Preparing for treatment

There are many lifestyle factors that have been proven to influence or enhance your chances of getting pregnant, both before and during fertility treatment. It is important to know that when you have been referred for fertility treatment, often the cause of your reduced fertility is out of your control. 

But there are some factors you can focus on that can have a positive impact. The below factors are equally important for men and women to follow. Remember it takes 100-120 days for eggs and sperm to mature, so what you do in the four months prior to conception has an impact.

Healthy weight

Though it is not the only factor, research shows that excess or insufficient weight in men and women is a contributing factor in reduced fertility. Body Mass Index or BMI is often used in research studies, a BMI of 20-25kg/m2 has been shown to improve chances of conception both naturally and in people undergoing fertility treatment.

If your BMI is outside this range, research shows that a smaller weight loss of 5% of your body weight can improve your fertility. This is even if this does not bring your BMI into the range of 20-25kg/m2. Learn more about BMI and fertility

Your diet

A Mediterranean dietary pattern has been proven to improve the chances of getting pregnant in people trying to conceive both with and without IVF.

Eating foods rich in antioxidants have shown to improve sperm quality by reducing the damage caused by free radicals. A healthy, balanced diet high in antioxidants is advisable for both partners and can be obtained from eating ample amounts of fruits and brightly coloured vegetables.

Foods such as berries, oranges, plums, grapes, tomatoes, red cabbage, artichokes, carrots, broccoli, spinach, or any dark leafy vegetables are especially rich sources of dietary antioxidants. Garlic, ginger, and dark chocolate are another good source.

Wholegrains, legumes (such as broad beans and soybeans), and healthy fats (mono and polyunsaturated) are also an essential component of a healthy balanced diet. Healthy fats can be obtained from avocados, olives and olive oil, nuts, and seeds (such as flaxseed, walnuts, almonds, sunflower and pumpkin seeds).

Drinking at least one litre of water per day is also recommended and will help to alleviate the common side effect of constipation following IVF drugs.

Exercise for the body and mind

Exercise is useful as it can enhance fertility and help manage any stress you may be experiencing due to reduced fertility or subsequent treatment. 

Now is the time to find a type of movement that you enjoy. 

Try to include a range of activities regularly in your life, including some low impact activities e.g. walking, yoga and pilates.

Preparing for treatment exercise

Get started with supplements

For anyone planning to be pregnant, you should supplement with folate or folic acid and iodine for at least three months prior to conceiving. A prenatal multi-vitamin is a good first step, other supplements are not recommended unless prescribed by your health care professional or you have a specific deficiency. Some people need a higher dose of folic acid because of their medical history, check with your healthcare professional if this applies to you.

Folic Acid (Folate)

Folic acid is important as it can help to prevent neuronal birth defects such as spina bifida. Although folic acid, in the form of folate, can be found naturally in leafy greens, whole grain breads and legumes, to ensure your intake is sufficient it is important to take one 0.8mg folic acid tablet every day for four weeks before you might become pregnant, and continue through to 14 weeks after becoming pregnant.

Iodine

As a baby’s only source of iodine is from the mother, anyone preparing for pregnancy needs to increase their iodine intake to support foetal growth and development, especially the foetal brain. Foods high in iodine include well-cooked seafood, milk, eggs, and some cereals. To ensure your intake is sufficient, it is recommended to take one 0.150mg iodine tablet every day before and during pregnancy, and while breastfeeding. The need for iodine supplements should be discussed with your doctor.

Iron

During pregnancy, the required daily intake of iron is double that needed prior to pregnancy. Eating iron-rich foods such as red meat, dark green leafy vegetables and legumes before pregnancy may be sufficient for some people, while others may require supplements, especially those with anaemia. The need for iron supplements should be discussed with your doctor. 

Calcium

The recommended daily calcium intake is 1,000mg before, during and after pregnancy. This can be reached in most people by consuming four servings a day of dairy products or other calcium rich foods such as calcium-fortified cereal, juice, soy, and rice beverages. If you don’t eat dairy products, a calcium supplement would be recommended.

Multivitamins and antioxidants

There are several commercially available multivitamin and antioxidant supplements specifically for pregnancy preparation. Based on trial analysis, we recommend that anyone with abnormal semen analysis take multivitamins/antioxidant preparations such as CoQ10 or Melatonin supplements for three months prior to starting treatment.

 

Stimulants and drugs

Quit smoking and vaping

It’s no secret that smoking has serious, negative consequences for our health. It’s well documented that smoking may harm an unborn child, but did you know that smoking can also hinder the chances of conceiving? People who smoke are 40% less likely to conceive each month than non-smokers.

The effect of smoking shows adverse effects on sperm concentration and sperm structure, as well as a flow-on effect on the health of children born. The use of recreational drugs, such as marijuana in men, is strongly discouraged, as significant effects on semen are frequently noted.

Smoking is also correlated with decreased egg quality, contributing to an increased incidence of miscarriage, ectopic pregnancy, and premature births. Smoking is especially harmful for anyone with polycystic ovarian syndrome (PCOS) as it exacerbates the symptoms.

If you smoke and are looking to conceive, quitting should be at the forefront of your mind. That’s because cigarette smoke both disrupts hormones and can damage DNA – even light or passive smoking. It limits endocrine function (the system that helps regulate hormones) and is just all-round bad for you.

As far as fertility is concerned, we consider Vaping and e-cigarettes to have at least as many, if not more negative effects on the function of our reproductive organs, as smoking regular cigarettes.  While most of our current knowledge about the adverse affects of Vaping on sperm, egg and uterine function is based on animal experiments, the relevance to human vaping is expected to be equally harmful. 

Even nicotine-free vapes that contain flavours such as bubblegum and cinnamon, have been shown to reduce sperm quality in mice due to the toxic substances created after they have been heated and vaporised.

NOTE: If you are wanting to access publicly funded treatment you must have been free from smoking nicotine for at least three months and illicit drug or alcohol abuse for at least 12 months.

Contact Quitline to get more information or to register: quit.org.nz or call or text 0800 778 778. Quitline also provides subsidised nicotine replacement therapy (NRT). Learn more on how smoking can affect your fertility.

Don’t take drugs

The use of any recreational drugs such as marijuana must be avoided altogether. Using prescribed drugs should be discussed in consultation with your doctor.

Abstain from alcohol

To put it simply, anyone who is pregnant, or trying to conceive, should not consume any alcohol. Research has shown that there is no safe level of alcohol consumption for embryo health.

Limit caffeine

Caffeine is the most widely used social drug and is present in tea, coffee, cola, and chocolate. It reduces the absorption of iron and should only be taken in moderation, for example, one cup of medium strength caffeinated tea or coffee per day.

Holding hands support

Support

Emotional support

Fertility uncertainty and treatment can be stressful and caring for your emotional and physical wellbeing is crucial during this time. Here are some of the ways our experienced counsellors can help:

  • Preparing you for treatments by exploring options, implications, providing coping strategies and practical resources.
  • Supporting you during difficult times when dealing with the emotional impact of treatment.
  • Supporting you during decision-making regarding treatments and endings.

Learn more.

Nutrition and wellbeing support

Repromed fertility Dietitian and Nutritionist Teresa Gudex is available to provide advice that is achievable, backed up by science and highly personalised. Learn more.

Work

Many people ask if they should consider not going to work during phases of treatment. Our recommendation is to avoid, where possible, any activities that you find stressful, so if you find being at work stressful then the answer is ‘yes’. If not, then continue life as per usual, aiming to avoid any undue stress. If you are undergoing an IVF/ICSI cycle, you will need to take off work the day of egg collection and the day after to recover from the procedure.

 

Travel

It is worth being mindful when planning travel that there are countries where Zika has been detected. Click here to read more about Zika virus.


Chemicals

Studies have shown that some chemicals, known as EDCs, can affect our fertility by interfering with the body’s normal endocrine (hormone) function. Click here to read more about EDCs and some simple steps you can take to reduce your exposure.


Genetic screening: VCGS

Prepair genetic carrier screening is a pre-treatment option to test for three commonly inherited conditions; Cystic Fibrosis (CF), fragile X syndrome (FXS) or spinal muscular atrophy (SMA). The test is a saliva sample which is sent to Victoria, Australia for testing, results take approximately two weeks. Your doctor will recommend this test if they think it’s required, or you have a family history of any of the three conditions. It is advised that you are tested and if any of the conditions come back positive for the inherited gene, then your partner would require testing too.

Other helpful links

See the Nationwide Green Cross Health checklist.

Megan Black
Nurse Manager

DipNurs

Megan leads the nursing team through the continually changing face of IVF. She works in a multidisciplinary team, providing the essential organization between the doctors and laboratory and ensuring communication between all departments.

Megan started her IVF nursing career in the United Kingdom, working in two large London clinic’s before returning to New Zealand. She is also the Secretary of Fertility Nurses of Australasia.

I love working with people and see nursing as a vocation, not a job. I usually spend my downtime absorbed in a good book and planning my next travel adventure.