diet to improve egg quality, ovarian reserve and IVF success

the main factors affecting egg quality and IVF success are...

  • good quality protein.  Only protein can build healthy eggs and healthy babies.  Carbohydrates and fats just support the process. The best quality protein is eggs - they are a higher quality protein than meat or fish.  During the stimulation phase of an IVF cycle you can eat them every day.  Eating eggs for breakfast will help control blood sugar and hormone levels throughout the day.
  • plenty of vitamins and minerals.  Your 5 a day is important.  If you have PCOS aim for more veg than fruit.
  • healthy fats.  Olive oil, avocados, nuts, seeds and oily fish are all good sources.
  • keeping well hydrated.   Aim to drink plenty of water throughout your IVF cycle.
  • avoiding toxins.  Eat organic where reasonable.

why 5 a day is important - how fruit can protect ovarian reserve

A study just published found that women who ate more yellow and green fruit started their menopause over a year later.  This is thought to be because the fruit protected the ovaries from damage and kept them functioning for longer - so this has clear implications for fertility.  The fruits contain beta-cryptoxanthin which the researchers believe is the protective substance.  It's especially rich in mandarins, oranges and peaches...

 

"While still acknowledging that further research is required, in the interim we would advocate that a diet containing ∼400 mcg of β-cryptoxanthin per day from fruits (mandarins, oranges and peaches) has significant potential to delay ovarian senescence by 1.3 years."  Pearce and Tremellen, Human Fertility July 2016

 

supplements to improve egg quality

 A 2014 study looked at whether supplementing with 600mg coenzyme Q10 could reduce chromosomal problems in 35-43yr old women undergoing IVF. The early results were promising…chromosomal problems were 46.5% in the coenzyme Q10 group compared to 62.8% in the control, pregnancy rate was 33% for the coenzyme Q10 group and 26.7% for the control group.  Sadly the study had to be abandoned because of safety concerns about screening the embryos.  An earlier study by the same author showed a marked increase in ovulation rate in aging mice given coenzyme Q10.  Higher levels of coenzyme Q10 in follicular fluid has been associated with better IVF outcomes. Add to this the various studies showing how sperm counts, motility and morphology can improve with coenzyme Q10 supplementation and it begins to be apparent how useful nutrition might be in helping conception. 

Higher doses of folic acid supplement - the jury's out...A 2014 study of 232 women undergoing IVF showed benefit for implantation and live birth rates with higher doses.  However a 2015 Swedish study of 340 women undergoing IVF showed no benefit from higher doses.  Also it could be argued that a high intake of vegetables and fruit will give a naturally high supply of folic acid and so the standard 400iu supplement would be sufficient.  Green vegetables and avocados are a good source.  Folic acid should be taken as part of a preconception multivitamin as other B vitamins assist absorption of folic acid.

Other supplements with promising results are Omega 3 and DHEA - see below for research.

 

how research on diet and egg quality is done

Human studies of how diet affects egg quality and IVF success are relatively few because it isn’t feasible or ethical to extract eggs simply to study them. They are too precious.  So it makes sense to look at the studies on diet and sperm.  It is a reasonable assumption that what is good for sperm is good for eggs, and this should be regarded as a valuable source of information.  See diet to improve sperm quality.  The research on egg quality that we do have tends to fall into three groups…

  • Studies focussed on follicular fluid composition as it is possible to sample this during egg retrieval for IVF.  Follicular fluid surrounds and nourishes the egg and helps it grow and mature so the nutrients it contains will be important.
  • Studies using diet questionnaires or dietary supplements in the weeks prior to IVF.
  • Animal studies are also a helpful indicator and so some have been included here.

Additionally there are studies looking at physical characteristics such as the BMI and exercise levels of women undergoing IVF and how these may affect success, so these should be included in the overall picture.

 

fertility nutrition research

omega 3 for egg quality

http://www.ncbi.nlm.nih.gov/pubmed/21130435 questionnaire study of 235 women undergoing IVF showed higher dietary omega 3 in the 4 weeks before stimulation related to better embryo quality, the study recommends eating fish twice a week especially during the IVF cycle

http://www.ncbi.nlm.nih.gov/pubmed/22978268 mouse study showing lifelong intake of higher omega 3 associated with prolonged reproductive life, and short term treatment with omega 3 in older mice improved egg maturation, while short term treatment with omega 6 had a negative effect

http://www.ncbi.nlm.nih.gov/pubmed/24062566  animal study showing that higher intake of omega 3 from flaxseed oil or fish oil improved follicle numbers, and increased the number of embryos developing to blastocyst.

 

coenzyme Q10 may improve egg quality in older women and reduce chromosomal defects in embryos

http://www.ncbi.nlm.nih.gov/pubmed/22139446 small study of 20 women undergoing IVF showing that higher levels of coenzyme Q10 in follicular fluid were associated with more mature eggs and better grade embryos

http://www.ncbi.nlm.nih.gov/pubmed/24987272 study which explored whether supplementing coenzyme Q10 could reduce chromosomal problems in older women undergoing IVF, the study was terminated because of safety concerns about screening the embryos during IVF

http://www.fertstert.org/article/S0015-0282(09)01557-X/fulltext mouse study which gave coenzyme Q10 to 40 retired breeder mice for 18 weeks prior to fertility treatment, the study showed increased ovulation rate with 19.2 in the coenzyme Q10 group compared to 11.7 in the control, it also suggests better mitochondrial function in the coenzyme Q10 group

 

why breakfast is important if you have PCOS

http://www.ncbi.nlm.nih.gov/pubmed/23688334 eating a large breakfast and a small dinner improved ovulation rate and decreased testosterone in lean women with PCOS

 

does a higher dose of folic acid help IVF success?

http://www.ncbi.nlm.nih.gov/pubmed/25198264 study of 232 women undergoing IVF showed increased implantation rates, pregnancy and live birth rates in women taking higher doses of folic acid as a supplement...

so this looks promising BUT...

http://www.ncbi.nlm.nih.gov/pubmed/25283235 Swedish study of 340 women undergoing IVF showed no benefit from higher doses or higher blood levels of folic acid

 

DHEA may help some women with premature ovarian aging

http://www.ncbi.nlm.nih.gov/pubmed/22811313 DHEA supplementation may affect pregnancy rates in a subgroup of women with premature ovarian aging, this study suggests a specific relationship to FMR1 genotype premature ovarian aging and DHEA response

 

how weight, BMI and exercise levels may affect IVF success

http://www.ncbi.nlm.nih.gov/pubmed/22572216 increased BMI related to lower egg retrieval and embryo counts in women under 36yrs, but did not affect embryo quality

http://www.ncbi.nlm.nih.gov/pubmed/22607889 overweight and obesity were associated with lower live birth rates following IVF

http://www.ncbi.nlm.nih.gov/pubmed/21806596 weight loss improves pregnancy rates for overweight and obese women undergoing IVF

http://www.ncbi.nlm.nih.gov/pubmed/21885344 a review of 33 studies including 47,967 IVF cycles showed women with BMI of 25 or over undergoing IVF had significantly lower clinical pregnancy and live birth rates, and a significantly higher miscarriage rate

http://www.ncbi.nlm.nih.gov/pubmed/24813759 doing regular physical exercise before the IVF cycle showed threefold improved pregnancy rates in obese women