Doctors recommend some dietary supplementation before trying to get pregnant or fertility treatments. But which ones? And are there other supplements and new discoveries that could help influence the outcome of your egg freezing cycle and bolster your natural fertility? ELANZA takes a look at the latest science.
There are more than 85,000 supplement products (including for fertility) for sale in the US market alone. From “skinny” teas that promise a paper flat stomach, to gummies for goddess hair, every time we open Instagram or walk down the pharmacy aisle we’re bombarded with an overwhelming number of options and far-fetched claims that a pill will transform one area of your body and life. The same goes for fertility.
With all the hype, it's no easy feat to sift the snake oil from the science-backed supplements that do actually have some potential to enhance your reproductive health before, during and after egg freezing and are worth dropping some cash on.
At ELANZA, we analyzed the published evidence on supplements that are linked to egg quality, fertility and reproductive health to help you make a better informed choice.
We're going to share what we've discovered about where the science matches up to the marketing to support certain types of supplement, and which specific brands we consider worth investing in, having weighed up the data and the drama with our independent analysis.
Please be aware that some supplements may not be suitable for you. This information is intended to be purely educational and may not be complete. Always check with your own doctor about adverse side effects or risks before taking any supplements.
What are supplements?
Dietary supplements are substances used to add nutrients to your diet or to lower your risk of health problems. They may contain vitamins, minerals, enzymes, amino acids, herbs, and more in the form of pills, capsules, powders, gel tabs, extracts, or liquids. Prescriptions are not needed to buy dietary supplements and, unlike medications, they are largely unregulated and freely accessible. That's why it's important to do your own homework before taking anything.
What is their role in fertility?
The central goal of dietary supplementation for fertility is to ensure you are getting the right amount of the right nutrients needed to protect your eggs from oxidative damage (a normal cellular process), while potentially improving ovarian function.
Supplements play one of two potential roles in fertility. Firstly, correcting nutritional deficiencies that could impact normal fertility functioning. These are the kinds of vitamins and minerals you might find in a prenatal blend. Secondly, there are some substances that could have the potential to augment fertility, but which are generally not found through dietary sources (or only in trace quantities). Scientists consider some of these less well known kinds of supplements to be “biologically plausible” as fertility enhancers (we’ll go into those), but just bear in mind that across the board, more well-designed, randomized studies are needed to establish scientific consensus on effectiveness.
Do supplements actually work?
There are certain supplements that have been consistently identified as being helpful for treating infertility and for increasing the success rates of various fertility treatments.
The science indicates they can have potential benefits for your eggs. However, it’s useful to think of them as the icing on top, rather than the whole cake. Eating a balanced, healthful diet is an essential foundation for reproductive health and hormone balance.
If I eat healthily, do I need to take supplements?
In an ideal world no, but in reality studies suggest that many people - even well fed people in developed countries - aren’t getting all the right nutrients from their diets alone and could benefit from dietary supplementation.
Micronutrient deficiencies are a genuine phenomenon in parts of the adult population in the US. Soil depletion, long food chains and the shift from organic to intensively farmed produce are just a few of the reasons cited for this.
While the advice is not to consider egg freezing an insurance policy, that's exactly how you can think of dietary supplementation: insuring against dietary insufficiencies. With that said, a varied diet rich in vegetables, fiber, lean protein (especially from plant and fish sources), good fats and complex carbohydrates is an essential part of getting Fertility Fit™.
Can you overdose on supplements?
Yes. Some supplements have the potential to be risky if improperly taken, so it's important to check the label for the advised dosage. While supplements can plug holes when it comes to deficiencies, there is the potential for overdosing on certain vitamins and minerals.
Supplements linked to fertility
Vitamin, mineral and other supplements that have been scientifically shown to help reduce oxidative stress and /or support hormone and reproductive health include:
Supplements that may be beneficial for certain people include:
What about all the other supplements people mention?
There are also some supplements where the jury's very much still out when it comes to proven benefits for fertility. Our principle at ELANZA is to stick to the science. In this summary article we do not currently specifically cover the following substances that are often promoted as fertility-enhancing because the balance of evidence available for those claims is weak at present: L-Arginine; Vitamin E; Vitamin C; Resveratrol, Catechins, Diosgenin, Pycnogenol, Maca; Chinese herbs.
Let's look at each of the currently scientifically-validated supplements for fertility in turn.
1. A Prenatal Vitamin
Why it's worth the money: It's not always possible to get all the valuable vitamins, minerals and antioxidants that can boost reproductive health from diet alone. Prenatal supplements are aimed at people trying to conceive or who are pregnant, but they're actually a great place to turn to when you're looking to prepare for your egg freezing cycle. That's because they are formulated to contain many of the substances known to that can enhance and protect your eggs during maturation. And they represent an easy way to get a lot of nutrients in one pill, many of which help the absorption of others in the mix.
What to be aware of: The downside of all-in-one prenatal supplements is that few of them supply all the desired vitamins/antioxidants in the specific amounts at which they are most beneficial to your eggs (as outlined below).
If you find a prenatal vitamin that you like but it doesn’t have sufficient amounts of one or more key nutrients, you might want to buy a separate supplement specifically of that nutrient. Do not simply take more than the daily dosage of the prenatal because you could risk an overdose of other vitamins also included in the supplement.
What to look for: Many of the vitamins included in a prenatal supplement can play a role in creating a healthier foundation for fertility, such as iron. But below is the evidence-based “hit list” of vitamins and minerals that research has specifically shown can improve or protect your eggs, whether directly or indirectly, to give your body the support it needs to hopefully mature multiple healthy eggs in one cycle.
When looking for a prenatal, make sure it has minimum values of the following ingredients:
Folic acid: 600mcg
Vitamin B12: 2.6mcg
Zinc: 8mg (12mg for vegetarians)
ELANZA top 3 picks:
This is one of the few prenatals that has all of the nutrients needed for egg quality at the desired level to make the most impact. Plus, it passes the trustworthiness test as it's been certified by a 3rd party (CGMP). Some of the women that have taken it also report feeling like they do actually "glow!" Not a terrible side effect.
Zero fillers, binders, or artificial ingredients.
No gluten, wheat, or dairy.
Easy to swallow formula
This supplement sticks to the tried and true basics. It offers the right amounts of nutrients needed to achieve quality eggs. We also like that the packaging doesn't overdo it on the "mommy" vibes.
While the prenatal is not currently 3rd party certified by a company like NSF, the company states that the product undergoes four rounds of internal testing to ensure it's quality.
NOTE: There is a very large amount of B12 in this supplement, which might be too high for women that are trying to conceive naturally.
This is one of the few GMP certified prenatal supplements that is vegan! It's free of artificial colors and flavors, sugar, sweeteners, preservatives, gluten, soy, yeast, fish/shellfish, nuts, GMOs, and dairy/lactose.
Includes methylfolate, a natural, more absorbable form of folic acid.
Vegan. Vitamin D comes from lichen, a plant source.
Includes probiotics and enzymes to enhance digestion and absorption.
2. Ubiquinol (Coenzyme Q10)
Why it's worth the money: Coenzyme Q10 (CoQ10) is a powerful antioxidant that shows promise as a supplement to improve egg quality and quantity. CoQ10, among other cofactors, is “a potent stimulator of mitochondrial function,” helping to synthesize energy in cells, including in your ovaries. Simultaneously, it provides protection against oxidative stress.
In both humans and mice, age-related fertility decline has been linked to decreased expression of enzymes responsible for the production of CoQ10. In mice with depleted ovarian reserves, CoQ10 supplementation was associated with a higher number of eggs, better development of those eggs, and more live births.
Researchers from around the world have stated “it seems clear that supplementation with CoQ10 improves mitochondrial function and confers antioxidant protection for organs and tissues.”
What to be aware of: Whilst a human study showed women age 35-43 years old undergoing IVF who received 600mg supplementation of CoQ10 had improved pregnancy rates and better quality eggs than those who were not supplemented, this is just one study and not enough women were enrolled in the study for the results to be statistically significant..
While it’s not fully understood how far CoQ10 can effectively “turn back the hands of time,” and randomized clinical trials in humans are still needed, it does provide promise.
The reason CoQ10 is frequently taken as a supplement is because it is found in only very small amounts in foods, including organ meats, fatty fish, spinach, cauliflower, broccoli, oranges, strawberries, lentils and peanuts. Even consuming large amounts of these foods won’t provide much of a boost.
What to look for in a Ubiquinol CoQ10 supplement:
Ubiquinol - Ubiquinol CoQ10 is not the same as conventional CoQ10 (called ubiquinone). Look for the word “Ubiquinol” on the package as this is the advanced active form of CoQ10 that your body can use without any conversion. When shopping for Ubiquinol in a store, you'll find that many conventional CoQ10 supplements use words such as “more absorbable” or “extra strength” on their packaging. This usually means the brand considers it to be a more effective or absorbable version of conventional CoQ10. That is, it's not being compared to the active form of Ubiquinol and you're simply buying a different version of the oxidized form of CoQ10. No matter how much you absorb, your body still needs to convert conventional CoQ10 into Ubiquinol – a process that becomes harder and less efficient as you age.
Kaneka seal - Today, Kaneka is the only manufacturer of Ubiquinol CoQ10, which it produces in a way that carefully protects against oxidation. Look for the Kaneka Quality Seal on the bottle to make sure that you’re getting genuine Kaneka Ubiquinol made in the USA or Japan.
For vegans or people with allergies - Read the ingredients on the Supplement Facts label. Some brands use gelatin or beeswax, which may be an issue for vegans or those who follow kosher diets. Other ingredients, such as soybean oil or sunflower oil, may be a concern for people with allergies.
ELANZA top picks:
This is one of the few supplements that offers coenzyme Q10 in its most active form, ubiquinol (as opposed to ubiquinone). It's a bit more expensive than your standard CoQ10 supplement but that's because you're getting more out of it.
Qunol CoQ10’s patented formulation is 100% water and fat-soluble, unlike regular CoQ10 that does not dissolve in water and dissolves very poorly in fat.
Best absorbed with a meal, preferably breakfast.
Doctors recommend that you take 100mg 3x per day, ideally for a few months before your treatment in order to get the best results.
This Ubiquinol supplement comes from certified Kaneka and is one of the best value for money versions on the market. With 60, 100mg softgels in the bottle, this will last you 2 months if you take one per day. And if you have been diagnosed with a diminished ovarian reserve (DOR) or if you're in your in your mid-30s early 40s, you might want to take upwards of 300mg per day, making this a great option.
These softgels are fairly large in size so if this bothers you, perhaps look for a 50mg version.
3. Omega 3 Fatty Acids (EPA & DHA)
Why it's worth the money: As we review in detail in our book, Everything Egg Freezing, a diet high in omega-3 and not too much omega-6 is important for maturing quality eggs.
Omega-3 fatty acids can only be absorbed through food and supplementation. And while omega 6 is plentiful in the Western diet, omega 3 (found in oily fish, seeds, seaweed and walnuts) is not generally consumed in a healthy ratio. This is where supplementation can prove to be useful.
What to be aware of: Omega 3 from fatty fish is absorbed twice as effectively as even the most potent fish oil supplement, so introducing more of that into your diet is likely to be more effective. However, it can be beneficial to take it in supplement form if you find it challenging to regularly incorporate seafood and other sources of omega 3 (nuts, seeds, plant oils like flaxseed and canola) into your diet.
What to look for: There are 11 types of Omega 3s are not all of them are created equal. The most beneficial are EPAs and DHAs (mostly found in animal foods like fish). Another type, ALAs, which are mostly found in plants, can be converted it into EPA or DHA by your body, although this process is very inefficient.
ELANZA top 2 picks:
This supplement has exactly the right amount of DHA and EPA, adding up to the 1,400 recommended dosage and it's certified by the NSF.
Designed for better absorption and no fishy aftertaste. Enteric coating for better absorption of the essential fatty acids resulting in no fishy aftertaste or burps.
100% non-GMO, wild-caught fish. Sourced from fresh wild-caught fish in an FDA registered & inspected GMP-certified facility.
Purified using molecular distillation to remove heavy metals, PCB's & other toxins.
3rd party tested for product purity, effectiveness, ingredient safety, nutritional value and label accuracy. The highest standard guaranteed.
Algal (algae) oil is one of the only effective omega-3 sources that are suitable for vegans. We love the sustainable, non-plastic packaging and this is one of the few brands that offer sufficient levels of DHA and EPA in the formulation.
If you take 3 pills per day, that will supply you with a sufficient amount of omega-3. The package will last one month.
Products are Made in the USA in a GMP Facility and third-party safety tested for purity.
Doctor Scientific Organica is a modern apothecary combining the good of the past with the science of the present.
Why it's worth the money: Melatonin is a hormone that is secreted at night, indicating to your body that it’s time to rest, which is why it’s sometimes called “the sleepy hormone.”
A large body of research has shown that this hormone has many functions other than just sleep, many of which pose potential benefits to fertility. For example, it serves as an antioxidant, an anti-inflammatory, an immune modulator, and helps regulate fat and glucose metabolism.
Recent studies have revealed that taking melatonin supplements can restore antioxidant defenses around your eggs, protecting them from oxidative stress that can damage them during maturation. Melatonin’s antioxidant properties have been found to be more powerful than those of vitamin C or vitamin E.
One indication comes from studies in which melatonin appears to accumulate preferentially in ovaries compared with other organs and that higher concentrations of melatonin are found in follicular fluid surrounding your eggs.
Another study found that larger, more mature follicles in women’s ovaries had higher concentrations of melatonin than the smaller ones. Similarly, a study in which women who took a daily melatonin supplement prior to egg retrieval in IVF had an increased proportion of mature eggs and high-quality embryos. (Note that in the study melatonin was taken in conjunction with some other supplements, so it is hard to separate out the precise benefactor).
Even from a long term standpoint, melatonin seems to provide some benefits to your reproductive health. The researchers from a study conducted on mice that were given melatonin supplements coined it an “anti-aging agent” for the protective benefits they found it to confer on the ovaries.
What to be aware of: Melatonin is considered safe for short-term use and unlikely to cause dependency or habituation. Although it is available over the counter in the US and in most countries, in some countries such as the UK it can only be acquired with a medical prescription, as it is considered "medicinal by function."