It’s been ten years since I started my fertility practice here in the San Francisco Bay Area. I’ve helped thousands of patients through the IVF process. I understand every nuance of how you might feel, both emotionally and physically, as you embark on your IVF journey. For this week’s Egg Whisperer Show, I shared the essential must-haves that my patients have really enjoyed in order to help make their experience and recovery more comfortable.
I hope my Must Haves will help you have a smooth and safe IVF cycle.
1. Get Your Electrolytes
This doesn’t mean having to drink sugary sports drinks. I recommend either Liquid IV or DripDrop. You just have to fill up your water bottle and add the powder. This is not only going to help you have juicy eggs, but also juicy veins so it won’t be a challenge when you have your blood drawn.
2. Stock up on Protein Shakes
You’ll be feeling bloated, and maybe you’ll lose your appetite or find it harder to eat solid food. Protein shakes are really easy to drink and tolerate, and they’ll provide you with all the vitamins and nutrients that you need as a snack or meal replacement. They’re also great during pregnancy too.
3. Schedule a Food Delivery Service
Patients are always asking me what food they should eat to improve their fertility or prepare for IVF. Research has shown that a plant-based diet close to a Mediterranean diet can enhance your fertility (both for men and women) and improve IVF outcomes. It’s also hard to think about meal planning when you’re going through IVF, especially if you’re juggling work, family, and visits to the fertility clinic. Thistle is one of my favorite services because it provides fresh, plant-based meals that are always satisfying.
4. Prepare for a Poop Emergency
As you take your hormone shots, your ovaries get fuller and bigger, which is good because it means that eggs are growing. But as the eggs grow, and you start to feel more bloated, everything slows down, including your bowels. I don’t want you running to the store in the middle of the night to solve this constipation problem. Be prepared and grab a stool softener that you can take every couple of days before and after your retrieval and transfer. Believe it or not, a lot of patients call me worried that they’re going to poop out their embryo. Trust me, this cannot happen.
5. Purchase Panty Liners
As you take the hormone shots, you’re going to see an increase in egg white cervical mucus. It’s similar to that slippery mucus you get when you’re ovulating. It happens because your estrogen levels are rising, which is what happens during a natural ovulation cycle too. Panty liners to the rescue!
6. Waterproof Underwear
7. Egg Whisperer Fertility Pants
They’ll be available soon, and will become an essential must-have. Basically, they are crotchless yoga pants designed to make your fertility care more comfortable and easier— they have an opening in order for your doctor to have access for ultrasounds and exams. Another plus is that you won’t have to be constantly naked in front your fertility team. They’re made of high-quality stretchy cotton, which is just what you’ll want to wear when you’re feeling bloated. They’ll also be a fun way to spice up the mood for date night.
8. Grab that Tylenol or Advil
An egg retrieval is like an ultrasound-guided surgery in which your fertility doctor passes a small needle through your vagina, inserts it into the fluid filled sacs called follicles to collect your eggs. You’ll be asleep and won’t feel anything, but when you wake up your ovaries will feel a bit swollen. It’s a good idea to have some Tylenol, Motrin or Advil on hand when you get home. I always offer my patients a stronger pain medication such as Tylenol with codeine, and maybe 5% of use it. But it’s still good to have the option to take something if the soreness wakes you up, so you can get a good night’s rest. Five percent of my patients feel too bloated to go to work the day after their egg retrieval, and those patients really appreciate having something stronger for pain.
9. Take Precautions Against Ovarian Hyperstimulation Syndrome (OHSS)
Ovarian Hyperstimulation Syndrome (OHSS) is one of the most severe complications that you can experience when you’re going through IVF. It’s basically your ovaries experiencing hormone overload, and symptoms can be mild to severe. Certain factors make a patient more predisposed to the condition. If you have a high follicle count or high Antimullerian hormone (AMH) level, you are more predisposed to the condition.
I take many precautions to prevent OHSS. I usually see these patients in the office more often than average in order to monitor them very closely.
A. Make sure that your doctor starts you on a low dose of the medication that stimulates egg growth.
B. Confirm that your doctor will check your estrogen levels after two days of injections if you’re at high risk of OHSS. If the levels are too high, they can adjust the dose early enough in your cycle to prevent severe OHSS.
C. Stay hydrated. If this is a challenge, I often use IV hydration with Hespan or Albumin on the day of the egg retrieval. For those patients at risk, I used Lupron for the trigger shot (the shot to release your eggs) instead of HCG hormone.
D. I also give patients Bromocriptine, which is a small pill that you can take the night before your egg retrieval and for about two weeks after or until you’re feeling better.
E. Freeze your embryos. If you have OHSS, pregnancy hormones secreted from an embryo can make your ovaries think that they should grow, and if this happens, you can get really sick. So it’s better to freeze your embryos and then do the transfer a few weeks later when the hormones are out of your body.
F. Keep the emergency number for the clinic on hand, so if you have any problems, you can call right away. If you’re at high risk of OHSS, connect with someone at the clinic daily to give updates about your weight, how you’re feeling, your hydration and the color of your urine. These are all steps that your medical team will monitor to keep you safe.
9. Build Your Fertility T. E. A. M.
This is one of my most used mnemonics.
T is for therapy. Since IVF can be emotionally challenging, it’s always good to have someone to talk to throughout the process. IVF can also make you more susceptible to depression and anxiety, especially if you have a prior history. It’s very easy to find a therapist online these days?—?I often recommend an online platform called OOTify to find the perfect fit for you.
E is for exercise. Try to get enough of it, especially because exercise can help raise your serotonin levels to minimize anxiety and depression. Talk to your doctor about what they recommend for your particular situation. Eating well is also part of a healthy exercise routine, so remember: proteins shakes, Mediterranean diet and healthy meal delivery kits to take the hassle out of your IVF weeks.
A is for Acupuncture. Research has shown that fertility acupuncture has many benefits. A key advantage is that it helps to improve physical symptoms such as nausea and soreness in your belly. I’ve also seen that patients who continue acupuncture into their first-trimester experience less nausea and generally feel better.
M is for Mindfulness. Today, many apps can guide you through short meditations that helps to clear and focus your mind on the present moment. Because there are so many unknowns in the IVF process, it can feel stressful. I always tell my patients to use mantras like “I’m going to be a parent one way or another.”
10. Get Your TUSHY checked.
This is my other favorite mnemonic, and an easy way to remember the 5 basic fertility screening tests that every patient needs for personalized fertility care. Knowing you’ve done all the testing to guide you can only help you feel better prepared for what’s ahead.
“T” in TUSHY stands for tubes (the fallopian tubes)
“U” in TUSHY stands for an ultrasound of the uterus.
“S” in TUSHY stands for semen analysis.
“H” in TUSHY stands for hormone testing.
“Y” in TUSHY stands for your genetic profile.
Life is complicated but learning about your fertility doesn’t have to be. If you do end up having to take the IVF route, being prepared is the most essential part of this process. I hope my Must Haves will help you have a smooth and safe IVF cycle.