- Home
- Advice Hub
- Conception
- Fertility & Infertility
- Poor Egg Quality And Fertility
How does poor egg quality impact fertility?
Explore what poor egg quality means for fertility, key causes, evidence-based strategies to support reproductive health, and when to seek medical guidance.
Trying to conceive can raise many questions, especially when things don’t happen as quickly or smoothly as hoped. You may be wondering about egg health and how this can contribute to conception, or for some people, further into their fertility journey, fertility investigations introduce the idea of “egg quality”.
This article is designed as a compassionate, evidence-based guide. Whether you are early in your fertility journey or already undergoing treatment, the aim is to help you understand what egg quality means, how it affects fertility, the signs and indicators clinicians look for, and the supportive steps may help optimise your reproductive potential.
What is “egg quality” & why it matters for fertility
Egg quality refers to how capable an egg is of being fertilised, developing into a healthy embryo, and supporting early pregnancy. It reflects several underlying features, including genetic integrity, cellular structure, mitochondrial function (the energy-producing components of the cell), and the egg’s ability to divide normally after fertilisation.
Unlike sperm health or hormone levels, egg quality cannot be directly measured in the body. Instead, it is inferred from outcomes such as fertilisation rates, embryo development in IVF, implantation success, and miscarriage rates. Research shows that eggs with compromised chromosomal or cellular health are more likely to result in failed fertilisation, embryos that stop developing, implantation failure, or early miscarriage. Importantly, this does not mean these outcomes are inevitable. Egg quality influences probability and risk, not certainty.
As people age, particularly from the mid-30s onwards, the proportion of eggs with chromosomal abnormalities increases. This is one of the main reasons fertility declines with age and miscarriage rates rise, even in otherwise healthy individuals.
Primary causes & contributing factors
Egg quality is shaped by a combination of non-modifiable and modifiable factors. Understanding this distinction can help place realistic expectations on what can and cannot be changed.
Age is the most significant non-modifiable factor. People are born with all the eggs they will ever have, and both the number and quality decline over time. Large population studies consistently show reduced fertility rates and increased chromosomal abnormalities in eggs after the age of 35, with a steeper decline after 40.
Genetic and developmental factors also play a role. Some individuals have a predisposition to reduced egg quality due to inherited conditions, early ovarian ageing, or variations in DNA repair mechanisms. Medical conditions such as endometriosis, autoimmune disorders, thyroid disease, and metabolic conditions can also affect ovarian function.
Potentially modifiable contributors include smoking, excessive alcohol intake, drug use, exposure to environmental toxins, poor diet, obesity or being underweight. These factors are associated with increased oxidative stress, which can damage the DNA and mitochondria within eggs. While modifying these factors cannot reverse ageing, they may influence the health of the remaining eggs.
Signs, indicators & how egg quality is assessed
Many people search for signs of poor egg quality or poor egg quality symptoms, but it is important to understand that there are no specific physical symptoms that reliably indicate egg quality on their own. Regular or irregular periods, for example, do not directly reflect egg quality.
Clinicians rely on indirect markers and patterns. These include age, ovarian reserve tests such as anti-Müllerian hormone (AMH) levels and antral follicle count, response to ovarian stimulation in IVF, fertilisation rates, embryo development speed and appearance, and miscarriage history. In IVF, preimplantation genetic testing can provide information about embryo chromosomal status, which indirectly reflects egg quality at the time of fertilisation.
These measures are tools for risk assessment rather than definitive judgments. It is important to remember that many people with lower ovarian reserve or previous poor embryo outcomes still achieve successful pregnancies.
Things which can support improving egg quality
Research in this area is still evolving, and it is important to know that it may not be possible to improve egg quality. However, there are plausible and biologically supported strategies that may help optimise egg health and your general health over time.
Lifestyle & diet strategies
A balanced diet rich in antioxidants is often recommended to support cellular health. Nutrients such as folate, vitamins C and E, omega-3 fatty acids, and minerals like zinc and selenium play roles in reducing oxidative stress and supporting normal cell function. Diets emphasising vegetables, fruits, whole grains, lean proteins, healthy fats, and minimal ultra-processed foods are commonly associated with better overall reproductive health in observational studies.
Stress reduction, sleep and overall metabolic health
Chronic stress and poor sleep can influence hormonal regulation and increase inflammatory and oxidative processes in the body. While stress alone does not cause infertility, long-term physiological stress may contribute to a less supportive environment for egg development. Practices such as moderate exercise, mindfulness-based techniques, adequate sleep, and addressing metabolic health can support general wellbeing, which is closely linked to reproductive health.
Adjunctive therapies in fertility clinics
Some fertility clinics use adjunctive approaches aimed at supporting egg quality, particularly in IVF settings. It is important to note that many of these approaches are still considered emerging and are not part of standard, evidence-based care. Patients should discuss potential benefits, risks, and evidence with their fertility specialist. The HFEA website may help you understand these adjunctive therapies are right for you.
Timing & planning
As age is the largest determinant of egg health, making the decision to start trying for a family early offers you the best option for success. However, as this is not always possible, taking steps to improve your lifestyle early generally offers a greater window for potential benefit. Egg development takes several months, which means supportive strategies are ideally adopted before treatment or attempts to conceive. For those starting in their late 30s or 40s, the scope for influencing egg quality is narrower, but planning and tailored medical support remain valuable.
When to seek medical support & fertility treatment options
Medical advice is generally recommended if you have been trying to conceive for 12 months under the age of 35, or for six months if aged 35 or over. Earlier assessment may be appropriate if you have irregular cycles, known medical conditions, previous pregnancy losses, or a family history of early menopause.
However, it is never too early to start making steps in improving your lifestyle or making the decision to ask your doctor for initial blood tests, as this information can help you to feel more empowered along your fertility journey.
Fertility specialists can help clarify whether egg quality is likely to be a contributing factor and discuss appropriate options. These may range from timed intercourse and ovulation induction to IVF, use of genetic testing, or, if appropriate, consideration of donor eggs in some circumstances. The right approach depends on individual circumstances, your values, and goals.
Conclusion
Egg quality plays a significant role in fertility outcomes, but it is only one part of a complex picture. Age and genetics are powerful influences, yet lifestyle, nutritional, and environmental factors may help optimise the potential of remaining eggs.
Fertility is a multifaceted journey involving both body and mind. With informed guidance, supportive care, and realistic expectations, many individuals and couples navigate challenges related to egg quality successfully. Working with healthcare professionals can help ensure that decisions are evidence-based, personalised, and aligned with your circumstances.
FAQs around impact of egg quality on fertility
Egg quality cannot be fully reversed, particularly when age-related changes are involved. However, supportive lifestyle and medical strategies may help optimise the health of remaining eggs and improve the chances of successful outcomes.
Egg quality gradually declines from the early 30s, with a more noticeable drop after 35 and a steeper decline after 40. However, it is important to be aware that egg quality varies between individuals, and no women is merely a textbook.
No supplement can guarantee improved egg quality. Some nutrients are biologically important for egg development, but supplements should be used thoughtfully and ideally under medical guidance. When trying to conceive, it is important to take a regularly daily dose of folic acid and vitamin D. Some women choose to take COQ10 supplementation for the perceived benefits to egg quality, however the evidence surrounding this supplement is currently limited.
Clinics cannot test egg quality directly. They assess indirect markers such as age, ovarian reserve tests, response to stimulation, embryo development, and sometimes genetic testing of embryos.
No. Many people ask, “Can I get pregnant with poor egg quality?” and the answer is often yes. While chances may be lower, pregnancy is still possible, particularly with tailored medical support and the appropriate treatment options.
