The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Tuesday, February 12, 2008
Egg Quality
A common cause of infertility in women is poor egg quality. Poor egg quality does not have to be the end of your chances for pregnancy – a variety of unique fertility treatments are available to help you achieve your pregnancy. All women have a finite number of eggs in their body which, when released during ovulation, can be fertilized to produce a child. Most people believe that all that matters when you are trying to get pregnant is the number of eggs you have – as long as you have a lot of eggs, you’ll get pregnant. Unfortunately, this is not the case. True, the number of eggs that you have does matter, but so does the quality of those eggs. Together, the number and quality of your eggs are referred to as your ovarian reserve. Egg quality refers to how prepared your eggs are to develop into embryos once they are fertilized. In order to be healthy enough to develop, an egg needs to have the proper chromosomes and the ability to combine those chromosomes with sperm. Some eggs in your body just don’t have the right number of chromosomes, making it impossible to have a successful pregnancy.
The eggs in your ovaries also need energy in order to split after fertilization. Your eggs contain mitochondria, which are tiny cell organelles that provide the energy for the egg. Without mitochondria, your egg wouldn’t have the energy to survive. As you age, these mitochondria produce less and less energy. As a result, any egg that is fertilized will eventually run out of energy and will be unable to divide.
Egg quality is greatly affected by your age. In your 20s and early 30s, you should have a large number of good quality eggs available for fertilization. Yes, you will have a few bad eggs too, but the good ones should vastly outweigh them. However, as you age your eggs will begin to decline in quality as well as in number. By the time you are in your late 30s or early 40s, you will probably have more poor quality eggs available than good quality eggs.
However, you don’t have to be over the age of 40 to have poor quality eggs. Some younger women can also have a poor ovarian reserve, either as a result of health problems or genetics. In particular, smoking, radiation therapy, and chemotherapy have been known to cause eggs to decline in health. If you suffer from endometriosis, you may also find that your egg quality is poorer than you would like it to be.
Egg quality has a huge impact on your fertility. If you have poor quality eggs, you will probably have a difficult time getting pregnant and staying pregnant. The impact of poor quality eggs is reflected in the general decline in pregnancy rates as women age. Women between the ages of 15 and 25 have a 40% chance of conceiving every cycle. Women who are over 40 however, have less than a 25% chance of becoming pregnant naturally. This is due to the fact that women who are older tend to have fewer eggs and eggs of a poorer quality. Poorer quality eggs can be one of the major causes of infertility in a number of ways. Firstly, poor quality eggs can make conceiving a child very difficult. If a baby is conceived, a poor quality egg can make the difference between carrying your baby to term or losing it in the first few weeks. Many poor quality eggs do not implant properly into the uterus once they are fertilized. Others implant properly but are simply not healthy enough to grow and divide, resulting in a miscarriage.
If you think you may be struggling with fertility issues, it is important to get checked out by a health care professional. In particular, you should probably make sure that your eggs are healthy and of a good quality. Women who are struggling with infertility and are over the age of 37 are usually tested for this.t is difficult to determine the quality of an egg simply by looking at it. Doctors usually have to implant the egg using in vitro fertilization to see whether it will grow or not. However, there is fertility testing to determine if you may be suffering from poor egg quality. Typical tests that evaluate your egg equality include:
Day 2/ 3 FSH Test: Measures your levels of FSH. Elevated levels may indicate poor egg quality.
Clomid Challenge Test (CCCT): The clomid challenge test is a blood test.
If you are suffering from poor egg quality there are a variety of fertility treatments that you can pursue to help you to conceive. Just because you have poor quality eggs does not mean that it is impossible for you to become pregnant. Using fertility drugs is one way to possibly increase the quantity and quality of your eggs. Typical female infertility drugs include clomiphene and cabergoline. In vitro fertilization is another treatment option. However, if your eggs are of too poor quality, you may be encouraged to use an egg donor.
Research into improving egg quality is ongoing. One treatment currently in the trial phase is cytoplasmic transfer. This form of treatment involves putting cytoplasm (the watery, outside layer of a cell) from a healthy donated egg into a poor quality egg in order to help it divide. Nuclear transfer is another form of treatment currently under investigation. Nuclear transfer involves taking a healthy nucleus from a donated egg and transferring it into an egg with an unhealthy nucleus. This helps to improve the quality of the egg thereby increasing the chances of conception occurring. Though neither of these procedures are currently available to the general public, there is hope that they may come to fertility clinics in the near future.
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