Egg Quality:  Myths and Truths

One of the most common causes of infertility is poor egg quality.  Spend just a few minutes researching online, and you’ll find egg quality listed as one of the most important factors in determining a woman’s fertility.  Much of what you might read will be discouraging, especially if you’re over 35 and worried about your chances to get pregnant.  On the other hand, the encouraging news is that there’s a great deal that can be done to improve egg quality, especially as part of a program designed and monitored by a fertility expert and or fertility coach.

Improving egg quality can – and should – be a vital component of a pre-conception health plan.  We’ll discuss that in a moment.  For now, let’s start with some important facts about eggs, both quantity and quality.

Quantity

While men will only start to produce sperm at puberty, the average newborn girl has an average of one million to two million immature eggs.  At this point, they’re not really eggs — just follicles.  Most of those follicles will die before a girl hits adolescence through a process known as atresia.  By the time a girl has her first period (menarche), she’s got about 400,000 follicles left.  With each menstrual cycle, she’ll lose another 1,000 follicles.  On average, only one lucky little follicle will develop into a mature egg (or ovum), and make its way down the fallopian tubes.

The average woman has 375-425 menstrual cycles over the course of her lifetime.  What does that mean?  Out of the one or two million eggs she was born with, only about 400 will fully develop.  And of course, only a tiny fraction of those, if any, will become fertilized.

The IVF process changes the numbers.  Many IVF treatments involve stimulating the remaining follicles to produce additional eggs during ovulation, increasing the chances for successful fertilization, implantation, and so forth.  Fertility specialists will often run tests to determine a woman’s ovarian reserve: that is, how many extra follicles are available.  A woman with a lower number of extra follicles may be described as having diminished ovarian reserve.  Women with diminished ovarian reserve can go on increase their follicle count, improve their overall egg quality and give birth to a healthy baby; a knowledgeable fertility counselor or coach can explore many natural and effective alternative options with you.

Quality

As important as egg quantity is, egg quality is perhaps an even more important factor to consider on your fertility journey.  Poor egg quality is emerging as the single most important cause of age-related infertility, recurrent miscarriage, and failed IVF cycles. It is also a major contributor to infertility in PCOS.  Unfortunately, there’s far more mystery and misunderstanding about quality than quantity.  The tests for ovarian reserve (CCCT, AMH, and so forth) are better indicators of quantity, but may be unreliable indicators of quality.  Instead, what the medical literature will tell you is that the chief indicator of egg quality isn’t determined by what’s in a woman ovaries as it is by the date printed on her driver’s license.”

“First and foremost, egg quality is determined by a woman’s chronological age,” writes one popular fertility website.  That view is echoed in doctors’ offices across the country and in many other parts of the world.    It is nearly universally accepted that ovarian reserve declines with age, though there’s notable disagreement as to when that decline starts to impact a woman’s fertility in a significant way.  Casual Googling will lead you to websites claiming the decline begins at 25, while others say at 30, others at 35, and still other only after 40.

What does all this disagreement tell us?  While it’s certainly true that maternal age has an impact on egg quality, there’s still uncertainty about exactly how aging impacts egg quality.

Percentage Game

Remember that we noted that the average girl has about 400,000 follicles at the onset of puberty?   Let’s assume that 10% of these, or 40,000, are of poor quality.  During ovulation, these poor quality eggs will not be chosen for ovulation.   Even if the number of poor quality eggs does not increase, the percentage of remaining eggs that are of poor quality will steadily increase as the number of healthy ones are used with each menstrual cycle.  If 10% of remaining eggs were poor quality at 15, some estimates suggest that 85% may be of poor quality by the time a woman turns 40.

Battery Effect

Another way in which age may impact egg quality is through what’s called the battery effect.   Just as batteries in your various devices wear out over time, so too may the “batteries” that power an egg.   In the reproductive process, there’s about a week between the time an egg is fertilized and the time it implants in the uterus.  During that week, the mitochondria in the egg act as batteries to power the fertilized egg through the process of cellular division or meiosis.    Researchers have noted that while the eggs of older women may appear of good quality and have little trouble getting fertilized, they often stop dividing at some point between fertilization and implantation.  The mitochondria in older eggs may lose the “battery power” to complete this stage of the process.

Much of this information may come across as deeply discouraging to those who are contemplating having a baby.  That discouragement is made worse by the way that most of the discussion about egg quality and maternal age is framed.  You can’t roll back time, you’re told, and so there’s nothing that can be done about age-related declines in egg quality.  As an expert fertility coach can tell you, this is unfortunate and incomplete information.  You can improve egg quality.

What You Can Do

You’re familiar with the idea that exercise and diet can dramatically reverse the effects of aging.  Within a short period of time after starting most diet and exercise programs regimen, you can expect to see real changes and feel dramatically better.  Something similar happens when you begin a program to improve your egg quality: you can improve the overall health of both your eggs and your ovaries, and in so doing, better your chances of both conceiving and experiencing a successful pregnancy.  The journey to a successful pregnancy starts with a focus on pre-conception health.

Please note: the following are general recommendations only.  They are not an outline of Lin Weinberg’s fertility protocol. Lin’s protocol is much more robust and uses the latest, most up to date research and science to achieve conception. Any plan to improve egg health should only be undertaken after consulting with a fertility counselor, fertility expert and or fertility coach.  Every woman is different, and every woman considering fertility treatment deserves an egg health plan customized just for her taking into consideration her current health, family history, fertility challenges, pregnancy goals and unique bio-individuality.  That said, here are five key things your fertility counselor may recommend to improve egg and ovarian health.  Please also note these are just some of the ways you can improve egg quality.

  1. The 90 Day Rule.   The key window to improve egg health starts 90 days before ovulation.  During those 90 days (the tonic growth and protein synthesis phase), the eggs are changing rapidly, and are most susceptible to lifestyle changes and choice a woman may make.  It’s not just the egg’s cycle that matters here: any plan to improve egg health will need to be followed for at least 90 days to have an impact.
  1. Diet and Nutrition.   How you eat during these 90 days can improve egg quality – or, unfortunately, have the opposite effect.  Certain superfoods (ask your fertility coach) can have a significant positive impact, while other things (caffeine, alcohol, sugar, trans fats) may damage egg health during this vital development phase.
  1. Exercise.  Yep, you guessed it.  Exercise sends fresh blood coursing through the body, and helps oxygenate the body.  Exercise can energize you – and the mitochondria in your eggs as well.  To be most effective, you may want to ask your fertility coach about various types of exercises known to enhance fertility as well as improve egg quality.
  1. Eliminating Toxicities.  Toxic substances can damage overall health as well as negatively impacting egg quality.  Some toxic substances are obvious, but they bear repeating: alcohol, tobacco, marijuana, and other street drugs.  Many toxic substances are less obvious: certain prescription drugs, of course, but also many household products.  Toxic metals, lead, xenoestrogens (often found in plastic products): all these can directly harm egg quality in some women.  Consult with a fertility expert to learn what toxicities are the most important for you to eliminate, and to find out various methods for detoxifying your body and your home.
  1. Supplements.   The previous tips are all important, but they’re also generally applicable to overall good health.  When it comes to improving egg quality, you may need some additional help in the form of natural supplements.    There are a number of supplements that have been shown to improve egg health and fertility outcomes in women.

A special note: the FDA provides very little regulation of supplements.  A fertility coach can tell you which supplements (and which brands) have been scientifically proven to work in research settings. Not all supplements recommended improve egg quality. Some commonly used supplements promoted to help improve egg quality, actually further impairs egg quality.  Hence why it’s important to know which supplements have been proven scientifically.  Even more importantly, supplement dosages are dependent on each person’s unique bio-individuality as well as fertility challenges.

Beware of anyone who offers a one-size fits all approach.  Everyone metabolizes nutrients differently; one woman may need much more or less of a nutrient than another.

One excellent way to gain insight into how much of a given nutrient you may need is to have your DNA analyzed by a fertility coach trained in DNA analysis.  For example, there are specific fertility challenges linked to various ethnic groups.  This reality makes DNA analysis far more relevant than simply gaining insight into one’s family tree.

The Bottom Line

Egg quality is a vital piece of the fertility puzzle.  And despite what some may tell you, there’s more to determining egg quality than knowing a woman’s age.  Most importantly, there are effective steps you can take to improve egg health.  A fertility counselor, fertility expert or fertility coach can get you started on that journey.