Top 20 Frequently Asked Questions on Fertility

Women are born with roughly 1 to 2 million eggs, drop to about 300,000 to 400,000 by puberty, and have around 25,000 by age 37. By the late 30s, approximately 90 percent of the original ovarian reserve is depleted.

However, egg quantity and egg quality are not the same thing; quality (mitochondrial function, oxidative stress, inflammation) can be meaningfully improved at any age.

AMH and antral follicle count tests give a clearer picture of where you actually stand than your age alone. We have seen 39-year-olds with better egg quality than some 28-year-olds because of how they have cared for their metabolic health.

Egg quality reflects mitochondrial function, oxidative stress, and inflammation in the ovarian environment, all of which are modifiable.

The most evidence-supported levers are CoQ10 (200 to 600 mg daily, ubiquinol form), DHEA where clinically indicated, omega 3s, vitamin D, NAC, melatonin, methylfolate, inositol (especially in PCOS), and a Mediterranean-style anti-inflammatory diet.

Eggs take roughly 90 to 120 days to mature, so meaningful improvement requires at least 3 to 4 months of consistent work. Sleep, stress regulation, and removing alcohol, smoking, and ultra-processed foods matter just as much as the supplements.

The core fertility nutrients are folate (preferably methylfolate, 400 to 800 mcg), vitamin D (most Indians are deficient and need 2000 to 5000 IU daily), vitamin B12, iron, zinc, selenium, iodine, choline, omega 3 DHA, and CoQ10.

For PCOS-linked infertility, myo-inositol and D-chiro inositol (in a 40:1 ratio) are particularly effective.

Generic prenatal supplements are rarely enough on their own; doses need to be matched to your actual blood levels through proper testing. We test these directly rather than guessing from a multivitamin label.

Yes, significantly. High sugar and refined carbohydrate intake drive insulin resistance, which disrupts ovulation (the central mechanism in PCOS), impairs egg quality through oxidative stress, increases the risk of miscarriage, and lowers sperm count and motility in men.

Even women without diabetes or PCOS often have hidden insulin resistance affecting their fertility, which is why we test fasting insulin and HOMA-IR alongside standard fertility hormones.

Cutting refined sugar and stabilising blood glucose is one of the fastest fertility upgrades available.

Sperm quality is highly responsive to lifestyle, and the male partner contributes to roughly half of fertility outcomes. Sperm regenerate every 64 to 90 days, so improvements show within 3 months of consistent work.

Key levers are quitting smoking and reducing alcohol, daily exercise, losing visceral fat if needed, avoiding heat (saunas, hot baths, laptops on the lap, tight underwear), reducing exposure to plastics and pesticides, and supplementing CoQ10, zinc, selenium, vitamins C and E, L-carnitine, and omega 3s based on a current semen analysis.

Both partners go through our fertility protocol together because conception is genuinely a two-person biology.

Fertility-supportive foods include leafy greens (folate, magnesium), eggs (choline, B12, vitamin D), fatty fish (omega 3s), nuts and seeds (zinc, selenium, vitamin E), berries (antioxidants), avocado (healthy fats), beans and lentils (plant protein, folate), full-fat dairy (in moderation, if tolerated), pomegranate, beetroot (nitric oxide for blood flow), and quality whole grains.

The Mediterranean diet pattern has the strongest evidence base for fertility outcomes in both natural conception and IVF.

A traditional Indian thali built around dal, sabzi, ghee, curd, nuts, and fresh fruits already covers many of these bases when refined sugar and ultra-processed foods are removed.

Reliable signs of ovulation include a clear shift in cervical mucus (becomes egg-white, slippery, and stretchy in the days before ovulation), a sustained rise in basal body temperature (0.3 to 0.5 degrees C) after ovulation, a positive ovulation predictor kit (LH surge), mild one-sided pelvic discomfort (mittelschmerz), and a rise in progesterone on a day 21 blood test.

The most accurate single marker is a mid-luteal (day 21) progesterone level above 10 ng/mL, confirming ovulation occurred.

Many women who appear to be ovulating regularly actually have anovulatory cycles or weak ovulation, which proper testing catches.

The protocol intensifies but the principles are the same: rigorous insulin and inflammation control, optimising vitamin D and B12, CoQ10 (300 to 600 mg ubiquinol), DHEA where clinically appropriate, melatonin (3 to 5 mg at night), NAC, omega 3 DHA, methylfolate, vitamin E, alpha lipoic acid, and inositol if PCOS is present.

Sleep optimisation (7 to 8 hours, dark room) becomes critical because melatonin is a major ovarian antioxidant. Stress reduction and cortisol management matter even more after 35.

This is best done as a 3 to 4 month structured pre-conception protocol, not a casual supplement habit.

Biologically, peak female fertility is in the early to mid 20s, with a meaningful decline starting around 32 and steepening after 35. Male fertility peaks slightly later and declines more gradually but is far from immune to age.

Practically, the best age is when your life circumstances, health, and metabolic readiness align. A metabolically healthy 34-year-old often has better outcomes than a metabolically struggling 27-year-old.

If you are in your 30s and planning ahead, pre-conception optimisation 6 to 12 months before trying is one of the highest-value investments in your fertility you can make.

For most couples, yes. IVF is a remarkable technology, but it is not the first line for the majority of cases we see.

If you have been trying for less than a year (or 6 months over 35), and there is no major structural issue (blocked tubes, severe male factor, advanced ovarian decline), 3 to 6 months of properly designed root-cause work often results in natural conception or significantly improves IVF outcomes if it is still needed.

When the underlying biology is corrected first, IVF success rates improve meaningfully. We coordinate with IVF centres when ART is genuinely the right call; we just do not want it to be the default before basics have been addressed.

---