23 Jan Egg Quality & Aging
Egg Quality and Aging
I want to start this post off with a story…
A woman, let’s call her M, contacted me online asking if I thought I could help her…she had suffered 2 miscarriages, was 37 years old, and feeling hopeless. As I always caution, “there are no guarantees, but there is hope.” M was a radiant, healthy looking woman. She ate a fairly balanced diet and she exercised regularly. She was kind, intelligent, and thoughtful. She was also heartbroken about her losses and still grieving. She also had some other factors in her history that hinted at underlying causes of decline in egg quality. I started by asking if she was willing to take a break from trying to conceive for about 4 months. Even though she felt like time was not on her side, she agreed. At 37 years old with one miscarriage confirmed asp a chromosomal abnormality, I wanted to make sure that we were doing everything we could to optimize egg quality- as well as uterine lining, circulation to the pelvic region and emotional readiness for pregnancy…But before we finish this story, let’s talk about why egg quality declines.
Oogeneis (a fancy term for the development of the egg)
Women are born with all the eggs (oocytes) they will ever have. At a certain point in fetal development, the egg development is arrested and the eggs will lie dormant until puberty. At puberty, a cohort of eggs is recruited each month. These eggs then take a 3 month maturation journey that will hopefully result in one healthy egg ovulating each month.
The Aging Egg
As women are waiting until later in life to start a family, we are seeing a decline in fertility. This is partly due to the DNA inside the egg beginning to degrade. These small changes lead to chromosomal abnormalities which can decrease the chance of fertilization and increase the chance of miscarriage and birth defects. Generally speaking, at age 35 we see a significant drop in the number of normal eggs (i.e. eggs without chromosomal abnormalities). The ovary is a highly metabolically active organ and the eggs inside are sensitive to stress, oxidation, infection, and toxins. After decades of exposure, egg quality will begin to decline. Even if a woman still ovulates each month, the chance of conception and healthy pregnancy goes down.
Pregnancy is STILL POSSIBLE, but it can take even longer at this age, which is not something most women want to hear after waiting in the first place.
Other factors aside from age can affect egg quality as well- reproductive disorders such as PCOS and endometriosis can cause issues with egg quality as there is generally more inflammation in the ovary in these conditions.
I get that everything described above sounds pretty depressing, and there is a ton of misinformation online about the ability to affect egg quality. The reality is that the ovaries are responsive to positive change, it just takes time…
A hopeful ending…
In M’s case, it took almost a full year to conceive. During the first 3-4 months she was very consistent with taking supplements and tracking her cycles. She then began acupuncture 2-3 times per month. At 9 months into the process she was feeling hopeless so we talked, reevaluated, changed the protocol a bit, referred out for Chinese herbs and began a personalized homeopathic protocol. At 11 months in, M conceived, and 40 weeks later delivered a beautiful healthy baby boy.
What can you do to boost egg quality?
- Clean up the diet- Eat organic as much as possible with as many vegetables as possible, fruits (esp. dark berries) whole grains, legume (lentils, beans), nuts, wild caught fish, pasture raised eggs and grass fed meats. Sometimes I will use more specific aggressive dietary changes depending on the situation. For example in someone with an autoimmune disease I might recommend the autoimmune paleo (AIP) diet, anti-lectin diet or some variation. For PCOS a paleo/keto approach can often be helpful. Either way the elimination of all processed foods (white flour, white sugar, trans fats) can dramatically decrease inflammation. Decreasing inflammation helps balance hormones.
- Avoid pollutants and toxins: plastics (BPA, phthalates), perfumes, pesticides and parabens are all potential hormone disrupters and can increase the oxidation in the body. Start making the switch to more natural products for cleaning and personal hygiene. Avoid storing foods in plastics, and eating canned foods. Switch to glass or stainless steel water bottles (and invest in a water filter). Switch to essential oils over perfumes and fragrances. A great guide to cleaner products can be found from Suzi at Gurl Gone Green.
- Create a fertile mindset– meditation, creating art, gardening, journaling- all of these activities can provide an outlet for stress as well as keep you grounded when things are feeling hopeless. Consider seeing a counselor who has experience in treating couples struggling with infertility.
- Move your body, but do the right movement for you– sometimes too much exercise can be counterproductive when it comes to fertility. Most women should aim for 30 minutes of moderate cardio daily, yoga/pilates 3-4 days a week and strength training 2-3 days per week.
- Supplements: these should be recommended by your healthcare provider and ideally based on the most current research and your unique situation. As with most nutritional supplements, more studies are needed, but the ones list below are very promising.
- Coq10 at 100-400 mg per day
- DHEA at 50-75 mg per day
- N.A.C at 600-1800 mg per day
- Melatonin at 3-10mg/day:
- Acetyl-L-Carnitine 250mg/day:
- Consider acupuncture for increasing blood flow to the ovaries and balancing hormones naturally. Acupuncture can also increase the success of IVF
- If you are already pursuing IUI or IVF, consider seeing a holistic fertility specialist or a naturopathic physician specializing in fertility who can help support you through the process and fine tune all of the above.
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