What I Would Do to Improve Egg Quality - as a Fertility Nutritionist

I was recently asked to contribute to Ovum’s blog to share my insights on how to support and improve egg quality – something I’m deeply passionate about in my work as a fertility nutritionist. In this piece, I’ve drawn on both research and clinical evidence, ensuring that every recommendation is science-backed and practical. My goal is to help you understand the key nutritional and lifestyle foundations that truly make a difference when it comes to egg health and fertility.

Improving egg quality is something every woman trying to conceive should know about. Here, I will talk you through how to do just that via diet and lifestyle with a helping hand from OVUM’s Pre-Conception Supplement ‘Time to Conceive’.

As a fertility nutritionist, I take a food first approach, however, food quality and nutrient levels have declined due to over farming, soil depletion and many other factors. What’s more, digestive function, stress and overall health may also impact nutrient absorption. This is why supplements can be helpful to consider when supporting egg quality – they help plug nutritional gaps and ensure that you are obtaining bioavailable nutrients in the correct forms that work well together to support egg quality and fertility.

Number one on my shopping list to support egg quality is OVUM’s Pre-Conception Supplement which is formulated with MTHFR-Friendly Methylfolate, OVUM's own patented formulation of MicroActive® CoQ10 and an optimised antioxidant blend to improve egg and embryo quality, restore ovulation and maximise chances of conception. Over 550 clinical studies have been utilised to create this formula. Let’s break some of this down.

Methylfolate

Methylfolate is the active form of folate (vitamin B9) or folic acid, and it underpins methylation, which is process that happens in every cell of the body. One of the vital roles of methylation is DNA synthesis and when we think about egg quality itself, the DNA within the egg is extremely important – 50% will become your future baby. Within this methylation process, methylfolate keeps homocysteine levels in check and research has highlighted an association between elevated levels of homocysteine and poorer fertility outcomes (1 & 2). We also have data that supports folate as an antioxidant helping to counteract oxidative stress (known as ‘reactive oxygen species’ or ROS), supporting its use for egg quality (3). Whilst folate can be obtained through foods such as leafy greens, legumes and even liver, it does need to be converted to the active form (methylfolate) to be utilised by the body. However, OVUM have done the hard work for you by including an optimal dose of 800mg of bioavailable methylfolate in ‘Time to Conceive’.

CoQ10

This antioxidant remains one of the most studied nutrients for its role in supporting egg quality, with research highlighting its benefits, particularly in the context of IVF outcomes. One study noted that CoQ10 improved ovarian response to stimulation in women with a poor ovarian reserve undergoing IVF, with higher pregnancy and live birth rates (4). Another study noted that follicular fluid CoQ10 levels were significantly higher in A and B graded embryos versus poorer quality embryos (grades C and D), leading to higher pregnancy rates (5). Whilst we can obtain CoQ10 from the diet by eating organ meats, oily fish and meat or poultry, it remains an important nutrient to consider supplementing to bolster dietary intake.

Antioxidants

‘Antioxidant’ is a bit of an umbrella term for ‘vitamins, minerals or nutrients’ which help to reduce oxidative damage to cells and in the context of fertility, support egg (and sperm) quality. OVUM’s inclusion of well researched antioxidants such as alpha-lipoic acid (ALA), zinc, vitamin C and vitamin E (amongst others) supports all aspects of egg quality. For example, studies have shown that ALA supplementation increases the number of mature eggs and good quality embryos in older women undergoing IVF (6). Antioxidants like zinc, vitamin C and vitamin E support everything from follicle development and repairing DNA damage (7) to reducing time to pregnancy (8).

As mentioned, a food first approach to egg quality is key, and we do have lots of research to support following the Mediterranean diet with statistically significant associations between adherence and positive ART outcomes, including increased number of embryos, and higher clinical and pregnancy and live birth rates (9). The Mediterranean diet is cited as the optimal preconception diet owing to several factors. Firstly, it is rich in antioxidants including those mentioned already, which can also be found in various plant-based foods from vegetables, fruits to legumes, wholegrains and nuts/seeds – think ‘eat the rainbow’ here. The second reason it is so supportive of fertility is that it is rich in healthy fats, such as omega 3, found in oily fish, nuts and seeds. Omega 3 is extremely anti-inflammatory, and studies highlight its role in reducing ovarian ageing (10). The Med diet tends to feature more fish than meat but it’s worth mentioning that nothing is excluded here – red meat, poultry, grains, potatoes and even cake (on occasion). But it is of course about moderation and keeping blood sugars in check is important when considering optimising egg quality. For example, choosing whole foods, wholegrains and ensuring and carbohydrates are paired well with protein and fats. The key takeaway with the Med diet is that balancing your plate is key – with whole plant foods taking up a large portion of the plate, alongside a portion of protein (e.g. chicken, fish, meat or tofu) and not to forget those all-important fats e.g. olive oil with every meal and a serving (thumb-sized) of extra fats such as a handful of nuts.

In terms of lifestyle, there are a few considerations when approaching egg quality. Endocrine disrupting chemicals including pesticides have been negatively correlated with fertility decline and lower pregnancy rates (11). Therefore, when optimising egg quality, it might be a good time to reduce exposure to pesticides by choosing organic where possible. Typically, the fruits and vegetables that grow above the ground tend to be highly sprayed such as leaves, berries, wheat (i.e bread), tomatoes and beans in pods. Animal products including dairy have a better nutrient status when organic or grass fed so buying the best quality within your budget can be helpful here. Reducing plastic exposure may be beneficial, since we have seen in animal studies that exposure led to a decrease in the number of oocytes retrieved and fertilisation rates, with increasing poor-quality oocytes (12). Consider swapping plastic food storage to glass or metal, avoiding plastic water bottles and avoid heating foods up in plastic containers. Alcohol intake has been negatively associated with reduced embryo quality during IVF (13), with as little as four drinks per week resulting in a lower live birth rate (14). Whilst you don’t have to stop drinking entirely, significantly reducing intake may be beneficial when optimising egg quality.

Finally, exercise is beneficial to include in your preconception prep, improving mitochondrial health (15) and therefore potentially egg quality. The wider benefits of exercise include enhancing different aspects of female fertility, including body composition, hormonal balance, menstrual regularity, sexual function, and spontaneous pregnancy rates (16). It is important to consider that some types of exercise (particularly low impact and strength training) are perhaps better suited for women with conditions that impact fertility such as PCOS or endometriosis. What’s more, research has highlighted a link with regular vigorous exercise and anovulation and/or a luteal phase defect in healthy women trying to conceive (17), so my recommendation would be to avoid regular high intensity exercise and focus on strength training, some cardio (zone 2) and restorative workouts like yoga or Pilates.

References

1. Paffoni, A.; Castiglioni, M.; Ferrari, S.; La Vecchia, I.; Ferraris Fusarini, C.; Bennardi, N.; Noli, S.; Parazzini, F.; Somigliana, E. (2018). Homocysteine pathway and in vitro fertilisation outcome. Reprod. Toxicol. 76, pp. 12–16

2. Boxmeer JC, Brouns RM, Lindemans J, Steegers EA, Martini E, Macklon NS, Steegers-Theunissen RP. (2008). Preconception folic acid treatment affects the microenvironment of the maturing oocyte in humans. Fertil Steril. 89(6), pp. 1766-70

3. Ebisch IM, Thomas CM, Peters WH, Braat DD, Steegers-Theunissen RP. (2007). The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility. Hum Reprod Update. 13(2), pp. 163-74

4. Xu Y, Nisenblat V, Lu C, Li R, Qiao J, Zhen X, Wang S. (2018). Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial. Reprod Biol Endocrinol.;16(1), p. 29

5. Akarsu, S., Gode, F., Isik, A. Z., Dikmen, Z. G., & Tekindal, M. A. (2017). The association between coenzyme Q10 concentrations in follicular fluid with embryo morphokinetics and pregnancy rate in assisted reproductive techniques. Journal of assisted reproduction and genetics, 34(5), 599-605

6. Kim, C. Moon, J. & Jeung, Y. & Kim, Sungeun & Chae, Hee Dong & Kang, B.. (2017). Lipoic acid supplementation increases the expression of pgc-1alpha gene in granulosa cells and improves IVF results in aging women undergoing IVF. Fertility and Sterility. 108

7. Liao X, Wu L, Yin D, Tian D, Zhou C, Liu J, Li S, Zhou J, Nie Y, Liao H, Peng C. (2023). The role of zinc in follicular development. Mol Biol Rep.

8. Ruder EH, Hartman TJ, Reindollar RH, Goldman MB. (2014). Female dietary antioxidant intake and time to pregnancy among couples treated for unexplained infertility. Fertil Steril, pp. 101:759–766

9. Laura Marun-Manchado, Miriam Sánchez-Sansegundo, Antonio M Moya-Yeste, José A Hurtado-Sánchez, José Tuells, Ana Zaragoza-Maru, (2025). Associations between adherence to a Mediterranean diet and assisted reproductive techniques outcomes: a systematic review, European Journal of Public Health.

10. Nehra D, Le HD, Fallon EM, Carlson SJ, Woods D, White YA, Pan AH, Guo L, Rodig SJ, Tilly JL, Rueda BR, Puder M. Prolonging the female reproductive lifespan and improving egg quality with dietary omega-3 fatty acids. Aging Cell. 2012 Dec;11(6), pp. 1046-54.

11. Cabry R, Merviel P, Madkour A, Lefranc E, Scheffler F, Desailloud R, Bach V, Benkhalifa M. The impact of endocrine disruptor chemicals on oocyte/embryo and clinical outcomes in IVF. Endocr Connect. 2020 Jun;9(6):R134-R142.

12. Qiaoling Wang, Fengli Chi, Yingdong Liu, Qiurong Chang, Siyu Chen, Pengcheng Kong, Wanli Yang, Wenqiang Liu, Xiaoming Teng, Yan Zhao, Yi Guo, (2025). Polyethylene microplastic exposure adversely affects oocyte quality in human and mouse, Environment International, Volume 195.

13. Wdowiak A, Sulima M, Sadowska M, Grzegorz B, Bojar I. Alcohol consumption and quality of embryos obtained in programmes of in vitro fertilization. Ann Agric Environ Med. 2014;21(2), pp. 450-3.

14. Rossi BV, Berry KF, Hornstein MD, Cramer DW, Ehrlich S, Missmer SA. Effect of alcohol consumption on in vitro fertilization. Obstet Gynecol. 2011 Jan;117(1), pp. 136-142.

15. Memme JM, Erlich AT, Phukan G, Hood DA. (2021). Exercise and mitochondrial health. J Physiol. 599(3), pp. 803-817.

16. Kovács BP, Balog J, Sebők B, Keszthelyi M, Várbíró S. (2024). Unlocking Female Fertility with a Specific Reproductive Exercise Program: Protocol of a Randomized Controlled Clinical Trail. Life (Basel). 27;15(1).

17. Mussawar M, Balsom AA, Totosy de Zepetnek JO, Gordon JL. (2023). The effect of physical activity on fertility: a mini-review. F S Rep.4(2), pp. 150-158.