A low Anti-Müllerian Hormone (AMH) level indicates a diminished ovarian reserve, meaning a lower number of remaining eggs. While egg quantity cannot be increased, the health and quality of the remaining oocytes can be significantly optimized. Improving egg quality involves creating a healthier microenvironment within the ovaries by enhancing cellular energy production and reducing oxidative stress. This requires a focused, multi-month strategy encompassing targeted nutritional support and lifestyle modifications.
Understanding Anti-Müllerian Hormone and Egg Quality
AMH is a protein produced by granulosa cells within the small, growing follicles. The AMH blood test serves as a reliable proxy for measuring ovarian reserve, estimating the number of eggs remaining. A low AMH level signals reduced egg quantity but does not measure the quality of individual eggs.
Egg quality refers to the oocyte’s ability to be fertilized and develop into a healthy embryo, determined by its genetic integrity and cellular energy capacity. This quality depends heavily on the proper function of the egg’s mitochondria, the cellular powerhouses. Supporting mitochondrial health is a primary focus when managing diminished ovarian reserve. Unlike fixed egg quantity, egg quality is modifiable through dedicated intervention.
Targeted Nutritional and Supplement Strategies
Improving oocyte health requires supplementing with compounds that support mitochondrial function and neutralize free radicals. Coenzyme Q10 (CoQ10), particularly ubiquinol, is central to this effort. CoQ10 is essential for producing Adenosine Triphosphate (ATP), the energy required for oocyte maturation and early cell division. Studies often recommend 200 to 600 mg of ubiquinol daily for at least three months to allow for tissue saturation.
Dehydroepiandrosterone (DHEA) is frequently discussed for women with very low AMH or poor ovarian response. DHEA is a precursor hormone converted into androgens, which support the early growth of ovarian follicles. While it can potentially improve both the number of eggs retrieved and their quality, it requires medical supervision, with typical protocols suggesting 75 mg per day.
Myo-inositol, often combined with D-chiro-inositol in a 40:1 ratio, supports the oocyte by improving cellular signaling and insulin sensitivity. This helps ensure the egg receives the correct hormonal and metabolic signals for proper maturation. Improvement in the follicular fluid environment can lead to better egg and embryo quality, particularly for women with underlying metabolic concerns.
Several potent antioxidants protect the developing oocyte from oxidative damage, which can lead to chromosomal errors. Melatonin, a neurohormone, concentrates in the follicular fluid, where it scavenges reactive oxygen species (ROS), shielding the egg’s DNA. Resveratrol, a polyphenol, activates sirtuins—proteins that aid in cellular repair within the ovary. Vitamin E, a fat-soluble antioxidant, helps protect cell membranes and mitochondrial DNA from oxidative stress during the 90-day maturation period.
Essential Lifestyle Adjustments for Ovarian Health
Stress Management
Managing chronic stress is foundational, as high levels of cortisol disrupt reproductive hormones. Sustained stress negatively affects the hypothalamic-pituitary-gonadal (HPG) axis, interfering with signals for healthy follicular development. Incorporating daily stress-reduction practices, such as meditation, gentle yoga, or moderate movement, creates a calmer hormonal environment.
Prioritize Sleep
Prioritizing consistent, high-quality sleep is necessary for optimal hormonal regulation and cellular repair. Restorative processes, including hormone release, are closely tied to the circadian rhythm. Aiming for seven to nine hours of uninterrupted sleep per night supports the endocrine function governing ovarian health.
Dietary Choices
Dietary choices influence the ovarian microenvironment by controlling inflammation and blood sugar. An anti-inflammatory diet, such as a Mediterranean-style pattern rich in omega-3 fatty acids, whole grains, and fresh produce, provides the micronutrients and antioxidants needed for egg development. Controlling blood sugar is important, as unstable glucose levels increase oxidative stress on the oocytes.
Minimize Endocrine-Disrupting Chemicals (EDCs)
Minimizing exposure to endocrine-disrupting chemicals (EDCs) is a significant lifestyle adjustment. Compounds like bisphenol A (BPA) and phthalates, found in plastics and personal care products, can mimic or block natural hormones. Exposure to these EDCs is associated with increased oxidative stress in the ovaries. Switching to glass or stainless steel containers and choosing less-processed foods limits this environmental burden.
Setting Realistic Expectations and Timelines
The impact of these changes is not immediate, as the final stages of oocyte maturation take approximately 90 to 120 days. This four-month window is the time required for a developing follicle to be fully influenced by the improved internal environment. Consistency over this period is necessary before any measurable improvement in egg health can be expected.
For women with low AMH, these interventions are often used in preparation for assisted reproductive technologies (ART), such as In Vitro Fertilization (IVF). Pretreatment with supplements like CoQ10 and DHEA has been shown to improve ovarian response, leading to a higher yield of mature oocytes and better-quality embryos. While these strategies do not increase the AMH number, they can significantly increase the probability of a successful outcome from the limited number of eggs available. Age is the single most significant determinant of egg quality, and these efforts must be undertaken in consultation with a fertility specialist.