Erin Barnes is Twig Fertility’s Nurse Practitioner and expert on all things egg-related. As the main point of contact when it comes to freezing your eggs at Twig Fertility, Erin supports patients from start to finish in their egg retrieval journey. Erin brings with her a deep knowledge of inclusive reproductive and sexual health care serving people of all genders and sexualities.
What are the factors that impact egg health and what lifestyle measures can improve egg quality?
When it comes to egg health there are factors we can control and also factors that are beyond our control. A person’s age, something they can’t control, is the most important factor when it comes to the quality of their eggs. People with ovaries are born with all of their eggs, so the eggs age with them, and both the quality and the number decrease over time.
As for the factors that are within our control, things aren’t always as straightforward. Intuitively, it seems that things like nutrition and a healthy diet should help with egg health, but this hasn’t been clearly shown in the research. Some studies, for example, have shown a correlation between particular vitamins or dietary choices and fertility, while other studies looking at the same things have not found the same association.
As a whole, the data about the impact of diet and nutrition on egg health is inconclusive at this time. Likely the best we can say right now is that maybe particular vitamins, nutrients, or dietary choices do help with egg health, and they likely won't hurt, but we can’t know for sure.
Understandably, this is a bit frustrating! It would be great if we could take a supplement to help increase egg health and fertility, and the internet certainly makes it seem like those solutions do exist. And they might, but we can't confidently say that at this point.
Other lifestyle choices exist, though, that are clearly associated with fertility, like smoking. People with ovaries who smoke are significantly more likely to experience infertility than those who do not smoke. For people with sperm, smoking can decrease sperm motility and affect the size and shape of the sperm. , On the other hand, it seems that things like caffeine and alcohol do not impact fertility in moderation, but can cause harm if consumed in excess. In many ways, fertility health is connected to one’s overall health, so for those who want to optimize fertility as well as their general health, these sorts of lifestyle choices are something to consider.
What about CBD and cannabis use?
When it comes to cannabis and CBD, many people assume that as long as you're not smoking it, cannabis is completely harmless when it comes to fertility––which doesn’t seem to be the case.
Science still has a lot to learn about the impacts of cannabis on fertility outcomes, but we do know some things at this point. For example, people with sperm who use cannabis regularly can sometimes have issues like lower sperm number or motility. In addition, some research has found that for people with ovaries who use cannabis, there can be higher rates of infertility.
If having biological children is something you desire, erring on the side of caution and avoiding the consumption of cannabis and CBD products is best until we know more about how they impact fertility.
Why freeze your eggs?
We know that age is the biggest factor that impacts egg quality. The older a person gets, the more likely it is that their eggs may have genetic abnormalities, which makes the eggs less likely to lead to pregnancy and more likely to lead to miscarriage. The end result of this is that it becomes harder to both get pregnant and stay pregnant as we age.
Freezing your eggs while you’re younger allows you to preserve your eggs at their highest quality. You can then use them when you’re older, which gives you a greater chance of successful pregnancy outcomes.
This is a kind of imperfect insurance against the future, as freezing eggs cannot guarantee a successful pregnancy down the road. What frozen eggs can do is provide people with more options if they wait until later in life to start a family. . Many folks might want to try to conceive on their own when the time is right, for example, and if that doesn’t work, they can then proceed with treatment like IVF using their younger eggs, which increases their chances of success.
When to freeze your eggs?
In a perfect world, the earlier the better as far as quality goes. If you have the time and financial resources to freeze your eggs in your 20s, that's fantastic. But many people are not in that position or don’t start thinking about their fertility until their early 30s.
Fortunately, for most people, the early 30s is still a good time to freeze eggs. It’s generally around the mid-to-late 30s that we really start to see significant age-related changes in egg quality.
This is not to say that people can’t freeze their eggs at that point, but folks in their late 30s likely need to do more rounds of egg freezing in order to freeze a number of eggs that leads to a reasonable chance of a baby in the future.
Do I need to stop my hormonal birth control in order to prepare for freezing my eggs?
If you are using birth control pills or an IUD as contraception, you do not need to stop or remove the device prior to egg freezing. As part of the preparation protocol, birth control pills would be paused shortly before the stimulation cycle begins, but not prior to that.
Similarly, an IUD generally doesn't interfere with the egg freezing process, since we're working with the ovaries and the IUD is placed inside the uterus.
How invasive is the procedure and what does the process look like?
Being aware of everything that’s involved up front is an important part of the decision-making process when it comes to undergoing any medical procedure.
We always start with a consultation where we look at medical history, review the process and set up some initial diagnostic testing. Once the decision to move forward has been made we’re ready to start the actual egg freezing cycle, the process is around two weeks from start to finish. There are hormonal injections involved, usually for about 9-13 days, and you can expect to be in the office about 4 or 5 times over the course of about two weeks to monitor hormone levels and egg reserves via blood tests and ultrasounds. Once we decide that the eggs are ready for collection, we schedule the retrieval for about two days later.
The retrieval itself only takes about 15 minutes and is performed via internal ultrasound where a thin needle is placed through the vaginal wall into the ovaries to collect the eggs. Patients are made comfortable with IV medication and given ample time to recover on-site before heading home. While it is an invasive procedure, we do our utmost to make it as comfortable as possible and most folks tolerate it quite well.
Does egg collection decrease my egg reserve, affecting my ability to naturally conceive in the future?
Contrary to what you might think, egg retrieval does not decrease egg reserve more than what would normally happen each month.
Each month, the egg that is ovulated is part of a cohort that is stimulated to mature. Even though a number of eggs are activated each month as part of this cohort, generally only one of them is actually released (ovulated). Those that are not ovulated are broken down by the body, they do not rejoin the reserve of eggs. With egg freezing, we’re simply using medication to cause more of that cohort to become mature so that we can collect them.