Veganuary: can a plant-based diet affect your fertility?

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First launched a decade ago, the Veganuary campaign had convinced half a million people to adopt plant-based eating by January 2021, almost double the number that had pledged to go vegan for January in 2019.

According to the Sainsbury’s Future of Food report, vegetarians and vegans will make up a quarter of the population by 2025. Individuals adopt a vegan diet for various reasons, including concerns about the environment, animal welfare, and personal health. While reducing animal product intake has proven health benefits, complete elimination may pose risks of nutrient deficiencies, potentially affecting fertility.

What are the pros of a vegan diet for fertility?

  • Eating plant-based foods means an increased consumption of fruits, vegetables, whole grains, nuts, seeds, legumes, and beans that can positively impact fertility, providing essential nutrients such as antioxidants, fibre, and B vitamins.
  • Increased vegetable protein intake by opting for plant-based proteins like beans, legumes, tofu, tempeh, nuts, seeds, and whole grains, instead of animal protein. This may reduce ovulatory infertility
  • Better gut health: A well-planned vegan diet rich in fibre supports healthy digestion and contributes to a balanced microbiome. This, in turn, may regulate hormones associated with fertility-related conditions.

What are the cons of a vegan diet for fertility?

  • Consumption of vegan ‘junk food’ – although these products may be marketed as healthy alternatives, many vegan options are highly processed, containing excess salt, preservatives, and fewer vitamins and fibre. Quality, rather than mere balance, is crucial for fertility.
  • A poorly planned vegan diet can result in nutrient deficiencies, and this is potentially the most significant impact on fertility. Common nutrient deficiencies in a vegan diet include vitamin B12 and iron. Iron from plant sources is poorly absorbable, and a deficiency can affect both male and female fertility. Vitamin B12, found exclusively in animal products, plays a crucial role in DNA production. Deficiencies in these nutrients can negatively impact fertility.

Current research doesn’t conclusively support the idea that eliminating animal products positively influences fertility. Some studies even suggest potential benefits of certain animal products, like dairy, in female fertility. Therefore, adopting a well-balanced diet containing both plant and animal products may be a prudent approach.

Other steps to take include supplementation of essential nutrients, embracing fortified products and enhancing iron absorption by pairing iron-rich vegetables with vitamin C-rich foods or supplements which can aid absorption.

Please visit our Support Hub for information on Fertility Nutritionists that can give you advice on a vegan-friendly fertility diet plan. If you have more questions about preparing for your fertility treatment, call +44 (0) 203 263 6025 or email us admin@ariafertility.co.uk on to book a consultation.

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Answering your egg freezing questions

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Egg freezing provides a unique opportunity to protect your fertility potential and it is becoming an increasingly popular and effective treatment option to preserve your eggs until you are ready to start a family in the future.

If you are contemplating egg freezing, it’s essential you are fully informed about the steps involved and the potential benefits as well as possible drawbacks. Here are just some of the questions we commonly get asked about egg freezing.

What is egg freezing?

Egg freezing is a process in which eggs are retrieved from the ovaries and cryopreserved for possible use later. As fertility declines as you age, your chances of achieving a successful pregnancy will be similar to the age you froze your eggs.

Why should you consider egg freezing?

Today, more and more women are delaying starting a family until later in life due to personal, social or career circumstances. As techniques and technology continue to evolve, egg freezing has become an increasingly popular method of preserving fertility, as freezing your eggs at a younger age may offer a better chance of a successful pregnancy.

How are eggs frozen?

Once the eggs are retrieved from the ovaries, they are assessed, and mature eggs are frozen soon after retrieval in a technique known as vitrification. This flash-freezing method means water molecules do not have time to form ice crystals, resulting in less damage when the eggs are thawed.

What can I expect during the egg-freezing process?

The egg-freezing journey typically takes approximately 14 days. As we want to collect as many mature eggs as possible per cycle, the ovaries are stimulated with hormone injections. We will perform scans and blood tests to monitor the progress so we can time the trigger injection. Egg collection is then timed for approximately 36 hours after this time.

What can I expect from the egg retrieval process?

Egg collection is done transvaginally in much the same way as a transvaginal scan. The procedure typically takes 30 minutes under mild sedation. Your eggs will be collected using a needle that goes into each ovarian follicle and uses gentle suction to pull out the fluid which contains the egg.

Once rested, you should be able to return home after a couple of hours. You may experience tiredness, bloating, mild abdominal pain and light vaginal bleeding for a few days after your procedure. Most patients can resume their regular routine the next day.

Is egg freezing painful?

Some elements of the egg-freezing process can be uncomfortable, depending on your sensitivity. However, the experience is not painful for most women.

The hormone injections can sting a bit, but your nurse will advise on how best to administer these injections. During this time, you can feel very bloated and crampy, varying from patient to patient.

Your egg retrieval will be performed under sedation so you will not feel anything, but afterwards, you may experience some mild abdominal pain and a little soreness.

What are the risks of egg freezing?

Egg freezing is considered a relatively safe, low-risk procedure. One potential risk is ovarian hyperstimulation syndrome (OHSS).

Stimulation of the ovaries is a deliberate aspect of egg freezing, as we try to obtain as many mature eggs as possible. When the ovaries are stimulated, there is a possibility of OHSS developing, which is an excessive response to the drugs used to encourage multiple follicles to form.

Most cases of OHSS are mild to moderate, occurring in up to 5% of all patients undergoing IVF treatment. This can give symptoms such as mild abdominal discomfort and nausea and usually settles with painkillers and maintaining a good fluid intake.

Very occasionally, OHSS can be more severe, causing marked swelling of the abdomen, dehydration, nausea and vomiting and difficulty in breathing. This is uncommon and may happen in up to 1% of women undergoing ovarian stimulation.

The team will manage the risk of OHSS, which might include altering the dose of stimulation medications or using a different trigger injection.

How many eggs should I freeze?

The success of techniques like IVF is dependent on two main factors: the age at which treatment takes place and the number of eggs the ovaries can produce.

With egg freezing, an additional factor to consider is the chances of eggs thawing successfully.

Current thinking is that women under 35 should try to freeze 20 eggs and women over 35 20-30 eggs. However, a woman’s ovaries may respond very differently to stimulation, which means multiple egg freeze cycles may be required to achieve this number.

How long can I store my eggs?

Once vitrified, eggs may be stored for any period up to a maximum of 55 years from the date they are first placed in storage. However, you must renew your consent every ten years; therefore, you must keep your contact details updated with us.

What happens when I’m ready to use my frozen eggs?

Your eggs will be transported from the cryostorage facility to the clinic and thawed. They will then be fertilised with partner or donor sperm using a fertility process called ICSI.

What happens next?

If you decide to proceed with egg freezing, the first step is a consultation with one of our fertility experts and a fertility assessment. Once any relevant investigations are completed, your consultant will discuss the results with you and any implications. They will inform you of what to expect from egg freezing and provide a detailed, fully costed treatment plan.

You will then attend a nurse planning appointment. During this appointment, we will map out the timeline of your egg-freezing treatment. They will also go through the consent process, which will be explained in detail, and your nurse will answer any further questions you may have.

When you are ready to start, you call to tell us when your period has started, and from there, the egg freezing cycle takes approximately 14 days.

If we haven’t answered your egg-freezing question, contact us to find out more.

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Can stress impact your fertility?

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April is Stress Awareness Month and although most of us can manage small amounts of stress – which can even help you focus on achieving short-term goals – chronic stress can eventually affect how you cope with daily life. And, the longer stress lasts, it can even become a threat to your health and wellbeing.

Long-term stimulation of the stress response system means we’re overexposed to cortisol and other stress hormones, and this can lead to mental health problems, insomnia, digestive issues, muscle tension, cardiovascular disease, high blood pressure, stroke, and cognitive impairment.

It is not fully understood how stress affects fertility. Some studies have shown adverse effects, while others don’t, and most are only small-scale studies at this stage. We certainly know that the reverse is true and struggling to conceive can be very stressful. One study published in the Fertility and Sterility Journal surveyed 352 women seeking treatment for infertility and found that more than half of them showed signs of depression and three in four showed signs of anxiety.

So, whether your stress is related to your struggles conceiving or other factors, how does it affect your fertility and pregnancy outcomes?

Stress and your fertility

Stress triggers the body’s fight or flight response. In short, this means releasing stress hormones like cortisol which have an immediate physical impact such as increased heart rate, shallow breathing, high blood pressure and stress headaches.

When you are experiencing a prolonged period of extreme stress, the body will shut down any systems that it does not deem necessary for survival. This is why you can experience hair thinning a few months after a very stressful situation – telogen effluvium is a type of hair loss that results from an interruption in the normal hair growth cycle. In terms of your fertility, this can cause delayed or absent ovulation and irregular or missed periods.

In one small-scale study from 2015, women in the high stress group based on perceived stress assessments were found to have lower levels of oestrogen, progesterone and luteinising hormone. They also had higher levels of follicle-stimulating hormone during a particular stage of their cycles which meant an increased chance of anovulation which is when an egg is released from the ovary during your menstrual cycle. Chronic anovulation is a common cause of infertility.

[ext link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315337/]

Another key stress hormone, CRH or corticotrophin-releasing hormone, is present in diseases that cause inflammation. Abnormal levels of CRH can affect the uterine lining and placenta and therefore could adversely affect implantation.

However, not every study has found a link and 2019 investigation found no difference in conception rates in women based on their daily reported perceived stress levels and a 2017 study of women undergoing IVF concluded that perceived stress and high cortisol levels “were not associated with IVF cycle outcomes”.

Managing stress during IVF

At Aria Fertility, we know how important it is to find ways to manage your stress throughout your fertility journey. Our doctors, nurses and embryology team provide comprehensive patient care combined with a wealth of medical experience and expertise, so you know you are in the best possible hands.

In our Support Hub, we have brought together organisations and individuals that offer fertility support, advice and information. Methods for managing stress encompass counselling, acupuncture, reflexology, and nutritional support.

For more advice on managing stress during your fertility journey, call +44 (0) 203 263 6025 to arrange a consultation.

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What is the difference between egg freezing and embryo freezing?

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Since Jennifer Aniston opened up about her own experiences with IVF and expressed her regret that she had not undergone egg freezing earlier, even more women have begun exploring their fertility preservation options.

Women now have the option of freezing their eggs or embryos, but there are critical differences between the treatments that can determine the best choice for them.

The collection stage

Both procedures start with the same basic premise of egg collection. You will self-administer hormone injections, stimulating the ovaries to produce mature eggs over 8 to 12 days. We will monitor your progress during this stage, and your eggs will be collected at the optimal time. This is a minor surgical procedure performed under sedation in the clinic. The collected eggs are then transferred to our laboratory.

To fertilise or not fertilise

This is the crucial difference between the two treatments. Before they are frozen, the eggs can be fertilised in our laboratory using either your partner’s sperm or donor sperm.

This takes place on the same day as the egg collection. Our embryologist will try to fertilise all mature eggs using intracytoplasmic sperm injection, or ICSI. If successful, the fertilised eggs will develop into an embryo. Over the next five to six days, the embryos will be carefully monitored as they hopefully progress to the blastocyst stage. The embryos that successfully develop to this stage are then frozen.

The freezing and storage process

Both eggs and embryos are frozen and stored using a method known as cryopreservation. Water in the cell is replaced with a freezing solution called a cryoprotectant which prevents this water from crystallising in the freezing process. The freezing process is called vitrification and entails flash freezing, instantaneous cooling from 37oC to -196oC. The eggs or embryos are then stored in liquid nitrogen.

Using your embryos or eggs

When you’re ready to use your embryos or eggs, our embryologist will thaw them. An embryo that has successfully thawed can be transferred directly back into the body. Frozen eggs that survive the thawing process will then be injected with a partner or donor’s sperm to fertilise them. The fertilised eggs will then develop into embryos and after five to six days can then be transferred to the womb.

The pros and cons of egg freezing vs freezing embryos

Previously, slow-freezing technology was used to freeze eggs or embryos. The cells were cooled very slowly over a couple of hours to avoid ice crystallisation until they reached the optimal storage temperature. Embryos were thought to survive the freezing and thawing process better than eggs as the latter are large size cells with a high-water content, so they are more susceptible to ice crystals forming and causing cellular damage.

The introduction of vitrification or flash freezing has largely eliminated this difference, and the survival rates when freezing eggs versus embryos are now very similar.

Choosing to freeze embryos means you have more information on how many eggs were healthy enough to fertilise and begin development. However, the most important difference is that freezing eggs rather than embryos grants women reproductive autonomy, giving them more options in the future.

Aria Fertility Counselling

Discussing your treatment choice with one of our counsellors can be a very rewarding and empowering session. At Aria, we wish for everyone undergoing fertility preservation treatment to have a full understanding of choices they are making and implications these may have for the future. Our wonderful counsellors will always be able to spare time to have a chat with you and help you come to a decision if you feel you require their expert support.

If you have more questions about our fertility preservation options, call +44 (0) 203 263 6025 or email admin@ariafertility.co.uk to arrange a consultation with one of our fertility specialists.

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What are mosaic embryos?

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New research has found that mosaic embryos, currently ruled out for IVF selection, could self-correct and lead to healthy pregnancies.

During embryo selection, a test known as preimplantation genetic testing for aneuploidy (PGT-A) is used to screen aneuploid embryos which have an incorrect number of chromosomes. This is performed to reduce the risk of miscarriage.

Embryos with the correct number of chromosomes are called euploid and have a higher chance of leading to a successful pregnancy than those with the incorrect number of chromosomes or aneuploid embryos.

What are mosaic embryos?

Previously, embryos were categorised as normal or abnormal, but in the mid-2010s, embryologists discovered that blastocysts aren’t necessarily 100% euploid or 100% aneuploid: sometimes they’re a mixture.

The term mosaic embryos were coined to describe embryos that have a mix of normal and abnormal cells. Data suggests that mosaic embryos account for up to 20% of all PGT-A-tested embryos.

Mosaic embryos can have different proportions of normal and abnormal cells and there is a criterion ranging from low-level mosaic where 20 to 40% of the cells are abnormal to high-level mosaic.

What did the study into aneuploid embryos find?

Scientists at the laboratory of synthetic embryology at Rockefeller University, New York found that some aneuploid embryos can self-correct. They transferred embryos that had failed the PGT-A screen into women who’d given their consent. Genetic tests performed a few months later found there were no longer any signs of aneuploidy.

The next stage of the study was to understand how the ‘faulty’ embryos developed. Using human embryonic stem cells, they generated artificial human embryos and studied their development. They found that the proportion of the aneuploid cells decreased and the aneuploid cells that remained were in the outer layer which eventually becomes part of the placenta.

As this research shows, the science behind embryo selection continues to evolve and PGT-A is one tool to help us choose which embryos to transfer. Throughout the process, we provide you with all the information you need to make these important decisions.

For more advice on IVF and embryo selection, call +44 (0) 203 263 6025 to arrange a consultation at Aria Fertility.

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Why do I need to freeze so many eggs?

The more eggs you freeze, the higher your chance of success is regarding fertilisation. This is because at each stage of the process there is a decrease in the number of eggs that survive to the next one. Dr Anna Carby outlines each stage and how the number of eggs decreases between them.

“The thaw survival rate for eggs is between 80 and 90%. Of that surviving thaw, the fertilisation rate is approximately 60 to 70%. Of the fertilised eggs remaining approximately 40% may be usable in terms of either transfer or freezing as embryos. It can be seen therefore that starting with 20 eggs may result in three or four embryos being produced.

“You must also be aware that occasionally these percentages are lower when it comes to thawing and that it is possible, though far less likely, that no embryos are produced as a result of thawing.”

What should you look for in a fertility clinic?

Dr Carby clarifies how “the skill of your team will contribute to the potential success of treatment if you use your eggs in the future. Speak to as many clinics as you can before deciding which clinic to go to. This usually gives you a good indication as to the level of service and the feel of the clinic and team.

“Find out if your clinic offers investigations before or during your consultation which can cut down on the visits required to the clinic.”

Contact us with any inquiries that you have regarding the egg freezing treatment by calling us on 0203 263 6025 or emailing us at admin@ariafertility.co.uk.

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What happens after egg freezing?

After egg freezing, there are many different paths that you can take. Dr Anna Carby discusses the different possibilities.

How long can I store my eggs after egg freezing?

After the fertility preservation treatment, your eggs will be stored, however, there is a limit. “Currently eggs can be stored for 10 years. However, in some circumstances, you may be able to store your eggs for up to 55 years.”

Interestingly, though, this limit has been extended in view of COVID-19.

What would I need to do to use my eggs in the future?

“The process of preparing for an embryo transfer is easier than the stimulation and egg collection required for egg collection. Usually, either oestrogen tablets or patches are used to build up the womb lining for approximately two weeks.

“If the lining looks thick enough on the ultrasound scan, progesterone is then used before embryo transfer to synchronise the lining to the age of the embryo generated,” Dr Carby explains. “This usually means starting progesterone on the day eggs is thawed. These medications then need to be continued until 12 weeks of pregnancy after which time they can be stopped.

“Once eggs have been thawed, they are injected with sperm using a process called ICSI (intracytoplasmic sperm injection) as the normal layer of surrounding cells is stripped before freezing to allow rapid colling of the eggs.”

What if I don’t use my eggs?

Egg freezing is often chosen as insurance, but what if you find you don’t need to use those eggs in the future?

As Dr Carby elaborates, “only approximately 10% of women freezing their eggs ever use them. This is because some will get pregnant naturally when they find a partner or others may decide they don’t wish to use them.”

Contact us with any queries that you have regarding the egg freezing treatment by calling us on 0203 263 6025 or emailing us at admin@ariafertility.com.

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How can I prepare for egg freezing?

There are many reasons why women decide to freeze their eggs and advances in egg viability once they have thawed means this procedure is becoming increasingly popular. However, there is a lot to consider in order to prepare for egg freezing, both mentally and physically, before you enter treatment.

How do I prepare for egg freezing mentally?

The consultation is an important part of the process to ensure you are happy with the clinic’s techniques and protocols. This is because there are two different sets of risks associated with egg freezing.

As Dr Anna Carby explains, “generally the chances of a significant complication with egg collection are less than 1% – these risks are infection, bleeding and damage to the pelvis.
Another condition called ovarian hyperstimulation can occur when the ovaries are stimulated for treatment such as egg freezing.”

However, it is important to note that “in the vast majority of cases this is avoidable by using specific protocols and medications with careful monitoring of treatment cycles.”

Therefore, it is crucial to ensure that you discuss your clinic’s approach to treatment with your clinic so that they can assess whether you are at higher risk of this happening.

How do I prepare physically?

Your ovarian reserve can be affected by several factors. Firstly, however, it is important to understand exactly what an ovarian reserve is.

Dr Anna Carby describes it as “the capacity for your ovaries to respond to stimulatory drugs and is generally measured with hormonal testing and an internal ultrasound scan looking at the ovaries and specifically the number of small follicles in each ovary – known as antral follicles.”

“Before going through egg freezing your doctor will make an assessment as to your general health. Your BMI is important as the process usually involves some sedative drugs through your veins. If your BMI is high (35 or over) you may need to lose weight before going through this process.”

“There are no specific dietary requirements ahead of treatment but wherever possible be as healthy as you can – eat a varied diet, try to do some regular exercise and although you can drink when doing egg freezing it is sensible to have no more than the recommended daily amount and not to have alcohol in the days immediately before and after egg collection.”

Contact us with any questions you have regarding the preparation for the treatment by calling us on 0203 263 6025 or emailing us at admin@ariafertility.com.

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What is ovarian reserve testing?

Ovarian reserve testing is an important process in successful fertility treatment. Dr Anna Carby explains exactly what this is.

What is ovarian reserve testing?

“You will frequently see this term referred to in fertility clinics. This is the capacity for your ovaries to respond to stimulatory drugs and is generally measured with hormonal testing (particularly AMH – anti-Mullerian hormone testing) and an internal ultrasound scan looking at the ovaries and specifically the number of small follicles in each ovary – known as antral follicles.

“In general, the higher the AMH and the total number of antral follicles, the higher the expectation that the ovaries could respond to stimulation.”

What does this tell me about my natural fertility?

Dr Carby points out that “your ovarian reserve has little bearing on your ability to conceive naturally and cannot be used as a marker of this. Generally, the tests performed for egg freezing do not tell us anything about whether your tubes (fallopian tubes) are open or damaged. Ovarian reserve testing is only used as a marker of response in assisted conception treatments such as IVF and egg freezing.”

Does anything change my ovarian reserve?

There are a few elements that can change your ovarian reserve, as Dr Carby reveals: “Ovarian reserve will get lower with age – this is a natural biological process. In addition to this, smoking is known to affect ovarian reserve. Whilst it is possible to undergo egg freezing if you smoke the outcome you may gain from treatment may not be as good.

“In addition, some contraceptives such as the Pill and some coils such as the Mirena coil can lower ovarian reserve. Depending upon how urgent egg freezing is it may be sensible to repeat ovarian reserve testing a few months after stopping or removing devices. Some studies suggest an up to a 20% decrease in ovarian reserve with contraceptives. Currently, there are no medications known which can improve ovarian reserve.” 

To arrange a consultation with Dr Carby to discuss further or organise ovarian reserve testing call us on 0203 263 6025 or email us at admin@ariafertility.com.

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Should I freeze my eggs?

There are many different considerations as to why you might decide to have your eggs frozen.

As Dr Anna Carby explains, “you may be single or in a relationship but perhaps not sure that you want to start a family at this moment or indeed ever. Perhaps you have a medical or surgical problem that may threaten your fertility – ranging from cancer to a family history of periods stopping early or other conditions that require medication that may alter the function of your ovaries. You may be transitioning and want to freeze eggs before undergoing surgery or hormonal treatment affecting your fertility.”

What must be considered prior to egg freezing?

“The success of egg freezing is related to the age at which eggs are frozen. Generally, the success rates with egg freezing start to fall after the age of 34 and therefore ideally it is good to freeze eggs before this time in your late twenties or early thirties.

“However, the actual age at which you freeze eggs may well be related to factors you can’t predict – relationship breakups, medical and surgical issues, gender issues. It is really important to talk to your doctor about the chances of success with treatment.”

Dr Anna Carby also explains what physical assessment might be made. “Your BMI is important as the process usually involves some sedative drugs through your veins. If your BMI is high (35 or over) you may need to lose weight before going through this process.”

If you are contemplating whether you should freeze your eggs, Dr Anna Carby can discuss the process in full with you in a consultation and advise whether you are suitable for egg freezing. To arrange a consultation with Dr Carby to discuss your fertility journey call us on 0203 263 6025 or email us at admin@ariafertility.com

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