Egg and Sperm: Gimme the Good Stuff
Eggs and sperm are both extremely sensitive to oxidative stress, which is a type of cell damage that comes from free radicals. Free radicals are irritating little molecules that can come from many sources. Some come from the environment, and some come from our food, but the majority actually come from our own cells - when we burn fuel to make energy, free radicals are left behind.
Usually this is no big deal. Our bodies have lots of ways to get rid of free radicals. But to do so, we need certain nutrients, like vitamin A, vitamin C, copper, zinc and selenium. If we have those nutrients in abundance, we're ok. But when we have free radicals coming at us from our own cells, PLUS our food, PLUS the environment, and on top of that our nutrition is so-so (not a ton of vitamin C in french fries, unfortunately), we can end up with high levels of oxidative stress.
This wreaks havoc on eggs and sperm. It can cause poor egg quality, low sperm morphology and motility, and high levels of sperm DNA fragmentation. All of this can lead to low fertilization rates and even early pregnancy loss.
Hormones, Ovulation, and Food
Fertility isn't just about egg and sperm quality. If you want to get pregnant via any method other than IVF, you or your partner or surrogate have to ovulate! That's when the egg is released, at a (hopefully somewhat) predictable time so the sperm/egg meet-up can be arranged.
All of these hormones are affected, either directly or indirectly, by what you eat. High carbohydrate diets, especially diets with lots of refined sugar, can keep insulin and leptin levels high. This may cause your body to become “resistant” to these hormones (like a child who’s parent has called their name too many times and they’ve become “selectively deaf”).
Thyroid hormone levels can also be strongly affected by what you eat. Food allergies and sensitivities, in addition to certain mineral and vitamin deficiencies, can lead to lower levels of thyroid hormone. This can cause problems with ovulation and even increase miscarriage risk.
Hippocrates Got it Right...
... when he said "Let food be thy medicine, and let medicine be thy food." Or, if he didn't really say that (as many cynical historians claim), at least I can quote a well known Ayurvedic proverb: “When diet is wrong, medicine is of no use; When diet is correct, medicine is of no need."
If you had a chance to read my last post, What is PCOS and How Can it Affect Your Fertility, you make have seen some surprising info about PCOS:
It’s way more common in queer people!
Yes, that’s right - in a 2004 study in Fertility and Sterility, queer-identified cis women were more than twice as likely to have PCOS vs straight-identified cis women. PCOS is even more prominent in individuals with ovaries that identify as non-binary or transgender - in several studies, an average of 30-60% of nonbinary / transgender people with ovaries had PCOS (compared to 7-12% in the general population).
There’s been a lot of debate about this. Many queer folks are uncomfortable with the idea of scientists finding out a “cause” of being gay, or with the implications that higher androgen levels (which are a part of the overall PCOS picture) would make someone who is assigned female “more like a man” and therefore queer or trans.
First of all, f*** that.
Scientists that see queerness or trans-ness as “abnormal” are always going to look at our sex hormones, sexual desires / behaviors, and sexual characteristics as part of their scientific spectrum of pathology, rather than as part of the incredible, beautiful diversity of this queer world. They are going to do that with whatever information they get about our bodies and our lives - that shouldn’t hold us back from having access to studies and the information they give.
Second of all, so what?
So what if PCOS is masculinizing to some people’s bodies, and for some people that informs their sexual or gender identity (and to be clear, there are TONS of people with PCOS who are femme, cis-identified...just saying)...? To borrow language from adrienne maree brown, our sexualities and our gender identities are emergent properties of our overall emergent beings. We are the sum of our complexities and we spill over from there.
I myself am a nonbinary / trans-masculine / queer person with PCOS. I see my extra androgens as a lucky blessing. They both enhance and, yes, inform my own queerness. So be it.
And lastly, when it comes to our fertility, we need the information. We need to know about our odds of having hormonal variations that respond well to specific types of dietary changes and herbs. Variations that can affect how much we respond to hormones in IVF, or change our risk for things like ovarian hyperstimulation syndrome.
If PCOS really is more common in our community, we need to put the effort and research into knowing how to respond, so that we have the best odds of starting our families.
PCOS stands for Polycystic Ovarian Syndrome, a natural variation in the genes that control certain hormones in the brain. Because of this variation, in PCOS androgens (masculinizing hormones) are slightly elevated, which can cause acne, high sex drive, and facial hair growth. In addition, the hormones that control ovulation (LH and FSH) can sometimes be balanced in a way that makes ovulation either irregular or not happen at all.
How common is PCOS?
PCOS is very common, and it’s been around for a LONG time - Hippocrates was even writing about it 2,400 years ago! In fact, PCOS is one of the most common sexual variations in people assigned female at birth. It’s common in cis-hetero women and especially common in LGBTQ+ people.
How common? In one study that looked at cis-gender women presenting to a clinic for fertility support, 14% of straight women and 38% of lesbian/queer-identified women had PCOS.
Are There Any Benefits to PCOS?
For masculine-of center and nonbinary people, PCOS can support an androgynous appearance or even help with secondary sex changes during testosterone therapy. And for people who are not trying to get pregnant, PCOS can result in fewer menstrual cycles, or a longer time between cycles. For many people this is seen as a huge benefit.
But… How Can PCOS Affect Your Fertility?
Because PCOS can stop your body from ovulating, it can make getting pregnant at home or via IUI difficult, as ovulation can be hard to predict (or not happen at all, even if you have a period).
When PCOS goes untreated, it can result in poor egg quality and can also cause insulin resistance, which elevates insulin levels in the body. High insulin is toxic to a brand new embryo, and even if someone with PCOS does get pregnant, this can cause a miscarriage.
To Sum it Up
Because of changes in ovulation and insulin levels, PCOS can be a major barrier for people trying to get pregnant or do reciprocal IVF. But don’t lose hope! Because we’ve known about PCOS for so long, we have TONS of ways to treat it - from hormone balancing herbs to oocyte-nourishing amino acids and carbohydrates. We also have excellent treatments for high insulin levels, including dietary changes, medications, herbs, and specific nutrients.
There are lots of things to think about when deciding whether to use a known donor or to purchase sperm from a sperm bank. Cost, convenience, future family dynamics, legality, and medical history and health are all factors to consider.
This subject is often one of the first things that must be figured out by LGBTQ couples and single people trying to conceive, but anyone may be faced with a decision about where to get donor sperm, for a wide variety of medical or anatomical reasons.
For azoospermic couples (a fancy work for "without sperm") who want to carry their own child and be their child’s sole parents, there are three main choices when it comes to acquiring sperm:
1. Use a known donor (friend, colleague, or acquaintance) for a fresh insemination.
2. Use a known donor and have their sperm frozen for IVF or an IUI (or at-home insemination, if the donor is far away).
3. Purchase frozen sperm from a sperm bank (for IUI, IVF, or at-home insemination).
There are advantages and drawbacks to each one of these choices. Lets take a closer look...
Using a Known Donor for a Fresh Insemination
Using a Known Donor for Frozen Sperm
Purchasing Sperm from a Sperm Bank
It can be confusing to make decisions about how to start your family when faced with so many choices. But with a little forethought, a lot of discussion before hand, and maybe a few sessions with a couples counselor trained in fertility counseling, the right decision for your family will make itself apparent over time.
Note: I’ve attempted to make the language in this blog post as inclusive as possible of all forms of gender identity, including transgender individuals and individuals with non-binary gender identities. Terms such as “partner or individual who is contributing the egg” or “partner or individual who is contributing sperm” are a little wordy but reflect the wonderful diversity of genders and relationships in family units.