Your Eggs Are Only as Healthy as You Are

By Dr. Natalie Crawford JUL 2026

The number one question I’m asked as a fertility doctor is, “When should I have kids?” I understand that this decision is complex and can feel almost impossible to make. Do you focus on your career goals and put family planning on hold? Or do you start a family, knowing it may affect your career trajectory? Then there are factors outside your control, such as the economy and your relationship status.

We often talk about the “ticking biologic clock” and place pressure on women with the message that age is all that matters. While it’s true that women eventually run out of eggs, long before that happens, it’s the decline in egg quality that most significantly impacts your ability to conceive. And egg quality is about more than age—it reflects both the genetic normalcy and metabolic health of your eggs. While you can’t rewind the clock, declining metabolic health can significantly affect fertility. As a population, most people become more metabolically unhealthy with age, creating a double impact on egg quality.

Fertility and age are closely connected. The chances of getting pregnant decrease with each passing year once you begin trying. About one in four women experience infertility by age 35, and over half of women over 40 face infertility. The risk of miscarriage also increases with age.

However, age is only one factor affecting egg quality. All your cells age together—you may notice wrinkles or back pain, and your eggs age as well. This means the same factors that support your overall health can also help support egg quality. Conversely, factors that drive inflammation can increase cellular damage within your eggs.

Egg quality depends on both genetic normalcy and the metabolic ability of your eggs to mature and develop properly. As you age, your eggs are more likely to become genetically abnormal. The longer eggs remain in your body, the more they accumulate damage from daily wear and tear, including inflammation. Unfortunately, there is no direct test for egg quality—age remains the best estimate we have.

The chromosomes in your eggs are held in a stage of cell division called Meiosis until ovulation. For example, if you are 25, your eggs have been in this stage for 25 years; at 40, they have been there for 40 years. The longer eggs remain in this suspended state, the more cellular damage and chromosomal misalignment can occur. As a result, by age 40, a large proportion of eggs are chromosomally abnormal. Many of these eggs will not fertilize, develop properly, implant, or may result in early miscarriage.

Genetics, however, is only one part of the picture. Proper egg function is also essential for ovulation and hormone production. Once ovulation occurs, the egg resumes meiosis and must have the metabolic capacity to complete maturation and allow fertilization. The mitochondria—the “powerhouse” of the cell—require energy, primarily from glucose, to function effectively.

Factors that increase inflammation, such as obesity, insulin resistance, and aging, can impair mitochondrial function and negatively impact egg quality. Even in IVF, insulin resistance is associated with fewer mature eggs and lower embryo quality.

In other words, egg quality is closely tied to mitochondrial function and metabolic health. This reinforces the importance of reducing inflammation to support proper egg function.

Age affects more than just genetics. Women over 35 have been shown to have different metabolic byproducts in their eggs compared to younger women. Even more notably, women aged 38 and older tend to have a higher number of abnormally shaped and less efficient mitochondria.

This helps explain why the probability of pregnancy per cycle—known as fecundability—declines with age. However, if part of this decline is related to metabolic changes, there are steps you can take now. While you can’t reverse age or eliminate all chromosomal changes, you can reduce inflammation and support the metabolic health of your eggs.

Because both egg count and quality are linked to age—and age itself can’t be changed—it’s important to focus on what you can control. Supporting your overall health also supports your egg health. The goal is to reduce inflammation while increasing the nutrients your body needs for optimal function.

Although an individual egg remains in your body for your entire life, it takes approximately 290 days for full follicular development, including about 60 days to reach the antral follicle stage. This means the months leading up to ovulation are when your eggs are most sensitive to environmental and metabolic influences. Supporting metabolic health during this window can make a meaningful difference. The sooner you begin making changes to reduce inflammation, the greater the potential improvement in egg quality and fertility.

Natalie Crawford, MD, author of “The Fertility Formula,” is double board-certified in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. She is the co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas, and co-founder and CEO of Learn at Pinnacle. Dr. Crawford is a leading fertility expert with a large social media presence, where she shares educational content on Instagram and TikTok (@nataliecrawfordmd), YouTube (“Natalie Crawford, MD”), and hosts the podcast As a Woman, which has over 6 million downloads.

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