In the above run-down, I’m just pulling out the author’s conclusions based on her review of the research, and I’m leaving out all the rationale and research details behind each idea, as well as specific recommendations on how to or how not to apply these measures. If you’re wanting to implement these recommendations, I would encourage you to read the book or do your own research, so that you can be as informed as possible. The beauty of this book is that it’s designed to educate you so that you can come to your own conclusions. Newer research may have come out since the publication of this book, so that is worth considering as well. My Reactions

Right off the bat, Fett misleads her readers. She talks about how she was diagnosed with diminished ovarian reserve (DOR) in her mid-20s, right before she underwent IVF. She claims she was told she would be “unlikely to conceive with her own eggs.” Determined to prove the medical community wrong, she ate really healthy, exercised a lot, and did a bunch of research on which supplements could improve her egg quality. And yay! She got 20 eggs at egg retrieval. (This is an average number, btw.) And she and her husband got 19 embryos. They “set a fertility clinic record” with their unusually high amount of embryos. I already didn’t consume sugar or gluten and almost never drank alcohol, so that was easy. A huge takeaway was the information on L-Arginine, which I had been taking for over a year at the recommendation of a different fertility book. I removed that and ate super clean, Mediterranean style, as she suggested. All organic, lots of salad and protein! I also lowered my caffeine significantly, which was probably the hardest part initially. We already used clean products and all glass Tupperware. Many of the book’s recommendations are universal, like reducing exposure to endocrine-disrupting chemicals. The recommendations become more granular, however, when it comes to supplement plans for women in different situations. To simplify things, here, we put together four supplement-focused recommendations from “It Starts with the Egg” specifically for women who are coming to the journey later in life. However, women in their 40s do face particular challenges when it comes to reproductive health. Studies show that it becomes progressively harder for women to get pregnant after about age 35, and once pregnant, complications become more common with age. As high-achieving planners, many women who pursue a pregnancy in their 40s do everything they can to prepare for a healthy pregnancy. While it is always a good idea to maintain a healthy diet, it is especially important when you decide to become pregnant. It can be difficult to get all of the prenatal nutrients from diet alone (that's why doctors recommend taking prenatal vitamins), healthy diet is the foundation.

There is some evidence that it could reduce miscarriage risk by lowering insulin levels, “but further research is needed.” To cover all your bases, The Powers for Females includes all these nutrients and more—each at optimal doses and in bioavailable forms. Here, we dive into some of the most common questions about these ingredients. What kind of Folate should I take?

I have not explored in great depth her research sources, so I can’t speak to the quality of her research review process. Most of her conclusions are consistent with other things I have read in my less-scientific gathering of information off the internet. She discusses the controversy around DHEA and concludes that arguments against its use are probably not warranted. I have come across enough cautions about its use and recommendations for medical monitoring of its affects, that I would personally recommend further exploration of the research and consultation with a medical practitioner if you choose to consider DHEA supplementation.So if you’re struggling to conceive, timing sex right is only part of the picture. Taking steps to optimize egg quality is equally, if not more, crucial. My husband implemented a few things out of curiosity and said he feels better, has more energy, can ride his bike longer, and is recovering faster from his workouts. Five essential takeaways from "It Starts With the Egg" 1) Avoid phthalates and other toxins when trying to conceive What simultaneously disappoints me and excites me about the book is that I believe there could be many more chapters on this topic. There is a whole follow-up to this book, just waiting to be written. Based on the notion that boosting mitochondrial functioning leads to higher quality eggs, it appears to me that any other measures that could impact mitochondria could also affect egg quality. Various healthy lifestyle practices such as stress reduction, sleep, and exercise have been shown to have a positive impact on mitochondrial functioning and none of these are even mentioned in this book. In my mind, the list of possible pathways to influence egg quality could be quite extensive.

However, if your ovarian reserve is moderately or severely diminished (which was my case at age 32), then sadly there's very little that will actually make a difference. We're born with all the eggs we'll ever have, so once the quantity/quality is low, I'm afraid that's more or less it.

How much Vitamin B12 do I need for fertility?

The BPA chapter in the 2019 edition is pretty good. I’m sure it was a lot crunchier and cringier in the first edition, but the edition I read gives practical tips for how to reduce your BPA exposure while also assuring you that BPA isn’t in every plastic, and that it’s impossible, and unnecessary, to stay away from BPA entirely. To me, even if BPA wasn’t bad for your fertility, replacing your plastic cups and Tupperware with glass is better for the environment anyway. It’s a win-win situation. One CRAZY MIND BLOWING thing I read, was that men think they're off the hook if they pass a sperm test--but she points out the tests only look at how many sperm and how they are swimming. The test doesn't look at their DNA! So what's the point of having a lot of sperm if they're defective? Fortunately, men can improve their sperm quality and she has a chapter dedicated to that as well.