Ideally, you should get the vitamins and nutrients your body needs through your diet and adequate sun exposure (for vitamin D). But in some cases, these avenues are not enough and supplementation is necessary. “The modern lifestyle might benefit from dietary supplementation,” says Kevin Doody, MD, a reproductive endocrinologist in Dallas, Texas. “Commercial products are available, but there is no data to recommend one formulation over another for improvement of reproductive capacity." You should always talk to your healthcare provider before starting any alternative treatment, which includes supplements you can get over-the-counter. However, keep in mind that providers can only advise on FDA regulated medications with given pregnancy categories. They may not be able to recommend a supplement, especially if it’s herbal, which means it will be up to you to make an informed decision.
The Problem With Supplements
Many non-prescription “natural” supplements are available for less than $50. Many of these products claim to improve your fertility without the need for prescription drugs. They might also claim to improve the odds of treatment. When you’re spending hundreds or thousands (if not tens of thousands) of dollars on fertility drugs, IUI, or IVF, it’s easy to justify spending much less on a product you can easily get online or at the store—which is what supplement manufacturers hope to sell you on. While they’re comparatively cheap and easy to get, supplements for fertility are not without their problems—many of which are not unique to the market of people who are trying to conceive. You’ve probably seen “This statement has not been evaluated by the U.S. Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure, or prevent any disease," written on product packaging and labels. The disclaimer often appears below a product’s impressive health claims—and you should heed its warning when you’re evaluating a supplement. For example, fertility supplements that contain an ingredient called coenzyme Q10 often claim that the enzyme can “improve egg quality” in women over 40. While the label might not say so directly, the implication is that the product will help a person overcome age-related fertility decline. “Mouse studies have suggested that supplementation with coenzyme Q10 can improve egg quality and litter size in older mice,” says Doody. “Coenzyme Q10 is a naturally produced substance involved in energy production within cells, but this molecule may be inadequately produced as we get older.” While it sounds good in theory, Doody adds that the research has a caveat: “No human studies have been done to confirm improvement in egg quality with CoQ10 supplementation. But this supplement is relatively inexpensive and unlikely to be harmful.” Another issue with supplements (in general, not just fertility supplements) is that they may or may not contain the ingredients listed on the label. Studies on general supplements and vitamins have found that the actual contents of the products don’t always match the labels.
Supplement Safety
Another issue with any supplement or vitamin product is that the word “natural” does not equal “safe” or side-effect-free. It is possible to overdose on vitamins, or experience adverse—even dangerous—reactions to herbal supplements. Supplements can also interact with prescription and over-the-counter medications. In some cases, supplements can make a drug’s effect weaker. In other cases, it can make the effect stronger. For example, St. John’s wort is used as an alternative remedy to treat depression. However, this herbal remedy can cause birth control pills to fail and can interact dangerously with some prescription medications used to treat mental health conditions. For example, selenium is found in many fertility supplements and is also found in most daily vitamin pills. Taking too much selenium can be dangerous. You might not even be aware that the supplement or remedy you are taking could be harmful because you can get these products without a prescription. That’s why you should always talk to your provider before taking a supplement, vitamin, or remedy or adding a new one.
Fertility Supplement Ingredients
Every supplement is different. You should carefully review the label on any product you are considering and ask your healthcare provider if it is safe for you to try. This list of ingredients is not exhaustive and does not list all the possible effects of each supplement. If you have questions or concerns about a specific supplement or ingredient, talk to your provider or pharmacist.
Antioxidants
Antioxidants are found in most fertility supplements, often as vitamin C. Other common antioxidant ingredients include green tea, melatonin, and ubiquinol. Some research has indicated that antioxidants might have a positive effect on sperm health and egg quality.
Amino Acids
Amino acids are the building blocks of protein and are essential to human life. Our bodies create some amino acids on their own, but others must be consumed through diet. Two amino acids commonly added to fertility supplements are L-arginine and L-carnitine. L-arginine might improve blood flow to the uterus and ovaries. However, a study published in 2010 found that higher levels of L-arginine in follicular fluid were associated with fewer embryos and egg retrieval numbers during IVF treatment. Studies on the possible benefits of L-carnitine have been small, but it might improve sperm motility (movement) and morphology (shape).
Chaste Tree Berry (Vitex Agnus-Castus)
Sometimes referred to as just vitex, chaste tree berry is an herbal supplement used for female reproductive health. There is evidence that supports its use in reducing premenstrual symptoms like breast tenderness. The research on fertility benefits is weaker, but it’s been suggested that it could help regulate irregular cycles and improve ovulation.
Coenzyme Q10 (CoQ10)
In animal studies, CoQ10 has been found to improve egg quality and quantity, but there’s no current research on these effects in humans. Of the human studies that have been done on CoQ10, more have been completed in men than women. The findings indicate that CoQ10 might improve sperm count, movement, and shape.
DHEA
Dehydroepiandrosterone (DHEA) is a hormone secreted by the adrenal glands. People with low ovarian reserves might benefit from DHEA. Research has found that treatment with DHEA in patients with diminished ovarian reserves might improve pregnancy success rates during IVF treatment. It’s unknown whether people with normal ovarian reserves can benefit from DHEA. In fact, DHEA supplementation can raise androgen levels and cause unwanted side effects such as unusual hair growth, irregular cycles, and a deepening voice, as well as possibly diminishing fertility.
Myo-Inositol
Inositol is produced by the human body and is also found in some foods, including beans, corn, nuts, and fruit. Inositol is sometimes assigned to the B-vitamin group, though the categorization is debated. Inositol also appears to be essential for insulin regulation. The research on myo-inositol as a supplement has primarily been in people with PCOS (a condition that is associated with insulin resistance). One small meta-analysis of myo-inositol and women with PCOS found that it might improve ovulation and regulate menstrual cycles. However, it was unclear whether it could improve pregnancy rates.
NAC (N-acetyl-L-cysteine)
NAC is also known as N-acetyl cysteine. It is a variant of the amino acid L-cysteine. NAC has antioxidant properties and might prevent certain types of cell death. It also seems to act as an insulin-sensitizing agent. Supplementation with NAC might improve ovulation rates, especially in people with PCOS. Some research has suggested that combining NAC with Clomid could help overcome Clomid resistance, but other studies have not found evidence of such improvements.
Vitamins
Vitamins commonly added to fertility supplements include folate, zinc, the B-vitamins, vitamin C, vitamin E, magnesium, and selenium. During pregnancy, folate (also known as folic acid) is necessary to prevent several congenital abnormalities. Healthcare providers sometimes prescribe extra folate to patients with a history of repeat miscarriage. Folate might also play a role in male fertility and sperm health.
Supplements Don’t Replace Fertility Treatment
If you are having a fertility evaluation, avoid trying supplements or remedies before you have the test. A delayed diagnosis could lower your odds for fertility treatment success—and remember: fertility supplements are not proven treatments. You might experience some benefit from taking supplements, but it’s best to keep your expectations conservative. A supplement or remedy is not going to be enough to cure something like primary ovarian insufficiency or boost sperm count overnight.
Reading Supplement Reviews
When looking at online reviews of fertility vitamins, expect to see more positive than negative comments. People who become pregnant after using the product are more likely to recommend it (even if it was a coincidence). Those who don’t conceive will likely just move onto the next treatment. However, some might post a negative (but honest) review if they are displeased that the product did not deliver on its promise. If you are looking at the manufacturer’s website, keep in mind that positive reviews might not always be from real people and any negative feedback might get removed or never posted at all.
Warning Signs to Watch For
Most companies selling fertility supplements are honestly trying to provide a quality, reasonably priced product, but others are attempting to scam you. Dishonest people and companies know how desperate couples with infertility can be to conceive and will take advantage of it to make money. Here are some warning signs that indicate a supplement could be low-quality or even a scam.
Claims to be research-proven but does not list the studies. Always look up any research claims a manufacturer makes on third-party websites (such as PubMed). Makes mega-promises. No supplement or vitamin can cure infertility (even IVF can’t guarantee you get pregnant). References “scientists” or “doctors” but does not list names. Without a full name, you can’t be sure the experts “standing behind” the supplements even exist. Not only should the expert’s names be clear, but their credentials should also be listed (and accurate). Website contains poor grammar or spelling mistakes. Carelessly put together websites or emails are major red flags that a product could be a scam.
A Word From Verywell
Making lifestyle changes to improve your overall health and well-being can boost your odds of pregnancy success and provide a sense of empowerment. Taking a fertility vitamin or supplement can be a part of that action plan, but it’s unclear how much (if any) benefit you will get from these products. If you’ve been trying for 1 year (or 6 months, if you’re over 35), make sure that both you and your partner get tested. After you’ve had a fertility evaluation you can talk to your healthcare provider about whether or not delaying conventional treatment is recommended. Always ask them before starting any supplements. Make sure they know about any products you are taking—even if it’s “just a vitamin.” Do not combine supplements, vitamins, herbal products, or alternative remedies with over-the-counter or prescription drugs without asking your provider. Unless your provider tells you otherwise, stop taking any supplements or herbal products when you get pregnant, as most of these products have not been proven to be safe to take during pregnancy. Once you get pregnant, it will be time to switch to prenatal vitamins as recommended by your provider.
