Starting a family is
an exciting chapter in a couple’s life.

Optimising Your Fertility

To make the most out of your natural fertility whilst preparing for an IVF cycle, your partner and you need to ensure you are both physically fit and mentally strong.

How to optimise your fertility1-6

Make sure you have a healthy diet that’s rich in fats, fibre, fruits and vegetables as well as all the other essential nutrients and protein. The Mediterranean diet may be a good option.1

As vitamin D seems to have a positive impact on fertility, do make sure you are getting enough of it. If your levels are low, your doctor will prescribe some supplements to help.

You need at least 7-9 hours of proper sleep each night. This means no tossing or turning.

To stay as healthy and active as possible, reduce or even abstain from alcohol.

A sensible exercise routine will help you keep your weight on track, and stay fit, alert and positive.

Take up meditation, yoga or tai chi to relieve tension and stress. Hobbies such as painting, crocheting, scrapbooking, photography, etc. may also help.

Have an open and honest discussion about everything, including what you feel about the process, how far you are both willing to go, and how you will cope with whatever outcome.

Reach out to family, friends or colleagues who have been through similar experiences. They will know what you are going through, be able to guide your expectations and lend a much-needed hand in case of any emergency.

What to ask your doctor before you start IVF treatment?
  • How many embryos would be transferred in my cycle?
  • Do I need to freeze my eggs?
  • Do I need to perform pre-implantation genetic testing?
  • Do you perform ICSI and will I need it?
  • How long will my entire treatment take?
  • Given my age and medical history, what are my chances of getting pregnant using IVF?
  • What supplements, diet or tips would you advise to improve my success rates of IVF?
  • Can I exercise and go to work as normal?
  • What psychological support or counselling is available during my fertility treatment?
  • What are my chances of having ovarian hyperstimulation syndrome, multiple pregnancies, birth defects, ectopic and heterotopic pregnancies? How will you help me minimise these risks?
  • Could you give us a cost breakdown for fertility treatment?
  • Would any insurance and the government help cover part of fertility treatments?
  • Will I need to miss work? How about my partner?
  • What types of medication do I need to take?
  • What are the side effects of the hormonal fertility drugs?
  • What is luteal phase support and how does it help prep my uterus for embryo implantation?
What you need to know about fertility medication?
Fertility drugs are usually prescribed to enhance reproduction fertility. As each drug treats a specific problem, they should be taken under the supervision of your doctor who prescribes them for you. You should consult your doctor before starting any medical treatment.

During the IVF process, you will need fertility drugs to support you through the stages of IVF.7-9

1. Suppression, also known as down regulation.
  • This is where your hormonal cycle is closely monitored and controlled to prevent early or unexpected ovulation.
  • A course of injections, either agonist or antagonist hormones, are prescribed.
  • Your doctor will inform you which treatment option works best for you.
  • Possible side effects may include hot flashes, mood swings, and vaginal dryness.
2. Ovarian stimulation
  • Once the eggs have matured, hormonal injections are given to induce the ovaries to release their eggs.
  • Some of the less common side effects are breast tenderness, swelling or rash at the injection site, abdominal bloating, mood swings, and mild abdominal pain.
3. Luteal phase
  • Using a hormone called progesterone, this process prepares the uterus lining for receiving an embryo.
  • It can be given vaginally, orally or via injections.
  • Injectable form of progesterone may be painful as it requires needle injection.
  • Oral progesterone needs to pass through the liver before it can be metabolised. Some of the less common side effects may include tiredness, headaches, dizziness and urine frequency.
  • Vaginal progesterone is more commonly prescribed and is inserted through the vagina. Some of the less common side effects may include vaginal discharge and irritation.
  1. Lăcătușu CM, Grigorescu ED, Floria M, Onofriescu A, Mihai BM. The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription. Int J Environ Res Public Health 2019;16(6):942. Published 2019 Mar 15. doi:10.3390/ijerph16060942.
  2. Muscogiuri G, Altieri B, de Angelis C, et al. Shedding new light on female fertility: The role of vitamin D. Rev Endocr Metab Disord. 2017;18(3):273-283. doi:10.1007/s11154-017-9407-2
  3. Sleep Foundation.org. How much sleep do we really need? Eric Suni. Updated July 2020. Available at: https://www.sleepfoundation.org/articles/how-much-sleep-do-we-really-need
  4. Van Heertum K, Rossi B. Alcohol and fertility: how much is too much?. Fertil Res Pract. 2017;3:10. Published 2017 Jul 10. doi:10.1186/s40738-017-0037-x
  5. S.L. Gudmundsdottir, W.D. Flanders, L.B. Augestad, Physical activity and fertility in women: the North-Trøndelag Health Study, Human Reproduction, Volume 24, Issue 12, December 2009, Pages 3196–3204, https://doi.org/10.1093/humrep/dep337
  6. Amelia K Wesselink, Elizabeth E Hatch, Kenneth J Rothman, Jennifer L Weuve, Ann Aschengrau, Rebecca J Song, Lauren A Wise, Perceived Stress and Fecundability: A Preconception Cohort Study of North American Couples, American Journal of Epidemiology, Volume 187, Issue 12, December 2018, Pages 2662–2671, https://doi.org/10.1093/aje/kwy186
  7. Depalo, R., Jayakrishan, K., Garruti, G. et al. GnRH agonist versus GnRH antagonist in in vitro fertilization and embryo transfer (IVF/ET). Reprod Biol Endocrinol 10, 26 (2012). https://doi.org/10.1186/1477-7827-10-26.
  8. American Society for Reproductive Medicine (ASRM). Medications for inducing ovulation. Available at: https://www.reproductivefacts.org/globalassets/rf/news-and-publications/bookletsfact-sheets/english-fact-sheets-and-info-booklets/booklet_medications_for_inducing_ovulation.pdf. Accessed: April 2020.
  9. Cemal Posaci, Johan Smitz, Michel Camus, Kaan Osmanagaoglu, Paul Devroey, Progesterone for the luteal support of assisted reproductive technologies: clinical options, Human Reproduction, Volume 15, Issue suppl_1, June 2000, Pages 129–148, https://doi.org/10.1093/humrep/15.suppl_1.129