How to improve egg quality with PCOS naturally
Growing a baby: How a human egg matures
We are born with all the eggs we’ll ever have. At birth you have about 1 million eggs tucked away in your ovaries. During your child bearing years, if your cycle is healthy, you ovulate one egg each month. But did you know that the egg you ovulate has actually been growing and maturing for almost a year before it was ready!?
Your eggs go through four phases before they are ready for ovulation.
Initiation: ~200 days
This is when an egg in your reserves is called up for duty! The egg begins to develop inside a follicle. Growth is very slow here. Multiple eggs go through the initiation phase at the same time. Primordial follicles do not have an independent supply of blood, so they are not affected by circulating hormones, glucose levels, or any other outside influence in the body.
Growth: ~60 days
During the growth phase the follicle develops more specialized cells that will help it to function when it’s time to ovulate. Inside the follicle the egg is surrounded by follicular fluid. Researchers don’t yet know exactly what follicular fluid does for the egg, but it’s presence in all mammals signifies its importance.
During the growth phase, multiple follicles are developing at the same time. The body has ways of observing the health of each follicle and any that are not developing correctly are weeded out from the pack and reabsorbed by the body. This is a very good thing - you want the strongest egg to ovulate each month.
Selection: ~10 days
At the end of your luteal phase (right before you get your period) a dominant follicle is chosen out of a selection of other class 5 follicles. This is the egg you will ovulate during your next cycle. Once the dominant follicle is chosen, it begins to grow and develop rapidly while the other follicles are absorbed back into the body.
Maturation: ~10 days
The dominant follicle is now sensitive to outside hormones. When it’s time to ovulate, your brain will release a surge of luteinizing hormone. The dominant follicle can sense this surge and gets the message that it’s time for ovulation!
Fun fact: a dominant follicle is 20 mm - about the size of a quarter!
Give yourself a 3 month time frame
I know what you’re thinking - oh my gosh, I do not have time to wait a whole year to improve my eggs, I want to get pregnant right now! I get it. I hear you. The good news is that you can improve your egg quality quickly and you only need to focus on the last three months of development. You can do 3 months right? After all, this is about developing the best, healthiest, most robust egg possible, so that you can give birth to the best, healthiest, most robust child possible. It’s worth the three months, right?
The best time to influence the health of your eggs is during the growth period.
The growth phase is when the egg develops the most, the follicle is developing new types of cells, and the follicular fluid is forming. All of the changes you’re making to diet and lifestyle right now impact the health and strength of the egg as it develops.
By the time the egg goes through the selection and maturation phases, it is mostly developed and less able to change. That’s why it’s a good idea to give yourself a solid three months to improve your egg health.
The good news is that you are always in the growth phase. Right now you have eggs in each of the development phases inside your ovary. That means you have an egg getting ready for ovulation - and you have the eggs you’ll ovulate next month, and the month after that, and the month after that already developing!
It’s never too late to start working on your egg health.
What factors affect egg health?
Overall health
Your body will always prioritize survival over reproduction. That means if you have nutrient deficiencies, blood sugar issues, gut infections, and rampant stress, your body will shuttle resources towards dealing with the highest priority problems first. Reproduction - and egg quality - will always come second.
It makes sense, right? Your body needs to make sure you will survive before it allocates resources towards building a brand new human.
Age
Yes, we all know age affects fertility. However, age is NOT a deciding factor. A woman who ate very poorly and never exercised in her 20’s may have better fertility in her 30’s after she improved her diet and lifestyle.
Oxidative Stress
This is a biggie. Oxidative stress damages the mitochondria in your cells. Your mitochondria are living organisms that convert glucose into usable energy so that you can cells can do work. Oxidative stress causes premature death of your mitochondria, making every part of your body work even harder to make up for the rapid loss. Oxidative stress also affects the cells ability to duplicate DNA correctly which can cause chromosomal abnormalities in underdeveloped eggs.
Sources of oxidative stress
Smoking
Pollution
VOCs from paint
Rancid oils (common in canola and soy oil)
Toxins in body products & make up
Infections and illness
Not getting enough sleep
Sedentary lifestyle
Poor blood circulation
Insufficient antioxidants in the body
Imbalanced hormones
Your entire endocrine system talks to each other and makes sure everything runs smoothly. Any dysfunction in your hormone balance - including blood sugar hormones, thyroid, adrenal, and pituitary hormones, and your sex hormones estrogen, progesterone, luteinizing hormone, and follicle stimulating hormone - will impact the health of your menstrual cycle and egg quality.
Stress
Stress comes in many forms. Over exercising and under eating creates stress. An unfulfilling and soul sucking job creates stress. Arguments with your spouse, worry over bills, low self esteem all create stress. Stress creates a higher demand for nutrients on the body. Dealing with the stress in your life is key to balancing hormones and improving egg quality.
Testing your egg quality
There is no test specifically for egg quality.
The best we have are a few tests that show how your ovary is functioning and the size of your egg reserves. Even with these tests, we can only make an interpretation about what might be happening with your eggs.
FSH
Follicle Stimulating Hormone is the hormone your brain sends to your ovaries to tell them they need to begin maturing an egg. A low FSH is better. Hormones are messengers, so if your FSH is high it’s like your brain is having to scream at your ovaries because they’re not responding.
Estradiol
Estradiol is an important form of estrogen. An abnormally high estradiol level may indicate the ovary isn’t functioning optimally and the egg quality is compromised. Don’t worry though - your estrogen levels can be improved with diet and lifestyle changes.
AMH
Anti-Mulerrian Hormone is considered the main test for ovarian reserve. AMH is produced by early stage follicles. The theory is that the body knows exactly how many eggs are in reserve and if there are plenty of eggs to go around, it will put more out to mature each month. As the ovarian reserve decreases, the body will be stingier and recruit fewer eggs each month. Theoretically, testing AMH tells us if there are plenty of eggs in reserve or if we’re running low.
AMH is considered the gold standard for ovarian reserve, however there are many factors that influence how many follicles are recruited each month. In fact, having too much AMH can be an indicator of PCOS rather than an abundance of eggs on reserve.
An AMH less than 1 is a potential indicator of low ovarian reserve.
If you are currently struggling with PCOS and low AMH, know that these issues are not set in stone. Many women have been able to reverse their PCOS and improve their AMH numbers (1, 2)
How to get started making changes to improve the quality of your eggs
Find the root cause of your PCOS.
Get your diet on point
Fine tune your supplements
Move your body and increase blood flow
I know, all things you’ve heard before, but that’s because it works! That’s because these have to be in place to see results. If you’re serious about improving your health so that you can conceive naturally and have a healthy baby, these foundations must be in place.
If you have been diagnosed with low reserve, poor egg quality, or you just know how important egg quality is and want to give yourself a headstart - this is what I recommend. Set a goal for each of these categories, give yourself two weeks to really focus on implementing the actions, and then when you’re two weeks are up, celebrate everything that went well, learn from anything that didn’t go well, and choose one more additional goal to add to your plan. So every two weeks you’re taking another step forward. If you do this, by the end of 3 months you will have actually implemented all of the ideas that you’ve been reading about but haven’t actually done.
Action is so powerful. Here’s the honest truth, any issues we have in our health right now, whether its low ovarian reserve, poor egg quality, or something like migraines, acne, fatigue, bloating - it is all a result of our current diet and lifestyle, and how those elements are acting on our genes. So to change our health, we have to change our life. We have to be willing to give up some of things we’re doing now if we want a different life. You’ve done this before and I know you can do it again. We had to give up being a student in order to go out and work and build a life for ourselves. We had to give up being single in order to have a partner to love and experience life with. And you have to give up the soda, the pancakes, the bread, the sitting all day long, in order to have the health that will give you the healthy pregnancy you want to experience.
You also don’t have to go through it alone. If you need help schedule a call with me and I can help you figure this out.
Lets dive in to each of the four action steps.
Find your root cause of PCOS
PCOS is a complicated condition with many different causes. Understanding the root cause of why YOU have PCOS is key to improving your overall health so that you can body feels safe enough to allocate more and better resources to fertility.
Insulin Resistance
This is the most common root cause of PCOS. Insulin resistance leads to high testosterone in the body, which in turn causes irregular cycles and many of the annoying symptoms of PCOS like weight gain and excess body hair. It is estimated that 70% of women with PCOS also have insulin resistnace. Luckily, insulin resistance - and most blood sugar issues - can be improved by upgrading your diet and lifestyle habits.
Thyroid dysfunction
In some women, a lack of thyroid hormone prevents the ovaries from ovulating which creates irregular cycles.
Adrenal dysfunction
Another male sex hormone, DHEA can become heightened in some women, leading to anovulation, irregular cycles, and annoying symptoms. This type of PCOS is not very common and all other causes of high DHEA should be eliminated by your doctor before diagnosing PCOS.