In this episode I’m going to be talking about testing egg quality.
So you may be asking yourself, how do I know if I have poor egg quality or not?
And I wish I could tell you that there is a really simple and easy test that you can do to find out.
But unfortunately there isn’t one.
However, there are a number of tests that can be done that can help to piece together your fertility status puzzle but there is no egg quality test as such.
For women going down the IVF path, it is possible to do pre-implantation genetic testing which can give some insight into egg quality.
Pre-implantation genetic testing, involves testing embryos for either a specific or known single gene condition or chromosome variation.
For women doing IVF, this means that only chromosomally healthy embryos will be selected for transfer, enhancing the chances of bringing a healthy baby home.
You may wish to consider this test if…
- You or your partner, or both, carry a gene mutation that you want to avoid passing on to your future baby
- You’ve experienced recurrent losses
- A previous pregnancy has been affected by a chromosomal variation or
- You’ve experienced repeated IVF failure
Hormone biomarkers such as FSH, AMH and estradiol are commonly tested and may help to provide some insight into your fertility status but they do not confirm your egg quality.
Let’s discuss these hormone biomarkers…
I’ll start with follicle stimulating hormone also known as FSH.
FSH is released by your pituitary gland which is located in your brain.
This is the hormone that stimulates the growth of your ovarian follicles.
FSH plays an important role in ovulation and the maturation of egg cells.
Throughout the different phases of the cycle, FSH fluctuates, spiking right before ovulation.
For women with irregular cycles, they may have low FSH levels which can make getting pregnant difficult.
For women with high FSH levels, this may indicate primary ovarian insufficiency.
Primary ovarian insufficiency is defined as having no period for 4-6 months in women under the age of 40, who have elevated FSH and low estradiol levels.
In other words this is when the ovaries stop working normally and fail to release an egg in women under the age of 40.
It is best to test FSH on cycle day 3.
A result less than 10 international units per litre suggests good ovarian reserve.
A result between 10-20 international units per litre suggests possible ovarian overstimulation and may indicate possible fertility problems.
A result greater than 20 international units per litre suggests ovarian overstimulation, perimenopause/menopause and/or primary ovarian insufficiency.
The next hormone biomarker is anti-mullerian hormone, also known as AMH.
AMH is a hormone that is secreted by cells in developing follicles, which are fluid-filled sacs that house the eggs in the ovaries.
The level of AMH in the blood can be used to help estimate (I just want to repeat that bit, estimate only) ovarian reserve, the number of follicles in the ovaries.
It doesn’t tell you how many eggs you have left but it compares you to others in your age group.
It is not a reflection of your egg quality and it does not reflect your ability to get pregnant.
If you’ve been told you have a low AMH level, it does not mean you are infertile and can’t get pregnant.
This level is really only useful to a fertility specialist planning for egg freezing or an IVF cycle as it can help them to determine the best course of treatment.
For example, this level helps the fertility specialist to effectively prescribe simulation medication.
A woman presenting with a high AMH level may require a lower dose of stimulation medication and a woman with a low AMH level may require a higher dose.
Women who have a low ovarian reserve can fall pregnant naturally at the exact same rate as women with a high ovarian reserve.
A higher AMH level doesn’t automatically equal lots of quality eggs and a lower AMH doesn’t automatically equal too few quality eggs.
I want to quickly share with you some comments I received recently on one of my IG posts talking about AMH.
The first comment reads…
“I was told my levels were 1.7 when we first started trying to conceive. A year or so of IVF, I’ve now got a 17 month old. Don’t give up.”
The next comment reads…
“I had low AMH and high FSH, told egg donor was my only option. Now I have 2 beautiful boys conceived with my own eggs at 35 and 37 (conceived naturally at 37). It is possible.”
And the last comment that I will share reads…
“I was told I had low AMH and the only way I could get pregnant was with IVF. I got pregnant naturally a month later. The doctors didn’t believe me and told me I couldn’t possibly be pregnant. That not possible, is now 7 months old.”
So I hope that puts your mind at ease if you’ve been told that you have a low AMH level.
And the last hormone biomarker that I am going to be mentioning in this podcast episode is estradiol.
Estradiol is a form of oestrogen and is involved in the communication between the ovaries and the brain.
When estradiol levels start to increase, it stimulates the ovarian follicles to grow.
Too much estradiol has the potential to suppress follicle stimulating hormone and interfere with the ovaries’ ability to produce mature eggs.
So I hope that you now have a better understanding of the tests that are commonly used to help piece together the fertility status puzzle.
Just to reiterate, there is no test that can be done to test your egg quality.
But there are some signs to look out for that likely suggest that your egg quality is low and I will be discussing these signs in episode 6 of the podcast.
Before I wrap this episode up, I just want to mention that even if there was a specific egg quality test, and even if your results came back that you have poor egg quality, you still have the power to turn that around and boost your egg quality.