Dos And Don’ts of Fertility Treatment

What do you do with your progesterone?

If you’re new to fertility treatment and you’ve never heard of progesterone, the way I describe progesterone is this: It’s like water to a marathon runner. You don’t want to run a race without water, and if you finish the race, it’s too late to drink water. I ask my patients to start progesterone supplementation 3 days after a positive opk/ovulation/trigger shot (whichever comes first) until the pregnancy test and to continue with a positive test. If your natural progesterone levels are very high, adding more may cause dizziness. Consider stopping it if this side effects happens to you.

Can I drink alcohol?

Let’s use IUI as an example. Say you’ve just done your IUI and your best friend’s wedding celebration is the next day. My answer is, no, you shouldn’t drink. Certainly there are people who drink during their pregnancy, but that’s not what I recommend to my patients. When you have done a treatment and you’ve worked so hard to get there, the best thing to do is avoid alcohol and ask for a mocktail.

What can I do for a cold or stuffy nose?

When it comes to a stuffy nose or a cold, what I tell my patients is: saline nasal spray, a humidifier or Vicks vapor rub on your chest, lots of rest, Tylenol, and Robitussin for a cough are all okay. It’s also okay, depending on where you are in your cycle to take Claritin or Zyrtec during the day. Avoid cold medications with dextromethorphan.

Can I do Botox?

Botox doesn’t hurt your fertility. It’s very localized in your skin and doesn’t spread systemically. If you happen to do Botox and didn’t know you’re pregnant, it’s not going to hurt your pregnancy. If you’re doing fertility treatment and you want to do one last Botox treatment before your transfer, that’s okay.

Can I still drink coffee? How much is too much?

I tell my patients, if you want to drink coffee, it’s okay. There’ve been studies looking at women who’ve gone through fertility treatment to look at their IVF pregnancy rates. And there’s no decrease in pregnancy rate when it comes to caffeine consumption (in moderation of course). However: you are what you drink, and you are what you eat. You can actually measure caffeine levels in the follicular fluid around the eggs, which made me think: limit your consumption for sure- one to two caffeinated beverages per day. In the beginning of pregnancy you’re very tired, so you may want a little boost.

What can I take when things slow down?

Another thing that will happen when you’re on fertility drugs is things might slow down, and when I say things, I mean your bowels. When you’re taking the fertility drugs, your ovaries are a little bit swollen, and that pushes down on your bowel and makes it harder to have a bowel movement regularly.

Can I visit the dentist, and have dental work done?

Who doesn’t want an excuse to avoid the dentist? I know that a lot of people still dread going to the dentist, but it’s really important to get your teeth cleaned every six months. Studies have shown that taking care of your gums and your dental hygiene can actually decrease risk of preterm labor and preterm delivery. When it comes to going to the dentist, you certainly can and should. Dentists will have a form that they’ll send to me that asks questions such as: is it okay if your patient is having this type of dental work? Can she have Lidocaine? The answer’s yes. You can use local anesthetics for procedures and there are pregnancy safe antibiotics that you can take as well that will not interfere with your growing embryo either before treatment or once you are pregnant.

How much exercise can I do?

It really depends on the person. If you’re someone who has a low BMI (less than 20) you may find that your uterine lining is on the thinner side. Maybe you’re having a hard time ovulating regularly every month. Cutting back on your exercise and doing more low impact activities, avoiding things like running, maybe consider yoga, walking, hiking, swimming, things that might be better for your fertility.

What should I eat? What can I eat?

First of all, things to look at are:

  • Your body size.
  • Your medical issues. Do you have problems with hypertension or high blood pressure, high blood glucose?
  • Do you have PCOS?
  • Metabolic issues

Can I travel?

I included this picture because I really want patients to reconsider flying while pregnant. Airplanes are really, really crowded. If you’re on an airplane with 200 people, and there’s one person on the airplane that has the flu, the next person who’s possibly going to get the flu is now the person who is pregnant. Especially in early pregnancy, when things are so vulnerable, it’s important to rethink travel based on the season and what’s going on.

Can I dye my hair?

My rule about hair dye and salons in general is this:

Do I need any immunizations?

If you’re going to take a big trip, what are you going to do? You’re going to talk to a travel doctor and get a list of all the immunizations you need. Well, same thing in pregnancy. Before a woman gets pregnant, we want to make sure that she’s immune to things like measles, mumps, varicella (chicken pox), and rubella. But the last thing you want to do is get these vaccines while you’re pregnant.

What can I take to help me with sleep and/or anxiety?

A lot of people have a hard time sleeping, especially when they’re super nervous. If you’re super emotional because you have your embryo transfer the next day, or you have your egg retrieval the next day, I tell my patients it’s okay to take things like Tylenol PM. If you’re feeling super, super anxious, talk to your doctor about prescribing one pill of Valium. I prescribe Valium before the embryo transfer, and if needed, one the night before the egg retrieval to help my patients get a good night’s sleep. I sometimes have them take one 3 hours before the egg retrieval if anxiety levels are extremely high.

Is nail polish safe?

It’s okay to paint your nails. There are some more fertility friendly nail polishes that don’t have formaldehyde that other nail polishes have, but it’s certainly safe to paint your nails.

Can I get a massage?

When you’re trying to get pregnant, it’s totally okay to do a regular massage. Many patients ask me if they need to get a prenatal massage and I tell them it may not be as satisfying of a massage.

What can I do about nausea?

When it comes to fertility treatment and IVF, we use medications like birth control pills and fertility shots, and all have a side effect of nausea. Some people are more sensitive to the side effects than others. So one of the things that you can do for nausea is acupuncture. It actually can work, especially in pregnancy: I find that my patients who do acupuncture do really well in the first trimester, and they need less anti nausea medication than patients who don’t do acupuncture.

Should I avoid pain medications?

The next thing I want to talk about is pain. It’s not unusual to have pain, for example, when you have a period. You can take Advil, you can take Tylenol. Why avoid these medications? I think a lot of people are scared of things like hurting their egg quality, or scared it’s going to interfere with the pregnancy and cause a birth defect. But when it comes to pain, there’s no need to suffer through a period at the start of your fertility treatment or when trying to conceive.

Can I go into the sauna/steam room/hot tub?

Just as I said before: Don’t get your sperm drunk. The next thing is: Don’t cook your balls. Your testicles are on the outside of the body. There’s a reason why: they don’t need to be as warm as ovaries. This is for the guys: stay out of the sauna until pregnancy is achieved.

Can I have sex? What kind of sex? How about now? Why can’t I have sex?

When it comes to sex, it’s really an individualized recommendation.

Can I smoke?

No. Cigarettes are basically sperm killers and they are toxic to the DNA in both the eggs and the sperm. Half a pack per day, one pack per day, doing it consistently can certainly be very harmful to your health, especially your fertility health.

Can I have Chinese herbs and teas? Is acupuncture okay?

Try it. Have a consultation and see what they say about you, your body’s chemistry, and what kind of schedule you should be on when it comes to doing acupuncture. I make really detailed calendars for my patients to give their acupuncturist and tell them to work their magic. And I have a very close relationship to the acupuncturists that I work with. I know what herbs they’re giving my patients, and the herbs are basically geared toward the part of the cycle the patient is in.

Is it okay if I do yoga?

Absolutely. The only type of yoga that I sometimes get concerned about is Bikram yoga or hot yoga. I ask patients to really make sure they’re hydrating well, and taking a timeout if they feel like they’re getting overheated. When you’re going through fertility treatment, fluid goes to the ovaries, they swell, and that’s a very vulnerable time when you could be at risk of becoming dehydrated.

Can you go up the stairs? How many times can you go up the stairs?

This question often comes to me after someone’s embryo transfer. Once you’ve done an embryo transfer, you want to do everything possible to give your embryo the very best chance of implanting. A lot of people have stairs, and just taking one flight of stairs to get to your bedroom is not a big deal.

Is it safe to travel to areas with Zika?

My recommendation is traveling is okay, but I’m always super sensitive about Zika infected areas like Mexico, India, Africa. Before you travel anywhere, look to see if there’s Zika reported in this area.

My goal is to always help people around the world keep ahead of infertility. If you’re reading this and you still have questions, I can help you by checking your levels, and talking to you about what they mean. If you want to learn more about how to get your levels checked, visit How It Works and follow the instructions.

You can also catch more of me and topics like this through The Egg Whisperer Show. The episodes are live-streamed on YouTube, Facebook, and Twitter and on Wednesdays at 7 PM PST. Subscribe to the podcast too!

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