What is low egg quality?

There are several factors implicated in female fertility. The two main variables are:

1. Egg quantity, or your ovarian reserve – The number of eggs available in your ovaries.
2. Egg quality – The viability of those eggs in your ovarian reserve.

Every biological female is born with a supply of eggs that diminishes as she ages. In addition to having enough eggs, those available eggs must also have the right number of chromosomes to be viable for fertilization and growth.

At the microscopic level, low-quality eggs (especially those with chromosomal abnormalities) can halt the normal fertilization and development process piloted by your reproductive system. These eggs might:

• Fail to be fertilized
• Fail to implant in your uterine wall
• Lead to pregnancy loss (miscarriage)

For this reason, the only plausible “sign” of low-quality eggs is the inability to achieve or maintain pregnancy after repeated attempts to do so—if under the age of 35, after 1 year of trying; if over 35, after 6 months of trying.

What causes poor egg quality?

Other factors could be contributing to your poor egg quality and overall fertility challenges. The main ones include:

• Your age – Age is considered the most critical factor in determining female fertility, including female egg quality. For most women, egg quality and quantity both abruptly decline in the mid-30s. Learn more about how age affects fertility.
• Medical conditions – Certain reproductive health conditions, like endometriosis, can impair egg quality and overall fertility. Other conditions, both reproductive and nonreproductive, also interact significantly with fertility, including PCOS (polycystic ovary syndrome), PID (pelvic inflammatory disease), and thyroid illness.
• Your lifestyle –Research indicates certain habits like tobacco use, alcohol consumption, and eating patterns are linked to lower egg quality and quantity.
• Your environment – A growing body of research indicates that certain environmental toxins can adversely impact female and male fertility. Toxins to avoid or limit your exposure to include pesticides (found in many foods and produce items) and household cleaning supplies.

How to Boost Egg Quality and Support Fertility Overall

Because egg quality is mainly tied to the passage of time, it’s generally not considered possible to retroactively improve the quality of your ovarian reserve if you’ve reached a certain age.

That said, certain strategies may help defer ovarian aging and possibly optimize your fertility overall.

• Eating a diet rich in omega-3 fatty acids –Several papers have observed a correlation between a higher-quality ovarian reserve and the lifelong consumption of omega-3 fatty acids, either as food or in supplement form. Eating salmon during pregnancy and before can be one way to pack your diet with this nutrient. One set of researchers even recommended omega-3s as a “short-term dietary treatment” for those with compromised oocyte quality.

While more remains to be researched, packing more of this fertility-forward nutrient into your diet could be a way to boost your chances of conceiving. You can also start taking a prenatal vitamin to improve fertility, giving your body the vitamins and nutrients it needs to support a pregnancy. Check out some vitamins to help get pregnant fast.

• Maintaining a healthy weight – Being either overweight or underweight can throw your hormones and reproductive health out of whack, which can ultimately compromise your fertility. Having excess adipose tissue can drive up your estrogen levels, while not enough of it can have the opposite impact. For this reason, hovering at a healthy weight can help stabilize your hormones.
• Quitting smoking – A vast body of research shows that smoking accelerates ovarian aging. Smoking causes oxidative stress, one of the primary forces that diminishes egg quantity and quality. It can also lead to major health issues and defects in infants if you’re able to conceive successfully.
• Limiting alcohol consumption – Excessive alcohol consumption has been shown to stress healthy hormone patterns that enable you to have a baby, leading to subfertility. In more recent studies, evidence suggests even moderate drinking could interfere with fertility at certain times in the menstrual cycle (specifically, the second half).

As a general rule, it’s best to put alcohol use on pause while you’re trying to conceive either naturally or during fertility treatment.

• Limiting caffeine consumption – Scientists haven’t quite reached a consensus on how caffeine impacts fertility. However, there’s some evidence to suggest caffeine in excessive amounts may impair your ability to conceive. It’s best to stick to 200 mg of caffeine per day while you’re trying to get pregnant.
• Avoid stress – While this can sometimes be easier said than done, it’s been found that stress affects conception. If there are external stressors around you and your partner, working through them and avoiding them can help with improving your fertility.
• Avoiding environmental toxins – Environmental agents are routinely implicated in damage to both female and male fertility. The two toxins raising the most concern are:
• EDCs, or endocrine disrupting chemicals – These interfere with normal hormonal function and can impair ovarian, thyroid, and overall reproductive health.
• Heavy metals –Lead, mercury, arsenic, and cadmium are some of the main metals that can affect female fertility. Exposure can come from your physical environment, like the paint in your home, or through diet (for instance, many fish have a high heavy metal content).

While certain environmental toxins are unavoidable, you do have the power to make other choices to limit your exposure. For instance, eating mostly organic produce, if you can afford it, can lower your exposure to endocrine-disrupting pesticides.

Remember, these interventions can’t reverse the age or quality of your eggs. However, they can be beneficial for the biological environment in which your eggs develop, which may indirectly help improve fertility outcomes.

How Fertility Specialists Determine Low Egg Quality

At present, there are no scientific lab tests to screen people for low-quality eggs. The only reliable determinant of egg quality is age—physicians’ and scientists’ leading benchmark for female fertility. In general, the higher the ovarian reserve, the easier it is for a woman to become pregnant.

Even though no tests directly evaluate egg quality, two key fertility tests can help estimate a person’s overall egg count:

• AMH (anti-mullerian hormone) test – The AMH test is considered the most sound screening for estimating the ovarian reserve. It measures levels of AMH, a hormone produced by the ovaries. Higher levels of AMH generally indicate a higher egg count, while low AMH can point to a deficiency.
• FSH (follicle stimulating hormone) test – FSH tests may also be used to evaluate fertility. However, these are considered less reliable because FSH levels fluctuate daily and between menstrual cycles (AMH levels tend to be more stable). That said, it can still be a useful test when taking a comprehensive picture of your fertility.

In addition to hormone-measuring tests, doctors can also use imaging techniques like ultrasounds to gauge female fertility. In combination, all of these evaluation tools can give you a clearer picture of where you stand on your prospects for conceiving naturally or through assisted reproductive technologies.

When to See a Fertility Specialist

If you’ve been trying to conceive without success, the next best step you can take is to reach out to a fertility specialist. Experts recommend seeking counsel if you are:

• Under 35 years years old and have been trying to conceive for 1 year
• Over 35 years old and have been trying to conceive for 6 months
• Prone to abnormal menstrual cycles (this can make it difficult to predict ovulation)
• Someone with a reproductive health condition, like polycystic ovary syndrome (PCOS)
• Someone who’s experienced repeated pregnancy loss

Poor egg quality can certainly contribute to female infertility, but it’s just one of many possible causes. Importantly, the CDC draws a distinction between infertility and impaired fecundity:

• Impaired fecundity is having difficulty getting pregnant or seeing a pregnancy through to term
• Infertility is the inability to conceive after 1 year or 6 months of attempts, depending on your age

It’s important to mention that sperm quality and male fertility can also contribute to struggling with conception. Around ⅓ of infertility cases are thought to originate with the female, while ⅓ stem from male infertility. In around ⅓ of infertility cases, the cause is unknown.

Fertility specialists can help by reviewing your and your partner’s medical histories, conducting fertility testing to identify any possible causes, and recommending treatment options for your specific family planning goals. There are many treatment options available, from less invasive procedures (like ovulation triggering) to more exhaustive ones, like IVF.

Success rates for fertility treatments largely depend on your age and the identified cause (if applicable) of your fertility challenges. That said, plenty of couples are able to overcome issues like ovarian quality, take advantage of assisted reproductive technologies, and successfully grow their families.

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