We look for five factors:
- Your age. Nearly all women under 35 will have good eggs. The vast majority will have good eggs until they’re 38. Over age 38, everyone is different. The average age beyond which women will not have a healthy ongoing pregnancy is 42.
- Your ovarian reserve. We measure that by AMH, antral follicle count, and FSH.
- Your cycle. Cycle length, premenstrual spotting, ovulation day, peak estradiol and peak progesterone can all help us determine the quality of your eggs.
- Outcome of any recent pregnancies. Early losses followed by longer and longer waits before pregnancy may mean decreasing egg quality.
- Lab results from any IVF cycle. It’s through IVF that we finally can see the eggs. The most accurate way of testing eggs is IVF with Preimplantation Genetic Screening (PGS). You can do PGS of the eggs themselves (”polar body biopsy”) but it’s probably safer to do PGS on day 5 or 6 of embryo development (”trophectoderm biopsy of blastocysts”). Over 90% of chromosomal abnormalities (“aneuploidy”) is thought to be of maternal (egg) origin, so PGS becomes the most accurate test of egg quality that we have.
Egg quality is complicated!