Egg freezing and quality

Egg quality is vitally important for a successful pregnancy — whether that’s natural or through IVF. Research has shown poor egg quality is strongly associated with chromosome abnormalities, which in turn impacts embryo quality. It is also the main cause for embryo arrest, IVF implant failure, and increased miscarriage risk for older women.

More and more women are considering freezing their eggs too. An egg freezing clinic will determine the likely quantity of one’s eggs, and the guidance on how to proceed, by looking at age, AMH and results from antral follicle scan (we can help with arranging an AMH test and antral follicle scan). Needless to say, regardless of procedural protocol, one would wish to freeze the highest quality eggs possible. 

Gynaecologists and IVF clinics tend to think of egg quality decline as part of an irreversible ageing process that can’t be improved. 

If you are a woman in your late thirties, or in your forties, you may be turned away for egg freezing or by an IVF clinic, saying your age and poor state of your ovaries are unlikely to respond well to stimulating hormones. You may be strongly advised to use donor eggs.

Women over 40 are statistically less likely to give birth, as they may produce fewer eggs, have fertilised eggs with more inclusions, with lower chance of implantation and full embryonic development. Even with donor eggs, older women still have less of a chance of conceiving. The problem is not just the quality of the eggs: The real problem is the IVF process only focusses on the last few weeks of the egg’s journey from initial follicle to the egg’s release.

An egg’s journey

The most important story about an egg’s journey from birth to maturity is often not fully told. It takes up to a full year for an egg to grow from a follicle in its resting state to being able to be released.

Follicles are selected from the pool of resting follicles almost a year before ovulation. About 5 months before ovulation, a follicle is chosen to become a primary follicle. A month later, it reaches its secondary stage, and approximately 65 days before ovulation, the follicle cycles through the pre-antral and antral phase. Over the course of these 5 months, the follicle quadruples in size and goes through many stages of proliferation.

During this period, before the follicle is signalled by follicle stimulating hormone (FSH) from the pituitary gland, key hormones prepare it to be healthy and responsive. The follicle only becomes dominant during the last 2–3 weeks through the ovary. During the selection phase, lasting ten days, the follicle activates mechanisms to make itself responsive to FSH. The follicle grows to twice its size, rises to the surface to the ovary and becomes oestrogen-producing.

It fulfils its major purpose and releases its egg, which leaves the ovary and travels down the fallopian tube, seeking its chance to become fertilised. The follicle ends its life cycle by turning into an endocrine gland, called the corpus luteum, which secretes the progesterone needed to maintain the pregnancy if the egg gets fertilised.

The intricate hormonal map that an egg has to navigate strongly suggests that when there is a hormonal imbalance, the chances of a good quality egg maturing would likely be compromised.

Egg quality 

It is important to note that while age is a major factor for egg quantity and quality, there are many others to consider, especially hormones. The immediate manifestation of how well your hormones are working is your periods; each menstrual cycle is governed by the growth of a single egg. When your menstrual cycle is not going well, the chances are you are unlikely to make strong, healthy eggs.

An egg grows in an antral follicle into a mature egg in its dominant follicle. Both the egg and follicle have to function properly for the cycle to go well.

Signs of a good menstrual cycle

Ideally ovulation occurs on day 11 or 12. Delayed ovulation may be fine, but earlier ovulation implies lower quality eggs.

Premenstrual spotting is not good, as it means you are not producing enough progesterone, which stabilises the lining of the uterus. Low progesterone is caused by low-quality follicles.

Long cycles are OK, but short cycles are not as they are because of early ovulation and shortened luteal phases. 

If you’re unsure about the quality of your eggs, we can help arrange AMH and Female Fertility Profile test which is often the first step toward looking at egg quantity and quality.

Poor follicle development is likely caused by poor general health, lower blood flow to the ovaries, and hormone imbalance. We at TCM Healthcare aim to improve all three, thereby helping follicle development and egg quality.

How do we help?

Our approach focusses on using natural herbal remedies and acupuncture to strengthen the reproductive system and general health, bringing the hormones into balance and ensure a regular period. We do not prescribe any synthetic hormones. Once hormonal balance is achieved and the period regulated, ovulation is likely to occur and egg quality will improve, where natural pregnancy results. We primarily use bespoke herbal remedies, but will use acupuncture if the situation warrants it. 

Patients bring us their test results and medical record. We do a 40 minutes long first consultation, in which we do non-invasive and pain-free Chinese medical diagnostic procedures, in order to understand your particular condition and circumstances thoroughly.

Our specialist prescribes a unique herbal formula, usually consisting of around 20 kinds of herbs, from which you will make drinks and consume twice a day for 18 days in a month.

A month after the first consultation, you will be done with the first round of herbal remedy. We do a second consultation, lasting 30 minutes, doing another diagnostic procedure to see how well you’ve responded to the treatment. Another prescription will be written. 

This monthly cycle will repeat 3 or 4 times before you are asked to have another AMH test carried out. Most patients see significant improvements. They also report their periods are now much more regular, which increases the chance of a successful IVF cycle (for instance, a higher dosage of stimulating hormone can be used). They then pursue a number of options, including working with us for longer to achieve natural pregnancy, or combining our treatment with IVF — we work some of the best IVF clinicians, who can offer the best of both worlds to our patients. 

What are our fees?

The fees come to about £350–400 a month, all inclusive.

How often do I need to come?

Once a month. Most patients come from 3 to 9 months. Some combine our treatment with further IVF cycles.