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In this post, we will talk about whether the quality of oocytes can be improved. Let’s discuss how successful the use of vitamins and antioxidants is in planning pregnancy and treating infertility, and consider the question “Do they really work?”
How long does it take to take vitamins in preparation for an IVF program?
Most recommendations show 90 days, which is likely to span the stages from secondary to dominant follicle. If research reports on the benefits of maintenance vitamins and micronutrients, it is probably best to keep track of dosage / timing and whatever your healthcare provider may consider for your particular situation.
What vitamins can improve the quality of eggs?
Vitamins or coenzymes are special molecules that help enzymes in a cell (or egg) do their job.
We can produce some vitamins ourselves (such as vitamin D), but many of them need to be supplemented from our diet.
Folic acid and folate (vitamin B 9) is an essential vitamin that participates in many processes in the body, starting from the moment the germ cells are formed and the child is conceived. With the participation of folic acid, glycine is synthesized – an amino acid that is important for energy metabolism (the division of the embryo in the early stages of development occurs precisely due to the energy that it received from the mitochondria of the egg). Folic acid is required for the synthesis of nucleic acids containing hereditary information (DNA).
Vitamin B 9 also affects the development of rapidly dividing cells (including endometrial cells, which ensure correct implantation).
Energy is also important for the correct distribution of chromosomal material within the oocyte and preparation for fertilization. Folic acid contributes to the formation of the placenta and supports the baby’s blood supply. Another main area of action of this vitamin is the nervous system, participation in the laying of the baby’s neural tube.
How does homocysteine affect fertility?
Impaired ability to break down folic acid (partial occurs from 20-53%, full 3-32%) leads to the accumulation of homocysteine. Homocysteine has a toxic effect – it disrupts the process of cell division, and leads to the destruction (loosening) of the vascular wall, which activates increased blood clotting. This, in turn, affects the bearing of pregnancy, the growth and development of the fetus. Based on a review (Carrell 2015), research shows:
higher blood folate levels correlate with better embryo quality and pregnancy rates. Increased homocysteine levels (= low folate levels) correlate with lower embryo quality. Higher implantation, pregnancy and childbirth depend on baseline blood homocysteine levels.
When planning pregnancy, all women are advised to determine the level of homocysteine. When it rises (hyperhomocysteinemia), pass an analysis for the possibility of correct splitting of folic acid and vitamin B 12 (polymorphism of the folate cycle genes). He surrenders once in a lifetime and helps the doctor and the woman to build a strategy to support the state of their reproductive sphere, the correct preparation for pregnancy, the right food, according to genetic analysis, to support the development of the embryo and its blood supply. Based on this analysis, tactics for protecting and maintaining the state of their vessels and cell division are clear.
The optimal value of homocysteine for conception is up to 5.6 μmol / L. When it is increased for planning pregnancy, it is recommended to use split folic acid in the form of metafoline (methylfolate) at 800-1000 mcg per day.
It has been established that the content of vitamin B 12, correct (gene MTR B 12), which affects the transition of this vitamin into the active (bioavailable form), also affects the decrease in the level of homocysteine. Therefore, if this gene is disrupted, it is important to supplement the split form of vitamin B 12 (methylcobolamine) at 1000 mcg per day.
Coenzyme Q10 (or – ubiquinone) is synthesized in every cell of the human body. It performs two important tasks: it participates in the production of energy and protects cells from free radicals. Because coenzyme Q10 is an active antioxidant, it is used as the first line of defense against free radicals. Another role – energy generation – is also very important. Especially for organs and tissues that require a lot of energy.
The work of the heart, liver, reproductive system – directly depends on the content in the body of a sufficient amount of coenzyme Q10, the use of which in medicine is no longer disputed.
What is the difference between regular antioxidants and coenzyme Q10?
By neutralizing free radicals, antioxidants are usually irreversibly oxidized. Coenzyme Q10 molecules can be repaired and reused by the body. In addition, coenzyme Q10 can activate other antioxidants already used.
It was found that with age, the synthesis of coenzyme Q10 decreases. In late reproductive age, the ability to produce it by cells is reduced. Potentially, taking Q10 protects eggs from free radicals and reduces the risk of genetic disorders.
One of the factors that affects the decrease in the quality of the eggs is the decrease in the energy content in the mitochondria. Mitochondria are the batteries of every cell. With age, the supply of energy in them decreases.
L-carnitine is an antioxidant that is made from lysine (an amino acid) and you can find it in large amounts in meat. It plays a role in the production of energy in the mitochondria, reducing oxidative stress, and reducing damage to mitochondrial membranes. Various studies have shown that it has a positive effect on fertility (reviewed by Agarwal 2018):
Improves the condition of the reproductive system in PCOS and endometriosis, improves the quality of oocytes.
How does taking antioxidants affect fertility?
Reactive oxygen species (ROS) are molecules produced during normal cell metabolism. At low levels, they serve as the necessary support for cell function, but when ROS levels rise this can lead to “oxidative stress.”
Because all of these highly reactive ROS molecules float around the cell, they can cause damage, including DNA. This can lead to a decrease in the quality of the egg and impair the possibility of proper development and implantation of the embryo.
Antioxidants work against ROS, “removing” them.
Antioxidants are an easier target for ROS than, for example, DNA, so the ROS will react preferentially with the antioxidant. Once he reacts, it is no longer AFK. So, antioxidants reduce ROS and, accordingly, help reduce oxidative stress! The balance of ROS and antioxidants is important.
There are many antioxidants in our cells that are produced by the cell to maintain this balance. Oxidative stress increases with age, so we can use antioxidants.
Diet and lifestyle choices can affect the balance of ROS and antioxidants. Cigarette smoke increases the level of ROS, which can damage DNA and lead to mutations, disrupting the process of proper cell division.
Insulin resistance increases oxidative stress, so adjusting blood sugar and insulin adjustments (toward lowering insulin consumption to keep blood sugar normal) can help reduce oxidation. We recommend that at the planning stage of pregnancy, it is imperative to determine the HOMA index to understand the insulin consumption in the body and to normalize it if necessary. You should know that most often the tendency to increase insulin consumption occurs when the thyroid gland is disrupted, the level of testosterone and prolactin in the female body is disrupted.
Knowing this helps to effectively influence eating behavior and reduce insulin consumption, and bring weight back to normal.
There is now compelling evidence on the effects of vitamin D on male and female fertility. A study at Curtin University published data that women whose vitamin D levels are normal (over 75 nmol / L) are 3.5 times more likely to successfully develop an embryo. The relationship between vitamin D levels and the likelihood of a successful IVF outcome has been proven in numerous clinical studies (Chu, J. et al. 2018).
How does iron deficiency affect fertility?
Low levels of iron and ferritin can affect pregnancy.
Studies have shown that women with iron deficiency have problems with the normal maturation and release of the egg from the ovary into the fallopian tube (ovulation). Violation of these processes is called anovulation. Also, iron deficiency can lead to a deterioration in the quality of the eggs. This is due to the fact that iron transports oxygen to the organs, and when it is deficient, oxygen starvation occurs. Therefore, with a lack of oxygen in the ovaries, the process of egg maturation is disrupted.
The chance of getting pregnant with iron deficiency is reduced by 60%. So-called latent iron deficiency is common among women. At the same time, the level of hemoglobin in the blood is normal, while the depots of this important trace element are depleted. Latent iron deficiency is found in 40% of women with infertility, and can lead to difficulties in the proper blood supply to the baby during pregnancy. In addition, the likelihood of success in IVF with iron deficiency is significantly reduced. It is important to remember that proper absorption of iron in the body depends on the ability to break down vitamins B9 B12 and the state of the thyroid gland.
So is it worth taking supplements?
It depends on you and the specifics of your situation.
The approach to planning pregnancy and bearing a healthy child should be comprehensive and individually tailored to each woman. Correct filling of deficiencies and support
the body significantly helps to increase the response to stimulation, obtaining high-quality oocytes and affects the success of the IVF program.