It Starts With The Egg
By Rebecca Fett
Pages - 243
What is the book about?
If you have ever been tempted to search Google Scholar for research on egg quality or how to improve your chances of conceiving (naturally or through IVF), honestly, don’t bother. Just buy this book instead, as the author has spent countless hours researching, assessing and summarising the evidence so that you don’t have to. What a trooper. This book is written in a more readily accessible manner that is easier to understand than most research papers and it is a lot more fun to read. It Starts With the Egg is a comprehensive review of available evidence (admittedly from 5 years ago) on anything and everything that can be done to improve egg quality via lifestyle changes.
About the author – ‘Rebecca’s Miracle Results’
The author, Rebecca Fett, has a degree in molecular biology, which makes her a) a biology geek and b) able to collate and understand scientific research beyond most of our wildest dreams (or nightmares, depending on your view of reading scientific papers). Having been told that she had diminished ovarian reserve in her 20s, Rebecca put her degree and research skills to excellent use and began to investigate for herself (in magnificent detail) how to improve egg quality. A summary of all the pertinent evidence forms the content of this book.
Her story is truly inspiring: Low ovarian reserve, first round of IVF, 22 eggs retrieved (holy cow), 19 fertilised (blimey) and all 19 made it to good quality day 5 blastocysts (what the…?!). If Rebecca achieved those results by following the advice in her book then I was SOLD. In my eyes she became the official Goddess of Egg Quality (I hope she uses this title on her email signature) and I vowed to absorb and copy every detail provided in her book. Bring. It. On.
And here comes my first note of caution: you may do everything right, follow all the advice and steps set out in this excellent book and still not achieve what I like to call ‘Rebecca Miracle Results’. Let’s take my case as an example. Now, I have the opposite issue to Rebecca in that I have polycystic ovaries and high AMH (50 pmol/l), I’m more follicle than woman, a folli-farm if you will. As a result I should expect more follicles and therefore more eggs during an IVF round than someone with low ovarian reserve. So, following all the advice in the book my results were (drum roll please……): 9 eggs collected (single figures? Really? What happened to being a folli-farm?), 7 fertilised (utter relief), 3 made it to day five good quality blastocysts (so pleased that any made it, let alone 3). A far cry from ‘Rebecca Miracle Results’, more ‘Amber you had me worried for a moment there but somehow managed to claw it back results’.
A few friends I know who have low ovarian reserve, like the author, have also followed the advice in the book and not achieved the same outstanding outcome as Rebecca. The drugs protocol that you are placed on by your IVF clinic and many other factors (within and outside of your control) play an important role in IVF egg numbers and quality also. That said, I truly believe that the advice and approach provided in this book made a huge impact to my PCOS, egg quality and general health and I thoroughly recommend it. Just beware that miracles don’t happen to everyone. If they did they would no longer be miracles, they’d just be what happens, right?
What does the book cover?
The book comprehensively walks the reader through the evidence on lifestyle choices and changes, explaining the impact on fertility. It covers the basic science behind egg quality, the common chemicals that sneak in to our daily lives and the damage they cause to fertility, unexpected explanations for fertility issues that should be checked out (vitamin D deficiency, hypothyroidism, celiac disease and dental care), the benefits of vitamins, which ones to take and which ones to avoid, myo-inositol and the benefits for PCOS, controversial DHEA and the benefits for low AMH, diet and sperm quality. The end of the book contains very short (about a page each) action plans of things to consider depending on your circumstances and the entirety of the book gives information founded in good evidence which provides you with the building blocks to enable you to consider what practical steps you want to take given your own circumstances.
This book is not designed to address either the process of IVF or the emotional side of infertility. If this is what you are after, I’d recommend the His and Hers Guide to IVF as a more appropriate option. It Starts With the Egg contains a chapter on sperm quality and evidence on how to improve it, which is incredibly useful, although I know there are specific books dedicated to solely this topic that may be more appropriate if that is your particular fertility struggle. The book does provide some diet advice, along with basic lifestyle plans in the back pages, but it is not designed to provide you with an exact diet to follow, or recipes to cook. It is similar in style and philosophy to The Better Baby Book by Lana and Dave Asprey and if you have read and enjoyed that one, you are also likely to relish It Starts with the Egg. I found that although these two books have similar outlooks on improving fertility through food and lifestyle changes, they are sufficiently different in content to make it worth your while to read both.
Who is the book suited to (and who may want to give it a miss)?
Let us start with who it may NOT be suited to:
You are new to the world of fertility: if you are just starting trying for a baby, you don’t know that you have any fertility issues, you will cut back on the number of benders you go on a week and you may cut out your cheeky cigs when you are tipsy with your mates, but otherwise not in the market for making wholesale changes to improve your fertility, then this book is definitely NOT for you. The final chapter does include a Basic Plan for those who are just starting to try or considering giving baby making a go, and I have no doubt that the information in the book would be invaluable to your fertility. But as fertility books go, this was by far the most overwhelming one I read (and I read over 30).
Not in the market for comprehensive changes to your lifestyle: if you do unfortunately suffer with fertility issues but you aren’t ready to make big lifestyle changes just yet (which is totally understandable, it has to be the right time and place for you), there is a danger that this book may cause you to stress out, making you feel bad about your lifestyle choices. If you are overwhelmed or acutely stressed by your fertility struggles, maybe wait until you are in an OK headspace before embarking on this book. It will scare the bejesus out of even the most emotionally stable infertile.
Those who ARE likely to enjoy the book and benefit are:
Those who are struggling with fertility or are on the path to IVF: and would literally sell their grandma for a chance at a baby. You would do anything and everything possible to increase your chances, no matter how scary, disgusting tasting or expensive.
Those who are already following a relatively healthy natural lifestyle but want to take it to the next level: and want to understand the research behind WHY you would be making these changes to scare you into staying on track.
Those who are in or nearing their 40s, have been diagnosed with low ovarian reserve or issues with the quality of their eggs: and who are willing to try whatever they can to improve their chances of conceiving.
Those who love research and detail: The geeks amongst us (my hand just shot up in the air, who is with me?) who love to read about topics in detail, aren’t satisfied by the basic and conventional health advice from many mainstream health providers and want to understand what is known outside the box.
Favourite aspect of the book
This book is so grounded in evidence and research that there are 58 pages of references at the back of the book. This is exactly what I wanted, someone to tell me what all the research says about fertility and egg health so that I could make an informed choice about what positive action I was (and was not) willing to take to modify my lifestyle without spending hours flapping around on Google.
There is a strong chance that this book will ‘put the wind up you’, to borrow a phrase from my dad (who hasn’t read the book, just to clarify). The research appeared conclusive and in summary it stated that nearly everything I was doing was damaging my chances of having a baby. By the end of the book I wondered how I could possibly still be alive, let alone fertile. In all honesty, it is impossible to follow all the advice contained in the book all of the time. It is setting out the gold standard, where we should be reaching for recognising that living anywhere other than an organic farm on an island (Dave Asprey style) will see us fall short of all the recommendations. We live in a toxic, plastic coated world and we can only do our best to limit the impacts on health. I’m in a better place than I was before I read this book, but I’m a long way from perfect. Still, that is progress, right? I take a more relaxed and philosophical view now, but whilst engrossed in reading the book I became all consumed, which resulted in a me having a number of book induced ‘mad moments’:
Reading about the dangers of BPA and plastics in general resulted in me grabbing a bin bag and rampaging round my kitchen ridding myself of those evils. In 10 minutes of concentrated purging, I threw open the kitchen cupboards and scraped out into my bin bag all plastic food containers and plastic cooking implements whilst shouting ‘Poison!’ ‘POISON!’ ‘Yet more poison…’ I wish I had had the foresight to order glass versions from Amazon BEFORE the big cleanse. My husband Joe, perplexed by the empty cupboard that usually houses our tupperware, asked whether they were all in the dishwasher. “Ummm…yeah, something like that.” I as too embarrassed to admit my plastic meltdown.
The book informed me that till receipts are covered in the chemical BPA (yep, your simple shop receipt is also toxic) and can be absorbed into your system through the skin on your fingers. On my next visit to the local shop I couldn’t disguise my disgust at the shop assistant offering me the receipt (‘Do you NOT WANT me to have a baby?’). You’d have thought she had tried to hand me a turd. I haven’t always been emotionally stable on this journey…. So I did the only logical thing, I turned 90 degrees, thrust my bottom towards the till and asked the checkout lady whether she could just slip the receipt into my back pocket. She firmly but politely told me that wasn’t going to happen. Fair enough. No receipt then thanks. Was that a balanced response from me? I fear not, especially considering that I commute daily in to a city with some of the worst air pollution in the world, London. So surely lounging around in a bath of receipts would be good in comparison?
Countless hours were spent researching a glass water filter, because I was now scared of tap water and plastic in equal measure. When it arrived I spent many a moment tapping it and listening closely, like a doctor checking over her patient. Is my water filter glass? Is it? It said so on Amazon but it feels a little like hard plastic. Surely it is glass, right? Roger the cat came to my rescue and solved the conundrum by knocking it off the kitchen counter whilst reaching for an elusive crumb, shattering it on the floor. Yep, that was definitely glass. I took the cost of the replacement out of his pocket money.
Takeaways from the book: top learning points that you may not have known before reading.
My learning points from this book were so numerous that it is tricky to know where to begin. Some topics covered by It Starts With The Egg were concepts of which I already had a vague understanding, for example that plastics are toxic, but I was missing the ‘why’ and ‘to what extent’ which was comprehensively covered within this book. Some of my main takeaways included:
This book finally persuaded me to undertake a wholesale change from plastic food storage and cookware to glass versions. The (expensive) switch to non-toxic personal care products, throwing out my chemical versions, was another kick up the bum resulting from the scary content of this book.
I followed the advice on vitamins, including understanding the difference between the two types of CoQ10, the relatively cheap but potentially crap ubiquinine, and the so expensive it will make you draw breath but much more effective ubiquinol. Adding NAC to my vitamin regime and ensuring good quality vitamin D3 (not other forms of vitamin D) was another takeaway.
I had never heard of DHEA, a controversial supplement (dehydroepiandrosterone) that is a naturally existing hormone in the female body that converts into androgens, mainly testosterone and is used to improve fertility in people with low AMH. This was not a learning point resulting in action for me personally, as DHEA is potential kryptonite for those of us with PCOS, but a learning point all the same.
It reinforced the importance of sleep, catapulting me into developing a rigid sleep routine, including the use of magnesium spray on my body prior to Bedfordshire.
I indulged in private testing for Vitamin D levels and a full thyroid panel as well as visiting the GP to be tested for celiac disease. This was to rule out the common undiagnosed reasons for fertility problems explained in the book.
Adding myo-inositol, a white powder that dissolves in water and makes you question whether you’ve been ripped off and it’s actually just a tub of icing sugar, to my diet to help control my insulin response was a potential game changer for my PCOS.
How long did it take to read?
3 weeks. To me, this book was fascinating and well written, therefore encouraging a quick read. However, the length of time it took to finish was mainly due to the need for mental health rest breaks following some of the more confidence crushing chapters. I was so overwhelmed at times by the level of information and the corresponding necessity for change in my lifestyle that I simply had to pause, take a breath and leave it for a day or two. Just like the episode of Friends where Joey had to put the book in the freezer because it became too scary, there were numerous ‘freezer worthy’ moments during my reading of It Starts With The Egg. In summary, this is an excellent book that I would highly recommend reading for improving fertility - just ensure you are in the right headspace for making wholesale lifestyle changes before starting to read.