Whether you are trying to conceive naturally or through IVF, the quality of your eggs will have a powerful impact on how long it takes you to get pregnant and whether you face an increased risk of miscarriage.

The conventional thinking is that women are born with all the eggs they will ever have and that the quality of those eggs declines drastically with age. But this is not the whole story. Most of our lives, our eggs are in a state of suspended animation as immature cells, but in the three to four months before ovulation, an egg must undergo a major transformation. It grows dramatically in size and starts producing much more energy. The egg must then execute a precise process of separating and ejecting copies of chromosomes. If this process goes wrong, and it often does, the egg will have chromosomal abnormalities. These chromosomal abnormalities are the single most important cause of early miscarriages and failed IVF cycles as well as the reason it takes older women so much longer to conceive.

Many women are told there is little they can do to improve egg quality, but the latest research defies that old assumption. The growth phase before ovulation is a critical time during which many things can happen that affect the quality of the egg, both positively and negatively. These include harmful effects from exposure to toxins such as BPA and phthalates as well as protective effects from added antioxidants and other nutrients. As a result, there is a brief window of opportunity in which you can make a difference to your egg quality.

It Starts With The Egg is a detailed guide to specific strategies that are supported by strong scientific research. Importantly, the advice in the book is not based on isolated animal studies that provide enticing hints as to the causes and solutions for poor egg quality. Individual studies, and particularly animal or test-tube studies, provide only limited evidence and must be taken with a grain of salt. Instead, the book is based on a comprehensive analysis of a large body of medical research involving studies that have been confirmed by multiple groups and that involve real patients.  (For links to over 400 of the scientific studies cited in the book, see my collection at the NIH PubMed website ).

Part 1 of the book explains the basics of egg quality, the importance of avoiding hormone-disrupting chemicals such as BPA and pthalates, and other common obstacles to fertility such as celiac disease and hypothyroidism.

Part 2 explains how to choose the right supplements for your specific circumstances, with detailed explanation of which supplements are supported by scientific research and which are best avoided.

Part 3 of the book addresses the bigger picture, such as nutrition and factors that impact sperm quality.

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