By Tara Brandner, Registered Nurse
As women get older, it is common for them to worry about their reproductive timeline. We know that when women age, it can have an impact not only on their overall health, but specifically on their egg quality and potential abnormalities. When looking at ways to improve the quality of the eggs we have, we should change our mindset to what we can do to keep our ovaries’ environment healthy.
Certain hormones can assist in assessing egg health and quality. Ovarian reserve is one piece of fertility testing that determines the number of eggs you currently have. This is shown through blood tests that check follicle-stimulating hormone (FSH), estradiol levels, and anti-müllerian hormone (AMH).
FSH is a common fertility test that is drawn on day 3 of your menstrual cycle. The pituitary gland produces FSH to stimulate growth of ovarian follicles along with production of the hormone estrogen. We see resistance to FSH as egg quantity decreases.
Estradiol (E2) levels are also drawn on day 3 of your cycle. If these levels are abnormally elevated, it may indicate the presence of a functional cyst (normal) or diminished ovarian reserve (DOR). The ovarian response to fertility treatments tends to be poor when FSH and estradiol are elevated.
AMH simply evaluates how many eggs remain in your ovary. This number does not tell us anything about the quality of your eggs. Women with polycystic ovary syndrome (PCOS) have higher levels of AMH than those without this diagnosis. Smoking is one reason we see a decrease in ovarian reserve. Weight may also play a factor—one study looked at overweight or obese women and found that weight loss did result in an overall improvement in reproductive function. Remember that AMH levels are a piece of your puzzle, not the entire answer. Knowing your lab levels is a powerful tool for you and your fertility health.
Here are 4 ways to improve ovarian health:
Quitting smoking is vital to improving egg quality. Cigarettes introduce toxins into the ovaries that can harm eggs. Yes, this also includes vaping. Vaping has the same harmful toxic chemicals as cigarettes. Smoking damages the genetic material in eggs and sperm, so this rule applies to both men and women. The good news is that studies have shown that when you stop smoking or vaping, fertility can improve.
2. Stay healthy
Maintaining a fertility-friendly diet can also improve egg quality and help with hormones that impact ovulation. Research has supported the Mediterranean diet to improve fertility. This diet includes fruits, vegetables (specifically leafy greens), nuts, seeds, beans, whole grains, and lean protein. Make it a goal to keep your blood sugars balanced throughout the day. Include protein with meals and snacks while ensuring you eat every 3-4 hours.
3. Add antioxidants
Try to incorporate antioxidant supplements into your fertility lifestyle. Some of these may include coenzyme Q10, melatonin, and omega-3 (fish oil)—all of which have been shown to support egg quality. You could consider adding coenzyme Q10 to your regimen—which helps to fight off certain damages caused by environmental toxins and stress. Melatonin is known to prevent or slow damage to cells while assisting in hormone balancing. Omega-3 is known to help with chromosomal and mitochondrial health. Antioxidants also help fight inflammation, which can interfere with hormones.
Everyone should have their own assessment, testing, and discussion with a fertility specialist (reproductive endocrinologist) who can best determine which supplements are right for you.
4. Get some sleep
Work on creating a healthy sleep routine. Our sleep cycle is a circadian rhythm (a natural, internal process that regulates the sleep–wake cycle and repeats roughly every 24 hours), as are our hormones. Sleep is the time when our bodies repair cells, restore energy and release certain hormones. Remember the supplement melatonin? While you are sleeping, the pineal gland releases this hormone naturally. Studies have demonstrated the negative impact of something called “oxidative stress” (which may result from lack of sleep) on fertility. Oxidative stress can impact the quality of oocytes and embryos. Supplementing with melatonin can positively impact our oxygen-rich scavenging abilities. Additionally, studies have found abnormal levels of FSH, luteinizing hormone (LH), and prolactin in patients who have sleep issues or circadian dysrhythmia (a disruption of the normal cycles of wakefulness and sleep). Commonly this occurs in shift work, jet lag, and daylight savings time changes. Studies have concluded that this does result in poorer fertility and impacts early pregnancy outcomes.
Always remember you know your body best. Create a team approach to your fertility care to optimize the appropriate modalities, fertility treatments, supplements, and lifestyle changes. It is essential to feel heard by your fertility specialist and fully trust the plan of care laid out by them. Never hesitate to seek a second opinion. Additionally, make sure you have a support system in place that you can lean on during those hard times.