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What is egg quality and how we can improve it?

16 October 2020

As you probably already know, as we get older, our egg count – also called ovarian reserve - declines. The same happens to egg quality, which is as, or maybe even more, important than the quantity. When we talk about quality, what we are really talking about is whether the egg is genetically normal (euploid) or abnormal (aneuploid). As women, we are born with the number of eggs we will have our whole life (around 1 or 2 million). Every month one of them gets ready to ovulate. Once the egg is selected, it starts maturation, which involves cell division, a process called Meiosis. As our eggs get older, they are more likely to have errors in this division process. That is why some of them might contain abnormal DNA, which will prevent the egg from doing its job: namely, make a healthy baby.

Why is egg quality important for fertility?

Egg quality plays a very important role when we are trying to conceive. Some experts say it is even more important than quantity. A chromosomally abnormal egg will sometimes not fertilise, or if it is fertilised, it can lead to an abnormal embryo and therefore, a miscarriage or an unhealthy baby.

Is there any test that assesses egg quality?

Unfortunately, the simple answer is no. The tests available are useful to see our ovarian reserve, which is egg count, but none of them shows us how healthy our eggs are. However, we do know that their quality decreases with age, so that is a helpful marker to predict our egg quality. For instance, a 20-year old woman, will have few low-quality eggs; conversely, a 40-year old woman will have more eggs with abnormal DNA.

What affects egg quality?

Besides age, there are other factors which can affect our egg quality. For example, smoking. It is well-known that smoking reduces our chances of conceiving. Also, endometriosis is related to lower egg quantity and quality.

How can I improve egg quality?

There is little evidence about how to improve egg quality because it is related to the genetic process. This is affected by our age –which, unfortunately we cannot do anything about. However, a healthy lifestyle is very important –avoid smoking, limit caffeine consumption and do exercise.

Are there any supplements for egg quality?

There is some research about DHEA and Coenzyme Q10, and egg quality mostly focused on women undergoing reproductive assisted treatments.

  • DHEA (Dehydroepiandrosterone) is a natural steroid hormone, which is present during a woman’s reproductive years. Also, it has an important role in the ovarian follicular steroidogenesis. It has been used as a supplement since 2004, especially in women with poor ovarian reserve. Some studies have shown that DHEA supplementation could improve the quality of eggs and embryos, increase pregnancy rates, and reduce miscarriages rates. Other studies consider its supplementation as experimental because there is a lack of strong evidence. It is worth saying that all studies were done on the IVF population and not on women trying to conceive naturally. Its prescription is still controversial.
  • Coenzyme Q10 (CoQ10) has also been studied as a supplement for women with poor ovarian reserve and quality. It is a fat-soluble coenzyme present in the mitochondria, which are responsible for energy production in the cells. CoQ10 acts as an antioxidant and plays a crucial role in energy production inside the mitochondria. It has also shown that it improves cardiovascular function and male fertility. In female fertility, the studies have been done in young patients undergoing ovarian stimulation, not in women trying to conceive naturally. In those studies, CoQ10 has increased ovarian response, egg and embryo quality. However, there is still not enough evidence to strongly recommend this product to improve egg quality.

What about acupuncture?

The evidence behind acupuncture in fertility shows that by doing acupuncture, your pelvis will have an increase in blood flow, especially to your womb and ovaries. In addition, it can also regulate hormones, and it helps to control stress and anxiety. Therefore, the egg quality might also improve. However, it is still controversial to routinely recommend this technique to improve egg quality.

Key takeaways:

  • Egg quality refers to whether eggs are genetically normal or abnormal. As we age, we have more low-quality eggs.
  • There are no tests that look at egg quality.
  • A healthy lifestyle always helps your eggs – quitting smoking is a must!
  • Discuss with your doctor using supplements and/or acupuncture to try to boost your fertility while trying to conceive.

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