The idea of improving egg quality has become a major issue and object of research in reproductive medicine, especially as a significant portion of women are having their first child after the age of 35, representing a 50% increase in the past two decades.
As women age, their monthly fertility rates decline significantly. This decline is well-documented, with marked differences after the age of 30. At age 35, it is approximately twice as difficult for a woman to conceive compared to age 25. By age 40, the monthly fertility rate drops to just 3–5%.
The reason for this decreasing fertility is a diminishing egg quantity and declining egg quality. In addition to limiting a woman’s chances of getting pregnant, the decline in egg quality also increases the risk of miscarriage. Older eggs are more likely to have chromosomal abnormalities, which can lead to pregnancy loss.
These pregnancy risks elevate the importance of understanding the relationship between age and fertility—and the options available for preserving and improving egg quality.
Are there any tests that can assess egg quality?
Unfortunately, there is not a test to directly assess the quality of eggs. However, we can assess egg quantity, often referred to as ovarian reserve, through tests like AMH (anti-Müllerian hormone) and FSH (follicle-stimulating hormone) blood tests, as well as antral follicle count. These markers provide insight into the number of eggs a woman has. It’s important to note that ovarian reserve and egg quality are distinct aspects of fertility.
Ovarian reserve pertains to the quantity of eggs, while egg quality refers to the potential of a fertilized egg to result in a viable pregnancy. Even if a woman of advanced reproductive age shows normal ovarian reserve markers, they may still face infertility due to diminished egg quality.
What affects egg quality?
Egg quality is influenced by several factors, and its decline is characterized by multiple key indicators. One prominent aspect is the acceleration of follicular atresia, which refers to the loss of developing eggs as women age.
While it is well-established that egg quality decreases with age, the precise mechanisms behind this decline remain a subject of ongoing research. That said, there are signs that can indicate a decrease in egg quality, such as:
- Difficulty conceiving
- History of miscarriage
- Thinning ovarian reserve
- Reduced response to ovarian stimulation
- Low levels of AMH
- Low FSH reserves
- Irregular menstrual cycles
Can egg quality be improved?
While there are no known methods for improving egg quality directly, there are several lifestyle factors that have been associated with improved fertility overall. By integrating these practices, it is possible to improve odds of a successful pregnancy.
How long does it take to improve egg quality?
There is no guarantee that egg quality can be improved, so for women seeking how to improve quality of eggs after 40, it’s best to consult with a fertility specialist to develop a comprehensive plan that considers all options for achieving a successful pregnancy.
This may involve a combination of tailored fertility treatments or an alternative route to family-building, like IVF with an egg donor. In general, the sooner you can begin efforts to conceive or to improve fertility, the better.
For younger individuals who wish to preserve their egg quality and enhance their chances of a successful pregnancy in their thirties or forties, cryopreserving, or freezing, eggs offers a highly successful option.
How to boost egg quality naturally
Because we don’t know how to improve egg quality directly, the best approach is to seek improvements to your overall reproductive health. In addition to working with a fertility expert to form a fertility plan, there are a few natural lifestyle practices that have been associated with fertility and that may help improve chances of a successful pregnancy.
Smoking is a well-documented risk factor for reduced fertility: several studies—including one large meta-analysis comparing approximately 30,000 women—show that a smoking habit negatively impacts fertility.
This risk factor is particularly relevant when it comes to age-related fertility and the question of improving egg quality. On average, menopause occurs 1 to 4 years earlier in women who smoke, indicating a possible acceleration of follicular atresia and the depletion of egg quality. Smoking is also linked to a higher rate of chromosomal abnormalities and miscarriages.
While quitting smoking can be immensely challenging, it is one of the most beneficial steps you can take for improving fertility and possibly improving egg quality.
Pursue a healthy weight.
The American Society for Reproductive Medicine considers a healthy BMI to be one of the most influential lifestyle factors in maintaining reproductive health. Obesity has been shown to adversely affect ovulation and menstruation, lower fertility rates, and limit the success of infertility treatments. Being underweight has also been shown to cause fertility problems by impacting hormone function and ovulation.
If you are underweight or overweight, achieving a healthy BMI through lifestyle interventions, like physical activity and diet changes, could improve pregnancy outcomes. While weight modifications may or may not contribute to improving egg quality, a healthy BMI could improve the effectiveness of IVF treatments and decrease the risk of some pregnancy complications.
Eat a balanced diet.
Over the last couple of decades, advancing research has continued to reveal a relationship between diet and reproductive health. Primarily, the literature has pointed to the importance of a nutrient-rich diet that is well balanced with fruits, vegetables, lean proteins, and whole grains. A growing body of research also points to a connection between omega-3 fatty acid intake and female fertility.
Additionally, high levels of caffeine consumption have been associated with decreased fertility and miscarriage. Improving your diet with balanced nutrients, limiting caffeine, and integrating omega-3 fatty acids could enhance your fertility, possibly improving egg quality.
Hormones play a major role in pregnancy, and stress has been proven to cause substantial hormonal fluctuations. While stress has not been proven as a cause of infertility, research has drawn a significant connection between high stress levels and difficulty becoming pregnant.
Stress has many causes, among them infertility itself—navigating infertility treatments and seeking methods of improving egg quality can be incredibly taxing. It’s important to understand the potential stress of becoming pregnant in the face of age-related infertility and to anticipate methods for reducing stress.
Whether addressing treatment-related overwhelm or unrelated stress, one of the management strategies we often recommend to our patients is acupuncture. This natural therapy in Chinese medicine has not only proven an effective means of stress relief, but some studies have shown it to improve fertility and IVF success rates.
How to improve egg quality in IVF
If you’re looking for how to improve IVF egg quality, it’s important to know that while IVF can help improve odds of fertilization in the presence of a low egg count, it is not, itself, a means of improving egg quality. As an age-related infertility treatment, one of the primary benefits of IVF is the opportunity for preimplantation genetic testing of the embryo.
If a patient receives one or multiple embryos through IVF, they can choose to test the embryos for chromosomal abnormalities prior to implantation by freezing and biopsying them.
Because miscarriage due to chromosomal abnormalities is one of the primary risks associated with poor egg quality, ensuring a chromosomally normal embryo allows patients to significantly reduce this age-related risk and increase the chances of a healthy pregnancy.
Starting a family in the face of declining egg quality
For women over 35 years, age-related infertility can pose a significant challenge to achieving a successful pregnancy. However, even if attempts at improving egg quality, or improving overall fertility to compensate for limited egg quality, are unsuccessful, there is still a path to parenthood.
The success rates associated with egg donation IVF are notably high, making it a viable choice for women well into their thirties. In fact, many women experiencing age-related infertility opt for egg donation right away in order to increase their chances of having a healthy child more quickly.
One of the incredible things about IVF with a donated egg is that it offers a way for women who don’t have the option for a genetic connection to still form an early bond through the carrying and delivering of their baby.
At the Idaho Center for Reproductive Medicine, we firmly believe that every person deserves the opportunity to safely bring a baby into the world, and we are committed to helping intended parents understand their options and the risks associated with infertility and infertility treatment.
We offer thorough diagnostic testing to help our patients understand their fertility status, even when egg quality cannot be directly assessed. While improving egg quality may or may not be possible, we are dedicated to exploring all options for helping our patients achieve their dreams of parenthood.
If you’re in your thirties or forties and wondering about your options for having a baby, our dedicated team is ready to provide the support and guidance you need. Your journey to parenthood is important to us, and we are here to make it a reality.