fertility nutrition

Many folks who have made the big (and exciting) decision to freeze their eggs want to improve their egg quality before freezing. But is egg quality really something you can control? What kinds of lifestyle changes should you make before freezing your eggs? Read on for a look at what the research says about egg quality — and what you can do to improve it before the egg freezing process begins. 

What is egg quality?

As you’ve been exploring the egg freezing process, you may have heard your fertility doctor mention that freezing during your 20s can be beneficial because your egg quality will likely be higher. 

It’s annoying, but true: as women age, our egg quality typically goes down further and further. The American College of Obstetricians and Gynecologists (ACOG) estimates a woman’s chances of getting pregnant begin to decrease at age 32 and continue to gradually go down until about age 37 when the decrease becomes more rapid. ACOG links this decrease in what they call fecundity — another word for fertility — to egg quality. 

This is one of the many reasons Freeze by Co partners with local fertility clinics to create opportunities for women in their 20s to freeze eggs more affordably. We want you to have more control over your reproductive choices, even if you’re not looking to get pregnant during this peak egg quality period.

But what does “egg quality” (also called oocyte competence) actually mean? Are doctors being a tad judgmental about a woman’s age? Not at all. 

When fertility specialists use this term, they’re referring to whether your eggs are considered genetically normal or abnormal, and it’s tied pretty closely to the chances that an egg could ever result in pregnancy.  

Euploid vs. aneuploid embryos 

While sperm health is undeniably important, it all starts with the egg. The quality of embryos made from your eggs comes down to two different types:

• Euploid embryos 

• These embryos are genetically “normal.” 
• They contain the right number of chromosomes at 46. 

• Aneuploid embryos

• These embryos are genetically “abnormal.” 
• They contain either fewer or more chromosomes than normal. 
• Embryos created with a low quality egg may inherit either too many or too few chromosomes. 
• Most aneuploid embryos will either fail to implant or result in miscarriage as they are usually not compatible with life. 

There’s also a significantly higher risk that an aneuploid embryo will not implant in the uterus after an in vitro fertilization (IVF) transfer — one study found as much as 96 percent of abnormal embryos transferred into the uterus did not implant. On the other hand, that same study found when euploid embryos were transferred, the pregnancy rate was 82 percent. 

Do I need to improve my egg quality before freezing? 

So if euploid embryos start with healthy eggs, you’re probably wondering: do I need to improve my egg quality before freezing? 

Some factors that affect egg quality such as your personal genetics and the passing of time can’t be controlled. But there are ample steps you can take to influence the health and quality of your eggs. 

Here are some simple changes that research shows may improve egg quality. We recommend you consider making these changes at least three months prior to egg freezing: 

1. Quit smoking 

If you’re using cigarettes, now is a good time to stop. Studies have found that smoking can have a detrimental effect on fertility. Puffing on cigarettes can increase the risk of infertility by as much as 60 percent with negative effects on the menstrual cycle, uterus, and ovaries. It’s the effect on the ovaries that is particularly troubling when it comes to egg quality with smoking damaging the DNA of the eggs themselves. 

2. Avoid marijuana

Although there aren’t a lot of studies on the effect of marijuana on fertility, those that exist indicate THC — the psychoactive ingredient in marijuana — can result in an impaired ability to produce viable embryos. According to a study published in the Journal of the Endocrine Society in 2020, the exposure of oocytes to THC was linked to a “significant decrease in the expression of genes called connexins.” These connexins are an important marker of egg quality. For our Split members, we require them to stop using marijuana products at least one month prior to retrieval.

3. Improve your diet

There is never a bad time to eat a healthy diet, and if you’re planning to freeze your eggs in the near future there are extra reasons to make smart choices at meal time. Eating a diet rich in leafy greens, whole grains, and lean proteins can all help those egg cells. 

Here are some rock star foods you might want to consider adding to your diet when you’ve got an eye on improving egg quality (plus the benefits they bring):

• Fish such as salmon, mackerel, and trout — Omega 3 fatty acids
• Egg yolks — Vitamin D
• Beans, oats, oranges, and cantaloupe — Inositol
• Fruits and veggies of any kind — Antioxidants
• Oysters, beef, chickpeas, lentils, hemp seeds, pumpkin seeds, and pine nuts — Zinc

Before embarking on any major diet changes, check with a registered dietician. They can help you craft a plan that’s just right for your body. 

4. Talk to your doctor about supplements

If you’re not already taking vitamins, you may want to chat with your reproductive endocrinologist about whether you should add Vitamin A, Vitamin B, folate and zinc — or maybe one of the four — to your daily routine. Studies have linked all three of these micronutrients to egg quality over the years, affecting the synthesis of DNA and other factors in oocyte development. 

Your doctor may want to check your vitamin D level with some bloodwork or go over your current vitamin regimen before deciding if adding on additional supplements is necessary. Make sure to bring any dietary changes you’re making into the conversation too — there can be too much of a good thing when it comes to some vitamins!

5. Talk to your doctor about your weight 

Being told you need to hop on the scale when you’re at the reproductive endocrinologist’s office can be frustrating, especially if you’ve struggled to lose or gain weight in the past, or if you have a condition such as polycystic ovarian syndrome (PCOS) that affects your weight. 

Still, the weight conversation is one worth having with your fertility specialist if you’re worried about your egg quality. Both being over and underweight has been linked to egg quality by researchers time and again. 

Obesity in particular has been found to affect the hormones that guide an egg as it matures. On the other hand, being underweight can stop the body from ovulating entirely. 

The “right” weight for your body is one you and your doctor can discuss. If changes are in order, they can help craft a plan for healthy changes — or recommend a dietician who can. For our Split program, there are BMI requirements, which you can read more about here.

The bottom line

The quality of your eggs may not be completely in your control, but you do have solid options when it comes to improving your egg quality before freezing. What you put into your body makes a difference, and making changes now can make a real difference down the line. 

As women, we are born with all the eggs we’ll ever have, so it’s crucial to consider the health of our eggs as we age — and that includes accounting for the impact diet can have upon egg quality. The number of eggs we have decreases and the percentage of our eggs that contain genetic abnormalities actually increases the older we get. We’re just the messenger here! 

To put this into perspective, women are born with around one to two million oocytes (or egg cells) and by the time we are around 37, this number drops to roughly 25,000. In addition, women in their 20’s will have mostly “normal” egg quality, while women in their 30’s will have mostly “abnormal” egg quality. Each of these factors plays a large role in why fertility may be harder to achieve as we celebrate each birthday. 

Before we dive into how to improve egg quality with diet, let us first explain that currently, there is no “test” for egg quality. The only way to know if an egg is chromosomally normal is to try and fertilize it, and if successful, perform genetic testing. 

Is there an egg freezing diet? 

Yes! What we’re putting into our body (both for better or for worse) can greatly influence the health and quality of our eggs. And during the cycle of an egg’s journey, there is a window of time (90 days) in which certain factors — like diet — can influence the health of that egg. So, it can take roughly three months to improve the quality of your eggs. I recommend optimizing your egg health for at least 90 days before egg freezing. 

When it comes to boosting egg quality, here is where we’d recommend starting:

Omega-3 fatty acids

Omega-3’s are a rockstar when it comes to women’s health and reproductive functions, and egg quality is no exception. Studies have demonstrated a diet rich in omega-3 fatty acids may help improve egg quality. 

However, not all sources are created equal! The omega-3 fatty acids you find in plant-based foods like chia seeds and walnuts, while definitely healthy, are nowhere even close to being as beneficial to egg quality as animal-based sources like fatty fish (think salmon, trout, mackerel, sardines, and tuna). This is because animal-based sources contain EPA and DHA (the kind of omega-3’s that are actually helpful for this purpose), while plant-based sources contain ALA which then needs to be converted into DHA and EPA. Unfortunately, the conversion rate is less than 10%. 

Vitamin D

Studies have shown women undergoing IVF who had higher levels of the sunshine hormone (aka Vitamin D) produced better quality eggs and were more likely to conceive. Not only that, but Vitamin D deficiency has been linked to other hormonal imbalances and anovulatory infertility. Basically, Vitamin D packs a powerful punch if you’re seeking to improve your egg quality. 

The easiest way to get Vitamin D is to head outside for some sunshine for 15-20 minutes per day, but you can also work it into your diet with foods like eggs (specifically the yolk), salmon, herring, sardines, and tuna. 

CoQ10

Coenzyme Q10 levels gradually decline as we age, so this coenzyme is especially important to consider when it comes to egg quality. Studies have demonstrated suboptimal CoQ10 status may drive age-associated declines in egg quality, so load on up. Some of the best sources of CoQ10 are organ meats, however, so if you’re not so keen on a diet loaded with liver, a supplement is a great way to go!

Inositol 

Inositol is thought to increase insulin sensitivity of the ovary, which may help improve egg quality. Working a combination of myo-inositol and D-chiro inositol into your diet is preferable and while beans, oats, oranges, and cantaloupe are good sources, taking a supplement  in the body's normal ratio of 40:1 is preferable here. Recent studies have shown that taking a combination of these two forms, in this ratio, is more beneficial than taking myo-inositol or D-chiro inositol alone. 

Zinc

Zinc is a key regulator when it comes to egg quality and development! Research shows a zinc deficiency may negatively affect the early stages of egg development, reducing the ability of egg cells to divide and become fertilized. Good sources of zinc to work into your diet include oysters, beef, chickpeas, lentils, hemp seeds, pumpkin seeds, and pine nuts.

Antioxidants

Research shows antioxidants such as vitamins A and E may help with the mitochondrial function of our eggs by helping with DNA replication — which is what you want when you’re aiming for healthy, fertilized embryos. Other studies of antioxidants such as catechins, N-acetylcysteine, and proanthocyanidins have also demonstrated a benefit to mitochondrial function in several organ systems. 

The best way to improve egg quality by getting a wide variety of antioxidants into the body is by simply eating the rainbow! This means stacking your plate with as many bright, colorful fruits and veggies as humanly possible. 

Blood sugar balance

Blood sugar balance is super important for egg quality, even if insulin resistance is not an issue. This is because high levels of insulin may be associated with impaired egg quality. More recent data shows that a high starch diet, which was associated with a higher plasma insulin to glucagon ratio, had adverse effects on egg quality. To work towards better glucose control, focus on proteins, healthy fats, and fiber and limit meals and snacks that are full of naked carbohydrates. 

The net-net on egg freezing and diet

In sum, what you put into your body (or what you don’t!) can have profound effects on the health and quality of your eggs. We recommend starting to work on egg health for at least three months before any fertility procedure. Use this list to help guide your diet and supplement intake so you can be on the path to improved egg quality!