Infertility/Fertility/Egg Quality


Hi Dr. Ramirez,

I had an ectopic pregnancy in September that was resolved with Methotrexate.  I became pregnant again in early December and found out at the pregnancy confirmation appointment that it was another ectopic.  The ectopic had ruptured and required emergency surgery and removal of my right tube.  During the procedure, my surgeon discovered endometriosis in the left tube and it too was removed.  Both ectopic pregnancies had very high HCG and were well in the 4000 range at six weeks and more than doubling every 48 hours.

I have just completed my first IVF cycle and in the two week wait.  Three perfect embryros (my eggs) were transferred on day three.  My question is: if I had the two ectopic pregnancies, does this mean I have good quality eggs even though I have been labeled a "low responder" during initial IVF testing? They retrieved four eggs, three were fertilized and I was told perfect.  If the embryos were such a high grade would it be true they will develop properly, or is it true they can still degenerate and fail to implant or miscarry.

Many Thanks,


Hello Christine from the U.S. (Illinois),

Sorry for the tardiness of this reply.

An ectopic pregnancy does not give any indication regarding the quality of the eggs.  Even a bad egg can produce a pregnancy.  Being a "poor responder" only indicates ovarian function and not egg quality or pregnancy potential.  The current system of determining egg quality is solely based on external appearance and does not give an indication of the internal viability of the embryo, which is the most important in determining a successful pregnancy.  Because of that, even an excellent looking embryo could be genetically or otherwise abnormal and lead to a pregnancy and/or miscarriage.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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