How to improve egg quality
As far as I can tell, there just isn't enough research in this area to really tell us the keys to egg quality and fertility. So in the absence of good science, the best we can do is try to learn from each other and our personal stories to try to figure out what might work.
After two miscarriages due to chromosomal abnormalities at age 45, I decided to focus intently on how to improve the quality of my eggs. Medical doctors tend to think that it's a given that your egg quality declines with age and it's a race against time and a roll of the dice to catch a good egg during the sunset of our fertility years. The statistics show the percentage of "good eggs" remaining at age 45 to be absymally low. The graph on this site, based on data compiled from multiple studies, shows about 90% of eggs being abnormal at age 44. (Sadly, the graph doesn't even go up to age 45, but we can assume the scene only gets worse.) Some alternative health practitioners, however, believe it's possible to improve egg quality. Given the choice between giving up, arbitrarily rolling the dice again, or attempting to improve my egg quality, I chose the latter. Despite my extremely low AMH (tested 3 times, ranging from 0.07 to 0.19; read about the AMH-fertility link), my advanced age, and my history of recent miscarriages, I successfully got pregnant with a healthy egg the next cycle after my "90 day healthy egg quest", two weeks before my 46th birthday.
Much of my inspiration came from this article: How to Increase Your Egg Health in 90 Days. I also drew from my beliefs about the mind-body connection and how we can support optimal health in mind, body and spirit. This is my personal story. Every body is different. So please don't try to follow my plan by rote. Rather, I recommend reflecting on the principles and considering how they might apply to your situation.
After two miscarriages due to chromosomal abnormalities at age 45, I decided to focus intently on how to improve the quality of my eggs. Medical doctors tend to think that it's a given that your egg quality declines with age and it's a race against time and a roll of the dice to catch a good egg during the sunset of our fertility years. The statistics show the percentage of "good eggs" remaining at age 45 to be absymally low. The graph on this site, based on data compiled from multiple studies, shows about 90% of eggs being abnormal at age 44. (Sadly, the graph doesn't even go up to age 45, but we can assume the scene only gets worse.) Some alternative health practitioners, however, believe it's possible to improve egg quality. Given the choice between giving up, arbitrarily rolling the dice again, or attempting to improve my egg quality, I chose the latter. Despite my extremely low AMH (tested 3 times, ranging from 0.07 to 0.19; read about the AMH-fertility link), my advanced age, and my history of recent miscarriages, I successfully got pregnant with a healthy egg the next cycle after my "90 day healthy egg quest", two weeks before my 46th birthday.
Much of my inspiration came from this article: How to Increase Your Egg Health in 90 Days. I also drew from my beliefs about the mind-body connection and how we can support optimal health in mind, body and spirit. This is my personal story. Every body is different. So please don't try to follow my plan by rote. Rather, I recommend reflecting on the principles and considering how they might apply to your situation.
The Window of Influence
According to the Egg Health article, there is a window during which egg quality can be influenced by what you eat, what you do, how you take care of yourself. This window is 20 to 90 days before ovulation. When I looked back at my calendar and reviewed what was going on in my life during this "window of influence" before my last two failed pregnancies, the landscape looked bleak. Before the first miscarried pregnancy, I had been working toward night weaning my daughter from breastfeeding which resulted in absolutely lousy sleep, complete exhaustion really...not a good foundation for cultivating healthy eggs. (In addition, breastfeeding can cause a hormonal balance that blocks fertility, so I also had that going on. I continued to breastfeed through all of my future pregnancies, but it was probably much less with the nighttime nursing being eliminated.) During the window of influence prior to my next pregnancy I had been in the first trimester of pregnancy (which means completely exhausted), I had a miscarriage (totally devastated), and I was recovering from the miscarriage.....all very depleting both physically and emotionally. For that pregnancy, I had focused really well on self-care in the weeks right before and after ovulation, but those weeks supposedly don't have any influence on egg quality! This 'window of influence' theory would suggest my eggs had a lousy chance from the get go, with the last two pregnancies. So, with a sigh of acceptance, I pulled up a calendar and calculated how many months I would have to wait before trying to conceive again if I really wanted to nurture my eggs. I needed to target the ten weeks that ended three weeks before my target ovulation date. Don't let the math drive you crazy....I'll try to make it easy for you....
If you are a TTC veteran you are probably already familiar with the length of your cycle, when you ovulate, etc. If you haven't figured these things out yet, this is very important for understanding your fertility. Read about how to track your cycle.
Once you have your cycle tracked, chart out your next 3-4 menstrual cycles. Look at the cycle during which you hope to conceive. Now count backwards three weeks from the expected ovulation date for that cycle. That is the end of your window. Now count back 10 weeks from there. This is the beginning of your window. Highlight these 10 weeks. This is your target time frame for nurturing you eggs! Of course, don't quit after the 10 week window, because if that cycle isn't the winner you want to be taking care of the eggs that are being influenced for the upcoming cycles. A common rhythm I see among TTC vets is to be super healthy until AF arrives, then binge on all kinds of vices for a week while grieving the end of the cycle, and then jump back on the health wagon for a couple weeks....rinse and repeat. That's probably not great for egg health if you believe in this 'window of influence' notion. If you fall off the wagon, brush yourself off and get up as quickly as you can. Your eggs are listening!
If you are a TTC veteran you are probably already familiar with the length of your cycle, when you ovulate, etc. If you haven't figured these things out yet, this is very important for understanding your fertility. Read about how to track your cycle.
Once you have your cycle tracked, chart out your next 3-4 menstrual cycles. Look at the cycle during which you hope to conceive. Now count backwards three weeks from the expected ovulation date for that cycle. That is the end of your window. Now count back 10 weeks from there. This is the beginning of your window. Highlight these 10 weeks. This is your target time frame for nurturing you eggs! Of course, don't quit after the 10 week window, because if that cycle isn't the winner you want to be taking care of the eggs that are being influenced for the upcoming cycles. A common rhythm I see among TTC vets is to be super healthy until AF arrives, then binge on all kinds of vices for a week while grieving the end of the cycle, and then jump back on the health wagon for a couple weeks....rinse and repeat. That's probably not great for egg health if you believe in this 'window of influence' notion. If you fall off the wagon, brush yourself off and get up as quickly as you can. Your eggs are listening!
Supplements
My own supplement regimen during my 90-day Healthy Egg Quest was fairly minimalist. I took Rainbow Light Prenatal Vitamins and Ubiquinol (100mg/day). That's it. During the previous year or so of TTC, I had taken a variety of supplements including vitex, vitamin E, vitamin D, vitamin B complex, and supergreen powder. I eventually decided to just simplify as there wasn't any evidence that I was lacking in any vitamins. I chose ubiquinol based on what I'd read online (such as this) and a recommendation from an acupuncturist. I don't have strong opinions about supplements. My only suggestion is to consult someone knowledgeable, but I don't really know how you can tell who to trust in this department as it appears to me that the research is fairly sparse, so there's a lot of guess work going on.
This is the Ubiquinol I took: Natural Factors Enhanced Absorption Ubiquinol, which was available at my local health food grocery store. I didn't have any particular rationale for picking this brand.
This is the Ubiquinol I took: Natural Factors Enhanced Absorption Ubiquinol, which was available at my local health food grocery store. I didn't have any particular rationale for picking this brand.
Nutrition
My approach to food/nutrition is also fairly simplistic. I'm pretty relaxed about the whole thing and I don't have any strict rules. I tend to limit processed food and refined sugar. I don't regularly ingest any caffeine; my impression is that it can be damaging, and I actually dislike coffee, so it's easy for me to avoid caffeine. I did not drink alcohol regularly. I did my best to eat reasonably healthy food (fresh and natural), and I avoided letting myself get hungry. I generally focus on what would be nourishing to my body--what food types would give me energy, particularly being sure to include protein in every meal and snack. I did not restrict myself to only organic produce and meats. There are a TON of recommendations for what one should eat to optimize fertility. I have seen women get very stressed out by trying to maintain a rigid diet that does not feel natural to them. I recommend creating an easy relationship with food and not getting tied up in knots about doing everything "right" but also making it a priority to put healthful foods into your body.
Traditional Chinese Medicine (TCM)
I did not use Traditional Chinese Medicine during my healthy egg quest, though I did use it in the prior year and a half. I'll share some of the details of my TCM explorations.
Traditional Chinese Medicine practitioners often use a combination of acupuncture and herbs to address fertility issues. My first acupuncturist did not suggest any herbs to me; my sense is that it wasn't a common part of her practice. I was receiving acupuncture treatments weekly (sometimes less) for about 7 months when I got pregnant in July 2014. After that miscarriage I started going to a different acupuncture group. One of the practitioners I saw there wanted me to take various herbal concoctions to boost fertility, while another practitioner there was not inclined to recommend any herbs. When I inquired, he said that based on my cycle patterns and hormone levels, he did not need to add anything, and that it was better not to risk imbalancing my system when he felt I could likely get pregnant without the interventions. Indeed I got pregnant again soon after. After that pregnancy also miscarried, I decided to take a break from TCM for my healthy egg quest phase. It was largely a practical decision because it was stressful for me to make time for regular acupuncture appointments, and I wasn't really sure what all these treatments were doing for me. (I did, however, start Ubiquinol based on one of my acupuncturist's recommendations, as soon as I found out I was going to miscarry, because I felt egg quality was turning out to be an issue for me.) I did resume treatment with a new acupuncturist during the week before ovulation on my first (and successful) TTC cycle after my egg quest. She wanted me to get started on herbs to boost egg quality (for future cycles as it was too late for this one), and she said she had better success with herbs than acupuncture for her fertility patients. Ugh, I thought, have I been getting the wrong TCM treatment all along? It was all a moot point though, because I got pregnant that cycle with a healthy egg.
I share all this to say, I have no idea the impact of TCM. I would like to think that it can be helpful. I find the concepts of TCM to be fascinating and compelling. Many women have reported that their cycles became much better regulated with TCM treatments. I really liked this series of articles by Jules Bogdanski about how TCM can be customized to address various non-ideal cycle patterns. One of my cycle patterns was that I had a short follicular phase (about 10 days, which is indicative of aging and diminished ovarian reserve), and I confirmed that my new acupuncturist was choosing treatments that were consistent with what that article had recommended. This gave me some confidence that she was on the right track. I think the tricky thing about incorporating TCM is determining whether a practitioner really does have expertise in working with fertility. So perhaps working with someone who can articulate their methods and comparing to other sources can be a helpful tool for evaluating their work. It's a long-term commitment, as these methods are not expected to work over night when it comes to improving egg quality. Usually a minimum of 3 months of treatment is recommended.
My general recommendation regarding TCM is to tune into your own response. If it helps you feel relaxed, there is value in that alone. If your practitioner has a healing, positive presence, there is value in that too. If you are charting and you see your cycles becoming more balanced, that is a good sign. If the process of scheduling appointments and paying for sessions is very stressful, that's could be a negative factor to consider in the whole picture of what you choose to include in your program. I also recommend seeking out acupuncturist who specialize in fertility issues.
Traditional Chinese Medicine practitioners often use a combination of acupuncture and herbs to address fertility issues. My first acupuncturist did not suggest any herbs to me; my sense is that it wasn't a common part of her practice. I was receiving acupuncture treatments weekly (sometimes less) for about 7 months when I got pregnant in July 2014. After that miscarriage I started going to a different acupuncture group. One of the practitioners I saw there wanted me to take various herbal concoctions to boost fertility, while another practitioner there was not inclined to recommend any herbs. When I inquired, he said that based on my cycle patterns and hormone levels, he did not need to add anything, and that it was better not to risk imbalancing my system when he felt I could likely get pregnant without the interventions. Indeed I got pregnant again soon after. After that pregnancy also miscarried, I decided to take a break from TCM for my healthy egg quest phase. It was largely a practical decision because it was stressful for me to make time for regular acupuncture appointments, and I wasn't really sure what all these treatments were doing for me. (I did, however, start Ubiquinol based on one of my acupuncturist's recommendations, as soon as I found out I was going to miscarry, because I felt egg quality was turning out to be an issue for me.) I did resume treatment with a new acupuncturist during the week before ovulation on my first (and successful) TTC cycle after my egg quest. She wanted me to get started on herbs to boost egg quality (for future cycles as it was too late for this one), and she said she had better success with herbs than acupuncture for her fertility patients. Ugh, I thought, have I been getting the wrong TCM treatment all along? It was all a moot point though, because I got pregnant that cycle with a healthy egg.
I share all this to say, I have no idea the impact of TCM. I would like to think that it can be helpful. I find the concepts of TCM to be fascinating and compelling. Many women have reported that their cycles became much better regulated with TCM treatments. I really liked this series of articles by Jules Bogdanski about how TCM can be customized to address various non-ideal cycle patterns. One of my cycle patterns was that I had a short follicular phase (about 10 days, which is indicative of aging and diminished ovarian reserve), and I confirmed that my new acupuncturist was choosing treatments that were consistent with what that article had recommended. This gave me some confidence that she was on the right track. I think the tricky thing about incorporating TCM is determining whether a practitioner really does have expertise in working with fertility. So perhaps working with someone who can articulate their methods and comparing to other sources can be a helpful tool for evaluating their work. It's a long-term commitment, as these methods are not expected to work over night when it comes to improving egg quality. Usually a minimum of 3 months of treatment is recommended.
My general recommendation regarding TCM is to tune into your own response. If it helps you feel relaxed, there is value in that alone. If your practitioner has a healing, positive presence, there is value in that too. If you are charting and you see your cycles becoming more balanced, that is a good sign. If the process of scheduling appointments and paying for sessions is very stressful, that's could be a negative factor to consider in the whole picture of what you choose to include in your program. I also recommend seeking out acupuncturist who specialize in fertility issues.
Worth Noting
What's noteworthy to me about my healthy egg quest is that I wasn't using some of the more commonly recommended strategies. The main things that I've seen recommended or I've seen others doing to influence fertility naturally involve nutrition, supplements and TCM. However, I didn't make significant changes to my diet, I didn't take many supplements, and I didn't utilize tcm acupuncture/herbs. I'm certainly not suggesting that these methods wouldn't be helpful for others, but it's interesting that they were not significant factors in my ability to catch a good egg. I'm excited to share what I DID do in hopes that it helps someone else who is on this fertility enhancing journey.....
Exercise
The priority in my exercise plan was to stimulate blood circulation throughout my body. I believe that all systems of the body will function better with good circulation; cells get better oxygenation, etc. My goal was to do mild to moderate cardio daily; I probably did 20-30 minutes 4-5 times per week (jogging or elliptical machine). I also incorporated yoga stretching, which I feel helps keep my body less tense thereby improving circulation. I did some strength training as well. My general suggestion is engage in regular cardio activity, but avoid high intensity workouts as I believe that can pull the body's energy away from non-essential functions such as reproduction. I have read some research that shows reduced fertility for women who exercise intensely long-term.
Yoga for Fertility DVDs: I came across two yoga dvd's designed specifically for fertility. Both of them offer sets of practices designed for each of four phases of the menstrual cycle. (It was these DVDs that actually inspired my original set of TTC Affirmations that I wrote for each week of the menstrual cycle.)
I did not follow either of these during my 90 day egg quest or my TTC cycle that followed. Rather, I did self-guided yoga practice based on what I felt I would benefit from at the time. I do think that watching these DVDs influenced my personal practice in subtle ways. I would recommend them for those who would enjoy following a guided CD. In general, my personal practice was mostly gentle and relaxing, focusing on creating openness and stimulating circulation.
Yoga for Fertility DVDs: I came across two yoga dvd's designed specifically for fertility. Both of them offer sets of practices designed for each of four phases of the menstrual cycle. (It was these DVDs that actually inspired my original set of TTC Affirmations that I wrote for each week of the menstrual cycle.)
- Dao Flow Yoga for Fertility and Women's Health - I felt this was the higher quality of the two options. Practices were more extensive, the production quality was more pleasant to me, and the creator seemed to have a lot of depth of experience she was offering throughout the practices.
- Restoring Fertility - This one did not have as much depth of content, I felt. But overall the quality was fine.
I did not follow either of these during my 90 day egg quest or my TTC cycle that followed. Rather, I did self-guided yoga practice based on what I felt I would benefit from at the time. I do think that watching these DVDs influenced my personal practice in subtle ways. I would recommend them for those who would enjoy following a guided CD. In general, my personal practice was mostly gentle and relaxing, focusing on creating openness and stimulating circulation.
Saving the Best for Last...
The list of other things I did to support my overall health and well-being includes sleeping, resting, de-stressing, nurturing my relationships, cultivating joy, practicing gratitude, and letting emotions flow. I have plans to elaborate on all this much more, but I have just not gotten to it yet. ....and it's not because these things are less important--quite the opposite. I actually believe that getting adequate sleep, taking time to relax and restore, and having good emotional balance may be very influential in our overall health and resulting egg quality.
Until I find time to properly write about all this, here is a copy of a post I shared on a chat board back in July 2015, on a thread about my egg quality quest. Here I summarized what stood out to me that I did during the 90 day period to improve egg quality.
****************************************************************
SUMMARY OF MY HEALTHY EGG QUEST (copied from a post on BBC 7/13/15)
****************************************************************
I just wanted to conclude this old thread so that if anyone ever visits in the future it's not a big mystery how my egg quest turned out.
I did it!! Either I completely lucked out or something I did during the 3 month break really did improve my eggs. I'm currently 11.5 weeks along and have gotten genetic testing results that show all's clear in the chromosomal department. Amazing but true, at age 46. Totally against the odds.
So in case it actually was something I did, I thought I should share a summary of what I did when I look back at those 3 months.
Another general question I would consider is, "Will this lead me to feeling expansive or constricted in my being?" I find I can often sense this through my breathing: does my breathing feel open and easy or does it get tight and shallow? This also meant I had to let go of being uptight or perfectionistic about this 90-day mission. Uptight, obsessive and perfectionistic are extremely constricting. So I didn't do everything "right" all the time by any means, but I kept leaning in the general direction of these goals, not beating myself up if I slipped here and there.
I would fall asleep at night often with my hands on my belly, practicing gentle breathing and imagining sending loving energy to my uterus and my eggs. I would also practice visualizing my life with another child OR my life without another child, and bring up warm, loving images for both sides.
By the end of my 90 days, I have to be honest...I felt physically and emotionally better than I have felt in a long, long time. I started feeling like I had the energy of my 30-something self. I also came to feeling like I would truly be happy with either outcome, and wow, what a breath of fresh air that was! It's not that I could see a light at the end of the tunnel, but rather, I discovered I wasn't in a tunnel at all! The sun was shining right where I stood.
Now funny enough, old habits die hard, and when I finished my 90 days and went back to TTC mode, I dropped a lot of the positive things I'd been doing and soon felt the obsessiveness and tunnel vision creeping back in. I have felt this on and off through my first trimester as well. And it occurs to me that pretty much everything I was doing during my 90-day quest would be helpful right now, or at any time in my life. Duh! Live well and you feel better. So I may be renewing my commitment to that 90-day quest over and over again, for my overall well-being.
As far as I can tell, there just isn't enough research in this area to really tell us the keys to egg quality and fertility. So in the absence of good science, the best we can do is try to learn from each other and our personal stories to try to figure out what might work. I hope my story can help others find their way out of the tunnel and into the light.
Until I find time to properly write about all this, here is a copy of a post I shared on a chat board back in July 2015, on a thread about my egg quality quest. Here I summarized what stood out to me that I did during the 90 day period to improve egg quality.
****************************************************************
SUMMARY OF MY HEALTHY EGG QUEST (copied from a post on BBC 7/13/15)
****************************************************************
I just wanted to conclude this old thread so that if anyone ever visits in the future it's not a big mystery how my egg quest turned out.
I did it!! Either I completely lucked out or something I did during the 3 month break really did improve my eggs. I'm currently 11.5 weeks along and have gotten genetic testing results that show all's clear in the chromosomal department. Amazing but true, at age 46. Totally against the odds.
So in case it actually was something I did, I thought I should share a summary of what I did when I look back at those 3 months.
- Supplements: Prenatal and ubiquinol 100 mg/day
- Exercise: Light/moderate cardio and yoga, avg 4-5x/week.
- Nutrition: generally healthy, minimal processed food, eating to maintain good energy; no caffeine or alcohol
- Acunpuncture/herbs: I abandoned this during my 90 days (Partly because making time for it was stressing me out), though I did have a few acupuncture sessions right around ovulation time on my bfp cycle.
- Sleep: I had to fiercly protect my sleep because there were so many things I would let get in the way in the past.
- Stress: I repeatedly made decisions to decrease stress. Letting go of certain goals and standards, turning down invitations...
- Nurturing relationships: focused more on connecting and take care of my significant relationships, but being careful not to deplete myself in the process. Let go of conflicts in relationships to try to stay in a positive place. Avoided negative relationships.
- Cultivating joy and gratitude: Kept looking for the quickest way out of negative spaces and refocused on what is beautiful around me already. Engaged more in non-TTC hobbies (ugh, had TTC become my main "hobby"??)
- Crying freely: I had some really big cries as I had a lot to process from everything thad gone on over the past year and a half...plus the sudden loss of a friend.
- Which path is going to help me feel most energized or restored?
- Which path is going to make my heart feel full and alive?
- How can I keep optimal circulation of blood in my body throughout the week?
Another general question I would consider is, "Will this lead me to feeling expansive or constricted in my being?" I find I can often sense this through my breathing: does my breathing feel open and easy or does it get tight and shallow? This also meant I had to let go of being uptight or perfectionistic about this 90-day mission. Uptight, obsessive and perfectionistic are extremely constricting. So I didn't do everything "right" all the time by any means, but I kept leaning in the general direction of these goals, not beating myself up if I slipped here and there.
I would fall asleep at night often with my hands on my belly, practicing gentle breathing and imagining sending loving energy to my uterus and my eggs. I would also practice visualizing my life with another child OR my life without another child, and bring up warm, loving images for both sides.
By the end of my 90 days, I have to be honest...I felt physically and emotionally better than I have felt in a long, long time. I started feeling like I had the energy of my 30-something self. I also came to feeling like I would truly be happy with either outcome, and wow, what a breath of fresh air that was! It's not that I could see a light at the end of the tunnel, but rather, I discovered I wasn't in a tunnel at all! The sun was shining right where I stood.
Now funny enough, old habits die hard, and when I finished my 90 days and went back to TTC mode, I dropped a lot of the positive things I'd been doing and soon felt the obsessiveness and tunnel vision creeping back in. I have felt this on and off through my first trimester as well. And it occurs to me that pretty much everything I was doing during my 90-day quest would be helpful right now, or at any time in my life. Duh! Live well and you feel better. So I may be renewing my commitment to that 90-day quest over and over again, for my overall well-being.
As far as I can tell, there just isn't enough research in this area to really tell us the keys to egg quality and fertility. So in the absence of good science, the best we can do is try to learn from each other and our personal stories to try to figure out what might work. I hope my story can help others find their way out of the tunnel and into the light.
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