Healthy Eggs

I've been thinking about whether I should adjust my diet at all in order to encourage "quality egg production".  One way to measure a successful egg retrieval outcome is the number of eggs (though not too many or else you risk OHSS), but perhaps more important is the egg quality.  What good is retrieving 20 eggs if very few of them are of sufficient quality to progress to the next stage?

Quick flashback to high school biology: the human cell is a diploid cell and has 46 chromosomes (which hold your DNA).  However, ovum (what I've been calling my "eggs") and sperm are reproductive haploid cells (aka gametes), and each only has 23 chromosomes (half of what we need to create a full cell).  When the sperm fertilizes the egg, the 23 chromosomes from each haploid cell fuse to form a single diploid cell containing 46 chromosomes.  This cell now has a unique set of genes, and it subdivides by mitosis to grow and become an embryo.  One of the factors in embryos not progressing beyond a certain stage may have to do with chromosomal abnormalities (Mother Nature's way of saying that that particular fertilized egg is just not meant to be).

The "egg spindle" organizes the 23 chromosomes in the ovum ("egg").  It's normal for a certain number of eggs to have abnormalities, but the occurrence of these abnormalities increase with age.  I found a summary explaining potential spindle abnormalities accompanied by images of what a healthy egg spindle looks like compared to an abnormal one.  I guess if an egg's spindle doesn't exist or looks highly fragmented, they won't freeze the egg.

When they retrieve my eggs, they will look for eggs that are "spindle positive" (good-lookin' spindles).  Here is video that shows you how technicians detect spindles.   At this stage, I don't think they will do a screen for chromosomal abnormalities-- they probably do this as an extra step (and cost) when I thaw and fertilized my eggs, before embryo implantation.  (I will ask my doctor to confirm this.)  The fact is that the cryopreservation process can result in additional spindle and chromosomal damage, which is why you end up with fewer usable eggs than you freeze.  Recent advances in egg freezing have helped improve the post-thaw yield rate, which is one of the reasons why I am choosing to undergo egg freezing now.  I am also hoping that technology in thawing and fertilization continues to improve, and that we're even further along by the time I'm ready to use these eggs.

What am I eating?

So-- back to the matter at hand.  What do I eat (or avoid)?  Many post-ers on IVF forums seem to promote a high fat, high protein, low carb diet, the reasoning being that such a diet encourages cellular development.  Some also say to cut out dairy (not sure why).  Some say pineapple is good for IVF transfer (less relevant to me).  There is the soy controversy.  Plenty of hydration is essential.  Some say B vitamins (which are said to help reproductive organs).  Chinese medicine says that women should only take in warm foods (no ice cream!), and meanwhile, my yoga instructor warned me not to overheat my body (ice cream, hooray).

OK, so no one really knows for sure.  What makes sense to me is to eat a well balanced diet rich in fruits and vegetables, heavy on protein and "good fats", and if eating carbs, choosing whole grains.  This works better for my body type, so this is what I'm going to pursue.  I am also taking a B vitamin complex supplement (which includes folic acid) and one Viactiv calcium chew a day (which is part of my regular diet).  I will not give up my ice cream; it is my foil to the Menopur.

This morning, I took advantage of the fact that it is Sunday and made myself a nice brunch of eggs, avocado, bacon, and multi-grain toast with raspberry jam:

I know I can't eat like this every day, but I've got to feed my growing eggs.

Smoking, Alcohol, and Caffeine

Smoking-- I mean, that just seems dumb.  I mean, whether you're undergoing egg freezing or not, just-- no.  Moving on.

I've read a lot about the negative effects of alcohol on egg retrieval success.  The Guardian article says that in a Harvard study, women who drank one or more alcoholic beverages a week had an 18% less likelihood of success at producing an IVF baby as compared with women who did not drink at all.  White wine for women and beer for men seemed especially detrimental.  Another UK article from the Daily Mail says that eliminating alcohol, caffeine, and smoking can help women conceive "naturally" instead of resorting to IVF, providing further evidence that these substances just aren't helping women conceive.

Now, women undergoing IVF have more factors to be concerned with than women going through egg freezing-- namely, IVF patients need to prepare their body for egg retrieval and embryo implantation (whereas I can worry about embryo implantation later).  It is possible that alcohol and caffeine interfere with implantation, and maybe it has little effect on healthy egg production itself.  And to be fair, you're born with all the eggs you've got-- you've already subjected your poor ova to years of college drinking and whatever other substances you may have abused in your less responsible years (or even now).

As someone who likes to drink at least two glasses of iced tea a day and enjoys wine with dinner several nights a week, I would like to believe that this is the case, that I don't need to worry about alcohol and caffeine consumption, but since no one can assure me that it's OK (my nurse said, "the occasional glass of wine is fine; one small cup of coffee a day is acceptable"), I've chosen to avoid both.  I figure that since I'm spending over $15K of my hard-earned money to undergo this procedure, it seems foolish to run this risk.  It is also makes sense-- your body doesn't actually require alcohol or caffeine to function, and both are known to have some negative effects on your body; why marinate your eggs in a toxic brew while you're going through this expensive and sensitive procedure?  And what if these substances interfere directly or indirectly with the hormones I'm taking?  I want to provide as regulated an environment as possible so that the hormones work optimally and my body is appropriately reactive to  any adjustments my doctor may make to my course of treatment.

I began drastically reducing my caffeine and alcohol intake about one month ago.  In the last month, I've only had four glasses of iced tea (heavy on the ice, very little tea), and none in the last 10 days.  In terms of alcohol, I've reduced my intake to "a few glasses of wine per week" in the last month (all red wine, no white), and in the last ten days, I've only had one glass of rose (I was desperate, on a terrible blind date, what was I to do?).  I have vowed to eliminate alcohol and caffeine entirely during my cycle, and I've been sticking to it.

Cutting down alcohol to a few glasses a week has had a few immediate positive outcomes-- my skin looks great, and I think I even lost a little weight since I've stopped drinking hundreds of wine calories a week!  Plus I don't spend as much money when I go out, which is good, because I'm spending $15K on this procedure and every little bit helps.  I think I may make the reduced alcohol consumption a regular part of my life, though I can't wait to have my first glass of rose post-retrieval.