Had a failed IVF cycle, or maybe you’re of advanced maternal age? If so, your fertility doctor may have diagnosed you with poor egg quality. Poor egg quality can drastically decrease your chances of a successful pregnancy during IVF treatment, and can be a barrier against conceiving if left untreated.
- Why is Egg Quality Important?
High quality eggs produce high quality embryos. Although embryos are one-half sperm, one-half female oocyte (egg) – almost all the embryo quality depends on the original quality of the female egg. Ninety-five percent of embryo quality comes from the egg. High quality embryos are more likely to survive the important early stages of development than poor-quality embryos. In short, high quality embryos are more likely to lead to successful pregnancies.
- How Do I Know if I have Poor-Quality Eggs?
A woman’s ability to produce high-quality eggs (also known as ovarian reserve/OR) decreases as she ages. This natural process normally takes place in a woman’s 40’s. This decrease in production of high quality eggs is known as diminished ovarian reserve (or DOR). DOR is characterized by a low number of eggs in a woman’s ovaries and/or impaired development of existing eggs.
DOR isn’t just a condition that affects the ovaries of aging women – sometimes it can affect younger women too. Around 10% of women will have a decline in their ovarian reserve earlier in life. Their OR, when compared to other women of their age group, will be far below average. This early decline of ovarian reserve is called premature ovarian aging (or POA). You can read in detail about diagnosis of DOR here and POA here (just click on “diagnosis” in the menu on the top of the page).
- Is There a Way to Improve Egg Quality?
Egg donation isn’t the only opinion for women with diminished ovarian reserve to conceive. There are new treatments and drugs now used to optimize a woman’s ovaries to produce high quality eggs.
One of these treatments is DHEA (or in full, dehydroepiandrosterone), a mild male hormone that the body converts into testosterone and estradiol). Over the past decade, DHEA use has sky-rocketed. It started off as an experimental treatment in world-renowned infertility clinic, The Center for Human Reproduction (CHR), New York, in 2004. Now it’s used by over 1/3 of infertility clinics around the world. CHR’s Medical Director, Dr. Norbert Gleicher commented that:
DHEA is in the process of revolutionizing infertility care for older women and for younger women with premature ovarian aging.
Read in more detail about how DHEA can improve egg quality here.
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Leading NYC fertility clinic – The Center for Human Reproduction – further consolidate their reputation as pioneers of diminished ovarian reserve (or DOR) treatment with DHEA, as they receive two new patents for this therapy.
The patents, awarded by The United States Patent and Trademark Office, claim to improve pregnancy chances for women with DOR by:
- Improving the ovarian environment
The first patent laid the claim that DHEA, and similar androgen supplements, can help restore the ovarian environment to its youthful state. When androgens restore the ovarian environment to this youthful state, there is often an increase in egg and embryo quality, which is linked to higher pregnancy chances and pregnancy rates for women with diminished (or low) ovarian reserve.
- 2. Lowering AMH levels
The second patient claims improvements in anti-Mullerian hormone (AMH) levels after androgen supplementation (such as DHEA) can have a positive prognosis in the context of female fertility. In other words, DHEA and other androgens can help improve AMH levels.
The researchers and scientists from CHR are extremely pleased with these new patents – they’re a result of years of research and clinical investigation about DHEA’s and androgens roles in improving female fertility. Dr. Norbert Gleicher, the center’s Medical Director and Chief Scientist, commented:
These two new patents reflect research findings made at CHR already a few years ago.
Then, Dr. Gleicher went onto explain the significance of these patents for the future of women’s infertility treatment:
“This is quite a departure from the long-held dogma that older women’s eggs are irreparably damaged, and their fertility prospects cannot be improved with medical intervention. We, indeed, have been clinically applying the knowledge described in these two patents for quite some time in our patients at CHR, as we no longer believe that eggs ‘age’ as women age. What ages is the ovarian environment in which the eggs mature. Low androgen levels are one manifestation of that ovarian aging. By increasing the patients’ androgen levels with DHEA, we are restoring the ovary’s androgen levels to where they should be at young ages.”
To read more about these new patents awarded for androgen and DHEA use, click here.
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A recent study in Israel found that women who took the over-the-counter vitamin supplement DHEA, a common anti-aging remedy, had higher chances of getting pregnant when compared to other women undergoing fertility treatments.
According to the American Pregnancy Association, 6 million women experience with infertility every year. Researchers at the Tel Aviv University say DHEA fertility treatments may give new hope to women who want to conceive.
In a study on the effects of the supplement, researchers found that women being treated for infertility who also received supplements of DHEA were three times more likely to conceive than women being treated without the additional drug.
Not only were women who combined infertility treatment with DHEA more likely to conceive, the researchers discovered, they were also more likely to experience a healthy pregnancy and delivery.
DHEA, short for 5-Dehydroepiandrosterone (5-DHEA), is a naturally-occurring steroid found in the brain, which plays an important biological role in humans and other mammals. Produced in the adrenal glands, it is also synthesized in the brain. The pharmaceutical version of this molecule is known as Prastera, Prasterone, Fidelin and Fluasterone, and identical generics are widely available over the counter in the United States without a prescription.
DHEA can also be used as a regular “vitamin” for women who have already conceived and are pregnant, but more research would need to be done on the compound to determine its effects. Women interested in using DHEA to conceive, however, should consult their practitioner first, according to the researchers.
For the study, researchers created a control group of women that received treatment for poor ovulation, and another group received the same treatment with the addition of the DHEA supplement. The latter group took 75mg of the supplement daily for 40 days before starting fertility treatments, and continued for up to five months.
While studies on the effects of DHEA are far from complete, researchers hope that further research will unlock the secrets of why the supplement aids in successful conception in women with an otherwise poor response to fertility treatments.
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In the near future, it may become possible to improve the success rate of in vitro fertilization with an over-the-counter supplement. Researchers at the Texas Fertility Center are studying the impact of DHEA on women trying to get pregnant.
DHEA is a naturally occuring horomone produced by the female body, but levels decrease as women get older. DHEA supplements can be bought over the counter. They have helped slow the progression of Alzheimer’s disease, Parkinson’s, and arthritis. Now doctors are paying attention to how DHEA helps fertility.
Physicians at Texas Fertility Center, have implemented the DHEA supplement among dozens of patients using in vitro fertilization on a trial basis. While it seems the treatment improves the egg quality and the live birth rate, not enough research has been done to conclude the process is completely safe.
Researchers warn DHEA should only be used under a doctor’s orders for women trying to conceive, otherwise, in some cases, it could hurt a woman’s chances.
So far, studies have seen anecdotal but positive results. Researchers says it’s not clear how DHEA helps, but it has shown a six-fold increase in IVF success rate according to a recent study in Israel.
Some researchers have been excited by the results since DHEA treatment is much cheaper than the in vitro fertilization treatment, and DHEA doesn’t have as many side effects and issues as other fertility medications.
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