Each month during ovulation, the woman’s ovaries often release one egg which could get fertilized by sperm to form an embryo and then if it gets implanted in the uterus, it could lead to a pregnancy. The quality of an egg can greatly affect fertility in that the poorer the egg quality the lower the fertility and the lesser the chances of conception. But what exactly is egg quality? Usually egg quality and egg quantity are mentioned together. Egg quantity is the total number of eggs that are still available in a woman’s ovaries and a woman is born with all the eggs she will ever have. This quantity decreases over time as they get used up or disintegrate. Egg quality is its genetic component, its structure, its composition and other things that make it normal or abnormal. The quality of the eggs also decreases over time.
Signs and symptoms of poor egg quality
Trouble conceiving- An egg of poor quality could lead to issues with fertilization, form an abnormal embryo, have trouble getting implanted in the uterus or cause miscarriages. If the pregnancy does go to term with an abnormal egg, it could lead to congenital defects like Down’s syndrome. Normally, the egg and sperm have 23 chromosomes each, totalling 46 chromosomes in the resulting embryo. Having multiple miscarriages could mean the eggs might not have the correct number of chromosomes or are abnormal.
Irregular periods- could include menstrual cycles which are long or short, or having periods that are late or having no periods at all or also having periods with light or heavy flow. Any of these could be due to poor quality eggs.
Low Anti Mullerian Hormone (AMH) levels- AMH is a hormone produced by cells in the ovaries which eventually mature to become eggs. As you age, your egg numbers or your ovarian reserve decrease and so do the AMH levels. AMH levels can help doctors predict if you are losing eggs too rapidly. However, it doesn’t necessarily tell you about the quality of the egg. (1) So a woman with low AMH levels could have less eggs and could also but not necessarily have poor quality eggs. Low levels of certain hormones like follicle stimulating hormone (FSH) or estradiol could also signal that there is an issue with egg count or egg quality because these hormones stimulate the ovaries to produce a mature egg every cycle.
Causes of poor egg quality
Genetics- Women who are carriers of certain genetic disorders, could have oocytes carrying the same issue leading to poor or abnormal embryo formation. ICertain abnormalities in the structural arrangement of the chromososmes or the amount of chromatin content can also affect egg quality.
Age- could affect egg quality although this rate of decrease in egg quality can vary with different women. Generally, fertility declines sharply after the age of 35 in women. This could be due to an increase in incidence of abnormal eggs as you age, due to various reasons like chromosomal damage
Obesity– can affect maturation of the egg by disrupting hormone levels. (2) Even a little weight loss could reverse these effects. So try to do regular exercise to help maintain a healthy weight.
Lifestyle- Maturation of the egg could be affected by diet, stress, smoking, drinking alcohol, toxins in the environment and various other things. This can affect your hormone levels which could impact how the egg matures. Eat wholesome, healthy foods and avoid processed, sugary foods, and drink enough water. Chronic stress could cause hormone imbalances and so try to learn to relax or remove stress by meditating or trying other relaxation techniques.
Endometriosis– is a condition where tissue similar to the lining of the uterus grows outside the uterus including the ovaries and this could affect egg quality.
Chemotherapy or radiation therapy- could affect egg quality and could even lead to early menopause.
Autoimmune disorders- could produce antibodies against their own eggs and affect its quality.
Polycystic Ovarian Syndrome (PCOS)- could cause high levels of insulin which can affect egg quality.
Treatment
There’s not much one can do to improve the quality of an egg if it’s already abnormal chromosomally. However, certain medications like Conzyme Q10 can help improve egg quality by improving mitochondrial function. Some other drugs like like amino acid Leucine, resveratrol etc can also positively influence egg quality. But one could determine if an egg is healthy and only choose those healthy eggs or embryos while undergoing in vitro fertilization (IVF).
IVF-It’s easy to count the number of follicles and estimate the number of eggs that can be obtained by doing an ultrasound or by determining the levels of various hormones. But finding out if you have poor quality eggs is harder to discern as it can be determined only after examining the retrieved oocytes and screening for genetic abnormalities in the oocytes is even more difficult. You could carry out a preimplantation genetic testing if you are going through IVF where you can screen the resulting embryo after fertilization for genetic diseases. Also, the embryos from a poor quality egg have a lesser chance of implantation or the egg might not fertilize during IVF.
As mentioned earlier, lifestyle factors, certain infections and diseases could affect the way an egg matures to make it healthy. So, treating these diseases or conditions as well as making better lifestyle choices could improve one’s fertility.
You could also freeze your eggs when you are younger to preserve your egg quality.
They could also study the morphology of the egg and its contents inside the egg to see if it’s healthy physically. However, more studies and advanced intricate procedures are needed to determine egg health.
Some lab tests like AMH, FSH and other levels could be used to infer egg quality although they don’t directly measure egg quality. A good ovarian reserve could infer that there is a good possibility that the egg quality is also good. In conclusion, it’s difficult to determine the quality of an egg although it can greatly affect fertility. If you would like to know about your egg quality or you are having issues with conceiving, please call the experts at Xenith Advanced Fertility Centre and they could answer any questions you might have and get you started on your journey to parenthood.