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What does “egg quality” actually mean?

The simple answer: an egg’s capability to turn into a baby. (With the help of sperm, of course!)  The complex answer: while there is no ONE true test for egg quality, there are several factors that give us an idea. Is the egg producing adequate hormones? A growing follicle (like the shell around the egg) is what MAKES estrogen. If estrogen is low, the follicle is not functioning very well, and usually indicates a low quality egg inside. This is true for progesterone as well. Is the diagnosis “unexplained infertility,” or “advanced age?” In lieu of other identifiable diagnoses, we can guess that egg quality may be playing a role in infertility. Is AMH and antral follicle count low? These...

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What you should know 3 months before TTC

If you are making positive changes to your health prior to conception, how long should you remain consistent with them to see a positive benefit to egg or sperm quality? It takes approximately 114 days for an egg to mature from start to finish, and approximately 72 days for sperm. So, we like to recommend 100 days (or approximately 3.5 months) to have the intended effect. Egg and sperm quality is strongly affected (and harmed) by oxidative stress. This is a biochemical reaction caused by everything from nutrient deficiencies, poor detoxification capacity, or a low oxygen environment. Oxidative stress is increased from normal exposure to things like chemicals, pesticides, plastics and air pollution that we are exposed to on a...

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The truth about AMH

AMH is used as a marker to gage a woman’s remaining egg supply. A woman’s AMH level is categorized by an expected range for her age, so if a woman has a lower than expected AMH for her age she will be said to have “diminished ovarian reserve.” I will note that while I have seen someone’s AMH increase (though theoretically impossible), it will rarely bring them to a different range than originally.  The purpose of measuring AMH for fertility is multiple: it gives an estimate of remaining reserve, and is more powerful in combination with antral follicle count (or AFC, found via ultrasound). The AFC is the number of follicles (eggs) that an ovary is starting to mature in...

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What’s my Fertile Window?

An egg is only viable for somewhere between 12-24 hours, and once it is ovulated it must be fertilized in that time otherwise it will begin to disintegrate. However, pinning down ovulation is not an exact science. If a woman is tracking some combination of her LH surge, cervical mucus, basal body temperature, bloodwork for estrogen and LH, and maybe even getting ultrasounds, she can have a pretty good idea. But several things will make the exact timing trickier to tell. Some women will ovulate the same day of an LH surge, or up to 48 hours later. Their temperature might take a few days to rise. It may vary month to month. One interesting study showed that some women...

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Intermittent Fasting and Fertility

Intermittent fasting for fertility? ⁠ ⁠Yes - BUT only for women with high fasting insulin levels. This is a simple blood test I have all my patients do. If it's high, that insulin could be getting in the way of follicle maturation, harming egg quality, and affecting placenta development. So for fertility we need to decrease it. ⁠ ⁠Fasting is an effective and simple way to lower fasting insulin levels. ⁠ ⁠HOWEVER, for women, fasting for too long is seen as a stressor by the body. ⁠ ⁠So I never recommend longer than 14 hours. 12-14 is the sweet spot. ⁠It means no calories, and no coffee (which essentially raises blood sugar).  ⁠I always check in with the patient that...

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