Intro
The landscape of the baby-making world has changed dramatically over the past several decades. Women are having babies later in life, with the average age of a first time mother increasing from 21 in 1972 to 26 today. That number rises even more, into the low 30s, as data gets drilled down to certain geographies and demographics. At the same time, same sex and non-gender conforming couples are feeling more freedom and acceptance to expand their families. (We celebrate this progress but know there is more to be done!)
Many companies are recognizing this, and are stepping in to financially support egg and embryo freezing and other reproductive assistance. But with this rise in egg and embryo freezing and related assisted reproduction technology (ART), we noticed that there isn’t much conversation about how to prepare your body. So we want to start that conversation! We’re diving into how to intentionally prepare your body (or your donor’s body) for optimal health and egg quality.
What are Egg Freezing and Embryo Freezing?
First, let’s make sure we’re all on the same page. Egg freezing, or oocyte cryopreservation, is a way to essentially “preserve” fertility by extracting eggs from the ovaries and freezing them so that they can be used for an ART procedure, like in-vitro fertilization (IVF), in the future.
Embryo freezing is similar. The difference is that when freezing an embryo, the egg is fertilized prior to freezing. Often, a person may choose to freeze eggs if they are undecided as to who they will choose to fertilize the egg in the future. If a couple has established the source of their sperm and egg, they may opt to freeze an embryo and essentially get one step further in the process of conception.
How Does it Work?
The egg freezing procedure and the embryo freezing procedure both start in a similar way. The egg donor is injected with specific hormones, typically over a period of 8 to 12 days. These hormones stimulate the ovaries to produce multiple egg follicles. This is done to increase the chances of fertilization, as not every egg will result in an embryo. Whether a person is freezing eggs or an embryo, producing multiple eggs increases the chances of the procedure ultimately resulting in a baby.
If just eggs are being frozen, they are retrieved and stored. If an embryo is being frozen, the process is taken further by also retrieving sperm with which to fertilize the egg.
The Health of Eggs and Sperm Matters
Just as with “traditional” conception, the health of the eggs and sperm at the time of retrieval really matters in determining the success rates of a viable embryo.
How many eggs survive the warming process and can be successfully fertilized depends largely on how old the donor was when they were frozen (we know that fertility declines beginning at age 35, but there are things you can do to optimize fertility at any age), and how healthy and viable they were when frozen.
Let’s first start with egg health, before shining a light on sperm.
How to Support Egg Health
Preparing the body for egg retrieval and freezing is a very similar process to the preconception planning that benefits all women when getting ready to conceive. Here are some things to focus on and things to avoid or limit:
IncludeIncluding the following in your diet, supplementation, and lifestyle routine can help support the health and quality of your eggs prior to retrieval. This quality is preserved in time until you are ready for the egg to be fertilized or embryo to be implanted.
Omega-3 Fatty Acids have been studied extensively for their ability to improve egg quality. One of these fatty acids in particular, DHA was found to increase embryo morphology - the structure of the embryo and a predictor of success.
A wide body of research has also suggested that Omega-3 consumption can improve egg quality and fertility outcomes. Furthermore, Omega-3 may also help outcomes by increasing the ratio of Omega-3 to Omega-6 fatty acids. As Omega-6 fatty acids are inflammatory, reducing this ratio can help decrease inflammation in the body which may support overall health and egg quality. In fact, one study showed that short-term dietary treatment with omega-6 fatty acids results in very poor oocyte quality.
Our Omega-3 capsules and powder are easy to take and vegan and provide an excellent source of both DHA and EPA to support egg quality. (Spoiler alert: Omega-3 is also one of the most important items for sperm health as well!)
The health and quality of a woman’s eggs (which translates into the quality of resulting embryos) are highly influenced by the level of blood flow surrounding the ovaries and the amount of antioxidants available for protection against the damaging effects of oxidation. Therefore, antioxidants, which help fight free radicals and prevent or slow damage to cells, are known to be supportive and protective of egg quality.
Vitamin C has powerful antioxidant properties and specifically acts to improve levels of nitric oxide which supports improved blood flow.
In addition, the antioxidant CoQ10 has been shown to improve egg maturation and embryo quality, support the energy production that powers the egg, and help chromosomes to replicate normally.
High antioxidant foods include berries, leafy greens, pomegranate, beets, and most nuts and seeds. Our Prenatal Multi is an excellent choice for preconception nutrition, as it contains a supportive 500mg of Vitamin C plus a powerful antioxidant blend.
Gut health is strongly linked to overall health and fertility. One study looked at the relationship between inflammation, gut health, and egg quality and found that diet-induced changes in gut microbial composition may be contributing to ovarian inflammation, which in turn alters ovarian gene expression and ultimately contributes to reduction in egg quality.
For more on how gut health impacts fertility, check out our blog on how preconception gut support can improve fertility outcomes.
We know that Folate is critical to baby’s neural development once in the womb, but Folate supplementation prior to conception has been associated with a greater chance for getting pregnant and improved success with fertility treatments. It’s unclear whether this influence is due to egg quality specifically, but the evidence is strong enough to suggest that Folate supplementation prior to egg retrieval may benefit pregnancy outcomes. Our Prenatal Multi contains a supportive dose of the optimally-absorbed L-methylfolate (not Folic Acid).
Often considered part of the B vitamin family, Inositol has been studied for its potential benefits to egg quality. It is frequently recommended for women with Polycystic Ovarian Syndrome for its ability to help regulate blood sugar. However, it has been studied more in recent years for its ability to increase overall ovarian response to stimulation and improve the quality of both eggs and embryos.
In one study of patients undergoing egg retrieval as a result of PCOS-related infertility, those who received inositol supplementation had a significantly increased number of follicles of diameter greater than 15 mm visible at ultrasound during stimulation as well as a significantly increased number of eggs recovered. In addition, the average number of immature eggs was lower.
Beyond specific nutrients, research has shown significant benefits to a preconception detox. This intentional process isn’t what you might think of when you hear the word detox, it is intended to support your body’s natural ability to detox from excess hormones or any other potential toxins.
Research has shown many benefits to a detox period prior to pregnancy and how it can support egg health. The burden of toxins has been shown to negatively impact everything from ovarian function to IVF outcomes. A preconception detox has the potential to impact a number of positive fertility and pregnancy outcomes. Check out our actionable three-part series on how to do an effective preconception detox.
Note, if you’d like to support the body in removing any excess hormones that were part of your treatment prior to retrieval, check out our blog on How to Balance Hormones. The detox steps outlined here can help support this process.
Avoid/limit
An often cited study from 1988 suggested that drinking more than the equivalent of caffeine found in 1 cup of coffee (roughly 85 mg) cuts a woman's chances for conception by 50%. However, no other study since has been able to support this claim. The results of other similar studies show a more complicated relationship between caffeine consumption and fertility. However, while the relationship between egg quality and caffeine is unclear, there is a clearer relationship between preconception caffeine consumption and pregnancy outcomes. A study from the researchers at the National Institutes of Health and Ohio State University showed that a woman is more likely to miscarry if she and her partner drink more than two caffeinated beverages a day during the weeks leading up to conception.
While healthy fats (Omega-3s, fatty fish, nuts and seeds, olive and coconut oil, and avocado) are a key component of a healthy diet and can support egg quality and fertility, the opposite is true of trans fats. A study in the American Journal of Clinical Nutrition found that each 2 percent increase in the intake of energy from trans unsaturated fats, as opposed to energy from carbohydrates, was associated with a 73 percent greater risk of ovulatory infertility. The study also determined that consumption of trans fat, rather than monounsaturated fats, was associated with a two times greater chance of ovulatory infertility.
We discussed the benefits of detoxing in the previous section, but in addition to supporting the clearance of toxins from the body, you can also reduce your toxic load by limiting exposure to known toxic substances, such as endocrine disrupting chemicals and heavy metals found in plastics, personal care products, cleaning products, nonstick cookware, conventionally grown or processed food, and more. Our series on how to do an effective preconception detox has step-by-step recommendations for how to reduce your toxic load.
Sugar causes inflammation, which is a detriment to egg quality. One study found that higher intake of sugary drinks was associated with lower total, mature, and fertilized oocytes and top-quality embryos after ovarian stimulation. There are a number of reasons to limit added sugar and to work to manage inflammation - egg quality is only one of them!
We know that chronic stress wreaks havoc on just about every aspect of our health. While stress hasn’t been definitely linked to egg quality, studies have suggested that it may impact implantation success. In fact, one study of over 200 women of similar age and fertility history tested the impact of providing a comedy routine following IVF implantation. The group that received the comedy had better outcomes than the control group, with 36.4% of women resulting in a pregnancy vs. 20.2% in the control group.
Try incorporating a mindfulness or meditation practice or incorporating some gentle yoga to address any stress or anxiety that your upcoming procedure may be causing.
How to Support Sperm Health
If you are preparing to freeze an embryo, quality of sperm matters too. When we refer to sperm health, we refer to sperm’s motility (ability to successfully swim to an egg), morphology (size and shape - defects can affect a sperm’s ability to reach and penetrate an egg), and quantity (amount of sperm in a given amount of ejaculate).
Include
There are a number of foods known to support sperm health. Check them out in our blog, 10 Foods to Boost Sperm Health (and ones to avoid).
There are a number of key nutrients that have been thoroughly researched around their ability to support sperm health. Check out the full list in our blog, Prenatal Vitamins for Men: Are They Needed?
As in women, the burden of toxins has been shown to negatively impact fertility outcomes. Multiple animal- and human-based studies on exposure to environmental toxins suggest “a negative impact on semen quality, in terms of sperm concentration, motility, and/or morphology. These toxins may exert estrogenic and/or anti-androgenic effects, which in turn alter the hypothalamic-pituitary-gonadal axis, induce sperm DNA damage, or cause sperm epigenetic changes”
A preconception detox has the potential to improve sperm quality prior to embryo freezing. Note that it takes approximately three to six months for the benefits of dietary changes and detoxification efforts to be reflected in sperm.
Avoid/Limit
As discussed in our blog, 10 Foods to Boost Sperm Health (and ones to avoid), caffeine, alcohol, unhealthy fats, and diet drinks are all linked to decreased sperm health.
Conclusion
While egg and embryo freezing are a wonderful way to preserve fertility, it’s important to remember that they also preserve a snapshot of your health at a point in time. Optimizing health prior to your procedure, just as you would prior to conception, can provide benefits far into the future for both you and your baby.
We hope you feel empowered with this information to prepare and plan for your family at whatever time is right for you!
