How I support clients going through IVF

Francesca Lyon, Director of Nutrition at FUTURE WOMAN shares how nutrition, lifestyle changes and individualised investigation can be a game changer for those considering or undergoing IVF…

I wanted to share with you something that really fired me up this week. A post from an IVF doctor on social media was telling people/ couples to never take a break from IVF to try and improve egg quality, that it was a waste of time. I honestly couldn’t disagree more. I have seen incredible changes in fertility when clients take an ‘IVF break’ to reassess and address underlying factors that may be impacting fertility. Big changes can be seen to markers such as AMH, estrogen, progesterone, CRP (inflammation), NK cells, as some examples, which all greatly impact fertility. In my experience, some of those couples have not even needed IVF anymore or have a successful next round of IVF after previous failed rounds. 

Many people assume that because I am a natural medicine practitioner and specialise in natural fertility that I would be against IVF. But that is not the case at all, in fact many of my clients are those who are undergoing or want to undergo IVF and want support to get the best possible chances of conception (as did you know there is only about a 20-30% chance of conception each IVF cycle?). In my experience pairing functional testing, nutrition and personalised supplementation with IVF can greatly increase your chances of implantation and conception success. 

So how do I support couples going through IVF?

Essentially my job is to both empower and educate couples throughout their journey, but also to enhance conception chances and egg/sperm quality by supporting their nutrition and addressing any underlying factors that may be impacting fertility such as thyroid health, inflammation, detoxification, oxidative stress, hormonal imbalance and more. 

Digging Deeper: Understand their individual hormonal picture 

One of the priorities I have with fertility clients and IVF clients is to test to understand their individual hormone health picture in order to ensure that nothing has been missed by conventional medicine (I have seen many clients who have low progesterone impacting their fertility and this has been missed by normal routine blood testing). Of course included in this is estrogen and progesterone. Estrogen is primarily responsible for the development and regulation of female reproductive organs and is needed in sufficient levels to initiate ovulation. Estrogen levels also impact fertility and IVF success, with for example higher estrogen levels being associated with lower IVF success rates.  Progesterone is vital for fertility as one of its main roles is preparing the uterus for pregnancy. Low progesterone levels are common and can prevent conception and the maintenance of pregnancy. Beyond estrogen and progesterone, I test all androgens, including testosterone, as they also play a role in fertility, ovulation success, implantation and egg quality.

Not only do I test the hormone levels themselves, but also the detoxification pathways in which they move through the body. This can only be done in urine testing (not blood testing), but I will shed more light on this below. 

Egg and sperm quality 

One of the ways that I can really help clients before and during IVF is supporting egg and sperm quality to ensure that they have the BEST possible quality in order to have the BEST possible chance of success. It is important that when fertility is considered egg quality is considered much more important than quantity. There are multiple ways to improve quality of egg and sperm health (even if your IVF Dr tells you you can’t, I have seen near miracles when nutrition, inflammation and hormones are addressed holistically) including assessing methylation status (this is always overlooked in conventional medicine and can make a huge difference, especially to those experiencing miscarriages), assessing vaginal and seminal microbiome, assessing nutrient status, addressing underlying oxidative stress and inflammation.

You can read more here about egg quality versus egg quantity. 

Assessing the Impact of Stress and the Brain-Body Connection

One of the most important ways to support couples on a fertility and IVF journey is to support their stress pathways, in particular the hypothalamic-pituitary-adrenal (HPA) axis, which is the communication pathway from the brain to the adrenal glands and the hypothalamic-pituitary-ovarian (HPO) axis which is the communication pathway from the brain to the ovaries, these are intrinsically linked.

Stress (including high or low cortisol), poor nutrition, age, toxin exposure, under-eating, and over-exercising are main causes of HPO axis dysfunction, which can lead to delay or lack of ovulation, resulting in low progesterone and unopposed estrogen. Disruption to these pathways due to stress can also result in poor egg and sperm quality and can have a negative impact on IVF success.

Therefore supporting the HPA and HPO axes through testing, supplementation, diet and lifestyle practices can make a huge difference to IVF success. We test HPA axis function and cortisol in our Advanced Hormone Test and I have seen that many on IVF journeys have low cortisol due to longterm stress which impacts their immune system, hormone levels and therefore egg quality and sperm quality too. 

Detoxification and Environmental Factors

One of the main areas I focus on for IVF clients is detoxification, not just of the body in general but also the detoxification of your hormones. This is something I support in advance of IVF but also after, especially if the clients chose a frozen embryo transfer, which allows time to detox from the IVF drugs and put support in place to support optimal implantation by supporting blood flow and immune system functioning. 

As I mentioned it is vital to support overall detoxification both before and after IVF by supporting lymphatic drainage, kidney, liver and gut function, as well as assessing heavy metal toxicity and environmental toxin load. Environmental toxins, including endocrine disrupting chemicals (EDCs), can interfere with hormonal processes, impacting hormone production, transport, and detoxification. EDCs can negatively affect the development of ovarian follicles and hormone production, suppress vital hormones like FSH, and contribute to hormonal imbalances such as unopposed estrogen by disrupting detoxification pathways, this can have a negative effect on IVF success, which is just one example of why detoxification is so vital for IVF success. 

I also support hormone pathway detoxification before IVF and after, as this is vital especially after various medication use that stimulates ovarian function, ovulation and to support implantation. Hormones are detoxified from the body primarily through the liver, bowel, and kidneys. If hormone detoxification is not supported it can lead to increased inflammation (especially if you favour the 16-OH or 4-OH pathway) in the body and resulting unopposed estrogen can negatively impact embryo implantation. 

A Holistic Approach: 

For many women and couples, the path to conception isn’t always straightforward. Fertility can be influenced by a complex interplay of hormones, lifestyle factors, and environmental exposures. I understand this complexity and take a comprehensive, personalised approach to support your fertility by addressing underlying drivers, including key hormones, stress response, and detoxification pathways. These are just some examples of how I support fertility and IVF, as each person is different and therefore deserves a unique and personalised approach. 

To effectively support IVF, at FUTURE WOMAN we recommend a great place to start is comprehensive hormone testing. Our Advanced Test looks at reproductive hormones like estrogen and progesterone, hormone metabolism, stress hormones, inflammation markers, gut bacteria imbalances, and oxidative stress. Specifically, we test estrogen and its Phase 1 and Phase 2 metabolites to understand production, detoxification status, and potential risks. We also test progesterone and its metabolites (alpha-pregnanediol and beta-pregnanediol) to assess ovulation and how your body processes progesterone. Androgen levels are tested, and the activity of the 5a pathway is assessed, which can be useful for understanding egg quality and ovulation quality. We assess free and metabolised cortisol levels to understand your stress response and HPA axis function over time. Markers for gut dysbiosis, inflammation, and oxidative stress are also included as these factors can contribute to fertility issues. 

Based on your unique test results, we create a personalised health plan with evidence-based recommendations for diet, lifestyle changes, and targeted supplementation