Egg Quality: new insights into why human eggs don’t age well

It has long been accepted that the primary reason that human eggs don’t age well is due to a dysfunction in when and how the chromosomes separate. This reduced chance of becoming pregnant associated with aging as well as the increased miscarriage rates. A new paper has now demonstrated that it’s not just the DNA separation that declines with time but also how the chromosomes are actually sorted and divided.

Within each egg are cable-like structures called microtubules. These microtubules not only help the egg maintain its shape but also are integral in sorting/separating the DNA. They are also in charge of cell division after fertilization is complete. In fact, some of the most powerful cancer fighting drugs are used to deliberately damage microtubules in order to prevent cancers from growing. This new information provides us with further insight into another important aspect of egg quality.

Although we don’t currently have any specific recommendations on what we can do to improve microtubule function; this information does provide us with more diagnostic information for patients that are going through In Vitro Fertilization (IVF). IVF is not only the treatment that provides patients with the highest pregnancy rates but when performed in a high quality setting; it also provides important diagnostic information. There is no accurate test for egg quality except to put a healthy sperm inside and see if/how well the process of fertilization and development takes place. We routinely use this information in discussing treatment options for patients that do not successfully conceive in their first IVF cycle at our center.

Fertile thoughts,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates

Thyroid Hormone for Women Trying to Conceive; why extracts and T3 can be harmful to your developing baby

Many patients that present to fertility centers are on thyroid supplements that are extracts from pig thyroid gland. Unfortunately, they have often embraced this treatment because it is presented as more “natural” then  the synthetic thyroxine often prescribed by most healthcare providers. In reality, the human thyroid gland converts T4 (thyroxine) into T3 (the active form) very efficiently. The typical ratio of T4:T3 in humans is about 14:1. By contrast, pig thyroid extracts have a 4:1 ratio so that there is much more active T3 in the preparation. The problem with this high level of T3 is that the developing baby needs the T4 from a pregnant mom’s blood; not T3. High T3 levels during early pregnancy can impair healthy brain development. So I recommend the following: 

          –take a stable dose of thyroxine. 

          –If you still feel challenged; consider meeting with an endocrinologist to see if you might be a candidate for small supplemental dose of T3; two or three times per day. 

http://endocrinenews.endocrine.org/controversy-continues-combination-treatment-hypothyroidism/

Selective dietary supplementation in early postpartum is associated with high resilience against depressed mood

Much of modern psychiatry is about using medications to try to normalize brain chemistry as a tool to help resolve mood disorders. Having been involved in considerable research on how hormonal shifts can cause changes in brain chemistry–I am always interested in trying to help my patients understand what may occur and what they may be able to do to take preventive actions. Here is a study that suggests that using a dietary supplement containing tryptophan (2 grams) and tyrosine (10 grams) may prevent postpartum blues without changing breast milk contents. Better still, this might interrupt the spiral to postpartum depression! Check out this link and then talk with your doctor before starting any program.

http://www.pnas.org/content/114/13/3509.abstract

Tens of Millions Lack Local Assisted Reproductive Services | Medpage Today

The lack of quality treatment has been something that we have taken on aggressively this year through our tele-medicine campaign. Since the new law was enacted in Colorado-making telemedicine fully reimburseable–we have been actively building our internet based services. If you’re one of the millions lacking care in your area, consider setting up a consultation. We’d love to meet you.

http://www.medpagetoday.com/Endocrinology/Infertility/63901?xid=nl_mpt_AACE_Daily_2017-03-17&eun=g7126400d9r

PCOS and AGE; how the foods you eat effect your chances for a successful pregnancy

Women with Polycystic Ovarian Syndrome (PCOS) are faced with a dual challenge. First, their inherent hormone imbalance makes it more difficult for an immature egg to become a mature fertile one. But less often appreciated is that they also tend to produce eggs that are less likely to fertilize or can be more likely to miscarry if they do conceive. This second problem is believed to be linked to poor egg quality. New research suggests that the impact of this second problem may be reduced by decreasing exposure to dietary toxins.

Advanced Glycation End products or AGE’s are formed when proteins or fats are exposed to sugars—especially when prepared by high heat cooking methods. These glycotoxins have been linked to aging, heart disease, cancer and infertility because they promote inflammation, reduce blood flow and promote the production of free radical formation. In fact, there are specific receptors (RAGE or “receptors for advanced glycation end products”) for these unhealthy chemicals that are concentrated on the surface of the ovary and have been linked to ovarian aging and reduced egg quality. Women with PCOS seem to have at least two times the levels of AGE’s and more concentrated RAGE on their ovarian surface; linking the reduced egg quality in PCOS to diet.

Importantly, there are steps you can take to reduce the impact that AGE’s are having upon your ability to become pregnant. It has been demonstrated that some simple dietary changes can profoundly reduce your AGE levels and start improving the quality of the eggs that you’re producing. Here’s list of helpful suggestions:

  • Dietary Recommendations:
    • Reduce consumption of meat, poultry, fish and dairy—all rich sources of AGE
    • Increase consumption of brown rice and mushrooms—which have been shown to help sequester these damaging chemicals after they already entered your body
  • Lifestyle Recommendations:
    • Adjust your cooking methods to reduce the production of AGE in your food before you eat
      • High heat and drier cooking methods like broiling, searing, grilling and deep frying all dramatically increase the formation of AGE
      • Lower heat and moist cooking methods like stewing, boiling and steaming minimize AGE production
    • Stay away from tobacco smoke—a potent source of AGE
  • Supplements to consider:
    • Resveratrol—a chemical found in red wine and now available in supplement form, has been shown to reduce the effects of AGE
    • Curcumin—a key product in the ginger-like spice turmeric—has also been shown to dramatically reduce the effects of AGE.
  • Medications that might help:
    • Metformin—a drug commonly given to women with PCOS and associated with higher pregnancy rates—has been shown to inhibit the activity of AGE
    • Aspirin—has been shown to help reduce AGE attachment

Daylight Savings Time May Lower Chances of IVF Success for Some: Study

At our center, we have long held that your circadian rhythm–how your biology responds to the day-night cycle–impacts your fertility. This is one of the many reasons we focus on optimizing vitamin D levels, melatonin (when necessary) and paying careful attention to our embryo transfer schedules. In case your fertility center hasn’t figured out how important that this is, check out the following recent study on miscarriage risk associated with time shifts.  https://consumer.healthday.com/infertility-information-22/infertility-news-412/daylight-savings-time-may-lower-chances-of-ivf-success-for-some-study-719514.html

Infertility Stinks! But perfumed products and air fresheners may be making it worse

As those of you who have already been through IVF may know, we advise you not to wear strong scented perfumes or lotions on the day of your egg retrieval. Evidence shows that strongly scented perfumes release chemicals that may be toxic to eggs and sperm.  Now studies show that you should consider avoiding fragrances all together, even if you aren’t at the IVF stage of treatment. Remember, if you can smell something it’s not only getting into your body but its actually getting directly into your bloodstream as if it were injected!

Don’t contribute to secondhand scent problems! One thing we all share intimately is the air that we breathe. There is growing evidence that your cologne, perfume or air freshener may not only harm your health and fertility; but those are around you as well.  A recent study found that one-third of Americans report health problems linked to commonly fragranced consumer products. So your as air fresheners, cleaning supplies, laundry products, scented candles, cologne, and personal care products may be worsening some else’s  asthma attack, migraine headache, or even poor performance in school or at work. Fragranced products are pervasive in our society, and over 99% of Americans are regularly exposed to fragranced products due to their own use  or to someone else’s use.  Some of the most bothersome chemicals include: Limonene, pinenes, acetone, ethanol, camphor, benzyl alcohol, ethyl acetate, limonene, benzene, formaldehyde, 1,4-dioxane, methylene chloride, acetaldehyde, synthetic musks, phthalates, etc . But rather than becoming an expert chemist, consider looking at a database like the one set up the be Environmental Working Group. This resource can help you better understand your own brands as well as provide guidance to some safer alternatives.

 

Take home points:

  • Look for “fragrance-free” not “unscented” products.
  • Do not use air fresheners. All air fresheners, even those advertised as “natural” or “organic” or with “essential oils” emit chemicals classified as toxic or hazardous. Don’t use them.