# Egg quality aids.



## Bellydancer44 (Jul 6, 2015)

Hi ladies my DH and I are due to start IVF but at 41 my main concern is egg quality.  Is there any thing I can take to maybe improve this? Or tips to help?  What should we be doing to get ourselves in best condition to hopefully give us best chance.  Thank you ladies. X


----------



## staceysm (Nov 18, 2010)

Hi,

Post on the over 40 thread, the lovely ladies on there will give you some good tips.

I had ICSI at 39 and although I only got 4 eggs, one is now my son.

X


----------



## Bellydancer44 (Jul 6, 2015)

Thank you Stacey, have done and congratulations . X


----------



## Cloudy (Jan 26, 2012)

There is a book called It Starts With An Egg by Rebecca Fett, another called Is Your Body Baby Friendly by Dr Beer (more for recurrent failure and mc, but still lots of general useful immunes/egg quality stuff).

A lot will depend more on your lh/fsh/afc/amh than your age. Although the general rule is decline occurs with age, it doesn't always work like that as such and there are plenty of ladies 40+ with "better" eggs than ladies half their age.

Xxx


----------



## Bellydancer44 (Jul 6, 2015)

Thank you cloudy, I will try to find those books and he a read.  Guess it's then wait til I get my tests done/results and cross my fingers.  It's all a lottery isn't it. Thank you for your advice x


----------



## CrazyHorse (May 8, 2014)

A quick note about FSH/AMH/AFC: While really high FSH is a strong clue that egg quality will be compromised, low AMH and low AFC don't tell you much about the quality of your remaining eggs. The only way to find out, unfortunately, really is to do a few rounds of IVF. (If you happen to need ICSI, the embryologist will be able to tell you more about your egg quality because they strip the cumulus away from the egg and can visually examine it, which they can't in conventional IVF.) My AMH and AFC are in the toilet (1.8 and 3, respectively) and I was 40 y.o. at the time (now 41), yet I got pregnant on 2 out of the 3 cycles where we actually went to egg collection, beating the odds for my age in a big way. First one ended in m/c at 9 weeks, but 2nd one is going strong at 20+ weeks now.

Gotta go for now, but will come back later and post a few thoughts on supplements as well.


----------



## Cloudy (Jan 26, 2012)

Good point CH, I probably should clarify what I meant (it was late so I wasn't very clear). I was just trying to say that what happens in IVF is related to a lot of different factors, and when you get the results of those tests you will have a bit better idea of where you stand in some respects (and likely responses to stims, although again its a bit of a guessing game). Also, even if someone was found to have perfect eggs (like CH pointed out, ICSI itself is a good indicator) the best quality of eggs dont always result in pregnancy. I think people worry too much about age sometimes, when that's not always the most important thing.

Those books are good to educate yourself about what the options are, and how things work. However, I still think waiting for those initial results is a good idea as they will impact in the type of treatment recommended.

Xxx


----------



## CrazyHorse (May 8, 2014)

Hi, Bellydancer, from what I hear, the books Cloudy listed are excellent, so definitely have a look at those.

I'm assuming you're already on a basic prenatal vitamin, correct? No smoking, no or minimal alcohol (i.e., no more than a few units of alcohol a week at most), no recreational drugs? Getting regular exercise, eating plenty of protein and healthy fats, and trying to keep your weight in a healthy range? All of these go for your partner too, although some kind of a men's multivitamin may be better (there's nothing in prenatals that men shouldn't be taking, however). Can't stress the no smoking thing enough, if either of you have been trying to quit.

One supplement I would start right away is CoEnzyme Q10, which ideally you would take for a few months before egg retrieval. It does not interact with any of the meds for IVF treatment and is generally regarded as safe to take in pregnancy as well (there was even a small-scale study in Brazil on using it to help prevent pre-eclampsia in pregnant women with risk factors, which had promising results), so you can take it up to ET and continue it in the tww if you want. Generally, 400 - 600 mg / day seems to be the usual dose, so buy the 200 mg capsules online. I think the Lister has all their older ladies (and maybe some younger ones as well) on 600 mg / day.

A high-quality molecularly distilled fish oil is also a good idea -- I took two capsules of these every day: http://www.amazon.co.uk/Bioglan-Super-Omega-3-Capsules-pieces/dp/B00503DSII. Because these fish oils do not contain any significant amounts of mercury or Vitamin A (not to be confused with cod liver oil, which is full of Vitamin A), they are safe to take up to ET and into the tww, unless you are on blood thinners. Fish oil has a modest blood-thinning effect, so if your clinic puts you on Clexane and/or aspirin, ask them if they think it's safe to take fish oil or if you should discontinue it.

I hear good things about melatonin, but have not researched it and did not take it myself, so cannot advise on dosages or when to discontinue. I believe Rebecca Fett mentions it in her book. Again, probably one to start taking sooner rather than later for optimal results.

If you have high FSH, it may be worth looking into wheatgrass. Women who have actually seen their FSH drop from taking it usually seem to be drinking fresh wheatgrass juice (can be shipped to you frozen) rather than using the powdered stuff. I ordered frozen wheatgrass juice from http://www.bigjuiceltd.com/. They ship it to you as individual frozen shots packed in little boxes that they put in an insulated box with a bunch of cold packs; mine arrived still perfectly frozen. You defrost and drink a shot a day (not sure if some ladies may take 2 a day); make sure to shake it up first, once defrosted. I always just drank it straight instead of trying to disguise it in a smoothie. Some ladies think it tastes incredibly disgusting, but I didn't think it was so bad; sort of tastes like fresh lawn clippings smell.

The thing about wheatgrass is that it LOWERS your FSH, so it will interfere with stims, which are meant to RAISE your FSH. Basically, FSH is like petrol making your ovaries rev up and produce more eggs; the older your ovaries, typically, the more FSH it takes to make them go, which is why your background FSH (as measured on Cycle Day 3) is likely to be elevated in your 40s and then soars as you approach menopause (your body is leaning on the accelerator as hard as it can, but your ovaries can't get the follicles to turn over anymore). So wheatgrass should always be discontinued before you start stims. The idea with wheatgrass is to reduce your background levels of FSH so that the extra FSH from the stims has a bigger impact.

One of the other big supplement options is DHEA. The usual dosage is 75 mg / day. DHEA is somewhat controversial, as it directly affects your androgenic hormones. Many women experience a decline in their serum free testosterone and DHEA-S as they age, and the idea is that bringing these levels back up can help improve egg quality / ovarian response. The Center for Human Reproduction in New York has probably been the premier clinical researcher into the use of DHEA in conjunction with IVF: https://www.centerforhumanreprod.com/services/infertility-treatments/dhea/whatis/. Personally, I would not recommend using DHEA without having your serum free testosterone and DHEA-S tested, which your IVF clinic can do or which you can have done through a private lab like Blue Horizon Medicals. If your values for these are on the high side, I would use caution with DHEA. I did not use it on my first 3 IVF cycles, as I always had borderline-high testosterone as a young woman. I did have my testosterone levels and DHEA-S levels checked before my 3rd cycle, and as my DHEA-S level was near the top end of the normal range, I chose not to use it. After my miscarriage, I decided it was worth a go before my next cycle (throwing the kitchen sink at things), but I only took 25 mg / day of DHEA; I did not have any significant side effects. Some women report various androgen-related side effects: acne, slightly increased body hair, oily skin / scalp, thinning scalp hair, increased sex drive.

DHEA is one to do your research on before deciding whether to take it; many women have good results with it, but some report actually having worse results on IVF cycles after taking DHEA than on IVF cycles without it. If your clinic is OK with it, you can take DHEA right up to EC. Most advice is not to take it in tww and early pregnancy, but I have seen at least one clinic keep women on it into early pregnancy and wean them off, so up to EC should be perfectly safe for any embryos you put back. If I recall correctly, DHEA is not a great option for women with PCO, and some women find it makes their endometriosis flare up, so use caution if you have high AMH (an indicator of PCO) or a history of endometriosis.

One last thing: some doctors will tell you that your egg quality will be what it will be, and that you can't really improve it with supplements or degrade it with large doses of stims. Myself, I do *not* believe this. They are correct that there are not high-quality, well-controlled, large-scale studies proving these effects. However, this is true of most treatment tweaks clinics can, and routinely do, make in IVF. In particular, based on my own experiences and the experiences of many other over-35 women with low AMH, I believe that for many (no where close to all, but many) older women large doses of stims and/or long periods of stimming have a negative effect on egg and embryo quality.

This is not to say that it's not worth trying a cycle of high-dose stims (e.g., 300 iu / day or more) if you have low AMH, as you may respond well, make more eggs, and have a better shot at getting frosties as well as a fresh transfer. If you try short protocol and it goes poorly, you may want to try long protocol (or vice versa, if you did LP first) before giving up on high-dose stims. However, if you don't respond well on high-dose stims using a couple of different protocols, I would get a second opinion at another clinic that has good success rates with over-40s, if your clinic recommends just putting up the stims even higher and doing the same thing again, or says that clearly your ovaries are past it and you need to go for DE. High stims seem like the logical answer to low AMH, but it doesn't always work like that in practice. Like so many things in IVF, you just have to try a few things and see what happens.

Whew! Sorry for the giant essay. Hope some of that wall of text is helpful! 

/links


----------



## Bellydancer44 (Jul 6, 2015)

Thank you cloudy, just ordered that book by Rebecca Fett  next day del. 
Wow thank you crazy horse, that reply was so so helpful and I will certainly try a few of those sups. DH and I did start pregnacare his n hers conception vits today :-D and will google a few of the ones you suggested and hopefully start ASAP. 
Neither of smoke or are over/under weight and don't really drink much tbh either. 
Going to cut down caffeine though as I drink lots of tea. And try to get mor fruit n veg I to our diet.  Then see what our results say and what the clinic recommends. Again thank you so much for taking time for that long reply, means a lot that ladies on this board offer help and advice whom have been there and are in similar boats.  
We haven't started properly yet but it seems all I think about at times.  Good luck all ladies with your journeys xxx


----------



## Mrs Courage (Jun 6, 2015)

Hi Bellydancer44,

I would recommend the following: cut out all caffeine, alcohol, cut down on sugar, increase your water intake. Also take the following supplements:Conception vitamins (such as pregnacare) it's worth shelling out a bit more money to get higher dosage of your vitamin intake, have a glass of spirulina and wheatgrarss mixed with juice as they taste a bit nasty on a daily basis, royal jelly tablets and maca tablets (all of these can be bought in Holland and Barrett). These should help increase the quality of your eggs. Also avocadoes are a superfood in helping to triple your chances in conceiving through IVF, Please see the attached daily mail link: http://www.dailymail.co.uk/health/article-2168494/Avocado-diet-triples-chance-success-couples-undergoing-IVF.html Good luck!   

/links


----------

