Aging and Environmental Factors Affect Embryo Growth

Ageing and the Environment for Egg, Sperm and Embryo Health

• positive environmental factors include; androgen supplementation (testosterone), healthy diet, exercise, nutritional supplements and pyschological interventions
• negative environment factors include; ageing, reduced androgens, oxidative stress, obesity, smoking, alcohol, oxidative stress
• CoQ10 – antioxidant found to be very important for cellular energy and energy for cell division, reducing CoQ10 was associated with a reduction in the number of follicles, the recommended daily dosage is 600mg per day for at least 2 months prior to IVF
• Androgen (eg, testosterone) – adrenal DHEA and testosterone decline with age and are associated with reduced number of follicles, increased cell death and reduced egg competence
• Antioxidants – reduced antioxidants reduce embryo quality, affects sperm DNA fragmentation and it’s recommended for all men over the age of 40 years old to be supplementing, vitamin C is the most cost effective antioxidant, increase pomegranate, berries, chocolate, espresso, fruits and vegetables, turmeric, cumin, ginger and oregano
• Obesity – associated with high level of oxidative stress in follicular fluid, moderate exercise was associated with 3 fold increase in clinical pregnancy, weight loss is recommended as well as supplementation of omega 3 and antioxidants
• Smoking – for the female smoker it can reduce IVF success by half and increase miscarriage rate by one fourth, a similar trend was found even with donor eggs so there is a uterine effect as well as ovarian, for the male partner smoking is associated with reduction in IVF success, results in severe oxidative stress, recommended to high does antioxidants and quit smoking 3-6 months before considering IVF
• Alcohol – reduces IVF success and increases miscarriage rates, suggested to avoid throughout IVF cycle
• Caffeine – conflicting research, advise to limit consumption
• AGEs (advanced glycation end product) – toxic end products from high glucose diets and ingestion of food at high temperatures, suggested to boil, microwave or poach food to cook to avoid
• BPA (bisphenol A) – a chemical found in plastic containers, canned food linings and credit card receipts, high levels found to show lower implantation rates, also associated with miscarriage and reduced sperm quality
• Exercise – moderate exercise recommended, found to improve egg and sperm function and IVF outcomes, also reduces oxidative stress, vigorous exercise can however reduce IVF success although not in obese women, men cycle more than 5 hours per week was found to reduce semen quality, proposing increased heat as the reason
• Diet – recommendations include less red meat, less saturated fats, more seafood, more fruit and vegetables – similar to a Mediterranean diet
• Omega 3 fatty acids – exist in large quantities in sperm membranes, early research shows it improves IVF outcomes, suggested to supplement with 1800 mg per day for 6 months to increase total sperm, motility and morphology
• Stress – stress of infertility has been compared to having a diagnosis of HIV, depression and anxiety are negative factors for pregnancy outcomes, negative life events 12 months before IVF cycle predicted failure and reduced number of eggs retrieved, suggested that stress shifts blood flow to the heart, brain and muscles and away from non essential organs like ovaries and uterus, decreases in anxiety were associated with the greatest improvement in pregnancy rates, suggested treatments included cognitive behavioural therapy and mind body sessions to work on relaxation, stress management, lifestyle recommendations and group support, also to deal with cycle failures