By Dr. Lisa Adams, ND
Whether you’re scrolling through Insta and wondering about the latest fertility supplement being promoted, or endlessly searching the web for a new fertility health hack, you’ve no doubt have heard the term ‘egg quality’ before. The lack of accurate and relevant information in the vast scope of the web is disappointing at best, so as a fertility focused Naturopath here in Mississauga, I’m hoping to shed some much needed light onto this term. I’ll outline what it actually means, along with other related terms, and how it applies to your fertility journey.
I think ‘Poor egg quality’ is a diagnosis too commonly used in medical assessment. Unfortunately, it often shows up in a brief conversation with a fertility doctor without a proper explanation about what this actually means. This term is frequently used as a static fact; immovable, insurmountable, and can greatly affect the emotional charge, which may already be significant, of an individual or couple that is seeking help.
The best way to define and describe egg quality is: The ability of an egg to turn into a healthy baby, and may vary greatly from woman to woman and from cycle to cycle. It really is a term that is dynamic, broad and subjective. Some experts would even say the only real measure of egg quality is actually the performance of an individual egg in an IVF cycle. So, you can see that this is not, in fact, a term that should be defining or predicting the entire fertility journey of an individual or couple.
The other key thing to keep in mind as we dig into this topic is that there are NOT any definitive tests for egg quality. That being said, age IS the most influential factor that will affect this slippery term of egg quality, especially for women over the age of about 35. (Somigliana, 2016) So, why does age affect egg quality? Women are born with the number of eggs she will have for her entire lifetime. When they are released later in a woman’s life, they may have, over time, accumulated genetic changes, and are likely affected by oxidative stress.
“I think poor egg quality is a diagnosis too commonly used in medical assessment”
Even with all that being said, we have to keep in mind that a younger woman can still be affected by ‘poor egg quality’ thant is usually typical for her age! There are many reasons this may happen, including certain conditions that may affect overall fertility and egg quality, like polycystic ovarian syndrome (PCOS), endometriosis, hashimoto’s Thyroiditis, Antiphospholipid Syndrome (APA). (Szeliga 2021).
‘Unexplained infertility’ is another term we hear often, and is overused. It should only be used when all other explanations are ruled out. Age related infertility or reduced egg quality is likely a large portion of women told they have ‘unexplained infertility.’ However, as outlined above, there are many other conditions influencing egg quality that should be explored in a thorough work-up.
When you’re working with a fertility clinic towards an IVF cycle, there is one more aspect to be aware of: Despite our age, our oocytes may carry other genetic mutations that affect how they develop.
Genetic testing of embryos is the only way to control the genetic aspect of egg quality! We can’t impact this part of egg quality and fertility without use of this technology. Namely, Preimplantation Genetic Testing (PGT), where genetically abnormal embryos (aneuploid) are identified so that only genetically normal embryos (euploid) are transferred in an IVF transfer cycle. Aneuploid or mosaic embryos (aka poor embryo quality) may cause birth defects, miscarriage, or may not implant properly.
The other term to be familiar with, and can be confused with egg quality, is ‘Egg Quantity.’ Egg quantity is only associated with egg quality, but they are not the same thing! Egg quantity is often explored as you start doing some testing with a fertility professional. You may be more familiar with some of these other terms and measures, including:
Ovarian Reserve: This is the estimation of your egg ‘pool’ (quantity) and is used for estimating your response to (In Vitro Fertilization) IVF.
Antral Follicle Count (AFC): Using ultrasound technology, small ovarian follicles can be seen and counted. More follicles generally translates to higher ovarian reserve.
Follicle Stimulating Hormone (FSH): This hormone is released from your pituitary gland and stimulates follicles in ovaries to mature. It is generally tested early in your menstrual cycle, and will continue rising until you ovulate. It gives an indication of how ‘loud’ your brain has to ‘talk’ to your ovaries to make you ovulate, and therefore higher levels may indicate lower ovarian reserve.
Anti-Mullerian hormone (AMH): This is produced by tiny ovarian follicles and tested from the blood. It represents the size of the pool of growing follicles (egg quantity), but does not give us accurate information for those with polycystic ovarian syndrome (PCOS).
Fertility medicine is evolving very quickly. We’re learning more about what influences fertility, and how to put all the pieces together to have the best outcomes for those seeking answers and care. Our fertility Naturopaths here at Lakeside Natural Health Centre are helping to bridge the gap in your fertility care by giving you a space to ask questions, understand testing and overall options, and then make informed choices aligned with your health and fertility goals.
Unique to the care with our Naturopathic Doctors is how we bring both the cutting edge research together with the personalized care. This, of course, always includes the natural health and lifestyle pieces that are so impactful and generally not well understood or emphasized in other fertility care models. We do know that lifestyle does have an impact on egg quality, and we’re becoming more confident every year about certain supplements having an effect. Researchers still don’t know much about all the other factors that affect egg quality from cycle to cycle, but there is also emerging evidence on Light Emitting Diode (LED) near-infrared low level light therapy (LLLT) which may be able to increase egg quality through its effects on the mitochondria of the oocytes.
I’m excited to share more about the diet, lifestyle and supplements that have an impact on egg quality and fertility in the next blog, so stay tuned!
Proper assessment and testing is KEY to have all the information needed to make informed health care and fertility choices. Discussing your prenatal and fertility care with your health professional, like a fertility focused Naturopathic doctor, is a great next step towards being empowered to make meaningful choices towards having a healthy baby.
If you are told you have ‘poor egg quality,’ don’t take this to mean that your journey towards having a healthy baby is over! You may still ovulate a healthy egg, and have a healthy baby. You may just need more support.
Reach out HERE to connect with a fertility focused Naturopath at Lakeside Natural Health Centre in Port Credit, Mississauga.
About Dr. Lisa Adams, ND:
Dr. Lisa is a fertility, women’s health and children’s focused naturoapthic doctor with over 15 years of clinical expertise and has been treating moms and kids for over a decade in Mississauga, Ontario. For more information about Dr. Lisa’s practice, click HERE
Our Naturopathic Doctors at Lakeside Natural Health Centre are here to support you in your fertility journey, book a free meet and greet to learn more!