For you to conceive, all you need is one egg. Continue to read on if you want to know how to improve your egg quality, naturally with Traditional Chinese Medicine.
What is poor ovarian reserve?
Medically, poor egg quality refers to poor ovarian reserve. There are three main markers of poor ovarian reserve(POR):
1. High follicle stimulating hormone(FSH)
FSH is a hormone released by pituitary gland to stimulate the growth and maturation of follicles and eggs within them. Normally, FSH is measured on day 2 or 3 of a woman’s menstrual cycle to test her ovarian function.
If the result is above ten, it suggests that she might be approaching menopause because her ovaries are working double time to produce eggs. High FSH might also mean that a woman would respond poorly to IVF because FSH is the drug used to stimulate eggs.
High FSH was once considered to be the key marker of POR, but we now know that FSH fluctuates throughout a woman’s lifetime. It is still used to determine how likely women can respond to FSH drugs. Normal FSH means they can respond well to IVF, but high FSH indicates a poor response to FSH drugs for IVF.
2. Low Anti-Mullerian Hormone(AMH)
Amount of AMH in a woman’s blood, which remains constant throughout her menstrual cycle, is considered as a better indicator for quality and quantity of remaining eggs in her ovaries.
However, AMH levels are considered controversial because it is still unclear how accurate or cost-effective it can be at predicting live births or improving reproductive health care, and there is still a lack of international standards for interpreting test results accurately.
In my own experience, I have seen some patients’ AMH improve after treatment. So, the jury is still out on this.
3. Low Antral Follicle Count(AFC)
What TCM thinks about your eggs
TCM acknowledge egg quality in terms of vitality and energy. In TCM, we believe that we are born with a certain amount of energy, which we inherit from our parents. This is known as Jing Qi(essence), which I have explained comprehensively in my article regarding the Three Vital Substances and Fertility.
Additionally, we are able to tap into and produce energy through our dietary preferences, which TCM refers to Gu Qi(acquired nutritive energy). We also acquire energy from thr air we breathe in.
While we can replenish our Gu Qi through our lifestyle, our Jing essence declines with age. TCM aims to preserve our Jing essence as much as possible so that our energy for reproduction won’t deplete that fast. The more we over-extend ourselves, the faster we deplete Jing essence. In today’s stressful society, things such as working long hours for many years, disliking your job and increased sense of un-fulfillment and unhappy relationships can increase depletion at a faster rate. Add on the stressful fertility journey, this is counter-productive.
According to TCM, we acknowledge that after the age of 35, reproductive energy starts to decline but we believe that as long as a woman who lives in balance with nature in body, mind and spirit, can conceive right up until the onset of menopause. The key is to know how to positively manage your stress and conserve your energy to improve egg quality.
It may seem an obvious thing to say, but the older you are, the more important it is to take charge of your lifestyle choices. I have seen many older women who have done just this and are healthier than their younger counterparts in many ways.
Within the follicular environment, the egg and follicular fluid together form a functional unit, providing an optimal micro-environment in which the follicle can develop. It is likely that the fluid has both nutritive and protective functions and that environmental factors affecting the follicular fluid will in turn affect the quality of the egg – the lengthy time the egg remains dormant in the ovary provides time and opportunity for environmental factors to take their toll on it. This parallels the belief in TCM that both Yin and Yang are essential to fertility: Yin being manifested by the fluids in the body, the nourishing and protective environment; and Yang being represented by the egg that contains the active fertile potential. Therefore, ensuring Yin and follicular fluid is of optimum quality can go some way to improving egg quality in women with poor ovarian reserve.
I hope to help women preserve their Yin and Blood through acupuncture to improve blood flow to the ovaries, but there are also some ways where you can keep Yin strong. Yin is the fluid environment that nourishes the eggs to be produced. If you feel you have been overworked, get hot and bothered or just feel your energy reserves are getting too low, it is an important time of your life to focus on replenishing Yin.
How you can improve your egg quality naturally
- Taking time out for yourself is essential, and rest is especially good in the early days of your period. Don’t run around all month long, instead try to listen to your body needs.
- Avoid stimulant foods such as coffee, alcohol, sugar and hot spices.
- Avoid binge drinking
- Some food tonic includes asparagus, avocado, honey, lemon, mango, milk, pear, poegranate, sesame, spinach, sweet potato, tofu and tomato
- Eat more nuts and seeds, each packed with essential fats.
- There is also some early evidence that eating omega-3 essential fatty acids, if consumed within a healthy diet can help to improve egg quality.
- Look to support your Jing essence, which is the foundation of our vitality and fertility. Foods that boost our essence include almond, seaweed, milk, egg, seasame seeds, walnut and oats.
Additional lifestyle tips to improve egg equality
1. Live a healthy lifestyle
You are born with all the eggs you have in your lifetime, but what we call “egg quality” is not actually a fixed thing—as the egg develops before ovulation, it’s affected by outside factors, so you want to keep your body as pristine as possible. We always encourage patients to maintain a healthy weight because being underweight or overweight can decrease chances to conceive. Exercise, but not to a point of exhaustion—do yoga, Pilates, walking, light jogging or strength training instead of long-distance running or CrossFit can improve your egg quality dramatically.
2. Manage stress
Releasing an egg each month may be affected by stress, as stress hormones are produced which can affect ovulation. For some women, chronic stress can affect ovulation by altering signals to the part of the brain that regulates the hormones that trigger the ovaries to release eggs each month.In cases where she ovulates in spite of the stress, there can be problems with fertilisation and implantation in the uterus. It’s not about eliminating stress; it’s about managing it. Many women de-stress with exercise, which is always a good thing, but the real benefits come from taking time to stop and practicing techniques that involve slowing down and doing nothing. Breathing techniques, meditation and yoga all help, and 20 minutes a day or more is perfect if you can incorporate this into your daily life.
3. Avoid smoking, caffeine and alcohol
Women do metabolize alcohol much less efficiently than men and there is certainly evidence to suggest that alcohol can increase incidence of some gynecological and other disorders which might contribute to infertility. Alcohol consumption is associated with altered estrogen and progesterone levels as well as menstrual irregularities and increased incidence of endometriosis, abnormalities in the ovaries, impaired implantation and blastocyst development and the early onset of menopause.[1]
The effect of smoking has been examined by many researchers and the general consensus here is the same. Most studies have shown negative effects of smoking on reproduction, and in couples where either partner smokes, it takes longer for them to conceive.[2]
A large study carried out by the Yale Medical School found that the risk of infertility (which they defined as not being able to conceive after 12 months) was 55% higher for women drinking just 1 cup of coffee per day; 100% higher for women drinking 1.5–3 cups per day; and 176% higher for >3 cups per day,87 and this was backed up 5 years later by a study in Europe, which found that high caffeine intake in women slowed rates of conception.[3]
4. Take supplements
Finding a good prenatal supplement which incorporates essential vitamins and minerals is important and consultation with a local naturopath or nutritionist for guidance may be advisable. A full discussion of the roles and dosage requirements of all these supplemental nutrients is outside the scope of this text, however it is worth noting that there are some nutrients that modern diets seem to be lacking, and which may be the cause of some disturbances in fetal development.
It has long been recognized that nutrients such as calcium and iron are important for the health of the pregnant woman and her baby. We now know that lack of folic acid can have dire consequences on the early development of the nervous system of the fetus, causing neural tube defects such as spina bifida. As more research is carried out on different nutrients, their role in fetal development will be elucidated. The above-mentioned nurses study found that women who took supplemental vitamins had a better chance of conceiving. [4]
Consumption of iodine has dropped in many countries (except those where a lot of seaweed is eaten), to levels that have caused concern for infant brain development. Iodine deficiency in the mothers’ diet can lead to miscarriage, premature birth and significant developmental delays in affected children.[5] Hence, it is important that women take a vitamin preparation containing 150 μg iodine daily, in preparation for and during pregnancy and lactation to supplement iodine intake from the diet – the total daily intake should be 250 μg. Dietary sources are seafood, dairy and eggs, and some vegetables. In some countries, foods like bread are fortified with iodine to prevent a public health problem. However, the amount of iodine in dietary sources is inadequate for pregnant and breast-feeding women.
Similarly, vitamin D levels are inadequate in a large number of women who are pregnant or preparing to conceive. Very few foods (other than some fatty fish) have significant amounts of vitamin D in them and the primary source, the action of sunshine on the skin, is limited in the lives of many modern women who work inside and seldom see the sun. Vitamin D deficiency adversely affects bone health and brain development of the baby, but also increases risk of heart disease, type 1 diabetes and cancer as the baby grows into an adult.[6] In summary, women preparing to conceive should take a prenatal multivitamin supplement and should check this for inclusion of adequate folate (500–1000 μg), Vitamin D and iodine. Women are often recommended to add Fish oil and CoQ10 capsules to a preconception vitamin preparation if it is not included.
5. Eat good food
The British Association for the Promotion of Preconception Care, called Foresight, has for many years dispensed information about diet and lifestyle to prospective parents. They have sponsored research which supports the notion that healthy, well-nourished parents have healthy pregnancies and make healthy babies.[7] Their advice includes a sound, well-balanced, and ‘clean’ (i.e., no junk food or added chemicals) diet and the optimum intake of many vitamins and minerals, namely: zinc, selenium, manganese, potassium, magnesium, iron, iodine, calcium, chromium, boron, vitamins A, B complex, C, D, E, folic acid, and essential fatty acids.[4]
I have written a TCM fertility diet that any couples who are trying to conceive should follow – make sure not to miss it. It is mostly based on Ancient Chinese texts with modern clinical evidence to support the nutritional evidence. You can click on the picture below to read more about that.
Conclusion
It is easy to be labelled with poor egg quality but never easy to reverse that. However, in our clinical practice, it is possible that we can help to improve our own egg quality with the correct lifestyle modifications as well as nutritional supplements.
If you would like an individual plan to boost your fertility and improve your egg quality, click on the button below to make an appointment with me.
References
[1] Gill J. The effects of moderate alcohol consumption on female hormone levels and reproductive function. Alcohol 2000;35:417–23.
[2] Hassan MA, Killick SR. Negative lifestyle is associated with a significant reduction in fecundity. Fertil Steril 2004;81(2):384–92
[3] Bolumar F, Olsen J, Rebagliato M, et al. Caffeine intake and delayed conception: a European multicenter study on infertility and subfecundity. European Study Group on Infertility and Subfecundity. Am J Epidemiol 1997;145(4):324–34.
[4] Naish F, Roberts J. The natural way to better babies. Sydney: Random House; 1996, 57.
[5] Renner R. Dietary iodine: why are so many mothers not getting enough?. Environ Health Perspect 2010;118(10):A438–42.
[6] Kaludjerovic J, Vieth R. Relationship between vitamin D during perinatal development and health. J Midwifery Womens Health 2010;55(6):550–60.
[7] Roberts J. The foresight program. J Austr Coll Nutr Environ Med 1995;14(2):16.