How can I increase the likelihood of a pregnancy?

“We have just a couple of good quality embryos, and we really want to ensure we get pregnant right away. I’ve read there are some treatments that can improve the chances of a pregnancy with an embryo transfer. What can you suggest?
–Linda & Mark

Thanks for the note, Linda. Over the years I’ve had clients come to me with different ideas for improving their chance of a pregnancy. Most of the ideas are picked up from the internet. Some are more reputable than others.

Of course there are always holistic or natural remedies suggested around the web to improve your overall fertility. These include adding antioxidants to your diet, reducing transfats and processed carbohydrates, exercising regularly, limiting caffeine and alcohol, and taking general fertility supplements (including folic acid). I should point out the obvious… these are the same recommendations just to stay generally healthy. So if you have an upcoming embryo transfer and want to boost your chances, just do what comes naturally and take good care of yourself.

That said… I suspect you’re referring to more extraordinary measures that are used in IVF cycles and embryo transfers specifically. In that case, there are a few options that have been popularized on the Internet, and maybe you’ve seen these.

Depending on the situation, the clinic may recommend a variety of options, including blood thinners, intralipid transfusions or even “embryo glue”. Honeslty, we tried some of these, but I have no certainty if any of these actually improved the likelihood of pregnancy in a typical case. You should ask your clinic to weigh in on the topic:

These are the ones I know of, in order of my understanding of the efficacy.

Assisted hatching Assisted hatching is a procedure where we can help the embryo “hatch” from its “shell” by creating a small crack in the “shell” of the embryo. It is believed that this can help an embryo implant in the uterus, leading to higher pregnancy rates in some patients. Many clinics do assisted hatching as a standard procedure.

Blood thinners Blood thinners are used in the prevention and treatment of blood clots. It has been suggested that they also may improve the intrauterine environment in some women. There is some clinical support for this in cases where a common genetic mutation creates an immune response that separates the embryo from the placenta. The gene is responsible for symptoms such as blood clotting and blood thinner counter this response.

Endometrial scratchingEndometrial scratching involves making a small wound in the lining of the womb. The idea is that the wound will increase blood flow to the uterus as part of the recovery response, which may improve the receptivity of the uterus to the embryo. The technique is suggested to facilitate embryo implantation and increase the probability of pregnancy, but I have not seen any studies that demonstrate that this actually works. On the downside, the wound opens the possibility of infection and immune respnses could reduce the likelihood of pregnancy.

Atosiban Atosiban is a medication used to delay the premature birth of the baby. In rare cases surrogates receiving an embryo transfer can react with muscle spams or contractions in the uterine walls. This can prevent the embryo from implanting. Atosiban injections can help prevent this. But the value of the treatment is really only for those women who suffer from uterine contractions, and not for all women.

Intralipid Intralipid is a 20% fat emulsion that is administered routinely by the intravenous route, as a source of fat and energy. It has been known for some years that intralipid causes mild suppression of the immune system. This is useful in rare cases where the mother’s immune system attacks the fetus as a foreign object. Admittedly, our surrogate has had a successful pregnancy in the past, so it’s unlikely her body would have such a response.

Embryo Glue Embryo Glueis a transfer medium with hyaluronic acid and recombinant albumin. The way it works is that the embryo glue helps the embryo attach, but once it does, it’s stuck there. So the embryo may not have implanted where it naturally would have. This was a trendy add-on to embryo transfers in the last decade, and a few initial studies looked promising. However recent studies have been less positive, and it’s not generally used anymore.

I hope this is useful,