Quality Over Quantity: Why Egg Quality Matters in Fertility
When it comes to trying to conceive, there is often a focus on the number of eggs a woman has. But in fertility medicine, the phrase quality over quantity is especially true. Having many eggs available is helpful, but what truly matters is the ability of those eggs to fertilise and develop into healthy embryos that can lead to a viable pregnancy.
Egg quality refers to the genetic and metabolic health of the oocyte. As women age, both egg number (ovarian reserve) and egg quality naturally decline. This is primarily related to an increased risk of chromosomal abnormalities, which can reduce fertilisation rates, impair embryo development, and raise the risk of miscarriage (RANZCOG, 2023; IVF Australia, 2024).
Why does egg quality matter so much?
A good-quality egg has the correct number and structure of chromosomes. This allows it to combine with sperm DNA successfully, and then undergo normal cell divisions to form a healthy embryo. As women approach their late 30s and beyond, the proportion of eggs with abnormal chromosomes (aneuploidy) rises significantly, which is one of the key reasons why miscarriage rates and difficulty conceiving increase with age (Monash IVF, 2024).
In assisted reproduction, clinicians may retrieve many eggs during an IVF cycle. However, if egg quality is poor, even a large quantity of eggs might not result in a viable pregnancy. In contrast, a single good-quality egg, fertilised and developing normally, can be enough to achieve a healthy pregnancy.
How can you support egg quality?
While you cannot change your age, there are evidence-based lifestyle and medical strategies that may help support egg quality:
✅ Complete a preconception assessment: If you are over 35, or have irregular menstrual cycles, consulting a fertility specialist early can help identify factors affecting your egg health and overall reproductive status (RANZCOG, 2023).
✅ Consider AMH testing: Anti-Müllerian Hormone (AMH) levels provide insight into ovarian reserve. Although AMH does not measure egg quality directly, it helps gauge the number of eggs you have remaining (ANZARD, 2023), and is a useful tool in predicting and planning your reproductive future.
✅ Maintain a healthy body weight: A body mass index (BMI) in the recommended range (18.5–24.9) is linked to better ovulatory patterns and lower rates of infertility. Being underweight or overweight can affect egg development and hormones (RANZCOG, 2023).
✅ Follow a Mediterranean-style diet: Studies suggest diets high in vegetables, legumes, fish, whole grains, and healthy fats, and low in processed foods, may be associated with improved fertility outcomes and healthier egg development (Monash IVF, 2024).
✅ Do not smoke: Smoking is strongly linked to reduced egg quality, accelerated ovarian ageing, and earlier menopause. Avoiding tobacco is one of the most effective modifiable lifestyle choices to protect your fertility (IVF Australia, 2024).
✅ Limit alcohol: Excessive alcohol intake can negatively affect ovulation, egg development, and overall reproductive hormones. National guidelines suggest limiting to four standard drinks or fewer per week when trying to conceive (RANZCOG, 2023).
✅ Manage stress: High stress can impact ovulatory function and egg health. Incorporating mindfulness techniques, yoga, physical activity, and prioritising sleep can help regulate stress responses and support overall reproductive wellbeing (Monash IVF, 2024).
One good-quality egg can be enough
While the focus on egg count is understandable, it is important to remember that one high-quality egg has the potential to result in a healthy baby. As fertility specialists, our aim is to help optimise the environment for those eggs to develop and be fertilised, whether naturally or through assisted reproductive technologies.
If you are thinking about fertility preservation, or would like to know more about egg quality and ovarian reserve, booking a preconception or fertility review can be an excellent first step. Evidence-based care, tailored to your circumstances, is the best way to feel empowered on your path to parenthood.
If you have questions or want to discuss your options further, I am here to help guide you with personalised, evidence-based advice. 💙
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References
Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Planning for Pregnancy and Parenthood; 2023. ranzcog.edu.au
IVF Australia. Optimising Egg Quality and Ovarian Reserve; 2024. ivf.com.au
Monash IVF. Egg Quality, Fertility, and Age; 2024. monashivf.com
Australia and New Zealand Assisted Reproduction Database (ANZARD). Assisted Reproductive Technology in Australia and New Zealand: 2023 Summary Report. npesu.unsw.edu.au
