What is good egg quality and can we improve it?

There’s often confusion about exactly what we’re talking about when we discuss good egg quality and its impact on your fertility. It’s easy to confuse egg quality with your ovarian reserve which is the number of eggs you’ve been told you have left, probably through an AMH blood test (not an exact science - see my blog post about low AMH here). We don’t know for sure about the quality of your eggs until your embryologist looks at them under a microscope and then they are assessing their cell structure, shape, shell etc.

So while we can’t know for sure about the quality of your eggs, we do know that there are factors that play a part in determining how successful your egg will be in terms of successful fertilisation.

Firstly, age is an important factor and this is something we have no control over, although nutrition and your general health status may well be able to positively impact your biological age vs your actual age. Occasionally I see younger women with very good egg reserve and high AMH but poor egg quality because they’re producing a lot of follicles which don’t reach maturation, and this is often down to hormonal imbalance and conditions such as PCOS. It’s likely that this is one of the reasons behind so-called ‘unexplained infertility’.

Secondly, genetics, and while there is PGTA testing available in some IVF clinics to screen your embryos, most of us can’t directly influence our genetic heritage.

The good news is that there is something that we can have some control over - your egg quality can be positively influenced by your hormone balance and your hormonal status - even small changes in your hormone levels can result in better follicular recruitment and more successful egg maturation. These changes may be small but they may be enough to get you another good quality embryo, which may be all you need for a successful outcome.

Targeted and individualised supplementation can also reap small but important rewards. I’m not a fan of multivitamin or all-in-one supplements which are marketed as being perfectly balanced to improve your egg quality. They are usually tiny amounts of each vitamin and these often compete for absorption with each other, so you don’t absorb any of them properly. Supplementation needs a carefully individualised approach and needs to rely on a good evidence base, not marketing.

We know that follicular recruitment takes about 90 days so this is the minimum time I like to see you before you start IVF because we need this time to influence the factors that we have some control over. We can get to work on optimising your hormone levels and regulating your cycle as well as assessing where you can make lifestyle changes which are meaningful.

Finally, if you are trying to conceive and you suspect your egg quality may be impacting your chances of conception please make sure you’re looking carefully into sperm health (NHS sperm analysis is not detailed enough) because if your egg health is less than optimal then your partner’s sperm health really does need to be as good as possible.

There’s always more we can do to support you while you’re TTC - if you’d like help to navigate what can be a bit of a nightmare, please get in touch and we will make a plan together.