Women can meaningfully improve their fertility through changes in diet, body composition, exercise habits, stress levels, and environmental exposures. Some of these changes take effect within a few menstrual cycles, while others (like improving egg quality) need at least two to three months to show results, since eggs take roughly 90 days to mature before ovulation. Here’s what actually moves the needle.
Eat a Mediterranean-Style Diet
Of all the dietary patterns studied for fertility, the Mediterranean diet has the strongest evidence behind it. Women with high adherence to this pattern of eating are about 40% more likely to achieve pregnancy compared to those with low adherence. In one large study, women in the top three-quarters of Mediterranean diet adherence had a 44% live birth rate, compared to 31% for women in the lowest quarter.
The pattern is straightforward: plenty of vegetables, fruits, whole grains, legumes, nuts, olive oil, and fish. Less red meat, less processed food, fewer added sugars. You don’t need to follow a rigid meal plan. The benefit comes from the overall pattern, not any single food. The likely reasons it works include reduced inflammation, better blood sugar regulation, and a steady supply of the antioxidants and healthy fats that support egg development.
Get to a Healthy Weight
Body weight directly affects ovulation. A BMI between 18.5 and 24.9 is the range associated with the most regular ovulatory cycles. On either side of that range, problems emerge through different mechanisms.
Women who are underweight don’t carry enough body fat to sustain normal reproductive hormone production. The body essentially decides conditions aren’t favorable for pregnancy and stops ovulating regularly, or stops entirely. Women who are overweight face a different issue: unbalanced insulin levels cause the ovaries to overproduce male hormones and stop releasing eggs. This is the same mechanism behind polycystic ovary syndrome (PCOS), one of the most common causes of ovulatory infertility.
Even modest weight changes can restore ovulation. Losing 5% to 10% of body weight in overweight women, or gaining enough to reach a healthy range in underweight women, is often enough to restart regular cycles.
Exercise the Right Amount
Moderate exercise supports fertility by improving insulin sensitivity, reducing inflammation, and helping maintain a healthy weight. But there’s a ceiling. More than an hour a day of vigorous exercise can suppress the hormones that drive ovary function, causing ovaries to become underactive and stop producing eggs and estrogen in some women.
The sweet spot for most women trying to conceive is 30 to 60 minutes of moderate activity most days of the week. Walking, swimming, cycling, yoga, and moderate strength training all fit well. If you’re a high-intensity athlete and your periods have become irregular or absent, that’s a signal your exercise load is suppressing your reproductive system. Scaling back intensity often brings cycles back within a few months.
Key Supplements to Start Early
A good prenatal vitamin covers the basics, but three nutrients deserve specific attention during the preconception period.
- Folic acid: 400 to 800 mcg daily, starting at least one month before you try to conceive. This is critical for preventing neural tube defects in early pregnancy, often before you even know you’re pregnant. Women with a history of neural tube defects in a prior pregnancy need a much higher dose (4,000 to 5,000 mcg daily) under medical guidance.
- Vitamin D: 600 IU daily is the standard recommendation, though many experts consider 1,000 to 2,000 IU safe and appropriate for women who are deficient. Vitamin D plays a role in hormone regulation and implantation.
- Iodine: 150 mcg daily, ideally starting three months before conception. Iodine supports thyroid function, which directly governs your menstrual cycle and the hormonal environment needed to sustain a pregnancy. Many prenatal vitamins include it, but check the label to be sure.
CoQ10 for Egg Quality
Coenzyme Q10 is an antioxidant that supports the energy-producing machinery inside cells, including eggs. Egg quality declines with age partly because this cellular energy system becomes less efficient. CoQ10 supplementation aims to counteract that decline. Most fertility-focused studies use 200 to 600 mg per day, split into two or three doses. For women over 35, many reproductive endocrinologists recommend 300 to 600 mg daily for at least 8 to 12 weeks before trying to conceive or starting IVF, since eggs need roughly three months to mature.
Reduce Stress Where You Can
Stress isn’t just a vague wellness concern when it comes to fertility. Researchers at Ohio State University tracked 501 women who were trying to conceive and measured stress markers in their saliva. Women with the highest levels of alpha-amylase, an enzyme the body produces under stress, were 29% less likely to get pregnant each month and more than twice as likely to meet the clinical definition of infertility (no pregnancy after 12 months of trying).
The frustrating part is that trying to conceive is itself stressful, which can create a feedback loop. What seems to help is building stress-reducing habits before and during the process: regular physical activity, adequate sleep, mindfulness or meditation practices, and maintaining social connection. You don’t need to eliminate stress entirely. The goal is bringing your baseline stress response down to a more manageable level.
Protect Yourself From Endocrine Disruptors
Certain synthetic chemicals mimic estrogen and other hormones in your body, directly interfering with ovulation and egg development. The two most studied are BPA (found in some plastics, can linings, and thermal receipt paper) and phthalates (found in fragranced personal care products, soft plastics, and some food packaging). These chemicals bind to the same receptors your natural hormones use, disrupting the timing of the hormonal signals that trigger ovulation. They also generate oxidative stress in ovarian tissue, which damages cells and impairs their function. BPA specifically can alter the way genes in developing eggs are turned on and off, reducing egg quality.
Practical steps to reduce exposure: switch to glass or stainless steel food containers, avoid heating food in plastic, choose fragrance-free personal care products, wash your hands after handling thermal receipts, and eat fewer heavily processed or canned foods. You can’t eliminate these chemicals entirely since they’re everywhere in the modern environment, but reducing your daily load makes a difference over time.
Prioritize Sleep
Sleep regulates the hormones that control your menstrual cycle. The hormones that trigger ovulation are released in patterns tied to your sleep-wake cycle, so irregular or insufficient sleep can throw off ovulation timing. Shift workers and women who regularly sleep fewer than six hours a night tend to have longer, more irregular cycles. Aiming for seven to nine hours on a consistent schedule supports the hormonal rhythm your reproductive system depends on.
Know When to Get Tested
If you’re under 35 and haven’t conceived after 12 months of regular unprotected intercourse, or if you’re 35 or older and haven’t conceived after 6 months, a fertility evaluation can identify treatable problems. The workup typically includes blood tests for progesterone (to confirm ovulation), estradiol, thyroid-stimulating hormone, and prolactin. Your doctor will also likely order an ovarian reserve test, which combines a blood test for anti-mullerian hormone (AMH) with an ultrasound to count the small follicles in your ovaries. Together, these tell you whether your egg supply is typical for your age.
Getting tested doesn’t mean you need fertility treatment. Many issues uncovered in a basic evaluation, like a thyroid imbalance or a luteal phase deficiency, are correctable with relatively simple interventions. The information itself is valuable because it tells you whether lifestyle changes alone are a reasonable strategy, or whether something specific needs to be addressed first.