Supplements to Improve Egg Quality

There is so little in this delicate game of TTC that we actually have control of, so when there is something that can improve our outcomes, it makes sense to act on it.

There isn’t a whole lot of information on supplements that can improve egg quality, but of what is known, I have summarized here. Obviously, I am posting this in my role as a blogger dealing with fertility challenges, and not as a physician.

Since follicles are recruited from “storage” as early as 90 days from when they are ovulated, supplementation is best started three months prior to when your IVF/IUI/BD is happening. In fact, most studies testing the efficacy of supplements on egg quality have subjects taking them for 3 months before their procedures.

Now, obviously, this isn’t always possible, but I don’t think it is an all-or-nothing kind of thing. For example, last cycle, I was doing an FET, so for several weeks, I was not taking these supplements. But I figure that giving my eggs 45 days of quality-improving support will be better than nothing. So don’t sweat it. Do what you can. After your eggs have been retrieved/ovulated, you stop these supplements.

So here’s what I am taking for this round of IVF:

Ubiquinol– this is the more active form of the antioxidant CoQ10. Doses that I have seen suggested range from 200mg to 600mg, going higher if your base egg quality is worse. I am taking 400mg daily, split up 200mg in the AM and 200mg in the PM. Warning: ubiquinol is very expensive.

Myoinositol aka Inositol – this supplement used to belong to the family of B vitamins but because it can be made by the body, they nixed its status. There have been positive studies on the use of Myoinositol for improving egg quality. The dose that was studied was 4 grams or 4000mg per day. Myoinositol at much greater doses has also been shown to be as effective as SSRIs in the treatment of mood disorders. I have taken mine in capsule form, 2 grams in the AM, 2 grams in the PM. The store I buy it from ran out of the capsules, so I am currently taking the same dose in powder form. I just have to measure it myself now.

Melatonin – follicle/egg samples taken from people with good egg quality have eggs that are bathed in naturally greater melatonin concentrations than those from people with lower quality eggs. 3mg is the recommended dose, taken at bedtime, as it can help with sleep. Be careful taking this if you are hypothyroid. Melatonin down-regulates (slows down) thyroid function, and thyroid function is super important in TTC. For example, my TSH level before tak
ing melatonin was 0.84, and after taking melatonin daily for a month, my TSH went up to 1.15! So it really does make a significant difference. Since 1.15 is still under the TSH limit for TTC of 2, I’m not worrying about it too much. Especially since I will be stopping it after egg retrieval.

Omega 3 Fish Oils – help to decrease inflammation, which is important in egg development. Inflammatory cytokines can compromise egg quality, and inflammation in general is bad. I have not found any solid suggestions for dosing, but I take a total combined dose of 1800mg daily. 900 mg in the AM, 900 mg in the PM. I took the same dose even before TTC. It is important to buy good quality brands. Ascenta is a good brand.

DHEA – I don’t take it, but there is research that shows that it can help with egg quality if you are found to have low levels of it. If you do not have low levels of it, it can do more harm than good. Generally, people who tend to produce lots of follicles (PCOS types) should not take this. I am not sure of dosages recommended.

Now there are some other supplements that I have seen recommended by trustworthy sources, but without the randomized controlled trials to back them up, I wasn’t going to spend the money.

I also think that food can be both healing and harming. I have major digestive issues, and when I eat something that triggers my immune system, I get major inflammation. It is noticeable the next day- my tattoos become puffy like braille, the fluid in my joints accumulates and becomes so sore that I feel pressure when I close my hand into a fist. As a result, I am doing my best to stay away from my food sensitives- gluten, dairy, fructans, and polyols. It is so hard, as I love the flavour of garlic and onions, and veggies like broccoli and brusselsprouts. But everyone is different, so just be aware of your food sensitivities and stay away from things that harm your gut.

Too much exercise can also cause problems, as increasing your metabolism causes free radicals and oxidative stress to happen. This can damage DNA in the long term, and I think is part of the reason why female athletes who had an exercise history of greater than 4 years prior to TTC had poorer IVF success. But of course, this is pure speculation, and really, the damage is done. Most women who have a BMI over 30 can benefit from regular exercise. What I’m talking about here is over-exercising to the point of stressing out your body. Like what I have been doing since the 1990’s, and still did until a few days ago.

Anyways, that’s all I’ve got. I hope you find this helpful. Stay tuned to see if 45 days on these supplements made a difference on my egg quality for the upcoming IVF#2 (predicted for end of January, early February).

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Happiness Cycle Days 19 & 20: Kindness

I’ve been thinking lately about savouring life. Taking it on your tongue and identifying each and every flavour, on its own, but also in its pairing with others. One common piece of advice that I keep receiving is be kind to yourself. I struggle so much with this, as I was raised to believe that putting yourself first was selfish. At the dinner table, you serve yourself last, and if there is nothing left for you, you are a virtuous daughter. (Funny how they never say this to sons, but that’s a rant for another day.) However, someone said something this week that changed this a bit for me. They said that if I won’t treat myself better for me, then I should do it for our future baby. This idea has been in the back of my mind all week.

There is no lack of kindness in my life.

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I have been busy the past two days, going to appointments and running errands, in preparation for our FET tomorrow.

– chiropractic adjustments to reduce any nerve interference to my uterus, and to reduce my stress response

– massage therapy to get rid of some chronic muscle tension and stress that I’m still holding in my body, and for relaxation

– acupuncture and herbs to warm my uterus, strengthen kidney and spleen meridians, and charge up my yin reserves

– one last heavy workout (squats, deadlifts, shoulders) and yoga class before I commit to at least three weeks of no lifting, no sprinting, and no yoga twisting

I have been a lot more open with people around me about this FET, and have been met with so much support.

I battled through rush hour traffic on the way home from downtown, which took me only 20 minutes on the way in, but an hour and 45 minutes on the way out.

When I got home, there was a mysterious package on my doorstep. I love getting mail, but wasn’t expecting anything other than a long-overdue book from Amazon, which was suppose to arrive two weeks ago. But this package was bigger.

I settled into the house, fed the dogs, and then opened the box:

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A care package from the amazing and thoughtful Mrs. MPB, who has been a wonderful support for me ever since I found her blog. These books will be part of my two-week-wait (really 10 day) survival kit.

I can almost taste tomorrow, it’s so close. Little Spark, your mamas are waiting for you, and there is an entourage of people cheering for your arrival, all of whom can’t wait for you to come home.

Happiness Cycle Day 14: Downtown

DW took the day off work today, as we had a day of medical appointments, in town and out of town. She has also been so busy and overworked so far this semester that she really needed a “mental health” day as well.

I must mention that I finally had a good sleep last night, after almost a week of terrible anxiety-induced insomnia.

This morning DW made me a decaf coffee (such a nice treat to be served coffee in the morning), we gave the dogs got some consolation pats on the head, and we were on our way.

Our first stop was the fertility clinic’s satellite clinic, which is in our city. I needed to have my blood work and ultrasound monitoring again. Things are on track, with my uterine lining measuring 9.4 today, up from 8.7 of two days ago. I also got a “present” from one of the receptionists, who wasn’t working today, but had mentioned last time I was in that “she’d give me a troll to put down my pants”. I wasn’t sure what she meant by that, but she meant Treasure Trolls, those dolls from the 80’s, for good luck. We joked about for a bit- especially the part about putting one down my pants. Anyway, today, the phlebotomist nurse gave me this on behalf of the receptionist:

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So thoughtful and sweet!

After that, we headed downtown, to see my family doctor. I was really nervous and stressed about this appointment, not knowing how to describe and explain the overwhelming emotions and feelings that I have been experiencing since the miscarriage. When we got there, my family doctor was super attentive, gave me room to talk, listened patiently and compassionately, and gave some good advice. I shared with her how depressed and anxious I have been feeling, how it has continued to affect my sleep and made me weary of socializing with friends who aren’t aware of our situation. She had me complete some forms: a depression questionnaire, an anxiety questionnaire, and a survey on the impact of my feelings on my activities of daily living. It was the first time that I had taken inventory of various aspects of my depression and anxiety, and how it has been affecting me beyond just my feelings and sense of hope for the future. This whole time I’ve been so consumed and obsessed with our miscarriage(s) and getting back to making babies that I completely lost sight of how I have been doing as a person. I mean, I knew that I was depressed, and I knew that I had an anxiety problem, but I had always placed them under the context of the miscarriage, and not really that they themselves are focal points that need to be addressed.

I have battled depression before, and had reached a nice homeostasis with Wellbutrin for years. When I first met DW, I had already been on it for many years, but like most people with mental health issues, because I felt better, I thought “why not, let’s try life anti-depressant free!”. That was a couple of years ago, and for the entire time, I have been fine. However, with the fertility challenges and heartbreak of three miscarriages, I think my dear friend depression has snuck back into my life, and has brought his asshole friend anxiety along as back-up.

I have mentioned my emotional struggles on my blog many times, but didn’t realize how bad it has gotten until I answered those questionnaires, and saw and felt the true concern in DW’s and my family doctor’s feedback on how I seem, and have been behaving. I guess this is sort of what an intervention feels like. I’ve been so caught up in my own head, and needed to hear what other people are observing. My depression and anxiety are a big concern right now, and my family doctor is concerned enough about it to suggest that I start some medications right away. She suggested Cipralex, which is an SSRI, and is effective for both depression and anxiety. I would love feedback from anyone who has taken it before. She says that it is safe before, during, and after pregnancy, even though Dr. Google claims otherwise. But I am convinced that you can search anything and find support for it in the form of a online support forum. This I have learned from the all-consuming world of TTC.

She wants me to double check with the RE that he Cipralex won’t interfere/interact with all of the other stuff that I will be on: estrace, prometrium/endometrin, aspirin, fragmin, prednisone, intralipids. I’ve emailed the RE’s nurse, so hopefully I will hear back soon.

I have mixed feelings about taking the Cipralex. On one hand I think that it would be better for me to just tough it out, that it’s normal to have feelings of sadness and despair, or constant worry, given what I’ve been through. On the other hand, it is becoming more and more apparent to me that my depression and anxiety levels are abnormally high, and the culmination of evidence is that that can negatively impact our potential pregnancy even more than the small risk of cardiovascular defects and autism that have been reported but not confirmed. I look at DW, and some of you who seem “recovered” from your miscarriages, and wonder why I’m still stuck in this destructive loop of depression and anxiety. I realize now that it’s because I am struggling with an extra layer of mental illness.

Work has been harassing me again as well. In the past seven days, the person in charge of leaves has called me three times and emailed me once. This is after talking to her already the first time. She didn’t have anything new to discuss the subsequent times, but rather has been very negative and pushy in her tone. DW says that if she calls me again, that we should complain to the union. The last thing you want to do when you have an employee suffering from a mental health challenge is harass them.

Anyway, after my doctor’s appointment we went out for lunch at our favourite Vietnamese place.

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Then grabbed some baked treats down the street at this great little bakery we found by accident one day the last time we were here. I got a gluten-free chèvre cheesecake, and DW got “the best butter tart ever”, as well as a pear almond tort-like thing that has a fancy French name that I don’t remember.

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We then went shopping at our favourite outdoor store: Mountain Equipment Co-op, where we caught up on some much needed shopping, and bought a couple of early Christmas presents (me mostly).

We also got a call from our primary nurse today. I am supposed to start my long list of meds on Saturday, in preparation for our embryo transfer on Wednesday morning!

I hope that time moves fast, as I’m anxious for our last embryo to come home, but I also feel like I need some time to process everything that has happened today. The good, and the bad new.

#30×30 Challenge Day 10

Is it wrong that I’m relaxing with a morning cup of tea while my soon-to-be impregnated wife is doing heavy yard labour?

Probably.

But the race is on. There’s a ton of gardening that needs to happen before her recommended two days of bed rest (May 12 and 13).

For example, we need to get these into the ground:

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Clearly, many of our plantlings are unhappy.

So we’ll be working the ground again, digging little holes, transplanting some of our veggies into the ground, and maybe harvesting some of the asparagus that has just come up:

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The lazy dogs are happy to be outside as well:

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Hope you all have an amazing Saturday!

#30x30Challenge Day 1

So, I probably get more exercise than the regular person.

When a colleague at work mentioned the 30×30 Challenge, I bawked at it because I regularly spend more than 30 minutes outside everyday. To prove it, I plan on posting a photo each day on this blog. Feel free to join me in this challenge. It’s free! It’s fun! And it’s good for you!

Today, DW and I took our fur babies on our regular hike through the conservation park. I didn’t remember to snap a photo until we were almost at the very end of our walk. But I managed to get in a panoramic and a photo of the big dog all proud of herself for finding a deer leg.

To learn more, you can check out: http://30×30.davidsuzuki.org

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