Many women want to know how to improve egg quality. And this is an important question, because healthy eggs aren’t just important for getting pregnant quickly.
Egg quality also lays the groundwork for the health of the entire pregnancy and the health of the future baby. And all this is being programmed in the egg in the months leading up to ovulation.
In this article, we will cover why egg quality is so important to consider before a pregnancy. We will also discuss who is at an increased risk of having poor egg quality. And finally, we will outline the diet and lifestyle steps that can help to improve egg quality.
Why Egg Quality Matters for Your Fertility
When we talk about egg quality, we are really talking about the health of the genetic material and the amount of nutrient and energy stores inside the egg. A lot happens in the early days of a pregnancy that depend on these factors.
And if an egg isn’t high quality, it might not have the means to successfully complete the crucial early steps that take a fertilized egg into a healthy growing fetus. Here’s a quick overview of how a fertilized egg transforms into a fetus.
After fertilization, the fertilized egg travels from the fallopian tubes to the uterus where it will implant into the uterine wall. Along the way, it goes through rapid cell division to form 2 layers. The outer layer will become the placenta and the inner layer, the embryo.
It takes 7-10 days for the fertilized egg (now called a blastocyst) to reach the uterus and implant. After implantation, the blastocyst is called an embryo.
Of course, after implantation the rapid cellular division in the embryo continues, with all major organ systems being differentiated by week 8 or 9. This is another major feat that relies on the health of the egg’s genetic material and preconception nutrition stores. Around week 9 the embryo is considered a fetus.
Miscarriage is unfortunately quite common in these early weeks as early embryonic development determines if the pregnancy will be viable. Embryos that develop from poorer quality eggs are more likely to have defects that will end in miscarriage.
Studies suggest that more than 60% of miscarriages are due to poor genetic health in the egg (1). So, as you can see, these early days of pregnancy rely heavily on egg health to support the early and rapid development of the egg into a healthy embryo.
From Primordial Follicle to Mature Eggs – The Final Stage of Development
Now that we’ve established just how important egg health is for your fertility and early pregnancy, you might be wondering whether it is even possible to improve egg quality. The good news, yes! You can certainly take steps to improve your egg quality.
Egg formation actually begins in utero. At around 20 weeks gestation, a developing baby girl has an estimated 6-7 million primordial follicles (or immature eggs). At birth, there are about 1-2 million egg follicles remaining. These egg follicles remain dormant until puberty when about 300,000-400,000 are left. At this point, a handful will start maturing each cycle.
Many people think that because a female is born with all the eggs she will ever have, that it is impossible to improve egg quality. But that’s not true because the eggs stored in the ovary at birth are still immature and require a final stage of maturation before ovulation.
This final maturation process starts about 90 days before ovulation and takes an immature primordial follicle to a mature egg that is ready for fertilization.
During this maturation process, the egg completes the final stage of meiosis which divides the DNA so each egg cell has the correct number of chromosomes.
The process of meiosis is very nutritionally demanding and without the proper energy and nutrients, errors are more likely to occur. This obviously can result in a lower quality egg with chromosomal defects.
Toxins, excessive stress, and missing nutrients also play a role in the final maturation. Having high levels of toxins or cortisol from stress can damage the developing eggs. And missing nutrients can affect genetic programming (called epigenetics) that is happening at this phase of development.
Risk Factors for Poor Egg Quality
Egg quality is important for all women to think about before conceiving. But certain groups of women may find it especially helpful to focus on overall egg quality before trying to conceive. This includes women who are over 35 years old or who meet any of the following criteria:
- Diagnosed with endometriosis
- Diagnosed with PCOS
- History of an autoimmune conditions
- A history of smoking or heavy alcohol use
- Obesity and/or insulin resistance
- A history of poor nutrition
- Frequent exposure to environmental toxins
As women get older, they are unfortunately less adapted to tackle oxidative stress and have less resilient mitochondria. This, along with the fact that there are just fewer eggs left are the main reasons why egg quality declines with age.
Endometriosis and autoimmune conditions are both accompanied by inflammation. Excessive inflammation creates poorer egg health, leading to egg quality issues.
Estrogen dominance, PCOS, insulin resistance, and diabetes all create hormonal imbalances that can interfere with egg maturation and disrupt ovulation.
And exposure to toxins and a history of smoking or excessive alcohol intake can interfere with egg development by creating excessive oxidative damage from chemical exposure.
Of course, all this sounds disheartening. Especially if you fall into one of these categories. But, I promise there is good news and that you can still modify your egg health with targeted nutrition and lifestyle interventions.
Test for Egg Quality
Another common question is whether you can test for egg quality. Although there are some considerations, the short answer is no, you cannot test for egg quality.
That being said, there are some lab tests or procedures that can be helpful and provide some insightful information.
Anti-Mullerian Hormone (AMH): This is a blood test that will provide information on ovarian reserve or how many eggs are left. It will not provide information on the quality of the remaining eggs. This test is most helpful for predicting the success of IVF treatments and should be interpreted with caution for couples who are trying to conceive naturally (2).
Follicle-Stimulating Hormone (FSH) + Estradiol: These hormones measured together will provide information on ovarian function. High FSH and low estradiol together may indicate fewer remaining eggs and/or ovarian dysfunction.
Embryo Grading in IVF: If undergoing IVF, an embryologist can evaluate the embryo’s development. Since this is done after fertilization, it provides indirect information on egg quality.
DUTCH Test: The Dutch Test measures hormones in a urine sample. And while it does not directly measure egg quality, the information you receive about hormonal health can help to identify imbalances that impact egg health.
How to Improve Egg Quality with Diet and Lifestyle
Let’s finally get to the action steps and talk about how you can improve egg quality with diet and lifestyle.
The objective with our diet and lifestyle interventions will be to supercharge the mitochondria and cut down on oxidative stress.
The mitochondria provide all the energy for the cell. And as we discussed above, the final stages of egg development are very energy intensive. Without proper energy to fuel these last steps, there is an increased chance for mistakes in DNA replication.
Oxidative stress can also damage DNA in developing eggs. Oxidative stress happens when harmful molecules called free radicals overwhelm the antioxidant system (the body’s natural defense against oxidative stress).
So, here are the things you should focus on to reduce oxidative stress, supercharge your mitochondria, and ultimately improve your egg quality.
1. Focus on Antioxidants
Antioxidants combat oxidative stress by neutralizing free radicals before they can damage cellular structures. Our goal is to maximize the amount of antioxidants available.
Our bodies make some antioxidants such as alpha lipoic acid and glutathione. But we also need to take in antioxidants from our diet too. Dietary antioxidants include vitamins (vitamin C, vitamin E), minerals (zinc, selenium), and phytochemicals (beta-carotene, lycopene).
The best way to maximize your antioxidant intake is to eat whole foods with a variety of color. Berries are one of the most dense sources of antioxidants so I always suggest aiming for at least 1 serving of berries (preferably organic) each day.
2. Hit Key Egg Quality Boosting Nutrients
Overall good nutrition with a vast intake of nutrients is super important for egg health. But I think it is necessary to highlight a few nutrients that are especially critical when working on egg health:
- Omega-3 Fatty Acids: Aim to eat a fatty fish 1-2 times per week
- Vitamin D: Recommended intake is 2000-4000 IU daily
- Folate: Recommended intake is 400-800 mcg daily
- Choline: Recommended intake is 425 mg per day but some research suggests that 900 mg per day is beneficial in pregnancy (3)
- Magnesium: Recommended daily allowance is 320 mg for women
3. Keep Blood Sugar Balanced
Poorly regulated blood sugar can promote oxidative stress and impair mitochondrial function. So, erratic blood sugar can create a big problem for fertility and egg health.
The main way to keep your blood sugar balanced is to make sure you are eating consistent meals and snacks. I encourage meals to be spaced every 4-5 hours with snacks every 2-2.5 hours between, as needed.
When you are planning your meals and snacks, it is also very important that they are balanced. A balanced meal or snack is one that has a protein and/or fat along with the carbohydrate. And ideally, the carbohydrate will be a complex carbohydrate (meaning it also contains fiber).
4. Cut Out Toxins
Environmental toxins can create lots of issues with your hormonal health and an unnecessary oxidative stress burden. Of course, there is no way to eliminate toxins from your lifestyle. You’d go crazy even trying.
But, making smart swaps to cut back on the places where you get the most exposure will go a long way. Here are a few ways you can get started cutting back on your toxic exposures:
- Choose organic when possible. Use the Dirty Dozen to help guide your priorities.
- Cut down on plastic in the kitchen. Use glass or stainless steel as much as possible.
- Be mindful of your personal care products. Use the Skin Deep database to find cleaner options.
5. Supplement Wisely
Supplements can be a big help in improving egg quality. But I would suggest focusing on steps 1-4 as foundational work before adding in supplements.
There is a common saying that “you can’t out supplement a poor diet”. And this couldn’t be more true when talking about egg quality. You can add all kinds of expensive supplements but they won’t be as effective as they could be without doing the foundational work to your diet and lifestyle beforehand.
Here I have included a list of supplements that are helpful for egg quality. It is in no way suggested that you should take all these supplements. But rather this is an overview of those known to help with egg quality. Along with your provider, pick and choose those that would be most helpful to you and your situation.
- CoQ10 (as ubiquinol), 400-600 mg daily: Helps with mitochondrial health and function (4)
- R-alpha lipoic acid, 200-300 mg daily: A potent antioxidant (5)
- N-acetylcysteine, 600 mg daily: A potent antioxidant (6)
- Vitamin E, 200 IU: A potent antioxidant (7)
- Melatonin, 3 mg: A potent antioxidant (8)
- DHEA (only after testing levels, dose will be individualized): hormonal precursor that assists with egg maturation (9)
Wrapping It Up
Egg quality is a very important part of fertility that can be overlooked. And many women wonder how to improve egg quality.
Some factors that play into egg quality, such as age, you can’t do anything about. But others like food, nutrition, and lifestyle can be modified to impact the quality of your eggs.
In this article, we covered some diet and lifestyle tips that can help to improve egg quality. If you are looking for more, be sure to check out my Egg Health Guide! In the guide, I cover more specifically what foods to eat to help improve egg quality. I’ve also included resources to help you cut down on your toxin exposure and a list of recommended labs to check preconception.