Disclaimer: The information provided is not intended as medical advice. Repronova LLC offers consulting and advisory services in reproductive physiology exclusively to participating physicians, who are fully licensed in their respective jurisdictions and who retain full clinical discretion and control over the diagnosis, care, and treatment of their patients.
With the current approach the method of predicting the time to harvest eggs and validate their competence is rather crude. Yet, IVF is very successful overall and most patients will eventually become pregnant. This is because in most cases, eggs have a high degree of tolerance, there are many of them harvested and even if only a small fraction of them are competent, childbirth will be achieved. However, if a patient develops few eggs or her eggs can’t compensate for the deficiencies created by stimulation, she will need a more delicate approach.
Currently, the doctor measures the size of the follicle and the amount of estradiol the follicles produce (which is another way to measure follicles) to decide if the egg inside of the follicle is ready to be harvested. This is not unlike measuring the pregnant woman’s belly to predict the maturity of her fetus inside – not very accurate.
Instead, doctor can simply ask: “When was your last period?”. This is because time is the most critical factor in determining the baby’s readiness for birth. A baby needs about 9 months in the womb to be born healthy at “term.” Babies born too early (pre-term) often face health challenges and so do eggs…
We proposed that eggs also have a “term”—the time needed to mature properly in the ovary for the best quality. Research shows that for women in their most fertile years, their eggs need 18 days (from the start of the period to ovulation) to become of good quality. We adopted this as the standard for a Term Egg™. The impact of time on egg quality is significant: shortening maturation by just 4 days can reduce fertility by half.
Importantly, the time egg spends maturing, must be quality time when egg is nurtured by so-called cumulus or in other words nursing cells. If the level of FSH is too low, few eggs will be harvested. But if it goes too high (this too high is unique for each patient), it begins to deprive egg of nursing cells, leaving it malnourished. Besides, excess of FSH will accelerate follicles expansion, shortening the time for egg to become – Term. LH – another reproductive hormone may also affect egg quality during the follicular phase, if it is too high or too low.
We developed the Term Stimulation (Term Stim™) platform to help physicians keep track of multiple data points to deliver a better quality egg – Term Egg™. We demonstrated that careful calibration of FSH levels during ovarian stimulation can improve egg quality in patients who failed conventional stimulation.
All our protocols are fully customized and as important as “term” is, it isn’t always feasible. In some cases – for example, when protecting the egg from elevated LH or FSH – the follicular phase must be truncated well before “term.”
