The first pregnancy achieved through in vitro fertilization (IVF) from a human egg and sperm was reportedly from Monash University in Australia in 1973 under Drs. Carl Wood, John Leeton, and Alan Trounson. That pregnancy only lasted a few days. Today, we refer to such an occurrence as a chemical pregnancy. On July 25th, 1978, Louise Brown was born in Manchester, England, from an embryo implanted by Drs. Patrick Steptoe and Robert Edwards with the help of embryologist Jean Purdy. History was made, and a world of opportunity opened for those suffering from infertility problems or unable to carry a pregnancy themselves.
Since those early days, doctors and scientists have continually looked at ways to improve IVF success rates. One of the most important factors in determining IVF outcomes is the quality of the egg and sperm. There are no clinically proven ways to improve egg quality once a decline in egg quality has begun since women are born with all the eggs they will ever have. Typically egg quality begins to decline around the age of 38 years. Poor egg quality is caused by diminished ovarian reserve and is strongly associated with chromosomal abnormalities in embryos, resulting in poor implantation rates, increased rates of miscarriage, and congenital disabilities. Alternatively, men develop new sperm every 74 days. Therefore, even a slight change in lifestyle choices often results in improved sperm quality.
Here are 6 tips on how to improve IVF outcomes:
- Freeze your Eggs.
According to SART (Society for Assisted Reproductive Treatments), which records approximately 90% of all ART clinic cycles in the USA, age is a significant factor in ensuring a successful IVF cycle. Overall live birth rates for singletons in 2017 were as follows:
- Under 35 years old: 33.6%
- 35-37 years old: 26%
- 38-40 years old: 16.9%
- 41-42 years old: 8.5%
- Older than 42 years old: 2.8%
In addition, the percentage of abnormal eggs increases with age. Studies have shown that women in their 20s have mostly healthy eggs, with around 20% of their eggs being abnormal. By the age of 40, about 80% are no longer healthy.
If you are not ready to start a family or have not selected a parenting partner, an excellent option to protect your fertility is to stop your biological clock and freeze your eggs. Frozen eggs remain the same biological age as when they were cryopreserved, thereby boosting your chance of a future pregnancy. It is recommended that women consider freezing their eggs before their 38th birthday.
Alternatively, creating and freezing the embryos for future use is possible. Fresh and frozen embryo transfer success rates have been almost identical in recent years. In December 2020 (yes, there is some good news from 2020), a baby girl was born in Tennessee, USA, from a 27-year-old frozen embryo! Embryos created in 1992 were donated to another couple and resulted in the birth in 2017 of Emma, followed in 2020 with the birth of Molly. Ben Gibson, the father, has cystic fibrosis, and his wife, Tina, is also a carrier. Fearing they may pass the disease on to their children, they elected to work with embryos that another couple gave them.
- Annual Hormone Check
It is also recommended that every woman monitors her hormone levels at least once a year from the age of 28 years onwards. Any fluctuation in her reproductive hormones (Follicle Stimulating Hormone, Estrogen, Luteinizing Hormone, and Anti-Mullerian hormone) or a change in her cycle should be a cause for concern. Concern but not alarm! If your hormone levels begin to fluctuate, we recommend consultation with a specialist in reproduction, with hormone levels tested twice a year in the future.
Although it rarely happens that women may have elevated reproductive hormone levels under the age of 38, all that is required is a blood test once a year to monitor hormone levels. It is better to know that your hormones are in balance than to learn too late that your egg quality is no longer optimal. A visit to an IVF clinic will result in a blood test for your hormone levels and an Antral Follicle Count (AFC) ultrasound showing the number of your “resting” follicles. The more follicles seen, the higher the ovarian reserve. In addition, the Anti-Mullerian (AMH) hormone blood test will be a good indication of whether a woman still has a large pool of growing follicles and, therefore, that she will continue to produce more viable eggs.
- Healthy Lifestyle
A healthy diet is highly recommended for both men and women. A Body Mass Index (BMI) for females below 35 has consistently improved IVF success rates. In addition, higher BMI increases the risk of complications during retrievals. Male fertility rates are easier to improve as new sperm takes just 74 days to mature. Within three months of a man can adjusting his lifestyle, he will see improvements in his sperm quality and quantity. Your best friend is water. Stay hydrated, as blood flow in the body can quickly decrease dehydration. Drinking 64oz/2L of water each day is recommended.
- Smoking, Alcohol & Drugs
Smoking, caffeine, alcohol, and the use of drugs should be avoided altogether, as they are regularly linked to difficulties in conceiving. All medicines, including over-the-counter, have risks. Your doctor may recommend medicine changes once your doctor knows you intend to achieve a pregnancy. If medications are not necessary, it is recommended that you avoid taking them.
- Vitamins & Supplements
There are some supplements and vitamins that are believed to increase egg quality. Note that there is an absence of strong scientific evidence on this subject. Foods that are rich in antioxidants and zinc are encouraged. Avoid trans fats, refined carbs, processed foods, and excessive salt and sugar. In other words, try eating healthy.
DHEA (dehydroepiandrosterone) supplements have demonstrated some improvement in egg quality and quantity. It appears to improve low androgen levels in women with diminished ovarian reserve. This improved level affects egg quality positively. Typically, 25 to 200 milligrams daily for eight weeks before an IVF cycle is recommended. CoQ10 (Coenzyme Q10) supplements may also help improve egg quality and implantation rates. CoQ10 is an important nutrient for mitochondria (from high school biology class: mitochondria are the cells that provide energy to the eggs and produce ATP that helps the cells properly divide). The use of DHEA and CoQ10 is presently lacking in scientific backing and remains experimental.
- High Success Clinics
Just because a clinic is close to your home does not mean it is your best choice. Individual clinic success rates should be reviewed. In the USA, clinic success rates can be reviewed on the SART (Society for Assisted Reproductive Technology) website: www.sart.org. However, more than these statistics are needed to provide a clear picture. Some clinics turn away patients with low chances of success, while other clinics will assist these patients. Some clinics transfer only one embryo per cycle, whereas others may transfer multiple embryos per cycle.
In addition, we highly recommend that you interview and research at least three clinics. Although IVF clinics are similar to one another, there are differences that you need to tease out. Costs can differ significantly between practices. The embryologist is the real, yet undiscovered, gem of any IVF clinic. That elusive scientist behind the scenes is mainly responsible for the fantastic success rates the clinics achieve. Make sure you know who the embryologists are, their reputation and qualifications, and how long they have partnered with the clinic.
Another avenue to pursue is recommendations. If any of your friends, colleagues, and relatives have been through the process, ask whom they worked with. Personal references are usually very trustworthy.
Factors such as finances, religious beliefs, and relationship dynamics significantly influence your selection of an IVF clinic. It is important for your mental well-being throughout your IVF journey to feel that your clinic understands your situation and that their staff promptly and adequately responds to your questions and calls. We advise you to schedule consultations with at least three IVF clinics before finalizing your choice. You will be well-equipped to make an informed decision after thoroughly conducting your research and reviewing statistical data and notes from your consultations. You can then proceed, confident that you’ve made the right choice for your healthcare needs.
Author: Karen Synesiou, Infertility Portal, Inc
