Simple changes to help improve your egg quality

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Fertility is largely influenced by the quality of both eggs and sperm. Age is the biggest determinant of egg quality1, but other factors such as diet, weight, physical activity and exposure to toxins (including illicit drugs or medications) also play a role. The good news is that whilst you cannot modify your age, there are things that you can do to improve egg quality and your chances of getting pregnant.

This involves making changes (if needed) to areas of your life that can influence various biological processes in the body – fertility included. With the proper modifications, you can protect your eggs from the harm caused by these factors and increase your likelihood of conceiving.

Why is age such a big factor?

Fertility starts to decline at the beginning of a woman’s 30s, but the decline is more rapid after age 35.1 This is because women are born with a lifetime supply of eggs – around 1-2 million – and this reserve gradually decreases over time. Egg quality also declines with age as the DNA in eggs becomes more susceptible to damage.

Eggs of lower quality are less likely to fertilise and develop into an embryo, affecting the chances of pregnancy. Additionally, older eggs are more likely to be affected by chromosome imbalance, which is associated with difficulty falling pregnant, an increased risk of miscarriage and a higher incidence of children born with a chromosome disorder (e.g. Down Syndrome).2

Unfortunately, once an egg’s DNA is damaged or the egg has an incorrect number of chromosomes (we call this aneuploidy), it cannot be reversed or repaired. For this reason, it’s important to protect your egg quality as much as possible.

Tips to improve your egg quality

Smoking

Women who smoke or are exposed to second-hand smoke often face delays in conceiving. Smoking damages egg DNA, which reduces fertility and increases miscarriage risk.3 It also increases the chance of ectopic pregnancy and makes embryo implantation harder, while increasing the risk of pregnancy complications.4 Therefore, avoiding smoking and second-hand smoke is crucial when trying to conceive and during pregnancy.

Additionally, researchers are still learning about all the risks of e-cigarettes (vapes) on conception and pregnancy. At this stage, no amount of vaping is considered safe when trying to conceive.

Alcohol

If you’re trying to conceive, drinking alcohol can affect your ability to get pregnant and stay pregnant. Some studies suggest that even low to moderate alcohol consumption is associated with reduced fertility.5 Drinking alcohol can alter hormone levels and disrupt the menstrual cycle and the ability to ovulate, therefore reducing the chances of conceiving. So, cutting down or cutting out alcohol can improve your chances of falling pregnant, along with helping you embrace a healthier lifestyle.

Coffee/caffeine

Some studies have shown reduced fertility and increased risk of miscarriage with excessive caffeine consumption.6 Most studies also indicate that the risk of infertility rises with higher levels of caffeine intake. Unfortunately, a safe daily amount of caffeine has not been established. For this reason, we recommend limiting your intake to one caffeinated drink per day (<80–100 mg of caffeine). If you can go without all together, even better!

Illicit drugs

Taking recreational drugs reduces the chances of becoming pregnant and having a healthy baby. For instance, cannabis and opioids are known to disrupt normal hormone production, leading to problems with ovulation and menstrual cycle disturbances.7 Additionally, stimulants such as cocaine and crystal meth have been linked to higher rates of miscarriage.8 Therefore, avoiding illicit drug use is one of the simplest ways to preserve your fertility.

Extreme exercise

Over-exercising can hinder ovulation and hormone production – specifically progesterone production, which is critical in supporting a pregnancy as it helps to thicken the lining of the uterus (needed for embryo implantation). Excessive exercise has also been linked to miscarriage.9 Vigorous exercise should not exceed 4 hours a week. However, lighter activities, such as walking and Pilates, are not limited.

Diet Mediterranean Diet foods, including fresh fruit and vegetables, lean meats, eggs, nuts, seeds and healthy fats like avocado.

The Mediterranean diet is often recommended for individuals undergoing in vitro fertilization (IVF) due to its potential benefits for reproductive health – and this may include egg quality. This diet emphasises the consumption of whole foods, including fruits, vegetables, whole grains, legumes, nuts, fish and healthy fats like olive oil, while limiting processed foods, red meat and added sugars.

Research suggests that adherence to the Mediterranean diet may improve fertility outcomes by promoting a healthy weight, reducing inflammation and optimising insulin sensitivity, all of which can positively influence ovarian function and embryo quality.10,11

Maintaining a healthy weight

Being underweight or overweight is associated with reduced pregnancy rates. This is because carrying too little or too much weight can disrupt the balance of hormones in your body, leading to ovulatory issues and irregular periods, along with an increased risk of miscarriage. Even if a woman has a regular cycle, fertility may still be reduced compared to women within the healthy weight range (a body mass index between 18.5 and 25).

Weight loss in overweight people doesn’t have to be drastic to improve fertility. Research has shown that even a modest drop in body weight (5–10%) can increase the chances of pregnancy – not to mention many other health benefits, such as a reduced risk of conditions like diabetes and heart disease, and a lower rate of pregnancy-related complications.12 Weight training and improving your lean body mass is also crucial for optimising your metabolism and reducing insulin resistance.

Weight loss is difficult, but your care providers can help you navigate the weight management journey. Talking to your GP or fertility specialist about weight is a great first step. We’ll make sure you have the support you need.

Medical conditions and medications

Conception is most likely to occur when you’re in good health. Untreated medical conditions, especially hormonal disorders (e.g. thyroid issues) and gynaecological conditions (e.g. endometriosis), can hinder fertility. It’s essential to manage these conditions before trying to conceive. Additionally, ensure that any prescribed medications are safe to take during conception and pregnancy by discussing these with your fertility specialist.

Night shift work

Night shift workers may experience reduced fertility because disrupted or insufficient sleep can interfere with the body’s circadian rhythm, leading to hormonal imbalances. Research on patients undergoing IVF has shown that women working night shifts tend to produce fewer eggs suitable for embryo development.13 Meanwhile, other studies have linked shift work to higher miscarriage rates.14 If possible, avoid night shift work and stick to a regular shift schedule rather than rotating between day and night shifts, as consistency can help reduce the impact on hormone levels.

Supplements for improving egg quality

In addition to lifestyle changes, certain supplements are often recommended. While evidence supporting their impact on egg quality and IVF success rates is limited, some studies suggest potential benefits, whereas others show no significant improvements in fertility outcomes. However, when taken at recommended doses, these supplements are generally considered safe.11

For instance, antioxidants like vitamin E and coenzyme Q10 may enhance IVF outcomes by reducing DNA damage and improving egg quality, particularly in older women or those with diminished ovarian reserve. Other commonly suggested supplements include vitamin D (especially for those with a deficiency) and omega-3 fatty acids.11

Additionally, all women trying to conceive should take a supplement containing at least 400 mcg of folic acid, which is crucial for DNA synthesis and reducing neural tube defects, along with 150 mcg of iodine to support thyroid function.11

Small changes can lead to big results

Simple yet impactful lifestyle changes go a long way towards preserving egg quality, preventing egg damage and improving your overall fertility. By addressing these modifiable factors and prioritising your overall wellbeing, you can boost your chances of conception and a healthy pregnancy.

If you’re ready to explore your options for having a baby or are concerned about your fertility, you can make an appointment with one of our specialists by calling (03) 8080 8933 or by booking online.

References

 

  1. Better Health Channel. Age and fertility [internet]. Victoria (AU): Better Health Channel; 2023 [updated 2023; cited 2024 Oct]. Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/age-and-fertility ↩ ↩
  2. Winship A, Stringer J, Liew S et al. The importance of DNA repair for maintaining oocyte quality in response to anti-cancer treatments, environmental toxins and maternal ageing. Hum Reprod Update. 2018;24(2): 19–134. doi: https://doi.org/10.1093/humupd/dmy002. ↩
  3. Pineles BL, Park E, Samet JM. Systematic review and meta-analysis of miscarriage and maternal exposure to tobacco smoke during pregnancy. Am J Epidemiol. 2014;179(7):807–23. doi: 10.1093/aje/kwt334. Epub 2014 Feb 10. PMID: 24518810; PMCID: PMC3969532. ↩
  4. Better Health Channel. Pregnancy and smoking [internet]. Victoria (AU): Better Health Channel; 2022 [updated 2022; cited 2024 Oct]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-smoking ↩
  5. Fan D, Liu L, Xia Q et al. Female alcohol consumption and fecundability: a systematic review and dose-response meta-analysis. Sci Rep. 2017;7(1):13815. doi: https://doi.org/10.1038/s41598-017-14261-8 ↩
  6. Lyngsø J, Ramlau-Hansen CH, Bay B et al. Association between coffee or caffeine consumption and fecundity and fertility: a systematic review and dose-response meta-analysis. Clin Epidemiol. 2017;9:699–719. doi: 10.2147/CLEP.S146496. PMID: 29276412; PMCID: PMC5733907. ↩
  7. The Society of Obstetricians and Gynaecologists of Canada. Substance use and fertility [internet]. Ontario (CA): The Society of Obstetricians and Gynaecologists of Canada; 2024 [cited 2024 Oct]. Available from: https://www.pregnancyinfo.ca/before-you-conceive/fertility/substance-use-and-fertility/ ↩
  8. Smid MC, Metz TD, Gordon AJ. Stimulant use in Pregnancy: An Under-recognized Epidemic Among Pregnant Women. Clin Obstet Gynecol. 2019;62(1):168–184. doi: 10.1097/GRF.0000000000000418. PMID: 30601144; PMCID: PMC6438363. ↩
  9. Barakat R, Zhang D, Silva-José C et al. The influence of physical activity during pregnancy on miscarriage-systematic review and meta-analysis. J Clin Med. 2023;12(16):5393. doi: 10.3390/jcm12165393. PMID: 37629435; PMCID: PMC10455409. ↩
  10. Hart RJ. Nutritional supplements and IVF: an evidence-based approach. Reprod Biomed Online. 2024;48(3):103770. doi: 10.1016/j.rbmo.2023.103770. ↩
  11. Yang J, Song Y, Gaskins AJ, et al. Mediterranean diet and female reproductive health over lifespan: a systematic review and meta-analysis. Am J Obstet Gynecol. 2023;229(6):617-631. doi: 10.1016/j.ajog.2023.05.030. ↩ ↩ ↩ ↩
  12. Haase CL, Varbo A, Laursen PN et al. Association between body mass index, weight loss and the chance of pregnancy in women with polycystic ovary syndrome and overweight or obesity: a retrospective cohort study in the UK. Hum Reprod. 2023;38(3):471–481. doi: https://doi.org/10.1093/humrep/deac267 ↩
  13. Liu Z, Zheng Y, Wang B et al. The impact of sleep on in-vitro fertilization embryo transfer outcomes: a prospective study. Fertil Steril. 2023;119(1):47–55. doi: 10.1016/j.fertnstert.2022.10.015 ↩
  14. Mínguez-Alarcón L, Souter I, Williams PL, et al. Occupational factors and markers of ovarian reserve and response among women at a fertility centre. Occup Environ Med. 2017;74:426-431. doi: 10.1136/oemed-2016-103953 ↩

Your guide to a successful egg collection

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What is egg collection?

Egg collection (also referred to as ‘egg retrieval’ or ‘egg pickup’) is the process by which we collect eggs from your ovaries. The eggs collected can then be frozen and stored, or used in the next step of an IVF cycle. Usually, we will be able to collect around 8–12 eggs but this is dependent on multiple factors, including your age.

Sometimes, you may need to undergo more than one egg collection, so we have a good quantity of eggs available (in the double digits is ideal). The number of eggs is important, whether you are freezing your eggs for potential use in later life, or whether you are moving on to the next step in the IVF process straightaway.

How do I prepare for my egg collection?

Two weeks before your egg collection

You will require regular hormone injections for around 8–14 days before your egg retrieval. This varies based on how your body is responding to the fertility medications and which regimen your fertility specialist decides is best for you. These injections encourage the maturation of eggs that would otherwise deteriorate. This is important as only mature eggs are capable of fertilisation when combined with sperm (an egg and sperm must successfully unite in order for an embryo to form).

While injections can sound painful and daunting, the needles are very small and easy to use. We will teach you (or a partner or another preferred person) how to give the injections at home.

You can read more about how we stimulate the ovaries to produce mature eggs here.

The week prior to egg collection

An ultrasound image showing the number of follicles within a woman's ovary
Ultrasound imaging is used during fertility treatment to track the development of ovarian follicles.

About a week after you start these medications, you will have a vaginal ultrasound so we can view your ovaries and count the number of follicles present. Usually, each follicle will contain one egg. The number of follicles gives us a good idea of how well you are responding to the fertility medications, while the size of the follicles is a good indicator of egg maturity. Unfortunately, small follicles usually contain immature eggs, which can be difficult to retrieve – they tend to stick to the follicle wall during collection. Thus, we may need to adjust your fertility medications to encourage more growth.

Ultrasound and blood tests also help us to determine the best time to collect your eggs. As such, these tests will be performed over the course of this week with the exact timing of your egg collection updated in line with your results. This change in schedule can sometimes be frustrating for patients, particularly in the midst of work commitments, but it ensures we are collecting your eggs at the optimal time in terms of both egg quantity and quality – the more mature eggs, the better!

1–2 days before your egg collection

Around 35–36 hours before your scheduled egg collection, you will have a ‘trigger injection’. This is a different hormone medication and will trigger ovulation (the release of eggs from your ovaries).

We will also ask you to fast from 6 hours before the time of your scheduled procedure (this reduces the risk of nausea and vomiting later).

Morning of your egg collection

On the morning of your egg collection, you may feel both excited and nervous – and hungry (!) from fasting. There are just a few things we need you to remember:

  • Continue to eat and drink nothing. Small sips of clear fluids are okay up to 2 hours before your procedure
  • Brush your teeth – we understand the last thing you want to do is to break our ‘nothing to drink’ rule but it’s okay to brush your teeth!
  • Wear loose fitting, comfortable clothing
  • Do not wear any makeup or jewellery, and
  • Confirm the availability of the person you have organised to drive you home after your procedure and to ideally spend the rest of the day with you while your sedation wears off.

What will happen when I arrive for my egg collection?

On arrival, please make your way to our Ground Floor reception to complete your admissions paperwork. We will then guide you through to a waiting area where you can change into a hospital gown. There will usually be a period of waiting at this point, as we schedule your admission time an hour before your procedure. We recommend bringing a good book or podcast along.

Next, we will discuss the procedure with you, check when you took your trigger injection, answer any last-minute questions you may have, and ensure you understand and feel comfortable with what will happen next.

When it’s time for your procedure, we will guide you through to the procedure room and give you some light sedation. Once the sedation has kicked in (you will feel drowsy and relaxed), we will insert an ultrasound probe into your vagina. This provides a clear view of your ovaries and the follicles inside them (the eggs are located inside these follicles). We will then guide a fine needle attached to the probe into each of the follicles, one at a time. A suction device attached to the needle drives the fluid inside the follicle up the needle and into a heated test tube. This entire process takes around 20–30 minutes.

An image of oocyte-containing fluid collected from an egg retrieval procedure
During the egg retrieval procedure, fluid is collected from ovarian follicles, which contain eggs (the dark, circular spots).

The fluid collected is taken straight through to our lab for examination by one of our embryologists. Under a microscope, they can carefully identify the eggs and discard the fluid. Our lab is directly adjacent to our day surgery so your eggs don’t have very far to travel!

If your egg collection is for the purposes of egg freezing, any mature eggs we find will be frozen and stored within a few hours of your procedure. If your egg collection is part of an IVF cycle, we may also freeze the mature eggs for use at a later date. Alternatively, we may proceed to the next step of the IVF process straightaway, placing your eggs with specially-prepared sperm from your partner or donor (this is called ‘insemination’).

Depending on how many eggs were collected and the volume of sperm available, 1–2 eggs will each be placed in a petri dish with a concentrated sperm sample containing around 100,000 sperm! Ideally, each egg will be fertilised by a single sperm, with every normally fertilised egg having the potential to grow and develop further into an embryo. However, it’s important to note that not every egg we collect will be mature, and not every mature egg placed with sperm will be fertilised. Hence, by collecting multiple eggs, we increase the chances of success at this step in the IVF process. You can read more about fertilisation and what impacts its success here.

What happens after my egg retrieval?

Around 90 minutes after your procedure, your designated person can take you home. Before you leave, let us know if you need a medical certificate. We recommend taking it easy for the rest of the day.

If you are planning to freeze your eggs, we will generally call you later that day to tell you how many mature eggs were collected. If we are proceeding with insemination, we will usually call you the next day instead, so we can also tell you how many of these eggs were successfully fertilised overnight. Any fertilised eggs will be placed in an incubator in our lab. Here, their development will be monitored closely with the hope that they continue to grow into healthy embryos, ready for the next step in the IVF process – embryo transfer.

How can I best support my recovery after an egg collection?

Most women will experience some mild pain or discomfort after an egg collection and it may take weeks for this discomfort to ease completely. To help support your recovery, we recommend:

  • Placing a heat pack over your belly and resting if you’re experiencing any cramping or discomfort. If your pain continues, take some paracetamol. Note: do not take any antihistamines, ibuprofen, aspirin or non-steroidal anti-inflammatory medications if you are planning to have an embryo transfer
  • Consuming clear fluids if you are nauseous until you feel better
  • Looking out for any vaginal bleeding (but don’t worry if you notice some light spotting or bleeding for a few days – this is completely normal)
  • Avoiding vaginal creams, lubricants or spermicides (aside from the progesterone cream we may have given you)
  • Avoiding all heavy lifting or vigorous exercise such as running or cycling for a few weeks
  • Staying away from hot tubs and Jacuzzis
  • Limiting your caffeine and alcohol intake
  • Avoiding intercourse for a few days or until you feel comfortable. Engaging in intercourse around this time can result in natural conception; however, it’s important to listen to your body and only do what it feels physically ready for.

Are there any symptoms I should watch out for?

There are a few symptoms to watch out for after this procedure, including fever; pain, nausea or vomiting that’s not improving; heavy vaginal bleeding; feeling overly weak, faint or dizzy; shortness of breath; pain in your shoulder area; severe stomach bloating; rapid weight gain; or little to no urination despite drinking plenty of water.

If you are concerned or worried about anything you are experiencing, please call our clinic for advice on (03) 8080 8933. Alternatively, you can contact your fertility specialist. After-hours, you should visit your closest emergency department.

Still got questions?

If you have an upcoming egg collection booked and still have questions, don’t hesitate to give us a call on (03) 8080 8933. If you’re interested in learning more about egg freezing or IVF, check out the rest of our website for further information. For personalised advice, you can also book an appointment with one of our fertility specialists.

Is egg freezing right for you?

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In principle, egg freezing sounds simple enough – have some eggs collected, freeze them for storage, then thaw them when you’re ready to undergo fertility treatment – providing you with a chance to store your eggs while you’re still young and beat the biological clock. But what exactly does egg freezing involve and are you an appropriate candidate?

Why freeze your eggs?

You may want to consider freezing your eggs if you’re worried about your fertility declining but your life circumstances mean that you’re simply not ready to start a family. Alternatively, you may have a medical condition or be receiving medical treatment that could affect your fertility. If you’re a female transitioning to a male, you may wish to preserve your fertility before starting reconstructive or hormonal therapy, which can lead to a loss of your fertility.

What does the egg freezing process involve?

The first stage of egg freezing is ovarian stimulation, which involves 10–14 days of hormone injections to stimulate your ovaries to produce multiple eggs. There are various techniques used for stimulation and your fertility specialist will decide, together with you, which is most suitable for you. The developing follicles, which contain your eggs, are monitored by ultrasound and sometimes by blood hormone levels to determine when they are ready to be collected.

When mature, your eggs are collected (usually while you’re under sedation rather than general anaesthetic), frozen and put into storage. In most cases, frozen eggs can be stored for up to 10 years.

When you’re ready to have a baby, the eggs are then thawed and used in IVF treatment. This involves fertilising your eggs with sperm using a method called intracytoplasmic sperm injection (ICSI), whereby sperm is injected directly into the egg. The embryos are then grown in the lab for up to 6 days and then transferred to your uterus (womb).

Factors to consider when deciding whether to freeze your eggs

1. Success rates

Egg freezing is an established procedure. It has now been two decades since the world’s first pregnancy using frozen eggs and over this time, there have been notable improvements in the technology and processes we use. High rates of success can now be expected when circumstances are optimal. A 2017 study showed that freezing 20 eggs before the age of 35 gives a 90% chance of having a baby.1

When considering these statistics, it is important to note that the number of women who actually go on to use their frozen eggs is still quite low. In 2017–18, less than 1% of IVF cycles in Victoria involved the use of a woman’s own thawed eggs.2  The data on egg freezing success rates are challenging to compile because many women choose not to use their eggs for many years after freezing and some may not use them at all. Furthermore, current figures may not reflect advances in egg freezing technology because the results are from a period when clinics were using different ‘slow freezing’ techniques.

In terms of understanding the success rates for frozen eggs compared to ‘fresh’ (recently retrieved) eggs, a study published in the Journal of Human Reproduction in 2010 examined the success of IVF in 600 women, half of whom were assigned ‘fresh’ eggs while the other half were given frozen and thawed eggs.3 The study found no significant difference in pregnancy rates between the two groups of women, concluding that freezing eggs and thawing them for later use has no effects on success rates. According to these findings, the likelihood that your eggs will result in a pregnancy will be the same whether you choose to freeze and use them later or use them straightaway.

2. Age

The age at which you choose to freeze your eggs is key to your chances of having a baby – the younger you are, the better. Egg quality declines more rapidly after the age of 35, so the best time to freeze your eggs is in your 20s and early 30s.4 Unfortunately, eggs collected from older women are less likely to form viable embryos and are also less likely to successfully implant in the wall of the womb. Thus, if you decide to freeze your eggs when you are older, we typically need to collect more eggs to ensure at least one egg is of suitable quality to result in a baby. However, as women age, they also have fewer eggs, so only a small number of eggs may be available for collection and freezing. If this is the case, you may need more than one treatment cycle to collect an adequate number of eggs for storage.

Both the number and quality of eggs available for freezing are important, because at each step in the freezing and subsequent IVF process, there is a risk that some are lost. Of the eggs that are collected, some may not be appropriate for freezing, some may not survive the thawing process, and some may not be fertilised or successfully develop into embryos.

3. Costs

In Australia, fertility treatment is only covered by Medicare and other government subsidies when there is a medical need for the treatment. If you freeze your eggs for non-medical reasons (i.e. ‘elective egg freezing’), you won’t be eligible for Medicare assistance.

For detailed information about the costs associated with egg freezing, please visit our fees page.

*Does not include hospital fees; †Does not include medications or hospital fees.

What are the alternative options?

If freezing your eggs is not a suitable option for you, other potential options include:

When considering your fertility and the options for extending it, there is no one-size-fits-all approach. As with all aspects of fertility care, the best decision for you is the one that is personalised to your individual situation.

Learn more information about Newlife IVF’s egg freezing services. If you would like to discuss your options with one of our fertility specialists, please call Newlife IVF on (03) 8080 8933. Alternatively, you can book online via our appointments page.

References

  1. Munné S et al. Human Reprod 2017; 32(4):743–749.
  2. Victorian Assisted Reproductive Treatment Authority. Annual Report 2018.
  3. Cobo A et al. Human Reprod 2010; 25(9):2239–2246.
  4. Saumet J et al. J Obstet Gynaeocol Can 2018; 40(3):356–368.