If you have ever had a screening with a fertility clinic, you might be familiar with the term “advanced maternal age.” This cruel designation is for anyone over the ripe old age of 35! Statistically speaking, this is because fertility and reproductive potential may decrease for some women over this age. Getting pregnant in your 40s may be challenging for women who fall into this age bracket. Mainly because egg quality and quantity tend to decline with age. The good news is that there are plenty of effective strategies that women can implement to maintain reproductive health and focus on egg quality, which may be even more critical than egg quantity, especially for those who are hoping for a spontaneous or natural conception without fertility treatment.
Supplements
Supplements have a tremendous effect on egg quality; however, not all supplements are created the same. Supplements are regulated by the Food and Drug Administration (FDA) as food and not pharmaceutical medications. As a result, it is important that when selecting supplements you make sure that it is verified for strength, purity, and accuracy. The easiest way to achieve this is to look for a third-party verification seal on your supplement label.
Supplements known to help with egg quality are:
Nutrient stores can take anywhere between 2-6 months to reach adequate levels. So, even if you are not actively trying to conceive, it is better to start supplements in advance if you are considering getting pregnant in. the near future. Before starting any new supplement, it is important to consult your healthcare provider, as some supplements may interact with prescription medications or be contraindicated with certain conditions.
Ovarian Rejuvenation
A few months back, I wrote an article about a groundbreaking procedure called ovarian rejuvenation. Women who have diminished ovarian reserve (DOR) or premature ovarian failure (POF) are ideal candidates for this procedure. Ovarian rejuvenation involves using platelet-rich-plasma (PRP) to help restore cell function to the ovaries in the hope of:
Induce follicle growth
Help eggs mature and ovulate
Improve IVF outcomes
Increase pregnancy success rate
Support egg quality
Restore hormone function
Not all fertility specialists offer this treatment. This may be because the American Society of Reproductive Medicine (ASRM) has not validated this treatment. A critical reason why they have not validated the therapy is that there are not enough large randomized controlled studies to state how effective this treatment truly is. However, this is not to say that the therapy is ineffective. The small studies that are available validate improvements in FSH levels, natural conception rates, and the number of eggs retrieved in IVF cycles.
Herbs
I talk a lot about the transformative power of herbs on my website and during my client consultations. To reap maximum benefits, I always recommend working with an herbalist who specializes in fertility since, like supplements, not all herbs are created the same. Similar to prescription medications, it is also dose-dependent, meaning for herbs to truly be effective, a specific dose needs to be consumed for a certain length of time. Using herbs in tandem with acupuncture has also proven to be more effective.
Many herbs boost fertility, and there are very specific ones that focus on egg quality. Most herbs are safe and non-toxic. Even when working with an herbalist, let your physician know since certain herbs interfere with prescription and over-the-counter (OTC) medication. A general rule I tell my clients when seeking fertility treatment rooted in Eastern Medicine is to visit the website The Acupuncture and TCM Board of Reproductive Medicine to select an herbalist, acupuncturist, or oriental medicine doctor from this site. Eastern medicine practitioners are not held to the same stringent guidelines as Western medicine practitioners, so utilizing the ABORM website ensures you work with somebody who is board-certified in oriental reproductive medicine.
Lifestyle Modification
Ok, so I know this is beating a dead horse, but the single most effective change you can make to enhance fertility and your overall health is lifestyle modification. Specific modifications include eating nutrient-dense foods that balance glucose and insulin, taking the correct supplements (ODI dosing and 3rd party verified), getting adequate restorative sleep, and incorporating a guided exercise routine. This can sound incredibly taxing for those who have not adopted this lifestyle, however, it does not have to be as arduous as it sounds. There is so much I can say about nutrition, sleep, and exercise, and if you have not done so, I would recommend visiting Guided Fertility’s forum, where I delve deeply into each of these topics.
Reading
I feel a little late to the game suggesting this book, and I only found out about it through my clients, who highly recommend “It Start with the Egg” by Rebecca Fett. I am about 50% done with it, and it provides some great insight and tips on improving egg quality. Another book I highly recommend, especially if you have suffered the devastating loss of miscarriage, is The Working Womb, by Alexandar Kofinas, MD. Unfortunately, women over 40 are at more risk of having miscarriages. This book provides valuable knowledge as to why this happens and how you can potentially prevent it.
Fertility Treatments
Having worked for phenomenal fertility centers as a fertility nurse, I have the utmost confidence in fertility treatments such as IVF and IUI. The recommendations and suggestions in this blog are no replacement for the advancements in the fertility field. I always use the guideline dictated by ASRM, which is women under the age of 35 who have been trying to conceive for over one year and women 35 and over who have been trying to conceive for six months should seek further evaluation from a specialist. Bear in mind not everyone will be fast-tracked to IVF. Fertility specialists have a very measured response based on diagnostic findings and do not arbitrarily recommend IVF to everyone who walks through the door. If you find yourself in this scenario and feel pressured by your doctor to be fast-tracked in a specific direction that you may not be comfortable with, I would recommend going for a second opinion.
Sources
Merhi Z, Seckin S, Mouanness M. Intraovarian platelet-rich plasma administration could improve blastocyst euploidy rates in women undergoing in vitro fertilization. Clinical and Experimental Reproductive Medicine. Sep 2022. 49(3):210-214. doi: 10.5653/cerm.2021.05057. Epub 2022 Aug 31. PMID: 36097737; PMCID: PMC9468693.
The Acupuncture and TCM Board of Oriental Reproductive Medicine
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