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Fertility Treatment

Egg + Implantation Enhancement & Immune Protocols

An advanced “protocol” for enhanced results. Our oocyte and implantation enhancement protocols factor in dietary guidance, supplementary support, pharmacological driven reproductive immunology, holistic therapies, and surgical interventions. It is designed to improve oocyte (egg) quality and the uterine environment and thus improve embryo quality, implantation, and live birth results.

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The Critical 90

Egg Development

The human egg starts its final developmental stage prior to fertilization, approximately 90 days before that egg is ovulated. In order to account for the full period of development and, in turn, optimize egg quality for your treatment cycle, it is important that some of the enhancement measures be started in advance of these 90 days when possible.

Egg Development

Dietary Changes

80% Fat 20% Protein

Fat is where it’s at

Fat is so important for fertility that we often deliver fat to our patients intravenously (intralipids – more on that below) . . . but if you’re eating enough high-quality fats you shouldn’t need intralipids.

Female Fertility Diet

Decades of clinical experience have shown that the food we eat impacts our fertility perhaps more than anything. We recommend that all women (and men) eat a high fat, moderate protein (because excess protein is converted to sugar via gluconeogenesis), and low carbohydrate diet (AKA a ketogenic diet).

The ketogenic diet improves female fertility via two primary mechanisms:

  • Reduces Inflammation: Inflammation is the number one root cause of infertility. Eating a Standard American Diet (SAD) means a low-fat diet with excessive amounts of carbohydrates, sugars, grains, fruits, fiber, and vegetables.  This high carb diet causes chronically elevated blood sugar which causes inflammation-inducing advanced glycation end products and impaired hormone functioning. A high carbohydrate/plant diet also comes with a burdensome load of phytochemicals that a plant makes to thwart the attack of bugs, pests, molds, and funguses (plants can’t move so they engage in chemical warfare). These molecules are antigens (foreign particles) to the human body and elicit an inflammatory response.  Additionally, high plant diets contain lots of fiber that ferments in the gut, producing large amounts of heat – and thus inflammation, right on top of the reproductive organs.  Removing this heavy burden and providing the body with large doses of anti-inflammatory fats improves the body’s ability to heal and deliver nutrients to important reproductive organs.
  • Improves hormone functioning: Many critical fertility hormones are made from cholesterol, but because cholesterol is also imperative for brain function and repair (aka survival) it’s almost impossible to maintain a healthy hormone balance if you’re not eating enough.

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Over the Counter Supplementation

Food is the foundation of female reproductive health, but dietary supplements can help fill in nutrient gaps and provide other nutrients that support the normal structure and function of the eggs and the female reproductive system.  Below you will find our CNY-developed and recommended fertility supplements to support egg, preconception, and prenatal health.

  • Peak Prenatal

    All the core preconception and prenatal vitamins and some. Ideally taken 90+ days prior to pregnancy, throughout entire pregnancy, and during lactation. 

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  • Ovarian Bloom

    Loaded with goodies like VESISorb Ubiquinol for a 600 mg deliverable dose of CoQ10, inositol, Vitamin D, PQQ, ovarian glandular, and more to support healthy egg quality, ovarian, and reproductive function.

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  • ViVomega Fish Oil

    An ultra pure, ultra potent fish oil from Norway that shatters all international standards for purity and potency. One serving of this fish oil delivers 6-8x the Omega 3 as your standard over the counter fish oil.

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  • Myo+D-Chiro Inositol

    Inositol helps restore and support normal ovulation. The Ovarian Bloom has some inositol, but some may benefit by taking more.

     

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  • Immunoglobulin (IgG)

    Immunoglobulins are a key component of the immune system. These dietary immunoglobulins are a great way to support the immune system and normal reproductive function.

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Reproductive Immunology

Prescription Medications

While dietary and lifestyle changes can go a long way, help from pharmacological medications (outside of traditional fertility medications) can be an important part of your fertility treatment, particularly when dealing with unexplained infertility, repetitive IVF implantation failures, and recurrent pregnancy loss.

  • Intralipids

    Essentially IV administered fat. Intralipids have been shown to improve implantation and reduce pregnancy loss by lowering the activity of the natural killer cells in our immune system.

  • Low Dose Naltrexone

    Traditionally developed to block the effects of opioid medication and treat addiction, LDN acts as an immunomodulator and increases the body’s ability to heal itself.  Through unknown mechanisms can improve fertility outcomes.

  • Somatropin HGH

    HGH has been found to help women with poor ovarian reserve testing (e.g., increased FSH, low AMH) and is believed to help with oocyte maturation and improved egg quality.

  • Antibiotics

    Eradicates bacteria and thus toxic byproducts and inflammation within the reproductive system that can cause failure to implant and miscarriage.

  • Tacrolimus (Prograf)

    An immunosuppressant originally developed as an anti-rejection medication for organ transplant recipients. Targets the immune system that can be responsible for recognizing and attacking the embryo as an invader.

  • Prednisone

    A synthetic hormone with anti-inflammatory and immuno-suppressive abilities. Used to treat a range of conditions, including allergies, blood disorders, respiratory problems, skin problems along with fertility issues.

  • Aspirin

    Low-dose aspirin (81mg) treatment has been shown to improve ovarian responsiveness, uterine and ovarian blood flow velocity, implantation, and pregnancy rates in patients undergoing fertility treatments.

  • Lovenox

    Lovenox is an anticoagulant that helps prevent blood clotting and is usually started several days before embryo transfer.  It can be prescribed in cases of recurrent miscarriage or where there’s a known blood-clotting disorder.

  • HCG Wash

    In IVF, HCG is absent in the uterus because the embryos are in a dish, not in the fallopian tube triggering HCG production. Placing HCG into the endometrium improves it’s “readiness” for transfer.

  • IVIG

    IVIG is made up of human antibodies. It is not clear exactly how IVIG works, but studies suggest that it may reduce the number of natural killer (NK) cells in the body, and/or may absorb or block a woman’s antibodies, which are causing the body to attack the pregnancy.

  • filgrastim (Neupogen )

    Increases white cells thereby suppressing the immune system so it does not attack the embryo. It can be used as an injection or a wash for the uterus.

  • Viagra

    Viagra works as a vasodilator which allows for improved blood and nutrition delivery. Used as vaginal suppositories to improve blood flow to the uterus for implantation.

  • Antihistamine

    Over the counter Antihistamine’s like Claritin, Pepcid, and Benadryl can be used to suppress the immune system.

  • Metformin

    Metformin is primarily used in those with PCOS to help regulate and lower insulin levels and balance the metabolic system.

  • Orilissa

    Orilissa is used to help treat endometriosis.

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4 Treatment Levels

Immune and Enhancement Protocols

There are 4 main stages/protocols used in our reproductive immunology based enhancement protocols. Of course, there are still things you can add on and mix about… but the below should give you a good idea.  Protocols one is often used to improve the success of first time IVF cycles, where two, three, and four are typically used after failed IVF cycles, recurrent pregnancy loss, or other known immunological dysfunction.

Start 30-90 Prior to Treatment Cycle

Nutrition: Kiltz’s Keto/Carnivore, One Meal a Day (OMAD), and Supplements (F: Peak Prenatal*, VIVOMEGA*, Ovarian Bloom, Immunoglobulin IgG | M: Male Preconception+, VIVOMEGA) + Light Exercise:  Yoga, Walking, Tai Chi. etc. No high-intensity exercise. Medications: LDN and HGH (with levels 3 and 4)


During Treatment Cycle

Protocol 1

  • Kiltz's Keto + OMAD + Supplements + light exercise
  • LDN
  • Aspirin*
  • Prednisone
  • Antibiotics (Z-pack or doxy)
  • Antihistamine (Pepcid, Claritin, Benadryl)

Protocol 2

  • Kiltz's Keto + OMAD + Supplements + light exercise
  • LDN
  • Aspirin*
  • Prednisone
  • Antibiotics (Z-pack or doxy)
  • Antihistamine (Pepcid, Claritin, Benadryl)
  • Intralipids
  • Lovenox*

Protocol 3

  • Kiltz's Keto + OMAD + Supplements + light exercise
  • LDN
  • Aspirin*
  • Prednisone
  • Antibiotics (Z-pack or doxy)
  • Antihistamine (Pepcid, Claritin, Benadryl)
  • Intralipids
  • Lovenox*
  • Neupogen
  • Prograf or Plaquenil
  • HCG Booster
  • PRP or HCG wash
  • HGH

Protocol 4

  • Kiltz's Keto + OMAD + Supplements + light exercise
  • LDN
  • Asprin*
  • Predisone
  • Antibiotics (Z-pack or doxy)
  • Antihistamine (Pepcid, Claritin, Benadryl)
  • Intralipids
  • Lovenox*
  • Neupogen
  • Prograf or Plaquenil
  • HCG booster
  • PRP or HCG wash
  • HGH
  • IVIG
  • Humira

*Only to be started after egg retrieval or with the start of an FET

Protocols Calendar

Down Regulation Agonist

{{protocol_selected}}

Below is a standard Antagonist IVF calendar. The calendar sets day one to the day medications are started (which is usually days 2-4 of a female’s menstrual cycle). Each phase of an IVF is inherently variable and will be customized specifically for you.

Below is a standard Mini IVF calendar. The calendar sets day one to the day medications are started (which is usually days 2-4 of a female’s menstrual cycle). Each phase of an IVF is inherently variable and will be customized specifically for you.

Below is a standard Down Regulation Agonist IVF calendar. Down Regulation protocols are uncommon but may be suggested by your provider based on your specific history. Each phase of an IVF is inherently variable and will be customized specifically for you.

Below is a standard FET calendar. The calendar sets day one to the day medications are started (which is usually days 2-4 of a female’s menstrual cycle). Each phase of an FET is inherently variable and will be customized specifically for you.

Below is a standard Egg Freezing calendar. The calendar sets day one to the day medications are started (which is usually days 2-4 of a female’s menstrual cycle). Each phase of an Egg Freezing is inherently variable and will be customized specifically for you.

Selected: {{!transfer_control ? "Clevage Stage Transfer" : "Blastocyst Stage Transfer"}}

Inmune protocol add ons

Add ons:

Z-Pack
Deoxycyclin
Selected: {{inmune_level_1_control ? "Deoxycyclin" : "Z-Pack"}}
Plaquinel
Prograf
Selected: {{inmune_level_3_control ? "Prograf" : "Plaquinel"}}

STIM MED

TRIGGER MEDICATION
Day
Trigger Medication Day {{trigger_day}}

Progesterone Start Day

Day
Progesterone Start Day {{progesterone_day}}
Selected: {{!transfer_control ? "Clevage Stage Transfer" : "Blastocyst Stage Transfer"}}
  • 30-90 DAYS PRIOR TO TREATMENT CYCLE Kiltz’s Keto/Carnivore, OMAD Supplements ( F: Peak Prenatal, VIVOMEGA, Ovarian Bloom, Immunoglobulin IgG | M: Male Preconception+, VIVOMEGA ) LDN (by prescription only after consultation) HGH Humira (1 time two weeks prior to start of cycle)

  • Day {{day}}

    • Office Visit: {{get_office_visit(day)}}
    • FSH {{ is_FSH_start(day) ? "start" : "" }} {{ is_FSH_end(day) ? "end" : "" }}
    • Lupron {{ is_lupron_start(day) ? "start" : "" }} {{ is_lupron_end(day) ? "end" : "" }}
    • Letrozole {{ is_letrozole_start(day) ? "start" : "" }} {{ is_letrozole_end(day) ? "end" : "" }}
    • hMG {{ is_hMG_start(day) ? "start" : "" }} {{ is_hMG_end(day) ? "end" : "" }}
    • hCG+LH {{ is_hCG_start(day) ? "start" : "" }} {{ is_hCG_end(day) ? "end" : "" }}
    • Antagonist {{ is_antagonist_start(day) ? "start" : "" }} {{ is_antagonist_end(day) ? "end" : "" }}
    • {{get_lupron_label()}} {{ is_trigger_lupron_start(day) ? "start" : "" }} {{ is_trigger_lupron_end(day) ? "end" : "" }}
    • hCG {{ is_trigger_hcg_start(day) ? "Take" : "" }}
    • Procedure Day: Egg Retrieval
    • Procedure Day: {{transfer_selected}}
    • Pregnancy Test
    • Estrogen, Progesterone
    • Estrogen
    • Progesterone
    • {{get_level_1(day).join(", ")}}
    • {{get_level_2(day).join(", ")}}
    • {{get_level_3(day).join(", ")}}
    • {{get_level_4(day).join(", ")}}
    • {{tooltip}}

  • Day {{day}}

    • Office Visit: {{get_office_visit(day)}}
    • FSH {{ is_FSH_start(day) ? "start" : "" }} {{ is_FSH_end(day) ? "end" : "" }}
    • Lupron {{ is_lupron_start(day) ? "start" : "" }} {{ is_lupron_end(day) ? "end" : "" }}
    • Letrozole {{ is_letrozole_start(day) ? "start" : "" }} {{ is_letrozole_end(day) ? "end" : "" }}
    • hMG {{ is_hMG_start(day) ? "start" : "" }} {{ is_hMG_end(day) ? "end" : "" }}
    • hCG+LH {{ is_hCG_start(day) ? "start" : "" }} {{ is_hCG_end(day) ? "end" : "" }}
    • Antagonist {{ is_antagonist_start(day) ? "start" : "" }} {{ is_antagonist_end(day) ? "end" : "" }}
    • {{get_lupron_label()}} {{ is_trigger_lupron_start(day) ? "start" : "" }} {{ is_trigger_lupron_end(day) ? "end" : "" }}
    • hCG {{ is_trigger_hcg_start(day) ? "Take" : "" }}
    • Procedure Day: Egg Retrieval
    • Procedure Day: {{transfer_selected}}
    • Pregnancy Test
    • Estrogen, Progesterone
    • Estrogen
    • Progesterone
    • {{get_level_1(day).join(", ")}}
    • {{get_level_2(day).join(", ")}}
    • {{get_level_3(day).join(", ")}}
    • {{get_level_4(day).join(", ")}}
    • {{tooltip}}

  • Day {{day}}

    • Office Visit: {{get_office_visit(day)}}
    • FSH {{ is_FSH_start(day) ? "start" : "" }} {{ is_FSH_end(day) ? "end" : "" }}
    • Lupron {{ is_lupron_start(day) ? "start" : "" }} {{ is_lupron_end(day) ? "end" : "" }}
    • Letrozole {{ is_letrozole_start(day) ? "start" : "" }} {{ is_letrozole_end(day) ? "end" : "" }}
    • hMG {{ is_hMG_start(day) ? "start" : "" }} {{ is_hMG_end(day) ? "end" : "" }}
    • hCG+LH {{ is_hCG_start(day) ? "start" : "" }} {{ is_hCG_end(day) ? "end" : "" }}
    • Antagonist {{ is_antagonist_start(day) ? "start" : "" }} {{ is_antagonist_end(day) ? "end" : "" }}
    • {{get_lupron_label()}} {{ is_trigger_lupron_start(day) ? "start" : "" }} {{ is_trigger_lupron_end(day) ? "end" : "" }}
    • hCG {{ is_trigger_hcg_start(day) ? "Take" : "" }}
    • Procedure Day: Egg Retrieval
    • Procedure Day: {{transfer_selected}}
    • Pregnancy Test
    • Estrogen, Progesterone
    • Estrogen
    • Progesterone
    • {{get_level_1(day).join(", ")}}
    • {{get_level_2(day).join(", ")}}
    • {{get_level_3(day).join(", ")}}
    • {{get_level_4(day).join(", ")}}
    • {{tooltip}}
* Antagonist Medications: Cetrotide, Ganarelix
  • Standard Medications
  • Office Visit
  • Procedure Day
  • Enhancement/Immune Protocol Medications

Fertility Procedures

Surgical Treatment Considerations

  • Laparoscopy

    A minimally invasive surgical procedure to visualize the pelvic cavity, ovaries, uterus, and fallopian tubes to discover and correct, endometriosis, adhesions, and myomas.

  • Hysteroscopy

    A minimally invasive diagnostic and corrective procedure to visualize, investigate, and correct (if discovered) the source of abnormal uterine bleeding or suspected cause of infertility and miscarriage. 

  • LIT

    A procedure whereby white blood cells from the father to be are isolated from the father’s blood and injected into the skin of the prospective mother to introduce the husband’s immune cells to the woman’s immune system in preparation for pregnancy.

  • ERA

    An endometrial biopsy that is then analyzed to determine a woman’s endometrial receptivity (aka how likely an embryo is to stick).  The test is performed to help prevent implantation failure by identifying a woman’s unique and optimum “window of implantation.”

  • Platelet-Rich Plasma

    PRP is a concentrate of platelet-rich plasma protein derived from whole blood, centrifuged to remove red blood cells. Intraovarian to improve egg quality or intrauterine to improve uterine lining and implantation.

Holistic Fertility Therapies

  • Massage

    Specific fertility messages like the Maya Abdominal Massage have been through to improve both male and female fertility.

  • Acupuncture

    Acupuncture has been proven to improve fertility treatment outcomes. Recommended to start 90 days before treatment but particularly important before and after transfer.

Other Factors Affecting Fertility

Lifestyle Considerations

  • Exercise

    We recommend abstaining from all high-intensity exercise. Go on a nice long walk or start a yoga for fertility program.

  • Environmental Factors

    Excessive heat or chemical exposure can have an effect on your fertility. Be mindful of your contact with toxic chemicals and extreme heats like saunas. 

  • Mindset

    Scientific studies are controlled against placebos BECAUSE THE POWER OF BELIEF IS INCREDIBLY STRONG. Practicing meditation and prayer can help manage the stress of life, infertility, and help build a positive belief system.

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