Consider getting an AMH blood test (approx. $79) and an antral follicle count (AFC) ultrasound in your late 20s/early 30s to understand your egg quantity. This information allows for informed family planning decisions, such as accelerating pregnancy attempts or considering egg freezing, especially since egg quality and quantity decline significantly after age 37.
Understand that harvesting eggs for freezing or IVF does not reduce the total number of eggs in your ‘vault’ or cause earlier menopause. The process stimulates the growth of eggs that would have been lost that month anyway, rather than drawing from future reserves, addressing a common misconception.
If not ready to have a family by age 32-33, consider freezing your eggs. This is the optimal time for the average person to intervene, as it offers the best intersection of good egg quality and quantity.
Prioritize adequate sleep for overall reproductive health. Sleep is crucial for cellular repair and dropping inflammation levels, which are toxic to eggs and sperm and not ideal for conception.
Adopt a diet high in fruits, vegetables, and whole grains, and limit red meat consumption (not daily) and processed meats. This decreases inflammation, improves fecundability, ovulation, IVF success, and decreases miscarriage rates.
Avoid added sugars and artificial sugars in your diet. These cause inflammation, stress reactions, and can lead to higher rates of miscarriage.
Avoid smoking cigarettes, vaping nicotine, and cannabis (edible or smoked), and consume alcohol in moderation (1-2 drinks a week at most) if trying to conceive, and none at all once pregnant. These substances negatively impact egg and sperm quality, increase miscarriage risk, and have fetal impacts.
If in reproductive years, take a prenatal vitamin with folic acid, 1000 IU of Vitamin D, and 1 gram of Omega-3 fatty acids (EPA form) daily. If trying to get pregnant, also take CoQ10 at 200mg three times a day. These supplements support cell division, prevent neural tube defects, reduce inflammation, and improve egg/sperm quality.
For women with PCOS, consider taking 2000mg of Myo-inositol. This supplement helps the body be more sensitive to insulin, potentially decreasing inflammation and testosterone production from the ovary.
For men with any abnormal sperm parameters, consider taking a gram of L-carnitine with a gram of Vitamin C, along with a multivitamin and CoQ10. This protocol aims to improve sperm quality, motility, and reduce DNA fragmentation.
If going through menopause (average age 51-52) or premature ovarian failure, consider Hormone Replacement Therapy (HRT) with estradiol and a progestin, initiated at the beginning of the transition. HRT can improve brain, bone, and cardiovascular health, and enhance quality of life by alleviating symptoms.
If diagnosed with premature ovarian failure or low ovarian reserve, understand you will likely go through menopause early and should consider HRT at the onset of symptoms. Early intervention with HRT can improve both the quality and longevity of life.
If anyone in your family has a history of deep vein thrombosis (DVT) or pulmonary embolism (PE), get screened for clotting disorders (e.g., Factor V Leiden) before taking the birth control pill. If a clotting disorder is found, avoid the birth control pill.
If using a progesterone-based IUD (e.g., Mirena, Kylina, Lailetta) that has caused an absence of periods, remove it 3-6 months before trying to conceive. This allows the uterine lining to regrow sufficiently for a regular period pattern and implantation.
Avoid the Depo-Provera shot if contemplating family building soon. It can prevent ovulation for up to 18 months, making it difficult to conceive quickly after stopping.
Use unscented products, especially with children (e.g., laundry detergent, shampoo, conditioner, soaps, body oils), and avoid rubbing lavender oil on babies. This decreases lifetime exposure to toxins and endocrine disruptors, which can accelerate puberty onset and impact development.
If considering a vasectomy, freeze sperm beforehand. Life circumstances can change, and vasectomy reversals are not always successful or may not result in sufficient sperm for natural conception.
If trying to conceive, have intercourse daily during the fertile window (5 days ending on the day of ovulation). Studies show this is associated with the highest chance of fecundability. If daily intercourse causes stress, aim for every other day, targeting the day before and day of ovulation.
Consume full-fat dairy products (e.g., whole milk, yogurt, cheese) rather than processed or skim versions, and include healthy fats from sources like avocados, nuts, and fish. Healthy fats are essential for hormone production and overall reproductive health.
Limit fish consumption to three servings per week if pregnant due to mercury concerns, and avoid raw seafood (sushi, sashimi) during pregnancy due to the risk of infectious disease.
When going through egg freezing or IVF, ensure your clinic uses IV sedation (e.g., Propofol) for egg retrieval. This helps avoid extreme pain during the procedure.
Consider genetic testing (PGT for aneuploidy) of embryos during IVF, especially if older. This allows for higher efficiency and success rates, reduces failed transfers and miscarriages, and helps in batching cycles for future family growth.
If you have frozen embryos, keep them in storage until you are certain you are done having children. Life circumstances can change, and having embryos available can provide future opportunities for family building.
For individuals with a normal egg count, do not opt for minimal stimulation protocols (low stim) during IVF unless specifically advised by a specialist. Minimal stimulation results in fewer eggs, lowering the odds of ultimate success.
If going through egg freezing or IVF, abstain from intercourse from approximately day 5 of stimulation until your next period (about 3 weeks). This prevents infection and avoids the risk of ovarian hyperstimulation syndrome (OHSS) if pregnancy occurs.
If on Hormone Replacement Therapy, choose an estrogen that mimics estradiol (e.g., pills, vaginal inserts, patches) and combine it with a progestin. This combination helps alleviate symptoms and provides health benefits while preventing endometrial cancer.
Men over age 50 should be aware of the increased risk of certain negative outcomes (e.g., autism, autosomal dominant disorders) associated with advanced paternal age. This information can inform family planning decisions.
Dissolve one packet of Element (electrolytes without sugar) in 16-32 ounces of water when waking up and during physical exercise. This ensures adequate hydration and electrolytes for optimal brain and body function, as even slight dehydration diminishes cognitive and physical performance.
Use meditation, mindfulness training, yoga nidra, or non-sleep deep rest (NSDR) protocols. Short sessions (e.g., 10 minutes) can greatly restore cognitive and physical energy and help place the brain and body into different states.