HOW TO PREPARE FOR IVF: DIET, EXERCISE, AND LIFESTYLE GUIDE FOR IVF SUCCESS

Chapter 5

You’ve made it to chapter 5! In this chapter, we will go over how you can prepare your body for IVF treatment for the best results. Remember, healthy babies are born to healthy parents. If you’re trying to increase IVF success, in addition to considering the adjunct treatments we previously talked about, you must go through some lifestyle changes, as the quality of your eggs and sperm is dependent on your health. In this chapter we will talk about;

IVF and weight
IVF diet
IVF and substance use
Exercise and sleep for IVF
Sex before IVF

and how you can better your lifestyle for a greater chance of success with IVF. The information provided in this chapter will talk about what you can do in preparation for IVF to improve your overall health, which will boost your fertility. We will also go over some misconceptions and debunk some myths about what you can and cannot do. The advice provided in this chapter is for IVF preparation, but we recommend keeping some of these habits throughout your journey, and well into pregnancy.

EXPLORE OTHER CHAPTERS

Chapter 1 What is IVF and how does it work?

Chapter 2 IVF and Female Infertility: Causes, Diagnosis, and Treatment

Chapter 3 IVF and Male Infertility: Causes, Diagnosis, and Treatment

Chapter 4 IVF Success Rates by Age, Diagnosis, and Additional Treatments

Chapter 5 How To Prepare For IVF: Diet, Exercise, And Lifestyle Guide For IVF Success

Chapter 6 IVF Treatment: Step by Step

Chapter 7 After IVF: Implantation, the 2-Week Wait, and Failure

Chapter 8 Cost of IVF Explained with Price Breakdowns

Chapter 9 Comprehensive Guide to IVF Treatment in Turkey: Cost, Planning, Experience

IVF and Weight

As we all know, when it comes to health, weight is a major factor in everything. Having a high BMI increases your chances of developing type two diabetes, heart disease, cancer, etc. And when it comes to infertility, it can be a major factor. When you’re getting infertility treatment, your entire medical history is examined, which also includes calculating your BMI and risk for other conditions.

For women, a higher BMI can be the problem that’s preventing them from getting pregnant in the first place, as it can affect ovulation and the quality of eggs they produce [1]. A higher BMI can also be a hindrance during treatment because medications do not work as intended compared to non-obese women. Even if everything went well, women with a higher BMI are still at a higher risk for developing complications during pregnancy. When the mother is overweight, there is a higher chance of the baby also being of a bigger size, thus making the birth process more difficult.

BMI is also as important for men as it is important for women when it comes to fertility, as obesity can affect sperm motility and cause DNA damage [2]. So both men and women must try to lose some weight before IVF treatment if they’re overweight.

On the opposite side of the spectrum, having a low BMI can also negatively influence fertility, causing low birth rates [3]. Especially in women, low weight and insufficient nutrition (caloric deficit, low-fat diets) can cause the menstrual cycle to shut down, leading to anovulation and infertility. Losing your menstruation for long periods due to an eating disorder, low weight, malnutrition or excessive exercise can be a problem if you want to get pregnant.

Even if the IVF treatment results in pregnancy, an underweight mother can be a risk factor for the developing baby’s health. Fetuses with underweight mothers have delayed development, and have low birth weights compared to babies with mothers that have a normal BMI. We advise that patients with low BMI adopt a nutritionally and calorically sufficient diet that can help them reach their fertility goals.

Whether you’re overweight or underweight, by changing your diet and exercise routine you can achieve a healthier BMI, thus increasing your fertility and success rates to give birth to a healthy baby.

Is there an IVF BMI limit?

Officially, no. But most clinics won’t treat patients with a BMI over 38.4 kg/m2 because the treatment may not work as intended, or there might be a higher chance of complications during operations.

What is a good BMI for IVF?

A good BMI for IVF should be between 19 to 25 kg/m2 which is the healthy range for all adult females and males.

IVF Diet

When it comes to IVF preparation, food & dietary habits might be the most complicated subject. As it is with all other diets, no best IVF diet can magically help you. There is no 10-day or 30-day balanced diet regimen that will contribute to your IVF success in a meaningful way. What we recommend is that, instead of searching for a miracle diet, you should change your lifestyle, and relationship with food and exercise for overall better health.

What is the best diet for IVF?

Although there are diets that claim to specifically help fertility, the consensus is that a Mediterranean diet is the best option for overall health, including reproductive health.

Do not let the name fool you, the Mediterranean diet isn’t a strict regimen, but more of a lifestyle. Unlike other diets, what makes it effective is not about what you are or aren’t allowed to eat, but the overall approach to nutrition.

The Mediterranean style diet is characterized by the intake of complex carbohydrates from whole grains, legumes, fresh fruit, and vegetables that are in season; healthy fats from olive oil, nuts, and seeds; protein from fish, other seafood, poultry, and dairy products; and the very occasional red meat and sweets. On top of its nutritional aspects, exercise, and enjoying meals with others for longer periods are also characteristics of this diet, making it more of a lifestyle.

The complex carbohydrates in the diet provide the body with fuel, without disrupting blood glucose levels or causing insulin resistance.
Vegetables and fruit provide much-needed fiber for healthy bowel movements, and vitamins for the body to function.
Healthy fats from olive oil and nuts nourish the body.
The seafood provides the body with essential amino acids and omega 3.
The conservative amount of dairy and poultry reduces the intake of saturated fats, but still provides nutrients.
The rare intake of red meat prevents gout, heart disease, and cancer.

The Mediterranean lifestyle is one of the best diets for overall nutrition and balance. It provides a great foundation for reproductive health and can improve results for ART patients. Now lets’s take a look at some specific food groups and nutrients that are good for IVF outcomes for both men and women.

Best IVF Foods

Your diet must include all food groups in varying amounts. However, some food groups have been proven to benefit fertility when incorporated into the diet. If you follow the Mediterranean lifestyle, these foods will be your primary source of nutrition. However, incorporating these food groups into your regular diet can also have a positive effect.

Fish

In a study focused on patients receiving ART treatments, a dietary increase in fish was associated with a 34% to 48% higher probability of live birth. In the same study, it was found that if the poultry and meat in the diet were replaced with fish, it improved the chances of live birth by up to 54% [2] For men, increasing the intake of fish can improve sperm count and morphology [4]. The diet must include a variety of fish, with low amounts of mercury for the best results.

Whole Grains

Dietary Intake of low glycemic index and low insulin resistance carbs can improve fertility [5]. Intake of simple carbs and sugars can spike the blood glucose levels, and in turn worsen the effects of insulin resistance, which is present in most women with PCOS. The ovaries are very sensitive to insulin, and with the wrong diet, this can affect not only insulin levels, but other hormones working for the reproductive system and can cause PCOS, anovulation, etc. Whole grains are also helpful for sperm production [4].

Fruits and Vegetables

Vegetables and fruits provide the body with vitamins and other micronutrients that improve sperm quality. Especially folate-rich vegetables such as asparagus, leafy greens, and beets have a positive effect on both male and female fertility [4].

Nuts and Seeds

Especially for men, nuts play a big role in the fertility diet [4]. In a study, the subjects added 75 grams of walnuts a day to their diet for 12 weeks. In the end, their sperm vitality, motility, and morphology have significantly improved [6]. In another study, intake of almonds, hazelnuts, and walnuts for 14 weeks significantly improved sperm motility, morphology, vitality, and total sperm count [7]. So it’s probably a good idea for men to incorporate various nuts and seeds into their diet, regardless of the kind of diet they have, to improve fertility.

IVF Nutrition

On top of general food groups that are good for fertility, let’s go over some specific vitamins, minerals, and nutrients that have a positive effect on fertility. Most people feel like they need to take a supplement for every micronutrient. However, we recommend you try to incorporate foods rich in these vitamins and minerals into your diet first. If you’re following the Mediterranean diet, you can get most of these micronutrients from your diet very easily.

Folic Acid/Folate

The benefits of folic acid supplementation for pregnancy are well documented and widely known. Folic acid use can improve fertility, and live birth results for patients going through IVF [5].

Omega-3 Fatty Acids

The benefits of omega 3 are considerable for both female and male fertility. It improves pregnancy and live birth rates for female ART patients [5]. For male fertility, omega 3 improves sperm concentration, total sperm count, sperm morphology, and motility[4].

Vitamin C

Vitamin C is the most well-known antioxidant. Antioxidants reduce oxidative stress and prevent DNA damage, thus improving sperm and oocyte quality [2] [4].

Selenium

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Zinc

Another antioxidant, zinc improves sperm concentration and motility [8].

CoQ10

Coenzyme Q10 is a vitamin-like antioxidant. In males, it can increase sperm concentration and sperm count and can improve motility and morphology [8].

Vitamin D

An essential vitamin for human health, lower Vitamin D levels are associated with anovulation and PCOS [9] [10]. Vitamin D improves follicular maturation and can help with implantation.

Arginine

Arginine can improve ovarian response and endometrial receptivity in patients, and lead to higher pregnancy rates [11] [12].

Monosaturated/Polyunsaturated Fatty Acids

Healthy fats are essential for hormones to work properly, and they play an essential role in female fertility and pregnancy.

When it comes to micronutrients like vitamins and minerals, we advise patients to be cautious. While we suggest getting these nutrients from your diet as much as possible, we know that in cases where there is a deficiency, or when it’s too difficult to get higher amounts of these nutrients through diet alone, sometimes dietary supplements are necessary. If you’re using a prenatal vitamin approved by your fertility specialist, most of the micronutrients we mentioned above will be included in its ingredients in safe doses, and you won’t need to take any additional ones. While it’s easy to discard the excess amounts of some water-soluble nutrients like Vitamin C, for others, specifically fat-soluble ones like Vitamin E, Vitamin D, and Vitamin A, it might not be as easy and it can cause some problems, and can even lead to toxicity. For this reason, we strongly advise you not to start using any IVF supplements without the supervision of your doctor and continue to follow their advice throughout the process.

Now that we learned about what kind of foods and nutrients can help with fertility, let’s move on to discussing some habits and substances that can have adverse effects.

IVF and Substance Use

It’s important that while we’re trying to incorporate healthy habits into our lives, we also avoid the ones that can harm us. Especially when the goal is fertility and getting pregnant, avoiding substances that can cause harm is more important than trying to compensate for their effects. By substance use, we mean the misuse use of any substance that interacts with the brain; caffeine, nicotine, alcohol, any medications you have to take, or illegal drugs you might be using. Let’s go over the effects of these substances one by one to see how they affect fertility and IVF outcomes.

Caffeine and IVF

One of the most common stimulants, caffeine affects the body through the central nervous system. Caffeine is mostly found in coffee, green tea, black tea, and energy drinks; and is available in powder and pill forms as pre-workout supplements. Caffeine is a great source of antioxidants that prevent DNA damage, but it shouldn’t be relied on by itself to provide antioxidant benefits. The consumption of caffeine is recommended via green tea, as it also has additional antioxidants, thus more effective than coffee.

When it comes to IVF and fertility, moderate to low caffeine consumption did not have any adverse effects [13] [14]. It’s recommended that patients that are trying to improve their fertility, patients that are pregnant, and breastfeeding do not exceed 200 mg of caffeine a day.

To make sure if you can consume caffeine or not, please consult your doctor. Doctors can ask you to remove caffeinated beverages from your diet for a while, as it has blood-thinning properties which can trigger bleeding. In high-risk pregnancies, and if the patient had previous implantation failures and miscarriages, caffeine consumption can be risky, and be cut from the diet by the doctor after embryo transfer.

So, generally, you can have 1 or 2 cups of coffee or tea while preparing or undergoing IVF, unless your doctor states otherwise.

Smoking and IVF

Nicotine has negative effects on all parts and components of the reproductive system [15][16]. Cigarette smoking significantly reduces oocyte quality and estrogen levels [17]. Though there are some studies suggesting that smoking doesn’t affect IVF outcomes, any study performed on the effects of cigarette smoking on the body would prove otherwise. Tobacco and smoking are highly toxic and should be avoided before, during, and after IVF and pregnancy.

Additionally, secondhand smoke can also affect the reproductive system. A metabolite of nicotine called cotinine has been detected in the follicular fluids of IVF patients [18]. So, patients that are going through IVF should avoid all forms of tobacco and nicotine consumption, including vaping, chewing, snuff, smoking, and secondhand smoke.

Alcohol and IVF

Effects of alcohol are pretty significant when it comes to IVF outcomes. Alcohol consumption has been linked to a decrease in the number of eggs retrieved, and an increase in miscarriage rates among female IVF patients. In males, alcohol intake was linked to a higher rate of spontaneous miscarriages in comparison to men who stopped consumption of alcohol at least 1 month before IVF. Even having alcoholic drinks containing lower amounts of alcohol like beer can affect live birth rates [16]. Even if you drink as few as 4 drinks per week, it can still have a significant effect on live birth rates [19].

When to stop drinking before IVF?

Both male and female patients should quit all types of alcohol at least 1 month before IVF treatment.

Can a man drink alcohol before IVF?

Again, alcohol consumption by male patients has been linked to spontaneous miscarriages compared to male patients that didn’t drink alcohol. Men should avoid alcohol consumption before IVF.

Illicit Drugs and IVF

Substance use in the world has become more common than it ever was. Most men under the age of 35 are using some kind of an illicit drug. With the changing views on drug use, in some parts of the world like the United States, marijuana, which once was a class I illicit drug, is not available for both recreational and therapeutic use. In Portugal, all drugs are decriminalized, which seems to have a positive effect on drug-related social problems.

Whether we like it or not, drug use is a reality of life. It’s also part of this reality that drug use is extremely dangerous. Most studies done on the effects of drugs on fertility have been focused on marijuana. According to studies, marijuana use can interfere with hormones and can cause disruptions to the menstrual cycle, causing anovulation [21]. In men, marijuana can interfere with hormone levels. For other drugs, they interfere with hormones, significantly reduce testosterone production, decrease sperm count and motility, and cause sperm DNA fragmentation [22]. For women, the use of cocaine seems to affect the fallopian tubes the most and can disrupt the menstrual cycle [21].

For all the reasons mentioned above, if you’re a consumer of illicit drugs and considering IVF treatment, we want you to know that this habit can have detrimental effects on your overall health, fertility, and the heath of your offspring. We recommend you find a way to quit this habit through therapy, hospitalization, or other forms of treatment.

Medications and IVF

Some prescription and over-the-counter medications can interact with the IVF process. It’s best to avoid the use of medications that aren’t approved by your doctor. Especially when you’re going through IVF, you should also avoid using common over-the-counter medications like Advil or Ibuprofen.

If you have any medications you’re currently taking, please share the details with your medical team if you’re intending to get IVF. Your medical team will guide you on which medications are safe for you to take and which aren’t during the process.

In some cases, some medications that are not generally safe for pregnancy can still be used during the IVF process. For example, according to instructions, you should avoid taking Xanax if you’re pregnant or trying to get pregnant. For this reason, it’s best to taper off from this medication before your cycle under the supervision of your doctor. Or, your doctor might approve the use of it during IVF and through pregnancy.

We think the best approach is to consult your medical team on which medications you’re allowed and not allowed to take personally.

IVF Birth Control

Sometimes, in preparation for IVF, your doctor can prescribe you a birth control pill. Birth control pills are mostly used as a contraceptive method, but they have many other uses when it comes to treating hormonal imbalances, PCOS, acne, etc. During IVF, the birth control pill can help with the management of some symptoms that can cause problems during treatment, and it allows the medical team to schedule your cycle in the most correct timeline. As with anything, please do not start a birth control pill on your own, especially if you’re intending to go through IVF treatment. If you think the pill could benefit you, consult your doctor for a possible prescription.

Why take birth control before IVF?

Taking birth control before IVF can be helpful both for the patient and the medical team. For the patient, the pill will regulate hormones and endometrial thickness, and it can prevent the development of cysts that can hinder the process. For the medical team guiding you, the pill allows them to predict and schedule your cycle to specific days, which makes everything easier since the IVF process is very time-sensitive.

When to start birth control before IVF?

There is no specific date, as all patients present unique cases. But your doctor can put you on birth control 1 or 2 months before your cycle starts.

How long do you take birth control before IVF?

You take birth control for one or two months. You’re supposed to quit it once your controlled ovarian stimulation begins.

Birth control before IVF: Side Effects

The side effects of using birth control are the same when it’s used for any other reason. The most common side effects are breakthrough bleeding and spotting, which happens in between your periods; mood swings, tender breasts, nausea, and headaches. When you get your prescription, please read the possible side effects carefully and contact your doctor if you’re having any uncommon side effects.

IVF Without Birth Control Pills

In some cases, you won’t use a birth control pill before your cycle. If you have low ovarian reserves, have ovarian cysts, or are at high risk for blood clots, using the pill might not be suitable for you. However, if you are prescribed the pill by your doctor you must take it. If you do not want to take the pill, mention it to your doctor, and do not stop its use before consulting.

Now that we talked about diet, food, and substance use, let’s move on to other lifestyle factors. How you take care of your body is as important as what you put into it. It’s a well-known fact that stress has negative effects on IVF outcomes. Changing the way you take care of your body can improve your overall health, stress levels, and fertility. Let’s go over some changes you can add to your routine to eliminate stress and improve your results.

IVF and Exercise

It’s well known that moderate, regular exercise is good for your health. But somehow, this idea that pregnant women should avoid exercise is widespread. Especially among women going through IVF and pregnancy, there is a belief that exercise can prevent implantation and cause miscarriages. This is simply not true.

Exercise should be a part of every adult’s life, whether they’re planning or not planning to get pregnant, going through IVF or not, pregnant or not pregnant. According to studies, physical activity before IVF and ICSI cycles can improve clinical pregnancy and live birth rates [23]. In another study, it was found that physical activity could increase the number of oocytes retrieved [24]. For obese female patients going through IVF, exercise can improve their IVF results whether they’ve lost weight or not [25].

A study performed on rodents suggest if the father is obese, especially the female offspring is more likely to be overweight and have insulin resistance because of DNA damage. And when obese fathers incorporated exercise into their routine with a healthy diet, the offspring became healthier, proving that a healthy diet and exercise are just as important for male patients [26].

How much should I exercise?

The recommended amount of exercise is 15-30 minutes of a mild to moderate routine 3-4 times a week. Vigorous, high-impact exercise and working out over 4 hours a week can negatively affect fertility.

What is the best IVF exercise?

Best IVF exercises are low to moderate impact. Avoid vigorous, high-impact exercises and lifting heavy weights. You can incorporate these exercises into your routine for 15-30 minutes a day, 3-4 days a week:

Light Yoga
Jogging and walking
Light pilates
Light-weighted exercises
Light stretching
Relaxed swimming

So now you know what kind of exercises you should be doing before and during IVF, let’s look at how you can avoid stress and reduce anxiety levels.

IVF and Stress

There is no question, IVF is a very stressful process. It can present a lot of emotional, financial, and physical difficulties. We also know that stress negatively affects IVF results. For this reason, it’s important to cope with stress in productive ways as much as possible, because let’s face it; stress is unavoidable. Rather than stressing about stress itself, let’s look at some ways we can deal with it, by adopting healthy coping mechanisms that we can use in preparation.

How to deal with IVF stress?

Having a healthy diet, exercise routine, and sleep schedule can do a lot when it comes to managing stress. We believe having these lifestyle changes before IVF can have great benefits. We also think it’s important that you adopt some healthy strategies to cope with the stress and anxiety beforehand, so you can make new habits that you can use well into your treatment process.

Journaling

Keeping an IVF journal before and throughout your journey can be a great help when it comes to letting out your thoughts and emotions in a healthy manner. You can write down your thoughts, and feelings, and document the treatment process and your new routine before it by including your medication schedule and other information you’d like to keep track of.

Counseling and therapy

Whether you think your problems are too big or too small, we recommend anyone dealing with infertility seek professional help from psychologists. Therapy is a great way to learn valuable and sustainable coping mechanisms. We also know that sometimes the IVF process can cause some problems between couples. For this reason, we strongly recommend couples therapy before and during IVF.

Meditation or prayer

Having a meditation or a prayer routine can reduce your stress levels. You can try taking 10-15 minutes of your day to ease your mind and ground yourself with anxiety-relieving meditations, breathing exercises, affirmations, or prayer.

Get a massage

You can definitely get massages before, during, and after IVF. Just don’t get deep tissue massages or the ones that are hard on the body. A light, relaxing massage is a great way to get rid of the tension built up in your body.

Ask for support

IVF and Sleep

Having a healthy sleep schedule is essential. Getting enough, and quality sleep every night is crucial for the body to restore its functions, and also for mental health. When it comes to IVF specifically, your sleep schedule can affect the outcomes of your cycle. Not getting enough sleep can lead to more cycle cancellations, fewer eggs retrieved, more cycle failures, and can even impact your baby’s birth weight [29][30][31][32].

If you’re having problems with your sleep schedule, please consult your doctor for possible solutions. We recommend at least 8 hours of sleep during the night.

But why at night specifically? Well, when it’s dark, your body starts to produce a hormone called melatonin which rules your circadian rhythm. Melatonin has antioxidant properties, and it scavenges free radicals to reduce oxidative stress and DNA damage. We know that other antioxidants are crucial for semen quality and sperm health. But women have specific melatonin receptors in their ovaries. Recently there have been studies suggesting that the use of melatonin for IVF can have potential benefits.

Melatonin, can reduce excess Reactive Oxygen Species produced during oocyte maturation in the ovaries, and protects the oocytes from damage [33]. In a study, the group that took 3mg of melatonin daily, had higher fertilization and pregnancy cares compared to the group that didn’t take melatonin [34], suggesting a correlation between the use of melatonin and oocyte quality that leads to better results.

The very little research on melatonin seems promising for the future, but there isn’t enough data to prove its 100% effectiveness. Unfortunately, while fixing your sleep schedule can improve your results, it doesn’t have much effect on the antioxidant benefits of melatonin, which are only possible with supplemental doses.

So, when it comes to sleep, we advise fixing your sleep schedule first. Melatonin supplements for IVF are still an unexplored topic. We strongly recommend you do not start taking melatonin unless your doctor approves it.

Sex Before IVF

A lot of patients are curious about how IVF will affect their sex lives. If you’ve been trying for a child for a long time, intimacy with your partner may start to feel like a chore. Or you might have some concerns regarding some negative impacts. There can be a tendency among people going through IVF to avoid intercourse for various reasons. Some patients might not be sure if having sex before IVF is okay or not. Having sex before IVF is completely fine. Especially for men, frequent ejaculation before IVF is actually encouraged since it’s good for sperm production. The only fine print is men should abstain from any form of intercourse and ejaculation 2 to 3 days before semen analysis to provide a good sample. Other than that, you can continue intercourse during your preparation period.

You’ve finished chapter 5! Now that we have learned how to prepare our bodies for the best IVF results, it’s time to move on to the next chapter and dive into the IVF process, step by step, and learn about how everything works.

References: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]