Maintaining of egg quality with increasing of age is challenging due to the biological clock after 35 years of age decline it naturally. In 1975, only 5% of female got pregnant after 30 years of their age and currently, more than 26% of pregnancy occurs after 30 years of her age. Quality of egg is one of the primary factor responsible for the reproductive outcome. Conceiving a child and deliver a healthy baby completely depend upon genetic and epigenetic programming of an egg. Mitochondrial functionality and cytoskeleton integrity in the egg is essential for spindle formation and modulation of chromosomal segregation along with maintaining the stability of genome during cell division. Spindle formation is an important step in cell division made up of microtubule bundles, which divide chromosomal material equally to form two daughter cell from the parent cell. Diminishing egg quality with increasing of age is related to disorganization and shrinkage of the spindle and resultant of this leads to maturation arrest. In addition, impaired functioning of mitochondria also restricts the oocyte activation by disrupting calcium-mediated intracellular signaling and restricting the transition from metaphase I to anaphase I.
There are some supplements useful to improve the overall quality of egg and support a pregnancy. These are as follows:
Increasing reactive oxygen species (ROS) burden enhances free radicals and exerts oxidative stress. This negatively affects reproductive health by limiting follicular development, hindering egg maturation, irregular ovulation, impaired functioning of corpus luteum, and breakdown of the ovarian follicles. Antioxidants, specifically melatonin supplementation acts as a free radical scavenger and improve egg maturation. Melatonin has a protective effect and prevents egg damage. A clinical trial result also showed that oral administration of melatonin with a dose of 3mg/day provides better fertilization rate in patients who had previous unsuccessful IVF history. Another study also supported that melatonin significantly increase pregnancy rate.
Myo-inositol is a derivative of Inositol, which is an essential vitamin B complex ingredient and normally found in the balanced diet. Inositol is involved in different cellular functioning and stimulating intracellular calcium ion (CA 2+) release. The intracellular Ca2+ levels enhancement is essential for egg maturation, fertilization, and embryo development. Myo-inositol stabilizes chromatin and also has a significant role in the cytoskeleton. Both of these mechanisms are essential for correct maturation of the egg.
An animal study showed myo-inositol supplementation and increase level of myo-inositol level in follicular fluid improve egg quality and morphology of the developing embryo is also good. However, instead of Myo-inositol supplementation alone, a combination of myo-inositol and D-chiro-inositol is more effective to improve egg quality.
In IVF treatment, incorporation of Myo-inositol can reduce the rate of risk of hyperstimulation syndrome by accelerating FSH stimulation in a low dose. This benefit is very effective for patients having PCOS and improve pregnancy rate.
Recently, fertility clinicians recommended a combination of Myo-inositol and melatonin for a better outcome of ART (Assisted reproductive technology).
Cathepsin B proteases blocking
Cathepsin B proteases is increasing with aging and responsible for the age-related poor-quality egg. Blocking of this protein is another approach to improve egg quality even after aging. Very recently Current Biology published a research study details where it has been motioned that the oocyte-specific insulin/insulin-like growth factor-1 signaling genes thereby can block the cathepsin B proteases proteins and extends egg viability. However, detail long-term human research report requires to establish this process.