Your questions answered by Nurse Cyndi

Huge thanks to Nurse Cyndi from Hart Fertility who joined us over the weekend on our instagram grid, to answer your questions.

For those of you who are not on instagram, we thought we would share some of the questions and answers with you.

Q: What are the tests needed to know whether i should freeze my eggs now – or if I have time to wait until I’m a little older/met the right partner?

A:The tests we usually request for patients considering egg freezing include the following:

AMH (anti-mullerian hormone) this helps us establish your ovarian reserve and helps predict your response to stimulation medication (and how many eggs we could expect)

Day 2/3 FSH (follicle stimulating hormone) – testing this level provides a similar function to the AMH

Antral follicle count at the start of your cycle

Together these tests will help you determine, together with your FS whether freezing your eggs is the the right choice for you.

Q:Can you explain why it is so important that BMI has to be between 19-30 in order to start ivf?

A:Many studies have shown that having a BMI greater than 30 could reduce your fertility by 50%. The reason for this is that an increase in weight often throws hormone regulation off and could impact ovulation. Having a BMI above 30 also affects IVF success and ongoing pregnancy rates. However, in saying this, I know exactly how difficult it is to lose weight, especially when suffering under the pressures of TTC – so on the flip side, in most of the above-mentioned studies, the majority consensus is that even a 10% drop in weight has great positive outcomes. Don’t be too hard on yourself, because this can also be counterproductive.

Q:I have PCOS and irregular periods. Every time I do an ovulation test it says I’m not ovulating, so can you explain why I still have periods, even though they are irregular?

A:This is a good question and quite a common occurrence. Although some women with PCOS have regular periods, high levels of androgens (‘male’ hormones) and excess insulin can disrupt the monthly cycle of ovulation and menstruation. If you have PCOS, your periods may be ‘irregular’ or stop altogether. When ovulation doesn’t happen, it interrupts the usual hormone cycle and causes the lining of the uterus to be exposed to constant levels of estrogen. This can encourage the lining to become too thick and cause abnormal bleeding. So technically, periods without ovulation aren’t periods, they are breakthrough bleeding.

Q:My husband was diagnosed with 100% anti-sperm antibodies. One failed fresh ivf transfer earlier this year and 1 frozen egg left, Fet has been delayed due to covid 19. 
Is there any way of conceiving naturally? Will changing diet help lower number? 
Also is it possible the anti-sperm antibodies have transferred to me? 

A:Unfortunately with the diagnosis of positive sperm antibodies, the chances of conceiving naturally are relatively slim. The reason why ART is the better route is because when sperm antibodies are present, it is best to be ‘washed and prepared’ in our fertility lab in order to enhance fertilization.

Q:Is there anything my husband can do before collection day to really really enhance his sperm?! I’m sorry if this is a silly question. I just want us to do everything we possibly can!!!! Thanks Cyndi x

A:So this is great question- sperm production works in 3month cycles – therefore any changes we implement now, we may only reap in 3 months time, however this doesn’t mean that you shouldn’t start if this gap has/is narrowed. We would advise that he should ejaculate regularly ie. every 3 days, minimise the wearing of tight undies, stop smoking ASAP, follow a healthy lifestyle, keep well hydrated and look into a good male fertility supplement. When focusing on the actual collection, studies have actually shown that a specimen collect in the comfort of the man’s home is often superior to one collect at the clinic, however the transport of the collected sample is vital (so please double check with your clinic)

Q:My husband and I have done 5 iui’s and are about to do our sixth. We are going to try for a seventh next month, if this one doesn’t work. Our plan is to start IVF in July. I’m terrified of all the shots and hormones I’ll be taking. I’ve only taken clomid so far, and it made me feel horrible. Sorry for going on and on, but my question for you is: Is there any advice you can give me that’ll help me feel a little more comfortable about taking hormones? 
I’m just worried how they’ll change my mood and how I’ll treat people, especially my husband. Clomid makes me crazy and I’ve definitely lashed out at him on more than one occasion. But, he’s been wonderful and so understanding through this. 
Thank you so so much. Hope you’re staying safe with all this craziness. 

A:I’m sorry to hear that you have been through so many unsuccessful cycles, however its awesome to hear that you have a supportive husband to hold onto (or even to lash out at). Yes the hormone injections could be intense however many patients actually say it way better than taking clomid. It’s best to see your fertility nurse for a session to explain the full use of the meds as well as preparing for possible side effects – this way you will feel more empowered and confident in their use. During the cycle focus on positive affirmations and many of our patients find daily yoga beneficial. Wishing you all the best.

Q:Is there a supplement that I can take that will balance out the mood swings I experienced last time when I went through ivf? I’m starting again next month and would like to feel more in control of my emotions. Thank you Cyndi!! 

A:I’m sorry to hear about the negative emotional side effects you experienced with your last cycle. We usually recommend evening primrose oil to our patients with great success. Non medication options we recommend include guided meditation and yoga asana’s.

Huge thanks to the wonderful Nurse Cyndi. 

Sister Cyndi completed her undergraduate Bachelor of Nursing Science Degree in 2007 at Stellenbosch University (SU), with Distinctions in Community Nursing, Psychiatry and Midwifery; thereafter, she completed her post-grad honours degree in Critical Care Cum Laude in 2010, also at SU. She has a wealth of knowledge and experience in caring for fertility patients. If you have any further questions for Nurse Cyndi, you can reach her at Hart Fertility.

 

 

 

 

 

 

 

 

 

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