Ep. 58: Why Egg Quality is Key, with Dr. Elisa Yao
Caitlin Estes:
Welcome to the Woven Well Podcast. I'm your host, Caitlin Estes. I'm a certified fertility care practitioner with a master divinity degree. Each episode will cover a topic that helps educate and empower you and your fertility, while honoring the deep connection your fertility has with your faith. Let's get started.
Welcome back to the Woven Well Podcast. I'm excited about today's episode, because we're going to be learning all about improving reproductive egg quality. Women from all ages can benefit from this information, but especially those who have identified issues with egg quality through work with a NaPro medical professional or those who are over the age of 40. And our guest today is the perfect person to walk us through this topic, because not only is she a NaPro trained medical professional and integrative and holistic medicine doctor, she followed these guidelines herself to welcome two biological children after the age of 40.
Our guest today is Dr. Elisa Yao. She has a holistic fertility medicine clinic in California. She helps couples get pregnant naturally by searching for and addressing the root causes of fertility issues. She graduated from UC Berkeley with Phi Beta Kappa honors, majoring in molecular cell biology, and completed her medical training at UC Davis School of Medicine. Dr. Yao, thank you so much for joining us today.
Dr. Elisa Yao:
Well, thank you so much for inviting me. It's such a pleasure to be here.
Caitlin Estes:
And it is a pleasure to have you. I'm really excited about this topic, and so much to share with our listeners. Longtime listeners of our show are pretty familiar with a woman's reproductive cycle and the fact that we're born with all the reproductive eggs we will have in our lifetime. So when we talk about egg quality, what do we mean and why is that important?
Dr. Elisa Yao:
Yeah, the reason why it's important is because it is deemed to be the number one factor needed for pregnancy success. And what is it? Well, one way to look at it is that it is the ability of the egg to sustain a pregnancy with a sperm after fusion with a sperm. And so sometimes people may have some confusion over this definition, because perhaps back in middle school sex ed, we were told that when a sperm meets with an egg, that's automatically going to get them a baby nine months later. But if we kind of step back, we realize that yeah, sometimes women can have a positive pregnancy test but end up having a miscarriage, and that is when an egg fuses with a sperm but may not result in a live birth.
And so all told, it's actually estimated about 15% of recognized pregnancy result in miscarriage, but what a lot of people do not realize is that there is actually a much bigger portion of early pregnancies are lost even before the pregnancy was recognized, meaning before a woman even has a positive pregnancy test. So keep in mind that a woman can only have a positive pregnancy test when her body starts producing HCG, and that HCG is not produced until after implantation, and that implantation usually occurs at least about seven days after ovulation. It also takes a couple of days for that HCG to reach a level that is detectable on the pregnancy test.
And so oftentimes, it's not until at least 10 days after ovulation that a woman get a positive pregnancy test, and during that timeframe, that's the time I'm talking about the early, early pregnancy, that there could be a good number of pregnancy loss. So based on research, it is estimated that about 40 to 60% of all fertilized eggs do not make it to a live birth.
Caitlin Estes:
Wow.
Dr. Elisa Yao:
So roughly speaking, yeah, about 35 to 45% of early pregnancies are lost. And so when we're talking about, say, a woman has low egg quality, what that really means is that she has even lower odds of having a live birth when her egg has been fertilized by the sperm.
Caitlin Estes:
Definitely shares why it is important as well, and you shared some facts there that I wasn't even familiar with, so that's certainly important to know. So it's not just enough that we have eggs, but the quality of those eggs makes a big difference to the success of future pregnancies and the possibility of things like a successful fertilization and implantation, even at those very, very early stages.
Dr. Elisa Yao:
Absolutely.
Caitlin Estes:
So obviously, improving the quality of our eggs is important after what you've said. Absolutely. But for any woman interested in conceiving a pregnancy, it's important. But are there particular populations of women who should be maybe especially focused on improving egg quality?
Dr. Elisa Yao:
Yes, certainly. Couples who have experienced recurrent miscarriage, couples who have been diagnosed with unexplained infertility, couples who have failed perhaps even interventions like intrauterine insemination or IVF, and women who are quote, unquote, "older" in their reproductive age. Generally, we're talking about women who are maybe in their late 30s, early 40s, because it is true that egg quality does decline with age. But the good news is that there are things that people can do to improve egg quality.
Now, there are other women that need to focus on egg quality. For instance, women with PCOS, they need to focus on egg quality because they tend to have hormonal imbalances that cause them to have not as high-quality eggs. Whereas women with endometriosis, they tend to have more inflammation in their body, and that can also have a negative impact on egg quality. But in general, I would think that for couples who are just wanting to set themselves up for a higher rate of success, it's a good idea to think about improving egg quality six months even before they actually want to start.
Caitlin Estes:
I so appreciate you mentioning how other aspects of reproductive health are also important and could have an effect, a negative effect even on egg quality, because we really do think about a woman, of course, we think about men too, but specifically with egg quality, we're thinking about a woman's whole body. And it's not just her eggs alone, but it's her entire body and all the systems that have a role and an effect on things like egg quality, so I appreciate you mentioning that as well.
And I know that that's something that you prioritize in your work, because it's not just the egg. We do talk about that a lot, but it's how the health of the entire body is going to have an impact on the reproductive hormones, on the eggs themselves, and ultimately on the potential of a successful pregnancy. So we know what it is and we know why it's important, even who should be focusing on it the most, so we're now eager to hear. We're ready to learn. What can we do on our own to improve our egg quality?
Dr. Elisa Yao:
Right. In order to improve egg quality, we need to first understand what contributes to egg quality. And really, egg quality has a lot to do with the proper development and maturation of the egg cell, and what contribute to that is having good hormonal balance and having healthy mitochondria.
Caitlin Estes:
Okay.
Dr. Elisa Yao:
Yeah. Now, let me explain this a little bit further. Why are hormones important? Well, it turns out hormones like androgens, such as testosterone and DHEA, they're important starting in the three to four months prior to ovulation to get the egg cells to further develop. So if you don't have enough of the androgens, you're going to have poor egg quality. That's an example of how hormonal imbalance can potentially contribute to poor egg quality. However, it's almost like a Goldilocks thing. You don't want to have too much androgens either, because too much androgens, such as testosterone, can potentially impair or inhibit ovulation, so the quality of ovulation may not be as good. That can be problematic as well.
But other hormones involved could be insulin, prolactin, thyroid. One of the first things that you can do is to test to make sure that your levels are in the optimal range. That's part one, and part two about the mitochondria health, that is important because in order for the egg to properly develop, it needs to have a lot of energy, and that energy comes from the mitochondria. And it turns out the mitochondria can be quite susceptible to things like inflammation, free radicals, and even stress. So in terms of what we can do to improve egg quality, well, eating an anti-inflammatory diet, for instance, can be helpful. One of the best things that you can do to eat more anti-inflammatory diet is to cut out sugar or eat a diet that's lower in sugar.
Caitlin Estes:
Yes.
Dr. Elisa Yao:
Yeah, lower in processed food. There are supplements you can take. In general, these are antioxidants, because they can quench those free radicals that can harm the mitochondria. And certainly, having good ways to manage stress can be very helpful as well.
Caitlin Estes:
I appreciate you mentioning stress, because I think that's one of those things in our culture that we sort of say, "Oh, well, everyone's stressed." We kind of discount it as something that's actually important to our health, but it really can make a huge difference in not only how we think and how we perceive the world and whether or not we have trouble sleeping at night, but it can actually help and influence for good or bad the quality of our eggs, and I find that really fascinating.
Dr. Elisa Yao:
Yeah, and the interesting thing I have noticed is that some women may say that they are not stressed, but their body may say differently when we do some testing. And so that kind of goes back to what I was saying a little bit ago, which is it's always good to test and not guess.
Caitlin Estes:
Yes. I found too, that sometimes when I'm talking with clients, they'll say, "Oh, I don't feel stressed," but I remind them it's not just mental stress that affects your body, but maybe physical stress. Are you drinking enough water? Are you getting enough sleep? Are you eating the right nutrients?
Dr. Elisa Yao:
Absolutely.
Caitlin Estes:
Because our body can be physically stressed, even if our mind feels totally great and carefree. There is still a way for our bodies to feel stressed in that, too. Okay, so balancing hormones and prioritizing the mitochondria, and I think that my third or fourth grade teacher would be very proud when I say that I remember that the mitochondria is the powerhouse of the cell.
Dr. Elisa Yao:
Good for you. Good for you.
Caitlin Estes:
That's about all I remember of it, though. Is it possible for you to share a little bit about what the mitochondria is and what role it plays in egg quality?
Dr. Elisa Yao:
Mitochondria is, we call it an organelle, so a part of the cell, and basically it has what's called an electron transport chain, which its job is to manufacture that ATP. And keep in mind that ATP cannot be stored in our cells, so the cell got to be constantly just manufacturing these ATP. And I think I've read a statistic about something like our cell needs 15 billion ATP a day or something like it, and so the mitochondria got its work cut out to do.
How energy is related to egg quality is that energy is required for our chromosomes to be separated correctly while the egg is maturing so that it can get to basically the mature egg cell. And so without enough energy, that separation of the chromosomes can go wrong. And having chromosomal abnormality is by far one of the number one cause of miscarriage, and having a miscarriage, it's correlated with poor egg quality. Hopefully I answered your question about the connection there. Yeah.
Caitlin Estes:
Absolutely did. That was extremely helpful and brought me back up to maybe sixth grade, eighth grade, 10th grade understanding of it, so I appreciate it so much. I'm curious, if we start making these changes and making these priorities in addressing our egg quality, how long will it be until we see an improvement in our overall egg quality?
Dr. Elisa Yao:
Yeah. It takes at least three to four months to improve egg quality. That's a critical timeframe, because as I mentioned earlier, the eggs that are meant for you to ovulate are recruited in the three to four months prior to ovulation under the influence of those androgens. And that's also the timeframe when your mitochondria number in your egg cells starts to amplify at a very rapid pace, so that is a very critical window of opportunity.
Now, sometimes the timeframe can be longer, because it may take someone longer to decrease, say, their inflammation or their insulin resistance, or it takes them longer to change their lifestyle habits, to reduce stress, whatnot. So there are multiple factors, and what I do in my clinic is I continue to monitor certain things like the various hormones and see if we're at target or not.
Caitlin Estes:
And that seems to be a great way to understand if we're moving in that direction of improvement or not.
Dr. Elisa Yao:
Exactly.
Caitlin Estes:
Which is wonderful to have that encouragement that we're headed in the right direction. It's important to know that it's not something that has an immediate effect. You really do need to invest in that future egg quality and egg health, and you're doing that with the choices that you make today.
Dr. Elisa Yao:
Right.
Caitlin Estes:
Thanks for explaining that, and thank you for sharing all of this. This has been so helpful. I think that for many women, being told that they have poor egg quality can feel really overwhelming and make them feel a little bit powerless. "What could I possibly do to help with that?" It feels like something that nobody can make a difference in, but there really is a lot that we can do to invest in our own egg health, especially when we understand what makes up our eggs and our egg health and what we can do to make a difference in it. I so appreciate you, first of all, taking a holistic look at this area, and then for sharing so much about it with us today.
Dr. Elisa Yao:
Yes, absolutely. My pleasure. And I do have an online course called Fertility Breakthrough Academy where I teach people the nitty-gritty of improving egg and sperm health. I go into a lot more detail on how to eat an anti-inflammatory diet, how to avoid different environmental toxins, how to even detox existing toxic burden in our body. And I also give people information about balancing hormones, what are the optimal hormonal values for both men and women, what are good antioxidants to take, and where to get these high quality supplements from, so it could be a good resource for people.
Caitlin Estes:
Absolutely. There is so much more that we have to learn about improving egg quality. This was just the beginning of the understanding of it, and I'm so glad that you shared about your course, because today was just the big main points. But if anyone wants to learn all those details that she just shared, she has very kindly given our listeners a 50% off discount code for this course, which I think is amazing. So I've included our particular link for that discount in the show notes, and anyone who's interested can make use of that as you're listening. And just for the record, I do not get any benefit or kickback or anything like that from listener participation. I just think it can be a very helpful course for those interested in improving their egg quality, and so I am thrilled to be able to offer this discount code with you.
Each week, our podcast focuses on educating and empowering you on an aspect of your fertility while honoring the unique connection between your fertility and your faith. So if you enjoyed this episode, we hope that you'll subscribe to keep listening and leave a review so that others can find us as well. If you're ready to work with us to improve your egg quality and cycle health and work toward your specific fertility goals, then we invite you to join us for this month's introductory session. It's an online presentation that gives you the specifics of how your body works and how to begin utilizing specific information from your body through the use of the Creighton method, the system Dr. Yao and other NaPro professionals use. You can find the link to join us in the show notes. As always, thanks for listening as we continue to explore together what it means to be woven well.