How to Improve Egg Quality Naturally: The 90-Day Fertility Window
September 3, 2026 No Comments
Best Supplements for Egg Quality: What Works and What to Skip
If you’re looking for the best supplements for egg quality, you’ve probably already found a list. Maybe several. And they don’t agree with each other.
One says CoQ10 is essential. Another leads with DHEA. A forum thread swears by melatonin. Somewhere in your saved posts there’s a carousel about NMN. Add inositol, NAC, alpha-lipoic acid, vitamin E, and whatever showed up in an ad this morning.
It’s very easy to walk away from all of that believing that improving your fertility means taking twelve supplements and hoping one of them is the right one.
It doesn’t.
Here’s what none of those lists told you: how strong the evidence actually is behind each one, and whether it was studied in women like you.
That’s what this post does. Every supplement below gets an honest evidence grade, including the ones where the honest grade is “not yet,” and one that’s currently everywhere despite resting almost entirely on a study conducted in mice.
You’ll notice something as you read. Most supplement research is done in women with a specific diagnosis, usually PCOS or diminished ovarian reserve. If you’ve been told everything looks normal, that doesn’t mean none of this applies to you. It means the research hasn’t been done in your group, which is a different problem entirely.
If you’re trying to get pregnant, it’s worth looking at the bigger picture before assuming that another supplement is the answer.
Sometimes the more useful question isn’t “What else should I take?” but “What’s actually preventing pregnancy?”
If you’re trying to get pregnant and looking for a solution-based, comprehensive approach, read my complete guide: What’s Actually Preventing Pregnancy and How to Fix It.
After nearly twenty years as a Certified Nutrition Therapist specializing in fertility, the question I’m asked most often is “what supplements should I be taking?” It’s almost always the wrong first question, and this post is partly about why.
Because it’s rarely unexplained. It’s uninvestigated.
Key Takeaways
Supplements are where fertility advice can get particularly confusing.
There are hundreds of products marketed as “egg quality boosters,” but marketing isn’t the same thing as evidence.
| Supplement | Strongest evidence for | Evidence strength | Who it's actually for |
|---|---|---|---|
| CoQ10 (ubiquinol) | IVF outcomes in diminished ovarian reserve | Moderate | DOR, poor ovarian response, pre-retrieval |
| Omega-3 (EPA+DHA) | Clinical pregnancy and live birth in ART | Moderate | Low fatty fish intake |
| Vitamin D | Pregnancy rates when correcting deficiency | Moderate | Anyone testing below range. Test first |
| Folate | Neural tube defect prevention, not egg quality | Strong, different outcome | Everyone preconception |
| Inositol | Metabolic markers and ovulation in PCOS | Limited | PCOS with insulin resistance |
| NAC | Some reproductive and metabolic measures in PCOS | Limited | PCOS |
| Melatonin | Mature oocyte count in IVF, not pregnancy rate | Limited | Discuss with provider, it's a hormone |
| DHEA | Mixed results in DOR | Inconsistent | Medical supervision only |
| Alpha-lipoic acid | Glucose metabolism in PCOS | Limited, indirect | PCOS metabolic support |
| L-carnitine | Embryo quality in one IVF study | Preliminary | Not established |
| Vitamin E | Mostly male fertility research | Insufficient in women | Food sources preferred |
| NMN | Mouse studies only | Preclinical | Not recommended yet |
Start as early as you reasonably can, and count backward from your date rather than forward from today.
If you have a retrieval or transfer scheduled, put that date on a calendar and count back ninety days. That is your window. If you are trying naturally, count back ninety days from the cycle you are hoping will be the one.
This is not an arbitrary number. Follicles spend months in development before ovulation or retrieval, which means the egg involved in your next cycle is already well into that process. The total egg maturation cycle (folliculogenesis) takes about 90 to 120 days from an immature resting state to a fully mature egg ready for ovulation and/or retrieval.
Many women reading this do not have ninety days. A retrieval is already booked, or the calendar is not negotiable.
Less time is not the same as no benefit. The final weeks before ovulation or retrieval are when the follicle is most metabolically active and most responsive to its environment. Starting late means you catch the last leg rather than the whole race, which is meaningfully different from catching none of it.
And if this cycle does not work, the supplements you start today are fully in play for the next one. That is worth knowing before you decide it is too late to bother.
Related: Why the ninety days before ovulation matter for egg quality.
You will notice that most supplement research is conducted in women with a specific diagnosis, usually PCOS or diminished ovarian reserve. If you have been told everything looks normal, that does not mean none of this applies to you. It means the research has not been done in your group, which is a different problem, and it is one more reason a general supplement list is a poor substitute for knowing what is actually going on in your case.
Coenzyme Q10 is involved in mitochondrial energy production and has attracted significant interest in reproductive medicine. CoQ10 is an antioxidant found in every cell of the body. CoQ10 is a component of the electron transport chain, the process mitochondria use to produce ATP. Eggs are among the most energy-demanding cells in the body, which is why CoQ10 has drawn more research attention in fertility than most supplements on this list. It is needed in the preconception phase to support both egg and sperm quality. CoQ10 also supports energy production, protects cells from damage, and supports metabolism. Levels of CoQ10 in the body decline with age, starting around the age of 30.
The takeaway: CoQ10 is top of my list when talking about supplements that may help improve egg quality. I always recommend using the active, antioxidant form Ubiquinol, which accounts for over 90% of the CoQ10 in the body. I recommend taking 200 mg of Ubiquonol CoQ10 per day.
My post on How to Improve Egg Quality Naturally covered the best food sources of omega 3s. This is the supplement question, and there are three things worth knowing that most fertility advice skips.
Additionally, a 2018 study published in Human Reproduction measured serum omega-3 levels in 100 women across 136 assisted reproduction cycles. Every 1% increase in serum long-chain omega-3 was associated with an 8% higher probability of live birth. The effect was driven mainly by EPA, where each 1% increase corresponded to a 15% increase.
That EPA detail matters, because most prenatal omega-3 supplements are DHA-weighted. They are formulated for pregnancy, where DHA supports fetal brain development. That is the right ratio once you are pregnant. It is not necessarily the right one for the months before. Check your label.
In my clinical practice, I recommend taking 800 mg EPA + 800 mg DHA per day.
On quality: choose the triglyceride form over ethyl ester for better absorption, and buy something third-party tested for heavy metals and oxidation. Fish oil goes rancid.
The takeaway: supplement if you are not eating fatty fish two to three times a week, or if you are vegetarian, since conversion of plant-based ALA into EPA and DHA is poor. This is one of the few nutrients you can actually test. The Omega-3 Index measures EPA and DHA in your red blood cell membranes. Test, then dose to the result.
Folate is essential for DNA synthesis and cell division and is particularly important before and during pregnancy.
A prenatal vitamin containing at least 800 micrograms of folate is generally recommended before pregnancy, although some women need a higher dose based on their individual health history.
Read more here on why it’s critical to make sure your prenatal only contains folate and why you shouldn’t take folic acid.
A study measuring vitamin D levels in women undergoing IVF found the odds of clinical pregnancy were four times higher in vitamin D–replete versus deficient women (adjusted for age, embryo number, and quality).
A study published in 2025 split IVF patients into three vitamin D categories (deficient: under 20 ng/mL, insufficient: 20–29.9 ng/mL, replete: 30+ ng/mL) and looked at clinical pregnancy rates separately for patients under 35 and patients 35 and older.
In patients 35 and older, the gap was real and statistically significant: 34.6% pregnancy rate for deficient, 47.6% for insufficient, 55.7% for replete.
Another more recent IVF study revealed a higher fertilization and implantation rate in a group of women with higher vitamin D levels. Additionally, research shows that having adequate vitamin D levels not only improves your chance of pregnancy, it also improves your chances of live birth. Unfortunately, poor vitamin D levels are associated with early pregnancy loss and miscarriage risk.
The standard lab cutoff for ‘sufficient’ is 30 ng/mL. In my practice I aim higher, generally 60 to 80 ng/mL, for women actively preparing for conception or a retrieval. That is above conventional guidance and it is a clinical judgment, not a research threshold.
What matters most is that you test rather than guess, because dosing without a baseline is how women end up either under-supplemented for years or well above what they need.
Vitamin D is one piece of a much bigger prenatal question, and prenatals vary enormously in form, dose, and what else they contain. If you’re still choosing one, start with the best vitamins for getting pregnant and what to look for in a prenatal.
DHEA (dehydroepiandrosterone) is a hormone precursor that has been studied as an add-on treatment for women with diminished ovarian reserve or poor ovarian response during IVF.
Some studies and meta-analyses have reported improvements in pregnancy or ovarian-response outcomes, but the evidence is inconsistent and limited by study quality. A 2018 systematic review and meta-analysis of five studies involving 910 women found an association between DHEA use and higher pregnancy rates, but more recent evidence and clinical guidelines have not established DHEA as a routine fertility treatment.
The takeaway: DHEA is a hormone, not a general fertility supplement. It should only be considered with individualized medical guidance, particularly because androgen levels and conditions such as PCOS can affect whether it is appropriate. Current ESHRE guidance does not recommend DHEA as an adjuvant to improve IVF efficacy or safety.
Melatonin is a hormone with antioxidant properties that has been studied as an adjunct during IVF. Because oxidative stress is involved in reproductive biology, researchers have investigated whether melatonin supplementation could support oocyte maturation and embryo development.
A 2021 systematic review and meta-analysis of seven randomized controlled trials found that melatonin supplementation during IVF was associated with a higher number of mature oocytes, but did not find significant improvements in clinical pregnancy or other measured outcomes. The authors also noted that most studies were small and that several had methodological concerns.
A newer 2024 systematic review and meta-analysis found improvements in fertilization rate and the number of mature oocytes, but not clinical pregnancy rate.
The takeaway: Melatonin is an interesting area of fertility research, but we don’t yet have enough evidence to say that supplementation improves egg quality or IVF success for everyone. If you’re considering it, discuss the timing and dose with your healthcare provider, particularly because melatonin is a hormone, not simply an antioxidant supplement.
Inositol supplements are particularly relevant to women with PCOS because of their potential effects on insulin signaling and metabolic health.
If PCOS is part of your picture, inositol is one piece of a larger strategy rather than the strategy itself. You can read more on how PCOS affects fertility and what actually helps.
The takeaway: Myo-inositol may be worth discussing with your healthcare provider if you have PCOS, particularly when insulin resistance or irregular ovulation is part of the picture. But it shouldn’t be positioned as a proven “egg quality” supplement, and the evidence does not support assuming that everyone with PCOS needs the same inositol combination or dose.
If you and your provider decide to use it: I recommend taking 1.6 g of myo-inositol + d-chiro inositol per day.
Vitamin E is a fat-soluble antioxidant that helps protect cells from oxidative damage. Because oxidative stress is thought to play a role in reproductive aging, vitamin E has been investigated as a potential fertility-supportive nutrient.
However, evidence that vitamin E supplementation improves female fertility or egg quality is limited. Much of the clinical research involving vitamin E and fertility has focused on male fertility, while research in women has largely examined associations rather than proving that supplementation improves reproductive outcomes.
The takeaway: Focus on getting vitamin E-rich foods as part of an overall nutrient-dense diet to meet your nutritional needs.
If you and your provider decide to use it: I recommend taking 800 IU of vitamin E in the tocotrienols form per day.
N-acetylcysteine (NAC) is a precursor to glutathione, one of the body’s major antioxidant compounds. Because oxidative stress and altered insulin signaling are relevant to PCOS, NAC has been investigated as a potential adjunct for women with PCOS.
A 2025 systematic review and meta-analysis of 22 studies involving 2,515 women with PCOS found that NAC was associated with improvements in some reproductive and metabolic measures, including progesterone and endometrial thickness. Earlier systematic-review evidence also found higher pregnancy and ovulation rates compared with placebo, although the authors emphasized the need for better-quality trials.
The takeaway: NAC is an interesting option for certain women with PCOS, but the evidence does not establish NAC as a universal egg-quality supplement. And while NAC has been studied in endometriosis, much of that research is experimental or focused on mechanisms rather than demonstrating improved fertility outcomes.
If you and your provider decide to use it: I recommend 1800 mg per day.
Alpha-lipoic acid (ALA) is an antioxidant involved in cellular energy metabolism and has been studied for its potential effects on oxidative stress and insulin sensitivity.
A 2024 systematic review and meta-analysis of seven randomized controlled trials in women with PCOS found that ALA supplementation improved some measures of glucose metabolism, including fasting blood glucose and insulin resistance, although the evidence varied in certainty and the studies were heterogeneous.
The takeaway: ALA may be relevant for certain women with PCOS or metabolic concerns, but evidence that it directly improves egg quality or IVF outcomes is currently limited. It’s better thought of as a potential metabolic-support supplement than a proven egg-quality supplement.
If you and your provider decide to use it: I recommend 200 mg per day.
L-carnitine plays an important role in transporting fatty acids into mitochondria, where they can be used for energy production. Because mitochondrial function and energy metabolism are important to oocyte development, researchers have investigated whether carnitine could support reproductive outcomes.
A 2018 study of women undergoing IVF found that approximately 82 days of L-carnitine supplementation was associated with improved embryo quality, although there were no significant differences in the number of retrieved oocytes, maturation, or fertilization rates.
A 2021 review concluded that L-carnitine has potential roles in oocyte metabolism, mitochondrial function, and protection from oxidative stress, but emphasized that much of the evidence remains preclinical or limited.
The takeaway: L-carnitine is an interesting area of research, particularly because of its connection to mitochondrial energy metabolism, but we don’t yet have enough evidence to call it a proven egg-quality supplement.
If you and your provider decide to use it: I recommend 800 mg per day.
You may have seen NMN discussed as an egg quality breakthrough. Here is the honest state of that research.
NMN is a precursor to NAD+, a molecule involved in cellular energy production and DNA repair. NAD+ levels decline with age, and that decline has been proposed as one driver of age-related changes in eggs.
The study that generated most of the excitement was conducted in mice. Researchers restored NAD+ levels in older female mice and reported improvements in egg quality and embryo development.
That is genuinely interesting. It is also a mouse study, and the gap between rodent reproductive biology and human oocyte biology is wide. There is currently no human trial demonstrating that NMN supplementation improves egg quality, pregnancy rates, or live birth.
The takeaway: I am watching this research closely. I am not building protocols around it yet, and I would be cautious about any product marketed to you on the strength of a mouse study. Worth noting: the regulatory status of NMN as a dietary supplement in the US is currently contested.
Egg quality isn’t just about what’s on your plate.
I know how this section usually goes. Sleep more. Stress less. Exercise, but not too much. You have read it before and it did not feel like information.
So let me be specific about why these four made the list.
Each one acts on the same biology the supplements above are aimed at: oxidative stress, insulin signaling, mitochondrial function, and hormone regulation. They are not the soft part of a fertility plan. They sit upstream of it.
And in the case of alcohol and smoking, the evidence is stronger than it is for most of the supplements you just read about.
Sleep affects metabolic health, hormone regulation, stress physiology, and overall health.
You don’t need a perfect sleep routine every single night. But consistently prioritizing quality, restorative sleep is a necessary fertility strategy. Aim for 7-9 hours per night of sleep in a pitch black room, kept on the cool side. Get in bed as early as possible and aim to stop eating 2-3 hours before bedtime. After sunset, begin to turn down the overhead lights in your home – use dimmers, red light bulbs and candles to reduce the amount of blue light you’re exposed to after sunset.
Smoking and alcohol use cause oxidative stress and hormonal imbalances that damage cellular DNA in developing eggs, accelerate the loss of ovarian reserve, and lower overall egg quality, which decreases the chances of successful fertilization and healthy pregnancy. Smoking damages the follicular fluid by allowing harmful byproducts from smoke to enter the fluid surrounding the eggs, directly impairing egg maturity and chromosomal integrity. Smokers also experience lower egg counts, poorer embryo quality, and reduced live birth rates during fertility treatments.
Heavy drinking alters estrogen and progesterone levels, which can stop regular ovulation and lead to poor-quality eggs. And women who consume higher amounts of alcohol often yield fewer mature eggs during fertility procedures.
Let’s clear something up: stress does not mean you caused your fertility problems.
You don’t need to become perfectly calm before you can get pregnant.
But chronic stress can affect sleep, blood sugar regulation, inflammation, eating patterns, and other systems that influence overall health.
So stress management isn’t about “thinking positive enough to get pregnant.” It’s about giving your body adequate opportunities for recovery.
This may be one of the most important sections of the entire blog post. Because when you’re trying to conceive, it’s very easy to turn fertility optimization into a full-time job.
Your liver and kidneys already have systems for processing and eliminating waste. You don’t need a juice cleanse to “detox your eggs.”
Severely restricting calories, carbohydrates, fats, or entire food groups can make it harder, not easier, to meet your nutritional needs.
More supplements don’t automatically mean better fertility outcomes.
The goal isn’t to build the biggest possible supplement routine. It’s to understand which factors actually matter for you, and then use the supplements that address them.
Before you add another supplement or take out another food group, it’s worth asking a different question.
Most women I work with have not been under-trying. They have been trying hard, in a lot of directions, without knowing which one mattered. That isn’t an effort problem. It’s a strategy problem.
Inside The Fertility Code, we find out which factors are actually relevant to your body, your labs, and your history, so the things you do next are the things that count.
See how The Fertility Code works → for women trying to conceive naturally or preparing for IVF.
Reducing unnecessary exposure to harmful substances makes sense when trying to improve egg quality.
But trying to eliminate every chemical, plastic, fragrance, or environmental exposure from your life can quickly become overwhelming, and may create more stress than benefit.
The bottom line
The most common thing I see is a woman taking eleven supplements, none of which were chosen based on anything specific to her.
That is not a supplement problem. It is an information problem. Every product on that list was selected to address a possibility rather than a finding.
The women who get results are almost never the ones taking the most. They are the ones who found out what was actually going on first, and then took three things that addressed it.
It’s rarely unexplained. It’s uninvestigated.
Not everyone reading this needs one-on-one help. Some of you will get your vitamin D tested, find it low, correct it, and get pregnant.
But there are situations where trying to work this out alone tends to cost more time than it saves.
Consider individualized guidance if:
What these have in common is that the next step depends on facts about you that a blog post can’t know.
If you’ve been told everything looks normal but you’re still not pregnant, or you have a diagnosis like PCOS, endometriosis, or poor egg quality and nothing is working, there’s almost always something deeper that hasn’t been found yet.
Standard fertility testing rarely evaluates the factors that actually determine whether pregnancy happens: egg quality, ovulation quality, metabolic health, inflammation, nutrient status, and how your body responds to stress.
After nearly 20 years and over a thousand clients, I’ve found that most fertility struggles come down to a small number of hidden drivers preventing pregnancy. When those drivers are identified and addressed in the right order, the body responds.
That’s exactly what we uncover inside The Fertility Code, my 12-week, high-touch fertility program for women who are done guessing. We find what’s been missed and build a clear, personalized strategy around your body, your labs, and your history.
With 1:1 coaching, direct access between calls, lab reviews, evidence-based content, and structured accountability, you get expert eyes on your case so you can stop second-guessing and start moving forward with clarity.
Over 90% of the women I work with go on to conceive.
If you’re ready to finally understand what your body needs for a successful pregnancy and address what’s been missed, you can explore the program here → The Fertility Code.
Or schedule a free Fertility Strategy Call to see if the program is right for you.
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