Supplements

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.

Egg Freezing: What You Should Know Before Freezing Your Eggs

July 4, 2025 by Olha Hutsman Leave a Comment

Ever thought about freezing your eggs?

Ever wondered what the process looks like?

What are the risks?

And how much is it going to cost?

If you’re looking for answers then you’re in the right place…

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

What is egg freezing?
How the egg freezing process works
Success rates with egg freezing
How much does egg freezing cost?
How to optimize your egg freezing outcomes

What is Egg Freezing?

Egg freezing is the process through which a woman undergoes ovarian stimulation followed by the subsequent retrieval of her eggs (i.e., “harvesting”) that are then frozen for a future pregnancy.

Historically, this reproductive technology was somewhat challenging because eggs have a super high water content… This means that when labs tried to freeze them by a method known as “slow freeze,” a lot of ice crystals would form which would damage the egg.

Luckily, the process has become more mainstream over the past decade – even for those not struggling with infertility – as the technology has greatly improved making it a much more successful endeavor.

In fact, newer technology has emerged where eggs can be vitrified. The vitrification process involves a “rapid freeze” using liquid nitrogen which addresses the issue of ice crystals. As a result, the vast majority of the eggs (~95% depending on the lab) are usable at a later date.

Pretty cool, huh?

The use of this amazing technology has only continued to increase. In 2014, there were around 6000 oocyte cryopreservation cycles annually for fertility preservation compared to over 16,000 freezing cycles in 2019 according to sart.org.

Interestingly, only about 10% of women have actually returned to using their eggs 2 years after they froze them (1). But, most of the data we have on this is based on prediction models of women with similar characteristics who have undergone in-vitro fertilization (IVF) for other reasons. More on that below…

For now, let’s talk about the process of freezing your eggs.

The Egg Freezing Process

The egg freezing process starts by meeting with and discussing your reproductive goals and medical history with your fertility doctor.

A basic evaluation includes getting blood tests to establish baseline measurements of ovarian reserve such as antimullerian hormone (AMH) levels. An ultrasound to assess antral follicle count (the number of resting follicles or potential eggs in the ovary) will also occur before the egg freezing work beings.

It’s important to understand these tests don’t predict fertility or reproductive health. Instead, they give you an overall idea of the number of eggs remaining and assist with choosing a medication protocol for your ovarian stimulation regimen.

3 step process for egg freezing and egg retrieval

Ovarian Stimulation

If you decide to move forward, your fertility clinic may have you start oral contraceptive pills for 2-3 weeks to suppress your endogenous hormones. Some will start with your natural menstrual cycle as well.

From there, you’ll go in for a baseline ultrasound to make sure your ovaries are quiet and there aren’t any follicles or cysts that would impair your responsiveness to the injectable medications.

If everything looks good then you will start subcutaneous injections daily for a total of 9 – 14 days on average. These injections are self-administered in your stomach with a very small needle. Some come in pre-filled syringes, and some you have to mix and reconstitute yourself.

You can think of it like you’re basically giving yourself back the same hormones that your body naturally produces in a menstrual cycle (FSH and LH) at MUCH higher doses than you would produce yourself. The goal is to recruit multiple follicles and eggs as opposed to just one that’s typically released during a normal, unmedicated menstrual cycle.

Your doctor will monitor your response to the medications with a combination of transvaginal ultrasounds and blood estrogen levels. This typically requires anywhere from 4 – 7 visits over the 9-14 days of ovarian stimulation, but this can vary depending on the ovarian response. As the follicles get bigger, estrogen increases.

When the follicles are big enough, you give yourself one final “trigger” shot that causes the eggs to mature. The egg retrieval procedure will be scheduled for ~34 – 36 hours later.

Egg Retrieval

The egg retrieval itself is considered a minimally invasive procedure. It’s typically done under moderate sedation, which means you’re asleep, but you don’t need a breathing tube, so you’re breathing on your own.

Some fertility clinics do retrievals with conscious sedation (where you’re awake) and local anesthesia as well. We recommend asking the clinic you’re considering going to what their protocol is so you know what to expect from the get-go.

No incisions are required with egg retrieval and the vast majority are done transvaginally. A transvaginal ultrasound is used with a needle guide wherein the needle is inserted through the vagina and into the ovary. Occasionally a transabdominal retrieval is performed if the ovaries can’t be accessed transvaginally – the same process happens, just through the abdomen as opposed to the vagina.

All visible follicles are punctured and aspirated on each ovary and the follicular fluid (including the egg inside) is passed off to the embryologist.

The procedure itself varies in length based on how many follicles there are but is typically anywhere from 10 – 30 minutes in length.

Post-Procedure

Common symptoms post retrieval include cramping, bloating, and constipation.

It’s important to stay well hydrated after the procedure and to use a stool softener as needed for constipation or even in advance to prevent it. Cramping is typically well controlled by simple over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Motrin).

Women may continue to experience some discomfort as their ovaries shrink down after the procedure but typically they feel back to normal by their next period which is about 10 – 12 days after the procedure.

Complications are rare but possible with this procedure including bleeding, infection, or ovarian torsion (where the ovary twists on itself). All of these necessitate immediate medical evaluation.

Freezing & Banking

Once the eggs are extracted, the embryologists will strip the cumulus cells off of them (the fluffy cells surrounding the egg) to determine which eggs are mature (meaning they’ve completed their cell cycle). You may hear your clinic refer to these as “MII’s”.

Of all the woman’s eggs that are retrieved, on average ~85% of them will be mature. These eggs are then vitrified and flash-frozen in liquid nitrogen and will stay frozen until you decide to come back and use them.

Health Risks and Side Effects

In addition to the procedure-related risks mentioned above, one of the biggest risks of egg freezing is ovarian hyperstimulation syndrome (OHSS).

Symptoms of OHSS can include abdominal pain, bloating, nausea, vomiting, increased fluid in the abdominal cavity, and decreased urine output. Some of the more severe symptoms of OHSS include decreased kidney function, difficulty breathing, and increased risk of blood clots. Severe cases are rare and largely preventable by avoidance of HCG for the trigger shot (using a medication called Lupron instead or a combination of both).

Ovarian torsion (where the ovary flips on itself) is also a rare but potential complication. In general modified physical activity is encouraged once women start stimulation medications and until their ovaries shrink back down to size (about 1 week after retrieval) to minimize this risk.

One last thing that to mention… At this time, the evidence does not support a relationship between the risk of fertility medications and breast or ovarian cancer (2). With that said, if you have a family history of these conditions, it’s important to discuss them with your healthcare provider.

When Should You Consider Freezing Your Eggs?

This is a GREAT question with a not so straightforward answer…

It’s incredibly important to recognize that you are born with all the eggs they’ll ever have and that egg supply decreases over time. On average, women start with about 2 million eggs at birth. By your first menstrual cycle or menarche, that total drops to about 400,000, and at age 40 most women have about 25,000 eggs left.

Graph showing decline in female egg count by age

You can think about your fertility in two ways:

The overall number of eggs remaining (egg quantity)
The genetic content of those eggs (egg quality)

Ultimately, as a woman ages, both the quantity and quality of her eggs decline. So when it comes to having a successful pregnancy (and live birth) from frozen eggs, two factors are important to keep in mind: the number of mature eggs frozen AND the age when they were frozen.

Before we leaving this topic, it’s important to highlight the importance of egg quality. By the time we turn 30, there’s approximately a 23% aneuploid rate (embryos with an abnormal number of chromosomes that won’t result in a viable pregnancy). This percentage increases between 30 – 40% at the age of 35 and then to 50 – 60% at the age of 40.

Of course, your future success isn’t the only thing to keep in mind…

It’s also important to consider the likelihood that you’ll actually use them. For example, a 25-year-old who is thinking about starting her family at the age of 30 wouldn’t be nearly as likely to use her frozen eggs as a 35-year-old who is thinking about starting her family at the age of 40.

Finally, if you’ve had a recent cancer diagnosis and you are facing cancer-related treatments (i.e., chemotherapy, radiation, surgery, etc.) that may directly impact your reproductive health and ovarian reserve. Make sure to request a fertility preservation consultation ASAP to discuss your options… because you do have options!

Success Rates and Your Future Fertility

As the average age of reproduction continues to increase, fertility continues to decline. And while over 16,000 cycles were completed in 2019 alone for the purposes of egg freezing for fertility preservation, not as many women have come back to use their eggs at this point. As a result, the majority of data on future success rates with egg freezing is based on prediction models (3).

As we mentioned above, future success with frozen eggs is largely a product of 2 things:

The age of the woman when her eggs were frozen
How many mature eggs are frozen

A group from Brigham and Women’s developed a handy egg freezing calculator that you can play around with to get an idea of the impact of age and egg number on future success.

For example, a 35-year-old who has 10 eggs frozen is predicted to have a nearly 70% chance of at least one live birth from those eggs in the future. Whereas those same 10 eggs for a 40-year-old woman would yield only a 30% chance of at least one live birth in the future.

Now, this isn’t to say that women in their early 40’s shouldn’t consider freezing their eggs… it’s just important to know that it may take more than one cycle (or maybe even two) to reach your goal.

Another study looking specifically at women who actually froze their eggs and came back to use them noted the highest success in women who were 36 years of age or less, and suggested at least having 8 – 10 eggs frozen for a reasonable chance of future success (1).

It’s important to understand that nothing ever guarantees a 100% chance of success, but egg freezing would definitely offer the highest chance of protecting your ability to have a biological child in the future.

What Happens When You’re Ready to Use Your Eggs?

First off, it’s important to point out that freezing your eggs and undergoing one (or more) egg retrievals will NOT decrease your future fertility.

If you’re <35 years of age and have been trying to conceive for 12 months or more or ≥ 35 years of age and have been trying for 6 months without success… it’s probably time to revisit your fertility specialist and talk about using those eggs. Or perhaps you’ve decided to move forward as a single mom by choice. Whatever the case, don’t be afraid to use them!

Once you’re ready to use your eggs, your uterus will first be prepared for embryo implantation. This can occur with a combination of estrogen pills and patches with progesterone OR timed off your natural menstrual cycle. Ultimately the eggs will be thawed to time the development of the embryo with your endometrial lining development.

Once the eggs are thawed they are inseminated via intracytoplasmic sperm injection (ICSI) where the sperm is injected directly into the egg. On average ~85-95% of eggs will survive the thaw (ask your clinic specifically what their thaw survival rates are for your age).

Of the eggs that thaw appropriately, assuming normal sperm parameters, about ⅔ will fertilize normally and turn into an embryo. Of those, about half will grow out into a blastocyst (day 5 or 6 embryo) that can then be transferred to your uterus, biopsied for genetic testing, or frozen for later use.

It’s important to point out that the blastocyst stage is when the embryo can be biopsy for aneuploidy screening (genetic testing of the embryo’s chromosomes for abnormalities). Keep in mind, this isn’t possible with just the egg.

How Much Does Oocyte Preservation Cost?

Egg freezing costs on average anywhere from $10,000-20,000 per cycle including doctor’s visits, the procedure, medications, and storage depending on the fertility clinic you visit.

The thawing of the eggs and transfer of a subsequent embryo will be factored in separately, so it’s important to consider and ask about these financial costs as well.

Thankfully, more and more companies are following the standard set by large tech companies like Google and Facebook and are starting to cover egg freezing and fertility preservation services in their insurance plans, but we have a long way to go.

Diet and Lifestyle to Optimize Success

Now that you’ve invested all this time and effort learning about fertility preservation, what can you do to OPTIMIZE your chances of success?

Unfortunately, no studies have looked directly at lifestyle factors and outcomes in women who are freezing their eggs. But, there is excellent evidence from both the Nurse’s Health Study as well as the EARTH Study that would suggest improved outcomes in terms of egg health by consuming a pro-fertility or fertility diet.

Infographic of the 5 Core Principle of the Fertility Diet

In the months leading up to treatment, making some simple changes like eating more whole grains, incorporating more of the good fats (omega-3s) found in salmon, chia seeds, and hemp seeds, consuming more plant-based proteins in place of conventional animal meat, and avoiding deep-fried foods and pre-packaged baked goods that are rich in trans fats can all help optimize your outcome.

In terms of beverages, remove those sugar-sweetened beverages (like soda, sweet tea, or energy drinks) and eliminate alcohol intake while you’re actually taking your injectable medications. If you want a deeper dive into the Fertility Diet, search through some of our prior blog posts on the topic.

In addition to adjusting your diet, stay active while taking your injectable meds, but clear your workout regimen with your fertility doctor as some things might be a little too high intensity as your ovaries get bigger.

Take a prenatal vitamin with at least 1000 mcg of folic acid in it even though you’re not actively trying to conceive. In terms of other supplements, things like Co-Q10, DHEA, vitamin D, or vitamin E amongst others may be recommended. Ask your doctor what might be helpful for you, as every individual is different.

Final Thoughts on Fertility Preservation

Egg freezing is an amazing technology that gives women more reproductive choices.

As the average age of reproduction continues to increase, and more women delay childbearing to focus on their education and careers, there needs to be increased awareness around this important topic.

If you’ve been thinking about freezing your eggs but haven’t wanted to take the leap, start with a simple consultation to discuss your family-building goals. Get some basic blood testing to see where your egg counts are.

Start by getting the information to make an informed decision for yourself!

References:

Cabo A. Garcia-Velascao J, Coello A, et al. Oocyte vitrification as an efficient option for elective fertility preservation.Fertil Steril. 2016 Mar;105(3):755-764.e8.
Practice Committee of ASRM. Fertility drugs and cancer: a guideline.Fertil Steril. 2016 Dec;106(7):1617-1626.
National Summary Report. (n.d.). https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx.

Vitamins and Supplements to Improve Egg Quality and Quantity

June 30, 2025 by Olha Hutsman Leave a Comment

We’ve all heard the stories before…

A woman in her late-30’s – who was told that none of her eggs were likely to be good – decided she wasn’t ready to go the route of donor eggs.

Instead, she took a cocktail of supplements and three months later she got pregnant naturally and gave birth to a healthy baby.

Of course, we know this isn’t always the outcome.

However, curious minds can’t help but ask…

“Which supplements did she take?”

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

Why Egg Health Matters for Your Fertility
How Supplements Can Boost Egg Quality and Quantity
Three of the Top Supplements to Consider to Help the Health of Your Eggs
What About the Other Vitamins Women Mention?
How Long Does It Take for Supplements to Impact Egg Quality?

Why Egg Health Matters for Your Fertility

As we’ve talked about in our post on infertility facts and statistics, women are born with all the eggs they’ll ever have, which is typically around 1-2 million.

Over time, healthy egg supply decreases in a few distinct ways…

First, women lose part of their total egg quantity with every passing month. Commonly you may hear that the egg quantity lost is from the egg that is ovulated. However, each month there’s an entire cohort of follicles with potential eggs that ultimately, if not selected for ovulation, undergo apoptosis (cell death) and atresia.

So even in women who aren’t ovulating (e.g., PCOS, taking oral birth control, etc.) overall egg quantity still declines with time. In fact, approximately one thousand eggs are lost each month after puberty which happens progressively until menopause.

Egg quantity aside, there’s also a decline in egg quality as women age. For the most part, the eggs that you have remain dormant in your ovaries for most of your life. Just before ovulation, your eggs go through a process of cellular division and maturation. Unfortunately, older eggs are more likely to experience errors during the division process, which means they are more likely to contain abnormal amounts of DNA.

Another important aspect contributing to egg quality is mitochondrial health. Mitochondria are the powerhouse of your cells – they make the ATP that the egg cell uses for energy. As your eggs mature, going from a microscopic primordial follicle cell to a visible egg cell, mitochondria multiply exponentially to 100,000–500,000 or more in fully mature eggs. The reason for this staggering increase? It takes a lot of energy for an egg to be fertilized, implant, and grow into a baby!

As you age, the number and efficiency of mitochondria decline. This happens as part of the natural aging process but is often sped up by a number of lifestyle factors including a lack of proper nutrients. More on that in a moment…

Tests for evaluating egg quantity

Fertility testing, such as checking anti-Müllerian hormone (AMH) levels, or ultrasounds to look at an antral follicle count (AFC, the number of resting follicles in your ovaries) tests for markers of egg count (quantity), not egg quality. Knowing how many eggs you have left is important information, but it’s only part of the picture.

Without getting too nerdy, the only way to know for sure if an egg is “normal” is to attempt to fertilize it and perform genetic testing on the embryo. Although a lot of research has been done surrounding polar body biopsy, the genetic quality of an unfertilized egg isn’t reliably or routinely tested at this time.

Age as a marker for egg quality

Errors in our DNA increase over time just as the health of mitochondria decreases. And because the impact of age on egg quality is fairly consistent, your age can give fertility specialists a fairly accurate picture of egg quality as it is currently the best determinant. Luckily, there are a number of factors unrelated to age that can also help support the health of your eggs and could likely benefit regardless of whether age is on your side.

How Vitamins and Supplements Can Boost Egg Quality

As you just learned, healthy mitochondria and DNA are both important when it comes to the quality of your eggs.

For proper mitochondrial function, the cells in your body need all the building blocks for producing adenosine triphosphate (ATP), the molecule which provides energy for all of the cells’ processes.

This includes plenty of b-vitamins, such as riboflavin (B2) and niacin (B3). Your mitochondria also need other micronutrients, such as omega-3 fatty acids, magnesium, iron, vitamin E, selenium, and CoQ10. (1)

Now before we dive into our discussion about supplements, here are a few everyday tips you can implement to improve the quality of your mitochondria:

Avoid sugar, alcohol, fried or processed foods which can damage mitochondria, causing premature aging of the egg cells. Remember, preparing fresh foods, rather than ordering take-out, is more likely to prepare your body for conception and healthy pregnancy.
Reach for foods packed with amino acids, antioxidants, and healthy fats. That means wild-caught fish, (preferably) organic vegetables, avocados, extra virgin olive oil, nuts/seeds, and some low-sugar fruits. Of course, you can never go wrong with green cruciferous veggies, like broccoli and brussel sprouts.
Give meditation and other relaxation-based techniques a try… They can reduce oxidative stress, and that means less damage to the mitochondria.
Don’t forget to exercise! We know this can be a bit of a confusing topic while trying to conceive, so feel free to check out our post on exercise and fertility. Bottom line, regular exercise is important for mitochondrial health.

Okay, we know that we got a little off-topic, but we wanted to share a few strategies beyond supplements that can help support and improve the quality of your eggs. We know it probably goes without saying, but taking a handful of supplements will never be able to overcome less than optimal dietary and lifestyle habits.

3 Supplements to Help the Health of Your Eggs

There are many vitamins and supplements out there beyond your everyday prenatal to consider when it comes to your fertility. Instead of trying to cover them all, we are going to focus on three of the supplements to potential use when it comes to improving egg quality.

Co-Q10

Coenzyme Q10 (CoQ10) is a fat-soluble nutrient found in almost every cell of our bodies, including your ovaries and eggs. Among other things, it functions as an antioxidant – meaning it neutralizes toxic byproducts from everyday chemical reactions.

Equally important to its antioxidant properties, CoQ10 is vital for energy production. Your eggs (oocytes) actually have the largest number of mitochondria of any cell in your body. This makes sense as the process of ovulation and forming an embryo takes a lot of energy!

So, what does the current scientific literature say about supplementing with CoQ10?

In one clinical trial, supplementation with CoQ10 led to a higher fertilization rate and more high-quality embryos (2). CoQ10 also has increased the number of ovarian follicles and improved ovulation rates in Clomid-resistant women with PCOS (3).

A recent meta-analysis (combined statistical analysis) looked at the combined results from 5 randomized controlled trials (including the 2 mentioned above) and noted that women who supplemented with CoQ10 had a higher odds of clinical pregnancy (28.8% vs 14.1%) (4).

And when researchers placed CoQ10 directly into the in-vitro maturation media (what the eggs are bathed in after they’re retrieved) among women undergoing IVF (≥ 38 years of age), they found (5):

Increased oocyte maturation rates (82.6% vs. 63.0%)
Decreased postmeiotic aneuploidies (i.e., cells with abnormal number of chromosomes) (36.8% vs. 65.5%)

DHEA

Dehydroepiandrosterone (DHEA) is a naturally occurring hormone that has minor biological activity on its own but has powerful effects when converted into other hormones such as testosterone and estrogen.

One randomized, prospective study found that daily DHEA supplementation improved egg quality and pregnancy outcome in women who were “poor responders” to IVF stimulation medication (5).

Moreover, a recent meta-analysis looking at a total of 9 randomized clinical trials found that DHEA supplementation among women undergoing IVF-ICSI was associated with (7):

Increased mean number of retrieved oocytes
27% higher chance of clinical pregnancy rate
76% higher chance of live birth rate

Before moving on, we want to stress the importance of using DHEA under the guidance of a fertility specialist. It is a pretty powerful hormone and when used incorrectly it can cause damage to the liver. DHEA may also increase testosterone levels and worsen polycystic ovary syndrome-like symptoms and may negatively impact the endometrium.

The bottom line, not every supplement is meant for everyone, especially when trying to conceive. Speak with your physician to determine what may be best for you and your reproductive health.

Melatonin

Melatonin is a neuro-hormone produced in almost all of our cells but it’s only secreted by the pineal gland in the brain. Melatonin has been shown to have strong antioxidant properties, which help prevent free radicals and reactive oxygen species (ROS) from creating oxidative stress and cellular damage. Oxidative stress can negatively impact oocytes as well as the ovulatory process.

Interestingly, melatonin has been found in ovarian follicular fluid and in the oocytes themselves. Hence, supplementing with melatonin when TTC has become a growing topic of interest in the fertility world.

Much of the buzz around melatonin and fertility surrounds women undergoing IVF. Initial research has suggested that melatonin supplementation could (8-11):

Lower levels of oxidative stress and cellular damage in ovarian follicles.
Increase the number of mature oocytes & high-quality embryos
Increase fertilization rates

It’s important to note that melatonin has the potential to disrupt the hormones secreted from your brain that regulate the menstrual cycle and actually interfere with ovulation. Women not undergoing IVF and/or those with irregular cycles should not routinely supplement with melatonin while trying to conceive until we have a better understanding of its application.

What About the Other Vitamins Women Mention to Increase Fertility?

There are so many vitamins and supplements out there that may or may not help increase your fertility and your efforts to get pregnant. When it comes to supplementation, it’s always important to first consider what the supplement has actually been shown to help improve as well as what the clinical studies show.

Important questions to ask yourself include:

Does the supplement help address my unique condition (e.g., PCOS, diminished ovarian reserve, ovulatory infertility, etc.)?
Has the supplement been shown to help women with similar circumstances (i.e., same age, same treatment plan, etc.)?
What do the clinical studies actually reveal (i.e., greater oocyte yield, higher fertilization rate, increased chance for live birth)?

Keep an open mind, but don’t be afraid to be critical. Supplements aren’t a magic bullet… and just because one combination of supplements worked for one woman, doesn’t mean it’s guaranteed to work for another. And remember, age will always be the best predictor of egg quality, so that has to be taken into consideration with the bigger picture.

Another important consideration when choosing supplements is cost. It probably goes without saying, but the cost of supplements can quickly add up, which is why it’s extra important to do your homework. Of course, it’s also extremely important to speak to your fertility specialist before taking a bunch of new fertility supplements.

How Long Does It Take for Supplements to Improve Egg Quality?

Historically, it has been thought that interventions for improving egg quality must be applied while the egg is undergoing the maturation process and not when it has already matured and is ready for release… Hence, the whole 90-day concept you’ve read about on the internet.

Although there’s definitely truth to this adage, and most studies look at outcomes after 3 months of supplementation, it can downplay or overlook the short-term effect of lifestyle factors, which have been shown to have an impact in less than 90 days!

The quality of developing eggs and their response to natural or external hormonal stimulation can be affected by stress, environmental contaminants, poor diet, inflammation, drug abuse, excessive smoking, hormonal imbalance, etc.

Supplements that help address these factors may indirectly improve egg quality and increase your chances of getting pregnant much sooner than 90 days. So, remember, it may start with the egg, but the quality of your eggs isn’t the only factor at play.

Final Thoughts on Egg Quality and Quantity

The topic of eqq quality and quantity is important for any woman trying to conceive. Although the age of the female is the biggest factor determining egg quality, there are actually many other things under your control that can help optimize overall egg health.

Supplements receive a great deal of attention because they are one of the easiest strategies to implement and it fits the traditional paradigm of taking a pill to improve one’s health.

Before popping a handful of pills though, it’s important to know which supplements have actually been shown to potentially benefit egg quality or quantity. You might be surprised to learn that many of the popular supplements that women are taking have little to no impact on egg health.

It’s also important to remember that no amount of supplements will reverse the negative effects of a pro-inflammatory diet and suboptimal lifestyle choices.

As always, empower yourself with the best information you can and partner with a physician and fertility specialist who is knowledgeable about the topic.

References:

Wesselink E, Koekkoek WAC, Grefte S, et al. Feeding mitochondria: Potential role of nutritional components to improve critical illness convalescence. Clin Nutr. 2019 Jun;38(3):982-995.
Xu Y, Nisenblat V, Lu C, et al. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial. Reprod Biol Endocrinol. 2018 Mar 27;16(1):29.
El Refaeey A, Selem A, Badawy A. Combined coenzyme Q10 and clomiphene citrate for ovulation induction in clomiphene-citrate-resistant polycystic ovary syndrome. Reprod Biomed Online. 2014 Jul;29(1):119-24.
Florou P, Anagnostis P, Theocharis P, et al. Does coenzyme Q 10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. J Assist Reprod Genet. 2020 Oct;37(10):2377-2387.
Ma Long, Cai L, Hu M, et al. Coenzyme Q10 supplementation of human oocyte in vitro maturation reduces postmeiotic aneuploidies. Fertil Steril. 2020 Aug;114(2):331-337.
Wiser A, Gonen O, Ghetler Y, et al. Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Hum Reprod. 2010 Oct;25(10):2496-500.
Xu L, Hu C, Liu Q, Li Y. The Effect of Dehydroepiandrosterone (DHEA) Supplementation on IVF or ICSI: A Meta-Analysis of Randomized Controlled Trials. 2019 Jul;79(7):705-712.
Jahromi B, Sadeghi S, Alipour S, et al. Effect of Melatonin on the Outcome of Assisted Reproductive Technique Cycles in Women with Diminished Ovarian Reserve: A Double-Blinded Randomized Clinical Trial. Iran J Med Sci. 2017 Jan;42(1):73-78.
Eryilmaz O, Devran A, Sarikaya E, et al. Melatonin improves the oocyte and the embryo in IVF patients with sleep disturbances but does not improve the sleeping problems. J Assist Reprod Genet. 2011 Sep;28(9):815-20.
Batıoğlu A, Sahin U, Gürlek B, et al. The efficacy of melatonin administration on oocyte quality. Gynecol Endocrinol. 2012 Feb;28(2):91-3.
Nishihara T, Hashimoto S, Ito K, et al. Oral melatonin supplementation improves oocyte and embryo quality in women undergoing in vitro fertilization-embryo transfer. Gynecol Endocrinol. 2014 May;30(5):359-62.

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.

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