Prepping for IVF round 2? Read these doctor’s tips

Whether you’re going again after a failed IVF cycle, or trying for a sibling, preparing for IVF round 2 warrants a doctor’s expert top tips. 

After all, you’ve been through the process already. You’re more familiar with the terminology, timeframes and some of the possible side effects. This time, you can focus on changing up the protocol – if that’s in your plan – trying new supportive therapies, and going into more detail with your questions and queries. 

Plan for success

For gynaecologist and fertility doctor with IVF-Life Spain, Dr Alejandra García Villalba, careful prepping for IVF round 2 is helpful – but so is staying as relaxed as possible. So prepare, yes, but don’t beat yourself up to achieve a perfect score on every aspect. You’re in good hands with your team, so get comfy and flick through these top tips for that next round of IVF. No pressure, though. Your body is doing amazing work. 

IVF Life Spain are a global reference point in complex infertility cases. Whether it’s round two or round six and beyond, the team are at-the-ready to consult by committee, pivot and utilise cutting-edge practices, putting everything into each individual patient care plan.

Here are the top questions asked by our TRB community when prepping for IVF round 2, and Dr Alejandra’s expert insight: 

Q: How will my doctor review my first round?

Dr A: It’s very important to review each cycle, to see if there’s something we can change or improve (for example, if the follicle growth is asynchronous (occurring out of sync) we can apply a different strategy, or if you experience a fertilisation failure, we could look at introducing calcium ionophore in the next cycle, etc.)

Q: Do you recommend a different approach/timeframe, depending on age?

Dr A: A woman’s age is very important (if not the most important factor), when making decisions on an IVF cycle. We know that with age the ovarian reserve decreases, and that the quality of the ovules declines. Therefore the approach, the recommendations, the treatment – everything changes, depending on the age factor.

Q: Are IVF success rates better first or second time round?

Dr A: It depends somewhat on the age of the woman and the cause of infertility. It is true that in the second IVF cycle we know more than before about the woman’s ovules (their quality, maturity rate, etc). We can use this information to readjust the treatment strategy. And we can even pivot in the laboratory – for example by introducing calcium ionophore, allowing the ovules to mature in vitro, etc.

Q: Do you recommend patients take a break between IVF cycles? Or avoid back-to-back cycles?

Dr A: It’s not necessary, as long as patients are in good medical and psychological health, and wellbeing isn’t an issue. It’s actually possible to use one cycle as preparation for the next cycle, so the results may be better without waiting in some cases, but you should always follow your doctor’s recommendations.

Q: What are your top tips for preparing mind/body, before the next cycle?

Dr A: For the body, eating a balanced diet, exercising, and taking supplements to improve sperm and oocyte quality, etc, can help. 

In terms of the mind-body connection, I recommend reviewing your entire medical history and first cycle with your doctor, asking lots of questions, seeking psychological support if required, always understanding your options and asking what Plan B might be. 

Q: What questions should patients ask their doctor, before starting round 2?

Dr A: It’s really important to ask all the questions you need to, and review your entire medical history with your doctor to understand possible areas for improvement. Some of your questions might be:

• Is there any explanation/likely cause for my first round failure?
• What strategy are we going to apply in this second cycle?
• Can I (or we) do anything specific, to improve the results?

Q: And … what factors should my IVF doctor be covering?

Dr A: Your doctor should always review your case in detail, covering the factors they think can be improved. They should evaluate each case – ideally by committee, factoring in their colleagues’ opinions in order to improve the results as much as possible.

Q: Do you recommend changing up protocols? How, and what do you look at first?

Dr A: I’d recommend assessing the case individually. Your doctor will assess whether there’s any reason to change your treatment strategy. Not everything depends on the treatment, and things can also be readjusted in the laboratory, if your case requires it. Your doctor may want to look at adding growth hormone, performing dual stim or luteal phase stimulation, doing a priming cycle, etc. But again, it will depend on your individual case.

Q: Is there any therapy or counselling you’d recommend, between or during cycles?

Dr A: Beginning an in vitro fertilisation cycle can be hard on your emotions. The process can, sometimes, take a long time, so you have to be very prepared psychologically.

I think it’s important to seek help from psychologists, support groups or look for reliable information on websites and social platforms like TRB, as well as chatting to people who’ve gone through a similar process.

Q: Should patients cut back on exercise and workouts, when preparing for IVF?

Dr A: If it’s light or moderate exercise, you don’t need to reduce it. Excessive exercise can have consequences at the oocyte or seminal level.

During egg stimulation, the ovaries grow and your doctor may recommend that you do not exercise, to avoid medical complications (such as ovarian torsion), or that after the transfer you take it easy for a couple of days. 

On a related note, lower weight in women can decrease success rates. In addition, some bodybuilding supplements can negatively affect sperm quality.

Q: How can patients shift and strengthen their mindset, ahead of their next cycle?

Dr A: Follow your doctor’s advice. Be physically and mentally prepared. Lead a healthy life, take recommended supplements. If you can, work at switching off from doubt and fear, especially when the time comes for medical intervention.

Q: Is there a risk of damage, after the first round?

Dr A: There’s no risk of damage, as long as your doctor checks that everything is correct – that you in yourself are fine, your ovaries are recovered, there are no complications, etc.

Q: What tests can you run, to see why my first round failed/succeeded? 

Dr A: There are many tests used to determine why a cycle has failed. 

• In the case of problems with stimulation or fertilisation, karyotype tests, genetic tests, more specific seminal tests (sperm fragmentation), etc may be used
• For implantation failure, your doctor may run endometrial receptivity tests, endometrial immunological tests, endometritis diagnosis, KIR HLAC tests, etc

Q: Do you recommend avoiding sex before/during/after the second round? 

Dr A: In the later stages/days of ovarian stimulation, since the ovaries are larger, you should avoid sex, especially if you have many follicles (to avoid ovarian torsion). During the transfer cycle, you should get advice from your doctor regarding the days that sex should be avoided.

Have you seen our giveaway with IVF-Life Spain? Enter for the chance to book a free first medical consultation (plus immunology or genetic test).