How to Improve Egg Quality: What the Research Shows
You haven't been told the whole story about egg quality.
If you've been told your egg quality is a concern, you're probably wondering what you can actually do about it. The conventional view has been that egg quality is determined by your age and genetics. But the research tells a more nuanced story, and our clinical experience confirms it.
Egg quality can be influenced. The follicle that will become your retrieved egg develops over approximately 90 days, and during that window, it's affected by your hormonal environment, oxidative stress levels, blood flow, and mitochondrial function. This means you have a three-month window to optimize the conditions for egg development.
This doesn't mean you can reverse your biological clock or guarantee results. But it does mean there are evidence-based strategies that can support your eggs during this critical development phase. And recent research suggests we need to think bigger than just the eggs themselves.
Can You Improve Egg Quality After 35?
For decades, scientists pointed to declining egg quality as the main cause of age-related fertility decline. But new research from UC San Francisco, published in Science in October 2025, shows that the story is bigger than the eggs themselves.
The surrounding cells and tissues of the ovary, what researchers call the ovarian "ecosystem," play a crucial role in how eggs mature and how quickly fertility declines. The supporting cells, nerves, connective tissue, and blood flow all change with age.
As Dr. Diana Laird, the study's senior author, explains: the environment around the eggs is also changing with age.
This research validates what we've observed clinically for years. Women with similar AMH levels respond very differently to treatment. Two women the same age with the same numbers can have completely different outcomes. The difference often comes down to the environment where their eggs are developing.
Egg quality isn't just about the egg itself. It's about the environment where your eggs develop. And that environment can be improved at any age.
Why We Go Beyond Supplements
Most fertility clinics give you a supplement list. Most acupuncturists offer acupuncture. But improving egg quality requires addressing the whole ovarian environment.
At Fifth Avenue Fertility Wellness, we integrate Traditional Chinese Medicine with longevity medicine and functional health protocols. We look at what's driving the aging process in your body: inflammation, oxidative stress, mitochondrial dysfunction, nervous system dysregulation, toxin accumulation.
Most women who come to us aren't looking for another list of supplements. They're looking for someone to help them navigate. To look at their whole picture. To create a personalized protocol and support them through it.
This is the difference between taking supplements and addressing root causes.
How Long Does It Take to Improve Egg Quality?
Eggs don't develop overnight. The follicle that will release an egg at ovulation has been developing for approximately three months. During this time, it's susceptible to damage from oxidative stress and responsive to positive interventions.
This is why most integrative fertility specialists recommend starting supplements and lifestyle changes at least three months before trying to conceive or beginning an IVF cycle. The egg that will be retrieved or released three months from now is developing right now.
If you don't have three months, start now. Even a few weeks of targeted support can make a difference. But if you have the time, use it.
Best Supplements for Egg Quality
Several supplements have been studied specifically for their effects on egg quality. The evidence supports several key nutrients. Dosages below reflect what has been used in research studies. This information is not medical advice. Consult with your healthcare provider before starting any supplement protocol, as individual needs vary and some supplements may not be appropriate for you.
Coenzyme Q10 (CoQ10)
CoQ10 is essential for mitochondrial function, and mitochondria are the powerhouses of the cell. Eggs have more mitochondria than any other cell in the body because fertilization and early cell division require enormous amounts of energy.
Research published in Fertility and Sterility found that women who took CoQ10 before IVF had higher fertilization rates and better embryo quality, particularly in women over 35. Another study suggested that age-related egg quality decline could be improved with CoQ10 supplementation.
Look for the ubiquinol form, which is better absorbed than ubiquinone. Research studies have used 400-600mg daily.
NMN (Nicotinamide Mononucleotide)
NMN is a precursor to NAD+, a coenzyme essential for cellular energy production and DNA repair. NAD+ levels decline with age, and this decline appears to directly affect egg quality.
Research published in Cell Reports found that NMN supplementation rejuvenated oocyte quality in aged mice, leading to restored fertility. The treated eggs showed enhanced mitochondrial function and restored energy production. A study in Reproductive Biology and Endocrinology found that NAD+ concentration in follicular fluid was positively correlated with egg maturation and fertilization rates in women undergoing IVF.
While human fertility trials are still ongoing, the research is promising. Studies have used 250-500mg daily, with some protocols going higher.
Myo-Inositol
Myo-inositol is particularly important for oocyte development. Research shows it plays a crucial role in both nuclear and cytoplasmic oocyte maturation. Higher myo-inositol content in follicular fluid has been correlated with higher quality embryos.
A meta-analysis published in Medicine found that myo-inositol supplementation significantly improved clinical pregnancy rates in women undergoing IVF. Research in Reproductive Biology and Endocrinology showed improved fertilization rates and better embryo quality with myo-inositol supplementation.
While myo-inositol is especially beneficial for women with PCOS, the research suggests benefits for egg quality more broadly. Studies have used 2-4 grams daily.
Açai Berry
Açai berries contain exceptionally high levels of antioxidants, specifically polyphenols, which help neutralize free radicals and protect eggs from oxidative damage.
Research from CCRM, published in the peer-reviewed journal Life, found that women of advanced maternal age who took an açai berry supplement had comparable IVF outcomes to their younger counterparts. The study showed a 75% live birth rate in women 39 and older. Earlier research showed an 81% ongoing clinical pregnancy rate in women with previous failed IVF cycles after 8-12 weeks of açai supplementation.
On a molecular level, açai supplementation was shown to increase antioxidant pathways, decrease cell death, and upregulate protective antioxidant genes in the ovary. The CCRM study used 600mg three times daily for 8-12 weeks before IVF.
DHEA
DHEA is a hormone precursor that declines with age. A study published in Human Reproduction found that women who took DHEA for four months before IVF had significantly more eggs retrieved and higher pregnancy rates.
DHEA should only be taken under practitioner supervision, as it can affect hormone levels and isn't appropriate for everyone. Studies have used 25mg three times daily.
Vitamin D
Vitamin D deficiency is common and has been linked to lower fertility and IVF success rates. Research published in the Journal of Clinical Endocrinology and Metabolism found that women with adequate vitamin D levels had significantly higher pregnancy rates with IVF.
Have your levels tested and supplement to achieve optimal levels of 40-60 ng/mL. Most people need 2,000-5,000 IU daily.
Omega-3 Fatty Acids
Omega-3s reduce inflammation and support cell membrane health. A study in Human Reproduction found that women with higher blood levels of omega-3s had better embryo morphology.
Studies have used 2-3 grams daily of combined EPA and DHA from fish oil or algae-based supplements.
Melatonin
Melatonin is a powerful antioxidant that protects eggs from oxidative damage. A study published in the Journal of Pineal Research found that women who took melatonin had higher fertilization rates and better embryo quality. Studies have used 3mg at bedtime. Melatonin also supports sleep, which is essential for hormonal health.
Folate
Methylfolate (the active form of folate) is essential for DNA synthesis and is particularly important during the rapid cell division that occurs after fertilization. Look for methylfolate rather than folic acid, as some women have genetic variations that impair folic acid conversion. Studies have used 800-1000mcg daily.
How to Improve Egg Quality Naturally
Supplements are only one piece of the picture. Lifestyle factors have a significant impact on the ovarian environment where your eggs develop.
Sleep
Sleep is when your body repairs cellular damage and regulates hormones. Chronic sleep deprivation increases oxidative stress and disrupts the hormonal signals involved in ovulation. Aim for 7-9 hours of quality sleep per night, and pay attention to sleep quality, not just quantity.
Stress
Chronic stress increases cortisol and inflammation, both of which can affect the ovarian environment. This doesn't mean stress prevents pregnancy. Women conceive under all kinds of circumstances. But reducing the burden on your nervous system creates more favorable conditions for your body. Finding ways to regulate, whether through acupuncture, meditation, breathwork, or other practices, supports the whole system.
Diet
An anti-inflammatory diet supports egg quality by reducing oxidative stress. Focus on vegetables, quality protein, healthy fats, and complex carbohydrates. Minimize sugar, processed foods, alcohol, and inflammatory oils. The Mediterranean diet has been specifically studied for fertility and shown to improve IVF outcomes.
Toxin Exposure
Environmental toxins, including pesticides, plastics, and chemicals in personal care products, can disrupt hormones and damage eggs. Eat organic when possible, avoid plastic food containers, and switch to clean personal care and cleaning products.
Blood Flow
Your ovaries need steady blood flow to deliver oxygen, nutrients, and hormones to developing follicles. Exercise, acupuncture, and avoiding prolonged sitting all support circulation.
A Note on Male Factor
Egg quality is only half the equation. Sperm quality matters too, and many of the same principles apply: reducing oxidative stress, supporting mitochondrial function, and addressing lifestyle factors. If you're working on egg quality, your partner should be working on sperm health. For more, read our article on male factor fertility.
Does Acupuncture Improve Egg Quality?
Acupuncture has been shown to increase blood flow to the ovaries, which is essential for follicle development. Research using Doppler ultrasound has demonstrated that acupuncture improves ovarian artery blood flow.
Acupuncture also regulates the stress response, reduces inflammation, and supports hormonal balance. All of these effects improve the ovarian environment where your eggs develop.
In our clinic, we recommend weekly acupuncture during the three months leading up to conception or IVF. Treatment is tailored to your specific patterns and needs. If you're preparing for IVF, read our article on acupuncture and IVF for a detailed protocol.
What Your Numbers Don't Tell You
If you've been told you have diminished ovarian reserve, low AMH, or high FSH, you may feel like your options are limited. These numbers measure ovarian reserve, which is the quantity of eggs remaining. They don't directly measure quality.
While quantity and quality tend to decline together with age, they're not the same thing. Some women with low AMH go on to conceive, while some women with normal numbers struggle. Quality matters more than quantity when it comes to getting pregnant.
This is why we focus on optimizing the environment for the eggs you have rather than fixating on numbers you can't change.
What This Looks Like in Practice
A woman came to us at 41 after two failed IVF retrievals. Each cycle had yielded only one embryo, and neither had been chromosomally normal. Her doctor was recommending donor eggs.
When we talked, I could see why her body was struggling. She was a litigation attorney working 70-hour weeks. She had chronic insomnia, lying awake for hours before falling asleep and waking frequently through the night. She had been living with digestive discomfort for years: bloating after every meal, acid reflux that she managed with antacids, and constipation that she'd accepted as normal. Her skin was dry, her hair was thinning, and she said she couldn't remember the last time she felt rested.
Her numbers showed diminished ovarian reserve. But what I saw was a system under severe stress, and an ovarian environment that wasn't getting what it needed.
We worked together for three months before her next retrieval. We focused on sleep first because everything else depends on it. We used acupuncture twice weekly, Chinese herbs to calm her nervous system and support her digestion, and we talked seriously about her schedule. She made changes she hadn't thought possible: leaving work by 7pm, protecting her weekends, saying no to cases that would have consumed her.
Her digestive symptoms resolved within six weeks. Her sleep improved. She said she felt like a different person.
Her next retrieval yielded four embryos. Two were chromosomally normal.
Her AMH hadn't changed. Her follicle count was the same. What changed was the environment those eggs developed in: less inflammation, better nutrient absorption, a nervous system that wasn't constantly in overdrive. Her eggs had better conditions, and they responded.
She transferred one of those embryos and is now 28 weeks pregnant.
Read stories from women we've worked with →
Your Next Step
If you're concerned about egg quality and want a personalized protocol, we can help. We'll review your history, labs, and goals and create a plan that addresses your specific needs. Not just a supplement list, but a comprehensive approach to optimizing your ovarian environment.
Learn more about our Fertility & Health path or contact us at 212.432.1110 or info@fafwellness.com.