Egg quality vs egg quantity: Gynaecologist reveals which matters more, debunks 3 common myths

Egg quality and egg quantity often come into conversations regarding reproductive health. Know the differences.

Egg quality and egg quantity often make their way into conversations around fertility, especially in the context of women's ‘biological clock,’ where age is considered a crucial determining factor. However, these two terms cannot be used interchangeably, nor do they imply the same thing.

Find out what is the difference between egg quality and egg quantity and which matters more. (cottonbro)

Clarifying the major differences in an interview with HT Lifestyle, Dr Kanika Gupta, consultant, obstetrics and gynaecology at Manipal Hospitals Dwarka, New Delhi, explained that there is a significant distinction between egg quality and egg quantity.

Fertility is not just about how many eggs remain in the ovaries, but also about how healthy those eggs are. “The number of eggs a woman naturally has decreases as age passes, but the health and genetic quality of those eggs also fluctuate with age, and both factors are known to be essential for fertility outcomes,” Dr Gupta noted. As women age, both factors change, and can affect pregnancy in different ways.

What is egg quantity?

First let's attempt to understand the egg quantity, or the number of eggs, which are linked to a woman's biological clock in most of the conversation.

“Egg quantity refers to the number of eggs that remain in the ovaries. We typically measure this via AMH (anti-Müllerian hormone) levels and antral follicle count scans. A smaller egg reserve generally doesn’t mean you can’t expect to conceive, but it decreases the chances of getting pregnant and shortens the reproductive window,” she helped define egg quantity clinically and what exactly happens to egg quantity with age.

So, this gradual decline means fertility naturally becomes very time-sensitive with age. Even though pregnancy may still be possible, a shrinking ovarian reserve can put a limitation to the reproductive window. But most importantly, the expert shed light on how women are born with all the eggs they will ever have, and this reserve declines with age.

"The number of eggs decreases dramatically by puberty and declines every month during reproductive years,” Dr Gupta explained, implying the continuous rate of decline over time.

What is egg quality?

Often, the primary focus is on egg quantity, where the number of eggs in the ovarian reserve determines the reproductive window, especially since it declines with age. But the quality of the eggs is overlooked, even though it has a much bigger implication for conception and pregnancy outcomes.

Let's see how the gynaecologist define egg quality and why it is important in conception. “Egg quality refers to the health and genetic normality of the eggs. Increasing age makes it more common for eggs to show chromosomal abnormalities, which can influence fertilization, embryo development, implantation and outcomes of pregnancy," Dr Gupta said.

Quality vs quantity

The debate of quality versus quantity often comes up in fertility conversations. But here's how the doctor settled the argument. “Younger women with fewer eggs may still find it easier to conceive sometimes than older women with a high egg count. Quality is oftentimes more important than quantity on fertility outcomes."

Know what is more crucial- egg quality or egg quantity. (Picture credit: Unsplash)

Does age matter?

One of the biggest questions surrounding fertility is whether age truly matters as much as it is portrayed in common discourse.

To which the doctor helped explain that fertility goes down with age, particularly after the mid 30s. But here's the catch, despite menstrual cycle appearing to be regular, egg quality may silently detoriate over time. What does this do? Dr Gupta mentioned risks of miscarriage, failed implantation and chromosomal condition.

Common myths people believe about fertility

Now, before wrapping up, let's quickly do a rundown of some common fertility myths and fact-check each of them. The doctor debunked the following misconceptions with medical facts:

1. Regular period does not mean normal fertility

• Regular cycles do not necessarily mean that egg quality is good, or the ovarian reserve is sufficient.
• Many fertility problems can occur even when periods seem normal.

2. Age-related fertility decline can be cured entirely with IVF

• While IVF can help with conceiving, it cannot fully undo the impact of declining egg quality.
• Success rates remain largely dependent on age and egg health.

3. Only women should worry about biological clocks

• Male fertility also changes with age.
• Sperm quality, motility, and DNA integrity can decline over time and affect pregnancy outcomes.

4. A healthy lifestyle guarantees fertility

• Good nutrition, exercise and stress management are preventive actions.
• They help to preserve reproductive health, but they cannot eliminate age-related changes in egg quality.

What people can do to support reproductive health

Early awareness and strategic planning help to play a major role in positive outcomes. Here are some of the practices couples can adopt, as recommended by the fertility expert:

1. Learn about fertility earlier

• People often only look up fertility questions if they want to conceive.
• Knowing about reproductive health in the late 20s or early 30s can aid in planning out the future.

2. Think about fertility testing

• Simple hormone tests and ultrasound assessments can give insights about ovarian reserve and overall reproductive development.

3. Avoid delaying conversations unnecessarily

• Family planning decisions are often shaped by career goals, finances, relationships and personal readiness.
• However, postponing fertility talks can limit options later.

4. Maintain overall health

• Balanced nutrition, physical activity, sleep, not smoking, and limiting excessive alcohol intake can help with hormonal balance and reproductive health too.

5. Explore fertility preservation if it is appropriate

• Egg freezing may be wise for some individuals especially if parenthood is not in the books due to medical or personal reasons.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.