Before I dive into telling you about the benefits of preconception care, I wanted to go back and explain why we talk about it at all.
Most of the time people are advised to start making health changes to improve egg quality at least 3 months in advance of desired conception. Why 3 months you ask?
Are you ready for a little human anatomy and physiology lesson?
Okay here, we go.
Many will know the basics of how a baby is made - egg is released from the ovary during ovulation, sperm meets egg, egg is fertilized, embryo implants in uterus and starts to grow. This is a massive over simplification, but you get the idea.
But what happens before then? How does the egg reach the point of maturation before ovulation? And how does preconception care play a role here?
The primary reproductive organs for pregnancy in a female bodied person include the ovaries, fallopian tubes, uterus, cervix, vagina. The main interests for this post are ovaries and the process of oogenesis, or egg development.
You have all the cells that could potentially become eggs within your body - you have since before you were born.
The process of egg development begins before birth, with the development of cells called primordial germ cells inside the ovaries. At the time of birth it is estimated that there are somewhere around 1 to 2 million of these cells present in a female's ovaries.
After birth these cells develop into a cell called a primordial follicle. Primordial follicles are cells that contain an oocyte (a fancy name for a cell that may become an egg) surrounded by a nourishing layer of cells. They develop by the process of cell division called meiosis, which essentially means they replicate with only half of their DNA present in the new cell. However this replication is paused at the very first stage, called prophase I, until puberty starts.
Ah, puberty. The entrance into the world of reproductive hormones flowing (or raging) through your body. And the onset of menarche for females, also known as
your period
monthlies
moon cycle
Aunt Flo
etc.
Your cycle beginning means that those primordial follicles have been taken out of stasis and activated by these reproductive hormones. They have begun to grow, divide and develop into larger follicles, one of which will be selected for ovulation. With each monthly cycle, approximately 1000 of these primordial follicles start development, and 999 are discarded along the way, with only 1 remaining to be ovulated (or occasionally more as in the case of multiple fraternal babies).
Still with me?
Let’s get a little more specific about the timing of this process then.
It takes approximately 1 year for those primordial follicles, the cells you were born with, to develop all the way to the egg that will be released during ovulation.
The majority of that time, somewhere between 9 to 10 months or approximately 10 average menstrual cycles, is called the pre-antral phase, where the primordial follicle is just growing in size without the assistance of hormones.
It moves through the 4 phases of Meiosis I (prophase, metaphase, anaphase, and telophase) becoming first a primary follicle when it increases oocyte size and adds receptors for the hormone FSH (follicle stimulating hormone) and then a secondary follicle when it adds extra layers of nourishing cells (called a granulosa layer) around the oocyte.
When it reaches the secondary follicle stage, it moves into the antral phase. This means an antrum, or a small fluid filled sac, develops in the cell. The secondary follicle is also in the process of the four stages of meiosis II (only completed with fertilization), which means more dividing and replicating. This antral phase is where the hormones really kick in, particularly FSH and LH (luteinizing hormone), which are responsible for the continued growth of the follicle.
The antral phase of development is considered to have 4 stages of its own that essentially boil down to the follicles getting larger and the largest one being selected for ovulation.
This process of going from a secondary follicle to the oocyte that gets released during ovulation takes about 75-85 days - or two full (average) cycles and it is then released during the third cycle.
Whew, that was a lot. Let's recap.
1 YEAR
Primordial Follicle - Primary Follicle - Secondary Follicle - Ovulation
Pre-Antral Phase Antral Phase
NO hormones HORMONES
9-10 months 75-85 days
So back to our original questions -
Why 3 months?
The reason for this timing is that this 3 month window is the antral phase, where the follicles are growing and being affected by your hormones. Arguably, this is the most crucial time of cell development prior to conception. Although if you start earlier, rock on!
And how does preconception care play a role here?
Health can be felt on a large and general scale - as in you feel good or you feel sick. But it can also impact you at the cellular level. Your cells all contain your DNA and your DNA is what forms the building blocks for your child. If the cells that are developing into the egg that may become part of your child are unhealthy, it can cause issues ranging from difficulty conceiving to long term health effects for your child. Everything your body is exposed to - from the environment, to food, to emotions (positive or negative), to movement, to sleep - has an impact on your health and the health of your cells.
The good news?
There is SO MUCH we can do to improve cellular (and overall) health!
This is an area where naturopathic medicine can truly shine and where I feel passionate about helping people meet their goals.
Ready to get started? Contact me for more information.
References
1. Cox E, Takov V. Embryology, Ovarian Follicle Development. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 8, 2022.
2. Holesh JE, Bass AN, Lord M. Physiology, Ovulation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 8, 2022.
3. Williams CJ, Erickson GF. Morphology and Physiology of the Ovary. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc.; January 30, 2012.