Many of you have heard that saying that it
all starts with the egg. Well, what if it
was true? And, what if there was so much that
you can do to improve your egg quality? That's
exactly what we're going to talk about in
this video, so keep watching.
Hi, I'm Dr. Marc Sklar, The Fertility Expert,
and I work with couples from all over the
world, helping you get pregnant naturally.
If you want more help from me, then you've
got to subscribe to my YouTube channel right
here with that bell so that I can support
you on your fertility journey. I just wanted
to let you know that my fertility coaching
program to work with me and my team one-on-one
is open for applications. If you want me as
your fertility coach to help you on your fertility
journey, then make sure that you use the link
down below in the description to apply to
qualify. This program is by application only.
If you qualify, you'll be able to join me
and my team so that we can support you on
your fertility journey.
So yes, it starts with the egg. And I don't
say that to put any undue pressure on any
of you watching. The reality is is that egg
health and egg quality is super important,
just like sperm health, and uterine environment.
All of these three factors combined will really
optimize and give you the best chance to conceive.
And, if one of those variables is not functioning
properly, if the other two are really at their
peak performance, then they can kind of compensate
for that third one that's not doing exactly
what it should do. So yes, all three are valuable,
but in this video, we're going to primarily
be talking about ovarian health and your eggs.
That's why it's called "it starts with the
egg." That's right.
So, there are several variables, several factors
that I want to review and go over and mention
that do influence egg quality and quantity.
So, the first one is a woman's age. Age is
obviously important. And, not that there is
a lot we can do about it, quite frankly, I
always tell every couple that I work with
the last thing you can change and try to influence
is your age, right? There's very little we
can do about that. But what we do know is
that age can influence other variables. Your
age alone will tell you where your success
rates and percentages fall. And, based on
that, that will help dictate some of the decisions
that you can make or should make on your fertility
journey. So age is a variable that we all
need to account for, but it's not a variable
that we can change.
All right, so some of the other variables
that do influence the egg and egg quality
are genetics. What's your genetic makeup,
exposure to environmental toxins, right? Are
there toxins that you've been exposed to over
your lifetime that have influenced or can
affect your reproductive system.
Obviously, nutrition. I talk about this all
the time. Drugs, exposure to drugs, whether
it's pharmaceutical or recreational drugs,
these can affect and do affect your reproductive
system and egg quality.
Alcohol consumption, stress, blood and oxygen
flow, and hormonal balance.
This is the core of the areas that can influence
your egg reserve and quality. We're going
to come back to those in so much more detail
in just a few minutes, but I do want to cover
a little bit more of the basics around egg
quality and egg reserve. So I've spoken a
lot about the egg specifically, but one of
the other pieces that we do need to understand
is where does the egg live? It lives in the
ovary, and actually it lives in the follicle
inside the ovary. And so, ovarian health is
also important. We can't ignore the health
of the ovaries, the home, the house of the
follicle and exit you're going to be producing.
So, it's not just about focusing on one area.
We do have to look at the whole reproductive
system and all the organs that are affecting
and influence egg quality, and egg reserve.
So ovarian health, and what's going on in
the ovary. Are there cysts? Is their endometriosis
growing on it? Are they too small? These are
all variables that do potentially influence
the quality of your eggs as well.
And then the other one is ovarian reserve.
How many eggs do we have to use inside of
our ovaries that may be able to be used in
the future? So this is definitely a key point,
right? I've spoken about ovarian reserve and
ovarian health on many videos so I'm not going
to spend a ton of time on it here, but I do
want to go over some key points if you're
new to my channel, all right?
So, ovarian reserve and egg quality are determined
by two main hormone tests, FSH and AMH. The
other variable that can influence or help
you determine the amount of eggs that you
have left is what's called an antral follicle
count. It's an ultrasound that's done on the
ovaries to be able to see how many follicles
are antral follicles, the ones that are getting
ready to mature and grow in that given cycle
are there to be matured. Now, just so you
know, that antral follicle count can change
and does change from cycle to cycle. So just
because you get a specific number, let's just
say 10 on an antral follicle count, it doesn't
mean that's all the eggs that you have forever.
No, that's just for that cycle. And it doesn't
mean that that number can go up or go down.
It can fluctuate and change.
So now coming back to the hormones themselves,
FSH, I get a lot of questions from all of
you, which I love, about FSH and AMH. What
do these variables look like? So my first
question back to all of you is have you had
your FSH and AMH tested? If so, comment below
and let me know. And if you're okay with it,
let me know what those numbers actually were.
I'd love to know.
All right, so what do these numbers actually
mean? There are groups and ranges of these
numbers that we need to account for. So FSH
has several different groups or ranges that
we need to pay attention to. In the bigger
picture, we want to see that number below
10. And, I like to see that number above 4
and 5. The first range of being excellent
in terms of FSH numbers is between 4 and 6.
The next range, which is considered good,
is between 6 and 9. Between 9 and 10 is fair
because you're kind of approaching that 10
mark, which we want to stay below. Then there
is another range between 10 and 13, which
really starts to show that your egg quality
is starting to diminish and potentially your
ovarian reserve, although that's not my favorite
marker for ovarian reserve. It starts to show
that that number is going down because your
FSH is going up, so it's just to show that
it might be compromised, right? And then,
from 13 to 17 and then 17 and above. And so
at every one of those variables, as FSH increases,
we start to get a little bit more concerned
about the quality and quantity of the eggs
that you are producing.
Now, it doesn't mean that this number doesn't
fluctuate. Actually FSH fluctuates dramatically,
and I see it fluctuate often. Most of your
IVF doctors are going to look at your highest
reading and base all of their treatments off
of that one number. That's one of the things
I really don't care for because that number
does fluctuate, and I think we need to account
for that. But for all of you, the lower that
number is, the better chance you're going
to have to conceive that cycle. So if one
cycle that number is higher, let's just say
13 or 15, and then a subsequent cycle that
drops down to 9, then that is the cycle that
we want to try to maximize for you.
I don't suggest testing your FSH or AMH every
cycle. I also want you to recognize that we
do need to take this number into account with
other hormones, LH and Estradiol as well,
but we're not going over that at this specific
moment. The other hormone that's super important
is AMH, Anti-Müllerian hormone. This hormone
is the one that is the primary one that we
use to determine ovarian reserve. Now, in
general, we want this number to be higher.
The higher, this number, theoretically, the
better ovarian reserve we do have. Now, that
comes with a caveat that we don't really want
it over 3, 3 and a half because once we start
to see that, we get concerned about polycystic
ovarian syndrome, but leaving that aside,
I'm going to go over some ranges based on
age that we want to see for AMH levels that
helps you determine what potentially or how
good potentially your ovarian reserve is.
So, if we see that your age is 27 or younger,
then we want your AMH to be around 2.7 to
3-ish. That's a good range. if you are 33,
between 27 and 33, 1.9 AMH. If you are from
33 to 36, then we'd like to see that at 1.3
AMH. If you are 39, then we'd like to see
that around 1.9 to 1 is great. And then from
42 and above, we do expect it to be somewhere
between 0.5 and 1. Again, the higher that
it is the better, right? I just spoke to a
woman yesterday, and I ran her labs and got
her lab work back, and she is 44, and her
AMH is 1.5, which is awesome. So in her case,
I'm not so I'm worried about ovarian reserve.
We need to start focusing on egg quality and
all the other variables that might be influencing
or affecting her fertility and ability to
get pregnant, right? So, in her case, it looks
great. I'm giving you these numbers just as
references to account for because everyone's
always asking, "Well, if my number is... if
my AMH is x and I'm 41, is that good or bad?"
So now I've given you those ranges that you
can make that determination for yourself and
see what you can do there.
I have seen AMH go up quite a bit over time
with the right plan, the right treatment,
and the right support for all of you, right?
Now, here is the biggest caveat. Everyone
always says, well, if AMH is a marker for
ovarian reserve, and ovarian reserve should
potentially never go up, it should only go
down, why do we see AMH go up? Well, that's
a great question. I've actually done several
videos on this specific topic if you want
to watch those, and you can check them out
right here. So I often get this question as
it relates to FSH and AMH. What happens if
my FSH is high and my AMH is low? What does
it mean? So, I'm not one to focus on the negative,
but we're going to talk about some of those
potential impacts right now, and then we're
going to talk about what you can do to affect
and improve and change those numbers yourself.
So, if your FSH is high and your AMH is low,
one is it does indicate that your poor ovarian
response to stimulation, so if you were to
do IVF, you're going to have a lower response
to the medication that they prescribed to
you doing a traditional stimulation cycle.
There are several different types of IVF procedures
that might be able to account for and accommodate
for that variable. But in general, that's
what it means. It also means that you're going
to have more poor quality eggs, and the embryos
that you're going to be producing are going
to be more poor quality as well. That's what
this starts to show. Your chance of pregnancy
does decrease, and your likelihood of miscarriage
does increase with those two variables.
Now, I say that because I want you guys to
all have the reality of what these numbers
mean. But, it doesn't mean that has to be
true for you. And I want you to know that
you can change and influence these numbers
to improve them, to give you better chances
to conceive. So the good news around all of
this is that you have the power. That's right.
You have the power to make change, to influence
your egg quality and ovarian reserve by the
things that you do. We talked about that those
different variables at the beginning of this
video, and I'm going to come back to those
in just a second to talk a little bit more
in detail, how those can influence your egg
quality and reserve. But the biggest point
that I want to make right now around those
numbers and improving them is that it takes
time. You're not going to see that change
in one cycle, potentially two cycles, potentially
even three cycles. You need a minimum of 90
to a 100 days, if not longer for you to improve
the quality of the eggs that you're producing
and start to recruit more eggs for a subsequent
cycle.
So I say that because I want you all to have
patience and understanding and be kind to
yourselves and most of all, not to question
the things that you're doing every cycle.
It can become difficult, and I see this often
with many of you that you switch gears too
quickly, when you're just about to see the
improvements and the change that you're making
on your egg quality and reserve. You're looking
for those numbers to improve on the snap of
a finger. You want to see that change from
one cycle. You want to see it change from
two cycles. That might not be possible depending
on what your numbers are and the whole picture
that we're looking at. So please be kind to
yourself, have some patience with yourself
and your ovaries, send them some good vibes,
but give them the time that they need to do
what you want them to do. So that's super,
super important.
So I started off this video talking about
age and how that's the one thing you can't
change or influence, right? Well now let's
get into those other variables that you can
have something to say about. The first one
or sorry, the next one, excuse me, was genetics,
right? So you might think, "Well, if I'm born
with these things, how can I change them?"
Well, just because you're born with predispositions
doesn't mean that they have to be true for
you. Imagine that all those genetic markers
were light switches, a bank of light switches
on a wall, right? And this one said, "You're
going to have constipation," and this one
said, "You're going to age faster," and this
one said, "You're going to have poor digestion"
or whatever it is. Just because you have that
tendency doesn't mean that it has to be true
for you. You can control with your lifestyle,
with your diet, with your sleep, with your
stress management, with potentially supplements.
You can control whether those switches are
going to go on or off. So I want you to understand
that. Now you need to know what switches do
you have that you've got to manage, right?
So this is where you do some more in depth
genetic testing, which one of your healthcare
providers can help you do, to find out what
genetic snips you have that you're predisposed
to, that you need to account for, that potentially
will influence your ability to conceive. I
know that's a lot potentially to digest, but
I want you to understand that in general terms,
and then you can dive deeper into that with
your healthcare team.
All right. So the next one is environmental
toxins. The way we control that first and
foremost is control our regular environment
that we're in regularly, right? That we spend
most of our time in. So that's our house,
that's our car, and that's our office, right?
If you all are going to the office these days.
So at home, make sure that you're using nontoxic
cleaning products, that all your skincare
products, all your beauty products, all the
things you drink out of and eat out of are
healthy, that when you walk into the house,
you take off your shoes, that you clean your
house regularly, that you dust regularly,
that you change your air vent filters regularly.
These are all variables that influence your
environment and can cause additional toxin
and burden on your body because it's trying
to clean out and manage all those exposures,
right?
Then obviously, car. We want to do the same
thing with our car. We want to make sure it's
cleaned regularly inside more importantly.
And you want to do the same thing with your
office environment. What can you do to manage
the health of your office environment, to
keep you healthy and not expose you to all
sorts of other things.
Some other key things that I do want to mention
with that is quality of water, your computers
and cell phones, like not keeping them around
you, although I have mine on my lap right
now, but it's not there normally. And, we
have to be careful for all of these things
because they influence our environment, influence
our health of our body, and our reproductive
system. So, environmental toxins is also one
that you can control and manage.
The one thing I didn't say here is what happens
if you were exposed to some toxin previously,
let's just say it's heavy metals. Let's say
you were exposed as a kid, or you work in
an environment that has all these toxins.
This is where you need to reach out to your
healthcare team to discuss what you've been
exposed to, and what's the best way to manage
that now, all right?
The next one is nutrition. Nutrition is key
and a huge foundational piece that everything
else needs to be built upon. I've done tons
and tons of videos on nutrition, so I'm not
going to spend a ton of time on it right now.
You can check those out later, but nutrition
is key. Keep it simple for yourself. Don't
eat junk. Stay away from packaged foods. Eat
fresh foods. Drink water, primarily. Don't
drink sodas. Non-processed foods. Reduce the
sugars. Eat good, whole foods. The more you
cook at home for yourself, the more you can
control what goes into your body, which is
key. And most of all, if you can do this,
purchase produce and food that is organic
because it's going to nourish your body more
than the conventional food that you potentially
eat.
All right, drugs and alcohol. So, these are
two variables that I think we do need to spend
a little bit of time on. Medications. Any
medication that you've taken does influence
the health of your body. Hopefully it's helping,
but it does have side effects. Most of them
do, right? Including the birth control pill.
It has side effects, dramatic side effects,
and I'm not a fan of you being on them. If
you're on it, I would prefer that you find
a different way for contraception. But all
medications, all drugs do or can influence
the health of your body.
When we're talking about drugs, start to stay
away from all the recreational drugs. Alcohol
is one of them. All of these things start
to damage the cells, damage the health of
the eggs, and diminish the quality of the
eggs that you are producing. So marijuana,
alcohol, these are key things that we want
to get away from. Also, we might actually
lump into drugs or recreational drugs, we
might put in caffeine actually because as
much as caffeine is beneficial, it does have
some negative effects around fertility and
pregnancy. So these are things that we want
to mitigate and decrease.
For all of you smokers out there, you can
reduce, you can lower, you can stop smoking.
I want to encourage you to do that. I just
had a woman who I started working with, and
she stopped three months ago. Is that potentially
too late? Maybe, but it's better that she
stops now than keeps going and just keep saying,
"Well, I've been doing it my whole life, so
why not continue now?" No, the more you can
stop smoking and the sooner you can do it,
the better you can improve your egg quality
and the health of the cells that your body
produces.
Stress. The big one. Listen, stress affects
everything. There are thousands and thousands
of research studies, how stress impacts any
health condition and makes it worse, right?
Fertility is absolutely no different. I speak
to so many of you and review your lab work
and see that it's really not a fertility issue.
FSH looks awesome. AMH looks great. All your
hormones look amazing. So why aren't you getting
pregnant? And the thing I keep coming back
to is stress. So we're not going to make stress
go away, but I want you to know that you can
manage your stress better. You have to prioritize
it. This is such a key component to your reproductive
health and the health of the eggs that you
produce. I know it doesn't seem to make sense
to many of you, but I'm telling you, it's
a key variable that all of you have the power
to control.
So I want you to start to make changes in
your life to minimize stress and improve your
egg quality. If you're constantly running
in that hamster wheel and not giving time
for you to focus on yourself, on your health,
on your loved ones, on the things that you
should be doing to take care of yourself now,
then you're going to have a much harder time
changing the egg quality and getting pregnant
because stress trumps everything. So, if that's
not reason enough to make a change, I'm not
quite sure what is, but I want all of you
who are not doing the jobs that you should
be doing to manage your stress to start making
change with that now.
Blood and oxygen flow. We need more blood
and oxygenation of ourselves, and we need
that to get to our ovaries to focus on the
quality of the eggs that we're producing so
we can have good ovarian function, right?
So exercise is key here.
Other things that you can do to improve blood
circulation and oxygenation of the cells is
acupuncture, castor oil packs, abdominal massage.
These are all things that improve circulation,
especially focused on your pelvic area and
your reproductive organs.
The other thing that I do think is important
is drinking enough of this, water, drinking
enough water to support your health and yourselves.
We want to keep those hydrated so that they
can also be nourished in that way as well.
And last but not least, we do need to have
proper hormone balance. So, if you haven't
had your hormones tested, start there. If
you need a resource for getting your hormones
tested because your OB-GYN or reproductive
endocrinologist won't test it for you, then
in the description below, there's a link to
help you get the testing that you need all
on your own. You can order it by yourself.
So you can't do a video that talks about the
eggs and ovarian function without talking
about supplements because I know all of you
are going to post questions about, "Well,
what can I take to improve my ovarian reserve
and the health of my eggs?" Well, I've done
many videos on this specific topic so I'm
not going to talk about the supplements that
you can be taking to improve ovarian health.
But, what I will do for all of you is post
a link below to my favorite supplements that
can help you improve your ovarian health and
function.
I do want to remind you all that just because
these are my favorite supplements doesn't
mean that they are the supplements that you
should be taking. We all have our unique makeup,
our unique issues. And the thing that you
need to do is find out and create your unique
plan to support you on your fertility journey.
This is where you need to work with someone
to understand your specific situation. And
then, you can come back to my favorite supplements
and determine which ones are best suited for
you. If you've already done that and you know
what you need, then awesome, just you use
those links to find the supplements that you
could use to support your fertility and egg
quality and ovarian health. These are the
supplements that I have vetted, I have researched,
and I approve to be safe for your fertility
and egg quality.
And as I wrap this video up, I just want to
reiterate to of you that you have the power,
right? I keep thinking of that song. I've
got the power. I'm not good at singing, but
you do. You do have the power. You have the
power to control and improve your egg quality
and your ovarian health. And the steps that
I just laid out here are the places that you
should be starting to take control and improve
your egg quality, and ovarian health. So,
if you don't remember anything else, I want
you to take this out of this video. You do
have the power to influence and improve your
egg quality and ovarian health. And it starts
with you. So take control of your fertility
and start making changes now.
If you liked this video, then give me a thumbs
up because that lets me know what you like,
and also lets everybody else know that I've
produced an awesome video that they need to
watch, all right. If you're not a subscriber
to my YouTube channel, then you should be.
So make sure you hit that belt to subscribe
and find out when I produce a new video to
help you on your fertility journey. And most
of all, I want you all to stay healthy, stay
safe, and stay fertile.
