It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF

It Starts with the Egg (2014) is a self-help text that offers a science-based roadmap for those seeking to improve fertility by enhancing egg quality through targeted lifestyle, nutritional, and environmental changes. Aimed at those trying to conceive, whether naturally or through assisted methods like IVF, the book breaks down complex reproductive science into practical, evidence-informed strategies. Drawing on her background in molecular biology, author Rebecca Fett presents the latest research on egg development, supplements, environmental toxins, and clinical interventions, empowering readers to take a more active role in their fertility journey. This guide is particularly valuable for those facing infertility, recurrent pregnancy loss, PCOS, or age-related fertility decline, but it also serves as a comprehensive resource for anyone looking to optimize their reproductive health.

Key takeaways include:

• Use Science to Demystify Fertility
• Identify and Address Environmental Toxins as Hidden Barriers to Reproductive Health
• Empower Yourself Through Evidence-Based Self-Care Practices
• Understand How Lifestyle and Biology Intersect in Conception
• Tailor Medical Knowledge to Make Informed and Personalized Decisions

This guide refers to the third edition of the book, published in 2023 by Franklin Fox Publishing.

Content Warning: The source material and guide feature depictions of pregnancy loss, illness, and substance use.

Summary

It Starts with the Egg is built around a central premise: Egg quality, once believed to be unchangeable, can be improved through intentional lifestyle choices. In the opening chapters, Fett examines how exposure to environmental toxins, particularly endocrine disruptors like phthalates and BPA, interferes with hormone regulation and damages reproductive cells. She draws on both epidemiological and laboratory studies to show how everyday products may silently undermine fertility.

Fett then introduces a supplement framework, distinguishing evidence-backed options such as CoQ10, myo-inositol, NAC, and vitamin D from supplements often promoted without scientific support, like royal jelly, maca, and resveratrol. This careful differentiation supports her overarching argument that fertility advice should be rooted in scientific evidence rather than marketing trends or anecdotal tradition.

Nutrition emerges as another key theme. Fett stresses the role of blood sugar control and recommends a Mediterranean-style diet, referencing cohort and IVF studies that link these dietary patterns to improved conception and live birth rates. She offers practical advice, such as meal sequencing, vinegar before carbs, and reducing refined sugar, to translate research into tangible daily habits. At the same time, she approaches controversial dietary topics such as gluten, dairy, caffeine, and alcohol with caution, and urges readers to treat restrictions as context-dependent rather than universally necessary, particularly in IVF or preconception periods.

The scope of the book widens to include male fertility, pregnancy loss prevention, and the cumulative impact of sperm quality. Fett highlights studies indicating that antioxidants, omega-3s, and targeted lifestyle interventions can reduce DNA fragmentation in sperm, an important consideration when female fertility is already age-constrained.

In its final chapters, the book delivers a clear-eyed critique of unproven interventions often marketed by fertility clinics. Treatments like red-light therapy, platelet-rich plasma, ovarian rejuvenation, and immune-based protocols, including intralipids and natural killer cell suppression, are flagged as experimental and, in some cases, risky. Fett frames the decision to avoid such interventions as a deliberate and protective choice that can save couples from false hope, unnecessary cost, and potential harm.

Rather than offering a one-size-fits-all cure, It Starts with the Egg equips readers to make informed, evidence-led decisions. From toxin avoidance and targeted supplementation to dietary adjustments and critical evaluation of clinical options, it empowers readers to focus on what is known to work and to avoid what isn’t.