Reproductive medicine is still in its infancy, but it’s growing up fast with each new study that’s published. Fascinating research examining the link between live birth rates and the number of eggs retrieved in one in vitro fertilization (IVF) cycle indicate that 15 may be the “magic number” to collect for the most successful outcomes. So, should you and your doctor lock in on this number, or are there other contributing factors you should be aware of? We break down the research, and provide some conclusions and guidelines for you to keep in mind.
A 2011 study published online in the journal Human Reproduction found that there was a strong relationship between live birth rates and the number of eggs retrieved in one IVF cycle. The likelihood of success rose with each additional egg retrieved, up to about 15 eggs. Outcomes leveled off when 15-20 eggs were retrieved, and then steadily declined beyond 20 eggs. The researchers analyzed more than 400,000 IVF cycles that occurred between 1991 and 2008 in the United Kingdom.
Dr. Arri Coomarasamy, an author of the study, and a clinical reader and consultant at the University of Birmingham (UK), pointed out that the study was the first to look at the association between the number of eggs and live birth. He added, “This is also the first study to devise a graph that can be used by patients and clinicians to estimate the chances of a live birth for a given number of eggs.”
Developing Correlations on Egg Retrieval
The UK researchers created a mathematical graph — called a nomogram – that doctors can use to better counsel patients on their probability of a successful outcome from a given IVF cycle. This graph shows the relationship between:
- A woman’s age
- The number of eggs retrieved
- The predicted live birth rate.
The data may be useful, but please be advised that you and your doctor shouldn’t make simplistic interpretations. Not every patient undergoing IVF can — or should — be stimulated toward the production of 15 to 20 eggs.
For example, women over 40 with maximal ovarian stimulation would have trouble reaching this range, whereas young women with polycystic ovarian syndrome (PCOS) will often exceed this range, even with the mildest stimulation. The number of eggs retrieved is ultimately determined by your own ovarian reserve, a medical term that describes your current level of ovarian function.
“There are tests of ovarian reserve, such as anti-mullerian hormone (AMH) and antral follicle count (AFC), which are good at predicting ovarian response and the egg yield following ovarian stimulation during IVF treatment,” according to Dr. Coomarasamy. “However, AMH and AFC are not good predictors of live birth rates. If clinicians use AMH or AFC to estimate the egg yield, they can then use our nomogram to convert this estimated number of eggs into a predicted live birth rate, thus completing the prognostic chain to estimate the chances of what both they and the women want: a live born baby.”
More Eggs Isn’t Always Better
A second study , published in January 2018 in the same journal, further supported the increase in live birth rates based on how many eggs were retrieved. After reviewing the results of 77,956 fresh transfers between 2007-2013 and 36,270 consecutive frozen embryo transfers from 2007-2014, the researchers found that the live birth rate from fresh transfers increased with retrievals of up to 11 eggs.The cumulative live birth rates, which included fresh transfers and all subsequent frozen transfers, increased with each egg retrieved up to 18-20 eggs before leveling off. Keep in mind that these results may be limited, as it’s possible that not every embryo frozen within the study’s timeframe has been transferred yet, and may still result in a live birth.
What’s important to further point out here is the finding that there was a decreased live birth rate when greater numbers of eggs are retrieved — between 15-20. But this assumption may not apply to all types of IVF cycles.
In cases of fresh embryo transfer, the elevated progesterone levels from recent ovarian stimulation may change the environment of the uterine lining, making it less receptive to an implanting embryo. In other words, the stronger the ovarian response to stimulation and the higher the number of eggs retrieved, the more likely it is that the hormonal environment will negatively impact the chance of pregnancy after a fresh transfer. However, in frozen embryo transfers, the embryo transfer occurs in a subsequent cycle, remote from the process of ovarian stimulation. As a result, the hormonal environment more closely resembles a natural cycle. Therefore, the outcome of the frozen embryo transfer is not hindered in patients who had a high number of eggs retrieved in a prior cycle. Of note, this study also looked at the risk of Ovarian Hyperstimulation Syndrome (OHSS). They found that the risk of OHSS increased when more than 18 eggs were retrieved.
So now, in addition to counseling you about your fertility prognosis based on your age and ovarian reserve, your doctor can also weigh in on how the number of eggs retrieved may modify your chances of getting pregnant. The decision of whether to perform a fresh or frozen embryo transfer should be made with your doctor based on your individual health circumstances, and may be influenced by your response to ovarian stimulation and the number of eggs retrieved.
- Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011;26(7):1768-1774. https://doi.org/10.1093/humrep/der106. Accessed July 9, 2018.
- Magnusson Å, Källen K, Thurin-Kjellberg A, Bergh C. The number of oocytes retrieved during IVF: a balance between efficacy and safety. Hum Reprod. 2018;33(1):58–64. https://doi.org/10.1093/humrep/dex334. Accessed July 9, 2018.
Dr. Lucky Sekhon is a reproductive endocrinologist and infertility specialist and board-certified obstetrician and gynecologist. She specializes in diagnosing and treating reproductive issues and has particular expertise in fertility preservation (egg freezing), LGBTQ family building, and in vitro fertilization with preimplantation genetic testing of embryos. She also uses minimally invasive techniques such as laparoscopy and hysteroscopy to treat a variety of surgical conditions including endometriosis and uterine factor infertility.
Is 15 eggs good for egg retrieval? ›
A study of more than 400,000 IVF cycles has found that doctors should aim to retrieve around 15 eggs from a woman's ovaries in a single cycle for the best chance of achieving a live birth.What is a good egg retrieval number? ›
As a rule of thumb, however, having about ten to 12 mature eggs after egg retrieval (not all eggs retrieved will be developed or mature enough to fertilize) is a good number of eggs and will give a woman a good chance of having at least one normal embryo, which gives a woman a 65 percent chance of pregnancy.Is 15 follicles good for IVF? ›
As a general guideline, however, antral follicle counts can be used to help determine the likelihood of success for ovarian stimulation and IVF, and may also be used to guide dosing for fertility medications. 15 to 30 is considered a good number.Is 14 a good number for egg retrieval? ›
In general, an average of 8 to 14 eggs are typically retrieved from a woman's ovaries with IVF; however, its ultimately not the number of eggs that matter but the quality. 1 high quality egg is better than 20 poor quality eggs when it comes to success rates.Is 15 frozen eggs enough? ›
For women less than 35, it is ideal to freeze at least 12-15 eggs for a high chance of one child; this number increases as women get older. Of the hundreds of thousands of egg retrievals we have done, we see an average of 9-10 eggs retrieved per patient in one cycle; the average patient age is 35.9.Is 17 eggs good for retrieval? ›
An average of ten to 20 eggs are usually retrieved for IVF, but the number can be higher or lower. You would think more eggs is always better, but that's not the case. Researchers who analyzed thousands of IVF cycles found that the magic number of eggs retrieved from IVF treatment that lead to a live birth is 15.What is a good number of follicles IVF? ›
What is the average number of follicles during in vitro fertilization (IVF) treatment? Ideally patients will want to have around 10 follicles before ovulation is triggered with fertility drugs. It's possible for the process to be performed with fewer than 10 follicles, and success can still be achieved.What percentage of eggs make it to Day 5? ›
As a general rule of thumb, at RMA New Jersey, which has one of the best embryology labs in the country (as evidenced by the clinic's high success rates), about 80 percent of eggs will fertilize (day 1 success), and of those, about 30-50 percent will make it to the blastocyst stage (day 5 or 6).What is the ideal follicle size for egg retrieval? ›
An ideal IVF follicle size for egg retrieval is typically around 15 to 22 millimeters in size, which falls right in line with the ideal size for an IVF trigger shot.Is 15 follicles a lot? ›
Anywhere between 8 and 15 follicles is considered an acceptable amount. During an egg retrieval, your doctor will aspirate the follicles with an ultrasound-guided needle. Every follicle will not necessarily contain a quality egg.
Is 15mm follicle mature for IVF? ›
The stimulation must result in a minimum of 3 mature (or close to mature) follicles (follicles are mature if they are 16-20mm in average diameter on the day of human chorionic gonadotropin (hCG), where a shot is administered to stimulate ovulation).What does it mean if I have 15 follicles? ›
If you have lots of follicles, then you have the potential to release more eggs increasing the chance that one of those eggs will be healthy enough to result in a successful pregnancy.Is 14 embryos good for IVF? ›
The more eggs produced from each IVF cycle, the better the chances of a live birth, but only up to about 13 eggs; after that, over stimulation may result in lower-quality eggs that are less likely to become fertilized and result in healthy embryos.Can a 14mm follicle releases an egg IVF? ›
While all the growing follicles may release an egg, the egg needs to be mature to be able to fertilise. Generally, doctors want the follicles to be around 18mm or more to be considered mature, but I found this varied depending on the doctor.What grade of eggs is good for IVF? ›
Grade 1 through 2.5 embryos seem to have the greatest potential for developing to the blastocyst stage. However, a grade 3 embryo may also be of good quality if its appearance can be explained by asynchronous cell division rather than by poor development.What is the best number of eggs to freeze? ›
The number of eggs to freeze also depends on the woman's age and how many children she wishes to have in the future. Women under age 35 should freeze 20 eggs for an 85% chance of having one child; women 38-40 should freeze 30 eggs for a 75% chance of having one child.How many eggs should I freeze if I want 3 kids? ›
If she'd always dreamt of a big family, she should consider freezing 25 eggs, for over a 1 in 2 chance of having three children.How many eggs is 15 dozen eggs? ›
Eggs Lion Free Range Large (15 Dozen/ 180 Eggs)Is 20 eggs for a retrieval good? ›
It found that the best chance of live birth was seen when around 15 eggs were collected. However, as many other studies have shown, the chance of success began to decline after 20 eggs were retrieved.How many Fertilised eggs make it to day 3? ›
Roughly about 50 % of eggs will develop into day 3 embryos and at around 20-25% of eggs will reach the blastocyst stage at day 5.
How do you maximize an egg retrieval? ›
- Stay Away from Cigarettes. ...
- Manage Stress. ...
- Eat Healthy. ...
- Achieve a Normal BMI (body mass index). ...
- Boost Blood Flow. ...
- Invest in Supplements. ...
- Freeze Your Eggs.
On average, women in their mid 20s to early 30s have around 12 to 30 antral follicles, while women aged 35 to 40 may have between 8 and 15 and women aged 41 to 46 may have somewhere between four and 10.What is the average follicle count by age for IVF? ›
Here is the range of what you could expect by age of a normal antral follicle count (AFC): Age 25 to 34, AFC from 10 to 13. Age 35 to 40, AFC from 10 to 8. Age 41 to 46, AFC from 7 to 5.How many follicles should I have each month? ›
On average ten to twelve follicles are produced per cycle, but this can vary from person to person and is affected by multiple factors such as age, medical history and your individual response to ovarian stimulation.How many eggs per week is best? ›
Most healthy people can eat up to seven eggs a week without affecting their heart health. Some choose to eat only the egg white and not the yolk, which provides some protein without the cholesterol.How successful is it with only 1 egg retrieved? ›
Ultimately, the chances that one egg retrieval cycle will eventually result in a live birth (based on data from the Society of Assisted Reproductive Technology, or SART) are 55.6% for people under 35; 40.8% for people 35-37; 26.8% for people 38-40; 12.6% for people 41-42; and 3.9% for people 43 and over.Is 6 eggs retrieved good for IVF? ›
Six eggs is definitely enough for IVF if that's what you've managed to produce. Quality over quantity – you're much better off having six eggs than 60 eggs and quality over quantity for sure. So six eggs is definitely enough for IVF.What is the perfect follicle size? ›
In a fertility cycle, the ideal size is between 18 and 22 millimeters in diameter. Once a follicle reaches this size, it means estrogen levels are rising and the uterine lining has thickened.What is the size of follicle on day 15? ›
Follicle Size - 16X17 Mm Follicle On 15Th Day Of Cycle.What size should follicles be to trigger? ›
In most centers, triggering is administered once two to three ovarian follicles are at least 17–18 mm in diameter.
Is 12 a good number of follicles? ›
A woman is considered to have adequate or normal ovarian reserve if the antral follicle count is 6-10. If the count is less than 6 the ovarian reserve could be considered to be low, whereas a high reserve is greater than 12.Can a 16mm follicle have a mature egg? ›
Overall, follicles of 16–22 mm on the day of oocyte retrieval are more likely to contain mature oocytes than smaller follicles, while larger follicles are more likely to contain post-mature oocytes (1).How many follicles are good for egg freezing? ›
The stimulation must result in a minimum of 3 mature (or close to mature) follicles (we consider follicles to be mature if they are 16-20mm in average diameter on the day of HCG). Alternatively, if there are 2 follicles 16-20mm and at least 2 more that are 13-15mm, we can proceed to the egg retrieval.Can a 14mm follicle have a mature egg? ›
As the follicles grow, the eggs inside them are developing too. When a follicle gets larger than about 13 mm, its egg is more likely to be mature and therefore capable of being fertilized. Once the largest follicles reach about 17 to 18 mm, they (and you) are ready for egg retrieval.What size follicle is too big for IVF? ›
The existence of follicles with a trigger day diameter greater than 25 mm may alter the result of IVF-ET, lowering the clinical pregnancy rate (40.92 percent vs 30.2 percent, P = 0.008) and the live birth rate (37.24 percent vs 27.43 percent, P = 0.017).Does follicle size matter? ›
Follicle size for Pregnancy
Follicles play an important role in determining your chances of getting pregnant as they ensure the ovulation process (the release of an egg from the ovaries).
The size of a follicle tells the fertility specialist how much an egg has developed during a woman's cycle. The bigger the follicle, the better it is for the IVF process. For most IVF treatments, a follicle that is around 15mm-22mm (micrometers) large is most likely to produce a viable egg.Do follicles grow after trigger shot? ›
The Timing of The Trigger Shot During IVF
This must coincide with most of the ovarian follicles being greater than 15 mm in diameter and with several follicles having reached 18 to 22 mm. The follicles grow an average of 2 mm per day during the later stages of stimulation.
We test it by performing a baseline pelvic sonogram during the first three days of your menstrual cycle. This shows us how many follicles are in your ovaries. A normal amount is 12 per ovary; 1-10 is considered low.What age is IVF most successful? ›
It's widely known that a woman is most fertile in her 20's. Studies show that women in their 20s and 30s have the most success when getting pregnant through IVF and other reproductive technologies.
How many embryos is a good number? ›
Research shows that 8 is best. (Day 3 embryos that had 8 or more cells showed a significantly higher live birth rate). However, not all good quality embryos follow the rules.Is 15 mm egg size for pregnancy? ›
It is clear from the secondary follicles in the multiple pregnancies that follicles of diameter 16 mm and 15 mm are capable of contributing to the implantation. Follicles with FD=14 mm also appear capable of yielding an implantation.What grade is the best quality egg? ›
USDA Grade AA – The freshest and highest quality eggs will receive a Grade AA. USDA Grade A – Very high quality eggs will receive a Grade A. USDA Grade B – Grade B eggs are usually used for breaking stock (liquid eggs) and baking, dependingon the number of defects.Is Grade A or AA eggs better? ›
The highest egg grade is AA, followed by A, then B, and the letter takes appearance and both exterior and interior quality into account.What is the best quality of eggs to choose? ›
Always purchase eggs from a refrigerated case. Choose eggs with clean, uncracked shells. Don't buy out-of-date eggs. Look for the USDA grade shield or mark.How many eggs is a lot for egg retrieval? ›
For women with 1–4 eggs at retrieval it was 30.8% and for 5–9 eggs it was 36.2%. In women age 35–39 (n=543), optimal pregnancy rates (34.8%) were achieved with 5–9 eggs at retrieval. Less than 5 eggs significantly reduced the pregnancy rate (15.6%) whereas more than 10 eggs yielded pregnancy rates between 28 and 29%.How many follicles are ideal for egg retrieval? ›
The required number of follicles for IVF is usually between eight and 15 mature follicles, depending on your doctor's recommendations for your specific situation. Three follicles are usually the minimum amount for the trigger shot and egg retrieval process to take place.How many eggs are ideal for IVF? ›
Women under 38 in our IVF program have acceptable live birth rates even with only 3 – 6 eggs, do better with more than 6 eggs, and do best with more than 10 eggs. Women 38-40 and 41-42 years old have low live birth rates with low egg numbers. Success rates are much better when relatively high egg numbers are obtained.What is a good number of eggs for egg freezing? ›
The number of eggs to freeze also depends on the woman's age and how many children she wishes to have in the future. Women under age 35 should freeze 20 eggs for an 85% chance of having one child; women 38-40 should freeze 30 eggs for a 75% chance of having one child.What is the most eggs retrieved in IVF? ›
Fascinating research examining the link between live birth rates and the number of eggs retrieved in one in vitro fertilization (IVF) cycle indicate that 15 may be the “magic number” to collect for the most successful outcomes.
What size follicles are good for retrieval? ›
Overall, follicles of 16–22 mm on the day of oocyte retrieval are more likely to contain mature oocytes than smaller follicles, while larger follicles are more likely to contain post-mature oocytes (1).How many follicles is too low for IVF? ›
What is the average number of follicles during in vitro fertilization (IVF) treatment? Ideally patients will want to have around 10 follicles before ovulation is triggered with fertility drugs. It's possible for the process to be performed with fewer than 10 follicles, and success can still be achieved.How many Fertilised eggs make it to day 5? ›
Remember, even if all of your embryos are perfect on day 3, on average only 40-50% of them will become blastocyst on day 5.How many fertilized eggs make it to day 3? ›
Roughly about 50 % of eggs will develop into day 3 embryos and at around 20-25% of eggs will reach the blastocyst stage at day 5.What is the average number of eggs retrieved IVF by age? ›
women under 35 years old need nine oocytes to get one embryo; 35–37 years old – about 12 oocytes; under 42 years old – 16; over 42 years old – an average of 100 oocytes.How much does it cost to freeze 15 eggs? ›
A single cycle of egg freezing can cost anywhere from $8,000 to $20,000. Costs may go up depending on the number of cycles needed and, later, embryo creation and implantation fees.