Long cycles and egg quality

Friday, May 4, 2012

I have been beating myself up about this for many months.  I have heard through many an infertility/miscarriage forum that having a longer cycle with late ovulation is a sign of poor or diminished egg quality.  Ever since going off the pill a little over a year ago, my cycles have been anywhere from 35 days (first 2 cycles off the pill) to 41 days (in cycles following miscarriage).  I verbalized my concerns to my RE who tried, unsuccessfully, to put my mind at ease by saying that a late ovulation does not automatically equal poor egg quality.

A few days ago, a girl in one of the miscarriage forums posted an article that she had found that completely refuted the theory of long cycles/late ovulation = bad eggs.  A gentleman by the name of Dr. Thomas Hannam posted an article with the exact opposite theory.  In his article he stated, "Delayed ovulation -day 13 or later- is not a sign of egg quality concerns; in fact, it is more commonly a sign of an excess ovarian reserve, generally a good thing."  Now compare that statement to something that I just found on BabyMed.com, "Delayed ovulation may be a sign of poor egg quality."  Another blurb on StorkNet.com, made by Dr. Sam Thatcher states, "The average cycle length is 28-29 days. The farther one deviates from the norm the greater the likelihood of poor egg quality, lack of ovulation. Delayed ovulation is also associated with an increased risk of miscarriage. The rate of infertility is very high when cycles are over 35 days and I do not even recommend testing for ovulation, just progressing with therapy. At 32-34 days you may be somewhat borderline for normal ovarian function."  Ok really?  Wow.  This doctor doesn't even want to give a longer cycle a chance at having a natural successful pregnancy.  Now I am thoroughly confused.

Back to Dr. Hannam, I read his biography and he seems legit.  He runs a large fertility clinic in Toronto, Canada and looks to be quite successful in his practice, judging by the patient testimonials.  I am wondering where he got his information though and how medical professionals could have such differing opinions on this subject.  I would love to speak with him and pick his brain about this.

A few other major points from his article that intrigued me:

-Earlier ovulation (days 8,9,10) can be a sign of lower egg quality especially if you once had a normal ovulation day and now your ovulation day is consistently earlier. 
-Spotting ahead of your period can be a sign of poor egg quality.  Apparently lower quality follicles are associated with less progesterone production.
-Shortened cycles can be a sign of poor or failing egg quality.

Ok so reading the article by Dr. Hannam, I would not think that my cycle length/ovulation days are an issue.  If you Google late ovulation and poor egg quality you get a million hits.  If you Google late ovulation and good egg quality you get  the Dr. Hannam article along with a bizillion other articles about late ovulation and poor egg quality.  What gives?  Am I doomed or blessed?  I posted a question to his blog about my situation.  I'll report back if I get a response.

References:
How your menstrual cycle reflects your egg quality: http://www.fertility.ca/2008/06/how-your-menstrual-cycle-reflects-your-egg-quality/

Long Cycles and Delayed Ovulation: http://www.babymed.com/menstrual-period/long-cycles-and-delayed-ovulation

Delayed Ovulation: http://www.storknet.com/cubbies/infertility/exst19.htm

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