Improving Egg Quality
It is possible to improve egg quality. The most important factor in treating a woman with diminished ovarian reserve, which is the cause of poor egg quality, is a timely diagnosis via proper ovarian reserve testing. Ovarian reserve (OR) will continue to decline with time. So the sooner diminished ovarian reserve is diagnosed, the sooner effective treatment can begin, and we will have a better chance of improving the quality (and quantity) of the patient’s eggs -- ultimately resulting in better pregnancy chances.
The therapeutic interventions must take place while the immature eggs are going through the maturation process in the ovaries. Traditional IVF focused on the last 2 weeks of the months-long journey eggs go through, but at that stage, their quality is already more or less determined. An effective treatment must happen earlier. The image shows the length of time each stage of egg (follicle) maturation takes. The orange rectangle indicates the window where immature eggs can be treated so that better-quality eggs are available for retrieval later in the cycle.
Trying to improve egg quality at the end of the months-long process of egg maturation is not as effective as intervening at earlier stages of this process, indicated with the orange rectangle.
How to Improve Egg Quality with DHEA Supplementation
In 2004, CHR’s Dr. Norbert Gleicher and Dr. David H. Barad introduced dehydroepiandrosterone (DHEA) supplementation as a form of innovative fertility treatment for diminished ovarian reserve. Since then, it has demonstrated some remarkable results and DHEA fertility treatment has been accepted worldwide. DHEA (a mild male hormone that is converted to testosterone and estradiol in the body) has been shown to increase the quality of eggs as well as their number, by improving the ovarian environment where the eggs mature.
Diminished ovarian reserve, which is characterized by abnormally low levels of androgens in the ovaries, typically results in poor quality eggs. Supplementation with DHEA raises the androgen levels in the ovaries, and this “restoration” of androgen levels appears to affect egg quality positively. This improvement in egg quality then leads to an array of female fertility benefits, including improvement in embryo quality, increased IVF success rates, decreased miscarriage rates, and decreased chances for chromosomal abnormalities in embryos.
DHEA Supplementation for Low Ovarian Reserve
Dr. Norbert Gleicher explains how CHR came to be the first clinic to use DHEA supplementation to improve egg quality.
How to Increase Egg Quality with CoQ10 (Coenzyme Q10) Supplementation
Recently, we have started using CoQ10 (Coenzyme Q10) supplementation in women with diminished ovarian reserve, in addition to DHEA, in order to improve egg quality. While DHEA works on growing eggs by providing an androgen-rich environment to mature in, CoQ10 is an important nutrient for the mitochondria, small organelles that provide energy to cells--including eggs--in the human body. CoQ10 levels, as well as the number of healthy mitochondria, decline as women age. Top researchers believe that the age-related decline in CoQ10 levels contributes to the age-related loss in egg quality. Supplementing with CoQ10 appears to replenish the much-needed energy supply for the growing eggs, resulting in eggs with higher competency.
There are many women who have been advised by other fertility centers that, because of their poor egg quality, their only chance of conception was with egg donation. But by combining DHEA/CoQ10 supplementation with a customized IVF protocol, we’ve helped countless women improve the quality of their eggs and successfully conceive with their own eggs. In fact, about one third of women who did not have enough good-quality eggs to attempt pregnancies with their own eggs at other fertility centers have successfully conceived and delivered, using their own eggs, after treatment at CHR!
How to Improve Egg Quality after 40
For women over 40, improving egg quality also involves getting the eggs out of the suboptimal ovarian environment sooner than it’s typically done in IVF cycles. In the last few years, CHR investigators have been researching the negative effects of premature luteinization on egg quality. In older women going through IVF, eggs appear to mature much more quickly than in younger women. Retrieving these eggs at the typical timing for egg retrieval, therefore, leads to the eggs being “overcooked” and of low quality. By removing the eggs from ovaries earlier and culturing them in the laboratory instead has resulted in more, better-quality eggs. We named this innovative technique HIER, highly individualized egg retrieval.
Foods to Improve Egg Quality?
There are plenty of foods and nutritional supplements purported to improve egg quality. It’s understandable that patients going through IVF want to find ways to increase fertility on their own and there are some nutrition-related steps patients can take to improve their chances of conceiving. However, a vast majority of the diets, foods and supplements marketed with egg quality claims, other than DHEA and CoQ10, have sufficient scientific backing to take seriously. Patients looking for ways to improve egg quality for IVF should start with a discussion with a physician versed in ovarian reserve and egg quality.
Read more about Egg Quality
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.