It Starts With The Egg by Rebecca Fett — The Ultimate Evidence-Based Guide to Fertility and Egg Quality (Book Review)

What It Starts With the Egg Is About

At its core, the book answers one question:

Can you improve your egg quality — and therefore fertility — through lifestyle changes?

Rebecca Fett’s answer, backed by decades of research, is yes.

Egg quality influences:

• Conception success

• Embryo development

• Chromosomal normality

• IVF outcomes

• Miscarriage risk

Most people assume egg quality is fixed. Fett’s research shows the opposite:
Eggs undergo crucial maturation in the 90 days before ovulation — and this window is highly responsive to diet, toxins, stress, and supplements.

This creates a hopeful, actionable roadmap for fertility that goes beyond “just relax” or “just try IVF.”

1. The Science: What Affects Egg Quality?

Fett explains egg quality through the lens of biology:

Eggs are vulnerable to:

• Oxidative stress

• Mitochondrial dysfunction

• Environmental toxins

• Chronic inflammation

• Insulin resistance

And egg quality can improve through:

• Antioxidants

• Nutrient-dense diets

• Blood sugar balance

• Targeted supplements

• Environmental detoxification

What makes this book so powerful is its clarity:
Egg quality isn’t a mystery — it’s chemistry, biology, and habit.

2. Environmental Toxins: The Biggest Fertility Saboteurs

This section is often the book’s biggest eye-opener.

Fett identifies three chemical categories with the strongest evidence of harming egg quality:

BPA + BPS (Plastics)

Found in food containers, water bottles, can linings, receipts, and even “BPA-free” plastics.

Impacts:

• Estrogen disruption

• Poorer embryo quality

• Increased miscarriage risk

Fix:
→ Switch to glass or stainless steel
→ Never microwave plastic
→ Limit canned foods

Phthalates

Found in fragrances, perfumes, lotions, shampoos, laundry detergents, and household cleaners.

Impacts:

• Reduced ovarian reserve

• Disrupted hormone signaling

Fix:
→ Choose fragrance-free or essential-oil–based products
→ Avoid scented candles, air fresheners, perfumes

Nonstick coatings, flame retardants, pesticides

These exposures can accumulate in the body and directly impair egg development.

Fix:
→ Replace nonstick pans with cast iron or stainless steel
→ Wash produce thoroughly
→ Use safer home-cleaning swaps

This section alone can improve a woman’s fertility environment dramatically.

3. Nutrition for Egg Quality: What to Eat

The book reinforces a nutrition philosophy perfectly aligned with your brand: whole foods, hormone support, and metabolic balance.

Core patterns that support egg quality:

• Mediterranean-style meals

• High-antioxidant fruits + vegetables

• Omega-3 rich foods (salmon, sardines, chia, walnuts)

• Protein + fiber at every meal for blood sugar stability

• Lower refined carbohydrate intake

Women with PCOS receive specific guidance on:

• Lower glycemic load

• Myo-inositol supplementation

• Reducing sugar and ultra-processed carbs

Fett doesn’t demonize food — she emphasizes blood sugar balance and nutrient density.

4. The Fertility Supplements With the Best Evidence

This is the section many readers buy the book for — but it’s also the most frequently misinterpreted online.

Below is the book’s evidence-based supplement framework.

CoQ10 (Ubiquinol): The Book’s #1 Recommendation

Why it matters:

• Supports mitochondrial energy production

• Improves egg performance during cell division

• Enhances embryo development and IVF outcomes

Typical dosage in studies: 200–600 mg/day ubiquinol.

Myo-Inositol

Especially helpful for:

• PCOS

• Insulin resistance

• Irregular ovulation

Improves ovulatory cycles and reduces IVF medication requirements.

Vitamin D

Essential for:

• Hormone regulation

• Endometrial receptivity

• Immune modulation

Deficiency is linked to poorer IVF outcomes.

NAC (N-acetyl cysteine) & Alpha-Lipoic Acid

Powerful antioxidants that may:

• Reduce oxidative stress

• Improve insulin sensitivity

• Support detox pathways

Omega-3 Fatty Acids

Benefits:

• Anti-inflammatory

• Improve egg membrane integrity

• Support fetal brain development

Melatonin

Acts as a mitochondrial antioxidant in the ovary (not just a sleep hormone).

Note: Best used under practitioner guidance.

DHEA

Not for everyone.
Used mainly for:

• Diminished ovarian reserve

• Poor IVF responders

Requires lab monitoring.

5. Special Fertility Circumstances the Book Covers

Rebecca Fett provides targeted guidance for unique situations.

IVF or Egg Freezing

The book outlines a 90-day prep protocol:

• High-dose CoQ10

• Aggressive toxin reduction

• Antioxidant-rich eating

• Supplements tailored to age and ovarian reserve

PCOS

Strong focus on:

• Insulin resistance

• Myo-inositol

• Carb quality

• Endocrine disruptor exposure

Recurrent Pregnancy Loss

Many miscarriages are linked to chromosomal abnormalities.
Improving egg quality reduces this risk significantly.

Women Over 35

Fett emphasizes mitochondrial support:

• Ubiquinol

• Omega-3s

• Antioxidant intake

• Toxin avoidance

The message is hopeful: fertility declines with age, but egg quality is still modifiable.

6. The 90-Day Egg Quality Plan

This is where the book becomes a blueprint rather than just a resource.

Level 1 — Easy Wins

• Switch to glass food storage

• Replace personal care products

• Start a high-quality prenatal

• Reduce plastic exposure

Level 2 — Intermediate Plan

• Add supplements (CoQ10, omega-3, inositol, NAC)

• Shift toward Mediterranean eating

• Reduce refined sugar and processed foods

Level 3 — Advanced 90-Day Protocol

Recommended for:

• IVF

• Women over 35

• Poor responders

• Recurrent miscarriage

Includes:

• 300–600 mg ubiquinol

• Full toxin detox

• Comprehensive supplement list

• Intensive antioxidant strategy

• Strict fragrance + plastic avoidance

This phased approach is approachable and empowering.

BOOK REVIEW: Strengths, Limitations & Who It’s For

Strengths

• Incredibly well-researched

• Actionable and realistic strategies

• Hopeful, empowering tone

• Organized into plans anyone can follow

• Strong alignment with integrative nutrition

Who Will Benefit Most

• Women with PCOS

• Anyone preparing for IVF or egg freezing

• Women 35+

• Those with unexplained infertility

• Anyone facing recurrent pregnancy loss

• Women wanting to prepare their body for pregnancy

Limitations

• Some supplements require medical supervision

• The toxin chapter may feel overwhelming for beginners

• Not a comprehensive fertility diet book

• Some studies are still emerging (but well-referenced)

It Starts With the Egg in 12 Bullet Points

1. Egg quality can improve — dramatically — in 90 days.

2. Plastics (BPA/BPS) and phthalates are major fertility disruptors.

3. Use glass, stainless steel, and fragrance-free products daily.

4. Mediterranean-style eating supports egg and hormone health.

5. Blood sugar balance matters — especially for PCOS.

6. CoQ10 (ubiquinol) is the top supplement for egg quality.

7. Inositol helps with PCOS and insulin resistance.

8. Vitamin D is essential for fertility and IVF outcomes.

9. NAC, ALA, and omega-3s reduce oxidative stress.

10. Melatonin may improve egg maturity (use with guidance).

11. Women over 35 benefit from mitochondrial support.

12. Small daily changes → measurable improvements in embryo quality.

Work With Me 1:1

If you loved the science in It Starts With the Egg but want help actually implementing it in a realistic, sustainable way, this is what I do.

As a women’s health dietitian specializing in hormones, metabolic health, and fertility, I help women build personalized, evidence-based plans that support:

✨ Egg quality
✨ Cycle regulation
✨ PCOS management
✨ Blood sugar stability
✨ Detox pathways
✨ Mitochondrial health
✨ Preconception nutrition

If you want a customized roadmap based on your labs, symptoms, and lifestyle, click here to work with me 1:1

Your body can change — and so can your fertility.
Let’s build your plan together. 🌿