Written by Jennifer Walpole. Reviewed by Dr Phoebe Howells. 

Jen Walpole is a BANT Registered Nutritionist specialising in Fertility and Pregnancy nutrition, supporting individuals and couples who are looking to optimise their fertility for conception, whether spontaneously or via IVF. Jen also works alongside Consultant Obstetricians and accredited specialists in Fetal and Maternal Medicine at Bliss - the Chelsea Clinic for Women & Children, consulting with parents for nutrition support throughout pregnancy.

Introduction

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, supplementation and lifestyle. 

The nutrition behind egg quality:

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 an increased number of embryos, and higher clinical, pregnancy and live birth rates. 

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, 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 protecting against ovarian ageing. The Mediterranean 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 essential when considering optimising egg quality. For example, choosing whole foods and wholegrains, and ensuring carbohydrates are paired well with protein and fats.

The key takeaway with the Mediterranean 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.

How to fill nutritional gaps: 

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 Time to Conceive® For Women, a pre-conception supplement which is formulated with MTHFR-Friendly Methylfolate, OVUM's own patented formulation of MicroActive® CoQ10 and an optimised antioxidant formulation to support egg and ovulation, thereby optimising 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 a 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. 

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. This is important because high levels of oxidative stress can damage the egg’s DNA, impacting its ability to mature into a healthy egg.

Whilst folate can be obtained through foods such as leafy greens, legumes and even liver, it needs to be converted to the active form (methylfolate) to be utilised by the body. However, OVUM has done the hard work for you by including an optimal dose of 800mcg of bioavailable Methylfolate in their Time to Conceive® For Women. 

CoQ10

This antioxidant remains one of the most studied fertility 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. Another study indicated 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. 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. Bioavailability again matters here, and Time to Conceive® contains the patented MicroActive® CoQ10, which is 3.7 times better absorbed than standard CoQ10s. 

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. Antioxidants like zinc, vitamin C and vitamin E support everything from follicle development and repairing DNA damage, to reduce time to pregnancy.

Lifestyle matters too:

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. 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 fed so buying the best quality within your budget can be helpful here. 

Reducing plastic exposure may also be beneficial, as animal studies have shown that exposure led to a decrease in the number of oocytes retrieved and fertilisation rates, along with an increase in poor-quality oocytes. Consider swapping plastic food storage for glass or metal, avoiding plastic water bottles and avoiding heating foods up in plastic containers. 

Alcohol intake has been negatively associated with reduced embryo quality during IVF, with as few as four drinks per week resulting in a lower live birth rate. 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 and, therefore, potentially egg quality. The broader benefits of exercise include enhancing different aspects of female fertility, including body composition, hormonal balance, menstrual regularity, sexual function, and spontaneous pregnancy rates. It is essential 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, 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.

Key Takeaways:

• Research is increasingly showing that egg quality is not something you are simply ‘born with’, but something you can impact either positively or negatively. 

• While nutrition is considered key to obtaining the right nutrients for egg quality and health, the consensus on the role of supplements in ‘filling in’ any nutritional gaps is rising. 

• Egg quality is not only determined by your nutrient intake; key lifestyle factors such as exercise and plastic exposure are thought to play a big role.