Take a look at your lifestyle. Have any of your habits changed since you conceived baby number one? For instance, is your diet still on track, or is there room for improvement? Getting your eating plan up to baby-making speed may help you close in faster on conception. Has your caffeine consumption gone up now that you’re a mom? That’s understandable, but too much caffeine isn’t great for fertility. Has your smoking habit returned? If yes, it’s time to kick butt, since smoking ages your eggs and decreases fertility. Are you getting way too little sleep? That may be likely, especially if your first child is keeping you up at night, but skimping on sleep can mess with your hormones — and possibly your fertility. If any new unhealthy habit has slipped into your lifestyle, now’s a great time to put the brakes on it. And it’s not just about your habits. Is your partner kicking back one too many beers each night? That could be affecting his sperm quality. Ditto for smoking or an unhealthy diet. If your partner’s lifestyle needs a little fine-tuning, make efforts to get his back on track, too.
For five to six days following fertilization, the developing embryos are cultured in the laboratory until the blastocyst stage of development has been reached. This represents growth of about 200 cells. We at RMA culture embryos exclusively to the blastocyst stage, because published data demonstrates that extended embryo culture results in improved implantation rates and pregnancy outcomes. This means we will never do an embryo biopsy – or an embryo transfer – at three days, or anything less than the blastocyst stage.
Luteal support is the administration of medication, generally progesterone, progestins, hCG, or GnRH agonists, and often accompanied by estradiol, to increase the success rate of implantation and early embryogenesis, thereby complementing and/or supporting the function of the corpus luteum. A Cochrane review found that hCG or progesterone given during the luteal phase may be associated with higher rates of live birth or ongoing pregnancy, but that the evidence is not conclusive. Co-treatment with GnRH agonists appears to improve outcomes, by a live birth rate RD of +16% (95% confidence interval +10 to +22%). On the other hand, growth hormone or aspirin as adjunctive medication in IVF have no evidence of overall benefit.