By Kacey Zuvella, RN, BSN
Preparing for IVF
If you’re preparing for an upcoming IVF cycle, there’s a lot to think about before you begin the process. The good news is, the more you prepare before your cycle starts, the easier the cycle can be. Preparing and educating yourself on the process will help you feel more in control and empowered. Here are a few things you can do to start your IVF cycle off on the right foot.
Five lifestyle changes that can make a difference
Studies show that making small lifestyle changes such as eating a healthy diet, steering clear of toxic products/chemicals, getting enough sleep and implementing a moderate exercise regimen has a positive impact on IVF outcomes.
- Diets full of lean protein, vegetables, fruits, and important nutrients such as omega-3 fatty acids and vitamin B12 can lead to better fertility outcomes in both men and women. When we can’t get every important nutrient by our diet alone, it’s a good idea to add additional supplements to our daily routine. CoQ10, Omega DHA, and folate can all be beneficial for better egg quality, while selenium and Vitamin C can be helpful for sperm. It can take about three months for both eggs and sperm to develop so the sooner you can start a healthy diet rich in beneficial nutrients, the better.
- Environmental toxins have been shown to negatively impact fertility for both men and women and can make IVF much less likely to succeed, so in the months preparing for IVF, it’s helpful to buy natural and organic products as much as possible. Bisphenol a (BPA), the toxin found in many household items such as canned goods, sports water bottles, baby pacifiers, and plastic food containers, has been linked to poor sperm quality, and exposure can damage sperm as well as lead to decreased sperm count. High BPA levels can also cause lower implantation rates for women going through IVF. If you can, switching to glass containers, stainless steel bottles and BPA-free canned goods is a good place to start when trying to rid your home of BPA. Pesticides are also considered to be some of the worst fertility disruptors, so going organic whenever you can is particularly important before and during IVF.
- Catching enough shut-eye can be more important for fertility than you might think. Disrupting your circadian rhythm can alter levels of FSH, LH, and prolactin- all extremely important hormones involved in ovulation and conception. Not getting enough sleep or engaging in sleep that is interrupted regularly can interfere with your circadian rhythm and is known to decrease fertility and even increase miscarriage rates. Prioritizing getting 8 hours of restful, uninterrupted sleep per night is an important step before beginning your IVF cycle.
- Exercise is always a good idea, right? The truth is, too much can be detrimental to fertility, and the jury is still out on exactly how much is too much. Experts suggest sticking to a moderate exercise regimen, as overdoing it can lead to issues with ovulation and implantation. For men, vigorous exercise (especially cycling) can lead to overheating, which can damage sperm. Some doctors suggest engaging in moderate exercise that doesn’t exceed more than an hour per day to be safe.
- Alcohol and caffeine are both up in the air when it comes to being helpful or harmful for IVF. It is proven, however, that overindulging in both of these can be detrimental to fertility. Depending on your doctor, he or she may suggest minimizing intake to one cup of coffee per day and 5-6 drinks per week or they may suggest eliminating caffeine and alcohol completely, just to be safe. Since there are mixed findings, do what is most comfortable for you and always ask your doctor what they suggest.
With all of these tips about changing your lifestyle, it’s important to remember that too much stress can be harmful for IVF, and that it’s best to not take all of these changes on at once. Start by what feels comfortable to you and work your way through these changes- your mental health and sanity is just as important as any of them!
What to expect with IVF and how you can prepare mentally
IVF can be stressful. Plain and simple. You’ll be stepping into a world full of unfamiliar terms, emotional highs and lows, intimidating injections, hormones, and invasive procedures. Hopefully though, knowing about what to expect beforehand can help alleviate some of the stress once you begin your cycle. Find ways to deal with the additional stress and find inner-peace, whether that be practicing yoga, reaching out to your support system, or anything else that may work for you personally (coloring, gardening, puzzles, anything!).
Once your IVF cycle begins, you’ll be going into the clinic for an average of four to six appointments over the course of roughly 10-14 days (sometimes shorter or longer depending on how you respond to medication). These appointments will be mostly blood draws and ultrasounds, and your final appointment will be your egg retrieval procedure.
One major stressor that patients frequently voice is the amount of time needed to take off work and the hardships of having to go in for unexpected additional appointments. It’s helpful to expect these appointments (usually done in the morning) and to understand that more may be added as your cycle goes on. After your retrieval, it’s suggested that you take the day of your procedure as well as the day after off of work to ensure your body has time to heal, so you can expect to miss full days of work during that time. You can always ask your IVF nurse for a calendar of your appointments which can hopefully lay these appointments out for you in an easy to understand format.
Preparing for injections
One of the biggest fears patients express is that of needles. It can be extremely intimidating, especially for those who have never given themselves an injection before. I recommend going over these injections and how to mix them in person with your IVF nurse. Record their explanation so you can watch it later at home and not have to worry about forgetting how to draw each medication up. There are also tons of resources out there that can show you how to mix and inject. Patients find it helpful to watch online videos or read anything your clinic has about injections prior to beginning IVF so that when the time comes for your first shot, you’ll already feel comfortable. After the first couple nights of injections, many patients report feeling much more comfortable with the injections. The first few nights always seem the most intimidating, but you’ll get the hang of it! By the time you’re ready for your trigger shot (your last injection), you’ll feel like a pro.
These injections can sometimes cause a range of side effects. The most common are headache, bloating, hot flashes, eye disturbances, and nausea. It’s important to speak with your doctor about what to expect, and what’s considered a normal side effect as opposed to what isn’t.
Another thing to consider while going through IVF is that since the medication you’ll be injecting causes the ovaries to become enlarged, you’ll want to tone down the exercise as well as any other sort of physical activity that can cause something called torsion (a medical emergency that occurs when an ovary twists and cuts off its own blood supply). These activities include exercise that involves bouncing, twisting, jumping, etc., intercourse, and heavy lifting. Patients sometimes struggle with cutting these out of their lives for a few weeks, as exercise can be an effective way of cutting stress levels. It’s helpful to find alternative ways to manage stress, and many physicians suggest swapping out vigorous exercise for long walks until your ovaries decrease back to their original size.
IVF items you may want to purchase ahead of time
There are a few products that you may find helpful throughout your IVF cycle. Many patients find it helpful to use a journal or tracker to help keep organized with appointments and medications. Another super helpful item to have is a heating pad and/or ice packs. These are great for injections as well as directly after your egg retrieval procedure. Also be sure to have Ibuprofen and thin pads on hand to help with any cramping or spotting post-retrieval.
IVF can be a tough process, but being prepared mentally and physically can help make it much more tolerable. Don’t be afraid to share any worries or concerns you may have with your clinical team, that’s what they’re there for! As hard as it is, do your best to let them do the hard work and let yourself focus on what you can control. And try to remember, that hopefully the outcome will make this process so worth it.
Kacey Zuvella, RN, BSN, BA is a registered nurse specializing in reproductive endocrinology and infertility. She is currently a nurse at Marin Fertility Center in Marin, CA and holds a BS in Nursing from Denver College of Nursing as well as a BA in Psychology from San Diego State University. You can follow Kacey on Instagram @kaceyzuvella.