Being healthy, happy and relaxed are three simple states that are sometimes forgotten but always necessary. With this in mind, here are a few pre-treatment tips for your consideration:
If you are significantly overweight (20% above ideal body weight), we encourage you to take part in the ‘Fertility Fitness for Women’ program we run at the Centre. Research, by the team at Fertility First and others, has shown that as a woman’s weight increases, her response to treatment and chance of pregnancy reduces, while her chance of a miscarriage, if she does get pregnant, increases. Therefore, this is an important issue to address prior to the start of a treatment program.
Women whose weight to height ratio is below a certain level, will be encouraged to increase their weight prior to any treatment. As weight drops women stop ovulating regularly. Therefore, an increase in weight might mean no other treatment is necessary. In addition, any child conceived while a woman is significantly underweight, will have an increased risk of growing poorly during pregnancy with possible long-term effects.
In moderation, there appears to be no negative impact on fertility. There is no need to abstain during this period of time but you should restrict your intake to less than 1 glass a day.
Drugs, Medications and Natural Remedies
It is important that if either of you take any medications, before or after your initial visit to Fertility First, you inform us. Some medications can impact negatively on male and female fertility, and these include natural remedies. Some Chinese herbs, for example, can have a negative effect on the development of eggs in a treatment cycle. Illicit drugs, such as marijuana and cocaine can also have significant effects on your fertility and response to treatment. Please talk to us before any treatment cycle starts.
Exercise is good for maintaining weight loss, lowering stress and increasing a sense of well being. Around the time of the actual treatment, however, we would recommend that if you have a vigorous exercise program, it is modified until you know if you are pregnant If you are not certain, just ask.
Recent studies on the effect of vitamin supplementation in women planning a pregnancy have found that folate (or folic acid as it is also called), one of the B group of vitamins, can prevent the occurrence of neural tube defects (NTD). The most common NTD is spina bifida. Women are therefore strongly encouraged to take folate supplementation (0.5mg a day) in the month prior to conception or treatment and the first three months of pregnancy. Women at increased risk of NTD, such as those who have had a previously affected child, should take 0.5mg a day. The tablets can be obtained from pharmacies and health food shops. Please read the leaflet (available at Fertility First) published by the New South Wales Department of Health for further information.
Even if your assessments have shown that a form of IVF is the best chance of having a child, it might still be necessary to have some surgery before the treatment cycle starts to maximise your chance of getting pregnant. Once again endoscopic surgical techniques, using a laparoscope, are used to avoid the need for a large wound in your abdomen. You are usually only in hospital for the day of the procedure.
- Endometriosis is a condition where a woman has endometrium (the tissue lining the cavity of the uterus) growing outside the uterus. The most common places are in the pelvic cavity and ovaries. It may cause pain and heavy periods. Recent studies have shown that even mild endometriosis can affect fertility and the development of the egg. Therefore, if we believe you have endometriosis, we would recommend that it be treated prior to your treatment cycle This is particularly important if there are pockets of endometriosis growing inside the ovaries. These will have a significant impact on the number of eggs that develop, their quality and the chance of becoming pregnant. These pockets can be detected at laparoscopy or by a vaginal ultrasound scan.
- Hydrosalpinges are fallopian tubes that become dilated with fluid following tubal infection and damage. A number of studies have shown that in women having IVF, hydrosalpinges halve the chance of getting pregnant and double the chance of any resulting pregnancy miscarrying, compared to women with tubal disease who do not have hydrosalpinges. It appears that the receptiveness of the endometrium (the tissue lining the uterine cavity) to an embryo hatching out and implanting is reduced. Treating the hydrosalpinges, by their removal or opening of the tubal end, reverses this negative effect. Therefore, if you have hydrosalpinges, which we will know from a previous laparoscopy or, sometimes, an ultrasound scan, you will be strongly advised to have them treated laparoscopically before your treatment starts.
There is increasing evidence of the negative impact of smoking on fertility and pregnancy outcome. Women who smoke are 3 times as likely to have fertility problems as non-smokers and do not respond as well to treatment. lf they do get pregnant, they have a higher chance of a miscarriage or ectopic pregnancy. There are also increased complications for the baby before and after it is born. Therefore, we strongly encourage both of you to stop smoking prior to starting a treatment cycle. If only the woman stops, she still has increased risk due to passive smoking. ln addition, there are reports of increased chromosomal breakage’s in the sperm of men who smoke. This could explain reports of increased birth defects in the children of male smokers. In addition, if a man is smoking at the time of conception, the resulting child has a 30% higher risk of developing cancer in childhood. Please read the leaflet supplied by the Quit campaign (available at Fertility First) for further information.
Sense of Humour
Last, but not least, maintaining a sense of humour is vital for the well-being of the two of you, and your relationship throughout this process. There is increasing evidence of the value of laughter and humour in maintaining and improving health. Now is the time to start getting out the comedy videos, joke books and reading the cartoons.
Fertility First’s counsellor (a clinical psychologist) has prepared a brochure on ‘Tips for Coping’ and the range of services she offers. ln addition, as we believe that the negative impact of fertility problems on your well-being can affect your chances of success, the Centre offers a 10 week ‘Fertility Feelings’ program. The basic goal of the program is to help people stop living in 28 day cycles and start to get more enjoyment out of their lives (see Counselling & Emotional Reactions).