Infertility is a complex disease that can result due to a variety of factors, including but not limited to: female egg quality and production, male sperm quality and production, disorders related to ovulation, hormones imbalances, conditions impacting the physical structures of reproduction, a person’s age, lifestyle, or other health conditions. Sometimes there is no clear cause of infertility, which we call unexplained infertility. Depending on the couple’s specific situation, infertility can be treated by medicine, surgery, or assisted reproductive technology, but many couples prefer to pursue other forms of treatment first. “Unlike food, (which should be one’s primary way to get in one’s vitamins and minerals), supplements should be used as a safety net, to help support and fill in the day-to-day gaps one may have during the fertility period.” says Dara Godfrey, MS, RD. “Certain vitamins and minerals are specifically important prior and during conception and this safety net…[they] can help increase the likelihood of a healthy pregnancy for baby and [pregnant parent].” When choosing a supplement to support your fertility and conception journey, consider the root cause and look for third-party tested supplements. Infertility is a complex disease, and many fertility supplements are very specific to specific needs. They are not a one-size-fits-all category, and some can have potential negative effects. It’s important to obtain meaningful blood tests and understand your diagnosis before supplementing. Not all supplements for fertility are evidence-based or meant to treat all causes of infertility, so it’s important to work with a healthcare professional throughout this process to determine what supplements best suit your needs.
Is a Fertility Supplement Beneficial?
For all persons wanting to conceive, diet and other healthy lifestyle habits are of utmost importance and a first line of defense when it comes to one’s fertility. Smoking, excessive alcohol use, and experiencing large fluctuations in weight should be considered when evaluating one’s risk of infertility. These factors are likely not going to be negated by supplementation; however, a fertility supplement could be helpful for other reasons or specific groups of people. It’s important to remember the ability to conceive impacts the partner who produces the sperm just as much as it impacts the partner who produces the eggs, so supplementation can be considered for both parties. “No one eats perfectly 100% of the time, so supplements can help “fill in the gaps” nutrient-wise and help us make great strides towards optimized fertility and healthy conception.” says Cory Ruth, MS, RD, PCOS expert and owner of The Women’s Dietitian. Specific groups of people at risk for infertility or those with certain conditions who would benefit from fertility supporting supplements are:
Those following a Western, vegetarian, or vegan diet Those with endometriosis Those with Polycystic ovarian syndrome (PCOS) Those of advanced maternal age (older than age 35) Those with a history of multiple miscarriages Those with diminished ovarian reserve (DOR) Those with premature ovarian insufficiency Those who have functional hypothalamic amenorrhea Those with testicular or ejaculatory dysfunction that impacts sperm count and/or quality (ex. varicocele, trauma to the testes, chemotherapy) Men with medical conditions such as diabetes, cystic fibrosis, and other autoimmune disorders
We like that this multi provides essential vitamins and minerals in one small tablet. It has key fertility nutrients including: vitamins D and E, an array of important B vitamins, and minerals magnesium, zinc, and selenium. We also like that it contains iron and calcium—two nutrients that vegetarians and vegans may not get enough in their diets. While this multi checks a lot of boxes as a multivitamin to help support fertility, keep in mind that the level of each vitamin or mineral amount may not suit everyone’s specific needs. A healthcare professional can give further direction if you would need higher (or lower) doses of each nutrient. Price at time of publication: $16.00 ($0.12 per serving) We like that Thorne provides the activated form of this B vitamin, known as methylfolate. This form is better absorbed and utilized in the body, and this form is also necessary for those who have the MTHFR gene mutation. This specific product provides 1.7 mg DFE (1000 mcg), but some women may need a higher dose throughout their fertility journey. Thorne offers a 5 mg and 15 mg of folate option as well which may be a better fit for these cases if recommended from a healthcare professional. Thorne prides itself on rigorously testing all their products for purity and quality. Other supplements by Thorne are third-party tested with NSF, and Thorne partners with organizations like NIH for clinically testing their products. Price at time of publication: $22.00 ($0.37 per serving) We like that HUM Here Comes the Sun Vitamin D3 is third-party tested and vegan-friendly. This HUM choice is considered a “high potency” product because it delivers 2000 IU of vitamin D in one easy softgel, whereas 1000 IU seems to be more standard. There is no set amount of vitamin D to take for fertility, but some studies suggest at least 2000 IU daily for a period of 6 months, so we found this supplement to provide a good base. Keep in mind it’s recommended to get your vitamin D levels checked before taking a supplement to help determine what level is best for you. Price at time of publication: $20.00 ($0.67 per serving) This product provides a total of 2150 mg of omega 3s, with 875 mg coming from DHA and the rest from EPA. While there is no set recommendation for how much omega-3s to take for improving sperm health, studies have shown that anywhere from 500-1000 mg of DHA to be effective, so the dose in this choice fits right in this range. Nordic Naturals makes a supremely high quality product that is third party tested, non-GMO, and Friend of the Sea certified meaning the fish are sustainably sourced. Keep in mind the omega 3 sources are from wild caught anchovies and sardines, so it would not be suitable for vegans or some vegetarians. Price at time of publication: $44.00 ($1.47 per serving) This product contains the optimal 40:1 ratio of 2000 mg myoinositol and 50 mg d-chiro-inositol. Research has shown that this combination of inositols improves insulin sensitivity and benefits ovulation. To see improvement in menstrual cycle regularity it is recommended to take Ovasitol for at least 3 months, and it can even be taken during pregnancy for additional blood sugar balancing benefits. This product is the first and only NSF Certified inositol meaning it is third-party tested for contaminants and ingredient amounts. It is gluten-free and contains no dyes or additives. As an unflavored powder, it is easy to mix into your favorite hot or cold non-carbonated beverage and comes as a convenient single serve packet or large format canister. Price at time of publication: $83.00 ($0.48 per serving) The focus on this male fertility supplement is improving semen quality which is why it contains antioxidants like vitamins C and E. It also provides vitamin D, selenium, and CoQ10, which may further help limit oxidative stress to sperm. Mannaker suggests omega-3 fatty acids have some of the strongest evidence for male fertility, and Natalist includes 450 mg of algae-based DHA. While this supplement is not third-party tested, it is rigorously evaluated for integrity and quality in house. It is gluten-free, vegan, and free from all major allergens, sugar, and artificial preservatives. Price at time of publication: $60 ($2 per serving) We like that this product because it is USP Verified, meaning ingredient amounts on the label and purity of ingredients can be trusted. This product is considered “high potency” because it delivers 300mg. Many other CoQ10 supplements only contain 50-200mg. Studies using CoQ10 in the setting of IVF have used doses as high as 1200mg, but always speak with a healthcare provider about the dose best for you. Given that this supplement is a high dose it does come packaged in a larger pill, which is something to consider. Price at time of publication: $34.00 ($0.34/count) Here are examples of conditions for infertility and specific supplements—although not an exhaustive list—that may be beneficial for each condition, although more research is needed in many of these areas. Remember, this is where some research may indicate these supplements might help in certain circumstances. Some can have serious side effects, so always speak with a healthcare professional before trying any fertility-related supplement to discuss overall need, safety, and proper dosage.
Vegetarians or vegans: Following a vegetarian or vegan eating pattern likely means that “your eating routine may be more likely to be lacking in the vital fertility nutrients necessary for healthy perinatal development” says Godfrey. Potentially beneficial supplements: B vitamins, iodine, zinc, calcium Endometriosis: Endometriosis is a leading cause of infertility that impacts 7 million women in the US. This condition occurs when the endometrial lining of the uterus attaches itself inappropriately to other organs outside the uterus. These deposits of tissue outside the uterus have no way of leaving the body during menstruation and can become aggravated, bleed, and form painful scar tissue which impacts ovulation and fertility. Certain supplements may help decrease inflammation, decrease pain, slow down disease progression, and improve egg quality. Potentially beneficial supplements: vitamin D, curcumin, NAC, alpha lipoic acid, melatonin, CoQ Q10 Polycystic ovarian syndrome (PCOS): PCOS is one of the most common endocrine diseases impacting women of reproductive age. It is characterized by having excessive androgen (male sex hormones) levels, missing or delayed periods, and/or cystic ovaries, which can lead to menstrual dysfunction or infertility. For PCOS, Ruth says, “Supplements that help to stabilize hormone levels, lower insulin resistance, and thus improve ovulation regularity could be considered.” Potentially beneficial supplements: inositol, n-acetylcysteine (NAC), vitamin D Irregular or missing periods: There can be many reasons why women experience irregular periods, but two of the most common conditions are PCOS and functional hypothalamic amenorrhea (FHA). Supplementation may be beneficial for FHA, but ultimately eating enough, reducing physical activity, and managing stress help address underlying root issues. Potentially beneficial supplements: folate, berberine, adaptogens such as rhodiola Advanced maternal age: The ability to produce eggs starts to decline at age 35, so those seeking a pregnancy after this time might benefit from supplements that boost egg production, quality or to support IVF. Godfrey says, “CoQ10 is one supplement that may be extra beneficial for someone who is 35 years of age or older. Although our body makes CoQ10 (and it occurs naturally in most cells in the body), the ability to make it as well as the absorption declines with age. Adequate CoQ10 may be linked to egg quality.” Potentially beneficial supplements: CoQ10, DHEA Those undergoing in vitro fertilization (IVF): During IVF, the goal is to have a high quality embryo and then a successful implantation of that embryo. Certain supplements may help with egg/embryo quality, and others will help boost the quality of the uterine lining by improving existing blood flow, dilating blood vessels to deliver key nutrients, or promoting the growth of new blood vessels to nourish the initial growth of the embryo. Potentially beneficial supplements: folate, vitamin E, L-arginine Male factor infertility: If male infertility is suspected, the first step is usually a semen analysis. Lauren Manaker, MS, RDN, LDN, CLEC, CPT and author of Fueling Male Fertility says, “Some data suggests that taking certain supplements may support male fertility by increasing sperm motility, morphology, count, and/or reducing DNA damage. Among the data, I find the strongest evidence leans toward taking omega-3 fatty acid supplements. These healthy fats are primarily found in oily coldwater fish. But since most Americans are not eating the recommended amount of this food type, taking a supplement can help fill gaps and allow a man to reap the benefits.” She also notes, “Some data suggests that antioxidant supplementation may offer some benefit, although more data is needed.” Potentially beneficial supplements: omega-3 fatty acids, selenium, CoQ10, carnitine
Fertility Supplements To Be Cautious About
Every woman and man looking to support his or her fertility has unique needs, so catch-all “fertility supplements’’ should be approached with caution as they may not be supporting your root cause. Ruth says that for PCOS specifically, “[PCOS] looks different on everyone, so I find money spent on fancy expensive blends that claim to help ALL women with PCOS’s hormones can usually be better spent elsewhere.” Fertility supplements are similar to any other class of supplements in that they are not regulated by the FDA and so may not contain the actual ingredients listed on the label, or in the amounts advertised. Always speak with your healthcare provider about taking any supplements if you are thinking about or trying to conceive.
How We Select Supplements
Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here. We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products. We prioritize products that are third-party tested and certified by one of three independent, third party certifiers: USP, NSF, or ConsumerLab.com. It’s important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. (include this citation link) Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.
What to Look For
Third-Party Testing
Supplements that are third-party tested are sent to a lab where they are tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it’s important to note:
Form
Fertility supplements, which can be vitamins, minerals, herbs, or other nutrient compounds, can be found in pill, gummy, powder, or liquid form. Supplements that contain multiple ingredients or “bulky” nutrients are less likely to come in easier to tolerate gummy or liquid forms, so this is something to consider when shopping.
Ingredients & Potential Interactions
It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included, relative to the recommended daily value of that ingredient. Please bring the supplement label to a healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking. Some fertility supplements may contain nutrients that interact with medications, or compete for absorption with other nutrients, so it’s wise to review these products with a healthcare provider before taking. You may also find other herbs, probiotics, raw food ingredients, and sugars added into fertility supplements, which may be concerning for certain health conditions you may have. Always speak with your healthcare provider to discuss potentially taking any of these products.
Fertility Supplements Dosages
Research is ongoing for how dietary supplements impact fertility and the recommended doses of each nutrient. There are few evidence-based recommendations for the dosages of these products. For some vitamins, like vitamin D and folate, fertility specialists will often suggest doses that go above the recommended dietary allowance (RDA), but no official recommendations have been set. If you have a question about the best recommended dose you should take of a fertility supplement, consult a healthcare professional.
How Much is Too Much?
You may notice when looking at fertility supplements that the amounts for some nutrients are often exceptionally higher than the percent Daily Value (DV). More research is needed to say at what levels many of these supplements are safe or provide benefit, so always discuss these products with a healthcare provider before taking them. It’s also important to consider if you have a true deficiency of a nutrient (this can be verified by obtaining blood work), if you have absorption issues, or other medical conditions. If you have one (or more) of these, that will play a role in determining what is an appropriate amount of a nutrient to take.
Why Trust Verywell Family
Casey Seiden is a registered dietitian nutritionist and certified diabetes care and education specialist based out of New York City. Casey works at Maternal Fetal Medicine Associates, the premier maternal fetal medicine practice in Manhattan, where she provides nutrition therapy and counseling to women with high risk pregnancies. She is also the founder of Casey Seiden Nutrition, a virtual private practice specializing in a non-diet approach to diabetes care and women’s health. Pursuing fertility treatments may mean that you have a condition like PCOS or endometriosis, or you are of advanced maternal age and conceiving naturally may not be possible. A woman may take supplements that support fertility with these conditions while undergoing treatments, but these supplements do not guarantee a pregnancy or a twin pregnancy for that matter. In the end, there is not strong evidence to suggest specific supplements aid in conceiving spontaneous twins or twins through reproductive technology. Keep in mind herb supplements can vary in purity of ingredients, contamination, and potency. Always look for third-party tested supplements and consult a healthcare professional before taking herbs.
