With a sharp rise in IVF (In vitro fertilization), women have entered a new age of awareness with regards to their fertility, as it has cracked open a host of possibilities.
From women-centric business ventures to online communities, it all focuses on empowering women with knowledge and gain a deeper understanding of their reproductive realities.
As the society’s approach towards the issues around fertility is changing, so is the science around it.
Here, we scratch beyond the surface on the subject of IVF and reproductive health with medical practitioner Dr. Mari Mitrani, Chief Scientific Officer at Gattaca Genomics.
Dr. Mari Mitrani, Chief Scientific Officer at Gattaca Genomics
Talk us through the IVF process – what can one expect?
The IVF process typically begins with a period of ovarian stimulation, during which a woman receives hormonal medications to encourage the development of multiple mature eggs. These eggs are then retrieved through a minimally invasive surgical procedure. Meanwhile, sperm, from a partner or donor, is collected and prepared. In the laboratory, the retrieved eggs and sperm are combined to facilitate fertilization, forming embryos. Over the next few days, the embryologist monitors the embryos’ development, assessing their quality. Selected healthy embryos are then transferred into the woman’s uterus, with any remaining viable embryos being cryopreserved for potential future use. The entire IVF journey requires careful monitoring, precise timing, and the expertise of fertility specialists.
The IVF process can have a heavy toll on the mind and body, it is often noted that infertility is considered multifactorial with respect to all the advancements in medicine and science, even now, there is still no guarantee that a successful pregnancy will and can occur for individuals seeking to conceive.
Let’s talk about your work process. How do you start in helping your clients with their fertility concerns?
As a physician-scientist in the field of infertility, I’m running a lab that offers Preimplantation Genetic Testing (PGT). PGT is a genetic screening done in fertilized embryos before they are selected for implantation. PGT is advancing and innovating the fertility space due to its added value in reporting Aneuploidy, which is the abnormal count of genes present in the embryo that explains a higher rate of miscarriages. Next-generation sequencing allows us to read valuable characteristics of embryonic genetics to predict and/or diagnose genetic disorders and diseases beforehand. Ultimately, we are utilizing artificial intelligence to further analyze and interpret data obtained through genetic testing.
“your chances of having a family in the future are possible if you act sooner, rather than later.”
When is the right time to consider it?
We have precise statistical data referring to maternal age and how it impacts the production of healthy eggs. Although fertility and infertility is so multifactorial, the one thing we know is how to act on this specific characteristic. We know that after the age of 35, women’s egg quality starts deteriorating rapidly year by year. This has a significant impact on embryo quality and genetic abnormalities. As a woman who continuously cheers on other women to pursue their dreams, I would say always keep this cut-off time in your mind. Freezing healthy eggs or embryos early on, helps preserve the ability of couples and individuals to have a family later on. Unfortunately, many couples and individuals wait until after this age to begin their fertility journey, with much time working against those seeking treatment. Doctors, in conjunction with science, can only do so much to aid this process. This is one thing I would love to keep educating women worldwide on: your chances of having a family in the future are possible if you act sooner, rather than later.
What are the benefits and risks that come along with it?
There are risks in everything we do in the IVF field, but because so many of the advancements are around technology and data, the risks of physical harm are low. While the benefits of this technology haven’t fully been realized, the mass amount of data will yield improvements on multiple fronts, from higher pregnancy rates to lower error rates. Even though this field of medicine is relatively new, the advancements and fertility benefits keep growing yearly!
The risk is very clear and not often spoken about, IVF will not achieve pregnancy in 100% of the cases, so it is important to know that your desired pregnancy might not happen after a cycle or cycles of IVF. Know that neither the medical or scientific community will give up to continue to advance innovation and therefore success rates.
What are the newest advancements and approaches that support fertility chances available in the region?
Advanced embryo selection tools like PGT and AI have added an extra layer of confidence when choosing the best embryo for transfer. Improvements in vitrification, embryo freezing, media, and techniques have allowed for improved survival of human eggs. This is a game changer for patients preserving their fertility before undergoing treatment for diseases like sickle cell and cancer. Time-lapse imaging has allowed us to collect and analyze data from every stage of development without disrupting embryo culture. More and more practices are prioritizing personalized care by tailoring treatment plans to their patient’s specific needs.
How do you choose the perfect clinic for couples deciding to try IVF?
Like any other specialty, the most important thing is to ensure that you and your doctor connect, on a professional and somewhat on a personal level. During this journey that many call long and complex, it is important for the couples to feel safe around the doctor, bold enough to ask questions or bring up concerns or even feel heard. Understanding one another plays a vital role in hopes of achieving the ultimate outcome of a successful pregnancy.
Another major factor to consider is the physicians’ qualifications; in the US, there is a subspecialty of Gynecology that only deals with fertility called REI (Reproductive Endocrinology and Infertility). These physicians have dedicated their careers only to helping couples in their fertility journey and have very high standards of care focused on the complex hormonal cycles and mechanics of conception with advanced knowledge of sperm, eggs, male anatomy, female anatomy, and scientific research.
How does proper diet and lifestyle play into the entire IVF process?
Dr. Natalie Crawford, a double board certified ObGyn/REI doctor, says: “A healthy diet that is good for your body is the best diet for your eggs and reproductive system!” A diet high in whole foods, rich in dark leafy greens, lots of fruits and veggies, nuts, seeds, and whole grains is scientifically proven to boost our overall health, including your fertility. While no one has a perfect diet all the time, the goal is to remain consistent and make healthy improvements as much as you can. Toxins also play a big role in the IVF process. Smoking, scented products and the chemicals in our household items can have a significant negative impact on your egg and sperm health. Reducing unhealthy habits like smoking, vaping, and cutting back on the amount of toxins in your household can improve your chances of having a successful IVF cycle. Regular exercise, has proven scientifically to increase your chances of fertility, and the interesting data comes not only from cardio training but from strength training, so ladies, it’s time to lift some weights!
“We are usually looking for the latest trends and crazy expensive solutions, but it is the simple, logical changes that give us the most significant results.”
Which food types should we incorporate to boost fertility naturally?
Nothing will miraculously ensure a boost in fertility in a way that will guarantee pregnancy. If somebody is offering you this, please run as fast as possible! Infertility is multifactorial, and there is no such thing as a magic pill or “one size fits all” kind of strategy. You need to ensure you have the best doctor, healthcare providers and lab team in your corner to excel in your journey.
We are usually looking for the latest trends and crazy expensive solutions, but it is the simple, logical changes that give us the most significant results. I propose something: what if you just start adding more “fruits” and “veggies” into your diet? Plant-based Omega-3’s are so essential to your diet, think walnuts, chia seeds, flax seeds or brussel sproust. They have proven to increase the time to pregnancy, improve ovulation and overall fertility outcomes. Even though fish has Omega 3’s, we want to avoid heavy metal consumption. Complex carbohydrates (brown rice, quinoa, amaranth, oats, etc) are the right choice, not your enemies! Carbs are not the problem; you need them! Refined carbohydrates like white sugar, white rice, white pasta, and white flour are the ones you have to limit; they have been shown to lower the chances of getting pregnant. High insulin levels impact normal hormonal function in the ovaries and, therefore, egg quality and chromosomal abnormalities. Higher sugar and insulin levels early in pregnancy have been associated with miscarriages however it is crucial to note that research in this area is ongoing. Vitamin D3 has been shown to increase reproductive outcomes, live rate births, and improve egg and sperm quality.
And the ones to avoid that adversely affect fertility?
In IVF studies, patients with a higher intake of plants and a lower intake of red meat had better embryo development. Red meat has a high glycation end product (GES). These are endocrine disrupting chemicals, which have been shown to be detrimental to egg quality. The more you eat red meat, the worst your reproductive parameters will be.
Two large cohort prospective studies have also shown a negative reproductive association with more dairy consumption, as it lowers reproductive outcomes. The suggestion is to limit or lower their intake of meat and dairy and increase consumption of a whole food plant based diet.
“In essence, a partner’s presence and active participation can provide practical assistance and invaluable emotional support during the IVF journey.”
How important is it to involve your partners in the IVF process?
The involvement of a partner in the IVF process is of profound importance, both emotionally and medically. While infertility is often thought of as only a woman’s issue, male factor infertility can contribute up to 40-50% of all cases of infertility. It is crucial to not only have a woman’s fertility tested, but the male partner as well. IVF is a journey that requires not only medical support but emotional and psychological support. Having a partner by one’s side provides crucial emotional reassurance, as it can be a challenging and emotionally taxing experience. Partners can offer empathy, comfort, and a sense of shared responsibility throughout the process, strengthening their emotional bond. Moreover, partners often participate in decisions related to IVF treatment, including choosing treatment options, attending medical appointments, and providing valuable input during the decision-making process. Their active involvement fosters a sense of unity and teamwork, which can be empowering and comforting during the sometimes unpredictable and uncertain path of fertility treatments like IVF. In essence, a partner’s presence and active participation can provide practical assistance and invaluable emotional support during the IVF journey.
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