good RE will look for problems like hypothyroidism as part of the diagnostic workup before he enrolls you in an IVF cycle.

Third, and I know this one is probably the hardest-  normalize your weight. Being either severely underweight or overweight can interfere with fertility. Occasionally we would have a patient who was severely underweight either from over training or from anorexia issues and they would have irregular or absent periods. Much more commonly, our patients had problems with obesity.

Obesity in women can cause a host of problems including irregular periods and not ovulating. Obese women have a higher risk of miscarriage if they do conceive and obesity drives down the success rate of ART. A body mass index or BMI greater than 30kg/m is associated with infertility. The infertility effect from obesity is linked to problems with insulin resistance or insulin excess which play a role in some forms of polycystic ovarian syndrome.

Being overweight makes for a more difficult pregnancy and increases the risk of certain birth defects. Some doctors will make you get a green light from a cardiologist before they start fertility treatment because if you are obese, a pregnancy-especially with multiples-  could stress your heart and kill you.

It might take a year to reach a normal BMI if you are really overweight, but you’ll get pregnant sooner, have a healthier pregnancy and live longer to take care of your kids. And if your fertility treatments fail, adoption agencies won’t be able to turn you down as a good candidate for adoption on the basis of being too fat.

Obesity can cause sperm problems by disrupting sperm production and/or affecting sperm quality. A semen analysis typically looks at sperm count, sperm appearance and percent of swimming sperm. These parameters can actually be normal in an infertile male if infertility is cause by a functional defect. For instance, defects with a sperm receptor that are not detected in a regular semen analysis. My lab did a clinical study that showed that both obesity and smoking was correlated with  a poor score on a functional sperm test compared to normal sized non-smoking men. Obese men in our small study also tended to produce fewer embryos and were less likely to have embryos to transfer.

So please don’t sabotage your IVF cycle. Help your clinic help you.

© 2010, Carole. All rights reserved.

Join the discussion