Phthalates are a group of chemicals found in many types of plastics in a variety of consumer products. We have previously discussed the negative impact of phthalates on fertility. A recent study adds to this: phthalates negatively impact an IVF cycle. Women are disproportionally impacted by phthalate exposure.
In this study, women with high levels of phthalates had fewer eggs at the time of egg retrieval, fewer fertilized eggs, and fewer top quality embryos. This group suggests that DEHP, a specific type of phthalate, may impair early IVF outcomes, specifically targeting the oocyte. If you are thinking of undergoing IVF this year, I encourage you to investigate what you can do to optimize your IVF cycle by limited your exposure to phthalates!
What you can do:
I am incredibly proud to work at a REI clinic that has the highest live birth rate in the country. A recent study, however, suggests that IVF may not be enough. Lifestyle and the environment can impact your IVF success rates, even at a top notch REI clinic.
In this study, levels of pesticides and common pollutants were measured in the fluid that was obtained from the ovary during an egg retrieval. They found that higher levels of Pretilachlor, β-cyfluthrin, PCB 28 and 180 was associated with fewer eggs at retrieval, lower fertilization rates, and impaired embryo development. They also found that high PCB and pesticide concentrations negatively affected embryological outcomes. This study provides evidence that these harmful chemicals are found in the fluid surrounding individual eggs and are associated with decreased success with IVF. This suggests that if you want the very best chances of success with IVF, you should consider optimizing your lifestyle to minimize exposure to these harmful chemicals.
What you can do:
- Learn how to minimize your exposure to PCBs and pesticides
- Make a plan to optimize your health before you invest in an IVF cycle
- Talk to your doctor about a timeline for implementing these changes
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.
Robert Greene, MD, FACOG
Conceptions Reproductive Associates
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
One of the emerging therapies in advanced reproductive techniques involves combining the parts of a healthy egg donor to rejuvenate or correct deficiencies in a woman’s own egg. When a sperm is then added, the resulting person can actually contain the DNA of three people rather than two. Although this technology is currently not available for use in the USA–the first babies have been born in England through this technique. Interestingly, there were 17 babies born in the USA using this technique more than a decade and a half ago. This procedure was then banned due to potential health concerns in the children that resulted. We now have a follow up report on these original children who are now teenagers. Most importantly, this update is reassuring that although caution is recommended, this procedure does seem safe and reasonable for continued investigation.
This headline is a bit misleading in that a similar technique was used in the 1990’s before it was decided that we need to proceed more cautiously in mixing DNA. Currently, the technique described is not available for couples treated in the USA and is only approved for use in treating specific genetic conditions. However, this is an exciting breakthrough that may prove to be useful in areas of reproductive medicine. https://www.newscientist.com/article/2107219-exclusive-worlds-first-baby-born-with-new-3-parent-technique/
This news will come as no suprise to our patients as we have been demonstrating this for years. It is good to have yet another study that further supports this recommendation. The cautionary note here for patients is to check with their center on the method of freezing used in their lab–if it not the modern rapid-freeze technique called vitrification then you might be better served by a fresh transfer. http://www.latimes.com/science/sciencenow/la-sci-sn-ivf-frozen-embryos-20160809-snap-story.html