The fastest way to a healthy pregnancy is to ensure the maturation and release of the best eggs possible.
Obviously there is more to it than that-for one thing, sperm are necessary-but good quality eggs are the basis of any successful outcome, and confirming egg quality is therefore the focus for so much of what we do.
Most women have a mix of eggs that are of good quality (fertilization should lead to a baby) and not good quality (the fertilized egg won’t grow, or if it does, won’t continue to develop into a healthy pregnancy). Hopefully you have more of the former.
To find out, we will take your history, and complete a series of tests. The results can conflict somewhat, so though you cannot focus too much on any one result, the larger picture should come into view once all the results are back.
Below are the factors that we consider; click on the links to learn more.
1. Your age
Nearly all women will have good eggs under the age of 35y.
The vast majority will have good eggs until 38y.
Over age 38, everyone is different. The average age beyond which women will not have a healthy ongoing pregnancy is 42y.
2. Your Ovarian reserve
Antral follicle count
3. Cycle factors:
4. Outcome of any recent pregnancies
Early losses followed by longer and longer times to pregnancy may imply decreasing egg quality.
5. Lab results from any IVF cycle
It is 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 is is probably safer to do PGS on day 5 or 6 of embryo development (”trophectoderm biopsy of blastocysts”). As over 90% of aneuploidy is thought to be of maternal (egg) origin, PGS becomes the most accurate test of egg quality that we have.
Egg quality is complicated!