What is egg quality?
Women are born with certain number of eggs (1-2 million) at birth and over time, they lose around 1000 eggs every cycle. The eggs inside your ovaries are “primordial,” or immature eggs. As you ovulate, they go through another phase of cell division, known as meiosis. Older eggs are more likely to accumulate errors in their DNA during that division process, leading to genetically abnormal eggs. There are several factors that impact egg quality and quantity such as:
- Age: older eggs tend to have more DNA damage and less number of eggs
- Genetics: Some women are born with a lower egg count or experience egg decline earlier due to inherited factors. Other genetic factors affecting egg quantities are Fragile X syndrome, Turner syndrome
- Hormonal disorders such as PCOS: Women with PCOS have higher androgen levels which has a negative impact in egg quality, they also have irregular/late ovulation which has a negative impact in their egg quality
- Endometriosis and other pelvic inflammatory diseases: chronic inflammation increases reactive oxidative species formation which has a negative impact in egg quality, studies have shown women with endometriosis have lower number of oocyte retrieved and fertilized. If there is endometriosis tissue on the ovaries which are called ovarian endometrioma (chocolate cysts), it will reduce oocyte quantity as well at quality.
- Life style: alcohol, tobacco, marijuana and other drug intake, diet, exercise and weight
Tests for measure ovarian health:
Currently there are no tests to measure egg quality. Age is the biggest factor to determine egg quality.
Tests to measure egg quantity: Discuss this with your Doctor
- AMH (anti-Mullerian hormone)
- Inhibin B
- Antral Follicle count (AFC)
Other Hormonal tests for Ovarian/Reproductive Health:
- FSH (follicle stimulating hormone): done on the 3rd day of cycle
- LH (luteinizing hormone)
- Estradiol
- Progesterone (7 days after ovulation)
- Thyroid panel
Holistic Treatment for Ovarian Health and egg quality and quantity
Diminished quality due to age is difficult to treat and since there are no tests to directly measure egg quality, it would be difficult to measure the impact of any treatments on egg quality. However, there are Holistic treatments which can help with associated disorders which can impact egg quality such as inflammation, insulin resistance, high androgen (in PCOS), and hormonal imbalance.
As mentioned earlier, women are born with a fixed number of eggs, they do NOT produce more eggs. The best test to measure egg reserve is AMH which measures the antral Follicles. However, using holistic treatments such as Acupuncture, herbs, and Nutraceuticals, the AMH level can increase by activating more primordial follicles to become antral follicles.
Acupuncture for Ovarian Reserve
A meta-analysis of 13 randomized control trial involving 787 patients revealed that acupuncture produced a significant efficacy in decreasing follicle-stimulating hormone (FSH) levels, FSH/LH ratio, and increasing anti-Müllerian hormone (AMH) levels, along with increasing Antral Follicle count (AFC) compared to controls.
Acupuncture is believed to improve ovarian reserve and reproductive outcomes in women undergoing in vitro fertilization (IVF). In a study, Women diagnosed with poor ovarian response were enrolled and randomly divided into two groups: IVF alone and Acupuncture + IVF groups (16 acupuncture sessions before IVF treatment). Among the participants, compared with the IVF treatment alone, the acupuncture + IVF treatment significantly increased the number of retrieved mature oocytes in women aged more than 37 years and in those undergoing more than one controlled ovarian hyperstimulation cycle.
A meta-Analysis of 31 studies including 4450 women showed that women with poor or decreased ovarian reserve and women with repeated implantation failures seemed to be benefit from the adjunctive acupuncture treatment when undergoing IVF. Patients receiving Acupuncture had higher oocyte maturation, more oocyte retrieval, higher fertilization and implantation and higher clinical pregnancy rate and live birth rates. This Meta-analysis showed women with poor ovarian reserve and unexplained fertility had the most benefit from Acupuncture.
Acupuncture and blood flow
Acupuncture improved uterine artery blood flow and ovarian sensitivity to gonadotropins, as the result has a potential in improving oocyte maturation and enhancing embryo implantation. It can also be postulated by improving blood flow to the ovaries and uterus more nutrients (from taking herbs and/or supplements) can reach the ovarian tissues and improve oocyte quality.
Acupuncture plus IVF
In seven clinical randomized controlled trials (RCTs) which included 516 women, the effects of Acupuncture plus controlled ovarian hyperstimulation (COH) vs only ovarian hyperstimulation was measured. The results showed that in acupuncture+ COH group had a significant increase the implantation rate, the number of oocytes retrieved, the thickness of endometrium, and the antral follicle count, reduce follicle-stimulating hormone (FSH) levels and improve estradiol (E2) levels.
A systematic review which included Twenty trials and 5130 women studied the effects of acupuncture treatments with embryo transfer (ET). The meta-analysis found increased pregnancies, live births, and reduced miscarriage when acupuncture was compared with no adjunctive control.
Acupuncture and Hormonal Balance
Acupuncture was shown to cause a significant increase in β-endorphin levels during treatment, which lasted for up to 24 hours. ß-endorphins have a modulatory action on Gonadotropin releasing hormone (GnRH). Because acupuncture treatment impacts on β-endorphin levels, which in turn affect GnRH secretion and the menstrual cycle, it is logical to hypothesize that acupuncture may influence ovulation and fertility. Animal studies have revealed that acupuncture treatment normalized GnRH secretion and affected peripheral gonadotropin levels.
In ovulatory and anovulatory women, acupuncture has shown to influence plasma level of FSH, LH, Estradiol and progesterone. Modulating hormones can help with follicular development and timely ovulation and reducing damage to the oocytes due to hormonal imbalance.
Electro-acupuncture has shown to regulate and normalize the hypothalamic-pituitary-ovarian (HPO) axis. GnRH is produced in pulsatile manner from hypothalamus; acupuncture can reduce GnRH pulsatile release. Lower GnRH pulse frequency helps with FSH secretion which helps with follicular development, higher GnRH pulse frequency favors LH release. Acupuncture modulates the frequency and GnRH production improving proper follicular growth and ovulation
Acupuncture for ovulation induction
Another study by Stener-Victorin et al. evaluated the use of electroacupuncture for ovulation induction on 24 oligo/amenorrheic women with polycystic ovarian syndrome (PCOS). The percentage of ovulatory cycles in all subjects was shown to improve from 15% (in a total of 3 months before treatment) to 66% up to 3 months after treatment. Responsive patients were noted to have significantly lower body mass index (BMI), waist-to-hip circumference ratio, serum T concentration, serum T/sex hormone-binding globulin ratio, and serum basal insulin level. They suggested that, in these selected patients with PCOS, acupuncture could be considered as an alternative or adjunct to pharmacological ovulation induction.
Another study showed that repeated acupuncture treatments resulted in higher ovulation frequency in lean/overweight women with PCOS, Ovarian and adrenal sex steroid serum levels were reduced with no effect on LH secretion.
Acupuncture and Immune function
Immune dysregulation can negatively impact egg quality by:
- Producing inflammatory environment which can cause oxidative stress on oocyte and negatively impact the DNA integrity
- Elevated inflammatory cytokines can impair the growth and maturation of ovarian follicles
- inflammatory immune environment can change the composition of the follicular fluid, the liquid surrounding the egg, which can hinder the egg’s development
A study measured the effectiveness of Acupuncture on Immune markers. The results showed that the most favorable effects of acupuncture on the immune functions appear 72 hours after the single session and persist one month after the end of the complete treatment. Impaired immune functions in anxious women (chemotaxis, phagocytosis, lymphoproliferation and NK activity) were significantly improved by acupuncture, and augmented immune parameters (superoxide anion levels and lymphoproliferation of the patient subgroup whose values had been too high) were significantly diminished. Acupuncture brought the above-mentioned parameters to values closer to those of healthy controls, exerting a modulatory effect on the immune system.
Acupuncture and Insulin resistance
Insulin resistance has a negative impact in egg quality by:
- inducing oxidative stress
- inducing mitochondrial dysfunction
- it leads to fewer mature eggs, and lower blastocyst formation rates.
A study which included 17 eligible randomized control trials (RCTs) with 1511 participants, showed that acupuncture therapy yielded a greater mean reduction in HOMA-IR and BMI. Additionally, the combination treatment of acupuncture and medicine is more effective in improving HOMA-IR, FBG, FINS and BMI than medicine alone.
Acupuncture and Stress
High cortisol level (stress hormone) can inhibit the release of Gonadotropin-Releasing Hormone (GnRH), which in turn has a negative impact in follicular maturation and ovulation.
Chronic stress has a negative impact on the Vegas nerve, this can lead to feelings of anxiety and depression. Certain Acupuncture points (Including ear acupuncture) can stimulate the Vegas nerve to reduce inflammation and reduce stress and anxiety.
Studies have measured the effectiveness of acupuncture in stress management for women undergoing IVF. Multiple acupuncture sessions, stress scores were significantly lower. As demonstrated by a dose-dependent effect, acupuncture appears to be a promising stress-lowering tool for women undergoing IVF.
Several studies have shown that Acupuncture can regulate and reduce cortisol level and reduce depression symptoms. This can be beneficial for women undergoing fertility treatments and/or who are trying to get pregnant naturally since the process can be very stressful.
Boost Fertility Naturally with Acupuncture & Herbal Medicine in Indiana – Yarrow Holistic Center
At Yarrow Holistic Center in West Lafayette, Indiana, we specialize in natural fertility enhancement through Acupuncture, Herbal Medicine, Functional Nutrition, and Nutraceutical Consultations. Our integrative approach supports reproductive health and hormonal balance for individuals and couples seeking to conceive.
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