New Perspectives on Fertility and Aging

Egg quality is well-known in the fertility world to be a major factor in whether a woman can conceive a healthy pregnancy with her own eggs, either naturally or through IVF.  As women age, egg quality declines, and the common assumption has been that there’s nothing that can be done to change this.  “It Starts with the Egg” by Rebecca Fett shows that this assumption needs to be seriously reconsidered. 

In Part 1 of this book review, I shared what I found most impactful to me in terms of its larger ramifications on prospects for improving fertility, particularly in a woman’s later reproductive years.  I was thrilled about how the book was research-based and well-referenced. Much to my delight, it cited research that indicated it is possible to influence egg quality though supplements, diet, and avoiding environmental toxins.  And even more significant to me, I was able to draw some conclusions about ways to influence egg quality beyond what was presented in the book. 

In Part1, I ignored the majority of the book, focusing on a few themes that were critical to me.  But that doesn’t mean the rest of the book is uninteresting or unimportant.  It’s all worth considering, but I’m not going to delve into these other topics in depth as, frankly, I don’t have a strong opinion about these topics at this time. 

For those wondering, “What else is in the book?” I’m going to give a quick and dirty run-down of the contents, Cliff’s Notes style.  After this listing, I will offer a few of my own reactions to the overall content of the book.  In Part 3 of this blog series I will share thoughts on how this body of information relates to the Fertility From the Soul Egg Quality program I am developing.

Book Chapter Highlights

It Starts With the Egg, by Rebecca Fett (2016)​
Chapter 1 – Understanding Egg Quality

1. The quality of an egg impacts how likely that egg will become fertilized, implant and grow into a healthy baby.
2. There are things we can do to improve egg quality.

Chapter 2 – Dangers of BPA

1. BPA causes errors in meiosis and disrupts hormone functioning that guides the reproductive system.
2. Stay away from BPA as much as possible.

Chapter 3 – Phthalates and Other Toxins

1. Phthalates are bad for you in so many ways.
2. You probably can’t avoid them completely but limit regular exposure as much as reasonably possible.

Chapter 4 – Unexpected Obstacles to Fertility

1. If you are deficient in Vitamin D, take supplements or increase sun exposure
2. Get your thyroid checked.
3. Get checked for celiac disease (even if you don’t have symptoms)
4. Address gum disease as it’s linked to premature birth, difficulty conceiving, and miscarriage.

Chapter 5 – Prenatal Vitamins

1. Take a prenatal vitamin that has at least 2 mg B6, 6 mcg B12, 100mg Iodine, 7 mg Zinc and 50 mcg Selenium. 
2. Add 400 mcg of folate if your vitamin contains folic acid instead of folate.

Chapter 6 – The Power of Coenzyme Q10

1. CoQ10 can help boost mitochondrial functioning which helps eggs produce more energy and can result in better egg development and embryo growth.
2. Ubiquinol is the preferred form of CoQ10 as it’s more readily absorbed and you don’t need as high a dose. 
3. Take 100-300 mg of Ubiquinol at mealtime. 
4. It may take a few months to build up in your system, so the earlier you can start the better.

Chapter 7 – Melatonin and Other Antioxidants

1. There is some support for using melatonin for IVF cycles.
2. There is some support for, Vitamin E, Vitamin C, Alpha-Lipoic Acid for natural or IVF cycles.
3. There is poor support for N-Acetyl Cysteine for fertility.

Chapter 8 – Restoring Ovulation with Myo-Inositol

1. Myo-inositol is routinely recommended for women with PCOS. 
2. It might also help those who don’t ovulate or have insulin resistance. 
3. There is some evidence that it could reduce miscarriage risk by lowering insulin levels, “but further research is needed.”

Chapter 9 – DHEA for Diminished Ovarian Reserve

1. Some research shows that for those with diminished ovarian reserve, more normal eggs are formed when supplementing with DHEA. 
2. There is some controversy about whether this is a good approach, but the author feels it is important to consider despite the light research support.
3. The exact mechanism of how DHEA impacts egg quality is unknown.

Chapter 10 – Supplements That May Do More Harm Than Good

1. There isn’t sufficient research support to recommend taking Pycnogenol, royal jelly, or L-arginine for fertility.

Chapter 11 – The Egg Quality Diet

1. “The clear message of all this research is that out-of-control blood sugar and insulin levels are bad news for fertility.”

1. The goal then is to manage blood sugar and insulin levels for optimal fertility.
2. Very low-carb diets might not provide enough nutrients.
3. Aim for a low-glycemic diet and also limit all sugars regardless of glycemic index.
4. Choose minimally processed whole grains over anything highly processed.
5. Choose high fiber options when you can.
6. “Almost all vegetables are superfoods for fertility”
7. Avoid trans fats; even a small amount can be harmful to fertility.
8. The Mediterranean diet is a good choice for fertility.
9. It’s probably better to cut out alcohol.
10. It’s probably better to limit caffeine.

Chapter 12 – The Other Half of the Equation:  Sperm Quality

1. Sperm quality matters and it can be improved with supplements
2. Helpful supplements:  multivitamin for men and Ubiquinol (200 mg)
3. Boosting antioxidant levels through diet can be helpful.
4. Avoid environmental toxins:  Phthlates, BPA, Lead, Mercury, lubricants that aren’t considered “sperm-friendly”
5. Cut back on alcohol
6. Keep cell phones away from the jewels.
7. Avoid tight underwear, hot baths, hot tubs to keep the goods cool.

Chapter 13 – Putting It All Together
Summary lists of recommendations are offered for various situations:

1. Basic plan – no known issues
2. Intermediate plan:  difficulty conceiving
3. Intermediate plan:  PCOS or irregular ovulation
4. Advanced Plan:  Recurrent miscarriage
5. Advanced plan:  trying to conceive through IVF with DOR

In the above run-down, I’m just pulling out the author’s conclusions based on her review of the research, and I’m leaving out all the rationale and research details behind each idea, as well as specific recommendations on how to or how not to apply these measures.  If you’re wanting to implement these recommendations, I would encourage you to read the book or do your own research, so that you can be as informed as possible.  The beauty of this book is that it’s designed to educate you so that you can come to your own conclusions.  Newer research may have come out since the publication of this book, so that is worth considering as well.  

My Reactions

​“It Starts with the Egg” translates research into plain English and shows that there is compelling scientific evidence supporting the notion that egg quality can be improved.  Fett delves into research in the realms of nutrition, supplements, environmental toxins and a few health conditions.  She also touches on the importance of sperm quality and discusses factors that can influence sperm health. 

I have not explored in great depth her research sources, so I can’t speak to the quality of her research review process.  Most of her conclusions are consistent with other things I have read in my less-scientific gathering of information off the internet.  She discusses the controversy around DHEA and concludes that arguments against its use are probably not warranted.  I have come across enough cautions about its use and recommendations for medical monitoring of its affects, that I would personally recommend further exploration of the research and consultation with a medical practitioner if you choose to consider DHEA supplementation.

What simultaneously disappoints me and excites me about the book is that I believe there could be many more chapters on this topic.  There is a whole follow-up to this book, just waiting to be written.  Based on the notion that boosting mitochondrial functioning leads to higher quality eggs, it appears to me that any other measures that could impact mitochondria could also affect egg quality.  Various healthy lifestyle practices such as stress reduction, sleep, and exercise have been shown to have a positive impact on mitochondrial functioning and none of these are even mentioned in this book.  In my mind, the list of possible pathways to influence egg quality could be quite extensive. 

The good news is that I have already been integrating this wider array of mind-body health components into the Fertility From the Soul Egg Quality program which I am currently developing.  And now, since reading “It Starts with the Egg” I can connect the dots to explain how my program recommendations make sense scientifically, not just based on my intuition.

Up Next

​In Part 3 of this blog series, I’m going to dive deeper into an exploration of how “It Starts With the Egg” relates to the “Fertility From the Soul” perspective.  They share a common scientific basis and some common components, but the implementation of my program will have a different style which I believe embodies an important dynamic shift that can give even more assistance in cultivating optimal fertility.

👉 Continue to Part 3 of 3 in this blog series. 

Download free guide: 20 Strategies for Improving Egg Quality