According to the National Conference of State Legislature, the average IVF cycle can cost anywhere from $12,000 to $17,000, not including medication. Once medication is factored in, one cycle can cost closer to $25,000. The success rates for IVF are 25.1% for maternal ages 38-40, and 12% for ages 41-42, according to data from the Society for Assisted Reproductive Technology.

In addition to this financial commitment and low success rates, the side effects of IVF should not be taken lightly and can span from pain at the injection site, to nausea, changes in cervical mucus, and ovarian hyperstimulation which may require immediate medical attention.  

Needless to say, the choice to pursue IVF is one that should not be taken lightly.

In this article we will break down everything you need to know about how IVF works, how to know if you are a good candidate for IVF, and how to improve success rates of IVF. 

What is IVF? 

IVF, or in vitro fertilization, is a fancy term for fertilizing the eggs outside the body (in a laboratory) and placing the resulting embryo back inside the uterus to achieve pregnancy. This is in contrast to in vivo fertilization, which is the usual birds-and-bees method of getting pregnant (in vivo meaning inside the body; in vitro meaning outside the body). You’re probably pretty familiar with how in vivo fertilization works ;), so let’s move right along to more about the eight steps of IVF:[1]

1. Birth Control or Estrogen: Before your eggs can be retrieved, your provider will likely place you on hormonal birth control to regulate your cycle and maximize the number of developing follicles (which house your eggs). The more eggs you have to work with, the higher your chances of pregnancy.
2. Ovarian Stimulation: In a regular, non-IVF menstrual cycle, estrogen stimulates multiple follicles to develop, but only one matures and is released at ovulation while the others shrivel up. But during IVF, you’ll inject hormones that stimulate the development of multiple mature eggs. This stage lasts 8-14 days, until your follicles are deemed ready for final maturation and retrieval.
3. Sperm Collection: Your partner’s or donor’s sperm can either be collected through masturbation or a quick sperm retrieval procedure.
4. Egg Retrieval: 36 hours before retrieval, you’ll inject a “trigger shot” that stimulates final maturation of your eggs. At your egg retrieval appointment, your eggs will be extracted using a thin needle and placed in an incubator.
5. Fertilization: Your incubated eggs will be injected with the collected sperm. Mature eggs have a 70% chance of becoming successfully fertilized.
6. Embryo Development: The fertilized eggs (called embryos) are monitored to ensure they are developing properly and will be able to survive the transfer into your uterus. Typically, 50% of embryos will be suitable for transfer.  
7. Embryo Transfer: Before the embryo can be transferred, you must take oral and injectable hormones to prepare your uterus for implantation. When your uterus is ready, the embryo(s) is injected into your uterus through your vagina.
8. Pregnancy! 9-14 days after the transfer, your provider can test for pregnancy. Several factors can influence your chances of pregnancy, which we’ll review a bit farther down.

Is IVF for Me? 

IVF is most commonly recommended for people using a donor or surrogate, or with one of these conditions:

• Endometriosis
• Damaged fallopian tubes
• PCOS
• Uterine fibroids
• Low sperm count
• Unexplained infertility

While IVF can be a great option for those struggling to conceive, it’s important to recognize that, in most cases, it should not be warranted as a first intervention. While structural issues with the reproductive system cannot be altered with lifestyle modifications or medication, hormonal issues like PCOS, luteal phase deficiency, estrogen dominance, and low sperm count can be! Even if you ultimately decide to use IVF, there are plenty of things you can do to improve your chances of success before you start.

The Problem with IVF

As mentioned in the opening paragraph, IVF is a serious financial commitment with a very low success rate, adds serious strain to a marriage or relationship, and can have serious side effects. So why is IVF the first intervention recommended after a couple has tried for one full year without success, often on their own without guidance? Shouldn’t other options be thoroughly considered and supported during this first critical year of TTC to either avoid IVF completely or improve success rates?

This is where Functional Fertility outperforms a standard approach to fertility.

Influential Factors for Success

There are several important factors that influence whether or not IVF is successful, including your age, the number of times you have given birth or been pregnant, if you are using your eggs or a donor’s eggs, your current health conditions, and what your causes of subfertility are. Many of these are things you can’t change, but you can make changes in your diet and lifestyle prior to an IVF cycle that can have some serious improvements in your outcomes including:

• improving egg and sperm quality
• Increasing the number of eggs retrieved
• improvement in uterine lining health which increases implantation success
• optimizing thyroid levels from the “normal” ranges to OPTIMAL ranges
• improving adrenal health (i.e. your stress response)
• and more

These improvements are only able to be addressed when you take a step back from the “hurry up and do IVF before my eggs dry up” point of view (often exacerbated by your doctor) and play a  vital role in fertilization and embryo development success.

It takes three months – that’s right, three months! – for your eggs to fully mature before ovulation (and a little less for sperm). This means that any lifestyle improvements you make today won’t have much effect on your eggs until three months down the road.  Hence, why my Fertility Unlocked Program is three months long 😉 So if you’re considering IVF, don’t wait until the process has started to make those changes.

But what changes should you even make?

It all comes back to your root causes (take our free root cause quiz here).

So…Where Do I Begin?

• Find what is stressing your hormones! This is really the foundation of my Fertility Unlocked Program. If we can find what is throwing your hormones out of whack, we can begin to address the root causes of subfertility. This could be lack of sleep, a stressful work environment, suboptimal thyroid functioning, estrogen dominance, a nutrient poor diet, insulin resistance – whatever the cause, we’ll need to take a deep dive into your hormones to optimize fertility.
• Get a FULL thyroid panel done.Women with high-normal quartile TSH were significantly more likely to be primary subfertile (P = 0.01), with a higher prevalence of unexplained subfertility and with 15% fewer live births after IVF compared to lower TSH quartiles (P = 0.02). In conclusion, primary subfertile women predominate in the high-normal TSH quartile, associated with significantly fewer live births in a subgroup of primary unexplained subfertile women (9%; n = 87/949), while in secondary subfertile women, dominated by male factor subfertility, high-normal TSH is associated with more live births. [7] Additionally, many studies have linked the presence of TPOAb (an antibody to the thyroid found in Hashimoto’s – the #1 form of thyroid disease in women) to adverse maternal and fetal outcomes in pregnancy, in particular miscarriage and pre-term birth, even in the absence of thyroid dysfunction. [8]
• Support higher-than-normal Vitamin D levels. A prospective study of 173 women undergoing IVF in Toronto revealed that women with sufficient vitamin D levels (> 75 nmol/L) had significantly higher pregnancy rates in IVF than women with insufficient levels (>75 nmol/L). Women with sufficient levels had a 52.5% clinical pregnancy rate compared to a 34.7% rate among those with insufficiency. [9]
• Get a sperm analysis. Don’t assume that a normal sperm analysis (SA) gives you the green light. A standard sperm analysis does not test for DNA fragmentation, which is the sperm that are damaged or broken. The higher the fragmentation, the higher the sperm carrying genetic damage, the higher the chance of pregnancy loss.[2] What’s more, just like other testing in the fertility world (thyroid, insulin, AMH, etc.), a “normal” sperm analysis does not mean OPTIMAL.
• Plan three (or more) months in advance. By taking this time now you are saving yourself a possible 2nd (or 3rd, 4th, or 5th) round of painful needles, hormone exposures, and a whole heck of a lot of money.
• Eat a nutrient-dense diet to optimize egg and sperm quality. The MACROtrio diet – a balance of protein, carbs, and fat at every meal – is designed to support healthy blood sugar, reduce damaging oxidative stress, and improve hormone imbalances, all of which contribute to fertility.
• Take your vitamins!
  • • • Melatonin might be best known for helping you sleep, but its high concentration in the ovaries acts as powerful antioxidant, protecting eggs from oxidative damage, promoting follicle formation, and supporting successful fertilization.[3]
      • CoQ10 is another potent antioxidant that has been shown to increase rates of pregnancy in women undergoing assisted reproductive technologies (like IVF) and may protect against egg damage associated with aging.[4,5] If you are 35 or over, this supplement is especially important as IVF success rates are influenced by maternal age.[1]
      • Vitamin A is necessary for sperm production, egg development, and successful embryonic development. [6] However, high doses of vitamin A can lead to birth defects, so stick to the amount provided in your prenatal and what you consume through your diet.

Deciding whether or not to pursue IVF is a difficult choice. While the outcomes can be wonderful for you and your growing family, the process can be physically and emotionally challenging. Remember, IVF is not a guarantee and should not be used as a first intervention. If you decide that IVF is the best path for you, set yourself up for success as best you can by supporting your hormones and egg production with a nutrient-dense diet, high quality supplements, and stress-relieving activities.

Affiliate Disclaimer: This post may contain affiliate links which means, to no extra cost to you, I would make a small fee if you use them.  

Citations

[1] https://my.clevelandclinic.org/health/treatments/22457-ivf

[2] Borini A, Tarozzi N, Bizzaro D, et al. Sperm DNA fragmentation: paternal effect on early post-implantation embryo development in ART. Hum Reprod. 2006;21(11):2876-2881. doi:10.1093/humrep/del251.

[3] Guo YM, Sun TC, Wang HP, Chen X. Research progress of melatonin (MT) in improving ovarian function: a review of the current status. Aging (Albany NY). 2021;13(13):17930-17947. doi:10.18632/aging.203231

[4] Florou P, Anagnostis P, Theocharis P, Chourdakis M, Goulis DG. Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. J Assist Reprod Genet. 2020;37(10):2377-2387. doi:10.1007/s10815-020-01906-3

[5] Ben-Meir A, Burstein E, Borrego-Alvarez A, et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. 2015;14(5):887-895. doi:10.1111/acel.12368

[6] Clagett-Dame M, Knutson D. Vitamin A in reproduction and development. Nutrients. 2011;3(4):385-428. doi:10.3390/nu3040385

[7] Repelaer van Driel-Delprat CC, van Dam EWCM, van de Ven PM, Aissa K, Ter Haar MK, Feenstra Y, de Roos A, Beelen G, Schats R, Lambalk CB. Thyroid function and IVF outcome for different indications of subfertility. Reprod Fertil. 2021 Oct 15;2(4):280-291. doi: 10.1530/RAF-20-0065. PMID: 35118405; PMCID: PMC8805483.

[8] Dhillon-Smith RK, Coomarasamy A. TPO antibody positivity and adverse pregnancy outcomes. Best Pract Res Clin Endocrinol Metab. 2020 Jul;34(4):101433. doi: 10.1016/j.beem.2020.101433. Epub 2020 Jun 18. PMID: 32883611.

[9] [CMJ Open, 2013 Jun 28;1(2):E77-82].