Preparing To Fall Pregnant

PRECONCEPTION CARE

The aim of preconception care is to prepare your body for pregnancy, birth and beyond.

A healthy lifestyle is recommended prior to and during pregnancy. Preconception care should be implemented 3 months prior to commencement of any fertility treatment to maximise the chances of conception.

DIET AND EXERCISE

It is important to maintain a suitable diet and exercise program that can improve reproductive health. It has become obvious that there is a clear relationship between weight and fertility. As body weight moves away from the normal range (above or below) fertility decreases. Pregnancy may still occur, but not at the normal rate, and the miscarriage rate is also higher than average. Weight loss as little as 3 kgs may improve your chances of conceiving.

Both partners should eat a healthy diet with at least five servings of fruit and vegetables a day, along with whole grains and protein such as meats, fish, eggs, or milk. Drink at least 8 to 10 of glasses of filtered water a day.

A regular exercise program 3 times a week for an average of 30 minutes is recommended to assist with keeping weight under control. Activity during the stimulation phase of IVF however should be limited to gentle exercise.

As the ovaries begin to stimulate they will become enlarged and tender. Limited activity reduces the risk of ovarian torsion and/or rupturing the follicles on the ovaries. Patients are advised to cease any activity that involves bouncing or jarring the pelvis by the time they return for their first ultrasound to monitor stimulation. Walking and swimming is recommended, however, if you are used to an extensive exercise regime seeking advice from your fertility specialist is recommended.

For further guidance regarding diet it is recommended to seek advice from a qualified dietician.

FOLIC ACID

Evidence shows that taking folic acid at least 3 months prior to getting pregnant and for the first three months of pregnancy can reduce your chance of having a baby with neural tube defects. The risk is reduced but no guarantee can be given that it won’t occur.

Life Fertility Clinic recommends a folic acid dose of at least 500mcgs daily, a minimum of a month prior to and particularly in the month of the treatment cycle. Folic Acid supplementation should also continue for the first three months of pregnancy. Recent studies indicate an adequate intake of vitamin B6 is necessary for full absorption of folic acid.

Life Fertility Clinic recommends taking only one prenatal vitamin daily, such as Elevit. For your convenience we stock supplies at the Clinic. It contains 3 key B Vitamins for overall health and energy; Vitamin C, which aids absorption of iron; and Zinc, which assists the immune system. However, please speak to your IVF specialist if you would like information about practitioners of complementary therapies.

CAFFEINE

Caffeine may lower your chances of conceiving, even if you don’t drink or eat large quantities of the stimulant, but the evidence is not conclusive. Caffeine may have an effect on a woman’s fertility and increase the risk of miscarriage. Caffeine is present in tea, coffee, cocacola products, chocolate, some foods and medicines. Caffeine reduces the absorption of iron and destroys B-complex vitamins. Ideally, caffeine should be avoided by men and women prior to and during fertility treatment and pregnancy. A caffeine free alternative can be taken instead. If you are unable to cease caffeine altogether, we recommend limiting caffeine intake to 200mgs a day. (One cup a day = 100mgs)

ALCOHOL

We recommend the cessation of alcohol consumption whilst trying to conceive and when a woman is pregnant. Moderate drinking is defined as not more than one standard drink per day for a man over the age of 65 or a woman of any age. A standard drink contains 10 grams of alcohol. Each of the following contains approximately 10 grams of alcohol:

  • a nip of spirits;
  • a can of mid strength beer; or
  • a 100mL glass of wine.

There is little evidence that low consumption of alcohol has any detrimental effect on your chances of conceiving or on pregnancy, but in the ideal world abstinence is best.

SMOKING

The health risks of tobacco smoking are well known with regard to diseases of the heart, lungs, and blood vessels. Cigarette smoking has a negative impact on the ability to become pregnant and carry a pregnancy to term.

Virtually all scientific studies support the conclusion that smoking has an adverse impact on fertility. The prevalence of infertility is higher and the time it takes to conceive is longer in smokers compared to nonsmokers. Active smoking by either partner has adverse effects, and the impact of passive cigarette smoke exposure is only slightly smaller than for active smoking. Research indicates that cigarette smoking is harmful to a woman’s ovaries, and the degree of harm is dependent upon the amount and the period of time a woman has smoked. Smoking appears to accelerate the loss of eggs and reproductive function and may advance the onset of menopause by several years. Components in cigarette smoke have been shown to interfere with the ability of cells in the ovary to make oestrogen and to cause a woman’s eggs (oocytes) to be more prone to genetic abnormalities. Smoking is strongly associated with an increased risk of spontaneous miscarriage and possibly ectopic pregnancy as well. Pregnant smokers are more likely to have low birth weight babies and premature birth. Nearly twice as many in vitro fertilisation (IVF) attempts are required to conceive in smokers than in nonsmokers. Studies of IVF have reported that female smokers require higher doses of gonadotropins to stimulate their ovaries, have lower peak oestradiol levels, fewer oocytes obtained, more cancelled cycles, lower implantation rates, and undergo more cycles with failed fertilisation than nonsmokers. The adverse effect of cigarette smoking is more noticeable in older women. Overall, the reduction in natural fertility associated with smoking may not be overcome by assisted reproductive technologies.

Men who smoke cigarettes have a lower sperm count, decreased motility and increased abnormalities in sperm shape and function. The effect of smoking on male fertility, however, is more difficult to discern because it is difficult to create studies to address that question. Although the effects of cigarette smoking on male fertility remain inconclusive, the harmful effect of passive smoke on the fertility of female partners and the evidence that smoking adversely affects sperm quality, suggests that smoking in men should be regarded as an infertility risk factor.

One important investigation showed that cessation of smoking for at least two months before attempting IVF significantly improved chances for conception. Although long-term cigarette smoking can have an irreversible effect on ovarian function, the harmful effect on treatment outcome may, in part, be reversed if smoking is discontinued prior to entering into fertility therapy.

In summary, the best available scientific data indicates that cigarette smoking strongly contributes to infertility.

Smoking should be discouraged for both male and female partners in couples with a history of infertility or recurrent miscarriage. Smoking cessation may improve natural fertility and success rates with infertility treatment.

DRUGS

Studies have shown that use of recreational drugs such as marijuana and cocaine will decrease your chance of conception. Avoid them under all circumstances.

When you are pregnant it is important that you watch what you put into your body. Consumption of illicit drugs is not safe for the fetus or for the mother. Studies have shown that consumption of illicit drugs during pregnancy can result in miscarriage, low birth-weight, premature labor, placental abruption, fetal death and even maternal death.

MEDICATIONS

Some medications may have an adverse effect on female and male fertility, or they may become ineffective when taken with certain supplements. Should any patient be taking medication, they will need to inform their Life Fertility Clinic clinician to ensure that potential drug interactions are avoided.

HERBAL REMEDIES AND COMPLIMENTARY THERAPIES

Many herbal remedies are considered beneficial to overall well-being and can be safely taken prior to treatment, or inbetween treatments. Many herbal remedies will effect a hormonal action, which may interfere with or counteract the action of your fertility medications. Herbs should be used with the same caution you would use with any other drug. All patients must notify their Life Fertility Clinic clinician if they are taking or intend to take, any herbal medication.

Common alternative treatments that are used by couples in conjunction with their conventional treatment include acupuncture, massage, meditation, yoga, hypnosis, herbal remedies and aromatherapy. When questioned about alternative treatments the majority of patients undergoing assisted reproductive therapy will admit to utilising these regimes. The philosophy is usually one of “we will be prepared to try whatever may help”. But you need to be cautious about what to use, especially if the alternative treatment could be detrimental to the outcome of conventional treatment. Please discuss this with your Life Fertility Clinic clinician prior to commencing any alternative treatments.

Often the treatment type has no documented well-studied results showing that the intervention is of benefit. But at the same time there does not seem to be any harm done either. As doctors and nurses we sometimes think that the greatest advantage of these treatments such as massage and yoga is the relaxation benefit and the associated ‘defocusing’ from IVF or other treatment that can be very stressful.

The most common alternative treatment and the most studied is acupuncture. This science has its roots in Chinese culture and has been practised for centuries. But does it work?

In response to the recent increase in popularity of acupuncture in IVF Stener- Victorin et al recently published “(The) Use of acupuncture in female infertility and a summary of recent acupuncture studies related to embryo transfer”.

The paper briefly discussed clinical and experimental data on the effect of acupuncture on uterine and ovarian blood flow, as an analgesic method (pain relief) during ART, and the effect on endocrine (hormone) and metabolic disturbances such as polycystic ovary syndrome (PCOS). Further, it gave a summary of recent studies evaluating the effect of acupuncture before and after embryo transfer on pregnancy outcome.

The review concluded that acupuncture has a positive effect “and no adverse effects on pregnancy outcome”. Another recent study, Smith et al from South Australia, studied the influence of acupuncture on pregnancy rates for women undergoing embryo transfer.

“The pregnancy rate was 31% in the acupuncture group and 23% in the control group. For those subjects receiving acupuncture, the odds of achieving a pregnancy were 1.5 higher than for the control group, but the difference did not reach statistical significance.” Thus there was no significant difference in the pregnancy rate between treatment groups; however, a small treatment effect cannot be excluded. The results suggested that acupuncture was safe for women undergoing ET.

To add to this evidence, Dieterle et al, studied the effect of acupuncture on the outcome of in vitro fertilisation and intracytoplasmic sperm injection in 2006. This study demonstrated that Luteal-phase acupuncture has a positive effect on the outcome of IVF/ICSI.

But others are more sceptical and published papers have declared “Acupuncture and infertility: we need to stick to good science”. Domar from Boston IVF in reviewing complementary medicine in ART goes on to state “The research published to date does not show a definitive positive impact of acupuncture on IVF success rates. However, researchers seem to lack traditional scientific practices when interpreting the data”. It is clear that more studies are required in this intriguing field of medicine.

Please discuss your alternative treatments with your doctors and nurses at Life Fertility Clinic. We will guide you with the most recent evidence published on the benefits or risks of these treatments.

 


 

For more information or queries regarding any of the services offered at Life Fertility Clinic, please contact us.

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