Mediterranean diet and IVF outcomes
Please follow the link to read more about how adherence to the Mediterranean diet is associated with an increased likelihood of achieving pregnancy and live birth after IVF/ICSI treatment Karayiannis and colleagues(2018).
Boosting Nutrition For Fertility
“Thank you to Lisa Donaldson, Accredited Practising Dietitian, for allowing us to share her informative article on boosting nutrition for fertility. Please follow the link to learn more about fertility and nutrition.”
As an Accredited Practising Dietitian I have worked with many couples trying to conceive. Often they are looking for some sort of elusive superfood to eat, to act as a magic bullet to fall pregnant. If only it was as simple as incorporating a new food! A healthy diet is critical though and not just for a week. Good, long-term nutrition in both partners is essential for establishing a healthy environment for a baby to develop and to promote both sperm count and motility. Studies show the ideal BMI to conceive is between 20 and 25. Getting into a healthy weight range is important – and not just for conception, but for pregnancy and the future health of your child.
So let’s take a look at how you can boost your nutrition to improve your chances of falling pregnant!
Basic Nutrition 101
Forget cutting carbs, converting to strict ‘Paleo’ or quitting sugar. Rather than cutting foods from your diet, boost your diet with nutrient dense foods. I’m not talking the food pyramid; rather I am talking about healthy portions of plant foods, lean protein, smart carbs and healthy fat. What does this look like? It’s half a plate of plant food (non-starchy vegetables, or a smaller portion of fresh fruit), a palm sized serve of protein and no more than a quarter plate of smart carbs or starchy vegetables. Amongst all this, a good dash of healthy fat is superb for your reproductive hormones.
1) Eat minimally processed foods – A diet consisting of fresh, unprocessed foods should supply you with all the nutrients you need for healthy reproductive function. Think wholegrains, legumes, fruit, vegetables, lean meat and dairy. Limit your intake of processed foods, high in salt, sugar, saturated fat, artificial sweeteners, flavours and additives.
2) Increase your intake of Omega 3 fatty acids – Omega 3s help regulate the sex glands’ function to produce healthy eggs and sperm. Try to consume at least two serves of low mercury, oily fish* each week (salmon, trout, sardines). Try dressing your salads with flaxseed oil and add a sprinkle of chia seeds to your cereal, smoothies or porridge. Easy!
3) The importance of Zinc – Zinc is absolutely essential to fertility in both men and women. For women, zinc helps mature eggs that are ripe for fertilisation. For men, zinc is necessary for creating the outer membrane and tail of a sperm. Think about sprinkling some pumpkin seeds over a salad, snacking on some Greek yoghurt and enjoying some beef and lamb each week. If you enjoy oysters, they are a superb source of zinc!
4) Consume ‘smart carbs’ – Consuming low GI carbs across the course of the day ensures that you won’t have sudden bursts of insulin that can disrupt a menstrual cycle. Swap all your refined breads and cereals for wholegrain versions. Try oats for breakfast, a wholemeal salad sandwich for lunch, some mashed sweet potato for dinner.
Consuming a healthy diet (as outlined) can make an enormous difference to a couple’s chance of falling pregnant. Making changes for a few days or one week is not enough. It’s about making long-term changes for the health of your reproductive organs and your future child. Swap your packets and tins of food for whole, fresh foods. Be mindful about your intake of Omega 3 fatty acids and zinc, and don’t forget to swap all those refined carbohydrates for wholegrain varieties. It’s about boosting and enriching your diet for the best chances to conceive. It’s also about making a healthier version of you – for life!
Lisa Donaldson APD (nee Simpson)
*Choose low mercury fish http://www.foodauthority.nsw.gov.au/consumers/life-events-and-food/pregnancy/fish-and-mercury-faqs
Read more about nutrition by visiting Lisa’s website:
Lisa Donaldson (APD) – nee Simpson
Adult & Sports Dietitian
4 Kennedy St, Kingston ACT 2604
PO Box 500, Civic Square ACT 2608
Fitness | Education | Energy | Diet
The new buzz word in the world of IVF in recent months is “endometrial scratching”. It has been reported to increase pregnancy rate as much as 20%, according to a recent publication. (1) Suddenly, every IVF patient is asking about endometrial scratching.
So, exactly what is endometrial scratching? Well, it is exactly what it means, gently scratching the lining of the uterus using a fine “pipelle” catheter pass through the cervix. Other terms used are “endometrial scraping” or “endometrial biopsy”.
Endometrial scratching is not a new concept. The experienced gynaecologist would tell you D & C (dilatation and curette) can improve pregnancy rate. The link between endometrial scratching and improve pregnancy rate in subsequent ART (artificial reproductive treatment) was first described more than ten years ago. Cochrane review, considered to be the highest level of research by the medical profession, published in 2012 summarised the currently available evidence on endometrial scratching and suggested that, the procedure doubled the chances of pregnancy and live birth after IVF treatment. The review, however stress that the evidence of benefit was restricted to women who had undergone previous unsuccessful IVF or ICSI cycles.
A recent randomised study published in September 2013 looked at endometrial scratching for all women undergoing ART. Their findings suggest that endometrial scratching done 7 to 14 days before the start of IVF cycle, increase the chance of pregnancy and live birth rate. Clinical pregnancy rate was 49% in the endometrial scratch group and 29% in the sham procedure group. The study was terminated prematurely because of the significant difference in the outcome.
How does endometrial scratching improve pregnancy rate? Researchers can’t tell us the exact mechanism, but we believe it has something to do with improving endometrial receptivity to embryos implanting. By causing an injury to the endometrium, the healing process that follows improves the signalling system within the endometrium, and allowing better synchronicity between endometrium and the implanting embryo.
How is endometrial scratching done? It can be done as outpatient or as an office procedure. A fine pipelle catheter is passed through the cervix and three or four strips of endometrium scraped off. During the procedure, some women might experience period cramps, and oral analgesia such as paracetamol is advisable. However, in majority of cases, the procedure is tolerated very well.
Finally, a word of caution for women considering the procedure, will it work for me? In the study published in September, the women studied were all under the age of 38. So, outcome for the older age group women is unknown. The study shows improvement in pregnancy rate from 29% to 49%. At Genea, our pregnancy rate is 46% for women under 38 (2011 internal data). Will addition of endometrial scraping further improve our pregnancy rate? Only time will tell, as fertility doctors move into a new era of performing routine endometrial scratching before the start of IVF treatment.
1: Endometrial scratching performed in the non-transfer cycle and outcome of assisted reproduction: a randomized controlled trial. C. O. NASTRI, R. A. FERRIANI, N. RAINE-FENNING & W. P. MARTINS. Ultrasound Obstet Gynecol 2013; 42: 375–382