Whether you’re trying to conceive naturally or with IVF, egg quality should be on your mind. Women are born with all the egg cells they’ll ever have – and we carry them with us throughout our entire reproductive lives! That’s a long time to be housed in a body, and a long time being exposed to every environmental toxin, nutrient, and hormone in the cellular environment.
The quality of the egg cell and sperm cell prior to conception are of paramount importance when you are trying to conceive. If you want to make a healthy baby, you should consider that the following factors absolutely affect the likelihood that you’re using your best quality egg cell to do that.
How do you know you’ve got an egg quality issue?
That can be tough to say - unless someone has actually pulled out your egg cells and looked at them - but there are some indicators. If you’ve done IVF before, your RE may have told you that your oocytes are of poor quality. If not, here are a few signs that your egg quality needs some attention:
-you’re over age 35 (I'll explain this one below)
-your FSH or LH are >10 IU/L
-your estradiol (E2, estrogen) level is <70 pmol/L
-you have PCOS
-you have insulin resistance
-you work (or have worked) with chemicals, solvents, dyes, or live near a farm or rural area where you may be exposed to pesticides/herbicides
-you have very high-stress levels
-you have a malabsorption syndrome (celiac disease, ileostomy, crohn’s or colitis, etc)
Before we dive into how to improve your egg quality (though we have many blog posts on that), we first need to understand the factors that affect egg quality, so that we can specifically target what might be affecting yours.
Without further ado, here are the 5 major factors that affect the quality of your eggs:
1. Age
From population studies, we know that female fertility peaks at age 25 and begins to rapidly decline after age 35. Why is that?
Take a look at the photo at the top of this page, of a young vs old oocyte, stained to show mitochondrial function...
Notice a difference? In the young oocyte, the mitochondria are very active. They’re manufacturing cellular energy, also called ATP. With aging, we see a decline in the number and the function of our mitochondria – leading to a decreased ability to manufacture cellular energy.
This is critical to egg cells. The mitochondria and ATP are responsible for the proper alignment of chromosomes during meiosis – poor mitochondrial function results in aneuploid embryos (embryos with one too many, or one too few, chromosomes). ATP from the mitochondria in the egg cell supports the survival of the early growing embryo until about day 6 after fertilization. And when ATP production is slowed, the production of reactive oxygen species (ROS) is increased – these ROS further damage the mitochondria and also damage the egg cell itself (including damage to cell proteins, lipids, DNA and increasing the susceptibility apoptosis aka cellular death).
We offer several recommendations and treatments at Acubalance Vancouver to support mitochondrial function and egg quality including laser (LLLT/Photobiomodulation) for fertility and antioxidant IV therapy.
So in a nutshell: aging = reduced mitochondrial activity = poorer quality oocytes. Read Dr. Ryan Funk’s latest blog on the importance of getting the right antioxidant support to battle ROS, and know that we can support healthier numbers and function of mitochondria with functional and traditional Chinese medicine. We can't change your chronological age, but we can boost mitochondrial function to reduce your biological age.
2. Nutritional Status
The nutritional status of a woman has a major impact on the quality and function of the mitochondria located in the follicles that nourish the egg cell itself. As with many things in functional medicine, too much is too much, and too little is too little:
-nutritional excesses: caloric excess or too many poor quality foods leads to high BMI, obesity, and inflammation in the system. High BMI has been shown to cause mitochondrial dysfunction as the inflammation generated by such excess is damaging to their structure and function.
-nutritional deficiencies are similarly dangerous. Women with low body fat percentage often present with egg quality issues – fats are the precursors to hormones, which support healthy egg quality. Both nutritional deficiencies (vitamin D, for example), and micronutrient deficiencies (like CoQ10) have been linked to poorer quality oocytes and embryos (and some have shown lower live birth rates) from IVF. Women who suffer malabsorption syndromes like celiac or crohn’s disease are often lacking in fat-soluble vitamins (like vitamin D, A, and essential fatty acids) that follicles need to manufacture appropriate levels of hormones to nourish the oocyte. Even vegetarians and vegans need to be careful – protein is a necessary nutrient for good egg quality and must be carefully considered by someone who avoids animal-derived protein.
I counsel patients on the Acubalance Fertility Diet - take a look here for more information, and ask your practitioner about it at your next appointment.
Contact us to find out which brands we recommend for the best absorption and nutrient quality when it comes to prenatal, CoQ10, Vitamin D3 and Omega 3's. If you have digestive concerns, or if time is not on your side and you need to correct those nutritional deficiencies quickly, then read more about the nutritional IV therapy I offer.
3. Environmental Exposures
The main concern with environmental exposures in the context of fertility is exposure to toxins called endocrine disruptors – a group of toxins known to alter the hormonal system in humans. There is a huge list of chemicals to look out for, and research done on some of these toxins shows their association with poor egg quality.
For example, women with high levels of BPA (from plastics) in their serum during IVF have poorer outcomes than women with lower levels. PAHs (polycyclic aromatic hydrocarbons), which come from smoking or burning of fossil fuels, are stored in adipose tissue and can alter levels of estrogen in a woman’s system. Even some pharmaceutical medications affect oocyte quality and the future health risk of a child. The most important toxins to look out for are:
BPA (plastics)
Phthalates (solvents, detergents, oils, plastics and personal care products)
Dioxin (from combustion processes, refining, and chemical manufacturing)
Heavy metals (from fillings or in the environment – mercury, lead, arsenic, etc)
Organophosphate pesticides (eat organic!)
Pharmaceutical medications
And if you're exposed to these chemicals on a regular basis, we need to work on assisting your body's ability to detoxify from these substances. At Acubalance we use diet, lifestyle, exercise recommendations, and nutritional supplementation to assist in proper detoxification. I often add a glutathione push to my patients' IV therapy to improve their natural ability to detoxify these environmental toxins.
4. Stress
We’re constantly talking to our patients about their stress levels and the impacts on egg quality, because of the strong effect the stress response has on both circulation and hormone balance. When the body is under stress, blood flow is diverted away from digestion and reproduction to the large muscle groups of the body in order to accommodate a “fight or flight” response. When you recover from the stressor, blood flow will return (“feed and breed”) – but many of our patients are stuck in a consistent pattern of high stress, adrenaline output, and blood flow redirection. If you have a cold abdomen, cold hands, and feet, feel anxious, have low energy, feel ‘amped up,’ or struggle with insomnia, you should consider stress as a contributor to poor egg quality. Acupuncture is one of my favourite modalities to help reset the nervous system that is constantly responding to a stressor. We often pair diet recommendations, gentle exercise, breath work or mindfulness meditation, and nutritional supplementation together to treat an inappropriate stress response.
5. Genetic Variability
This is a difficult topic to understand due to how deep our understanding of genetics is becoming, but know that genetic factors can absolutely influence whether you manufacture excellent quality oocytes. What’s great news is that not all of these genetic factors are un-modifiable. Sure, if you were born with a frank genetic abnormality (like an extra chromosome or translocation), it could explain your struggles to conceive – have a karyotype done to see if this is the case. But there are many other genetic variants that can actually be modified by diet and lifestyle. We now offer to test for these kinds of genetic variants (called SNPs) at Acubalance. This is useful for patients who have unexplained poor egg quality (ie. young women who have poor responses to IVF for no known reason) or want to do whatever they can to optimize their genetics. It will also help us identify individual patterns of hormonal metabolism and detoxification, to know how you may respond to IVF medications or even herbal hormonal support. In the meantime, we coach patients around diet, lifestyle, stress reduction, exercise habits, and mind/body techniques that positively influence gene expression.
If you have more questions about how these 5 factors play a role for you in your fertility journey, feel free to book a free 15 minute consult with one of our practitioners. We look forward to helping you improve your egg quality and getting you to the end goal - a healthy baby! Best in health,
Dr. K
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