In today’s fast-paced world, women have a lot to achieve and priorities are shifting for a better quality of life. That’s the reason, family planning is put on hold. Many women decide to delay getting pregnant until their late 30s. Do you know, a healthy 30-year-old woman has about a 20% chance of getting pregnant naturally each month whereas, a healthy 40-year-old woman has about a 5% chance each month? When human reproduction is highly inefficient as compared to other mammals and age becomes a deciding factor when trying to conceive. Age and quality of eggs have a direct link. As the age increases, there is a rapid decline in the quality of eggs. We at Yash IVF are often greeted by patients whose concerns are as follows after failed IVF cycles elsewhere. 35 year older female, trying to become pregnant, has multiple failed IVF cycles, is mentally exhausted with high stress, often briefed by the centre about poor egg quality. Low AMH, High FSH and low ovarian reserve make embryos resulting in the repeated failure of implantation. Every journey of infertility is different and struggle is inevitable. Don’t lose hope. If this is your story, then you are on the right page to know, how parenthood can be achieved irrespective of all the odds. Let’s discuss egg quality in brief: 1. Importance of egg quality Oocyte quality is one of the important factors for achieving pregnancy. For the fertilization, implantation, and development of the embryo, it is essential to have eggs of good morphological and genetic quality. Not-so-desirable or low oocyte quality is one of the main causes of female infertility and is dependent on a women’s age. From the age of 35 years, the quantity and quality of eggs begin to decrease considerably. However, a good number of oocytes does not mean that they will be of good quality. 2. Egg quantity vs. Egg quality Did you know that all the eggs a woman will ever have, are created and deposited in the first 16 weeks when she is in her mother’s womb? Approximately four to five million eggs are formed in those first 16 weeks, but only one to two million eggs remain at the time of birth and only 400 000 to 500 000 are still viable at puberty. No wonder, human eggs are “destined to die”. There will be a release of mature eggs in each menstrual cycle, while many other immature eggs will undergo a degradation process, atresia and eventually will be lost. This is the way, a woman’s ovarian reserve gradually decreases until it is completely over when she reaches menopause. It is a process of hormones. 2. Oocyte quality analysis There are many diagnostic tests to evaluate the state of a woman’s ovarian reserve, such as an antral follicle count by ultrasound, anti-mullerian hormone analysis, or determination of blood FSH levels. But to know the quality of the eggs is not so easy. In IVF treatments too, one has to fertilize and perform a pre-implantation genetic diagnosis (PGD) of an embryo. There is a lot of research happening on oocytes that the recovered have chromosomal alterations. During IVF treatment, it is possible to evaluate the morphology or structure of the eggs under a microscope to know the abnormality. 3. What are the causes of poor egg quality? We know by now, the advanced age of women is the main cause of poor oocyte quality, especially from the age of 35. In addition, other health conditions or unhealthy habits can also hurt the eggs. Endometriosis, Polycystic ovary syndrome (PCOS), Diabetes, Tobacco and alcohol, Poor eating habits, and Radio/ chemotherapy treatments are some of the few. Therefore, maintaining a healthy lifestyle sports, and avoiding the consumption of toxic substances will be the best prevention to not have the oocyte quality affected. 4. Is there any way to know, about good quality eggs? The quality of the eggs is a very important factor in assisted reproduction technologies or treatments. Even though the eggs are morphologically normal, this does not mean, full-term pregnancy will be achieved. However, it is possible to predict how embryonic evolution will be, although other aspects must also be taken into account. The three types of good-quality egg markers are often taken into consideration by practising doctor Gynaecological evaluation: Patients are generally analysed and assessed by the medical team: age, environment and ovarian reserve. Age is the main culprit of egg quality. We should not equate quality with ovarian reserve. 36-year-old Amrita has a good ovarian reserve when the antral follicle count is analysed by ultrasound and good levels of the antimullerian hormone, but the oocyte quality can be worse than that of a 30-year-old patient. The same is the case with an antimullerian hormone which does not determine egg quality but rather egg quantity. So, a young patient with a low AMH, despite obtaining a low number of oocytes, can still have the possibility of a good-quality egg and can carry a full-term pregnancy. The environment can greatly affect oocyte quality. Unhealthy habits (tobacco, alcohol, drugs, etc.) and toxic substances to which one may be exposed, can directly or indirectly affect egg quality. Morphological evaluation: These are seen in the laboratory, once the oocyte extraction is done. Analysing the cumulus-oocyte complex is important in conventional IVF procedures. In the case of (ICSI), there is the removal of the cells that are around the oocyte, to check the optimum stage of maturity. After this step, one can watch for clarity, granularity, endoplasmic reticulum, These are the characteristics which may not be harmful in all cases but do provide some information Embryonic evaluation: In general, a worse oocyte quality is due to abnormal fertilization during the first days of evolution, although it is true that at the moment in which the malefactor is added, it is more difficult to point out exactly which factor is affecting embryonic development. How can we improve the egg quality? According to data collected by the Spanish Fertility Society (SEF), a body mass index (BMI) greater than 30 or less than 20, can affect fertility. Therefore, food is a crucial factor that can affect fertility. Obesity or being overweight in women is associated with ovulation problems. altered maturation of the ovarian follicles leading to poorer egg quality. A varied diet, composed mainly of fruits and vegetables, ensures the necessary supply of vitamins, minerals, trace elements, and antioxidants that are crucial for reproductive health. In addition, you should not forget to include healthy fats (nuts, olive oil), proteins, and dairy products. Although age is a key factor in egg quality, embryo quality and pregnancy rate vary from month to month. This means, even if your first cycle is unsuccessful, there is a reason to try again. Yash IVF has a centre of excellence in treating repeated failures of implantation due to egg quality. An excellent embryology lab is the heart of this process and we maintain the same standard which is the reason our success rate of YASH IVF is around 70%.
