In this guide, we’ll review the most common supplements to take during fertility treatments and if there’s any data to back them up.
By IVF warrior and women's health expert Halle Tecco, MPH, MBA
Going into IVF we all hope for the best and to minimize the amount of egg retrievals and transfers required before taking home a baby. In addition to making lifestyle changes to ensure you are your healthiest self before IVF and pregnancy, you may be considering what supplements to take. But what supplements to take, if any at all, depends on your reason for going through fertility treatments in the first place. In this guide, we’ll review the most common supplements to take during fertility treatments, and if there’s any data to back them up.
Antioxidants for infertility
Antioxidants are organic nutrients that reduce oxidative damage. They include vitamins, minerals, and polyunsaturated fatty acids (PUFAs). Some of the common antioxidants used for infertility in women are CoQ10, N‐acetyl‐cysteine, melatonin, vitamins A, C and E, folate, myo‐inositol, zinc, and selenium.
A Cochrane systematic review of 50 clinical trials involving 6,510 women found that antioxidants may be associated with an increased live birth rate for women with infertility. Specifically, for women with an expected live birth rate of 20%, using antioxidants increased the live birth rate to 26%-43%.
But some antioxidants showed more promise than others. The study found that CoQ10 is associated with increased pregnancy rate. But they found no evidence that melatonin, L‐arginine, myo‐inositol, or vitamin B complex improves pregnancy rate. However, the studies were deemed “low quality,” and more research is needed.
Best prenatal vitamins for IVF
If you’re not already taking a prenatal vitamin, it’s important to start taking one now. But not all prenatals are created equal, and some (like the Prenatal for her) are formulated with women going through fertility treatments in mind.
A Harvard study led by Dr. Audrey Gaskins evaluated the relationship between pretreatment adherence to various dietary patterns and outcomes of fertility treatments across 357 women and 608 cycles, like IVF. The study found that adherence to a pro-fertility diet was associated with an increased probability of live birth. The pro-fertility diet was developed based on factors previously related to outcomes and included higher intake of supplemental folic acid (folate), vitamin B12, vitamin D, low (rather than high) pesticide residue produce, whole grains, dairy, soy foods, and seafood (rather than other meats).
The Prenatal for her formula intentionally includes nutrients found in the pro-fertility diet: folate, vitamin B12, and vitamin D. In fact, it contains levels of folate, vitamin B12, and vitamin D that meet or exceed the levels shown to support positive fertility outcomes in this particular study.
What about myo-inositol during fertility treatments?
Myo-inositol is a member of the vitamin B complex group. It is found in foods such as fruits, beans, whole grains, and seeds, as well as in supplements. Myo-inositol is often recommended for patients with PCOS. This is because women with PCOS are often insulin resistant, and myo-inositol may improve insulin sensitivity and reduce insulin levels.
In a meta-analysis of six clinical trials involving 913 patients, patients who took myo-inositol saw a significantly higher pregnancy rate than the control group. However, a Cochrane review concluded that there are too few quality studies to be certain if myo-inositol improves pregnancy rates or live birth for women with PCOS.
If you have PCOS, talk to your doctor about what supplements or medications are right for you.
What supplements should my husband take during IVF?
Men should absolutely be taking steps to improve their sperm health during fertility treatments! This is especially important if any issues in sperm health—motility, count, concentration, or morphology—have been identified.
Antioxidants have been shown to improve live birth rate for couples undergoing fertility treatment. A 2019 Cochrane systematic review concluded that antioxidant supplementation in men improves live birth, clinical pregnancy rate, and sperm DNA fragmentation.
The Prenatal for him was carefully developed using peer-reviewed studies that reflect the latest research in male fertility. The formula development was led by a Harvard-trained urologist and a registered dietitian-nutritionist. Not only were the specific ingredients selected based on strength of evidence, but the dosages of each ingredient are also evidence based to ensure adequate impact.
Folate for women with high exposure to traffic-related air pollution
The CDC urges women to take 400 micrograms (mcg) of folic acid (folate) every day one month prior to trying to conceive.
In addition to this amount, additional folate supplementation could be beneficial for women with high exposure to traffic related air pollution. A 2019 study by Dr. Audrey Gaskins showed that women undergoing IVF who had high levels of air pollution exposure were able to help protect against the impact of NO2 exposure and increase their chance of live birth.
DHEA for women with DOR or POR
Some research has been conducted on the impact of DHEA for women with diminished ovarian reserve (DOR, also known as age-related infertility) and/or poor ovarian response (POR). One systematic review and meta-analysis of nine randomized controlled trials involving 833 patients showed that patients treated with DHEA retrieved more oocytes (eggs) during egg retrieval and had a higher pregnancy and live birth rate than control groups. However, there was no difference in miscarriage rate. Another study found that DHEA was associated with higher pregnancy rate, but did not affect egg retrieval success.
- Antioxidants may be associated with an increased live birth rate for women with infertility. CoQ10 is among the most promising of the antioxidants studies.
- Make sure your prenatal vitamin is formulated to support your IVF journey, with the right amounts of folate, B12, and vitamin D.
- Men should take a prenatal too! Studies show that antioxidant supplementation in men improves live birth, clinical pregnancy rate, and sperm DNA fragmentation.
- Myo-inositol is often recommended for patients with PCOS. This is because women with PCOS are often insulin resistant, and myo-inositol may improve insulin sensitivity and reduce insulin levels.
- Make sure your prenatal contains the recommended 400 mcg of folate. If you are exposed to high levels of pollution, evidence suggests upping that amount with supplemental MTHF folate.
- Some evidence suggests DHEA can improve IVF outcomes for women who have been diagnosed with DOR or POR.
Halle Tecco is the Founder of Natalist and an infertility warrior. Her experience struggling to get pregnant (which includes multiple rounds of IVF) inspired her to start Natalist and help other women on their journey. If you want to learn more about fertility treatments, sign up for her personal IVF newsletter. 💌