Written by: Dr. Aimee Eyvazzadeh, MD, MPH
Written on 4/23/21
Keep reading to learn more about the differences between egg and ovulation quality, and why focusing on ovulation health may be a better goal.
If you’re a member of the fertility community, you’ve likely heard a thing or two about egg quality. We’ve also heard this buzz word thrown around a lot.
Along with it though, we’ve heard quite a few misconceptions. Keep reading to learn more about egg quality and why focusing on ovulation may be a better goal.
What is egg quality?
Egg quality refers to whether or not an egg is chromosomally (or genetically) normal. This means that the egg has the right amount of chromosomes so that when it meets sperm, it can help form a healthy embryo. If an egg doesn’t have healthy chromosomes, it is considered abnormal and likely will not result in a healthy pregnancy.
The genetic composition of an egg is determined long before it’s actually released during ovulation. The egg’s DNA is created when we are born, but can mutate as we age. This means the longer the egg is around, the higher chance that it is abnormal. Because of this, it can be difficult to influence the normality of the egg itself (more on this later!).
Eggs are produced in your ovaries. Through an intricate series of changes in hormones, an egg is matured and released by the ovaries each cycle — a.k.a. ovulation. Therefore, optimal egg quality requires optimal ovarian health and hormone production.
Ovaries are full of follicles and inside each follicle is an egg. Hormones such as follicle stimulating hormone (FSH), estrogen, and luteinizing hormone (LH) act to mature the egg. Ovulation occurs once the mature egg is released.
Together, egg DNA and your hormones make for a healthy egg!
Once the egg is released, however, the ovary’s job is not yet done; it then produces estrogen and progesterone to prepare your uterus and body for conception. Progesterone is especially important since without enough progesterone present after ovulation, the uterus may not be “sticky” enough to allow an embryo to properly implant.
This is why ovarian health is so important — your hormones are essential to producing good eggs and giving them the opportunity to be fertilized and implant. Optimizing ovarian function is a better goal than solely focusing on the egg itself.
How do I know if I have poor ovarian health?
While we always recommend consulting your doctor if you’re concerned about egg quality, there are a few ways to determine if you have poor egg quality due to poor ovarian function. Here are a indicators you might be at higher risk of poor egg quality:
- Inability to conceive
- One or more miscarriages
- Negative PdG (progesterone metabolite) tests before day 10 past peak fertility
- Female partner is over 35
- Low AMH (anti-mullerian hormone) and high FSH (follicle stimulating hormone)
If any of these apply to you, we recommend consulting your doctor.
How to Improve Ovarian Health
In order to improve egg quality, you have to focus on the two main functions of the ovaries: producing the egg and regulating your hormones.
1. The Egg
All women are born with the number of eggs they will have for their whole life. Every egg is in the immature stage and each cycle, one egg will be selected to mature.
If you are born with a genetic condition or of late maternal age, (if you are older or are born with a genetic condition like Fragile X) the genetic makeup of the egg can be abnormal, leading to poor egg quality. The older a woman is, the higher chance her eggs will be genetically abnormal, making it harder for her to have a healthy pregnancy.
Most doctors believe you cannot reverse the genetic makeup of an abnormal egg. This means not much can be done to make an abnormal egg normal again.
However, there are a few supplements you can try to improve the genetic makeup of your eggs, such as CoQ10. CoQ10 is an antioxidant that acts to recharge the mitochondria (the powerhouse of the cell!). The biggest cell in the body is the egg and therefore it needs the most energy to be created. Adding CoQ10 can help fuel the mitochondria in order to create a healthy egg.
I recommend Theralogix NeoQ10 to my patients who are concerned about egg health because its contains a unique formulation with VESIsorb® technology making it a highly bioavailable coenzyme Q10 (CoQ10) supplement that is easily absorbed by the body compared to other CoQ10 supplements.
2. Your Hormones
When you have a healthy balance of estrogen and progesterone, you know your ovaries are functioning at their best because your ovaries actually secrete these hormones. A healthy hormone balance prepares the uterus for conception and gives the egg the best possible chance at conception.
Unfortunately, your hormones can easily be thrown out of balance from things like PCOS, poor lifestyle choices, and stress. Stress especially impacts ovarian function as stress inhibits the ovaries from releasing mature eggs and hormones. This is your body’s natural way of preventing pregnancy during times of stress (which would come into play if, for example, you were starving).
Stress especially impacts ovarian function as stress inhibits the ovaries from releasing mature eggs and hormones.
Why Optimizing Ovarian Function is a Better Goal
As we’ve seen, it’s very difficult — if not impossible — to change the DNA and genetic quality of our eggs. Because of this, optimizing ovarian function is a much more attainable and rewarding goal. There are plenty of ways to test for and treat hormonal imbalances!
Here are some signs to lookout for that may indicate poor ovarian function (i.e., a hormone imbalance):
- Spotting before your period
- PCOS diagnosis
- Endometriosis diagnosis
- Long, irregular, or painful periods
By now, you may be wondering how you can check ovarian function. Luckily, Proov PdG tests can give you insight into the health of your ovulation from the comfort of your home!
Proov tests measure PdG, a urine metabolite of progesterone. After progesterone circulates through your bloodstream, it is metabolized by your liver and excreted from the body in urine as PdG. Studies show that PdG levels in first morning urine show an average of serum progesterone levels from the day before.
When using Proov PdG tests to assess ovulation health, we like to see 3-4 positive test results on days 7-10 past peak fertility (i.e. a positive LH test), with a positive on day 10, to confirm that “successful” ovulation occurred. Successful ovulation refers to an ovulatory event in which an egg is released and PdG (and therefore progesterone) levels remain elevated for long enough post-ovulation to allow for the best possible chance at conception.
Anything less than 3-4 positive PdG tests during the testing window can indicate a problem with ovulation and that may make it more difficult for you to successfully conceive.
Why should PdG levels be high on days 7-10 past peak fertility?
This is a great question! The truth is that days 7-10 past peak fertility make up a critical window when TTC: the implantation window.
Progesterone, as we’ve seen, is critical during conception as it prepares the uterine lining for implantation. Without enough progesterone after ovulation, it can be more difficult for implantation to occur.
Studies show that women are five times more likely to have a successful pregnancy if PdG is elevated during the implantation window. Additionally, studies show that high PdG levels on day 7 past peak (and beyond) increases live birth rates from 18.5% to 91.7%. That’s a huge jump!
How to Improve Ovarian Function
If you have less than 3-4 positive Proov tests, this may be a sign of “weak” ovulation, or poor ovarian function, which could be preventing you from conceiving. Luckily, there are many effective ways to improve ovarian function and increase PdG levels. Here are some of our favorites:
- Diet changes : Some foods have been shown to improve PdG production.
- Healthy lifestyle choices: Maintaining a healthy body weight and avoiding things like smoking can help your hormone levels.
- Seed cycling: Seed cycling involves eating certain types of seeds during certain phases of your cycle to promote a hormone balance.
- Progesterone supplementation: Bioidentical progesterone supplements are great options for raising progesterone levels.
- Prenatal vitamins: Prenatals feed your body with the appropriate nutrients so that your ovaries can make hormones.
If you have any further questions about egg quality or ovarian function, we’re more than happy to answer them! Feel free to reach out to us at firstname.lastname@example.org.