Egg quality is primarily determined by age and genetics—factors we can't change. But eggs don't go directly from dormant to ovulated. They spend about 3 months in active development before ovulation. During this window, the environment matters.
Here's what the research actually supports—and what's mostly marketing hype.
Eggs take approximately 90 days to mature from dormant follicle to ovulation-ready. Interventions need this much time to have an effect. Start 3+ months before trying or IVF.
Understanding Egg Quality
When we talk about "egg quality," we're really talking about:
Chromosomal integrity: Whether the egg has the correct number of chromosomes. Eggs with too many or too few chromosomes (aneuploidy) usually don't fertilize, don't implant, or result in miscarriage. This is the main factor that changes with age.
Mitochondrial function: Eggs need enormous amounts of energy (ATP) to complete cell division after fertilization. Mitochondria are the cellular powerhouses that produce this energy. Dysfunctional mitochondria can lead to failed fertilization or arrested embryo development.
Cytoplasmic health: The egg's interior environment needs the right proteins, RNA, and structures to support early embryo development before the embryo's own genes turn on.
Most interventions target mitochondrial function and oxidative stress—areas where we have some ability to intervene.
Supplements with Evidence
CoQ10 is essential for mitochondrial energy production. Levels decline with age, and supplementation may help eggs produce the ATP needed for proper chromosome segregation and early embryo development. Multiple studies in older women and those with diminished ovarian reserve show improvements in egg quality markers and IVF outcomes.
Inositols improve insulin sensitivity and support ovarian function. Particularly well-studied in PCOS, but beneficial for egg quality broadly. The combination of myo-inositol and D-chiro-inositol in a 40:1 ratio mimics the body's natural ratio and shows the best results for egg quality and IVF outcomes.
DHEA is a hormone precursor that declines with age. Supplementation may improve ovarian response and egg quality, particularly in women with diminished ovarian reserve. Several studies show improved IVF outcomes. However, it's a hormone and should be used under medical supervision.
Vitamin D receptors are present in ovarian tissue, and deficiency is linked to poorer IVF outcomes. Many women are deficient, especially in northern latitudes. Optimizing vitamin D levels is a low-risk intervention with potential fertility benefits.
Omega-3s are important for egg cell membrane composition and reduce inflammation. Studies suggest they may delay ovarian aging and improve egg quality. Higher omega-3 intake is associated with better embryo morphology.
Oxidative stress damages eggs. Antioxidants may help protect eggs during maturation. Vitamin E and C have modest evidence; resveratrol shows promise in animal studies. Often included in prenatal vitamins or fertility formulas.
Based on current evidence, a reasonable egg quality supplement protocol includes: CoQ10 (400-600mg), Myo-inositol (2-4g, or Ovasitol), Vitamin D (if deficient), Omega-3s (1-2g), and a quality prenatal vitamin. Add DHEA only under medical supervision if you have diminished ovarian reserve.
Lifestyle Factors That Matter
Smoking accelerates egg loss and damages egg quality through oxidative stress and toxin exposure. Smokers reach menopause 1-4 years earlier than non-smokers. Quitting improves outcomes—the sooner, the better.
Heavy alcohol consumption is associated with reduced fertility and poorer IVF outcomes. Moderate drinking's impact is less clear, but most fertility specialists recommend minimizing or eliminating alcohol when actively trying, especially before IVF.
Both obesity and being significantly underweight impair fertility. Obesity increases oxidative stress and inflammation; underweight can disrupt ovulation. A BMI of 20-25 is associated with the best fertility outcomes. Even modest weight loss (5-10%) in overweight women can improve egg quality and ovulation.
Endocrine disruptors (BPA, phthalates, pesticides) may harm egg quality. While the evidence is still developing, reducing exposure is precautionary: avoid heating food in plastic, choose fragrance-free products, wash produce, consider organic for high-pesticide crops.
Chronic stress elevates cortisol, which may impair reproductive hormones. Studies on stress and egg quality are mixed, but stress reduction supports overall health and may indirectly benefit fertility. Find healthy outlets: exercise, meditation, therapy, hobbies.
"You can't make your eggs younger, but you can give them the best possible environment to mature in. Think of it as optimizing, not reversing."
Diet for Egg Quality
No single food is magic, but overall dietary patterns matter:
Mediterranean diet is consistently associated with better fertility outcomes. High in vegetables, fruits, whole grains, fish, olive oil, and nuts. Low in processed foods, red meat, and sugar.
Antioxidant-rich foods: Berries, leafy greens, colorful vegetables, nuts (especially walnuts), green tea, dark chocolate.
Protein balance: Some evidence suggests replacing some animal protein with plant protein may benefit fertility. Include legumes, nuts, and seeds.
Healthy fats: Emphasize omega-3s (fatty fish, walnuts, flax) and monounsaturated fats (olive oil, avocado). Limit trans fats and excessive saturated fat.
Limit: Processed foods, excessive sugar, trans fats, excessive caffeine (moderate caffeine is likely fine).
What Doesn't Work (or Isn't Proven)
Some things commonly promoted for egg quality lack good evidence:
- Royal jelly: Popular but minimal human evidence
- Maca root: Limited and inconsistent evidence
- Most "fertility teas": Unlikely to have meaningful impact
- Acupuncture for egg quality: May help with stress, but direct egg quality effects unproven
- Excessive supplementation: More isn't better; some supplements at high doses can be harmful
Where Are You in Your Journey?
Our quiz can help point you toward the right resources for your situation.
Take the Fertility Quiz →The Bottom Line
Egg quality is largely determined by age and genetics—factors outside your control. But you can optimize conditions during the final 90-day maturation window:
- CoQ10 (400-600mg) has the strongest evidence for mitochondrial support
- Myo-inositol (Ovasitol) supports egg quality and is well-tolerated
- DHEA may help with diminished ovarian reserve—but only under medical supervision
- Don't smoke—this is the most damaging modifiable factor
- Maintain healthy weight and follow a Mediterranean-style diet
- Start early—give interventions at least 3 months to work
Be realistic: these interventions may provide modest improvements, especially for women with age-related decline. They're not miracle cures but part of optimizing your chances. For women with significantly diminished ovarian reserve, medical options like IVF with PGT-A testing or donor eggs may ultimately be more effective paths forward.