Guest Blog: What to Think About Before IVF

This is a guest post by Dr. Erin Wolff of Pelexmd.com, an online fertility and women’s healthcare platform leveraging the latest technology and advances in telehealth. Together we’re offering a FREE webinar on April 20 at 2 pm ET on Functional Medicine Fertility and IVF, including how to support your body naturally for fertility with or without IVF. Join us!  

Knowledge is power, and this is paramount when it comes to female reproductive health. Reproductive health doesn’t just affect fertility—it’s a critical part of our general health—but as we approach the time in our lives when we want to become pregnant, it assumes center stage

What reproductive health factors should I be aware of?

Maintain awareness of your menstrual health. Knowing your body—keeping track of your menstrual cycles and being aware of changes in your body during each menstruation—will help you understand your own reproductive health—a cornerstone of good health for all women. 

Focus on your endocrine system. Female fertility not only depends upon the adequate functioning of your reproductive organs but also on your endocrine system, the collection of glands that produce hormones that regulate metabolism, growth and development, tissue function, sexual function, reproduction, sleep, and mood, among other things.

Check hormone levels. Sometimes even minor changes in hormonal levels indicate dysfunction of an organ within the system. Various reproductive endocrine conditions can lead to life-long sequelae (after effects), including infertility. So, to optimize health, one should have regular reproductive evaluations to prevent and detect gynecologic diseases.

Gynecologic diseases that may affect fertility—and overall health 

- Polycystic Ovarian Syndrome (PCOS)—a prevalent reproductive disorder that’s important to recognize and treat early. It’s a disorder associated with hormonal imbalances, multiple small follicles in the ovary, and menstrual irregularities. These irregularities are often caused because ovulation doesn’t occur in a regular fashion each month. The lack of an egg being released monthly decreases fertility. 

PCOS is also associated with cardiovascular, neurological, psychological problems, and endometrial cancer. Although the exact cause of PCOS is unknown, it is believed to be a multifactorial disorder in which genetic and environmental factors are combined.  The good news? Changing some environmental factors can correct underlying hormonal imbalances associated with PCOS. And the best way to prevent the health risks associated with PCOS is to manage it early on. 

- Endometriosis—a debilitating disease characterized by cyclical pain and infertility. It’s an estrogen-dominant inflammatory disease where endometrial tissue (normally present as the lining of the uterus that is shed each month during menstruation) grows anywhere else (e.g. in the uterine muscle, tubes, ovaries, bowel, bladder, diaphragm, or even in the lung). 

It’s associated with ovarian and endometrial cancer, cardiovascular diseases, autoimmune diseases, and allergies and results in inflammatory changes in the pelvis which decrease fertility. Endometriosis remains underdiagnosed as the disease location and symptoms vary widely. Oftentimes, the severe pelvic pain of endometriosis is dismissed as primary dysmenorrhea. 

The definitive diagnosis of endometriosis relies on laparoscopy, but an early presumptive diagnosis based on clinical symptoms allows for early treatment and prevention of disease progression. For earlier diagnosis and management, seek care from a provider who specializes in endometriosis if you have pelvic pain, constipation, painful defecation, blood in the stool, painful intercourse, painful menstrual periods or heavy menses.

- Premature/Primary Ovarian Insufficiency (POI)—a decline in ovarian function and subsequent increase in the hormones that stimulate the ovary, which rise to menopausal levels before the age of 40. There are several known causes of POI, including genetic and autoimmune disorders, but in many cases, the reason is unknown. Following a decline in ovarian follicles, estrogen levels fall, resulting in secondary amenorrhea and subfertility. 

Importantly, the fall in estrogen levels results in hot flushes, poor sleep, mental fogginess, anxiety, mood changes, poor bone health, osteopenia, osteoporosis, and fractures. Thyroid disorders, diabetes mellitus type II, Addison's disease, and hypoparathyroidism are a few of the endocrine diseases associated with POI that have serious health consequences and should be screened for in women with POI annually.

Who are the best health professionals to have on my fertility team?

A Reproductive Endocrinology and Infertility (REI) specialist is a subspecialist in OB/GYN who focuses on the care of endocrine and reproductive issues.

Whether you are pursuing pregnancy or not, an REI will ensure that you are getting optimal endocrine and reproductive healthcare. During these unusual times, it may be challenging to book an in-person appointment with an REI. But, this does not mean that you will have to delay seeking health and fertility care! 

Telehealth fertility services will allow you to manage your health remotely. Whether a consultation, a second opinion, or discussing lab tests, you don't have to delay treatment. Pairing your REI fertility telehealth services with a certified nutritionist will provide you with the perfect health management plan. 

A fertility nutrition specialist can support you with a custom, evidence-based nutrition plan to optimize fertility—improving egg and sperm quality as well as screening for and treating nutrition-influenced conditions including hormonal imbalances—a perfect partner with your medical providers to assist you in optimizing your health for fertility and beyond.

Trying or planning to get pregnant? Wish you could figure out what you need to know to improve your odds naturally and with IVF? You can!

Watch Annina Burns, PhD,RD Certified Functional Medicine Fertility Nutritionist and Erin Wolff, MD Reproductive Endocrinologist cover this topic in our Functional Medicine Fertility and IVF Webinar below: