By the mid-thirties, many women arrive at a fertility clinic carrying a quiet anxiety: have I waited too long? Age does matter in reproduction, but what often gets overlooked is how powerfully everyday habits interact with age to influence egg health. After 35, biology becomes less forgiving, but it is not indifferent, says Dr Rohani Nayak, Fertility Specialist at Birla Fertility & IVF, Bhubaneswar.
Age sets the stage, lifestyle writes the script
Women are born with all the eggs they will ever have. By 35, both the number and quality of eggs decline, largely due to accumulated cellular damage. One of the most important drivers of this decline is chromosomal error. Large IVF datasets consistently show that the proportion of eggs and embryos with chromosomal abnormalities rises sharply after 35, affecting implantation and miscarriage risk. However, the cellular environment in which eggs mature is deeply influenced by daily behaviour.
Metabolism, weight, and inflammation
Insulin resistance and chronic low-grade inflammation have a direct impact on ovarian function. Studies show that women with higher BMI often have poorer egg competence and altered follicular fluid composition, which affects how eggs mature. This does not mean weight loss must be drastic or rapid. Even modest improvements in metabolic health through balanced meals, reduced ultra-processed foods, and regular movement can positively influence ovarian physiology within months.
Sleep, stress, and hormonal rhythm
Egg development is not a one-day event; it unfolds over several months. During this time, hormonal signals must remain tightly coordinated. Poor sleep and sustained psychological stress disrupt cortisol and melatonin levels, both of which play roles in follicular development.
Smoking, alcohol, and oxidative damage
After 35, eggs are less resilient to oxidative stress. Smoking accelerates follicular depletion and increases DNA damage in oocytes, while regular alcohol intake has been associated with reduced ovarian response during fertility treatment. These effects are dose-dependent, meaning reduction still matters.
Why this matters when considering IVF
IVF does not bypass egg biology; it amplifies it. The quality of eggs retrieved determines embryo development, genetic normalcy, and ultimately success rates. Lifestyle changes cannot reverse age, but they can meaningfully improve the odds by optimising the eggs that remain.
For women over 35, fertility is no longer just about when treatment starts, but how the months leading up to it are lived.
