Can You Still Get Pregnant with Poor Egg Quality? IVF Realities Explained
A common fear among IVF patients is that poor egg quality guarantees failure. A pivotal factor influencing IVF success is the quality of the eggs used in the process. While egg quality significantly impacts success rates, the relationship isn’t absolute. Having a better understanding of egg quality and IVF outcomes will help you set realistic expectations and explore alternative options. First, let’s get into the facts about poor egg quality and what it may mean for your IVF journey.
Myths vs. Facts About Egg Quality and IVF
Understanding Egg Quality
Egg quality primarily refers to the genetic integrity of the oocyte. High-quality eggs possess the correct chromosomal composition, increasing the likelihood of developing into healthy embryos. Conversely, eggs with chromosomal abnormalities may result in failed fertilization, implantation failure, or miscarriage. As women age, particularly beyond 35, the proportion of chromosomally normal eggs decreases, impacting fertility.
❌ Myth 1: "Poor egg quality = No chance of pregnancy."
✅ Fact: Even lower-quality eggs can sometimes produce viable embryos.
Aneuploid eggs (abnormal chromosomes) usually fail, but some self-correct during early development.
Morphologically 'ugly' eggs (granular cytoplasm, irregular shape) may still fertilize and implant.
❌ Myth 2: "Only young women have good-quality eggs."
✅ Fact: Age is the biggest predictor, but not the only one.
Some younger women have poor egg quality due to endometriosis, genetics, or autoimmune conditions.
Some older women (even late 30s/40s) still produce euploid (chromosomally normal) embryos.
Understanding the Impact on IVF Success Rates
It's a misconception that poor-quality eggs invariably doom IVF attempts. While they pose challenges, success is not solely dependent on egg quality. Factors such as the number of eggs retrieved, sperm quality, and the overall health of the individual play crucial roles. For instance, younger women with diminished ovarian reserve may still achieve favorable outcomes if viable eggs are obtained.
❌ Myth 3: "If one IVF cycle fails due to egg quality, all future cycles will too."
✅ Fact: Egg quality varies between cycles.
Changing protocols (e.g., growth hormone, antioxidants, or dual stimulation) may improve outcomes.
Natural cycle IVF or minimal stimulation sometimes yields better-quality (but fewer) eggs.
Not true. IVF cycles are never perfect, if one was good then we expect the next to be good as well, but it’s certainly not a guaranteed situation. Many factors go into each cycle and many things can change by the next IVF cycle.
❌ Myth 4: "There’s no way to test egg quality before IVF."
✅ Fact: While no perfect test exists, clues include:
AMH & FSH levels (indirect indicators of ovarian reserve).
Previous IVF cycles (fertilization rates, embryo grades).
PGT-A testing (reveals if embryos are chromosomally normal).
The reason no perfect test exists is that testing egg quality would require the lab to do various molecular tests on the egg, which would make it unusable. This test will give valuable information on that specific egg, but it may not be the case for other eggs in the cycle or even eggs from another cycle. The tests we currently use can only give us an idea of the egg quality so it’s making an assumption.
Strategies to Improve Outcomes
Optimizing Protocols
Growth hormone (Omnitrope) → May enhance egg quality.
CoQ10, DHEA → Some evidence for mitochondrial support.
Advanced Lab Techniques
ICSI (for fertilization issues).
PGT-A (to avoid transferring abnormal embryos).
Lifestyle Adjustments
Reducing oxidative stress (quit smoking, Mediterranean diet).
When Is Donor Egg IVF the Best Option?
Repeated IVF failures due to poor embryo quality.
Very low AMH + advanced maternal age (e.g., over 42).
Genetic conditions affecting egg viability.
Donor eggs don’t mean giving up genetically—some couples use embryo adoption or mitochondrial replacement. Mitochondrial replacement is extremely rare and actually banned in the USA. There have been recent changes in European country regulations that allow for this procedure so it may be worth a trip!
Bottom Line
✔ Poor egg quality reduces—but doesn’t eliminate—IVF success.
✔ Some "low-quality" eggs still produce healthy babies.
✔ Testing (PGT-A) and tailored protocols can help.
✔ Donor eggs remain a high-success alternative.
IVF can certainly succeed with poor egg quality, but it won’t be an easy path. We hope that sharing this information can help prepare you for realistic expectations and goals when starting your IVF cycle. Don’t be discouraged by poor egg quality because thousands of patients who have been diagnosed with poor egg quality have delivered children!
“Listen up, egg. I don’t care if you’re feeling ‘tired’ or ‘low quality’ today. We’re fertilizing, we’re dividing, and we’re making magic happen. No excuses!”
