When pursuing IVF to grow your family, whether you’re looking to bank embryos for multiple children or just hoping to have one successful pregnancy, the number of eggs retrieved during your cycle will weigh heavily on your mind. But is that really what should be the focus of your efforts?
When I was going through IVF, I only had 4 eggs retrieved and I was devastated. I knew the math, and that having only 4 eggs retrieved likely meant I wouldn’t have multiple embryos to try with and possibly, I wouldn’t have even one embryo by the end of the excruciating 5-day waiting period. But in the end, I was so fortunate that all 4 eggs fertilized and all 4 fertilized eggs became 5-day, genetically normal embryos. I give a lot of credit for this outcome to my endometriosis surgery, my clinic’s protocol and my commitment to fertility helping supplements and lifestyle changes leading up to my IVF round.
But in the moment, I was completely dismayed by the number of eggs I got, and I couldn’t help but remember all the women in the IVF support groups who posted about 10s and 20+ eggs retrieved. But what I hadn’t paid close attention to was that while many women will post big numbers of eggs retrieved (20+) they may only end up with 1 or even 0 embryos at the end of the process.
As it turns out, the number of eggs retrieved may not be the best metric to focus on. In the end it’s important to remember that it’s not about the number of eggs, it’s all about the number of viable embryos you have to transfer or freeze. While on the surface it would logically follow that the more eggs you have retrieved, the more embryos you will end up with, that’s simply not true for everyone or even in most situations.
Some real results from actual IVF patients that shows # of eggs retrieved does not correlate to # of embryos you will have to transfer:
| Real IVF Outcomes Eggs vs Embyros | ||||
|---|---|---|---|---|
| IVF Cycle Example | # of Eggs Retrieved | # of Mature Eggs | # of Fertilized Eggs | # of Embryos to make it blastocyst |
| Woman 1 | 5 | 4 | 2 | 1 |
| Woman 2 | 20 | 19 | 14 | 2 |
| Woman 3 *PCOS | 17 | - | 13 | 4 |
| Woman 4 | 27 | 18 | 10 | 3 |
| Woman 5 | 35 | - | - | 3 |
| Woman 6 | 31 | 23 | 21 | 15 |
| Woman 7 | 4 | 4 | 4 | 3 |
| Woman 8 | 26 | 25 | 17 | 0 |
| Woman 9 *PCOS | 19 | 15 | 12 | 0 |
| Woman 10 | 21 | 12 | 8 | 5 |
From these ten women’s results from their IVF cycle the typical range of embryos that made it to blastocyst, either for a fresh transfer or for freezing, was between 0-5 irrespective of the number of eggs that were retrieved, which ranged from 4 mature eggs to 25 mature eggs (except for one woman who amazingly ended up with over 15 embryos produced from 23 mature eggs).
This shows that in many cases, it’s not about the number of eggs retrieved, that dictates the number of embryos you might end up with. In fact, aiming for fewer eggs stimulated with a lower level of medications has been shown to produce better quality eggs, leading to better chances of high-quality embryos. All of this is nuanced, and impacted by your particular fertility concerns (sperm fragmentation, male factor, low egg reserve, PCOS, etc.) of course, but no matter what your fertility challenges may be, higher quality eggs will improve your chances for a positive outcome.
Women with polycystic ovary syndrome (PCOS) typically will produce way more eggs during an IVF cycle than a woman without PCOS. But these patients will also tend to see a bigger drop-off between eggs becoming embryos.
Whether you have PCOS or not, opting to go with a lower-level of stimulation can help avoid “frying” your eggs, and potentially inadvertently damaging the quality of your eggs retrieved during your cycle.
Another added benefit of lower levels of egg stimulation medications (mini-IVF) is it can also help reduce the risk of ovarian hyper-stimulation syndrome (OHSS). OHSS is a scary and potentially deadly side effect of artificially forcing your body to produce more eggs than normal through medication.
Way to maximize the quality of eggs over the quantity of eggs, with the goal of increasing the quality of embryos:
● Discuss the pros and cons of a mini-IVF cycle where you use fewer stimulation drugs with your doctor.
● Especially if you have PCOS, work on your metabolic health. Many PCOS sufferers also suffer from insulin-resistance and metabolic syndrome. Getting a handle on your metabolic health can help alleviate PCOS. Natural options to mitigate PCOS include intermittent fasting, low-carb diets, avoiding processed foods and unnecessary sugars.
● Take egg-quality supporting supplements like our Vitamin D, CoQ10 and PreNatal vitamins for at least 90 days prior to your IV cycle
And remember, that your IVF experience is unique to you. You could end up with lots of eggs and no embryos, you might end up with lots of eggs and lots of embryos. The process of IVF is emotionally charged, expensive and will not follow the same path as anyone else’s experience.
Do the best you can do for yourself, and always be kind to yourself. What you’re going through is not easy.
