Dos and Donts during IVF Stimulation

I often get asked in clinic if there is anything that should be done differently whilst in the stimulation phase of a cycle.  It is a busy and stressful time, and if it’s your first cycle it is a big learning curve; how to inject yourself, lots of scans, blood tests etc.  One thing is for sure you hand over control of your life for at least 2 weeks; you don’t know how the follicles will develop, you need to be ready to go to the clinic at the drop of a hat, you don’t know how long this phase will last, and you don’t know when egg retrieval will happen.  Try and lean into the fact that for the next few weeks you won’t have all the answers.  When there is a loss of control the best strategy is to focus on what you can control – and here are a few suggestions of things you can!

• What should I eat? High levels of protein are needed at this time – clinics used to say drink a pint of milk a day – but dairy can be very Damp forming from a TCM perspective and not the best for everyone.  Certainly a glass of organic whole milk is ok but there are other sources of protein such as eggs, chicken, beef, aduki beans, black beans, lentils, fish which are better.  Blood and Qi nourishing foods are the order of the day in the stims phase so beetroot, (ask me for a lovely beetroot soup), apricots, bone marrow/broth, dark leafy greens including watercress, spinach, parsley, and asparagus.  Think dark coloured foods and you won’t go far wrong.
  And to avoid…….sugar of course!  It “consumes” blood in TCM so has the opposite effect of the above therefore undoing all the hard work.  Emma Canon in her book Fertile – has some wonderful recipes to enjoy during the stimulation phase and for fertility in general.
• Massage for the abdomen Pre transfer massaging the abdomen can be very comforting and can help to alleviate some of the bloating. It is not for everyone but if you want to give it a try I have tried to create a self-massage for the abdomen which you can do easily – apply the pressure that suits you.  I am hoping to produce a few explanatory pictures but haven’t done so in time for the newsletter – so please get in touch and hopefully I will have done them!
  1. Lay on your back in a relaxed position on the floor or a bed
  2. Begin by moving your hands, one on top of the other in a clockwise direction around your navel (if you have loose stools go anti clockwise). Start gently and gradually apply more pressure – repeat 9 times
  3. Next work on the Ren/Conception channel between the navel and the pubic bone. If you have acupuncture with me you will likely have had points on this channel.  Move up from the pubic bone towards the navel in a stroking fashion – you can press as deep as feels comfortable.  The movement should be just in that one direction – so that you are strengthening and tonifying the channel – continue for a few minutes.
  4. Next work on the inguinal channel. With two fingers press into the crease and release – move from the centre outwards.  Then repeat on the other side.  Do this x3 – this is an area where there are lymph nodes so it will help to stimulate circulation.
  5. During this process you may have found areas which were uncomfortable and now is the time to visit these places and apply medium pressure in a circular fashion for as long as feels necessary
  6. Place your hand to one side of your navel pointing in the direction of your pubic bone. When you have found one hands width away move down toward your pubic bone to find the point Zi Gong (Palace of the Child).  Move down so you are about two finger widths above the pubic bone.  Circular movements applying a pressure which is comfortable for you will stimulate circulation in the area.
  7. To finish off rub your hands together to create heat and lay them on your abdomen – in a triangle – fingers pointing down and thumbs joined above the navel. 2-3 mins – breath into the diamond shape where your hands meet.

• Fresh air and breath work is so important. Walking in nature and breathing deeply, using our diagram to its fullest extent is exhilarating and we are moving our Qi as we walk so it’s a double whammy.  Really good for the soul and Lung Qi.  If you want to look further into breath work you could check out Rebecca Dennis @breathing.tree on Insta.
• Supplements – I am often asked what supplements can be taken during the stimulation phase. Best advice from Rebecca Fett  “Starts with an Egg” fame, is to continue with what you are doing until egg collection.  After transfer stop Vit E and continue with CoQ10, NAC, Vit D to prevent miscarriage.  Once pregnant revisit your supplements again.  I should point out that I am not a qualified nutritionist but I am a Chinese herbalist.  Over the years I have gone with Fertility Clinics recommendations and suggested no herbs during Stimulation Phase.  The more I learn the more I am leaning towards continuing with a bespoke formula which is carefully constructed to support the  individual and enhance and complement the stimulation process, but this is very much client choice.
• Hydration – keeping hydrated is important – according to Michael Dooley in his book “Fit for Fertility” if you are 2% dehydrated (which is not much) this can affect overall performance by 10%, this is in relation to a tennis player but you can easily extrapolate that out to include all the systems in our body (including reproductive) because water affects us at a cellular level. Received wisdom is you need 8 glasses of fluid spread over the day – about 2 litres but this does include herbal teas and other drinks besides water.  The rule of thumb is that your pee should be clear/straw coloured and if it is any darker you are probably slightly dehydrated.
• Rest and relaxation/over exercising – find time to quieten the mind and body – think mindfulness, a warm bath (yes you are allowed a bath during stimulation phase), yoga, meditation, or walk in nature – see above. This replenishes Kidney Yin which you need in abundance at this time.  A word about exercise – make sure you are not over exercising as this can deplete Qi and divert energy away from the uterus – play safe 15-20 minutes moderate daily exercise is enough.  For tips on Sleeping see my other blog.
• Acupuncture – of course!! Helps with all important blood flow to the pelvic area encouraging uniform growth of follicles on both sides.  In my clinic I like to clients to keep in touch and forward me a picture of their follicular gram they are shown during their scans so we can monitor the development and treat accordingly.  Other benefits are to aid relaxation and calm, improve sleep, and combat any side effects such as headaches, constipation or bloating from the stimulation drugs.