If you've been trying to get pregnant for a while, you've probably heard other women talking about all kinds of ways to improve your egg quality—everything from vitamin supplements to herbal concoctions to ground-up placenta powder (yes, that's a thing. Don't ask how I know.) You might be concerned that your eggs are, well, not as robust as they used to be, especially if you're over 35.
But of all the crazy quick-fixes you read on the internet, which ones actually work? Is it even possible to improve the quality of your eggs? We talked to a fertility specialist, a women's health expert and a Chinese medicine guru to get their take on what you can do.
You are born with all the eggs you have in your lifetime, but what we call "egg quality" is not actually a fixed thing—as the egg develops before ovulation, it's affected by outside factors, so you want to keep your body as pristine as possible. "Everything that you do affects your eggs, so the older you get the more environmental toxins they've been exposed to and the more likely they are to be abnormal," says Alice Domar, Ph.D., an assistant professor of obstetrics and gynecology at Harvard Medical School and director of the Domar Center for Mind/Body Health at Boston IVF. But that doesn't mean there aren't ways to keep your eggs healthy as you age. "It is always good to improve your overall health as a way to improve your fertility potential," says Lora Shahine, M.D., an OBGYN and reproductive specialist at Pacific NW Fertility in Seattle. "I encourage patients to maintain a healthy weight because being underweight or overweight can decrease chances to conceive. Exercise, but not to a point of exhaustion—do yoga, Pilates, walking, light jogging or strength training instead of long-distance running or CrossFit."
Anyone trying to conceive for a while has heard the unwanted advice, "just relax." Although stress can't cause infertility, it may be another environmental factor that could cause your eggs not to perform at their optimum level. "There have been a couple of studies that found the more stressed the woman is the longer it takes to get pregnant," Domar says. Trying to reduce stress can be stressful in itself, so instead, figure out ways to handle it. "You cannot avoid stress, but build tools to manage it such as meditation or low impact exercise," Dr. Shahine says. The most important thing is to find whatever works for you. "Look at your lifestyle, and if you find that exercise reduces stress walk more, learn a relaxation technique, hang out with your friends—think about what feels good and reduces your stress level," Domar says.
Unfortunately, you shouldn't use wine as a way to reduce stress, since alcohol has also been shown to lower pregnancy rates, Domar says. And it should go without saying that if you're a smoker, you should quit. "Nicotine is toxic to eggs, and there's data to show that women who smoke basically add 10 years to their reproductive age," Domar says. Studies on caffeine are less clear, but both Domar and Dr. Shahine say to cut back if you drink a lot of it. "When you're pregnant, it's recommended you limit caffeine, so anything you would do pregnant you would want to do when you're trying to get pregnant," Domar says.
There is a myriad of fertility supplements out there you may have heard of, but only some have been shown to work. One that all our experts agree on is the antioxidant Coenzyme Q10 (CoQ10). "Antioxidants help with free radical damage caused by a stressful environment or environmental toxins," says Randine Lewis, Ph.D., author of The Infertility Cure and trained in both Western and Eastern medicine. "If a woman is 45 and she has less reproductive capacity than her younger counterparts, she's more susceptible to this damage." Domar agrees: "As eggs get older dividing normally to make a baby might become a little tougher, so CoQ10 might give the cells more energy to do that," she says.
Other supplements also help cells work better. "Besides Coenzyme Q10, taking folic acid, and antioxidants such as vitamins A and E may help with mitochondrial function of eggs, which is the energy source that helps with DNA replication," Dr. Shahine says. "Another supplement proposed to improve egg quality but should be taken with caution is DHEA—this is a male hormone that if taken in excess may have side effects such as acne and excessive hair growth." This is especially true if you have Polycystic Ovary Syndrome (PCOS), because you may already have elevated DHEA. Another supplement to avoid is melatonin, Dr. Shahine says, because it might actually decrease ovulation. Whatever supplements you take, discuss them with your doctor first. "It is very important to know the source of supplements since this industry lacks oversight—many times they have been found to not actually have any of the supplement they claim and be full of fillers!" Dr. Shahine says.
Although the internet may be full of fad diets promising to improve fertility, our experts agreed that a wholesome, well-balanced diet is best. "It's never been shown that there's a diet that makes you more fertile," Domar says. "Unless there's a medical reason for you to avoid a certain food group, I would rather you not stress out about what you're eating and just eat good food like your grandmother would give you: fruits and vegetables, whole grains, lean meats, full-fat dairy products, nuts and berries." A diet with plenty of variety, organic if possible, can help your body's overall function, including your eggs. "Vitamin-packed food such as dark leafy greens like kale and spinach, and antioxidant-filled fruit like blueberries might help," Dr. Shahine says. "Avoiding processed foods full of excessive salt and trans-fats is a good idea. If someone has celiac disease, they should avoid gluten, but most people can eat food with gluten without negative consequences."
Acupuncture has been shown to increase pregnancy rates in women undergoing IVF, but there haven't been studies yet that show it improves pregnancy rates for those trying to conceive on their own. Even so, it can be a good way to reduce stress. "Acupuncture has been shown to be beneficial in many aspects of health," Dr. Shahine says. "The studies for fertility are mixed but I have many patients that do acupuncture and enjoy it." Domar says that even with the lack of conclusive data, she would recommend it because it can't hurt. "I have four acupuncturists who work in my center, and they believe if you do acupuncture for several months it can improve egg quality," she says.
This is a tricky one: Domar said "absolutely not" to taking herbs while Lewis said "absolutely!" The potential interaction with fertility drugs is the main reason why many Western doctors don't approve of herbs. "I respect Eastern medicine techniques which can sometimes involve herbs," Dr. Shahine says. "But I recommend stopping herbs if patients are taking Western fertility medications under my care because I do not know how the two may interact." Even if you're not undergoing fertility treatments, Domar is still skeptical. "I've never seen a study showing that they are safe and effective," she says. But Lewis argues that if you can trust your practitioner, herbs can be beneficial. "I work with a lot of reproductive endocrinologists [fertility doctors] who know that I know what I'm doing, so they'll let me do it; but they won't necessarily encourage their patients to go out and just take herbs because somebody says these are good for your egg quality," she says. "You run into problems when your practitioner does not know reproductive medicine in and out from both sides, Western and Eastern." So herbs shouldn't be taken lightly—make sure you talk it over with your doctor first if you want to explore that path to conception.