Let's Talk About Egg Quality and Fertility

Today, we're talking about female human eggs—not your breakfast. (Although, spoiler alert: we'll discuss this, but what you eat in the morning might actually play a role in keeping your eggs healthier.)

While most women know they have eggs, many don't know much about them or about how their menstrual cycle and fertility truly work. Human eggs (and the female body in general) are fascinating. And when it comes to fertility and family planning, the egg cell plays a central role.

Egg quality, quantity, and fertility are topics many women start exploring when they begin thinking about having children.

Our expert OBGYN put this guide together to help you better understand your reproductive system (specifically your eggs) so you can feel more informed, more empowered, and more confident in your fertility journey.

Basic Understanding Of The Female Egg And Ovary

Before we dive into egg quality and fertility, let's start with a quick (and very basic) female anatomy lesson. We're also going to throw in a few fun facts about the female egg and ovary.

Why? Because the female body is incredibly fascinating! Plus, understanding how your reproductive system works will help you better understand all of the important information about egg quality and fertility that follows.

Let's start with the female egg…

Have you ever wondered, "What do women's eggs actually look like?" Or even, "Is a woman's egg visible to the eye?"

Well, a human female egg doesn't look anything like a chicken egg. To the naked eye, it would appear as a tiny, translucent sphere with a pale yellow tint. However, they are a little more detailed than that. Female eggs have a smooth outer membrane and a granular-looking inside, but that can only be seen under a microscope.

And while many might assume female eggs are large, they are actually a single round cell that only measures about 100 microns across. To give you a visual, that's roughly the width of a strand of hair.

What about how big a woman's egg is when released? It's still the same size. The egg itself doesn't grow or shrink at ovulation. What changes is that it leaves the fluid-filled follicle it was resting in. To the naked eye, it remains nothing more than a tiny pale dot.

However (and here's one of those fun facts), female eggs are actually the largest cells in the human body. In fact, they are the only human cells visible to the naked eye. Other cells, like red blood cells or sperm, are far too small and require magnification to be seen.

Moving on to the many names of the female egg… Sometimes, you will see people call the female egg or egg cell an ovum. People use the terms interchangeably, but there's a small distinction.

"Egg" is a general term that can refer to the cell at different stages of development (from immature to fully mature and ready for fertilization). It's not an ovum until it's fully mature, meaning it's completed the final stages of cell division and is ready to be fertilized. Only mature ova can be fertilized.

This entire process of egg development begins long before puberty. In fact, your egg cells begin forming while you're still a fetus. By around five months of gestation, a baby girl may have as many as 20 million immature eggs.

However, most of these undergo a natural process called atresia, where they degenerate and are reabsorbed by the body. This process leaves only about 1 to 2 million eggs remaining by the time you're born.

And whatever your number is at birth… that's it! Unlike other cells in your body, like skin or blood cells that constantly regenerate, no new eggs are made after birth. Women are born with all the eggs they'll ever have.

Furthermore, not only do you not make any new eggs after birth, but you also continue to lose them. By puberty, only around 300,000 to 500,000 eggs remain. From that point on, you'll only ovulate about 300 to 500 eggs over your reproductive lifetime.

Additionally, as you age, the quality of your eggs declines due to accumulated DNA damage and a higher likelihood of chromosomal abnormalities during cell division. Exactly why both egg quantity and quality matter when it comes to fertility.

Women have a lot of questions about how to support egg quality and improve the quality of eggs. We'll be talking more about egg quality further down, including how to improve egg quality naturally. But first, let's talk about where these eggs are stored: the ovaries.

The Female Ovaries

Your ovaries (you have two) are small, almond-sized organs that sit on either side of your uterus (that's the muscular organ where a fertilized egg implants and a baby develops during pregnancy).

The ovaries are a key part of your reproductive system. Not only do they store your eggs, but they also produce important hormones like estrogen and progesterone, which regulate your menstrual cycle and support pregnancy.

Quick fact about your ovaries… did you know they don't always look or function exactly the same? One might be slightly larger, shaped differently, or more active in releasing eggs. And yes, you can still ovulate and get pregnant with just one ovary if it's healthy and functional.

Speaking of pregnancy, here's where things get interesting.

Inside each ovary are tiny fluid-filled sacs (follicles) that each contain one immature egg. The egg stays on the follicle and lives in a dormant state until puberty. Once you begin your menstrual cycle, monthly hormonal signals, primarily from the follicle-stimulating hormone (FSH), kickstart the egg maturation process and prompt a group of follicles to begin growing.

Typically, only one follicle becomes dominant, fully matures, and prepares to release its egg. Then, around the midpoint of your cycle, a surge in luteinizing hormone (LH) triggers ovulation (the release of the mature egg from the ovary). Once released, the egg travels into the fallopian tube and survives for only 12 to 24 hours.

And that tiny little one-day or less window is your only shot at getting pregnant. That's assuming the quantity and quality of your eggs are where they need to be. Fertility is not just a matter of "trying" to conceive; it involves more complexity.

A healthy supply of eggs is essential, and since ovulation occurs only once per cycle and the egg has a limited lifespan, getting pregnant involves a narrow time frame and intricate processes.

Now that you have a better understanding of how this works, let's examine the factors that influence both the quantity and quality of your eggs.

We'll discuss what egg quality and egg quantity mean and how each impacts your chances of becoming pregnant, as well as answer common questions about female egg quality, such as:

How can I boost my egg quality naturally?
How do you maintain egg quality?
How long does it take to improve egg quality?
What destroys egg quality?
++ More

What Affects Egg Quality and Quantity?

Egg quality refers to how healthy an egg is, especially in terms of its ability to be fertilized and develop into a healthy embryo.

When egg quality is high, there's a better chance the egg will be fertilized, implant successfully in the uterus, and develop into a healthy pregnancy. Lower-quality eggs are more likely to have chromosomal abnormalities, which can lead to failed implantation, miscarriage, or conditions such as Down syndrome.

Egg quantity, often referred to as ovarian reserve, is the number of eggs available in a woman's ovaries. Unlike sperm, which are produced continuously throughout a man's life, women are born with all the eggs they'll ever have, and their supply naturally declines with age.

A higher ovarian reserve means more chances for successful ovulation and fertilization, while a low reserve may make it more difficult to conceive, especially without medical support.

Both egg quality and quantity play a critical role in fertility, and many things can affect them. Many believe that age destroys egg quality. Yes, age plays a significant role in fertility because egg quality and ovarian reserve naturally decline over time, especially after age 35.

However, a healthy supply of eggs doesn't just depend on age. Many things can destroy egg quality. Genetics, hormonal health, medical conditions, and lifestyle factors can all influence the quality of your eggs and your overall fertility potential. Let's go over each of these factors in a little more detail.

What Destroys Egg Quality?

Age

Age is the most well-established factor affecting both egg quality and quantity. Women are born with all the eggs they'll ever have, and this supply steadily declines over time. While hundreds of thousands of eggs remain at puberty, only a very small number will ever get the chance to fully mature and be released. The rest will gradually break down over time through a natural process called atresia.

Both egg quality and quantity are finite resources because, as you age:

Egg quantity declines — meaning fewer eggs are available each cycle.
Egg quality decreases — the remaining eggs are more likely to have chromosomal abnormalities due to accumulated DNA damage over time. This increases the risk of failed fertilization, miscarriage, or conditions such as Down syndrome.
Ovulation becomes less predictable, and your hormone levels may shift, making it harder to conceive naturally.

It can happen earlier and sometimes later, but on average, fertility typically starts to decline in the early 30s, with a more significant drop after age 35, and a sharper decline after 40.

By the time a woman reaches menopause (usually late 40s to early 50s), few or no viable eggs remain, which marks the natural end of reproductive potential.

Genetics

Some women are born with a lower egg count or experience egg decline earlier due to inherited factors. If your mother or sister had early menopause, diminished ovarian reserve, or fertility struggles, your egg health may follow a similar pattern.

Genetic influences can affect:

How many eggs you're born with – a lower starting point means earlier fertility decline.
The rate at which eggs are lost – some women experience a faster depletion of their egg supply, even in their 20s or early 30s.
The timing of menopause – women whose mothers experienced early menopause are more likely to go through it early themselves, reducing their fertile years.

Additionally, inherited genetic conditions can also lead to diminished ovarian reserve, impact egg health, and affect ovarian function.

These include:

Turner Syndrome – a chromosomal disorder that can lead to premature ovarian failure.
Fragile X premutation – carriers may have an increased risk for premature ovarian insufficiency.
Galactosemia – a rare metabolic disorder that can damage the ovaries if undiagnosed early in life.

These conditions may not always present obvious symptoms, but they can significantly affect fertility and are often discovered during fertility testing.

Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder that affects ovulation. It's one of the most common causes of infertility in women, impacting up to 1 in 10 women of reproductive age.

In addition to irregular or missed periods, PCOS is often associated with elevated androgen levels (male hormones), insulin resistance, and the presence of multiple small follicles in the ovaries that don't mature properly.

Because women with PCOS often have a high number of small follicles but may not ovulate regularly, this can impact egg maturation and release and leaves many women to wonder if PCOS affects the quality of eggs or if you can get pregnant if you have PCOS.

Unfortunately, PCOS can affect egg quality. In some cases, eggs from women with PCOS may be of lower quality, especially when ovulation is infrequent. Does this mean you can't get pregnant if you have PCOS? Not necessarily.

You can get pregnant if you have PCOS. In fact, many women with PCOS conceive naturally. However, some require the help of fertility treatments, especially if ovulation can be regulated.

If you have PCOS and want to become pregnant, talk to your doctor about lifestyle strategies and medical options that can support healthy ovulation. Medications like letrozole or clomid, blood sugar regulation, weight management, and targeted supplements can all improve your chances of conceiving.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on or inside the ovary, often as a normal part of the menstrual cycle. Most are harmless, resolve on their own, and don't affect fertility.

In most cases, ovarian cysts do not impact a woman's ability to get pregnant. Once your cycle returns to normal and the ovary remains healthy, conception is usually possible. In fact, pregnancy can occur as soon as ovulation resumes (typically within one or two menstrual cycles).

However, a ruptured ovarian cyst can sometimes cause complications. If the rupture leads to internal bleeding, scarring, or damage to ovarian tissue, it may affect egg supply or interfere with normal ovulation, which can, in turn, make it harder to conceive.

Symptoms of a ruptured ovarian cyst can include sudden, sharp pelvic pain, abdominal bloating, nausea, faintness or dizziness, and light vaginal bleeding outside of your normal period. If you experience these symptoms, especially if they come on suddenly or are severe, you should seek immediate medical care.

Prompt treatment can help prevent further complications and preserve ovarian function, which is key for future fertility.

Ectopic Pregnancy

An ectopic pregnancy happens when a fertilized egg implants outside the uterus, most often in one of the fallopian tubes. Unfortunately, ectopic pregnancy can potentially affect fertility, particularly if it damages the fallopian tube.

If one tube is removed or scarred, the chances of natural conception may decrease. However, many women still conceive successfully using the other tube as long as it's healthy and functional. How difficult it is to get pregnant after an ectopic pregnancy depends on the extent of the damage and whether both fallopian tubes remain open and functional.

To reduce the risk of long-term fertility problems, it's important to catch an ectopic pregnancy early. If you're experiencing severe abdominal or pelvic pain, shoulder pain, vaginal bleeding, or dizziness in early pregnancy, don't ignore it; these could be warning signs.

An ectopic pregnancy can often be detected via transvaginal ultrasound and blood tests as early as 5 to 6 weeks after your last period. Early diagnosis not only protects your health but may also help preserve your fertility by minimizing damage to the reproductive organs.

Less Common Factors That Impact Egg Fertility

While these conditions may not directly reduce egg quality or quantity, they can still interfere with fertility by affecting ovulation, hormone balance, or the egg's ability to be fertilized and implant successfully.

Endometriosis: Endometriosis can cause inflammation or scarring near the ovaries or fallopian tubes, which may interfere with egg release or fertilization—even if egg quality is unaffected.
Thyroid Disorders: Both hypothyroidism and hyperthyroidism can disrupt menstrual cycles and ovulation, making it harder to conceive.
Autoimmune Conditions: Some autoimmune diseases, like lupus or rheumatoid arthritis, can trigger inflammation that impacts ovarian function or hormone levels.
Pelvic Inflammatory Disease (PID): Past infections can cause scarring in the reproductive tract, affecting the egg's path to fertilization.
Chemotherapy or Radiation: Cancer treatments can damage the ovaries and significantly reduce egg quantity and function—even years later.
Extreme Weight Loss or Over-Exercising: A low BMI or excessive exercise can disrupt hormone levels and shut down ovulation despite having a healthy egg supply.

How Do You Know If You Have Healthy Eggs?

While there's no single test to assess egg "quality" with complete certainty, there are several indicators doctors use to evaluate both quantity and potential fertility.

As technology stands today, the best indicators of egg quality are a woman's age, hormone testing, and actually "counting the eggs" using transvaginal ultrasound.

Age

Despite hearing more and more stories of women getting pregnant later in life, age is still the most reliable predictor of egg health. As women age, both the quality and quantity of their eggs decline. This decline accelerates in your mid-to-late 30s and becomes even steeper after the age of 40.

One of the biggest concerns with egg quality is the risk of chromosomal abnormalities. Eggs from older women are more likely to have an abnormal number of chromosomes, which can lead to failed implantation, miscarriage, or genetic conditions like Down syndrome.

By age 35, only about 50% of a woman's eggs are still considered chromosomally normal. By age 40, that percentage drops significantly. Some estimates suggest that only about 10–15% of eggs remain viable after 40 days.

That's not to say pregnancy isn't possible later in life—it absolutely is. But age-related declines in egg quality and quantity are why fertility specialists often encourage women to start planning earlier if they know they want children.

Estradiol (E2) Testing

Estradiol is a form of estrogen, and it is how the ovaries communicate with the brain. E2 levels should rise with the monthly cycle.

Estradiol (E2) testing helps track how well your ovaries are communicating with the brain. Early high levels can indicate that the ovaries are responding too early, resulting in decreased egg quality.

AMH (Anti-Müllerian Hormone) Testing

AMH is a hormone produced by the follicles in the ovaries. AMH testing gives a rough estimate of your ovarian reserve.

Having a normal range of this hormone in the blood can mean eggs are healthy. Too little can mean premature aging, and too much could indicate a hormone disorder like PCOS (polycystic ovarian syndrome).

FSH (Follicle-Stimulating Hormone) Testing

FSH is released by the pituitary gland in the brain. This hormone prepares eggs for maturity and aids in ovulation.

It's normal for FSH levels to fluctuate throughout your cycle. However, if levels fall outside the typical range, it could point to conditions like PCOS or a diminished ovarian reserve.

Specifically, when FSH is elevated, it may signal that your body is working harder to stimulate ovulation—often a sign of reduced egg quantity or quality.

FSH testing is usually done on day 3 of your cycle (the third day of your period) because that's when baseline hormone levels give the clearest picture of your ovarian function. High FSH at this time may indicate that your ovaries are less responsive to stimulation, which can impact fertility outcomes.

Antral Follicle Count (Counting Eggs)

If you want to become pregnant, you have to have eggs. Antral follicle count using transvaginal ultrasound allows doctors to "count" visible follicles and estimate egg supply.

This test takes place before ovulation, and the number of enlarged follicles that could mature an egg is counted. More follicles mean you should have a higher egg quantity available.

However, while antral follicle testing can help determine approximately how many eggs you have left, it can't tell you if those eggs are healthy.

If you are curious about your egg quality and fertility, schedule an appointment at Cool Springs OBGYN to have medical testing.

How Do You Maintain Egg Quality?

While you can't increase the number of eggs you have, there are things you can do to support the health of the eggs you still have. The goal is to create the best possible environment for healthy ovulation, egg maturation, and fertilization.

How to Support Egg Quality

Supporting egg quality starts with your overall health. Regular exercise, stress reduction, quality sleep, and proper nutrition all play a role in egg quality.

Some women also explore targeted supplements to support reproductive health and improve their chances of conception, especially if they're planning to get pregnant later in life or have underlying hormone imbalances.

Here are some examples of both how to boost your egg quality naturally through simple lifestyle changes, as well as supplements to consider for additional support.

How To Improve Egg Quality Naturally

Many women search for how to improve the quality of a female egg, specifically how to boost egg quality naturally. Here are five areas of your lifestyle to examine to support egg quality and give your eggs the best possible environment to thrive.

Lifestyle Changes to Improve Egg Quality Naturally

1: Don't smoke: The chemicals in cigarettes are known to mutate the DNA in egg cells. When this happens, the eggs can become unsuitable for conception, or the risk of birth defects may increase.

2: Try not to stress: Stress can hinder or altogether halt egg production. When you get stressed, your body releases cortisol, which can make it much harder to get pregnant. Look for ways to reduce stress, like yoga or meditation, journaling, exercise, or even consider a career change..

3: Eat healthy food: If you are healthy, so are your eggs. Stay away from fast food and highly processed foods. Instead, opt for nutrient-rich foods known to support ovarian health and help protect eggs from oxidative stress:

To get you started, here are 5 foods that improve egg quality:

Leafy greens (spinach, kale, broccoli): High in folate and antioxidants that support cell health and DNA integrity.
Berries (blueberries, strawberries, raspberries): Packed with vitamin C and polyphenols that reduce oxidative damage.
Fatty fish (salmon, sardines, mackerel): Provide omega-3 fatty acids that improve blood flow to the ovaries and support hormone balance.
Nuts and seeds (walnuts, almonds, sunflower seeds): Rich in vitamin E, selenium, and healthy fats that protect egg cell membranes.
Whole eggs: A natural source of choline and high-quality protein that contribute to proper cell function and reproductive health.

4: Get active: Improving your blood flow will help oxygen-rich blood flow to your ovaries, keeping the egg cells healthy.

5: Maintain a healthy weight: This can go both ways. If you are overweight, you may have reduced fertility due to increased oxidative stress and altered mitochondrial function. If you are underweight, you may have hormone imbalances that affect ovulation and can reduce your chance of getting pregnant. A healthy body mass index (BMI) is between 18.5 and 24.9.

Calculate your BMI.

How To Improve Your Egg Quality with Supplements

Supplements can't guarantee pregnancy, but certain nutrients may support cellular health, hormone balance, and ovarian function, all of which play a role in egg quality. While research is still evolving, some supplements show promise for improving fertility markers, especially when paired with the healthy lifestyle habits mentioned above.

Of course, always talk to your doctor before starting any new supplement, especially if you're actively trying to conceive or undergoing fertility treatment.

Antioxidants: Vitamin C and E, as well as selenium and zinc are known to combat oxidative stress, which can affect egg quality and overall reproductive health. Folic acid (folate) is another antioxidant important for women of childbearing age. It supports healthy egg development and is believed to reduce the risk of certain birth defects.
Vitamin D: An important vitamin for follicle development that could potentially improve egg quality and ovarian function.
CoQ10: This supports energy transport in cell membranes and is an antioxidant. Older women can experience a breakdown in energy production in egg cells.
DHEA (Dehydroepiandrosterone): A hormone that can increase follicular stimulation. DHEA production declines with age and can help women with Decreased Ovarian Reserve (DOR) or Premature Ovarian Failure (POF).
L-Arginine: An amino acid that can increase circulation to the uterus and ovaries. This aids in the quality of maturing eggs and can improve the chances of implantation.
Myo-Inositol: This can help improve glucose metabolism and can improve fertility rates in women with PCOS. Inositol has been shown to restore normal ovulation patterns.
Melatonin: Melatonin has antioxidant traits that will improve egg quality. One study found that pregnancy rates in those with unexplained infertility were 30% higher in those taking melatonin.
EPA/DHA Fish Oil: Fish oil can help regulate hormones, increase blood flow to the uterus, reduce sensitivity to the hormone prolactin, and increase egg white cervical mucus.

How Long Does it Take to Improve Egg Quality?

There's a lot of information out there about how quickly egg quality can change. Some factors, like age or genetics, can't be reversed. Other ways to boost your egg quality naturally, like stress management, diet, sleep, or targeted supplements, may help support the eggs you still have, but the timeline of results depends heavily on how consistent you are and what your starting point looks like.

There isn't an exact timeline, but you'll often hear people say it takes about three months. So, does it really take 3 months to improve egg quality?

That number likely comes from the fact that it takes around 90 days for an egg to mature before it's released during ovulation. While that isn't a hard-and-fast rule, it does mean the habits you build today may influence the eggs released a few cycles from now.

Conclusion

While pregnancy happens easily for some, the truth is that getting pregnant is a complex process that relies on everything lining up just right, and at the center of it all are your eggs.

Both the quantity and quality of your eggs play a significant role in whether conception is possible, how easily it happens, and whether a healthy pregnancy can be sustained.

We hope this article helps you better understand your fertility, how to detect potential issues that could interfere with egg health early on, and helps you make empowered decisions for the future.

If you are concerned about your egg quality, quantity, or have other fertility concerns, we'd love to help. Dr. Jeffery Lodge, our experienced and trusted Middle Tennessee OBGYN, is currently accepting new patients at Cool Springs OBGYN – a leader in women's healthcare in the Nashville metropolitan area.

To schedule an appointment with Dr. Jeffrey Lodge at Cool Springs OBGYN, call 615.690.6600.