It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF

Fett broadens the scope of fertility challenges by turning her attention to the often-overlooked role of the immune system and uterine environment in implantation failure and recurrent pregnancy loss. While previous chapters focus largely on gamete quality, Fett argues that even chromosomally normal embryos can fail to implant if silent infections, endometriosis, or immune dysfunction are present—conditions that are surprisingly common, frequently undiagnosed, and sometimes entirely asymptomatic. Drawing from recent advances in reproductive immunology and endometrial testing, she introduces a range of diagnostic tools such as EMMA/ALICE microbiome tests, ReceptivaDX, and various antibody screenings to uncover hidden causes of infertility. Through studies showing dramatic increases in live birth rates after antibiotic or immunological treatment, Fett illustrates the tangible value of these tests, especially in cases of repeated IVF failure or pregnancy loss. Yet she also reveals the systemic inertia of modern medicine: Many clinicians hesitate to explore immune or microbial causes unless a patient has experienced multiple losses, reinforcing a model of care that is reactive rather than preventative.

This chapter not only demonstrates scientific rigor but also encourages readers to challenge conventional treatment pathways. Fett identifies a critical lag between emerging scientific evidence and mainstream clinical practice, urging readers to self-advocate in an environment where access to newer diagnostics remains uneven.