Infusions For Fertility Support

There is so much to supporting eggs, sperm and fertility. At IV Health we offer a FREE 30-minute chat with our fertility nurse specialist so you can discuss your concerns and health goals.

How to Maximise the Chance of Conception
Fertility preparation is incredibly important and in fact, your health and wellbeing today is largely determined by your grandmother and what she was exposed to, so it’s never been more important to consider the following when you are thinking about starting or extending your family.

Detox: take steps remove from your body and reduce exposure to hormone disrupting toxins (also known as endocrine disrupting toxins (EDCs), including BPA (Bisphenol A (BPA) a chemical produced in large quantities for use primarily in the production of polycarbonate plastics), and Phthalates (a group of chemicals used to make plastics more durable).
Alcohol consumption: binge drinking (more than 4 drinks in one sitting) in women more than 2 times a week has shown to reduce AMH (egg timer test hormone) levels by 26% compared to women who don’t binge drink. For the men Research shows heavy drinking can lower testosterone production, reduce libido (interest in sex), make it harder to get an erection and maintain one, and reduce sperm quality.
Female Obesity: has been associated with a lowering of the production of fertility hormones, affect oocyte (egg) morphology (structure), increase the rate of abnormality in the number of chromosomes (aneuploidy), reduce the ability of the lining of the uterus (endometrium) to grow and allow for implantation and increases the rate of miscarriages
Exercise balance: the exercise type and frequency need to match the hormone phenotype (person’s observable traits i.e. height, weight), of the person doing the exercise, for example some people are more susceptible to damage when doing really vigorous exercise i.e. women with normal and low BMI’s due to an energy deficiency and are more suitable to walking or Pilates or yoga. Exercise in obese women can assist in the restoration of ovulation by reducing insulin levels and restoring hormonal balance by as little as a 5-10kg loss.
Smoking or even passive smoking: being exposed to the effects just by lying next to a partner who smokes in bed overnight can affect fertility.
Irrespective of where you are on the fertility journey it is critically important to provide eggs and sperm with nutrients needed to support their health growth, fertilisation and embryo development.
It has traditionally been thought that women are born with all the eggs that they will ever have which are given to them when they are about 16 weeks developing in the uterus and that the quality of these eggs decline with age. Most of our lives the eggs are in a state of suspended animation (on pause), as immature cells known as antral follicles. The 3-4 months before ovulation the egg undergoes major changes and processes and grows significantly in size and starts producing and needing much more energy to undergo these changes. During these changes the egg must separate and eject copies of chromosomes – if this goes wrong, and it often dose, the egg will have chromosomal abnormalities which are the single most important cause of early miscarriages and failed IVF cycles and also the reason why it can take older women much longer to conceive. The exciting thing is that the latest research suggests that there is a lot that can be done to improve egg quality. When the egg is growing before it is ovulated, is an important time when many things can happen and affect egg quality in both a positive and a detrimental way.
Improve diet by eliminating refined carbohydrates (such as white bread, pizza dough, pasta, pastries, white flour, white rice, sweet desserts, and many breakfast cereals) which are known to increase insulin levels and shown to impact egg quality.
Aging generally results in decreased egg quality and quantity and we know this because older women who use donor eggs have the same chance of conceiving and having a healthy baby, is the same as the age of the women whose eggs were donated, in other words they have similar pregnancy rates to younger women. Egg quality generally refers to the ability of the egg to fertilise and become a viable pregnancy (7 weeks). What many people are not aware of is that most eggs that fertilise, never reach it to implantation or a viable pregnancy stage. We know that from IVF findings that suggest that of all eggs that fertilise in the laboratory approximately 1/3 of these will make it to a day 5-6 embryos known as a blastocyst and then only a small number of these will implant to create a viable pregnancy as many stop developing at some stage from fertilisation to the viable pregnancy stage. In fact, many naturally conceived embryos are most probably lost before there is even a positive pregnancy test, fertilisation may take place but the embryo does not make it to the implantation stage.

For an embryo to continue developing the egg and sperm quality plays a critical role (more on sperm quality later), on how long it takes to become pregnant either naturally or with the assistance of fertility treatments. The key is held in the eggs DNA (structures that carry the genetic material). If an egg has a chromosomal abnormality even if it does fertilise, it has a much less likely chance of continuing to develop and can result in an inability to become pregnant or early miscarriage.

Women who have a history of recurrent implantation failures in fertility treatments (IVF and frozen embryo transfer cycles), can have as many as 70% of their eggs being chromosomally abnormal. Abnormalities in eggs not only affect the likelihood of someone becoming pregnant but also are a large cause of early miscarriages, with miscarriages occurring in 1 in 5 pregnancies that have tested positive on a urine or blood sample.

For many years it has been thought that little or nothing can be done about egg quality however, recent scientific research has demonstrated that the number of eggs that have chromosomal abnormalities can be reduced by the introduction of vitamins and nutrients and lifestyle changes.

Vitamin D Deficiency, Underactive Thyroid and Coeliac Disease
Testing for these conditions is often overlooked, however each one of these has a strong link to infertility and miscarriage. Therefore, if corrected can give you the best chance of conceiving quickly and having a healthy baby.

Vitamin D

In recent years, Vitamin D has attracted a lot of attention and low levels have been found to be connected to a lot of diseases such as diabetes, cancer, arthritis and multiple sclerosis. It has also been strongly associated with infertility.

In 2012 researchers found that out of 200 women studied, the odds of pregnancy were 4 times higher for Caucasian women with high Vit D levels when compared to those with a Vit D deficiency.
Other studies have revealed higher fertilisation and implantation rates in women with high Vit D levels.
It is still unclear what role Vit D plays in fertility, but it is thought that one role is making the uterine lining more receptive to implantation of the embryo with research confirming the presence of certain metabolic enzymes being found in the ovary, uterus, fallopian tube, vagina and placenta of both human and animals, confirming the direct role of Vit D in these organs.
Vitamin D also influences hormone production, specifically oestrogen, with Vitamin D deficiency being associated with lowered estrogen levels and also associated with a decrease in the production of anti mullerian hormone (AMH), often referred to as the egg timer test, which can potentially lead to infertility.
Low Vit D levels also appear to contribute to endometriosis and polycystic ovarian syndrome (PCOs).
Miscarriage: Adequate Vit D levels (100-150 nmol.L or 40-50 ng.mL), before pregnancy reportedly significantly reduces the risk of miscarriage. Women with adequate preconception Vit D levels reported to have a 10% higher chance of pregnancy and 15% likely to give birth compared to those with Vit D deficiency.
The optimalsupplement is Vit D3 in oil based drops as Vit D3 is fat soluble and the oil makes it more available to the body. There are also Vit D injections available which are faster acting.

Sperm Support Infusions

This fertility focused IV infusion contains powerful antioxidants [vitamin C, vitamin E, vitamin b12, zinc, glutathione or NAC and selenium], and is designed to support sperm health and help to promote a healthy pregnancy. The infusion provides a base formula of high-dose antioxidants (vitamins C, E, and selenium), folic acid in the form of folinic acid as there has been some research that suggests a possible link between recurrent miscarriages and folinic acid deficiency in males. Adding some CoQ10 (Ubiquinol), may be beneficial as men with low levels of C0Q10 have been found to have lower sperm counts and poorer motility.

In addition to the antioxidants the addition of alpha lipoic acid (ALA) and L-carnitine are thought to support healthy sperm motility (movement) is also thought to improve total sperm count, concentration (numbers) and motility.

Diet to support sperm and egg health:

Nuts and seeds and are packed full of fertility supporting nutrients. Different nuts and seeds provide different nutrients for example:

Pepitas, chia sand hemp seeds and almonds can help build up iron stores which can support fertility and prepare the body for the increased demands in pregnancy
Walnuts, chia seeds and flaxseeds provide plant-based Omega 3 fatty acids, which are important for both male and female fertility. Omega 3 has been shown to increase sperm count, concentration, motility and morphology and reduce the percentage of spermatozoa with DNA damage.
1 Brazil nut daily meets the daily selenium needs which will help support sperm health and female fertility. Selenium a nutrient that the body needs to stay healthy. Selenium is important for reproduction, thyroid gland function, DNA production, and protecting the body from damage caused by free radicals and from infection. Selenium is found to be very concentrated in follicular fluid. Also associated with increased number of oocytes after IVF Stim. Other sources of selenium are eggs, spinach and lentils. from follicle development to the implantation environment
Walnuts, pecans, sunflower seeds, almonds, pumpkin seeds and brazil nuts are particularly rich in antioxidant properties
Pumpkin seeds, hemp seeds, pinenuts, cashews, almonds and sunflower seeds are just some of the nuts and seeds that are great for providing zinc, which is needed for healthy egg and sperm.

Zinc is important for improving epigenetic (lifestyle and environment) damage in oocytes (eggs), and embryo development including reducing the risk of Nueral Tube Defects (cleft palate, spinabifida). For the men zinc deficiency has been associated with reduced sperm fertilisation capacity, with supplementation seeing an increase in semen volume, progressive sperm motility and total normal sperm count. Sources include meat, chicken, turkey, fish, shellfish esp. oysters, eggs, pumpkin seeds.

Omega-3 fatty acids support fertility by improving hormonal balance, oocyte quality, embryo implantation, menstrual cycle function, and sperm count and motility. Sources include fish and other seafood (especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines), nuts and seeds (such as flaxseed, chia seeds, and walnuts), plant oils (such as flaxseed oil, soybean oil, and canola oil).

Lycopene. Men consuming a daily glass of tomato juice containing approximately 30mg of naturally occurring lycopene had a decrease in semen white blood cells (thought to negatively impact semen quality as a result of ROS production), and significantly improved sperm motility compared to control. Sources include tomatoes plus carrots, capsicums, guava, red cabbage.

Interested in a FREE consult with a fertility nurse specialist? Book Online or book via the Book Online Button above.

Intralipid Infusions For Fertility Support

What is Intralipid?
Intralipid is a milky fluid containing fat (lipid), originally developed to provide intravenous (IV) nutrition for patients unable to eat. Intralipid infusions are now often used as an add-on therapy for women with “immune mediated” implantation failure or miscarriages. In regards to implantation failure, this may occur during the attachment and migration process, with a negative urine or blood test for human chorionic gonadotropin (hCG) or failure to form an intrauterine gestational sac with positive hCG. Recurrent implantation failure (RIF) is a clinical phenomenon with no widely accepted definition.

Intralipid therapy is used to reduce an immune “rejection” of an embryo because it may suppress immune activity whilst being relatively safe and inexpensive.

Some trials have suggested that the levels of Natural Killer Cells (NKC) can be suppressed by administering intralipids to women with elevated NK cells and how long that effect lasts for however, pregnancy rates were not evaluated.

A recent meta-analysis study in 2021 looking at Intralipid infusions, identified that a significant body of evidence exists showing that intralipid infusions can help implantation in those with otherwise unexplained infertility and may improve the live birth rate in those with recurrent miscarriage and recurrent IVF failures and recurrent implantation failures and recurrent pregnancy loss in the presence of known immunological risk factors. There is a role for Intralipids for strong consideration in selected cases, especially when standard treatment has failed, and identifiable risk factors are present (1).

Interpretation of the available information is as follows:
Intralipid might also be useful in women with elevated NK cells, but it’s not known if this means improved pregnancy or live birth rates. It is important to test both peripheral (blood) NK cells and uterine NK cells as they can be different (i.e. just because the blood is normal doesn’t rule out the possibility that NKC are raised in the uterus). There are also medications that can be used to suppress NK cells. that your specialist may discuss with you and additionally, Intralipids could be considered as an adjunct (add on) to your treatment.

Why would a doctor prescribe Intralipid therapy?

Immune Suppression:
Pregnancy, in some women, can be an immunological challenge because the embryo/fetus is considered “foreign” to her immune system as half the embryo is derived from the father. As the primary function of the immune system is to attack foreign invaders (bacteria, virus’, foreign proteins), there is a potential for the immune system to attack the developing embryo/ fetus.

While natural protective mechanisms prevent this immune rejection in most pregnancies, unfortunately, for some women, an immune response to the embryo/fetus has been thought to produce implantation failure and miscarriage. It is also interesting to note that women with an established history of auto-immune disease, or those women found to have some evidence of auto-immunity on testing (for example positive ANA/APLAs or thyroid antibody blood tests, raised Natural Killer cells on endometrial biopsy), are more likely to experience this type of immune mediated pregnancy loss.

Various forms of immunosuppressive therapies have been employed to improve pregnancy outcomes, with mixed results. More recently, Intralipid therapy has been used to prevent immune rejection of embryos because some studies indicate that it can suppress immune activity, while being relatively safe and inexpensive compared to these other treatments.

If a woman trying for a pregnancy has a history of auto-immune disease, or a blood or endometrial biopsy result suggesting an over-active immune system, a doctor may decide to use Intralipid to try to reduce immune rejection of the embryo.

A discussion between a patient and their treating doctor can determine if Intralipid treatment is a reasonable approach, considering the patient’s specific medical issues and past treatment experiences.

Endometrial Growth Promotion:
Intralipid therapy may also be used to help promote endometrial (lining of the uterus) growth in women known to have a thin endometrium on ultrasound assessment. In some of these cases inadequate endometrial development is possibly caused by poor blood flow to the uterine lining, linked to a deficiency in production of what is known as Vascular Endothelial Growth Factor (VEGF) in the endometrium, a vital growth factor for new blood vessel formation. Intralipid therapy has been found to significantly boost women’s levels of VEGF in their blood, with these levels remaining elevated for up to 10 days after treatment which is why the infusions are recommended as often as they are before and after ovulation/embryo transfer and upon a positive pregnancy test until 12-14 weeks gestation.

A discussion between the patient and treating doctor can determine if Intralipid treatment is a reasonable approach, considering the patient’s specific medical issues and past treatments.

How is Intralipid therapy given?

Intralipid is a milky fluid that is added to a saline (salt) solution and administered intravenously usually over a 1-2 hour period according to the doctors’ orders.

Patients will initially be assessed by a nurse to check that they are well (no temperature, high blood pressure or acute illness) and have no allergies to the components within Intralipid (soy, eggs)

Intravenous access will then be obtained by inserting a needle (cannula) into the patients’ arm.

Patient observations are monitored throughout the infusion.

When observations are within normal limits and stable, intravenous access will be removed and the patient free to leave

The timing of Intralipid infusion in relation to the patient’s IVF treatment will be determined by the treating doctor. However, for presumed immune mediated implantation failure the typical practice is as follows:

Intralipid Regime for Natural Intercourse (suggested)

An Intralipid treatment 1-4 days before ovulation

A second treatment 7-14 days following ovulation

If a +ve hCG is established a third treatment is administered within 7 days of a positive serum hCG.

Every 2 weeks once a pregnancy test is positive until 14-16 weeks’ gestation.

Intralipid Regime for Fertility Treatments ie IVF (suggested)

An Intralipid treatment 7-14 days before embryo transfer where possible but can be done 0-14 days before.

A second treatment may be administered 7-9 days following embryo transfer

If a +ve hCG is established a third treatment is administered within 7 days.

Every 1-2 weeks once a pregnancy test is positive until 14-16 weeks’ gestation.

Some research has shown that Intralipid can modify women’s immune systems for at least 7 days between treatments.

Intralipid use to Enhance Endometrium (suggested):
When using Intralipid to improve blood flow to the endometrium it is administered as follows:

7-8 days before your egg collection or ovulation (no earlier as inadequate E2 level to stimulate lining)

Some modifications to these timings may occur to accommodate a client’s availability.

What are the potential side effects of Intralipid?
Fertility specialists and immunologists have been prescribing intralipid therapy for many years with no reported serious adverse reactions. However, it has been reported that intralipid infusions have been associated with the following:

Rise in body temperature (occurs in less than 3% of clients having infusions)
Shivering and chills
Nausea and vomiting occur (less than 1%).
Other relatively rare side effects which have been reported to occur immediately or soon after the infusion begins include allergic reactions (skin rash); breathing difficulties; an increase or decrease in blood pressure; abdominal pain; tiredness; headaches; slight and some dizziness.

As Intralipid is produced from soybeans and egg yolk, people who are allergic to soy or eggs should not receive this infusion. As there is a known cross reactivity between soy and peanut allergy, people who are allergic to peanuts should also not receive this therapy therapy. If you have severe liver or renal disease you will not be able to have this infusion.

There is no evidence that Intralipid is harmful to embryos or the fetus. The published literature on the use of Intralipid during pregnancy has been reassuring that it is a safe therapy for both mother and baby, provide safety precautions are taken.

Preparing for your procedure:

Your specialist (or one of our doctor’s), will provide a medication order and the timing for the infusion will be set around your embryo transfer. You may need to have time off work so that the timing is correct for your treatment.
We recommend that you drink at least 2 litres of water the day of and prior to your therapy.
You will be able to eat and drink as normal prior, during and following the infusion.
Purchase some Emla patches (numbing cream) from a pharmacy and place one patch on the inner side of each arm at the level of the elbow at least 1 hour before your infusion is scheduled.
Please bring with you a book, your iPad, phone etc as the infusion can take 1-2 hours (2 hours if it’s your first infusion)
You will be provided with a drink during your procedure; however, you are welcome to bring something more substantial

FAQs:

Can I return to work after my infusion?
Yes, you can return to normal activities after your infusion (including gym classes). There are no restrictions, however some patients have reported feeling tired a few hours after their infusion. We advise thst you avoid heavy lifting for 24hrs with the arm the IV was inserted.

Is there a cost?
Yes. Our admin team will provide you with a quote. If you have cover for extras with a private health fund it is worth asking if they will cover some of the infusion cost,

Do I need to fast?
No, you can eat and drink normally prior, during and after your infusion. We will provide you with either a herbal tea a cold kombucha or water drink during your infusion.

Post Infusion Instructions
If you have any urgent concerns after your infusion, please contact IV Health Sunshine Coast on 07 5406 0689 (during business hours), your GP/Specialist or present to your nearest hospital.

We look forward to seeing you soon!

Interested in a FREE consult with a fertility nurse specialist to discuss Intralipid Infusion? Book Online or book via the Book Online Button above.

Link to Reference cited above.

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