Fertility Is More Than Age: Egg Quality, Nutrition & The Vaginal Microbiome – with Natasha Evans

takeaways

1. Egg quality is described as the most important factor in fertility, with the guest noting that AMH (ovarian reserve) is an imperfect marker – people with low AMH can conceive naturally while those with high AMH can struggle.

2. Because eggs and sperm take roughly three months to mature, the quality of an egg or sperm released today is described as reflecting the past three months of lifestyle, making a preconception phase of at least three months a key focus.

3. A fertility-supporting diet was discussed as being largely unprocessed and colourful, with quality protein, healthy fats and reduced sugar, refined carbohydrate and ultra-processed foods, while male fertility and age were highlighted as equally relevant.

4. The reproductive microbiome (vaginal, uterine and semen) was presented as an emerging, testable area, with Lactobacillus – particularly L. crispatus – linked to better outcomes and BV bacteria linked to poorer ones.

5. Environmental toxins such as BPA, phthalates and parabens were discussed as endocrine disruptors, alongside suggestions around period-care products, natural fabrics and supporting the body's detoxification.

6. Coming off the contraceptive pill gradually rather than 'cold turkey', plus managing stress and slowing down, were discussed as part of a holistic approach; the NHS offers fertility support only after one year of trying.

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