# Egg/genetic quality related to age - can we improve this?



## mowgli09 (Sep 3, 2008)

Hello,
Just seen you and thought what a very good idea!

I am 40, about to attempt IVF No 6, been TTC for 4.5 years:

Miscarriage from pill pregnancy when 19, 
1st IVF, 2 follicles, conversion to IUI, March 2007, BFN.
2nd IVF, 3 folllicles, early LH surge, cycle abandoned July 2007.
Missed miscarriage at 11wks 4days from natural conception immediately following abandoned IVF in 2007. 
3rd IVF 7 follicles, 3 eggs, failed implantation from 1st time I got to ET April 2008.
4th IVF 2 follicles, ovulated prior to EC, lost 1 egg, 2nd egg immature, no fertilisation. July 2008.
Diagnosed with immune and thyroid problems during this last cycle.
5th IVF 2 follicles, best cycle yet, 2 Grade 3 embryos (4 being best), BFN December 2008.

My Hashimoto's disease is under control, been stable for 6 months and know I will need immune support. Also know I will never get higher numbers of follicles, but clinic have said they now think the issue is egg quality and that I am unlikely to get pregnant from my eggs.

I researched a lot about this (have some medical knowledge as physiotherapist) and decided to try DHEA for last 3months prior to this attempt. I have also been taking multi-vitamins, Omega 3 oil and Co-Enzyme Q10, plus Vit D (as bit deficient).

What is your view on being able to help egg quality? 
Is it true we will have used all our best eggs up to now in our life or might there still be a good one lurking somewhere? 
Can you explain the process of maturation during the 90 days before ovulation and if we can actually improve the quality through eating well etc?

Have I asked too much??  


This is my last attempt before moving on to donor eggs I think and would be really interested to know your thoughts.
many thanks

sashbash


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## CrystalW (Jul 25, 2007)

Hello Sashbash,

I wish i could give you some definite answers. 

Egg quality is, as you correctly say, most influenced by female age. There have been some studies that suggest different drug protocols can make a difference and i have heard some good things about DHEA, although this drug is not suitable for everyone. Smoking is certainly something that has been shown to have a negative impact on egg quality in a number of studies.

There are two main theories - that all the eggs a women will ever have are present at birth. And either the good ones are ovulated earlier in her life or that the older the eggs get the poorer they become. However, there are plenty of 40+ ladies who do get pregnant so there is always a chance that there can be a good egg in there. Only your clinic can really advise you of how high your chances may be, they have your full history and the lab staff have actually looked at your eggs - and, from your history it seems recruiting the follicles can also be an issue. This makes it very hard to find a good egg.

As for egg maturation, this is all to do with trying to make sure the egg has the correct number of chromosomes. The eggs remain in a resting phase from birth. In a single cycle an egg moves from meiosis 1 to meiosis 2, before ovulation and meiosis 2 is completed only when a sperm enters the egg.  This is all to do with the egg getting rid of an extra set of chromosomes. It is this mechanism that does not seem so efficient in the eggs of ladies as they get older.

I do not know of any good scientific evidence that proves that eating well / eating certain foods etc can improve things (though i certainly do not know all the studies being carried out or if small studies have been done by individuals). But being healthy, at the very least may improve your general well-being to go through the whole IVF process. And it is a very difficult thing to really test. Some consultants suggest certain things - they would not suggest them if they did not believe they may be good so always go with their advice.

Best wishes


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## mowgli09 (Sep 3, 2008)

Thanks Crystal,
I knew there wouldn't be definitive answers, but understanding the meiosis stages makes sense when thinking about genetic quality.
Sadly I was a smoker for many years and of course wish that I hadn't looking back now. Does the man smoking make much of a difference, my husband still smokes cigars? His samples always seem to be good, but would the genetic make up be affected that we can't see?

The embryologists were very hopeful on our last attempt, said my eggs released easier on collection which was a good sign and that they had looked normal, so clearly it is not always the same, as previous attempts said my eggs were dark and old looking!

Because my LH surges early, they were learning how to manage that better without having to give me lots of cetrotide throughout the cycle, with one big dose early on then small doses to maintain that. Drs suggested that giving large doses of cetrotide at odd times during the cycle could affect quality as you want a smooth/steady growth, would you agree?

But what you are saying confirms my thoughts that it has to be a personal decision to go to donor, no-one can make it for us.  

Thanks again.


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## CrystalW (Jul 25, 2007)

sashbash said:


> Thanks Crystal,
> I knew there wouldn't be definitive answers, but understanding the meiosis stages makes sense when thinking about genetic quality.
> Sadly I was a smoker for many years and of course wish that I hadn't looking back now. Does the man smoking make much of a difference, my husband still smokes cigars? His samples always seem to be good, but would the genetic make up be affected that we can't see?
> 
> ...


Hello,

What the embryologists said from your last cycle was definitely encouraging. Its always a difficult one to know how many more cycles to keep going for. It seems your last cycle was your best and it certainly sounds good that they are tailoring the cetroide protocol more and more to you. It makes sense what they are saying, its a difficult thing to prove conclusively but i can see the theory.

If you are financially/emotionally able to go through another cycle it may give you more answers at least as to whether there are better cycles ahead or if your good one was a one-off. I don't want to sound harsh, and i always believe it is important to be optimistic but realistic. Using donor eggs is a big decision and not one to be rushed into.

Re the smoking - there is evidence that smoking does effect eggs and sperm - with the sperm, exactly as you say - at a genetic level that cant be seen. But, as with a lot of things, it is not a complete story - we all know someone who smokes 40 a day and has six children! I think there needs to be a balance - if he smokes excessively then it cant be a bad thing to cut down but if it is just occasionally then sometimes you need to enjoy things in life.

Best wishes

*edited to fix quote box.


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