“What else can I do to improve the quality of my eggs?” the new frontier in fertility treatment

Unlike men, it is very difficult to assess a woman’s fertility at any given time. A man simply needs a quick trip to the video closet to collect a sperm specimen for viewing under the microscope; whereas it is only through the process of IVF that it is possible to truly assess the quality of a woman’s eggs. This entails several weeks of medication to prepare for an egg retrieval at which time her eggs are collected, fertilized and then monitored for normal embryo development prior to placing them back in her body to implant and become a pregnancy. There is no comparable test. As a result, recommendations of treatment to improve egg quality have been based upon unproven and often misguided observations.  

One of the more popular myths has been to encourage women to consume wheat grass. Although the suggestion is harmless enough, the only basis for its link to “improved fertility” can be traced back to a Kansas farmer from the 1930’s named Charles Schnabel. He claimed that when he fed wheat grass to his ailing chickens that they not only recovered but increased their egg laying potential. Not the best model to making assumptions about human egg quality.

Another folk remedy is the use of royal jelly. This is a special secretion made by honey bees and fed to future generations in order to cultivate the conversion of a drone to a fertile queen bee. Unfortunately, it doesn’t work as well in humans and has been linked to severe allergic reactions, asthma and even in rare situations death. Analysis of this chemical product reveals that it is little more than vitamins and other healthy nutrients. I think the lesson here is that good nutrition is important which is why it is a good idea to start a prenatal vitamin at least 3 months prior to trying to conceive.

A more recent recommendation has been for women with low ovarian reserve to take the pre-hormone supplement DHEA. While there is limited data that it may cause a slight increase in the number of eggs produced— in this clinical trial the average participant went from producing three eggs to four—there was not any demonstration of an improved pregnancy rate. From a practical standpoint, since it required 90 days of the supplement prior to undergoing IVF these patients may have produced even more eggs by going through 2 or 3 cycles of IVF instead. Most importantly, without a measureable improvement in pregnancy rate, it is premature to suggest that this may improve egg quality. There are ongoing studies which may provide insight as to whether there are some women that can benefit from this treatment but at this point the question remains unresolved. In fact, the available research is given a “C” grade indicating “there is unclear scientific evidence for its use.”

A well researched suggestion has been to optimize the energy storage/ utilization of the egg through supplementation with CoEnzyme Q10. This has not been considered a necessary supplement since your body can manufacture this on its own. However, the human egg has the greatest energy demand of any cell in the body; and its needs go up considerably during the process of follicle growth. It was therefore theorized that supplementing with CoQ10 could improve egg quality. Early studies have confirmed this theory.

Finally, it’s worth mentioning that avoiding harmful chemicals is also likely to improve egg quality as well. There is a growing list of toxins referred to as endocrine disrupting chemicals (EDC’s) that have been linked to diminished fertility and reduced egg quality in animals. Many of these same products have been tied to a reduction in male fertility which is easier to track through diminished sperm counts and decreased motility. Until it’s confirmed that EDC’s don’t compromise egg quality as well, I recommend that you take steps to reduce your exposure to chemicals like Bisphenol A (BPA) and phthalates.

In summary, here are some steps you can take and have confidence that you’re doing all that you can to optimize your chance becoming pregnant:

  • Avoid well intended but not well researched recommendations
  • Begin a prenatal vitamin several months before you want to become pregnant
  • Take CoEnzyme Q10 to optimize the quality of your eggs—typical dose is 100 mg taken two or three times each day

Consider modifying your food choices, cooking preparation, personal care products and lifestyle to reduce your exposure to endocrine disrupting chemicals. If you need some specific advice, check out my book PERFECT HORMONE BALANCE FOR FERTILITY which is loaded with useful charts, tables and tips.

17 thoughts on ““What else can I do to improve the quality of my eggs?” the new frontier in fertility treatment

  1. Hi Dr Greene,
    Several people who know I’m trying ivf (none of them doctors) have recommended me 5htp and Spirulina. I know nothing of 5htp. Spirulina seems like a valid recommendation on the face of it but I didn’t know if the high level of Vitamin A would be a problem. Are there any benefits to these supplements while doing ivf? I was also afraid that they my conflict with other things I’m taking or, be redundant. Thank you

    1. Hello Nancy,
      The world is full of well-intended individuals that would love to give you advice. Unfortunately, many of them are also selling a product. That doesn’t mean that there may not be some data supporting their recommendation but in the adsence of some good data, I recommend avoiding anything that hasn’t been shown to be safe and at least somewhat effective. There is often a rather naive assumption that supplements can only do good and not cause harm. In reality, if anything has biological activity it can absolutely cause problems. I have not seen any data whatsoever suggesting that 5-HTP can be beneficial for fertility problems. If you are aware of any studies, please let me know and I’ll review them. Spirulina is supposed to be great for birds and fish but our physiology is very different so I would not take the leap that it will have benefits for us as well unless there is some research to support it.

      Best thoughts,
      ~Robert

  2. Hi,

    I have just emailed an IVF clinic. I said to them that over 40 women’s eggs may have
    more chromosome abnormalities and is there
    anything a woman can do to improve the genes
    in the eggs eg. taking vitamins.

    The clinic wrote back and said there really
    is nothing you can do you improve the quality of the genes say in an older woman’s
    eggs. The egg may be screened and look big
    and healthy but that does not tell you anything about the genes in the nucleous.

    I find this hard to believe. Can you tell
    anthing a woman can do to improve the genes
    in the nucleous.

    I look forward to your reply.

    1. Dear Carla,
      Unfortunately, based upon our current knowledge and understanding of biology it is true that we cannot improve the genetic competancy of an egg. However, it is also believed that some of your diet/lifestyle, medications, etc may actually compromise the normal DNA in an egg. That is why I feel it is very important to guide patients on the steps that they can take to optimize their egg quality while they are undergoing fertility treatment. In my book, PERFECT HORMONE BALANCE FOR FERTILITY, I describe the foods, chemicals, personal care products and activities which can guide you toward this improved outcome. I have also written a blog post on this site about how supplements may influence your egg quality and a separate one on how your medication protocol can also have influence. I do hope that all of this provides you with some of the information that you are seeking.

      Best thoughts,
      ~Robert

      Robert Greene, MD, FACOG
      Medical Director
      SIRM–Northern California

  3. Hi Dr. Greene,

    I just finished my second IVF cycle which was unsuccessful. The first one was successful and resulted in a miscarriage. I am 38 years old and the last cycle I had 7 eggs retrieved of which 3 made it to the day 5 transfer, blasto stage. They transfered 3 and it resulted in a pregnacy. All three were grade a quality. This cycle they stimmed me more to recruit more eggs , I had 12 eggs retrieved, we were also recommended a pgd so we waited until day 6 however on day 5 the embryologist told us that 4-5 were looking ok and were still progressing at a slow rate and we might not be able to make the day 6 transfer. Ultimately we had a day 5 transfer without pgd and transfered 4 embryos (2b and 2 c). Thisd time it resulted in no pregnancy. I am confused why this happened. Is it that over stimming hurt my quality. Is there anything that can help me? Please advise.

    1. Dear Dina,
      I am sorry that your cycle(s) were not successful. Professionally, I would not consider your first cycle a “success” since it did not result in the birth of a healthy baby. Most early miscarriages are due to embryos that are not genetically competent and are therefore unable to continue their growth. This may also be the cause of your second failed cycle–by the description provided. If you are not confident about your current course of action, it would be in your best interest to consider a second opinion. With such a consultation, someone should be able to review the complete details of your cycles and include that information along with your previous testing in order to formulate a list of treatment options for you. Each option should be presented with a thorough explanation of the risks, benefits and anticipated success of each choice–tailored to your unique history. Only with such a thorough review and consideration could anyone–myself included–answer your question about what can help you. I am confident however that options do exist. I do hope that you find this reassuring. In fact if you’d like to consider a consultation visit, let me know.
      Best thoughts,
      ~Robert

  4. Dear Dr Greene,

    1. Is there any reason why coQ10 should be taken twice or thrice daily, instead of taking eg 3 nos capsules of 100mg at one fixed time in the morning?

    2. What are your views about using TCM (traditional chinese medicine) say 5-6months before doing an IVF cycle? Do you think TCM can help improve egg quality, quantity and overall ovarian functions such as prepping the womb? Thanks!

  5. I we have one child she is 13 years old. I have been trying to conceive since 2008,I had 5 miscarriages due to abnormal chromosome, my most recent miscarriage was this year at 3 months that was just before my 44th birthday. I am now 44 years old and my TSH level is 9.6. I heard that Q10 and DHEA will help, what do you suggest? I do not want to give up.

    1. Dear Martha,
      I am so pleased to learn that you have a 13 year old daughter; not only does she enrich your life but she is living proof that you can produce good quality eggs. Unfortunately, the passage of time typically results in the progressive loss of those healthy eggs. As a result, the remaining ones have a progressively higher chance of genetic damage and associated risk of miscarriage or failure to conceive. That said, it is not impossible that you can produce another healthy pregnancy but it would be improper if I didn’t reaffirm that it is a longshot. Nonetheless, an elevated TSH level should be treated appropriately. The use of CoQ10 may prevent additional damage to your developing eggs but it cannot reverse damage which has already occurred. In short, I am not telling you tive give up but please keep a realistic perspective on your chance for a successful outcome in order to avoid further emotional trauma.
      Best thoughts,
      ~Robert

      Robert Greene, MD, FACOG

  6. Dear Dr Greene,

    I am 29yr old married since 3years. I had concieved in April 2011 but it was detected as molar pregnancy and i had to go in for a D&C in May . Then after a gap of 6 months as asked by my doctor(my HCG levels were below 1) i had a immediate conception in dec 2011. But this time aslo unfortunately the embryo did not form till the 9th week and it was a Blighted ovum. I had to do a D&C. we are obviously heart broken and shattered as this has happened twice in a row and my confidence level is totally lost. Can you please suggest what should be our next step , i dont want to give up and living with only a hope that i will have my baby soon in my arms. Please Help

    1. Dear Ms. Saraf,
      I am so sorry to hear of your misfortune. Unfortunately, there is not enough information here for me guide you and it would not be appropriate in this venue even if I did know your full history. If you would like for me to provide you with some guidance, please call my office (800-539-9870) and set up a consultation. In the meantime you and your husband will be in my thoughts.
      In sympathy,
      ~Robert

      Robert Greene, MD, FACOG
      CNY Fertility Center

  7. Dr Greene,

    Firstly I would like to say thank you, I have been enjoying your book immensely, it has become my no. 1 reference book🙂

    In regards to supplements, I would like to run some rather quirky results past you and see what you make of them. My AMH levels (my age is 36):

    – 5 months ago : 4.4 pmol/L
    – 1 month ago : 15.1 pmol/L
    – Last Week : 22.2 pmol/L

    After first test was told that I don’t have time to waste TTC & may have LOR. During the above period I have: taken Vitimin D supplements to increase from 41 nmol/L to 79 nmol/L (last test 6 weeks ago). Stopped social smoking entirely. Taken prenatal Vitamins. Gone off the contraceptive pill. First test was 2 weeks after Lettz surgery. Had a miscarriage nearly 2 months ago. Two weeks ago started taking coQ10, L-arginine, DHEA, Melotonin, Inositol.

    Other tests are: 1 month ago AFC on Day 10 with 4 follicles on right and 2 on left = 6 in total. Ovarian Volume was 6 ml (around 3 ml per ovary).

    If I could ask you some questions to you don’t mind:

    – I was given to understand that amh levels should not fluctuate, have you seen such an increase in AMH with any of your patients?

    – Could the Vitamin D supplements have caused this increase (read studies that may be possibility)? Or one of the other changes I made?

    – Re AFC, I know 6 is low’ish, but I would like to know whether being day 10 could many of the follicles have died off or the smaller ones hidden by the larger? i.e. AFC of 6 does not really correlate with AMH of 22.2 pmol/L.

    – Should I still consider Low Ovarian Reserve as possibility?

    Thanks for you time🙂

    1. Thank you for your kind comments. Unfortunately, I do not know nearly enough about your medical history to accurately answer specific questions regarding your situation. Additionally, current regulations would prevent any such comment–which is in your best interest. That said, I have most definitely seen patients of mine have a significant improvement in their AMH. Considering that this hormone is measuring immature but growing/active follicles, it is theoretically explainable. What we believe is occurring is that with the healthy changes that you’ve made in your lifestyle, you may be more effectively recruiting eggs into that active growth state. Congratulations! I do hope that others in similar situations find inspiration in your story. That said, consult with your fertility specialist to see if they recommend that you move forward with your plans to conceive at a more aggressive pace due to your recent history.
      Best thoughts,
      ~Robert

      Robert Greene, MD, FACOG
      CNY Fertility Center

  8. excellent submit, very informative. I ponder why the other experts of this sector
    do not notice this. You should continue your writing.

    I’m sure, you’ve a huge readers’ base already!

    1. Dear Lora,
      Thank you for your kind comments. Although I am not convinced that I am worthy of such high praise, it is rewarding to know that the information that I am presenting is useful. Please share it as you feel appropriate and stay tuned.
      Smile loudly,
      ~Robert

      Robert Greene, MD, FACOG
      CNY Fertility Center

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