Cracking the Code: How understanding your egg quality can help improve your fertility outcomes
[Disclaimer: This article is for informational purposes only and is not intended to be a substitute for professional medical advice.]
Being bound up with the hopes and dreams of becoming a parent can make IVF an emotionally charged process. So undergoing an IVF cycle without achieving a pregnancy can be devastating — both financially and emotionally. And the difficulty of explaining your feelings to others can leave you feeling isolated. What’s more, the reasons why your procedure failed may not be clear, making it easy to doubt yourself.
Undergoing multiple failed rounds can compound these feelings as friends and family members excitedly pester you for updates you don’t want to give. In these circumstances, just listening to IVF success stories can deepen your frustration.
However, the truth is that despite the efficacy of IVF treatment, there are many reasons why IVF cycles can be unsuccessful. And, while many women need multiple cycles to get pregnant, some never achieve their ultimate goal (including most famously, Jennifer Aniston).
Traditionally, determining “egg quality” seems to be a bit of a black box and providers haven’t had the tools to understand how individual egg quality impacts cycle outcomes. The current standard way of estimating egg quality is based only on age-based population health statistics.
This may mean that unsuccessful cycles are attributed to poor egg quality in older patients, and to factors other than egg quality in younger patients — sometimes mistakenly. These incorrect assumptions have consequences, sometimes leaving you feeling stuck doing cycle after cycle without an understanding of what variables can be impacted.
Our MAGENTA™ reports are filling this gap in care by giving you a more thorough, personalized understanding of the quality of each of your eggs. This provides additional data that helps you and your doctor understand why your IVF cycle failed, thereby allowing you both to focus your future IVF decisions on optimizing the factors most likely to improve your chances of success.
CAN YOUR IVF DOCTOR TELL IF YOUR EGGS ARE HIGH QUALITY?
To date, there hasn’t been a standard for grading eggs, making it impossible to consistently forecast whether an egg will lead to a healthy embryo and eventually, the birth of a child. Instead, predictions about your chance of success are estimated based on your age and the number of mature eggs retrieved.
Despite being the standard of care, this statistical method does not account for individual variability. Yes, it’s true that overall fertility rates decline with age, but egg quality isn’t consistent across all patients in one age category, or even within cycles for one person. In other words, not only can an older patient have good eggs, but those of a younger one can be unexpectedly low quality.
Moreover, egg quality isn’t the only input that matters when it comes to IVF. And, without a proper way of assessing each one of your eggs, you may not have a true picture of which factors are impacting your IVF cycle success.
MAGENTA™ gives patients undergoing IVF-ICSI greater insights into your egg quality by using artificial intelligence (AI). Trained and tested on over 120,000 egg images and their outcome data (i.e., Did the egg fertilize and form a usable blastocyst?), MAGENTA™ uses a type of AI called Deep Learning to recognize patterns between eggs and their outcomes that are otherwise invisible to the human eye.
Through this learning, MAGENTA™ is able to generate a quality score for each of your eggs that is correlated to its chance of forming a blastocyst (a healthy embryo). The higher the score, the more likely it is that your egg will fertilize and develop into a blastocyst. These scores can be viewed in a report alongside images of each of your eggs.
Armed with this new information about your individual egg quality, you and your doctor can determine which steps may have the potential to increase your odds of having a child through future cycles.
I’M OVER 35. HOW MIGHT MAGENTA™ PREDICTIONS AFFECT MY FUTURE CYCLE PLANNING?
(Click here to jump to the next section if you are under 35.)
Scenario 1: MAGENTA™ predicted that my eggs are lower-quality. I expected this because of my age.
When it comes to predicting egg quality, your age is a big factor, as statistics show that each subsequent birthday brings a reduction in your overall chances of having a baby. MAGENTA™ results that reinforce your age-related expectations may not come as a surprise, however confirming that your odds are in line with age-related expectations can help you better anticipate the challenges that may lie ahead on your IVF journey.
Nevertheless, while you may have been expecting your results, they can still be frustrating, especially if it’s not your first failed cycle. At this point, you may be throwing everything you have at the procedure — giving up alcohol, drinking daily fertility tea concoctions, undergoing weekly acupuncture… And learning that your eggs aren’t as high quality as you’d hoped can leave you feeling all manner of things, from bitter disappointment to deep sadness to anger.
But MAGENTA™ gives you and your doctor a more nuanced picture of your eggs versus simply assuming that they’re “low quality” or “high quality” based on your age alone. Instead, it scores each of your eggs on a scale of 0-10, allowing you to track any variability in egg quality over multiple cycles. This gives you the opportunity to consider with your doctor whether it’s worth undergoing another round of IVF or if your next move should be something different.
Knowing your individual egg quality scores, your doctor can recommend more personalized adjustments for future cycles that may help to improve your result. If your egg quality is low, boosting other factors in the IVF process may help achieve success.
For example, if you’re older or what’s referred to as “advanced maternal age,” changes to your IVF protocol may be in order. Alternatively, your egg quality insights may push you to consider lifestyle modifications before undergoing another round as a number of things may influence fertility, including smoking, diet, and weight.
In other cases, low MAGENTA™ scores may prompt you and your fertility team to consider another path, like egg donation. But whatever you choose, this can help you make better decisions about your future treatment or other options on the path to parenthood.
Scenario 2: My eggs are better quality than expected based on my age. What are my options?
Discovering that your eggs are better quality than you anticipated is likely to elicit relief. However, good egg quality doesn’t guarantee a successful pregnancy.
Instead, your MAGENTA™ report allows you to rule out your eggs as the primary issue. As a result, you and your fertility team can focus on addressing other factors such as endometrial receptivity or sperm quality that may have impacted previous unsuccessful rounds.
But, while there are a number of interventions you can take, sometimes IVF can simply be a numbers game. As with getting pregnant naturally, it may take a few tries, even if nothing’s wrong.
I’M UNDER 35. HOW MIGHT MAGENTA™ PREDICTIONS AFFECT MY FUTURE CYCLE PLANNING?
Scenario 3: MAGENTA™ predicted that my eggs are good quality, as expected for my age — so why didn’t I get pregnant?
It’s certainly reassuring to receive MAGENTA™ scores that reinforce your expectations that your eggs are high quality.
This may also raise the question of why previous rounds haven’t worked. In reality, there could be a number of reasons. For starters, egg quality can fluctuate within the same person over cycles, and even within the same cycle. So, it’s possible your previous cycle had a higher proportion of lower-quality eggs.
Alternatively, implantation could have been an issue. Ideal endometrial thickness (EMT) hovers around 10mm for IVF with fresh eggs and isn’t considered low unless it’s under 8mm. However, you may wish to explore options for optimizing your EMT if it falls near the lower end of what’s considered acceptable.
For some patients, hormonal, genetic, and immunological factors can influence their uterine environment. As a result, your provider may suggest introducing an anti-inflammatory or other immunomodulating medication to increase your uterus’ receptivity to accepting a fertilized egg for implantation.
Ultimately, the issue may not lie with you. Your IVF journey likely included a semen analysis to check your partner’s sperm count, as well as its shape, and movement. However, as with all assessments of these types of variables, they’re not perfect. Both sperm quality and quantity can be affected by dietary and lifestyle factors. If you have high quality eggs yet aren’t getting pregnant, it may be due to your partner’s sperm. In this case, they may benefit from interventions to increase their sperm quality.
Scenario 4: My egg quality is lower than my doctor and I expected, given my age. Is this the end of my fertility journey?
HOW CAN MAGENTA™ CAN HELP YOU?
Having an IVF cycle fail can be bitterly disappointing. Worse, not understanding the reason behind it can lead you to mistakenly focus on “fixing” the wrong factors.
Examining your newly retrieved eggs with MAGENTA™ can provide much-needed insight into the cause of previous IVF failures. While we can’t guarantee that you’ll always receive the scores you’d hoped, MAGENTA™’s personalized insights into the quality of each of your eggs will arm you and your fertility team with valuable knowledge to help improve your future treatment approach and decide what’s best for you.
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