Do's and Don'ts During the Two-Week Wait After Embryo Transfer
Transfer Day is an exciting and hopeful point on your fertility journey, but the two-week wait that follows can be a challenging period filled with stress, anxiety and impatience. To help you make the most of this crucial time, we consulted with Monika and Mel from our amazing IVF team. They shared some important do's and don'ts to help you through the two-week wait post embryo transfer.
❌Don't Google - Trust Your Medical Team for Guidance
We know it’s tempting, but one of the most common instincts during the two-week wait is to turn to Google for answers and reassurance. However, this can lead to unnecessary stress and confusion. Remember your fertility journey is unique to you and best understood by your medical team. Rely on their expertise and guidance to ease your concerns and not Dr. Google.
✅Follow Medication Instructions
Unless instructed otherwise by your doctor, make sure to continue your medication regimen. Medications like progesterone help support embryo implantation. Consistency in following your doctor's orders is key to your success.
❌Don't Take a Pregnancy Test
It's natural to be anxious and eager to confirm a positive outcome, but taking a home pregnancy test too early can be inaccurate and potentially lead to disappointment. These tests may show a negative result because it's too soon to detect the necessary hormone levels. Or, in some cases, they might show a positive result, but the pregnancy may not continue to develop as expected. Instead, wait for the blood test, which provides more accurate and reliable results.
✅ Rest on Transfer Day, but Stay Active
While it's important to take it easy on the day of the embryo transfer, this doesn't mean you need to spend the entire two weeks in bed. Light activities such as walking can actually help boost blood flow, potentially benefiting the implantation process.
❌ Don’t Have Sexual Intercourse
To support the best conditions for the embryos to implant, refrain from sexual intercourse and orgasm during the two-week wait. This helps prevent uterine contractions that may interfere with the process.
✅ Do Delay Having a Bowel Movement
After the embryo transfer, it's wise to avoid any activities that might strain the pelvic area, including pushing during a bowel movement. Wait for about 5 hours before trying to have a bowel movement.
❌ Don't Drink Alcohol
During this critical period, it's best to maintain a healthy lifestyle, including your diet. Avoiding alcohol and focusing on a well-balanced diet is essential.
✅ Try to Relax and Manage Stress and Anxiety
Stress and anxiety are natural during the two-week wait, but managing these emotions is crucial. Consider relaxation techniques such as acupuncture, yoga, journaling or simply pampering yourself. A calm mind supports your fertility journey.
Always remember to follow the specific instructions provided by your dedicated care team. They are here to support and guide you through this journey. You're not alone, and we're here for you every step of the way.
For any concerns or questions, don't hesitate to reach out to our team. We're here to provide the care and assistance you need.
Patient Story- Breda
“Not everyone will understand IVF or be able to relate, so it’s important to surround yourself with support. More people than you realize struggle with infertility.”
Today’s patient story is from Breda. After not finding success or feeling comfortable at another fertility clinic, Breda came to us. We are all glad she did! Dr. Miller was able to diagnose her with endometriosis and after surgery and IVF, she was able to get pregnant. Breda is due in January!
Breda writes:
I met my husband later in life and we got married when I was 38. I was and still am wary of the stigma of older mothers, even though being older is accepted. I’ve always wanted a family and we started trying right away, but I had three miscarriages in a year and a half. I was at a different fertility clinic for a year, but didn’t feel comfortable there. My husband’s colleague recommended we see Dr. Miller and what a difference!
We first met online during COVID and Dr. Miller told us, “You’ll be a mother, kiddo.” He was so kind, didn’t rush us, and he explained everything. He learned I was an English teacher and told me a story that put me at ease. He never stopped his storytelling, and I welcomed his personable demeanor after some bad experiences at the previous clinic. Dr. Miller found issues that the previous doctor did not, including endometriosis.
After a biopsy, Dr. Miller found abnormalities in my uterus and I was diagnosed with Level 1 endometriosis. During surgery, he removed five spots on my uterus. I also had the Endometrial Receptivity Assay biopsy to determine the receptivity of the uterus to implantation. Soon after, we had an egg retrieval and two transfers.
Throughout this process, Dr. Miller and his staff explained everything so thoroughly and never seemed irritated or disinterested when I had questions. I also got to know Dr. Miller and the nurses because they talked to me during appointments. I always felt people cared and were invested in our success. I felt so secure going into our procedures and never felt anxiety or stress visiting the office.
Even though our first transfer failed, a second embryo implanted and I will never forget that experience. Dr. Miller, Courtney, and Melody were present for the transfer, and made me feel so comfortable. Dr. Miller even told us a funny story about meeting an actor from Will & Grace. While we waited after the transfer, my husband and I held hands and prayed, and we also talked about how wonderful it would be if it worked. Many times, we dreamed of finishing our nursery and being able to move forward with our plan. The transfer worked, and our baby is due January 8, 3.5 years after we began IVF and what seems like a million doctor appointments.
I was very nervous the first 12 weeks of my pregnancy and braced myself for bad news, but at every ultrasound Courtney reassured me with her positivity. We are so grateful for everyone at the Naperville office.
It took until I was about 20 weeks pregnant for me to relax and realize we’re finally going to be parents! I’ve cried many happy tears for a change! Not everyone will understand IVF or be able to relate, so it’s important to surround yourself with support. More people than you realize struggle with infertility. Meditation and journaling are helpful (as well as long walks with our dog, my first baby). Finally, never stop hoping and praying, even if you’re an older mother!
Patient Story- Molly
“We have been so blessed that I know all the pain and suffering we endured was worth it.”
We’re featuring Molly’s story today! Molly’s story is unique because she was diagnosed with unexplained infertility. This is a tricky diagnosis, because even after testing a cause cannot be determined. When this is the case, there is a lot of trial and error in order to achieve pregnancy. But as Dr. Miller always says: “Trust the process.” That’s just what Molly did and now she has two beautiful sons. Read her story below.
I first became a patient of Dr. Miller’s in 2012 when I had a myomectomy, a surgical procedure to remove uterine fibroids. After getting married and trying for several months to get pregnant, a co-worker suggested I see Dr. Miller, but this time as a fertility specialist. At our first appointment, Dr. Miller ordered blood work and a hysterosonogram which is an ultrasound exam that provides images of the inside of the uterus to help diagnose the cause of abnormal vaginal bleeding. However, everything came back fine. I was told I had unexplained fertility. This wasn’t the news I wanted to hear! It would have been easier to have a specific reason for why I could not get pregnant.
I was put on medication for thyroid and prolactin issues. After a month on the medication, it was advised we try an IUI. We failed all three attempts. Dr. Miller said IVF would need to be our next step. Soon after, my retrieval resulted in 26 eggs! My husband and I were so excited, our dream of having a baby was one step closer.
However, we were unable to do a fresh transfer at that time because I was borderline for Ovarian Hyperstimulation Syndrome (OHSS). This occurs when a woman’s ovaries swell and leak fluid into the body. This condition is temporary and occurs in less than 5% of women who receive fertility treatments. Instead, we ended up freezing 8 embryos. About two months later one embryo was successfully transferred. It was a strange feeling, because I was so happy and terrified at the same time.
After graduating from Dr. Miller’s office, my OB/GYN monitored me closely and that little embryo was born at 34 weeks gestation. Again, I was happy and terrified at the same time. Thankfully our little boy was healthy and strong.
After our son turned 18 months, we decided to start the process to have another child. We decided to follow the same protocol as before and do a transfer in three months. Unfortunately, it failed. After meeting with Dr. Miller again, he advised us to do a trial cycle with an Endometrial Biopsy (EMB). An EMB tests whether the uterine lining is preparing itself adequately for implantation of the embryo. If the lining is out of phase, it can prevent implantation from occurring or result in an early miscarriage. Because the results of my EMB were abnormal, I was treated with progesterone. The following month we had another transfer and it was successful! We welcomed our second baby boy this June./p>
Our two little boys are thriving! We are so happy we found Dr. Miller and are so grateful for everyone in the office as well as Dr. Deutch who did our last transfer. Our advice to other couples going through infertility is to know that you are strong, brave and deserve to be parents. Don’t ever give up! We have been so blessed that I know all the pain and suffering we endured was worth it.
COVID-19 Update (April 2, 2020)
COVID-19 and Fertility: Update
[PLEASE SEE OUR APRIL 2 UPDATE ON THIS]
These are the most recent recommendations from the American Society of Reproductive Medicine (ASRM). I have spoken with a number of reproductive endocrinologists in the area as well as Lisa Ray, our embryology director. I do realize that there are 9 cases in China where women diagnosed with coronavirus did have successful pregnancies. Unfortunately, the numbers are too small to ultimately know the risk to mother and baby with this novel coronavirus.
Therefore, based on ASRM’s recommendations, the discussion with my peers and my own concerns with potential risks in pregnancy (i.e. heightened risk to the mother of coronavirus due to pregnancy and the potential problems with diagnostic studies and treatment, if a pregnant woman has severe complications due to Coronavirus), at present, our team is proceeding as follows:
- Patients on Clomiphene Citrate and gonadotropins should stop their cycle and not attempt pregnancy either via inseminations or timed intercourse. However, if the couple is inclined to proceed with cycle completion (inseminations and timed intercourse), they must sign a waiver stating that they understand the unknown risk to mother and baby in regards to the virus. Otherwise, the cycle will be cancelled. No new cycles with Clomiphene Citrate and gonadotropins will be initiated.
- Women who are currently undergoing IVF stimulation can proceed with their cycle. We do recommend a freeze‐all with the caveat that fresh transfer can be considered if it is deemed that freezing of the embryos/eggs would be detrimental to successful pregnancy. Once again, a waiver must be signed stating that at present, the risk of subsequent transfer of coronavirus-infected embryos/eggs, although believed very low, is ultimately unknown to mother and baby. Furthermore, it must be understood that these cycles may be stopped at any time given further recommendations from the ASRM.
- Because of the anticipated increase in the coronavirus, the ASRM has recommended that no new stimulations be started. However, as this is solely a recommendation, for the immediate future, we will continue to evaluate stimulation starts on an individual basis; again, with the recommendations as outlined above (i.e. freeze‐all of embryos/eggs, waiver must be signed, cycles may be stopped, etc.). Please contact our office regarding your individual cycle concerns.
- In regards to patients who already have frozen embryos and wish to proceed to frozen embryo transfer and are currently on medication, once again, the risk of pregnancy in a patient who is positive for Coronavirus is unknown. Therefore, our recommendation is to not proceed at present. However, if a couple wishes to proceed, they need to be aware that we will support them in their decision, but will require them to sign a waiver. This decision could change at any time.
Thank you,
Charles E. Miller, MD FACOG
ASRM Issues New Guidance on Fertility Care During COVID-19 Pandemic: Calls for Suspension of Most Treatments
3/18/2020 The American Society for Reproductive Medicine (ASRM), the global leader in reproductive medicine, today issues new guidance for its members as they manage patients in the midst of the COVID-19 pandemic. Developed by an expert Task Force, of physicians, embryologists, and mental health professionals, the new document recommends suspension of new, non-urgent treatments.
Specifically, the recommendations include:
- Suspension of initiation of new treatment cycles, including ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF) including retrievals and frozen embryo transfers, as well as non-urgent gamete cryopreservation.
- Strongly consider cancellation of all embryo transfers, whether fresh or frozen.
- Continue to care for patients who are currently ‘in-cycle’ or who require urgent stimulation and cryopreservation.
- Suspend elective surgeries and non-urgent diagnostic procedures.
- Minimize in-person interactions and increase utilization of telehealth.
The above recommendations will be revisited periodically as the pandemic evolves, but no later than March 30, 2020, with the aim of resuming usual patient care as soon and as safely as possible. ASRM has been closely monitoring developments around COVID-19 since its emergence. Data on its impact on pregnancy and reproduction remains limited. However, the task force used best available data, and the expertise and experience of the members to develop the recommendations. Until more is known about the virus, and while we remain in the midst of a public health emergency, it is best to avoid initiation of new treatment cycles for infertility patients. Similarly, non-medically urgent gamete preservation treatments, such as egg freezing, should be suspended for the time being as well. Clinics who have patients under treatment mid-cycle should ensure they have adequate staff to complete the patient’s treatment and should strongly encourage postponing, the embryo transfer.
Catherine Racowsky, President of ASRM, noted, “ASRM is striving, as we always do, to ensure our members have the very best information available as they care for their patients. We are all facing a great deal of uncertainty, but we do know our health care system is about to be stressed in a way it has never been stressed before. Only by working together medical professionals, patients, citizens of an inter-connected world, can we hope to meet this latest challenge.”
Ricardo Azziz, CEO of the ASRM stated, “This is not going to be easy for infertility patients and reproductive care practices. We know the sacrifices patients have to make under the best of circumstances, and we are loath to in add, in any way. to that burden. And it will not be easy for our members. The disruption to routines, the stress on staff members and the very real prospect of economic hardship loom large for ASRM members all over the world. But the fact is that given what we know, as well as what we don’t, suspending non-urgent fertility care is really the most prudent course of action at this time.”
Dr. Racowsky added, “We should recognize that the situation on the ground is fluid, and as such we will continue to revisit and review our recommendations at least every two weeks, to provide providers and their patients with the best information and support we possibly can.”
For almost a century, the American Society for Reproductive Medicine (ASRM) has been the global leader in multidisciplinary reproductive medicine research, ethical practice, and education. ASRM impacts reproductive care and science worldwide by creating funding opportunities for advancing reproduction research and discovery, by providing evidence-based education and public health information, and by advocating for reproductive health care professionals and the patients they serve. With members in more than 100 countries, the Society is headquartered in Washington, DC, with additional operations in Birmingham, AL. www.asrm.org
A Note About COVID-19 From Dr. Miller
Please see our 3/18/20 update about COVID-19 and fertility treatments.
Dear All,
Fertility preservation for cancer patients required to be covered by insurance under new Illinois law
This past Monday, Governor Bruce Rauner passed a bill (House Bill 2617) that will require health insurance companies in Illinois to cover the preservation of eggs, sperm and embryos for patients with cancer and certain other diseases.
In my years of practicing medicine, there have been many evolutionary advances, which have enhanced patient care; none more important than the birth of the first IVF baby in July, 1978. In addition, there have been seminal events that have transpired to aid our patients in their quest to conceive. For example, in our state, the Illinois Family Building Act of 1991 mandated fertility coverage for our patients. Monday’s groundbreaking event marks yet another occurred.
In my role as consulting reproductive endocrinologist of Advocate Lutheran General Hospital's Hematopoietic Progenitor Cell Transplantation (HPCT) program, I’ve had the great honor to provide egg cryopreservation services to patients newly diagnosed with various forms of cancer. At a time when patients are wrapping their heads around a new found diagnosis, deciding on medical or surgical treatment, the thought of fertility cryopreservation, which must be completed within weeks of their diagnosis, adds yet another burden to this very daunting and difficult time. Add to this, considering payment for services, even though markedly reduced, makes the situation even more problematic. With the implementation of this bill, we can take the concern of cost off of the patient’s very full plate and provide the most advanced care as possible to enable their future miracle.
This bill includes the following passage:
“Amends the Illinois Insurance Code to provide that a policy of accident or health insurance shall provide coverage for medically necessary expenses for standard fertility preservation services when a necessary medical treatment may directly or indirectly cause iatrogenic infertility to an enrollee. Defines ‘iatrogenic infertility’.”
In my interpretation of the above, it would appear that patients will now have insurance coverage for egg freezing when there is potential impact of ovarian function secondary to ovarian cysts, especially cysts of endometriosis (endometriomas) or the resultant necessary surgery.
I salute our state legislature and the governor for passing and signing this bill. I congratulate the patient and patient advocacy groups for their efforts in raising the consciousness of our state government. It is truly inspiring.
Keeping Hope Alive: My Infertility Journey
In 2009, I married my best friend. Joe was loving, fun, a protector and my perfect match. He loved going out, being social and living in the moment. He was okay to never commit or have children. But that all changed when he met me.
One warm April day I got in a car accident. Joe was the responding officer, and he wrote me a ticket! But Officer Joe saw me in distress and panic, and offered to drive me home. Talking about where I was headed, we quickly learned that we had mutual friends at the restaurant where I worked. Let's just say these friends made this relationship happen.
Over the next few months of dating, I learned Joe had testicular cancer years ago and was already in advanced stages when he found out. He quickly had surgery and started chemotherapy a few weeks later. His family encouraged him to bank his sperm, but his doctor assured him the type of chemo he was using would not affect his fertility. Since Joe always planned to be single and never have children, there was no need to bank. But when he met me in 2005, I told him on our first date that it was my dream to have children. Needless to say, he changed his mind and wanted a child just as much as me.
Fast forward to September 2009: beautiful wedding, perfect life. We decided to start trying for a child in 2010. First month, nothing. Next month, nothing. 12 months later, nothing. We decided to get help. I scheduled an appointment with my ob/gyn and had tests conducted in November 2011 that determined I was not ovulating on time. He also wanted me to have a scan.
Concurrently, Joe's doctor wanted him to complete a sperm analysis. The office called and left a message saying that "everything looked good." During my scan, they determined I had what is called a septate uterus. Which means my uterus had tissue that divided it and that makes it difficult for an embryo to implant. My ob/gyn wanted to schedule surgery to cut the excess tissue out. Joe and I decided we needed a second opinion so we called a fertility specialist.
When we were meeting with the doctor, he turned to Joe and asked for the results of his sperm analysis. Five minutes later, a nurse retrieved our results and our world was rocked. Joe's analysis stated he had ZERO sperm. He wasn't okay. Our minds were blown to say the least. Then he asked us if we were open to adoption because we could never have children. We stood up crying in disbelief and left the office.
After doing some research and talking with my cousin who was an ob/gyn doing her fellowship in fertility, she recommended we visit a urologist and see if there was a way to "go in and get them". After seeing three different urologists over the course of four months, Joe had to start taking injections to prep for the TESE surgery in which sperm is surgically removed. Wouldn't you know in this six month span, our fertility specialist retired? Now we had to find a new one.
We were referred to Dr. Miller at the Advanced IVF Institute by many friends. They talked about everyone from the receptionists, nurses, and doctors. "They work miracles there," they said. Our first appointment with Dr. Miller was in late March of 2012. He looked over our file and said, "We are going to get you pregnant." He prepped us on the schedule of everything, including surgery to remove the septum and coordinating with the Urologist to prep Joe for surgery. Joe and I left the office that day smiling over our infertility struggle for the first time in two years.
In July of 2012, I had my surgery to remove the septum from my uterus. Everything went as planned and we were ready to proceed with ICSI, a type of in-vitro fertilization where a single sperm is injected into an egg. Over the next few months we had countless appointments with both Dr. Miller and the Urologist out of Northwestern. We had to wait for Joe to be at a certain level of testosterone in order to do surgery.
Fast forward a few months, and the doctor stated we were at the highest level he would ever be. It was time to start prepping me for my egg retrieval AND choose an anonymous donor sperm just in case Joe's surgery wasn't successful. Because we knew the TESE surgery was only a 50/50 shot, we had to have donor vials waiting after the retrieval. This was a huge obstacle as Joe was not sure how he felt about using donor sperm.
Over the next few weeks, I mulled through the cryobank checking for common traits and examining the donors’ health records. Finally, I found the perfect one! In April of 2013, my eggs were retrieved in Dr. Miller's office, while Joe was in the next room having TESE surgery.
After we both woke up, Dr. Miller informed us my retrieval was very successful and they retrieved 19 eggs. However, the Urologist did not have any good news. Joe had ZERO sperm, and they believed he may have been born infertile, so the donor sperm was used. Our worlds were rocked again! Days after the surgery, I ended up hyperstimulating and they had to cancel my transfer because of the swelling. However, the good news was we had 14 embryos fertilized. We were informed about the freezing process and discussed that many embryos would not mature normally to the freezing process at five days. We did and ended up with six viable embryos.
The following month, once again I was prepped for a transfer through hormones and many doctors’ appointment. Five days before my transfer I went in for the final check to start the progesterone shots. What the doctor and nurses told me was startling. My uterus was full of fluid and they had to once again cancel my transfer. Two weeks later, I went back to Dr. Miller and he did a quick procedure to ensure the septum wasn't growing back. It appeared that it was, so he once again scraped it out.
Unfortunately, this prolonged the next transfer. We had to wait until October to transfer our frozen embryos. We waited anxiously for the date, and began prep. Our transfer finally occurred on November 2, 2014. Two embryos survived the thaw and were implanted. I was over the moon!
Ten days later, I returned to the office for my pregnancy blood draw. I went to work that day like it was any other day. I knew my nurse usually called me around 1:30 pm with my results from the mornings' tests. At 1:32, my phone rang. It was my nurse and she didn't sound positive... She told me that I wasn't pregnant... I quickly gathered my belongings and called my principal to get me a substitute. Then I ran out of my building and got in my car sobbing and shaking. I called my husband and he assured me it was going to be okay. This just wasn't our time, but that time would come.
The next day, I returned to the clinic for more testing. Again, not pregnant. Joe and I met with Dr. Miller a week later to discuss the failed cycle. Without genetic testing, the most likely reason for implantation failure is a genetically abnormal embryo. We decided that we would try again. Before we did though, he wanted to check my uterus for scar tissue from the surgery. 4 weeks later and another quick procedure, we got the clearance to begin our next cycle. On February 16, 2015, Joe and I entered Dr. Miller's office. We laughed and talked to our nurses and they comforted us in the situation. And then they transferred 2 more embryos while I was put under.
The next ten days waiting to do my pregnancy bloodwork were the longest days of my life. Joe and I were building a house at the time, so we tried to keep ourselves busy. Then on February 26th, I entered the office for my bloodwork. I continued to work as always, but I asked my nurses not to call me until after school. Every five minutes though, I kept checking my phone. The dismissal bell rings at 3:15pm At 3:14, I saw my phone light up... the bell hadn't rung and my students were cleaning up and organizing to leave for the day, but I couldn't miss this call.
I picked up the phone and I heard Patty's voice. "Danielle." I quickly asked her to hold on... the bell rang, I said goodbye to my students and picked up the phone. "Danielle... you are pregnant!" I heard all the nurses on speakerphone yelling and praising our pregnancy and actually felt emotions from each and every one of them coming through the phone. I almost think there were as many tears of joy happening in Dr. Miller's office as I had spewing down my face!
Over the next two weeks, I went in multiple times to assure my hormone levels were rising, and they were. Finally two weeks after we initially found out we were pregnant, we had our first ultrasound to confirm pregnancy and how many embryos took. The ultrasound technician confirmed one embryo implanted, and then we heard the heartbeat for the first time!
Our sweet girl, Elia Meadow, was born in October of 2015, four weeks early. While she had to spend a week in the NICU at the hospital, she was perfectly healthy. We were so in love with our miracle girl.
We are forever grateful for the love and support we received from Dr. Miller and the members of his team. After so many years and tears, his team made our dream a reality. There were so many times we thought we had to give in to our dream of having children, but they kept our hopes alive. Our nurse, Patty, was an absolute dream to us. I truly feel that they are just as excited as Joe and I are to have our sweet little girl. We truly believe that without the help of Dr. Miller and all his staff, we would not have our miracle baby in our arms.
Keep hope in your journey, as Dr. Miller and his team did for us. You too, can share your story one day and give hope to those who are facing infertility struggles. Thank you Dr. Miller, Patty, our nurses, and all of the staff. You have made our dreams come true with our sweet girl!
-Danielle
The Fertility Diet: Can It Boost Your Fertility?
A healthy fertility diet is one of the first things I mention when couples ask about what they can do to help achieve pregnancy. For that reason, I was interested in an article USA Today published last week discussing the fertility diet. It’s a plan based on research from the Nurses’ Health Study, one of the largest and most comprehensive studies on women’s health.
For years, I have been telling my patients to follow a diet high in protein, vegetables, fruits and iron, and low in fat and carbs. The fertility diet goes into more detail, which I certainly do not disagree with.
The study detailed steps for improving fertility through changes in diet, weight and activity for women with ovulation-induced infertility.
Here is a list of the top 10 recommendations from the fertility diet:
- Avoid trans fats. Eating trans fat raises the level of your LDL (bad) cholesterol, according to the Food and Drug Administration. It’s one of the reasons the FDA has ordered food manufacturers to phase them out.Trans fats are found in fried foods (like french fries) and in baked good (like cookies and cakes).
- Consume more unsaturated vegetable oils. Monounsaturated and polyunsaturated may help improve your blood cholesterol, according to the American Heart Association. Add more olive oil and canola oil to your diet, and try to consume healthy fats from foods like fish and avocados.
- Get more protein from vegetables. Instead of a serving of steak, consider a serving of lentils.
- Eat slow carbs. Choose whole grains, oatmeal and vegetables, which are not highly refined, over carbs like white bread and pasta, which can increase ovulatory infertility (meaning irregular ovulation or lack of ovulation).
- Make it whole milk. If you’re trying to get pregnant, a fertility diet consisting of whole-fat diary is the best choice. Opt for whole milk over skim, and enjoy a small dish of ice cream or full fat yogurt each day.
- Take a multivitamin. Folic acid (400 mcg) and vitamin B are essential. The CDC says folic acid helps prevent birth defects.
- Don’t neglect iron intake. Get plenty of iron, but not from red meat. During your fertility diet, eat vegetables high in iron, like spinach, and consider taking an iron supplement.
- Drink water. Skip the soda. Everything else (coffee, alcohol) in moderation.
- Get to a “fertility zone” weight. Being in the “fertility zone” means achieving a BMI of 20 to 24. Weighing too much or too little can affect your menstrual cycle.
- Be active. If you don’t exercise regularly, starting a workout plan could help your fertility. If you’re already active, be careful not to overdo it. According to Resolve, low body fat can affect ovulation and fertility.
The number one recommendation listed is for the use of trans fat to be drastically reduced and I must stress how important that is. I become especially concerned with a diet of excess fat and carbs when women have a hormonal imbalance related to polycystic ovary syndrome (PCOS).
I am somewhat surprised, however, with the recommendation of whole milk in the fertility diet, given the increased fat content. While it probably does not impact the normal female attempting fertility, it could have a negative effect on patients with PCOS. Dairy may even have a negative effect on endometriosis.
The PCOS patient may not only be impacted by the high fat in dairy but also by the sugar content as well. Women with PCOS have hyperinsulinemia (thus metformin is helpful). The high sugars can cause exaggeration of insulin output and long term, which can lead to weight gain. Glucose levels fall and have an impact on the menstrual cycle and egg quality.
Below is a list of foods to avoid in the fertility diet, because they can increase inflammation and may negatively impact endometriosis and subsequent fertility.
- Processed and packaged foods
- Sugar
- Gluten, white bread, and wheat
- Dairy products
- Meat (especially red and processed meats)
- Alcohol
- Fried foods
While this suggested fertility diet may not be the magic bullet couples are seeking, it is certainly a step in the right direction. Of course, every woman if different, so it is very important to talk to your physician regarding your diet.
In Good Health,
Dr. Chuck Miller
Avoiding a Second Surgery: How a Change in Medication Could Lead to Pregnancy
Our last blog post detailed a successful isthmocele repair surgery that will hopefully lead to a healthy pregnancy. Today’s post is a little different.
Here is a case where surgery, performed by another surgeon, had failed. The patient, Lindsey*, was still symptomatic with fluid in the cavity. Dr. Miller provided the patient with a new medical protocol, avoiding a second surgery.
Read Lindsey’s story to find out the result.
After almost four years of struggling with secondary infertility, I was fortunate enough to discover Dr. Charles Miller and the Advanced IVF Institute. I had been diagnosed with an isthmocele, which was a defect in my cesarean scar that was leading to fluid accumulation in my endometrial cavity. Just reaching the diagnosis of an isthmocele and the potential impact it could have on my fertility had taken many years. I was exhausted, frustrated, and unsure if I would ever have another child. My local physicians seemed to be at an impasse. Despite having my isthmocele surgically repaired, I was continuing to develop fluid which was impairing the ability of my physicians to transfer any embryos.
After contacting Dr. Miller, I knew it was the right decision. He was very resolute in the forward management of my situation. He did not recommend a repeat surgery to repair the defect that had not been successfully repaired. This was initially surprising to me! Repeat surgery seemed to be the obvious decision, but his thoughts were that possibly changing the protocol for my Frozen Embryo Transfer (FET) would decrease the amount of fluid I was producing.
When transferring frozen embryos, the usual protocol is to use estrogen and the route can vary (i.e. oral, patch, intramuscular). The patient then adds progesterone prior to the transfer. Unfortunately, in my case, the estrogen caused a build-up of fluid, particularly with the isthmocele.
Due to his extensive experience in this matter, I trusted Dr. Miller’s judgment and I am so thankful that I did. After two previously canceled FET cycles with other protocols, I followed the protocol set forth by Dr. Miller on my third attempt.
The protocol that he recommended, and he said was successful on many occasions, is that rather than utilizing estrogen initially, the meds are used to stimulate the ovaries so that my own estrogen levels rise. Thus, taking away the need to utilize estrogen.
I am ecstatic to say that it worked and I am eternally grateful to Dr. Miller and his staff. We are set to welcome our miracle in May 2018!!
-Lindsey
*Name changed to protect patient privacy