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Egg Quality CAN be Improved

Egg quality is a combination of the patient’s history and ovarian stimulation or another method to influence the ovarian cycle. Both can improve or reduce the quality of the oocyte.

What is Egg Quality?

Egg quality can only be defined as a probability of an oocyte to become a child, once fertilized. In the vast majority of cases, oocyte quality is the most important variable determining the success of reproduction. Yet, there is no single clinically useful marker that would predict it. Neither the level of reproductive hormones, the size of the follicles, nor even a visual observation of the oocyte after it is retrieved during IVF, can provide guidance to its developmental potential.

What is Poor Egg Quality?

It can be said that a female has poor egg quality only after an IVF attempt, when eggs were obtained, and often fertilized normally, but failed to develop in vitro. In rare cases this can be due to the sperm problems, but in the vast majority of cases this mean that eggs were of “poor quality”.

Ovarian Stimulation May Improve or Reduce Egg Quality

Ovarian stimulation protocols, used to encourage multiple follicle development in IVF, can impact egg quality in both positive and negative ways. When stimulation is carefully tailored to a patient’s individual hormone levels and ovarian reserve, it can help produce a cohort of mature eggs with good developmental potential. However, overly aggressive stimulation may lead to suboptimal egg maturation and trigger biochemical imbalances within the follicles, potentially compromising egg quality. Thus, identifying the optimal stimulation “sweet spot”—to neither under- nor over-stimulate—plays a critical role in maximizing the chances of retrieving high-quality eggs.

There are not many approaches to improving egg quality with assisted reproduction technologies. Here are three examples.

Mini Stim

Mini Stim stands for minimal ovarian stimulation. The idea is that using minimal amounts of FSH for stimulation will produce better-quality eggs. “Minimal stimulation IVF” (often called “mini IVF” or “mild IVF”) was pioneered and popularized by Dr. Osamu Kato at the Kato Ladies Clinic in Tokyo, Japan, beginning in the 1990s. Dr. Kato and his team sought a gentler approach to fertility treatment—using lower doses or fewer fertility medications—to recruit fewer but potentially higher-quality eggs. Since then, various fertility specialists worldwide (including Dr. John Zhang at New Hope Fertility Center in New York and Dr. Geeta Nargund at Create Fertility in the UK) have refined and adopted minimal stimulation protocols, all to improve egg quality, lower costs, and reducing side effects compared to conventional IVF.

Some physicians found that this approach works, while others denied any benefit of the low FSH approach. read more

Highly Individualized Egg Retrieval

Highly Individualized Egg Retrieval was developed by Dr. Norbert Gleicher. He has hypothesized that egg quality is affected by exposure to LH and putative premature luteinization. To pre-empt luteinization, the eggs are harvested just after a few days of ovarian stimulation, as soon as they reach about 13 mm in diameter. Gleicher has reported several cases of improved egg quality and pregnancies in women over 45 years of age. This method has not improved egg quality in younger patients and has not been duplicated by others. read more

Term Stimulation

Term Stimulation or Term Stim emerged recently as a derivative of correcting several major errors in the physiology of reproductive cycle. It introduces a completely new benchmark – time, postulating the existence of a duration of the follicular phase that is required to produce a competent egg – term egg (similar to term newborn). With Term Stim the duration of stimulation is set before the ovarian stimulation even begins. Then, Term Stim uses a patent-pending algorithm to pace the follcles expansion so that they reach the right size at term. To qualify for Term Stim patient must fail at least one IVF attempt and be diagnosed with poor egg quality. read more