Health

Quantity Versus Quality? Why Your Ovarian Egg Reserve Matters To Your Fertility

By Gwen Farrell
·  6 min read
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We may have the fun, physical aspect of baby making down pat, but it doesn’t hurt to take a deep dive into the clinical side of things either.

Body literacy – or being in tune with our body’s signals and using them to decode their subtle messaging, especially when it comes to our reproductive system – can especially benefit us when the time comes for us to start a family. For some women, that might look like delving into their menstrual cycle, especially if it’s irregular or out of whack. For others, it might mean going to the very source of potential problems with conceiving: our eggs.

While this may seem like an oversimplification, our female bodies strictly play a numbers game when it comes to our eggs. But that doesn’t necessarily mean we have to choose quantity over quality. Whether you’re actively trying to conceive or not, your ovarian egg reserve does matter. Here’s why.

What’s in Your Ovarian Reserves?

High school health class is sadly behind the times when it comes to education on matters of female fertility, so if you’re not well-versed in the subject but want to be, don’t be discouraged. What’s important to acknowledge, first and foremost, is how tightly connected our ovarian egg reserves are with our age. In fact, age is one of if not the most crucial indicator of fertility.

As women, our fertility pretty much peaks in our 20s. After all, puberty and years of menstruation have worked toward that summit, and the chances of conceiving are most optimal during this period. Fertility begins to decline sharply after age 35. However, just because fertility does decline after this age doesn’t mean that it’s impossible to conceive, but the process may be more difficult.

Biologically, our reproductive systems are pretty incredible. Women are born with millions of eggs, and as menstruation begins to occur, our bodies become capable of potentially sustaining a pregnancy. With every year and every menstrual cycle that passes without an unfertilized egg – particularly after age 35 – the number of viable eggs begins to dissipate.

Around age 35, our number of healthy eggs starts to decline.

Our egg production occurs as we mature in our mother’s womb, around 20 weeks' gestation. When we menstruate for the first time as pre-teens or teenagers, that number has already declined to around 350,000 to 500,000 eggs. Our reserve also loses hundreds of unfertilized eggs during each cycle. As we age, so do our eggs, and it’s also important to know that women over 35 not only have a decreased egg reserve, but also an increased number of abnormal eggs.

Here’s What a Healthy Egg Looks Like

We’ve talked about egg reserve, or the quantity side of things, but what about quality? Egg quality is just as important for optimizing your chances of conceiving, and it can be a crucial aspect of conceiving, especially if a woman is already outside the window of her most fertile years. Our number of eggs may be finite, but that doesn’t mean we can’t improve their quality.

Older women are at an increased risk for abnormal eggs. An abnormal egg or one with poorer quality often has poor cell division with chromosomal deficiencies, and if fertilized, can result in serious pregnancy complications and difficulties, including miscarriage. Fertilization of an abnormal egg may result in no uterine implantation, or implantation that is not able to be sustained, resulting in miscarriage. 

As you’ve probably already guessed, healthy eggs that are of good quality won’t have these issues – they’ll have enough energy for accurate cell division and be able to sustain a pregnancy with little to no complications for the developing baby. A healthy fertilized egg correlates to a healthy pregnancy and a healthy baby.

If you’re potentially concerned that you might have poor egg reserve or poor egg quality, screening tests can definitely address those concerns for you. An anti-mullerian hormone test can detect potentially low egg reserves. An AMH screen is a reliable indication, as it’s a hormone that is produced by your ovarian follicles. Contrary to other hormone screens, such as a follicle-stimulating hormone test, the AM hormone doesn’t fluctuate depending on where you are in your cycle, meaning that it’s a dependable test to measure your egg reserves. If your AMH screen measures high, you have a healthy number of mature, viable eggs, and if the AMH measures low, you likely have a poor ovarian reserve. If your ovarian reserve is low, don’t be too discouraged – you just need one healthy egg to get pregnant naturally!

Ways To Improve Egg Health

While we can’t increase the number of eggs we have, we can improve their quality. Improving egg quality starts with improving ourselves. Fertility specialist Dr. Jolene Brighten advises five specific steps for improving egg health: eating a diet of rich, fertility-fueling foods that support a balance of hormones, increase antioxidant consumption, decrease intake of environmental toxins, reduce stress, and take certain supplements, like coenzyme Q10.

Dr. Kalea Wattles, functional medicine and fertility specialist, recommends focusing on supporting your mitochondria, as they play an essential role in cell division by providing the necessary energy to the cell. Some supplements she recommends for mitochondrial support are NAC, CoQ10, resveratrol, and alpha-lipoic acid. If you’re looking to begin your conception journey, you should begin these practices at least a few months in advance to improve your egg quality and health.

You can improve your egg quality by increasing antioxidants and decreasing toxins and stress.

It may seem tempting – especially because it’s so heavily advertised – to consider freezing your eggs or IVF if you’re frustrated with the process. Egg harvesting, IVF, and egg freezing seems to be the go-to solution for women over a certain age, or women who dream of having a family but aren’t ready yet. But what’s not often advertised is how damaging these processes may be, physically, financially, and emotionally.

Contrary to widespread belief, you can work on and preserve your fertility without freezing your eggs (and face the potential complications of doing so). And you don’t have to completely deplete your ovarian reserve with IVF to achieve a pregnancy – especially because the process actively depletes egg quantity, as many are needed to attempt a successful embryo. Wherever you are in your fertility journey, the time to start thinking about your ovarian reserve is now, not later. 

Closing Thoughts

If you’re 30 and haven’t met Mr. Right yet or you’re fed up with a process that’s become long and drawn out, don’t feel pressured to immediately consider outside procedures like freezing your eggs. The potential for better body literacy, better knowledge, better fertility, and yes, even pregnancy, is within you. All that’s required is a little homework – on yourself and your ovarian reserves – to begin to understand what your potential future may look like. 

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