You’ve probably heard the term “hacking” as it pertains to computers, smartphones, and even the US elections but did you know you can also “hack” your own body? No, not in the horror film kind of way, but rather, it’s just a way to think about optimizing your biology to help you achieve a specific outcome.
What is fertility biohacking?
The term "biohacking" covers the gamut of both lifestyle changes and technologies, all with an aim to give you shortcuts to success. When it comes to fertility, there’s no sugarcoating the fact that we will all eventually be infertile, as marked by the start of menopause (The average age of menopause is 51 years old, but menopause may occur as early as the 30s or as late as the 60s).(1) But there are a variety of fertility biohacks WITHIN YOUR CONTROL that can help you decelerate down that steep decline.
Why should you be biohacking your fertility?
Maintain your egg quantity
You were born with all the eggs you’ll ever have, about 1-2million. Your body cannot create new eggs, they just keep them preserved in your ovaries until they’re pulled into recruitment. Around 1,000 follicles (the fluid-filled sacs that contain your eggs) are pulled into recruitment every month, which is an average of about 33 per day, depending on your age. Only ONE of these eggs will make it to the point of ovulation.
As the number of follicles are lost each month, so does what’s called your “ovarian reserve.” The ovarian reserve is a metric for fertility because it indicates how many potential eggs are left in your ovaries that could one day become a baby and it indicates how close you are to hitting menopause (when only around 1,000 follicles remain, menopause begins).
Some lifestyle choices and activities can damage the ovaries, which studies have shown can reduce the total number of eggs contained within. And, some behaviors like smoking can prematurely “kill off” the eggs that are busy maturing in effort to make it to ovulation (i.e. the potential to become a baby).
Maintain your ability to create quality eggs
Despite the fact that we use egg quantity as a predictor of fertility potential, all you really need is one quality egg to make a healthy baby. A low quality egg, in simple terms, is one that is chromosomally abnormal. Declining egg quality is problematic for older women trying to conceive for two reasons: First, because a poor quality or chromosomally abnormal egg is less likely to make it through all the hurdles (fertilization, implantation, full term pregnancy) of getting pregnant and staying pregnant. Low quality eggs with chromosomal abnormalities are the most common cause of early miscarriage (2) - the older you are, the more likely your eggs are to be low quality, which is why miscarriage rates increase as you age.
Second, because the amount of DNA errors that occur increase as you age, the risk of your child having a genetic disorder, such as Down syndrome, rises abruptly in your mid-30s. (4, 5) By the time you hit your early forties, 80% of your eggs will be chromosomally abnormal, and that’s what makes it harder to get pregnant and stay pregnant with a healthy baby. (6)
When it comes to biohacking your egg quality, the key factor to acknowledge is that it’s not your eggs that get old and thus are more likely to be low quality. But rather, it’s that as you age, your body loses the ability to mature chromosomally normal eggs. Put simply, there are ways to “hack” your body into a younger state, which then provides your eggs with the tools it needs to reach a state of quality.
1. Quit smoking immediately
One of the most colossal changes you can make for your short and long-term fertility is to quit smoking. (7) Smoking is a surefire way to reduce both the quantity and quality of your eggs. In fact, doctors have told us that the ovaries of women who smoke can look more like those of women up to five years older. This visible damage to the ovaries explains why smokers are more likely to start menopause (i.e. a state of infertility) 1 - 4 years earlier than women who don’t. (8, 9, 10)
Egg quality is also greatly affected by cigarette smoking, with studies indicating that the risk of miscarriage increases by 1% for every cigarette smoked per day. (11) In egg freezing and IVF cycles, smokers’ egg quality appears to be lower than that of non-smokers. This is evidenced by the fact that smokers undergoing IVF have more canceled cycles (usually due to poor egg development), lower implantation rates and more cycles with failed fertilization compared to non-smokers. (12, 13, 14, 15, 16, 17) This is also supported by research showing that women who smoke are more likely to conceive a chromosomally unhealthy pregnancy (such as a pregnancy affected by Down syndrome) than non-smoking mothers. (18)
It’s unclear how much of the damage is reversible but one large study showed that when women stopped smoking, the risk of earlier menopause decreased. (19) What is clear is that the sooner you quit, the better it is for your fertility.
2. Freeze your eggs
Egg freezing is a more expensive option and is not right for every woman but it’s a pretty amazing technology that offers us a chance of preserving our eggs at a younger age when their quantity and quality is higher. In essence, your frozen eggs will remain at the same biological age at which you froze them. (20)
To put this in perspective, if/once you start trying to conceive and you have trouble doing so naturally, you might choose to undergo IVF treatment. In a regular cycle of IVF using fresh eggs, you would stimulate your ovaries to produce and mature more eggs than you would in a normal menstruation cycle and the doctor would retrieve those eggs in a short procedure (this is the same process for egg freezing). Once retrieved, the doctor will try to fertilize the eggs with sperm and then implant the resulting embryo into your uterus in the hopes that it grows into a healthy baby.
However, if you are doing IVF using fresh eggs, it might give you a better chance than conceiving naturally but the success rates are still in line with age. On the other hand, if you freeze eggs when you’re younger, using those eggs would theoretically give you a better chance of carrying a healthy baby to term, even with your older womb. (21, 22, 23, 24) Not only are you more likely to get pregnant, but you’re less likely to miscarry and more likely to have a healthy child who does not have a condition such as Down syndrome or Turner syndrome. (25)
Scientists have shown that it’s the age of the egg rather than the age of the womb than matters when it comes to getting pregnant and giving birth to a healthy baby by comparing fertility treatments where older women use younger eggs (from donors), compared to older women using their own older eggs. Plot this on a graph and you can see that the women using younger eggs have dramatically improved chances of ending up with a baby:
3. Take a Coenzyme Q10 supplement
Your growing eggs need an incredible amount of energy to get safely through all the stages of chromosomal processing in order to be considered quality. They get this energy from mitochondria, which are the tiny “power plants” in your cells. While mitochondria are contained in almost every cell in your body, your eggs contain more than ten times the number found in any other cell (there are about 100,000 mitochondria in one fully-grown human egg).(27) Even the follicle surrounding your egg has its own mitochondria, which are known to give your egg an extra power boost when needed.(28) In fact, it’s now thought that the ability of mitochondria to effectively create a substance called ATP (cell energy) when it is needed is the single most important factor in determining the viability of eggs and embryos. (29)
As you age, your mitochondria decline both in quantity and in power supply, similar to the fading capabilities of an AA battery. By the time you hit 40, almost one-third of the mitochondria in your eggs will no longer be efficient energy producers. And when this happens, there isn’t enough energy to fuel egg maturation and chromosomal processing, which often results in low quality eggs. (31, 32, 33, 34, 35)
What is amazing is that scientists now believe that, whilst your mitochondria are like batteries, they’re more like the rechargeable kind. One potential means of recharging them is through a supplement called coenzyme Q10. This supplement is known as “a potent stimulator of mitochondrial function.” (36) Because egg maturation is a very energy intensive process, if your mitochondria are given a boost, it’s a little like rolling the clock back. While it’s not fully understood how far CoQ10 can effectively turn back the hands of time yet, and randomized clinical trials in humans are still needed, it does provide promise.
4. Stabilize your blood sugar levels
Your blood sugar level has an effect on just about every aspect of your reproductive system, so not surprisingly it also includes the health of your eggs. Looking at the effects of elevated blood sugar levels and how they impact your long term reproductive health, research indicates that even slightly higher blood glucose levels can reduce the chance of a natural pregnancy by more than 50%. (37)
Imbalanced blood sugar levels can be destructive in a few ways. Most crucially, it’s thought to reduce the production of reproductive hormones needed to mature your eggs. (38) But also, insulin resistance - a condition when your cells resist the signal from the hormone insulin, caused by elevated levels of insulin by time due to high blood sugar - is associated with oxidative stress, which causes damage to your ovaries and to the mitochondria needed to provide the energy your eggs need to reach full maturity. (39)
Unfortunately, managing your blood sugar is a bit more complex than just eliminating soda or candy. And even if you follow a generally healthy diet, there’s a chance your blood sugar levels are still off kilter. In fact, approximately 84 million American adults—more than one out of three—have a condition called pre-diabetes where blood sugar levels are higher than normal, but not high enough to be considered Type 2 diabetes. And, 90% of the people that do have it don’t even know it. (40) Part of the reason it’s so easy for blood sugars to get out of whack is that managing them properly requires you to think about eating the right foods, in the right format, at the right time and it can be influenced (positively and/or negatively) by other lifestyle factors like stress, sleep and exercise.
Don’t get overwhelmed! It’s certainly not impossible to regulate your blood sugar levels, it just requires some effort and a bit of a mindshift. More resources on managing your blood sugar levels can be found in the Resources section of the website.
“From the new changes you adopt when optimizing your egg health, you're really creating powerful habits that will also impact your nutrition if and when you decide to get pregnant in the future. The quality of your diet is essential for your future baby's health.” - Elizabeth Stanway-Mayers, Clinical Dietitian, Stanford University Medical Center
These fertility biohacks are just a few of many that you can pursue in effort to preserve your natural fertility for as long as possible. An exhaustive list can be found in the book, Everything Egg Freezing, which is about more than just egg freezing itself.
Be advised that this is not a replacement for your doctors advice or care.
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