Supplement

Decoding The Fertility Diet, Part 4: Is Your Prenatal Vitamin Helping Your Fertility?

July 8, 2025 by William Haas 2 Comments

If you’re trying to conceive, you should take a prenatal multivitamin – no surprise there.

But, is your multivitamin helping your fertility or just preventing birth defects of your future child?

It all comes down to the components inside as well as their dose…

And you might be surprised to learn that only a few of the components in your standard prenatal vitamin play a role in boosting your fertility even though they are all essential for pregnancy.

Here’s a quick overview of what you’ll learn in this post:

Why you should be taking a prenatal multivitamin
The b-vitamin you might need more of when trying to conceive
A mighty mineral and its surprising source
The benefits your man can get from a multivitamin too

As you’ve learned in the first 3 parts of the Decoding the Fertility Diet series, avoiding certain foods and consuming others has been scientifically shown to boost fertility and increase your chances of getting pregnant.

Before getting too far into this post, we want to remind you to ALWAYS get as many of your nutrients from a whole-foods, plant-based diet as possible.

Students of our Fertility Foods Formula know exactly what we mean when we say ‘plant-based’, and it’s not a full-on vegan or vegetarian diet or just tossing out the junk food.

We also want you to know that there are many micronutrients and supplements to consider when trying to conceive. And for the purposes of this article, we’re going to focus only on those found in a standard prenatal multivitamin.

Don’t worry, we’ll present a more comprehensive review of other fertility supplements in future posts.

Making the case for multivitamins

The argument has often been made that at the very least we should be taking a daily multivitamin to ensure that we’re getting every nutrient that we need and to fill in any nutritional gaps from our diet.

The real question to ask is not whether your multivitamin fills in any nutritional gaps, but whether it helps prevent disease or improves your health in some way.

When we look at taking a multivitamin for general health and disease prevention, the evidence is actually somewhat unclear… it might help, but then again it might not. It’s actually a fairly controversial topic.

However, when we turn our attention to pregnancy and preventing birth defects, the evidence is quite clear – multivitamins containing folic acid are a MUST when trying to conceive.

Multivitamins containing folic acid generated a lot of attention when they were first found to dramatically reduce the chances of birth defects related to a developing baby’s brain and spinal cord (i.e., neural tube defects).

As the infographic below reveals, there’s a lot of other micronutrients beyond folic acid in your standard prenatal multivitamin. Each and every single one of these are important to help prepare for and thrive during pregnancy.

But the important question still remains… which of these components matter most when trying to increase your chances of getting pregnant?

The b-vitamin you might need more of when trying to conceive

As you may have guessed, folic acid is the b-vitamin you need to be consuming more of when trying to conceive.

In 1998, the FDA actually required food companies to add folic acid into grain products because the average American woman at the time only consumed 250 mcg of folate per day – 350 mcg below the recommended daily amount in pregnancy.

When the book The Fertility Diet by Dr. Jorge Chavarro and Dr. Walter Willett was first published back in 2009, the recommendation for women trying to conceive was to get at least 400 mcg of folic acid a day. Since that time, additional research has suggested that higher amounts of folic acid may be beneficial, especially in women trying to conceive.

As we will discuss in another post dedicated exclusively to folic acid, 800-1200 mcg of folic acid per day has been shown to be a better target when trying to optimize your efforts to conceive.

Let’s take a quick look at folate and folic acid right now…

When looking at dietary intake, women with the highest consumption of naturally occurring folate were found to have a 64% lower odds of anovulation while trying to conceive compared to women who consumed the least amounts. Similar positive findings for increased dietary folate intake have also been seen among women undergoing IVF – 57% higher live birth rates in fact.

Turning our attention to supplemental folate (folic acid), additional fertility benefits have been seen. Data from the Nurses’ Health Study II showed that women who took a multivitamin with folic acid were noted to have a 35% lower risk of ovulatory infertility compared to women who didn’t take a supplemental multivitamin (note the greatest benefit was seen with daily use).

Data from the Nurses’ Health Study II also revealed that higher folic acid intake from supplements was associated with a significantly lower risk of miscarriage and had an inverse association with stillbirth when compared to lower doses. Similarly, data from Brigham and Women’s Hospital supports this too. Women supplementing with higher folic acid (800 mcg to 1200 mcg) prior to IVF and embryo transfer experienced higher fertilization rates, lower cycle failure rates, and higher live birth rates.

So check your multivitamin bottle and make sure it has at least 800-1200 mcg of folic acid.

And of course, always discuss your decision to add or change a supplement with your physician! Based upon your personal and family history you may require more or less folic acid.

A mighty mineral and its surprising source

Oftentimes we get so focused on vitamins that we overlook the importance of minerals in our bodies…this is especially true when it comes to trying to conceive.

Iron, a powerhouse mineral that’s responsible for carrying oxygen from the lungs to the rest of the body, has been associated with a decreased risk of ovulatory infertility.

It shouldn’t come as a big surprise given that iron also plays an important role in the synthesis of DNA (the molecule that contains your genetic code) and ATP (our body’s most important energy molecule).

Usually, we only get concerned when iron levels drop to the point of creating a decrease in hemoglobin levels, a condition referred to as iron deficiency anemia.

Some studies have suggested that maternal iron deficiency anemia has been associated with reduced fetal brain maturation, pediatric cognitive defects, and maternal depression, outcomes we know everyone in the OvulifeMD community would like to avoid. However, these studies are limited by a lack of control for socioeconomic factors as well as other pre-existing chronic diseases that are likely to play a large part in these outcomes as well.

To complicate matters, up to 1 in 7 women will have below-normal iron levels without notable anemia. Generally this is not regarded as a problem, unless of course you’re working hard at trying to conceive.

Again, findings from the Nurses’ Health Study showed that women who consumed iron supplements had a 40% lower risk of ovulatory infertility compared with women who did not consume iron supplements.

The benefit was noted at a daily dose between 40 – 80 mg, significantly below the amount found in most prenatal multivitamin as well as the FDA’s recommended daily intake during pregnancy (keep in mind gummy vitamins typically don’t contain iron at all). Interestingly, women who got most of their iron from meat weren’t protected at all against ovulatory infertility, a topic we explore closely in the Fertility Foods Formula and our post on protein.

So just as you did with folic acid, look closely at your multivitamin label and discuss with your physician whether or not you’re getting enough iron.

It’s important not to get too much iron as excess amounts can disrupt the health of your liver (an important detoxification organ), so we can’t understate the importance of talking with your doctor.

The benefits your man can get from a multivitamin too

Let’s be real for a moment, most men (up to 80% in fact) don’t get their recommended servings of fruits and vegetables in a given day.

Heck, they might not even get their daily allotment throughout the course of an entire week (unless they love brussel sprouts as much as Dr. Haas). This can lead to significant vitamin and mineral shortages that affect sperm health.

Unfortunately, the research on supplementation for male fertility is not as robust as it is for women’s fertility. Yet despite this fact, you’ll encounter many websites claiming that the antioxidant components of a standard men’s multivitamin have been shown to be beneficial for sperm health. For instance:

However, the studies we’ve seen referenced to support these statements are generally limited by their research design (e.g., small number of participants). Well designed studies are especially important when making claims about sperm health given that the typical semen analysis varies by as much as 400%. Additionally, some of the nutrients referenced are sourced from dietary intake, not supplement form.

When looking at a recent Cochrane Review on this topic, the evidence evaluated from 61 randomized controlled trials was considered low-quality for the use of antioxidant supplements to enhance male fertility. In fact, the authors of the paper go onto state that “subfertile couples should be advised that overall, the evidence [for antioxidant supplementation among men] is inconclusive.”

Given the limitations of the current evidence, we agree with the Cochrane review in saying that more evidence is needed to make definitive recommendations or to justify the cost of specific antioxidant supplements for men who are trying to conceive with their partner. It is important to note that this study does not advise men against taking a broad-spectrum multivitamin for general health purposes.

Bottom line recommendation – if your man is opting to supplement too, have him stick with a basic multivitamin that contains appropriate doses of folic acid while being careful to avoid ‘proprietary’ fertility supplements that are unlikely to help and may be harmful.

Make sure he’s also taking one designed for men and not one of yours! Men should not take extra iron without appropriate medical evaluation, especially if they’re not a risk for iron deficiency.

Of course, the best advice is to always check with a knowledgeable healthcare provider before taking any form of supplement.

Final Thoughts

There are SO many special “fertility boosting supplements” and prenatal vitamin options out there that it can be hard to delineate fact from fiction.

As we mentioned above, we’ll be doing an entire separate blog post of supplements at a later date to review the EVIDENCE and help you decide what actually matters to you.

However, when it comes to choosing “the right” prenatal vitamin to optimize your fertility while trying to conceive. Look for those with around 800-1200 mcg folic acid and 40-80 mg of supplemental iron, which you now know have been associated with:

Decreased risk of ovulatory infertility
Decreased risk of miscarriage
Higher probability of live birth following IVF

Another post down in the Decoding the Fertility Diet mini-series.

Folic Acid for Fertility: How Much Folic Acid is Enough?

July 8, 2025 by William Haas 1 Comment

Almost every woman knows that folic acid is one of the MOST important vitamins for pregnancy.

But what about when you’re trying to conceive?

What’s often missed is that the standard folic acid dose recommended for pregnancy may NOT
be enough if you’re trying to boost your fertility potential.

Let’s take a closer look at folic acid as it relates to your reproductive health.

Here’s a quick overview of what you’ll discover:

Folic Acid vs. Folate
The Importance of Folate in Your Body
Folic Acid for Female Fertility
Folic Acid for Male Fertility
Getting Enough Folic Acid to Conceive
Foods Rich in Folate
Risks of Supplementation
MTHFR and Folic Acid

Folic Acid vs. Folate – A Subtle Yet Important Difference

If you find yourself asking what’s the difference between folic acid and folate, or perhaps you didn’t even realize there was a difference, you’re not alone. Many medical professionals mix up the terms or use them interchangeably. So, you’re not the only one that gets it confused.

To keep things simple (we’re big believers in keeping it simple around here), folic acid is the synthetic form (i.e., man-made version), while folate is found naturally in foods. You may also see both of these names referred to as vitamin B9, one of the many B vitamins in the body.

So, if folate is naturally found in the food we eat, why do we have a synthetic version, and why are we consuming so much of it?

That’s because more than 20 years ago (in 1998 to be exact) the FDA mandated that folic acid be added to processed grain products (i.e., bread, pasta, rice, and cereal).

This was deemed necessary due to overwhelming evidence that folic acid supplementation before and during early pregnancy could protect against neural tube defects (NTDs). Neural tube defects are issues with spinal cord development (e.g., spina bifida) and brain development (e.g., anencephaly) that occur during an early period of growth in the womb.

We know it goes without saying, but this is a big deal!

In fact, according to the Centers for Disease Control and Prevention (CDC), at least half of the 300,000 cases of neural tube defects around the world each year can be prevented by taking folic acid.

The Importance of Folate in Your Body

Aside from protecting against neural tube defects, folic acid, or folate for that matter, is essential for the synthesis of DNA, production of new cells in the body (e.g., red blood cells), and the support of proper brain and immune function.

Folic acid also works with vitamins B6 and B12 to control blood levels of the amino acid homocysteine. High levels of homocysteine are associated with heart disease and as well as recurrent pregnancy loss. But alas, we digress… back to folic acid and fertility.

Folic Acid For Female Fertility

Now that you understand the difference between folic acid and folate as well as the reason they get lots of attention around pregnancy, let’s look at an often overlooked benefit of folic acid – increased fertility.

The EARTH (Environment and Reproductive Health) study, conducted at Harvard Medical School, was one of the initial studies to report an association between higher blood folate levels and an increased chance for live birth, specifically among women undergoing assisted reproductive treatments.

In case you’re curious about the details, the researchers found a 62% greater probability of live birth among women with the highest levels of folate in their bodies (>26.3 ng/mL) compared to the women with the lowest levels of folate (<16.6 ng/mL).

And as you’ve just learned, folate occurs naturally in foods, thereby raising an important question… “what happens when you supplement with folic acid?”

Two different studies, one based out of Harvard and another out of the University of Buffalo, have both shown that supplemental folic acid taken before pregnancy is associated with a lower risk of ovulatory infertility and a shorter time to pregnancy. Awesome news if you’re struggling to conceive as anovulation is one of the most common causes of infertility.

What if you’re already undergoing infertility treatment? Well, some research indicates that women who take folic acid supplements before IVF treatment have been found to have a higher proportion of mature eggs as well as eggs of higher-quality.

Folic Acid For Male Fertility and Sperm Health

Now before we move on to our action items for this post, let’s take a look at folic acid and the male-factor. And yes, while we’re confident you know who runs the world (sing it Beyonce), Dr. Haas wants to make sure that men are doing their part too.

In a study published in the journal Human Reproduction, it was found that men who consume high levels of folic acid through their diet (over 700 mcg/day) reduced their risk of sperm aneuploidy (abnormalities of genetic material) by up to 30 percent. This means a lower chance of problems that can lead to miscarriages or birth defects.

Switching over to the supplementation side of things, researchers in the Netherlands have demonstrated that men who took a combination of 5mg of folic acid and 66mg of zinc, increased total sperm count by 74 percent.

Keep in mind that this was a very high dose of folate compared to the recommended daily intake of 400 mcg (and zinc was also included). So make sure that your man talks with his healthcare provider before supplementing with such a high dose. Don’t forget to ask about the need for supplemental copper if using a supplement with zinc in it!

Getting Enough Folic Acid to Conceive

As you’ve just read, one of the few studies on folic acid supplementation in men used an exceptionally high dose for optimizing fertility parameters. Studies on supplemental folic acid among women trying to conceive, on the other hand, have used much more moderate doses, with positive results noted around 800 micrograms per day.

In fact, women taking 800 mcg of supplemental folic acid daily – instead of the standard 400 mcg found in most prenatal vitamins – have shown significantly better fertility outcomes, including higher implantation rates, higher clinical pregnancy rates, and a 20% higher probability of live birth.

And among women undergoing fertility treatment with in-vitro fertilization (IVF), higher folic acid supplementation has been associated with higher fertilization rates and lower cycle failure rates prior to embryo transfer.

Another quick, yet super-relevant fact about taking folic acid… it’s a water-soluble vitamin, which means it must be regularly replenished in the body. To get the most benefit from this vitamin, make sure to take your supplement daily.

For your reference, we’ve listed the recommended daily intake of folic acid beyond fertility optimization below:

600 mcg for pregnant women
500 mcg for breastfeeding women
400 mcg for men and women 14 years and older

Recommend Daily Intake of Folic Acud for Women infographic

Caution When Supplementing With Folic Acid Supplements

Anytime you’re thinking about taking a dietary supplement, treat it with the same respect as using a prescription medication – there are always potential adverse effects if used incorrectly.

As a general word of caution, you should NOT take more than 1,000 mcg of folic acid per day across all your supplements without first discussing it with your doctor.

Large doses of folic acid may mask a vitamin B12 deficiency, which can cause irreversible nerve damage. It’s a good idea to have your doctor test your B12 levels if you need to start a high dose of folic acid.

Unless you have a family history of neural tube defects or take certain medications, you will not generally be instructed to take high-dose folic acid, so this shouldn’t be an issue for most women.

You should also know that folic acid can interact with other medications, most commonly anti-seizure medications (e.g., phenytoin) as well as methotrexate (an immunotherapy agent). And although folic acid does not typically interact with fertility medications, some supplement combinations with folic acid in them contain other herbs that can affect these medications.

So, at the risk of sounding like a broken record, always make sure to talk with your doctor before starting any supplement, including a multivitamin. And don’t forget to source your supplement from a trusted source.

How to Get Folate in Your Diet

If you’re looking to get in some extra folic acid beyond supplement form, there are plenty of foods rich in this vitamin.

As mentioned at the beginning of this article, most bread and cereals in the United States are fortified with folic acid. That means you’re likely getting some amount of folic acid into your body if you eat those sorts of foods.

For those of you who have joined us inside Nourish Your Fertility, you know why we don’t recommend consuming these sorts of foods and how they can harm your reproductive health. So, instead of relying on folic acid in processed foods, try incorporating some of these items into your everyday healthy diet:

Need a little more direction? Consider one of these simple substitutions to boost your folate:

Use leafy greens like spinach instead of iceberg lettuce in your wraps
Sprinkle chickpeas on your salad in place of bacon or eggs
Spread mashed avocado on your toast instead of butter
Add lentils to your stew in place of beef or chicken

MTHFR and Folic Acid

Some of you might be familiar with MTHFR and others are probably wondering what foreign language we’re speaking. A detailed synopsis regarding the enzyme methylenetetrahydrofolate reductase (MTHFR) is a bit beyond the scope of this post, but it’s one of the important topics to mention as you’ll see it talked about if you spend enough time searching the internet.

In short, it’s been suggested that some people may not gain benefits from folate or folic acid due to a genetic issue. More specifically, due to mutations in the genes that code for MTHFR. When the MTHFR enzyme is not working optimally, folic acid is unable to be converted into its biologically active form.

We’ve come across some buzz surrounding the use of pre-activated folic acid (5-methyltetrahydrofolate or 5-MTHF) for women struggling to get pregnant.

This has centered largely around a small, case-series publication. For those of you familiar with statistics (a source of excitement for Dr. Eskew and a source of pain for Dr. Haas), you’ll recognize that it’s not the best type of study from which to make bold statements.

Moreover, other research suggests that high folic acid intake and MTHFR gene variations seem not to be associated with helping women to achieve pregnancy during or after fertility treatment.

With that said, we believe there might be something more to the story of using 5-MTHF as another well-designed study found a strong association between an MTHFR gene mutation and recurrent pregnancy loss.

All-in-all there’s much to learn about the use of 5-MTHF among women struggling to conceive before we feel comfortable suggesting you should replace it with conventional folic acid.

Final Thoughts

Folic acid is an important vitamin for both men and women, especially when trying to conceive. Beyond protecting against the risk for certain birth defects, folic acid can optimize many aspects of your fertility and help your body prepare for a healthy pregnancy.

Remember that folic acid and folate are not the exact same type of b-vitamins, and despite the need for folic acid supplementation, there are many healthy food sources of folate.

Disclaimer alert… always talk to your doctor before beginning any supplement, and make sure they understand the potential risks and benefits of their use. The goal is to optimize your fertility as well as your overall health, not put it in harm’s way.

How to Choose the Best Supplements for Your Fertility

July 7, 2025 by Olha Hutsman Leave a Comment

If you’re planning to become pregnant, then you already know that you need to take a daily prenatal vitamin that contains key nutrients like folic acid to support a healthy pregnancy.

But how do you know which fertility supplements are a good choice…

And which ones are just junk?

Before you head to the vitamin shop or read endless reviews on Amazon, it’s important to make sure that the pills you are popping check a few key boxes. So, keep reading to discover some of our top tips when perusing the supplement aisle at your local wellness store.

Here’s a quick overview of what you’ll discover:

Importance of Third-Party Testing
Check the Label for Fillers
Choose Absorbable Forms of Nutrients
Review the Appropriate Dosing
Double Check Your Prenatal Vitamins
Review Your Medications Before Supplementing
Avoid Products With Bold Pregnancy Claims
Revisit Your Supplements If You Get Pregnant

Make Sure Your Fertility Supplements Are Third-Party Tested

We know it goes without saying, but quality is crucial when choosing fertility supplements.

The United States Food and Drug Administration (FDA) does not routinely evaluate whether supplements are safe, effective, or meet their label claim before they make it to the shelf. They do, however, require supplement manufacturers to adhere to Current Good Manufacturing Practices (CGMP). These are intended to ensure quality and safety. However, compliance is not always enforced. So, we must do our part to ensure what we choose comes from a trusted source.

Finding a company that is third-party tested ensures accurate labeling, packaging, holding, and manufacturing processes. This is to prevent contamination and impurities from being in the final product. Third-party testing is not required and companies that do so, do so voluntarily.

Third-Party testing companies that you may see on the side of some supplement bottles include the National Science Foundation (NSF) and the United States Pharmacopeia (USP). Some great tools to personally check your own fertility supplements include LabDoor and Consumer Labs.

Remember That The Best Pills Contain Nutrients, Not Fillers

The term “other ingredients” used on supplement labels is a nebulous term that can mean a lot of things – some safe, and some not-so-great. “Other ingredients” can mean ingredients like fillers, binders, or bulking agents that were added and provide no nutritional value.

Filler ingredients are often easy to spot. Seeing ingredients like magnesium stearate, propylene glycol, vegetable gum, starch, and silicon dioxide are all fillers and are not doing much for you in the nutrition department.

Bottom line, stay away from supplements that choose to use fillers and choose to purchase from brands that are committed to pure, high-quality ingredients.

Ensure You Are Choosing Absorbable Nutrients

Vitamins, minerals, and antioxidants come in various forms. Some are better absorbed by the human body than others. Unfortunately, the less-absorbable forms are often cheaper to use.

When you’re investing in a new supplement – like a daily prenatal multivitamin – it is worthwhile to make sure that you get the ideal form of certain nutrients to get the most bang for your buck (and up the chances that it’ll help you get pregnant and have a healthy pregnancy too!).

Coenzyme q10 / CoQ10

CoQ10 is an antioxidant that helps reduce free radicals in both men and women alike. It’s particularly popular among women facing fertility treatments (e.g., IVF), especially those with polycystic ovary syndrome (PCOS) and diminished ovarian reserve (DOR).

The biologically active form of CoQ10 is ubiquinol. It’s believed to have better absorption than ubiquinone, the typical form found in most fertility supplements. As a result, dosing with ubiquinol is usually less than ubiquinone.

Vitamin D

Better known for its role in supporting bone health, vitamin D has also been shown to have an important role in regulating reproductive health too. And even though we can make vitamin D from sunlight exposure, it’s a vitamin we typically don’t have adequate levels. Thus, it’s best to choose a form that’s easily absorbed. Most physicians recommend taking vitamin D3 (cholecalciferol) instead of D2 when possible.

Magnesium

We often see magnesium oxide added to fertility vitamins. However, it is not as well absorbed as other forms. Instead, choose a source containing magnesium citrate or magnesium glycinate.

Folic Acid

When we take folic acid (vitamin B-9), our body needs to convert it into the active form known as methylfolate. Activation occurs with the help of an enzyme known as methylenetetrahydrofolate reductase (MTHFR). Some women have mutations in their MTHFR gene making this activation step difficult.

Given all the buzz around MTHFR, many women struggling with infertility will simply choose to take “activated folate”. However, as we discuss in our post all about folic acid, the routine use of methylated folate is somewhat controversial. If you have concerns about which form of folic acid you should take, it’s best to ask your doctor if you should get tested.

Iron

Iron comes in many different forms. Ferrous salts are the best-absorbed iron supplements and they are often considered the standard compared with other iron salts. Look for fertility supplements containing:

Ferrous fumarate
Ferrous sulfate
Ferrous gluconate

As we’ve mentioned before, calcium can interfere with the absorption of iron, while vitamin C can promote absorption.

Before taking an iron supplement, you should find out if you’re iron deficient, which can be determined via a simple blood test at your doctor’s office. Too much iron may cause liver disease, abdominal pain, joint pain, heart attack, and an increased risk for diabetes.

Bottom line, make sure to get tested!

Make Sure The Dose Is Appropriate For You (And Your Fertility)

The “more is better” approach isn’t always the case when it comes to nutrient supplementation for female fertility (or male fertility for that matter!). In fact, you can get into serious trouble if you are overdoing it in some cases.

Conversely, many over-the-counter supplements contain popular nutrients, but they are often at insufficient levels to offer any significant benefit. This is often the case with the folic acid and iron in your daily prenatal vitamin.

Pay attention to nutrient doses when selecting your supplement, and don’t be afraid to ask your healthcare provider for guidance.

When in doubt, test!

In some cases, it might be a good idea to get your vitamin levels checked. Vitamin D and iron are two potential nutrients worth testing. Women with heavy menstrual cycles are often at risk of being iron deficient. And as you already know, the more time we spend indoors, the greater the risk for vitamin D deficiency.

Double Check Your Prenatal Vitamins

Just a friendly reminder to track the total dose across ALL your supplements, including your daily prenatal vitamin.

Combining your prenatal vitamin with other supplements can give you WAY too high of a dose of certain nutrients. Again, more is not always better.

Note that certain nutrients may be “healthy” for general health, but come with some risk if taken in too high of an amount during pregnancy. For example, high doses of preformed vitamin A (not beta carotene forms like retinyl palmitate) can be harmful to a developing fetus.

Review Your Medications Before Supplementing

It is important to check with your medical provider before adding supplements to your daily routine. Not only should you share which supplement you are interested in taking with your doctor, but you should also ask if there are potential interactions.

For example, calcium supplements may reduce your absorption of iron. Alternatively, vitamin E may increase the risk of bleeding if one is on blood-thinning medications.

Avoid Products With Bold Pregnancy Claims

There’s no magic bullet to getting pregnant and giving birth to a healthy baby. Any promises that you see on a label should be taken with a grain of salt. And even though the FDA requires health claims to be medically reviewed by scientific evidence, this requirement is commonly ignored.

Revisit Your Supplements If You Get Pregnant

Just a reminder that not all supplements have been studied and are safe in pregnancy. If you were taking certain supplements while trying to conceive, you should review them with your doctor once you get pregnant. It’s critical to make sure that you’re not causing any potential harm to yourself (or your future baby) by popping an extra pill or two.

Infographic with tips for choosing fertility supplements

Final Thoughts

Choosing the right dietary supplements goes beyond simply making sure that the pill you are popping contains the nutrients you are hoping for. Ensuring that the supplement you use is third party tested, contains optimal ingredients, and is safe without adverse side effects is just as important as paying attention to nutrients.

Are Antioxidants Important For Male Fertility?

June 30, 2025 by William Haas Leave a Comment

We know it goes without saying that it takes two to make a baby.

And when it comes to the man’s role in the process there are so many things that go overlooked.

One topic that does seem to get a fair amount of attention (and is somewhat debated) is the question of whether or not antioxidants improve male fertility.

It would be great if you could tell the man (or sperm donor) in your life to take a few extra antioxidants and call it a day.

But is it really that simple?

Here’s a quick overview of what you’ll discover:

Male fertility and sperm health
How oxidative stress effects sperm
Addressing the factors causing oxidative stress
Which antioxidants to take for sperm health

Male fertility and sperm health

When it comes to fertility issues among men, defective sperm function has been identified as one of the most common causes.

In fact, ‘male factor’ is generally seen as an alteration in sperm concentration, sperm motility, and/or sperm morphology (i.e., shape). And technically, abnormalities must be noted in at least one of two sperm analyses, typically collected 4 weeks apart.

Quick fact… oligozoospermia – a medical condition characterized by low sperm count and quality – is responsible for 90% of male-factor infertility. Obviously, this topic is obviously a big deal!

How oxidative stress effects sperm

Issues identified in sperm dysfunction and male factor infertility are primarily environmental, physiologic, and genetic factors. Both environmental and physiologic factors are big contributors to oxidative stress and damage to sperm health.

But what exactly is oxidative stress?

Oxidative stress is the effect on the body resulting from oxygen species that break down and become reactive, aptly known as reactive oxygen species (ROS). The accumulation of ROS can occur when our bodies are depleted of antioxidants (more on that in a moment…)

It’s important to note that sperm cells do require some degrees of oxidative stress to achieve optimal fertilizing capacity, especially for the process referred to as hyperactivation.

However, too much oxidative stress can easily become a problem for sperm due to the chemical makeup of its structure.

Sperm contains a large amount of polyunsaturated fatty acids which make them prone to oxidation. If too much oxidative damage happens, then pre-programmed cell death (apoptosis) is activated which can contribute to fertility issues.

Quick fact… studies have shown that between 30-80% of men with fertility problems have elevated levels of oxidative stress.

Addressing the factors causing oxidative stress

As mentioned previously, both environmental and lifestyle factors can be big contributors to oxidative stress.

Here are some important factors that can put a strain on the body’s natural antioxidant defense system and actions the man in your life can take to lessen and prevent oxidative stress:

Sources of oxidative stress affecting male fertility when considering antioxidants.

Alcohol and tobacco use:

Alcohol and cigarette smoke can cause oxidative stress directly by generating large amounts of free radicals and indirectly by reducing circulating antioxidant levels in the body.

Recommended action: We won’t get on a soap-box here… just don’t let these two factors go unaddressed! No amount of exercise, sleep, and healthy food will undo the damage done from these toxins. We recommend quitting smoking everything completely (marijuana, cigarettes, cigars, vaping, etc.) and limiting alcohol intake to no more than 6 servings per week.

Circadian rhythm dysregulation:

Sleep is a commonly overlooked cause of oxidative stress. In fact, many of our antioxidant enzymes follow a tightly timed rhythm within our bodies. When our natural circadian rhythm is disrupted by sleep deprivation, levels of oxidative stress have been shown to increase.

Recently, blue-light exposure has gotten a lot of attention for disrupting circadian rhythms, but extremely low-frequency electromagnetic fields (ELF-EMF) from electronics (e.g., cell phones) have also shown to have the same effect along with a direct link to oxidative stress.

Recommended action: Aim for a regular sleep schedule, avoid blue light at night, remove electronics from your nightstand, and get plenty of sunlight during the day.

Environmental toxins:

We’ve covered the topic of environmental toxins in-depth in a prior mini-series, but it’s important to remember that exposure to chemicals and pollutants can be a major contributor to oxidative stress.

Things like pesticides and heavy metals are some of the biggest culprits, but increasing evidence suggests that plastics can have an impact too (that’s another strike against BPA).

Recommended action: Swap out plastic for glass containers whenever possible, shop for groceries according to the Dirty-Dozen, wash your produce thoroughly, and filter your drinking water.

Psychological stress:

Recurrent or ongoing psychological stress doesn’t just impact our quality of life, it also promotes oxidative damage through sustained activation of our hypothalamic-pituitary-adrenal (HPA) axis.

Recommended action: Meditation and yoga often come to mind but don’t feel like you need to sit around in uncomfortable positions while forcing positive thoughts into your subconscious.

Stress reduction can take many forms (e.g., breathing, walks in nature, journaling). What matters most is not the form, but carving out regular time to recenter yourself.

Pro-inflammatory diet:

Consumption of processed foods, especially those made with industrial vegetable oils that are high in omega-6 fatty acids, introduce free radicals into our bodies.

Once consumed, these oxidized polyunsaturated fatty acids can trigger an inflammatory reaction that impairs the very cells meant to protect us from oxidative damage in the first place. They can also oxidize vitamins (A, C, and E) that serve as natural antioxidants.

Recommended action: Steer clear of processed and pre-packed foods, especially those containing canola, soybean, sunflower, peanut, or grapeseed oils – these are pro-inflammatory fats. Of course, this same advice is true for any food that is heavily fried in oil or fat for
that matter 🙁

Loading up on fruits and vegetables rich in different colors is the absolute best way to supply your body with the natural antioxidants it needs to combat oxidative stress. Adding anti-inflammatory fats from wild-caught seafood and nuts is also a great choice.

Physical inactivity:

Skipping out on regular physical activity can increase levels of oxidative stress. There are so many reasons to get those 10,000 steps in a day… reducing oxidative stress is one more!

Recommended action: Aim for 30 or more minutes of exercise four to five days a week. And don’t forget the power of intermittent physical activity throughout the workday including midday walks and standing up for 10 minutes every hour.

When to consider antioxidants for male fertility

Several studies have evaluated the ability of antioxidants to improve semen parameters and fertility outcomes. However, it’s somewhat challenging to make definitive recommendations on who is most likely to benefit given the wide range of treatment regimens as well as the inherent differences among the men in all of the studies performed thus far.

As a result, clinicians typically fall into one of four camps when deciding whether or not to recommend antioxidant supplements:

So where does that leave you and your male counterpart?

As mentioned, there is no clear-cut, single best strategy based on current evidence when it comes to choosing when to ‘prescribe’ antioxidants. Specialized testing of sperm for oxidative stress is not routinely performed and there are some concerns that taking too many antioxidants can potentially lead to decreased fertility and other potential health issues.

So from a practical standpoint, many integrative medicine specialists consider recommending antioxidants for men who have certain risk factors for increased risk of oxidative stress such as those discussed earlier in this post.

Choosing the right antioxidants for sperm health

If you’ve spent any amount of time searching the internet, you probably already know that there are a wide variety of antioxidant supplements available with many sensational claims about “boosting male fertility today.”

Unfortunately, according to a study published in Urology, only 22% of the ingredients commonly included in male fertility supplements have published data relating to semen parameters and pregnancy outcomes.

Furthermore, amongst the numerous studies evaluating supplements for male fertility, there’s a wide range of the type of antioxidant supplement being given along with wide variability in outcome measures. And it’s important to note that changes in sperm parameters don’t always result in changes in pregnancy rates.

With that said, the authors of that same study published in Urology highlighted the ingredients with the most evidence, three of which are known to be potent antioxidants:

And in case you’re curious, zinc and L-carnitine made the list, but they are not traditionally classified as antioxidants.

Of course, you should know that not all studies have found antioxidants to be beneficial, including the Males, Antioxidants, and Infertility (MOXI) trial, which found that antioxidants do not improve semen parameters or DNA integrity among men with male factor infertility.

On the other hand, the most recent Cochrane review does indicate that there may be some evidence to suggest antioxidant usage among men can improve both pregnancy rates and live birth rates, albeit the level of evidence was classified as low (due to small sample size and variability amongst the intervention and outcomes being compared) and the specific antioxidant(s) of potential impact is not clear.

But then again, perhaps researchers simply haven’t found the right dose or combination of treatment yet.

Final Thoughts

After reviewing this topic, the important thing to focus on seems to be less about whether antioxidants are important for male fertility, but how one goes about reducing oxidative stress.

Oxidative stress is a clear factor contributing to male infertility and poor sperm health.

Luckily, there are a number of lifestyle changes men can make to reduce oxidative stress without having to spend money on antioxidant supplements.

However, if life circumstances or other health conditions create an internal environment that leads to high levels of oxidative stress, then it may be appropriate to discuss taking an antioxidant supplement with your healthcare provider.

Diving into antioxidant supplements for male fertility is definitely an important and loaded topic- so stay tuned for part 2 of this post.

Choosing the Best Antioxidant Supplements for Male Fertility

June 30, 2025 by Olha Hutsman Leave a Comment

Do “fertility boosting” supplements for men actually work?

It’s a great question!

Logically, the use of antioxidant supplements for male fertility makes a lot of sense, especially given the numerous factors that can cause oxidative damage to sperm.

In case you missed our prior post, oxidative damage occurs when reactive oxygen species (highly reactive chemical by-products) break down the cells in our body. In excess they can even result in complete cell death – so it’s important to keep them in check!

In terms of their impact on fertility, an increased number of reactive oxygen species can lead to the disruption of normal events required when the egg and sperm meet. Not to mention their negative impact on sperm motility resulting in decreased fertilization and pregnancy rates.

Enter antioxidants…

Antioxidants have the exact opposite effect. They act as free radical scavengers and decrease the number of reactive oxygen species and associated cellular damage. Therefore, it makes sense that antioxidant supplements are promoted as improving sperm health.

But the question remains whether or not antioxidant supplements are really beneficial for male fertility. There are arguments both FOR and AGAINST them…

So today we want to present you with both sides of the story along with our take on the matter.

Here’s a quick overview of what you’ll discover:

What are antioxidant supplements
The argument against antioxidant supplements
The argument for antioxidant supplements
How to make sense of conflicting information

What are antioxidant supplements?

Some of you might be thinking, “What’s the harm in taking antioxidant supplements… Aren’t they just vitamins anyway?”

There are hundreds of different substances that can act as antioxidants. The most familiar ones being vitamin A, vitamin C, and vitamin E.

However, there are many other minerals, amino acids, and enzymes that act as antioxidants too. The list of antioxidants is long and includes things like:

Arginine
Selenium
Glutathione
Coenzyme Q10
N-acetylcysteine
Folate
Magnesium

So with this many options, how can we tell which ones actually make a difference?

This can be quite challenging, especially since the Food and Drug Administration does not tightly regulate the supplement industry. Not to mention each male fertility supplement often has many different combinations of antioxidants at different doses.

Let’s take a deep dive into the existing evidence to see what matters most!

The argument against the use of antioxidants for male fertility

Rather recently, several studies have been conducted suggesting that male antioxidant supplements might not be everything they’ve been promised.

A Cochrane review (well-respected analysis of several studies) published in 2019 sought to examine if antioxidants had a positive effect on male fertility…

They looked at 18 different antioxidants across 44 studies. And before we reveal their findings, it’s important to note that only 12 of the studies reported on pregnancy or live birth. Obviously, it’s hard to make strong endorsements when the majority of studies didn’t evaluate the ultimate desired outcome – live birth.

Additional limitations that should be considered include the fact that many of the studies included in the Cochrane review had small sample sizes, which limits a study’s power to detect differences in clinical endpoints.

Furthermore, the majority of studies included were considered to be of “low quality” and had different supplements at different doses, making it difficult to compare one study to another.

This review also included any type, dose, or combination of oral antioxidant supplements that could be obtained without prescription against placebo, no treatment, or other antioxidant supplements among men with male-factor or unexplained infertility… Meaning there were no consistent comparisons.

Ultimately they concluded that:

“There is low-quality evidence from seven small randomized controlled trials suggesting that antioxidant supplementation in subfertile males may improve live birth rates for couples attending fertility clinics…

Subfertile couples should be advised that overall, the current evidence is inconclusive based on serious risk of bias due to poor reporting of methods of randomization, failure to report on the clinical outcomes live birth rate and clinical pregnancy, often unclear or even high attrition, and also imprecision due to often low event rates and small overall sample sizes.”

Translated in one sentence… more studies are needed to support the use of antioxidants supplements for enhancing male fertility.

Ultimately, this Cochrane review then led to a randomized, double-blind, multicenter placebo-controlled trial called Males, Antioxidants, and Infertility (MOXI) Trial. This study included 174 couples with male factor infertility.

The MOXI study randomized men to a combination antioxidant (Vitamin C, 500 mg; Vitamin D3, 1000 IU; Vitamin E, 400 IU; Folic Acid 1000 mcg; Zinc, 20 mg; Selenium 200 mcg; Lycopene, 10 mg; Capsule: Vitamin D3, 1000 IU, L-Carnitine, 1000 mg) or placebo for 3-6 months.

That’s quite the antioxidant cocktail!

In terms of clinical outcomes, interestingly sperm concentration actually decreased in the antioxidant group. Among men with decreased sperm parameters at baseline, there were no significant changes in sperm parameters at 3 months of treatment.

Additionally, cumulative live birth rates between the antioxidant versus placebo group were 15% vs 24% respectively (which wasn’t a statistically significant difference), but was 9% lower in the antioxidant group.

Again, with this type of cocktail, it is hard to determine which of these individual supplements if any had an impact.

More recently an even larger trial has been published – Folic Acid and Zinc Supplementation (FAZST) Trial. This trial included 2370 couples with infertility, 20% of which had a male factor diagnosis. Men were randomized to 5 mg of folic acid + 30 mg of zinc or placebo for 6 months.

Results demonstrated no difference in pregnancy, live birth rate, or difference in sperm parameters when undergoing IVF, IUI, or timed intercourse.

A criticism of this study, however, was the extremely high dose of folic acid. This is important to note given that high dose antioxidants may paradoxically increase reactive oxygen species and inflammation levels in the body.

Altogether, these studies have shown a higher risk of gastrointestinal symptoms including abdominal discomfort, nausea, and vomiting in men taking the supplements compared to those taking placebo.

Antioxidant pills that may not support male fertility

So when looking at the argument against routine antioxidant supplementation for male fertility, trials to date are currently limited by:

Heterogeneity (differing) of intervention
Small sample sizes (lack statistical power)
Poor quality (due to the variety of supplement cocktails being studied)
Primary outcomes measured (remember changes in sperm parameters don’t necessarily equate to pregnancy or live birth)

With this said, is there evidence that supports the use of oral antioxidants for male fertility?

Possibly…

The argument for the use of antioxidants for male fertility

One could argue that the issue with the current trials is that there has been an overinterpretation of the current evidence… meaning we falsely assume that ALL antioxidants have a similar effect.

So when a study compares – Vitamin C, 500 mg + Vitamin D3, 1000 IU + Vitamin E, 400 IU + Folic Acid 1000 mcg + Zinc, 20 mg + Selenium 200 mcg + Lycopene, 10 mg + Vitamin D3, 1000 IU, + L-Carnitine, 1000 mg to Folic acid 5mg + Zinc 30 mg – it’s difficult to determine which antioxidant actually had an effect or if one cancelled out the effects of another.

It’s also important to point out that these doses are up to 2 – 30x higher than what you typically get in a daily multivitamin, which as we noted above, might actually increase reactive oxygen species – yikes!

So what evidence can we find in support of using antioxidant supplements?

When looking at the Cochrane review again, the strongest evidence showing a potentially positive impact on live birth occurred when narrowing the focus down to Vitamin E alone(2 trials), Zinc alone (1 trial), or combined antioxidant (1 trial).

When looking at improvement in sperm parameters, 1 trial for vitamin E alone, 1 trial for vitamin E + zinc, 1 for vitamin E + vitamin C + zinc, and 5 trials for combined antioxidants found favorable results.

But again if that doesn’t translate to improved live birth… the question arises does it even really matter?

One way to interpret this data is that perhaps there’s something there with vitamin E or zinc, but we just don’t know exactly what or at what dose. The reality is that due to the super high dosing as well as the diversity of interventions it’s hard to make any sweeping conclusions.

Antioxidant pills supporting male fertility

A review published in Urology in 2020 sought to make sense of this mixed message and conflicting evidence…

Researchers analyzed data for the top 17 male fertility supplements sold from the most popular online retailers. Interestingly, only 22% of the 90 ingredients actually had published evidence for impact on sperm parameters.

They noted potential positive effects with:

L-carnitine
Vitamin E
Vitamin C
CoQ10
Zinc

Whereas they found minimal evidence for popular supplements including:

Maca
Selenium
B12

Ultimately they concluded that few male fertility supplements are actually backed by evidence and their efficacy largely remains unknown and therefore should be used cautiously.

How to make sense of the conflicting evidence

Perhaps we haven’t found the right group of men that might benefit?

Or the right dose?

Or the right combination of antioxidants?

It’s truly hard to say at this point.

But the assumption that if some antioxidants are good, more must be better simply isn’t true and may in fact be harmful. The concept of the “antioxidant paradox” is something we’ve mentioned a few times (so it’s kinda important!).

If you look at the dosing of antioxidants in MOXI and FASZT Trial, the doses are MUCH higher than what is typically included in a store-bought multivitamin.

Ultimately, regardless of the dose or the particular antioxidant, there’s insufficient evidence to confidently make routine recommendations for a male antioxidant supplement.

We know… It’s a bummer.

We have to say, your first priority (before searching for the right supplement) is to make sure you are eating a balanced diet filled with natural antioxidants (food is an AMAZING source of these!). And it’s important to note that no supplement can replace a healthy diet.

But still, the question remains if you HAD to choose something, what might help?

Obviously, we don’t recommend purchasing high dose antioxidant supplements specifically marketed for male fertility.

But when looking for a supplement or daily multivitamin, consider one that includes the standard daily dose of vitamin C, vitamin E, zinc, and folic acid (again, not at the super-high doses as noted in some of these studies).

As always speak with your doctor before starting any new supplements to discuss your personal needs… and be sure to always tell them ALL the supplements you are taking as well – these definitely count as “medicine” even if you can buy them over the counter.

Final Thoughts

One problem with modern medicine is the tendency to try and improve health using pills. And even though many conventional medical doctors don’t reach for supplements, they should be evaluated just as critically as prescription medications.

Sometimes supplements are highly effective… Other times they are a waste of money and potentially harmful. Without a careful review of the evidence, you’ll never know.

In the case of antioxidant supplements for male fertility, the evidence is inconclusive at the present moment… And the most important thing a man TTC can do is make key lifestyle changes that far exceed the benefit of a few supplements.

Yup, that means increasing the intake of naturally occurring antioxidants in food is a great way to support his fertility. And if you’re looking for other actions to reduce oxidative stress, we got you covered in a prior post.

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