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RSI if stomach not empty High tier straight RSI with cuffed ETT whatever the scan shows 4) Glycaemic Bridge: Continue basal insulin at 60-80 % and use CGM alerts throughout the pause Fertility-Benefit Rationale While GLP-1 receptor agonists (GLP-1RAs) offer promising fertility benefits, particularly in women with obesity or polycystic ovary syndrome (PCOS), the core rationale for brief, protocolized pauses stems from the need to safeguard airway safety during anaesthesia

Trials comparing MI plus folate with folate alone have reported improvements in oocyte and embryo parameters.46 Wholesome Story uses L-methylfolate (MTHF), the biologically active form of folate, which does not require conversion in the body and is often chosen in reproductive-health formulations.47 Vitamin D3 (25mcg / 1,000IU) Vitamin D insufficiency is common in PCOS and has been linked to insulin resistance and metabolic dysfunction.48 Supplementation has been studied for modest improvements in insulin sensitivity and related markers, particularly in individuals who begin with low vitamin D status.49 50 The 1,000IU dose included here is above the recommended dietary allowance but remains well below established upper intake levels for adults, making it appropriate for ongoing daily use with a low risk of oversupplementation.51 One additional consideration is dosing flexibility