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How do you check egg quality before IVF?

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3 fertility expert(s) answered this question

Answer from: Lucy Lines

Embryologist, Business Owner at Two Lines Fertility
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You can’t. We know through statistics that the decline is in egg quality with age. We know statistically speaking when we think about how old you are, what impact that’s likely to have on your egg quality but other than that, we really have no idea until we get them out which is why I like to talk about IVF being not a treatment but a way of gathering more information. So we’re gathering more information when we do IVF and one of those bits of information that we’re gathering is what do your eggs actually look like because we don’t know until we get out.

Answer from: Michael Carroll, BSc, PhD, PgCAP, CBiol, FRSB, FIBMS, FHEA, FLS, ANSHCS

Embryologist, Reader (Associate Professor) in Reproductive Science at Manchester Metropolitan University
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It’s very difficult to check the egg quality before IVF but you can check the egg quality after the eggs are extracted from the ovaries (during oocyte recovery or aspiration) and what the embryologists would do, they would look down the microscope and look at those those eggs in the dish that has been collected and that was very difficult to discern poor or good quality eggs at that stage but if they’re going to ICSI, these cells that surround the eggs are removed, they’re removed chemically and physically and then you can see the quality of the eggs. Again, you’ll see the maturity of the eggs if they’re at different stages of maturity. One is known as the image egg the metaphase I egg or metaphase II egg and you can look at the A to D stage of maturity of things but also you’ll be able to see some abnormalities if they were missing the zona pellucida or if their granulations or abnormal shapes to the eggs. But you’re limited by the quality by discerning good quality/ poor quality eggs – even at that stage you would still carry on without IVF with the mature eggs and collect it from the woman, unless they’re extremely abnormally shaped or damaged during the process.

Answer from: Sokratis V. Grigoriadis, B.Sc, M.Sc

Embryologist, Reproductive Biologist-Clinical Embryologist, Postgraduate Researcher at Assisted Reproduction Unit of Aretaieio University Hospital
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In the embryology laboratory clinical embryologists indirectly evaluate oocyte quality and its competence by assessing oocyte maturation status as well as a pleiad of morphological features. To further elaborate on that, immediately following oocyte retrieval we assess the architecture and texture of the cumulus oocyte complex. At this stage oocytes are surrounded by several cells, namely cumulus cells, which support oocyte development. If the cumulus oocyte complex is compacted, probably the oocyte is immature. On the other hand, an expanded “fluffy looking” cumulus oocyte complex indicates that probably the oocyte is mature. Following this step, we have the choice to deeply assess oocyte quality by completely removing the cumulus cells, in order to have a direct and a clear picture of the oocyte. This procedure is well-known as denudation. At this point we are able to comprehensively assess both oocyte maturity and morphology. A mature oocyte is characterized by the absence of a visible nucleus and the presence of a small cell-like structure described as the first polar body. Only these oocytes are able to be normally fertilized, because only these have successfully completed the first meiotic division. Unfortunately, immature oocytes cannot be fertilized. It is generally recognized that, under normal circumstances, 85% of the retrieved oocytes have successfully matured and only the 15% of them are immature. Except for the maturation status, we can also evaluate several morphological features of the oocyte which are strongly associated with oocyte quality and its competence. Generally, clinical embryologists assess the size and the shape of the oocyte, the presence or the absence of intracytoplasmic features such as vacuoles, the architecture of the polar body as well as the characteristics of the zona pellucida. At this point it should be noted that the presence of some abnormal morphological features does not necessarily mean cycle failure. Morphological assessment of oocyte quality helps embryologists and clinicians to design the appropriate management strategy in order to increase the chances of in vitro fertilization success.

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How do you test egg quality for IVF?

To know the potential of ovaries, doctors order hormonal tests to check the level of anti-mullerian hormone (AMH) and do scans to see the number of the follicles. Are those procedures sufficient to determine the quality of eggs?

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