Infertility/Fertility/Egg Quality


Hello Dr Ramirez.  I am writing to you from Nebraska.  I have had 2 fresh IVF cycles and 2 FET cycles.  Only one pregnancy  - from the first IVF 5 years ago.  We have been trying to have a baby through various methods for over 14 years - with only one successful pregnancy.  I am 36 and have had a laproscopy and been diagnosed with endometriosis.  Other than that it was explained infertility until recently.  After my last IVF my RE said that she feels our issue is egg quality - as only one out of 12 embryos made it to blastocyst (cycle was not a success).  My previous cycles were all day 3 transfers with another dr, but she has reviewed the information and feels those embryos were likely delayed in development as well due to embryo quality (even at 32 when they were produced).  My current dr did not recommend any supplements or vitamins other than regular healthy lifestyle.  Is there anything that you would recommend to increase egg quality?  Thank you for your assistance!

Hello S from the U.S. (Nebraska),

Unfortunately, the technology to enhance or improve "egg quality" does not yet exist and that is a major problem for many women seeking fertility treatments.  However, I'm not sure that I can agree with that diagnosis without review of the IVF embryo results, because that would be unusual in a younger woman.  For my patients, I have them take CoQ10 600 mg per day, which in mice (no human studies) has been shown to improve cell and egg quality.

There are two components that produce the embryo: egg and sperm.  If there is a problem with either component, then embryo quality will suffer.  Unfortunately, without trial and error (using donor egg or sperm), there is no way to know which could be the problem.  If you don't want to do that, then the next step would be to do PGS (preimplantation genetic screening) to see if there the embryos formed are chromosomally normal and allow you to select from that group.  Of course, that means that you have to have enough embryos to take to blastocyst.

On the other hand, you also have to ask if the clinic you are going to is good enough.  Laboratory quality can also cause embryos to not do well and thereby decrease your quality.  So another option might be to try a different clinic.  Labs make a huge difference in pregnancy rates.

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.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at if you are interested in continuous access to me.


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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, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

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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