This is the kind of email which I often get (in different variations) from ladies aged forty and above who are trying to conceive:
I have found your blog on the Internet, and I have been reading it nonstop for two days. It is very interesting and enriching. Thanks a lot for this information! And thank you again for your work! I think the knowledge you are spreading is very valuable. I think I am a highly educated person with quite a good understanding of biology, and even for me it was a surprise that at forty you have almost no eggs left. Somehow with all these celebs getting pregnant at forty and above, we all lose a sense of reality. So, I guess spreading the knowledge about fertility is extremely important. Thank you again!
Thank you for the compliments! But why don’t women know more about their eggs?
Why do we easily get blinded by the celebrities getting pregnant in their mid-forties? Only because we so desperately want it to be true?
And how could it happen to me that I got a PhD in cell biology and still let my eggs almost disappear before I ever tried to get pregnant?
Wish to get pregnant at 40 + ? Here is what to do
The principles of improving egg quality and getting pregnant for women of forty and above are not essentially different from the rest of the methods outlined so far.
Only that, obviously, women of this age must be even more economical with time. Every single ovulation can make a difference at that age and wasting chances to get pregnant due to eggs having insufficient quality not getting fertilized, and not giving viable embryos can mean destroying a dream of becoming a mother.
Aging is by far the biggest obstacle to pregnancy for women over forty.
The good news, though, is that the effects of aging on egg quality can be partially reversed at any age.
Even though the biological clock can’t be reset, it can be slowed down to some extent. This extent is different for each woman and is set by her genes and her lifestyle.
We now understand eggs much better than only one decade ago, and after having researched this topic for several years, I am more sure than ever; as long as there are eggs, there is a hope.
Women over forty who wish to enhance their egg quality need to individually address several lifestyle areas in the way which supports health in general, while focusing specifically on the metabolic needs of eggs. This will include:
1) Diet. Similar to younger women who wish to get pregnant, improving fertility in women over forty who needs to start with a diet. Eating organic, nutritious, and fresh food in addition to living a generally healthy, stress-reduced, and pesticide- and pollution-minimized lifestyle provides a good foundation on which to build.
Some diets, such as the Mediterranean diet and the fertility diet, have been found to specifically help increase fertility and pregnancy rates. There are subtle differences between these styles; the Mediterranean diet supports fertility in both women and men by supplying high levels of folate in combination with a range of antioxidants, including resveratrol, whereas the fertility diet is more successful in counteracting infertility related to ovulatory disorders.
That’s why it is important that every woman takes an individual approach to improve egg quality in a fast and focused way. While it is possible to increase fertility by the trial-and-error method, consulting and working together with a specialist is better for women at the high end of reproductive age.
You can think about it as getting your best beach body before the summer; going to the gym is better than no sport at all, but focused daily exercise with a personal trainer will more likely bring your fertility to shine in the shortest time possible.
2) Folate. This is one supplement no woman should omit during the preconception time, and ladies with 40+ should make sure to have it in plentiful amounts. Taking extra folate in the months prior to conception contributes to the prevention of severe neurological disorders in babies. Folic acid also increases fertility by affecting the microenvironment in the uterus and providing the best developmental conditions for babies.
3) Vitamin D. Our modern lifestyle has created a situation where, for the first time in human history, the majority of our time is spent inside and not outside, which has caused a pandemic of vitamin D deficiency. A healthy level of 40–50 ng/ml 25(OH) vitamin D is nearly impossible to reach without year-round supplementation.
A 2010 study by Dr. Lubna Pal from Yale University was among the first to show a positive relationship between vitamin D blood levels and IVF treatment outcomes. Although the details on how exactly vitamin D works to support egg health and early embryonic processes are unknown, the relationship between vitamin D and pregnancy rates was strong enough for the authors to suggest assessing vitamin D status as part of any routine fertility work-up: “…appropriate supplementation of those deplete in vitamin D may translate to improved fertility outcome as well as improved overall health.”
4) DHEA. Dehydroepiandosterone (DHEA) is an important building block and precursor of several sexual and steroid hormones. It is produced daily in high amounts by our adrenal glands, which I love to repeat because so many ladies are scared of taking DHEA because they were falsely convinced it was a synthetic medication which would only will make their hormones go wild.
The inconvenient truth is that our DHEA concentration declines as we age. This is a normal physiological process and there is no disease or mystery behind it. Our DHEA concentration peaks at about twenty to twenty-five years and then declines at about 20% per decade. For that reason, women over forty who wish to increase their fertility and bring their eggs and ovaries into the best possible shape will most likely need to supplement DHEA.
So far, the majority of studies with DHEA have reported the best results with women taking 75mg of DHEA daily over a period of at least three to five months. Although there have never been any serious clinical side effects related to this dosage, it is advisable to keep in mind that various other hormones, including testosterone, can be built from DHEA. For that reason, before supplementing DHEA, it is best to consult a fertility specialist (here is how to find me if you need my advice) and have DHEA-SO4 as well as testosterone levels monitored occasionally.
5) CoQ10. This is another essential substance that decreases in amount as we age, which is unfortunate because it is part of the system needed for energy production in every cell of the body. Since women’s eggs belong (together with the heart muscle) to the cells with the highest energy demand, they are particularly sensitive to low levels of CoQ10.
Recently, there has been some exciting new research performed at TCART (Toronto Center for Advanced Reproductive Technology). There, teams led by Drs. Robert Casper and Yaakov Bentov could show that CoQ10 has a positive effect when given to women of advanced age as well as those with a history of failed IVF due to poor egg quality. Ladies were given 600mg/day of ubiquinol (the most readily available form of CoQ10), which increased egg quantity and quality and translated to better pregnancy rates.
Since CoQ10 is very safe to use (and very hard to obtain in therapeutic amounts from food alone), ensuring adequate levels of CoQ10 antioxidants for maturing eggs is certainly a good strategy for women over forty who wish to increase their chances of becoming pregnant.
And please allow enough time to achieve the results!
Most studies suggest that a timeframe of three months at least needs to be allotted for most women to achieve any significant results. And please feel free to email me if you are working on improving egg quality and have questions and wish to adapt supplements to fit your individual situation.
Good luck and lots of baby dust to you,
Darja
Supplements which are scientifically proven to increase egg quality:
To know when you ovulate:
Prenatal vitamins:
