By Mary Sabo, L.Ac, DACM
On average, women in developed countries are delaying childbearing until later in life.[i]Many modern women are waiting until their 30s and early 40s to start a family in order to focus on their careers, gain financial stability and find the right partner.[ii]Women who learn to take excellent care of their bodies and health can sometimes delay the appearance of aging and feel great, but unfortunately eggs and ovarian function decline whether they are in perfect health or not, and the age at which they decline can, unfortunately, be unpredictable.
In Chinese medicine, we support fertility naturally using herbs, acupuncture, and dietary and lifestyle changes. We help women conceive with these tools either alone, or in conjunction with assisted reproductive techniques like In Vitro Fertilization (IVF) and Intra Uterine Insemination (IUI). Acupuncture and herbs can improve hormone balance and overall health, which optimizes fertility at any age. However, the biggest determinant of conceiving a healthy child is the chromosomal quality of eggs and sperm, which declines naturally as we age. We now know that the uterus can remain healthy and able to carry a baby long after the ovarian health and egg quality prohibits pregnancy. For this reason, egg freezing has become a popular option for women to preserve their younger egg health for use later in life. It’s a type of fertility insurance. Egg freezing is more affordable than ever and new advances in techniques have made it more reliable, improving outcomes.
Plenty of women conceive easily in their thirties and early forties, but the likelihood of struggling with fertility at this age is higher.[iii]Screening for infertility in women not trying to get pregnant is not yet standardized in our medical system and many couples who struggle to conceive are “unexplained”, meaning that all tests look normal but pregnancy is still not possible. Conceiving as an older woman can become a bit of a gamble then. Miscarriage rates are higher in this population and the reasons for both higher rates of infertility and miscarriage are commonly the “quality” or chromosomal makeup of the eggs and sperm. Researchers are exploring ways to influence this chromosomal content, and it is suspected that some agents like antioxidants can influence the overall health of the egg, which can potentially improve the quality, but currently the biggest determining factor is age. The older a woman gets, the more eggs in her ovaries mature with chromosomal abnormalities. Until we understand how to directly influence this development predictably and reverse the effects of aging on eggs, the best way to preserve them is to extract and freeze them when we are young.
Currently, there is no test to determine egg quality. There are some tests to determine the health of the ovary and the “ovarian reserve”, but they do not assess the health of the chromosomes inside the eggs. According to CCRM NY Reproductive Endocrinologists co-founders/authors of East Meets West Fertility Dr. Jaime Knopman and Dr. Sheeva Talebian, the ideal time to freeze eggs is between 30-34 years of age. Freezing at a younger age, in theory, will produce healthier eggs, but you’ll pay more over time to keep those eggs frozen longer as facilities charge an annual “rent” for your frozen eggs. You also may not need them. Waiting until later means more eggs may be abnormal. However, if you are older than 34 and having a child is nowhere in sight, it’s worth discussing your options with an RE. Egg freezing is insurance, not a guarantee, but it is the only option for women who know they’d like to have a family one day, but it’s taking a bit longer to feel ready than they expected.
If you are considering freezing your eggs, you can take some steps now to improve your health and potentially optimize the health of your eggs. Dr. Knopman and Dr. Talebian recommend stopping smoking, decreasing alcohol use, and increasing foods that are high in antioxidants for three months before your egg freeze cycle. I also work with women in those three months before their egg freeze cycles to optimize overall health and egg quality with acupuncture, customized dietary and lifestyle changes, and customized supplement and herbal plans. Because fertility potential and egg health cannot be determined until a woman starts trying to conceive, there is no way to know your fertility status or egg quality, but you can absolutely maximize your chances of freezing healthy eggs with the right support and empowering changes.
[i]Matthews TJ, Hamilton BE. NCHS Data Brief.Delayed childbearing: more women are having their first child later in life. 2009 Aug;(21):1-8.
[ii]Hammarberg K1, Clarke VE. Reasons for delaying childbearing--a survey of women aged over 35 years seeking assisted reproductive technology. Aust Fam Physician.2005 Mar;34(3):187-8, 206.
[iii]Baird DT, Collins J, Egozcue J, Evers LH, Gianaroli L, Leridon H, Sunde A, Templeton A, Van Steirteghem A, Cohen J, Crosignani PG, Devroey P, Diedrich K, Fauser BC, Fraser L, Glasier A, Liebaers I, Mautone G, Penney G, Tarlatzis B; ESHRE Capri Workshop Group. Hum Reprod Update.2005 May-Jun;11(3):261-76. Epub 2005 Apr 14.