Book Review Part 1 - It Starts with the Egg
For a few years, I had seen women on my online fertility forums raving over this book, claiming that it was the ultimate reference guide for fertility and egg quality, but it wasn’t obvious to me that it had information that I hadn’t already gleaned from the internet. On a whim, I decided just last week that it was time for me to get a first-hand look at what everyone else was chattering about. What I discovered is pretty much rocking my world. I am so excited to share what I have found and how it’s influencing how I’m thinking about fertility and the egg quality program I’m developing.
In this article I will provide some background context to the book, then I’ll highlight the information in the book that I felt was most critical and that I believe has a tremendous impact on the way we think about improving fertility. I’ll also address some huge potential that I think this book has missed and I’ll summarize takeaway messages for those wanting to take action immediately. In a separate article, I will give a “Cliff’s Notes” style rundown of what else is in the book, with mention of each general recommendation that the author makes for improving fertility.
A Little Background
It is common knowledge in the fertility world that egg quality is a huge issue in fertility, especially as we age. Poor egg quality leads to problems with fertilization, implantation, and embryo development, and is responsible for a large proportion of miscarriages and births with chromosomal abnormalities (such as Down Syndrome).
The common belief in the medical community is that egg quality decline is a natural part of aging and it's a one-way ticket—it declines gradually with age and there are no options for going back.
When I was dealing with my own fertility challenges (recurrent miscarriages due to poor egg quality), I read on many websites that egg quality could indeed improve, but I had not yet come across scientific support for this notion. None of the websites or books I had read were sharing where they got their information. I attempted to read scientific studies about egg development, but frankly they were a little over my head. (My background is in engineering and psychology.) I decided that I would just take that promising information on faith as it was my only option outside of just “hoping for the best”.
So I ran with the assumption that it was possible to improve egg quality and did my best to implement a plan based on what made sense to me. Despite being almost 46 years old with with blood test results that suggest ridiculously poor fertility (low AMH, high FSH), I got pregnant soon after that and had a beautiful healthy baby. But one success story isn’t what anyone would call sufficient scientific evidence. So, I’ve continued to wonder if there was any solid research behind these premises about improving egg quality--or perhaps it was just a rumor passed around by alternative health types, and I just got lucky. As someone with a background in science and research, the question of “where is the research” has been nagging me for quite some time.
A Research-Based Book on Egg Quality
It Starts With the Egg” was first published in 2014 and again in 2016. When I finally got my hands on it just last week, I was stoked. It was first time I’d seen a discussion of this topic—fertility and egg quality—by someone who was logical and articulate, had a strong science background and provided references to the research behind claims being made. It’s written in the style of a scientific text, with footnotes next to key pieces of information, properly referenced so that a reader can look up the original research study being referenced. There were over 500 articles reviewed in the writing of the book.
The author, Rebecca Fett, is a science writer with degrees in molecular biotechnology and biochemistry, and laboratory experience in genetics research. She became interested in this area when she was diagnosed with diminished ovarian reserve in her late 20s. She implemented changes in her lifestyle based on the research she found and when she later had eggs retrieved there were no sign of egg quality or quantity issues at all. She wrote this book hoping to share her knowledge with others who might be helped.
She does an excellent job of putting scientific terms into common language that is easy to understand. The format of the book and the author’s educational background gave me much more confidence in the information she was reporting compared to random articles I came across on the internet. The way she steps you through her thought process and provides references allows you to evaluate the research and draw your own conclusions.
A Quiet Revolution
At first glance, I was favorably impressed by the overall approach of the book, bt I was still waiting to see if there was going to be anything new for me, particularly in terms of relevant research evidence. When I read this paragraph in the book’s introduction, I was hooked:
“In the process of earning my molecular biology degree, I had studied mechanisms of DNA damage and repair, the detailed process of energy production inside cells, and how both processes relate to antioxidants. I had also studied the complex system in which chromosomes in an egg are recombined and then mechanically separated before and after fertilization. As I delved deeper into the scientific papers addressing egg quality, all the pieces that I had learned about years earlier started to fit together with groundbreaking recent studies to form a picture of the various causes of chromosomal abnormalities in eggs and the influence of external factors. In short the research revealed a quiet revolution in the way we think about egg quality.”
Stunning. Here was someone with the background to interpret the research, fervently trying to answer the question, “How can I improve my eggs?” And she discovers, “the research revealed a quiet revolution in the way we think about egg quality.”
Tell me more about this revolution! I can’t wait to learn more! (Here’s the other thing I like about this book: it’s not filled with a bunch of inspirational stories…just her own story in the intro, and after that, she gets straight to the research in every chapter.)
Understanding Egg Quality
In chapter one “Understanding Egg Quality,” after explaining the importance of egg quality and how chromosomal abnormalities are more common as women age, Fett writes,
“The critical point to note—and one that many fertility doctors are not aware of—is that most of the chromosomal abnormalities in eggs do not accumulate gradually over 30 or 40 years as an egg ages, but instead happen in the couple of months before an egg is ovulated.”
So this means it’s like our eggs are in the freezer, well preserved, for many years until it’s their turn to prepare to be released. They then go through a few months of growth and maturation (consider that like thawing from being frozen), which is when critical cell division occurs. After a few months, a mature egg is released to be fertilized.
She goes on to explain that what is showing signs of age is our mitochondria—the cells present in tissues throughout our body that provide the energy needed for various tissues to function optimally. As we get older, mitochondria become damaged and are less able to provide as much energy to support functioning of various tissues, much like a weakening battery in a flashlight giving off a gradually-fading beam of light.
So it looks like it’s poor mitochondria that lead to poor egg development. And here’s the game-changing piece of information for fertility: recent research is showing that mitochondria health can be improved.
This is a huge departure from the common message I hear older women being told all the time by their doctors: “I’m sorry, your eggs are old. If you manage to get pregnant, you’re likely to miscarry, and it’s just luck of the draw whether you’ll get a good egg.” They think of old eggs liked spoiled milk—once it’s gone bad there’s nothing you can do about it.
Well, the research is showing that old eggs are like a flashlight with a weak but rechargeable battery. If you’re following me so far and you’ve had fertility struggles that might be due to egg quality, your burning question right now is how can I recharge that battery?
(I’m jumping ahead now to Chapter 6, "The Power of CoEnzyme Q10, because this is where I see the logical continuation of this story.)
The author cites research indicating that a big contributor to mitochondrial health is Coenzyme Q10 (CoQ10) which is an enzyme produced naturally in the body but can decline with age. Fortunately, it can be boosted through taking supplements, ubiquinol being the form of CoQ10 that is best absorbed into our bodies.
So taking ubiquinol supplements in the months preceding conception might give eggs the energy they need to properly grow and form correct chromosomal arrangements. Ubiqinol is actually being researched in many different health arenas and is being found to benefit a variety of conditions. The exact link showing that taking ubiquinol will improves human egg quality has not been specifically tested yet, but it’s a logical conclusion to draw based on other findings.
This is very encouraging! There’s reasonable scientific evidence to suggest you can improve egg quality by taking ubiquinol for several months prior to ovulation.
What's Missing Here?
As if that weren't awesome enough, there's an even more exciting prospect I'm seeing that comes up in Fett's discussion here. After citing various research findings related to the relationship between mitochondria and development of eggs and embryos, she offers this perspective:
“Based on all the scientific knowledge about the importance of fully functioning mitochondria to egg and embryo quality, it stands to reason that anything we can do to boost mitochondrial function and help eggs produce more energy will improve egg quality and embryo viability.”
Throughout the book she touches on various things besides ubiquinol that might improve mitochondrial functioning and otherwise improve fertility. She addresses diet, supplements, environmental toxins, and a few specific health conditions (gum disease, celiac disease, and hypothyroidism). However, I think there’s a huge wide open field of possibilities here that she didn’t even mention in passing.
Let’s zoom in on that last exerpt:
“…it stands to reason that anything we can do to boost mitochondrial function….will improve egg quality and embryo viability.”
Her exploration of the research covers diet, supplements, toxins, and a few health conditions. I’m a psychologist specializing in health behavior and the mind-body connection. My wheels were turning fast now! ….anything we can do to boost mitochondrial function…. Surely there’s more here.
I was immediately thinking about the egg quality program I had developed for myself, which I am currently refining to share with others, and I went down the list of components in my program that I believed were important but for which I hadn’t yet found research to support.
My fingers were flying as I typed into my google search bar:
Article after article was citing evidence that these lifestyle factors have an impact on mitochondrial functioning and that implementing the healthy lifestyle activities seems to reduce the age-related decline in mitochondria. I can go into more detail in the future of some of the inspiring findings in various studies. But for now I want to pause and just review the significance this very encouraging line of research.
Here are the biggest takeaways from this post:
Based on this line of reasoning, there is a whole world of possibilities for how we can impact egg quality. This is a dramatic departure from the common notion that "there's nothing you can do about your egg quality once you are older."
I am more motivated than ever now to get my program out and available so that women can move forward quickly and confidently with taking steps that can make a difference in their egg quality.
If You Want to Start Now
I'm getting closer to launching the next round of my online egg quality program, but it’s not ready quite yet. I know that time is of the essence for many of you, so I’m going to make a very short list of things that you can do to get started right away, based on what I've covered in this article.
Here's a short list of recommendations you can implement right away to start working on improving egg quality:
It can be stressful trying to make a lot of changes in your life all at once, and of course, it turns out that stress is not good for our eggs either. So I’m purposely keeping this list short. Over time you can add in more helpful changes, and in fact, that is how I will be developing my 90-day egg quality program—to gradually layer in healthy lifestyle changes that can be implemented in a low-stress manner.
In a future post, I will go through the entire book, chapter by chapter, sharing very briefly about the recommendations the author offers based on her review of the research. Consider purchasing the book if you’re interested in all the details.
I’m grateful to Rebecca Fett for her hard work on pulling together this body of work. It appears that she has moved on to another area that became personal for her. She has recently released a book on arthritis and psoriasis called “The Keystone Approach”, exploring these conditions and reviewing research which she similarly applied to herself to overcome her own health issues. If you happen to have one of these conditions, I expect this book could be enlightening and useful as well.
Read Part 2 of It Starts With the Egg Book Review
Learn about the Fertility From the Soul 90-Day Egg Nurturing Program.
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