What every woman in her 20s should know about egg quality and fertility decline

Your 20s are exciting, scaling the corporate ladder, discovering new hobbies, and planning for the future. However, one important issue that often gets overlooked during this decade is fertility. Even if it doesn’t seem urgent now, the choices you make today can significantly impact your ability to have children in the future. Learning how your fertility works, most importantly, the dynamics of ovarian reserve, oocyte (egg) quality, and age, will help you gain control over your reproductive life.

Unlike men, who produce sperm throughout their lives, women are born with primordial follicles (immature eggs). A girl has approximately 1 to 2 million eggs at birth. At puberty, this number reduces to about 300,000–400,000. A batch of eggs matures every month, but one sheds normally during ovulation. The rest are wasted.

This number declines as women age, and since new eggs cannot be produced, fertility is closely linked to age.

Women in their 20s experience the best egg quality, with the highest number of genetically normal eggs, which decreases the chance of genetic issues for a baby. The likelihood of conception is maximized at this age. For example, women 20-24 years old can expect up to an 85% chance of pregnancy within one year of attempting to conceive, with a 25-30% chance of getting pregnant each month. Women in their 20s also face a notably lower risk of infertility than women in their 30s and 40s.

If you are considering having children, your 20s are the ideal time. Even if you’re not ready yet, understanding that this is your peak fertility period will help you make informed decisions for your reproductive future.

As true as it is that women do become pregnant in their 30s, even 40s, remember that fertility does start to decline in the early 30s, well beyond the age of 35. Egg number as well as quality declines, and it becomes harder to conceive, and the risk of miscarriage or chromosomal disorders increases.
It is a natural aging process that cannot be prevented, but if you are aware of this in advance, then you can prepare and plan accordingly.

Your daily habits also affect your fertility. Smoking, heavy drinking, chronic stress, sleep deprivation, and obesity can accelerate the decline of healthy eggs. Conditions like Polycystic Ovary Syndrome (PCOS) can also interfere with ovulation and fertility.

Making good choices in your 20s not only makes you better for your overall well-being, but it also protects your reproductive well-being.

Egg freezing is safe and has become a very popular option. It allows women to store healthier, younger eggs for later use. The sooner you freeze your eggs, the healthier your eggs and the better the success rates in the future.
Regular fertility check-ups are also extremely informative. Anti-Müllerian Hormone (AMH) and antral follicle count tests can estimate your egg reserve and will give a better idea about your reproductive health.

Additionally, maintaining a healthy lifestyle, eating a well-balanced diet, regular physical exercise, stress management, and good sleep can also improve egg health and future fertility.

Your 20s might not be the time when fertility starts becoming a concern, but knowledge about it is empowering you to make wiser choices for tomorrow. Understanding ovarian reserve, egg quality, and fertility decline is the first step. Your 20s are the best years to prevent, because whatever you do now can determine your tomorrow.

Dr. Kaberi Banerjee, Infertility & IVF Expert | Founder & Medical Director, Advance Fertility & Gynecology Centre