11 Questions to Increase Egg Reserve and Quality

Women’s egg reserve decreases with age.

Women’s egg reserve decreases with age. Anadolu Health Center In Vitro Fertilization Center Director Assoc. Prof. stated that in order to have children, the egg reserve, that is, the number of eggs as well as their quality, is much more important and that egg quality decreases with age. Dr. Tayfun Kutlu and Gynecology, Obstetrics and In Vitro Fertilization Specialist Dr. Ebru Öztürk Öksüz answered the frequently asked questions about the egg reserve in women…

On average, how many eggs does a girl have when she is born?

When a baby girl is born, the number of eggs in her ovaries is approximately 1.5-2 million. This number decreases until adolescence and drops to 300-400 thousand. Women ovulate every month along with their menstruation. During their fertile period, the number of eggs is around 300-400 thousand. These eggs are used every month, and when the eggs run out, the menopause process comes into play.

Why does egg reserve decrease over time?

Every month, around 1000 eggs rise to set out and all of them try to grow, but since not all of them can stand out, usually 1 or 2 eggs take the lead in the female body every month. She’s getting ready to lay those eggs. Women are born with 1.5-2 million eggs, but around 1000 eggs are lost every month. However, not every woman is born with the same number of eggs and does not enter puberty with the same number of eggs. Therefore, there may be differences in women’s fertility periods.

What are the factors that affect or accelerate the decrease in egg reserve?

There are many factors that affect the reduction. The first is how many eggs we are born with. We can also think of this as a bit of genetic luck. In fact, if you come to life with more eggs due to genetic luck, your fertile period can be extended even if your eggs are lost over time. But of course, smoking and stress can also reduce the egg reserve during this fertile period. We also know that this reserve definitely decreases with age. We know that when there is any operation on the ovaries, that is, any surgery that may affect the tissue of the ovaries, or any medication use, the ovarian reserve necessarily decreases. We also know that chemotherapeutic and radiotherapeutic agents used in some systemic diseases such as cancer shorten the fertility period considerably by reducing the most sensitive cells in our body.

After what age does the decrease in egg reserve accelerate?

In the past, we used to consider the age of 40 as a risky age and said that the number of eggs decreases at a very significant rate after the age of 40. Over time, we accepted that 37 years of age is a more risky age. Now, when we look at the data around the world, we can say that this decrease accelerates after the age of 35. Nowadays, the egg reserve in women, that is, the decrease in the number of eggs, and even more importantly, the problems in egg quality occur at an earlier age. That’s why we can say that it is necessary to act faster after the age of 35 to have a baby.

Compared to 10 years ago, we started to see a much higher risk of serious egg reserve deficiency or early menopause. The percentage of this in society has begun to increase significantly. Since this increases, we recommend not exceeding the age of 35 to have a baby.

What are the reasons for the rapid decrease in egg reserve?

If there is early menopause in the family, it is very important to be warned about genetic factors coming from the woman, especially her mother, aunt, sister. Because this may be a finding that shows us that there is a genetic predisposition to low reserve in that family. Additionally, for women who require chemotherapy or have a systemic disease such as cancer, their ovarian reserve may be evaluated beforehand and frozen and stored if necessary. These types of treatments are factors that seriously reduce egg reserve.

Smoking and nutritional conditions are also very important. We attach great importance to healthy eating and avoiding smoking. Surgeries due to ovarian cysts or any other problem that may occur in the ovaries are among the biggest problems of women.

What should be the ideal egg reserve?

How many eggs do I need to have in my “egg reserve” to have a child? Can a number be given? We are looking for an answer to the problem. In fact, even one egg is enough to have a child. It’s all about the quality of that egg, the woman’s fertility, and the formation of a beautiful embryo from that egg. In fact, one egg and one sperm are enough to have a child. Therefore, women with very low egg reserves can also become pregnant spontaneously. But of course waiting here is a bit risky. Because while waiting, the eggs may run out completely. That’s why we quickly switch to effective treatments for these women. Of course, we think that the more eggs we get, the more benefits they will have in effective treatment.

It would not be correct to say “this many eggs are needed for pregnancy”. However, the more eggs we have, the better it is for pregnancy. The more good quality eggs and embryos combined with sperm, the higher the chance of choosing the best among them, and the higher the chance of freezing and storing them for the next pregnancy after selecting the best ones.

When does this reserve become “insufficient” to be a mother?

It is important to evaluate a patient with low egg reserve as a whole. In other words, current situations such as how long she has been married, how long she has wanted to have a child, and how her husband’s sperm are, need to be evaluated. The approach to a 20-year-old patient with low reserves is not the same as the approach to a 40-year-old patient with low reserves. You can evaluate a 20-year-old newly married patient with low reserves by monitoring the eggs for a few months, but at the age of 40, you may need to make more radical treatment decisions. The fertility period of patients needs to be evaluated very carefully. You should not be late, you should use your time wisely.

What are the symptoms of low egg reserve?

By counting the number of eggs in the patient’s ovaries during ultrasound, we can tell whether the egg reserve is appropriate for the patient’s age. Of course, we also have some hormone tests that support us. The most important of these is Anti-Mullerian Hormone (AMH). If Anti-Mullerian Hormone is measured correctly, it can give us reliable results regarding egg reserve. Again, it is necessary to evaluate the patient’s FSH and E2 values ​​together on the second or third day of menstruation. All these tests and checks give us information about the patient’s egg reserve.

What precautions can be taken to prevent the egg reserve from decreasing rapidly or the quality of the eggs from decreasing?

There are many situations we cannot control. We tell the patient, “Stay away from stress,” but this is not an easy thing to do in today’s living conditions, especially for a working woman. However, even if exercise does not increase the number of eggs, it improves their quality. In other words, it increases the amount of oxygen in the tissue and reduces stress. This definitely contributes to egg quality. There are factors in our lives that we can change and factors that we cannot change. Healthy nutrition, regular exercise, a protein-rich diet, not smoking, and the use of some antioxidant drugs with the recommendation of a physician, especially after the age of 40, will definitely have a positive effect on the egg quality we will obtain in the egg reserve.

Is the quality of eggs more important than their quantity?

Definitely. The most important thing is egg quality. The most important meaning of egg reserve, that is, the number of eggs, is how many processes we have and how easily we can move or not. In terms of pregnancy, having 2 quality eggs rather than 10 poor quality eggs is always preferred by every physician.

The decrease in the number of eggs warns you that not only the number but also the age is important. In fact, the most important factor is age. These are all factors that reduce or increase the chance of pregnancy. For example, you are 40 years old and your ovarian reserve is very good. This does not mean that you can postpone pregnancy. Because age is a factor that negatively affects egg quality. Therefore, it is necessary to consider many factors together when making an evaluation. Egg reserve, age, duration of marriage of the patient, how long she has wanted a child, whether she has any disease, surgeries, previous pregnancies and sperm are factors that should be taken into consideration. In other words, it is necessary to evaluate each patient as a whole. Not only egg reserve, every factor can change the treatment approach.

What is the healthiest age to give birth?

We can say that the age between 25 and 35 is the best age for birth. Even though we sometimes don’t admit it, we are starting to get older. Our metabolism begins to slow down. It is especially beneficial for couples who want to have a baby to take the age factor into account.