Understanding Ovarian Reserve and Egg Quality

Women are born with around 1 million eggs, and by the time they reach puberty, they have about 300,000 eggs. Of these, only 300 to 400 will be ovulated throughout her life.

During each menstrual cycle, a certain number of follicles are activated to prepare for ovulation, but just one egg matures and is released from the ovary. By the time a woman reaches menopause, egg supply has been depleted.

What is ovarian reserve?

Ovarian reserve is the technical term for the number of eggs a woman has. A woman’s ovarian reserve is assessed via ultrasound to count the number of follicles within both ovaries and by hormone tests.

One of those hormone tests is for Anti-Mullerian Hormone (AMH), which helps indicate the number of eggs a woman has. The higher the value of AMH, the more eggs a woman has.

Another hormone test is FSH levels on the third day of the menstrual cycle. If FSH levels are high, it means the body is producing more FSH to stimulate the ovary.

These tests indicate the number of eggs (ovarian reserve) and not the quality of those eggs. However, if your ovarian reserve is low, you may have more difficulty getting pregnant.

What is egg quality?

Egg quality consists in the ability of the egg to be fertilised, to multiply, to implant in the uterus and develop into a baby. Age is the most crucial factor affecting egg quality. In women over 40 or with high FSH levels, eggs may appear normal, fertilize normally, and undergo initial embryonic cleavage but have difficulty implanting.

Improving the quality of your eggs

Even though a woman is born with all the eggs, she will ever have, these are in a ‘sleeping’ state. It takes 3-4 months for an egg to develop, and in one cycle, the egg will finally mature. During this process, several lifestyle and environmental factors can affect egg development and ultimate quality.

So, even though you can’t produce more eggs, you can improve the quality of the eggs you have. Egg health is, in fact, crucial to fertility, so each egg can mature well, ovulate, fertilise, implant and finally, develop into a baby. Let’s look at seven aspects that can help you improve egg quality:

  1. Hormones: The amount and timing of hormones in your body are important to growing, mature and ovulate an egg. Hormones can be affected by blood sugar levels, stress, lack of sleep.
  1. Nutrients: Improve egg quality by avoiding “white” carbohydrates and processed foods with trans fats by limiting alcohol, caffeine, and starchy vegetables. Include more non-starchy vegetables, lean un-processed wild and grass-fed protein and healthy fats. Proteins are useful for hormones and egg quality. Non-animal protein seems to be better than animal protein when it comes to fertility
  1. Supplements: Energy is needed for proper egg development and for an egg to mature with the correct number of chromosomes. Apart from getting energy from food, you may want to supplement with C0Q10. This supplement takes months to build up in the tissues, so start at least 3-4 months in advance.
  1. Free radicals: Free radicals are a natural part of our metabolism, but if you drink alcohol, smoke and have a poor diet, the values increase and are harmful to the egg. Including antioxidants in your diet, neutralises free radicals, so make sure you include fruit, vegetables, Vitamin C and Selenium.
  1. Habits and medical conditions: Alcohol, smoking and drugs affect egg health. Being overweight or underweight also affects fertility. Gum disease may also be a concern, so make sure you are flossing and brushing. Certain conditions like Vitamin D deficiency, hypothyroidism, Celiac disease can also affect egg health. If you suspect or know that you have any of these conditions, speak with your doctor.
  1. Environmental factors: You can improve egg quality by reducing your exposure to specific toxins that can harm fertility. BPA (a chemical found in plastic food containers and paper receipts) and phthalates (found in plastics, fragrances, beauty and cleaning products) disrupt proteins that help make oestrogen and oestrogen production, and it blocks oestrogen from binding to its receptors. Oestrogen is needed to stimulate follicle growth further for the egg to mature.
  1. Managing emotions and stress: Stress and emotional ups and downs can affect ovulation, fertilisation and implantation. Meditation, mindfulness, going to the gym or a walk in the park can help manage emotions and stress.

Even though women are born with a limited supply of eggs, there is a lot that can be done to improve the quality of those eggs. If you make lifestyle and environmental changes today and are able to sustain those changes, that will be reflected in your egg quality in 3 to 4 months’ time.