Egg Quality & Ovarian Reserve

Common Fertility Problems
Key Points

  • Ovarian reserve relates to the number of eggs a woman has and reduces with age.
  • Egg quality refers to the ability of the egg to be fertilised, multiply, implant and grow into a healthy baby.
  • Lifestyle, nutritional and environmental factors can improve egg quality.

What is Egg Quality?

Women are born with around 1-2 million eggs and by the time they reach puberty, they have about 300,000 eggs. Of these, only 300 to 400 will be ovulated throughout her life. During each menstrual cycle, a certain number of follicles are activated to prepare for ovulation, but just one egg matures and is released from the ovary. By the time a woman reaches menopause, egg supply has been depleted.

Egg quality consists in the ability of the egg to be fertilised, to multiply, to implant in the uterus and develop into a baby. Age is the most important factor affecting egg quality.

Women's Age Factor

This is the most important factor in egg quality and ovarian reserve. Women after 40 may have reduced number of eggs and often, the eggs that are available, appear normal, fertilize normally, and undergo initial embryonic cleavage in a normal manner but have difficulty implanting.

What is Ovarian Reserve?

Ovarian reserve is the technical term for the number of eggs a woman has. A woman’s ovarian reserve is assessed via ultrasound to count the number of follicles within both ovaries, and by hormone blood tests.

One of those hormone tests is for Anti-Mullerian Hormone (AMH), which helps indicate the number of eggs a woman has. The higher the value of AMH, the more eggs a woman has.

Another hormone test is FSH levels on the third day of the menstrual cycle. If FSH levels are high, the body is producing more FSH in an effort to stimulate the ovary. These tests indicate the number of eggs (ovarian reserve) and not the quality of those eggs. However, if your ovarian reserve is low, you may have more difficulty getting pregnant.

Can Egg Quality Be Improved?

Even though a woman is born with all the eggs she will ever have, these are in a ‘sleeping’ state. It takes 3-4 months for an egg to develop and in one cycle, the egg will finally mature. During this process, several lifestyle and environmental factors can affect egg development and ultimate quality.

Even though you can’t produce more eggs, you can improve the quality of the eggs you have. Egg health is in fact crucial to fertility, so each egg can mature well, ovulate, fertilise, implant and finally, develop into a baby. Let’s look at the following aspects that can help you improve egg quality:

Hormones: the amount and timing of hormones is important to grow, mature and ovulate an egg. Hormones can be affected by blood sugar levels, diet, stress, lack of sleep.

Nutrients: chromosomal abnormalities can be influenced by nutrients we eat. Improve egg quality by avoiding “white” carbohydrates and processed foods with trans fats, by limiting alcohol, caffeine, and starchy vegetables. Include more non-starchy vegetables, lean unprocessed organic protein and healthy fats. Proteins are useful for hormones and egg quality. Non-animal protein seems to be better than animal protein when it comes to fertility

Free radicals: are a natural part of our metabolism but if you drink alcohol, smoke and have a poor diet, the values increase and are harmful to the egg. Including antioxidants in your diet, neutralises free radicals, so make sure you include fruit, vegetables, vitamin C and selenium.

Proteins: are useful for hormones and egg quality. Non-animal protein seems to be better than animal protein when it comes to fertility Lifestyle factors: Alcohol, smoking and drugs affect egg health. Being overweight or underweight also affects fertility.

Environmental factors: You can improve egg quality by reducing your exposure to specific toxins that can harm fertility: BPA (chemical found in plastic food containers and paper receipts) and phthalates (found in plastics, fragrances, beauty and cleaning products) disrupt proteins that help make oestrogen and oestrogen production and it blocks oestrogen from binding to its receptors. Oestrogen is needed to stimulate follicle growth further for the egg to mature.
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