With advances in reproductive medicine coming at an increasingly rapid pace, it is vital to keep oneself abreast with the developments in the field of fertility assessment and advanced reproductive techniques (ART). Medline Academics is a premier platform for academia with a vision of enhancing medical education through industry-oriented programmes based on solid evidence provided by qualified clinicians and subject matter experts. With its prime objective being the establishment of a link between theory and practice, Medline Academics provides a wide range of educational programs, including its Certificate Course in Infertility in India, which would help health care professionals diagnose and manage infertile couples, the first thing I want to talk about today is assessing your fertility and what you can do to improve your chance of success.

As part of the effort by Medline Academics to ensure the easy accessibility of fertility education, it constantly provides high-quality educational information that makes understanding the complex issues related to fertility easy for both students and doctors. In today's session, Dr. Aimee Eyvazzadeh, who is famously known as the "Egg Whisperer," talks about one of the crucial things when it comes to IVF, which is the importance of understanding your diagnosis before going through IVF.

Why? It's because it's so important to know what your diagnosis is before you do IVF. I know that sounds so weird, so lame, like isn't IVF supposed to fix everything? And the answer is no. So I've come up with something called the Egg Whisperer Diet.

For those of you who don't know, I was lovingly called the Egg Whisperer by one of my sweetest and dearest patients. And then she bought me a website called eggwhisperer.com as a gift. And that's how it all started.

So, I've used these terms to kind of help patients remind them basically like what to ask their doctor and how to be more empowered and more informed. My mantra is test, don't guess. Very simple words to remember and live by.

Why a Fertility Diagnosis Comes Before IVF?

So the Egg Whisperer Diet, D is for diagnosis, I is for your IVF cycle, E is for embryo transfer preparation, and T is for transfer. So that's what makes up the diet. It is my recipe for success.

So the D diet is like our diagnosis. How do you figure out like what your diagnosis is and why does it matter? Well, it actually matters a lot. You want to make sure that your doctor is planning your IVF cycle in a way to address the diagnosis.

I'll share a scenario with you. The other day I did a second opinion consult and the husband had low motility. Motility was around 15%.

And no one really told them that that was the diagnosis. They thought they were, you know, unexplained, which in my world or in my mind and in my world means that no one explained it enough to you. So, the doctor, guess what? They did IVF and they did not do ICSI.

ICSI is where you take a single sperm and put it into the egg. So if you think about it, that could be pretty frustrating when you wake up after the egg retrieval and find out that there are no fertilised eggs. So the diagnosis, if you had understood it and you had designed your IVF cycle to basically address it, that could have been prevented.

Don't Settle for "Unexplained" Infertility

You wouldn't have learned your diagnosis the hard way. So do whatever you can to talk to your doctor about what have you ruled out about me? What do you know about me? And if they say, Oh, it's unexplained, you know, if you're a 44 year old who was told it was unexplained, I can promise you, it's not because it's unexplained it's because you're 44 years old. So you want to talk to your doctor about what can I do that's in my control to give myself the best chance of pregnancy.

And if you're telling me I'm some unexplained, what are the possible explanations for me? And then you can use the words, what have you ruled out? What have you ruled out lately? I mean, there should be a song that goes in there somehow, but another mnemonic you guys, and that is the tushy method. That's how you get to the diagnosis, the five steps to figure out your fertility. Seems complicated.

I try and make it not so complicated. Life is complicated enough. Tushy method.

Editor’s Note: Understanding the Fundamentals of Fertility assessment is essential for every healthcare professional involved in reproductive medicine. Educational programmes such as online infertility courses in India help clinicians build a strong foundation in fertility evaluation, diagnostic workups and evidence-based treatment planning before applying these concepts in clinical practice.

The TUSHY Method: Five Key Fertility Assessments

• T for tubes
• U for uterus
• S for sperm
• H for hormones
• Y for your genetics

You can get it all tested in one month. If it's been more than a year, do it again, especially if you're going to do IVF here, especially if your doctor is telling you your diagnosis is unexplained. So, in one cycle, your period starts, cycle day three, get your FSH, oestradiol, AMH, all your hormones and your preconception labs drawn.

Do your carrier screen and chromosome analysis if you haven't done it already. Order your HSG done between cycle days eight through 10, get an ultrasound done between day three and day eight through 10. So that if you have, let's say a big fibroid or a big ovarian cyst, you want to know that before your HSG appointment.

Order a semen analysis. If your site, because of COVID, isn't doing a semen analysis right now, no big deal. Meet fellow.com backslash egg whisperer.

That's how you can get a do it yourself semen analysis kit delivered to your home. If only for women, it could be that easy that we could just put our eggs in a cup and send them off to be frozen or analysed, but it's not until then we got to sleeves up pants down. You know what I'm talking about? So super important to find out what your diagnosis before your IVF cycle.

So now let's talk about preparing for your IVF cycle. The things that I talk to my patients about are this, look at your lifestyle. It's not about losing weight.

It's about the healthiest lifestyle. Some of the most traumatic doctor experiences I've had growing up and you know, even like two, three years ago, for example, it would be providers telling me that I'm not, I'm too heavy and they didn't use words like that. They're actually quite mean and I would never do that to anybody.

So the way I talk to my patients, cause I think they're beautiful and they're healthy and they're young and they're fertile and that's how I see them is that I want them to be as healthy as possible. So strength training, eating right, plant-based diet, all that kind of stuff, sleeping well, making sure that you have a normal circadian rhythm, make sure your relationships are in the healthiest state.

Planning for IVF does not just mean lifestyle modification and clinical testing, but also involves finding a suitable fertility center. Being one of the best in the provision of reproductive medicine services, Dr. Kamini Rao Hospitals, an outstanding IVF Hospital Bangalore, provides fertility assessment, customized treatment options, and scientifically proven ART methods. The clinic’s multidisciplinary team consisting of fertility experts, embryologists, and counselors provides quality, individualized care and helps people throughout their fertility journey.

Build Your Fertility Support Team

And I came up, you guys, I know, I know, I hear you saying it, another mnemonic and that's the fertility team. So, your therapist, you're eating and exercise specialists and nutritionists, acupuncture, mindfulness and meditation.

Supplements That May Support Fertility

So, preparing also means taking supplements. So supplements could be CoQ10. It could mean N-acetylcysteine. If for example, you have endometriosis, it could mean TruNiogen and let's say Terostilavine, Resveratrol. Resveratrol, I know I can say that again.

Resveratrol. There you go. And acai berry.

If let's say you have decreased ovarian reserve, you can see that I have my certain recipe that I recommend to my patients. Ask your doctor what their recipe for supplement success is. Some people call it a supplement soup.

I just call it my egg whisperer special sauce and I swear it's magic. For some people it works, for other people it doesn't, but I really think at least taking a prenatal CoQ10, vitamin D, fish oil, I know I just rattled off a whole bunch of stuff, but I only have 30 minutes here. And then adding in, for example, TruNiogen and all the other things that I explained to you, and then Ovacetol, if you have PCOS.

Personalising IVF Preparation for Your Diagnosis

So remember diagnosis before IVF cycle, diagnosis before treatment, test, don't guess, right? So if you have PCOS, you want to make sure your hormones are balanced and you've healed it. If you have endometriosis, talk to your doctor about, have you ruled out adenomyosis? Is it possible that endometriosis is affecting my tubes and I'm hydrosalpinges, right? All super important stuff. So that's how we prepare healthiest, most sane, most relaxed that you can possibly be before going into your IVF cycle. And if you are in a partnered relationship, make sure your relationship is really, really strong. Take the time, take a break, take all the necessary, you know, what is, what am I trying to say? Measures to make sure that you guys are on the same team, and this is, this is right for both of you.