In this article we review Rebecca Fett’s best-selling guide "it starts with the egg." The book distills the research Rebecca – who has a PhD in molecular biochemistry – did to optimize her own egg quality. Applying her biology background to the task, Rebecca poured over hundreds of scientific studies to maximize her chances of pregnancy with her own eggs through optimum egg quality and everything else that supports a pregnancy. Then, she made the knowledge available to everyone in a book form, easily digestible to those of us without a background in science.
We love this research-driven yet approachable and actionable guide and would recommend it to anyone getting ready for a pregnancy.
RECOMMENDED SUPPLEMENTS FOR EGG QUALITY
- Prenatal with Folate
- CoQ10 / Ubiquinol
- Melatonin /sleep aid
- Alpha-Lipoic Acid
- Vitamin C
- Vitamin E
- N-acetyl cysteine (NAC)
- Inositol
- DHEA
- Vitamin D
To cover all your bases, our FertiMax includes all these nutrients and more—each at optimal doses and in bioavailable forms. Here, we dive into some of the most common questions about these ingredients.
FOLATE: NUTRIENT WITH TWO IMPORTANT ROLES
Folate is on top of the priority list for women preparing for a pregnancy, because of its role in the development of the baby’s central nervous system. During early pregnancy, folate supports the formation of the brain and spine, and a healthy level is necessary to prevent neural tube defects (like spina bifida).
It Starts with the Egg’s Folate Recommendation
So, as soon as you start trying for a baby, make sure your prenatal vitamins contain at least 600-800 mcg of folic acid – or folate, to support the baby’s brain development, but also to potentially support normal ovulation and egg health.
VITAMIN C AND VITAMIN E: the Prenatal Antioxidants
Prenatal vitamins usually contain Vitamin C and Vitamin E, both potent antioxidants. Antioxidants are molecules that scavenges reactive oxygen species (sometimes called free radicals), normal but harmful byproduct of the metabolic processes. Left untouched, reactive oxygen species cause oxidative damages to cells and DNA, and some scientists suspect that accumulated oxidative damage and lower antioxidant defenses play a part in the age-related changes in our reproductive systems.
It Starts with the Egg’s Vitamins C & E Recommendation
Rebecca points out that “every small incremental improvement in egg quality helps.” If you decide to incorporate Vitamins E and C into your preconception and prenatal routine, “It Starts with the Egg” recommends up to 200 IU of Vitamin E and 500-1,000 IU of Vitamin C.
REPRODUCTIV HEALTH
Vitamin D and reproductive health have been in the spotlight in the last decade, with studies examining its role in pregnancy rates with (Assisted Reproductivity Technologies) ART, fertilization rates, implantation rates and uterine receptivity. (how easy it is for embryos to implant in the endometrium). While we don’t know how Vitamin D may support female reproductive health, these studies have found positive correlations between higher Vitamin D levels and reproductive success.
Although our skin synthesizes Vitamin D when exposed to the UVB in the sun, inadequate levels of Vitamin D is surprisingly common – and as Rebecca points out, whether the official cut-off value of adequacy, set to support bone health, is really adequate for reproductive health is hotly debated among Vitamin D researchers.
It Starts with the Egg’s Vitamin D Recommendation
What to do? Rebecca recommends getting tested for Vitamin D levels first. (You can take a home test, or ask your doctor to test it for you.) If your level falls below the 30 ng/mL (or, even better, 40 ng/mL level), you can start supplementing with 4,000-5,000 IU per day of Vitamin D3. If you have a significant deficiency, your doctor may put you on a higher dose for a few weeks to top up.
Choline: Just as Crucial as Folate for Brain Development
In her follow-up book, “Brain Health from Birth,” Rebecca tackles the question of how we can set the stage right for the baby’s brain development, both during pregnancy and in the baby’s first year. One of the most significant takeaways from this book might be the importance of choline in your preconception nutrition.
Choline, like its better-known cousin, folate, plays a crucial role in the baby’s brain growth and cognitive development. It’s an essential building block for nerve cells, and the baby cannot produce nerve cells without a sufficient supply of choline. Furthermore, choline is necessary for the production of a neurotransmitter that regulates the functions of brain cells.
Despite its importance, choline is somewhat of a neglected nutrient. A staggering 90-95 of women have inadequate choline in their diet, and most prenatal vitamins don’t contain enough to make up the difference.
Rebecca Fett’s Choline Recommendation
Make sure your prenatal vitamins contain at least 350 mg of choline, if your diet is healthy and contain natural sources of choline like eggs, meat and soybeans, says Rebecca. Vegans and vegetarians may want to supplement with more choline, as it’s difficult to get enough choline from plant sources alone. It’s also essential to get a steady supply of choline when nursing – it’s a key ingredient in breast milk.
WHEN SHOULD I START TAKING PRENATAL VITAMINS AND SUPPLEMENTS TO IMPROVE EGG AND SPERM QUALITY?
It’s best to start taking prenatal vitamins and supplements about three to four months before trying to conceive. This is because eggs (and sperm for that matter!) take roughly that amount of time to fully develop and mature. Starting this early before trying to get pregnant ensures that the supplements you’re taking will affect that next cohort of ovarian follicles for better quality when you ovulate that egg. If you were planning to try sooner, or if you’re preparing for an IVF cycle, these nutrient supplements can be started as soon as possible—even one or two months beforehand can be beneficial for egg quality.
SPERM QUALITY SUPPLEMENTS
One of the supplement man need to take daily to improve egg quality is a multivitamin with methylfolate.
- Ubiquinol or CoQ10
- Alpha-lipoic Acid
- Omega 3 (fish oil)
- L-Carnitine
PREPARING FOR EMBRYO TRANSFER
As discussed in greater detail in the book, the supplements to consider taking in the lead up to a frozen embryo transfer are:
- Prenatal
- Vitamin D
- Vitamin E - the research used in the book is 900IU, which is a fairly high dose.
- L-Arginine (This is not recommended before egg retrieval because it may compromise egg quality, as explained in the book). The dose used in the study that found L-Arginine can improve endometrial thickness was 6 grams per day, divided in 4 doses.
- CoQ10
After embryo transfer, you can continue with your prenatal and vitamin D until you can get a positive pregnancy test