In outpatient clinics, especially for first-time infertility patients, we often prescribe nutritional supplements and complementary medications according to the situation, and we will also share these “nutritional supplements” with each other, and it is common for patients to ask me during the second visit why others need to take DHEA but she does not? What is the purpose of selenium yeast tablets? Do I still need to take folic acid? Patients also often come in with some overseas purchased ** to ask if it is suitable for them.
IVF in vitro culture test found that: VC, VE can increase the level of HCG and progesterone in the placenta in the culture medium, probably with its reduction of mitochondrial damage, supplementation of antioxidants VC, VE and selenium, zinc, copper and other minerals help to remove free radicals in the body. Of course, supplementation with antioxidant nutrients can also be helpful in improving the success rate of IVF.
I will introduce some of our commonly used pre-conception supplements and complementary medicines.
1. Folic acid
Folic acid, also known as vitamin B9, is very important for the normal development of the fetus because of its important role in the formation of the neural tube, so it is important for pregnant women to consume enough folic acid before pregnancy. Lack of folic acid during pregnancy can affect the development of the fetal nervous system, and adequate folic acid supplementation during the first and second trimesters of pregnancy can reduce the birth rate of neural tube abnormalities and cleft lip fetuses. As we can guess from the name of folic acid, folic acid is found in large quantities in leafy vegetables. In addition, animal foods such as pork liver, chicken and beef are also rich in folic acid, but due to the destruction of folic acid by high temperature during cooking and the low absorption efficiency of the human body, the daily diet cannot fully meet the needs of pregnant women for folic acid, so it is necessary for pregnant women to take folic acid supplements before and during pregnancy. Patients are recommended to take 0.4-0.8mg of folic acid supplementation daily from before 3 months of preconception until after 12 weeks of gestation.
Suitable for: Pregnant women should take 0.4-0.8mg of folic acid supplementation from 3 months before conception, at least until 12 weeks of gestation or continue throughout pregnancy.
2.Selenium (Xavier, Selenium Yeast Tablet)
Selenium (Xavier, Selenium Yeast Tablets): Selenium this nutrient has antioxidant damage, delay aging, anti-tumor activity, reproduction and other effects, selenium in physiological functions in addition to antioxidant, but also regulates the metabolism of the thyroid gland and the redox state of vitamin C, in addition to goiter, cretinism and habitual abortion related. Selenium is found in the soil, and the selenium content of the soil varies around the world, so the concentration of selenium in plants varies from place to place. In general, lean meats, persimmons, garlic, seafood, green onions and pumpkins in food contain high amounts of selenium. Animal products have higher selenium content than plants, but in marine organisms, although the selenium content is also higher than plants, the bioavailability of selenium is extremely low due to the formation of mercury─selenium complex in fish (especially fish with mercury in their bodies), so although the selenium content in fish is high but the availability for fish itself is extremely low; whole grains and drupe seeds are also good sources. In the process of assisted reproduction, we mainly use the antioxidant damage effect of selenium, and for selenium supplementation, we recommend 100-200μg (2-4 tablets) once a day.
Suitable people: pregnant and lactating women can supplement selenium.
3.Vitamin E
Vitamin E: It is a fat-soluble vitamin and is one of the most important antioxidants. Supplementation after the lack of vitamin E can promote the secretion of sex hormones, so that the male sperm vitality and number increase; so that the female estrogen concentration increases, improve fertility and prevent miscarriage. Natural vitamin E often comes from palm oil, sunflower oil, mesquite oil, corn oil, soybean oil and vegetable oils such as olive oil, nuts (peanuts, sunflower melon seeds, etc.), grains, fish, peanut butter and green leafy vegetables. The recommended daily intake of vitamin E from food is 15 mg, which is equal to 22 IU of natural vitamin E or 33 IU of synthetic vitamin E. Our regular multivitamins also contain adequate amounts of vitamin E.
Suitable Groups: Women can take a normal dose of vitamin E during pregnancy until delivery. High doses of vitamin E are often used for male infertility.
4, DHA, deep-sea fish oil, omega-3 fatty acids
DHA, deep-sea fish oil, omega-3 fatty acids (Omega-3 fatty acids): all taken for the purpose of supplementing DHA.
Recent research by the Women and Infant Health Trial Consortium , the right ratio of polyunsaturated fatty acids can improve IVF success rates. Studies have shown that having higher levels of specific combinations of polyunsaturated fatty acids can significantly improve pregnancy rates. Women with an omega-6/omega-3 ratio of 14.5 are most likely to become pregnant.
DHA is found in plankton (plants) in the sea, and when these plankton are eaten by fish, DHA is transferred to the fish, and the part of the fish that contains the most DHA is the fat of the eye sockets, followed by fish oil, which has also been made into fish oil. It has been documented that most Chinese pregnant women do not consume the “recommended amount” of DHA in their diet. The daily DHA consumption of pregnant and lactating women ranges from 45 mg to 115 mg.
The recommended intake of DHA for women in this period is 300 mg per day.
Suitable people: Pregnant and lactating women can take DHA supplements, and the recommended daily intake is at least 200 mg.
5.DHEA
DHEA: The scientific name of DHEA is dehydroepiandrosterone, which is the precursor of androgens and estrogens in the body. It can help improve the ovarian microenvironment of infertile women, thus improving the quality of eggs and embryos, scientifically and effectively increasing the pregnancy rate and reducing the miscarriage rate. In patients with poor ovarian function, it has the potential to improve ovarian response and increase the number of follicles.DHEA is secreted by the human adrenal glands, ovaries and central nervous system. In clinical practice, we mostly recommend patients with poor ovarian function to take 75mg daily, preferably orally for 3 months prior to ovulation promotion, in the hope of improving outcomes in patients with low ovarian response.
Suitable population: Advanced age, ovarian low response patients start supplementation 2 months before entering ovulation treatment or IVF cycle, and can be discontinued after pregnancy confirmation. For a small number of patients who require multiple consecutive ovulation or IVF cycles, it can be taken continuously.
6.Vitamin A
The scientific name is retinol, which, as the name suggests, is an alcoholic organic substance that plays an important role in the retina of the eye. Other types of vitamin A include retinaldehyde and retinoic acid. Of these, retinaldehyde is important for vision and reproduction, while retinoic acid plays a role in growth and differentiation.
Vitamin A helps in the growth and repair of tissues containing epithelial cells. It fights pathogenic bacteria and harmful particles (including air pollutants). In addition to improving the body’s immunity, other important functions of vitamin A include: assisting in the construction of bones and teeth, hematopoiesis, reproduction, maintenance of cell membrane stability and vision health.
Vitamin A is associated with sexual function and reproduction. The presence of adequate vitamin A is necessary for the conversion of cholesterol into estrogens and androgens. Insufficient androgens and estrogens in the body will lead to reduced sexual function. Animals with low levels of sex hormones have normalized their sexual function when given vitamin A. A related study showed that men with varying degrees of spermatozoa reduction returned to normal sperm levels after treatment with vitamins A and E.
Appropriate nutritional supplements and complementary medicines are essential in the process of assisted reproduction, but their use should be individualized under the guidance of a physician. If a patient needs to purchase pregnancy supplements on their own, it is best to consult with a doctor or professional about the nutrients and doses needed before purchasing them to avoid duplication or deficiencies that could lead to waste.