Infertility
Supplements studied for infertility.
Overview
Ten supplements are indexed for infertility (31 studies), all with low-to-modest ratings. Melatonin, N-Acetyl Cysteine (NAC), and Vitamin D share WA 52 with low effect size and medium trust. Melatonin has not improved IVF/ICSI pregnancy rates despite some embryo-quality signals. NAC may improve some sperm parameters in mixed male-infertility trials. Vitamin D may increase clinical pregnancy rates mainly in deficient women, though IVF-specific outcomes are inconsistent.
Inositol (WA 52; low effect size, high evidence, medium trust; 8 studies) may improve egg retrieval and fertilization before IVF but usually not pregnancy rates. Astaxanthin has very limited data. See the heatmap and evidence reviews below.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Vitamin D | ★★★★★ | Low |
| N-Acetyl Cysteine (NAC) | ★★★★★ | Low |
| Melatonin | ★★★★★ | Low |
| Inositol | ★★★★★ | Low |
| Vitex agnus-castus | ★★★★★ | Low |
| Green Tea | ★★★★★ | Low |
| Astaxanthin | ★★★★★ | Low |
| Vitamin B9 (Folate) | ★★★★★ | Low |
| Milk Thistle | ★★★★★ | Very Low / None |
| Lutein | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
10 supplements for and rated at least stars. All purchase bands. No minimum star filter.
InositolView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Research shows that taking myo-inositol supplements before IVF or ICSI may help increase the number of eggs retrieved and improve fertilization rates, but it usually does not change pregnancy or miscarriage rates.
- Most people in these studies took 2-4 grams of myo-inositol daily with folic acid for several weeks before treatment.
- In special cases like cancer survivors, taking inositol may improve some hormone levels and ovarian function, but more research is needed.
- Women with PCOS might see better pregnancy rates with inositol compared to some medications, but overall evidence is mixed.
- Supplements combining myo-inositol with vitamins and probiotics generally do not help women conceive faster or increase live births, although they might slightly shorten conception time in women who are overweight.
Browse 8 studies·1 meta-analysis
RCTTime-to-conception and clinical pregnancy rate with a myo-inositol, probiotics, and micronutrient supplement: secondary outcomes of the NiPPeR randomized trial2023n=736
A secondary analysis of the NiPPeR trial (736 women, ages 18–38) found a myo-inositol, probiotic, and micronutrient supplement modestly improved time to conception versus standard supplement.
- Effect
- Benefit
- Population
- Women
- Participants
- 736
- Ages
- 18–38
MetaEffectiveness of inositol, metformin and their combination in women with PCOS undergoing assisted reproduction: systematic review and meta-analysis2022n=4,668
A meta-analysis (4,668 women with PCOS) found inositol alone or with metformin improved assisted reproduction outcomes versus control.
- Effect
- Benefit
- Population
- Women
- Participants
- 4,668
ObservationalEffects of Oral Supplementation with Myo-Inositol and D-Chiro-Inositol on Ovarian Functions in Female Long-Term Survivors of Lymphoma: Results from a Prospective Case-Control Analysis2022
In female long-term lymphoma survivors, myo-inositol plus D-chiro-inositol (135 mg/day) over 12 months improved ovarian function markers versus untreated controls.
- Effect
- Benefit
- Duration
- 12 months
- Dose
- 135 mg/day
- Population
- Female lymphoma survivors
- Avg age
- ~34
RCTMyo-inositol effect on pregnancy outcomes in infertile women undergoing in vitro fertilization/intracytoplasmic sperm injection: A double-blind RCT2022n=36
In 70 infertile women undergoing IVF/ICSI, myo-inositol for 2 months improved pregnancy outcomes versus control in a double-blind RCT.
- Effect
- Benefit
- Duration
- 2 months
- Dose
- 200 mcg 2×/day
- Population
- Women
- Participants
- 36
- Ages
- 20–40
RCTThe effect of Myo-inositol on fertility rates in poor ovarian responder in women undergoing assisted reproductive technique: a randomized clinical trial2021n=30
In 60 poor ovarian responders undergoing ART, myo-inositol improved fertility rates and ovarian response versus control.
- Effect
- Benefit
- Dose
- 400 μg
- Population
- Women
- Participants
- 30
- Ages
- 20–43
RCTEffect of myo-inositol supplementation on ICSI outcomes among poor ovarian responder patients: A randomized controlled trial2020n=56
In 112 poor ovarian responders, myo-inositol (4 g/day) for 1 month before ICSI improved oocyte quality and reproductive outcomes versus folic acid alone.
- Effect
- Benefit
- Duration
- 1 month
- Dose
- 4 g
- Population
- Pregnant women
- Participants
- 56
Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study2012n=50
In 100 non-PCOS IVF patients, 3 months of myo-inositol pretreatment improved ovarian response and reduced gonadotropin requirements versus control.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 150 IU/day
- Population
- Women
- Participants
- 50
- Ages
- <40
RCTMyo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial2011
In 84 euglycemic PCOS patients undergoing ICSI, myo-inositol (2 g twice daily) improved oocyte quality more than D-chiro-inositol.
- Effect
- Benefit
- Dose
- 2 g 2×/day
- Population
- Women with PCOS
MelatoninView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Studies show that taking melatonin does not help women get pregnant when going through IVF or ICSI.
- While it may make eggs and embryos look healthier in some cases, it does not improve pregnancy rates or reduce miscarriage.
- Most research has used 3 mg daily, which might be too low a dose.
- Some data suggest melatonin could improve how often eggs are fertilized with ICSI, but it has not been shown to increase actual pregnancy rates.
Browse 8 studies·2 meta-analyses
MetaOral melatonin supplementation during in vitro fertilization treatment: a systematic PRISMA review and meta-analysis of randomized controlled trials2021
A meta-analysis of 7 IVF RCTs found oral melatonin increased mature oocyte count by 1.82 per cycle and showed a nonsignificant trend toward higher clinical pregnancy rates, with most studies small or moderate quality.
- Effect
- Benefit
- Population
- Women
RCTEffect of myo-inositol and melatonin versus myo-inositol, in a randomized controlled trial, for improving in vitro fertilization of patients with polycystic ovarian syndrome2016
In 526 PCOS women undergoing IVF, myo-inositol plus melatonin 3 mg/day improved oocyte and embryo quality versus myo-inositol alone, with higher fertilization, implantation, and clinical pregnancy rates.
- Effect
- Benefit
- Dose
- 3 mg/day
- Population
- Women
MetaMelatonin supplementation during controlled ovarian stimulation for women undergoing assisted reproductive technology: systematic review and meta-analysis of randomized controlled trials2014n=680
A meta-analysis of 5 RCTs (680 women) found melatonin during ovarian stimulation did not significantly improve clinical pregnancy (RR 1.21), live birth, or miscarriage rates, with low-quality evidence.
- Effect
- No Benefit
- Population
- Women
- Participants
- 680
Clinical trialOral melatonin supplementation improves oocyte and embryo quality in women undergoing in vitro fertilization-embryo transfer2014
In IVF patients taking melatonin 3 mg/day for at least 2 weeks, ICSI fertilization and good-quality embryo rates improved in a second cycle, especially among those with prior fertilization rates below 60%.
- Effect
- Benefit
- Duration
- ≥2 weeks
- Dose
- 3 mg/day
- Population
- Women
RCTDoes supplementation of in-vitro culture medium with melatonin improve IVF outcome in PCOS?2013
In PCOS patients undergoing IVM IVF, melatonin-supplemented culture medium raised pregnancy and implantation rates compared with standard medium, particularly after hCG priming.
- Effect
- Benefit
- Population
- Women
RCTThe efficacy of melatonin administration on oocyte quality2012n=85
In 85 women undergoing IVF, melatonin increased the proportion of mature MII oocytes and class 1 embryos versus no melatonin, though fertilization rates did not differ between groups.
- Effect
- Benefit
- Population
- Women
- Participants
- 85
RCTMelatonin improves the oocyte and the embryo in IVF patients with sleep disturbances, but does not improve the sleeping problems2011n=60
In 60 IVF patients with sleep disturbances, melatonin increased retrieved and MII oocyte counts and grade-1 embryo ratio versus no melatonin but did not significantly improve sleep symptoms.
- Effect
- Benefit
- Population
- Women undergoing IVF
- Participants
- 60
RCTEffect of the treatment with myo-inositol plus folic acid plus melatonin in comparison with a treatment with myo-inositol plus folic acid on oocyte quality and pregnancy outcome in IVF cycles. A prospective, clinical trial2010n=65
In 65 women undergoing IVF, myo-inositol plus folic acid plus melatonin yielded more mature oocytes (6.56 vs 5.76) and higher-quality embryos than myo-inositol plus folic acid alone, with 13 versus 9 pregnancies.
- Effect
- Benefit
- Population
- Women
- Participants
- 65
N-Acetyl Cysteine (NAC)View supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It’s not clear if taking N-acetylcysteine helps with male infertility.
- Some studies show it may improve the number and quality of sperm over several months, but results are mixed and not fully reliable.
- For men who’ve had COVID-19 and saw their sperm health drop, taking N-acetylcysteine seemed to help improve sperm over a few months, but better studies are needed.
Browse 4 studies·1 meta-analysis
MetaEffect of Antioxidants on Sperm Quality Parameters in Subfertile Men: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials2023
A network meta-analysis of 1,790 subfertile men found CoQ10 and several antioxidants including NAC ranked highest for improving sperm concentration and motility.
- Effect
- Benefit
- Population
- ALL patients
The effect of N-acetyl cysteine consumption on men with abnormal sperm parameters due to positive history of COVID-19 in the last three months2021n=100
A study of 100 men with COVID-19-related semen impairment found NAC significantly improved sperm motility and morphology versus untreated controls.
- Effect
- Benefit
- Population
- Men
- Participants
- 100
RCTEffects of N-acetyl-cysteine supplementation on sperm quality, chromatin integrity and level of oxidative stress in infertile men2019
A 3-month RCT of 50 infertile men (ages 25–40) found NAC (600 mg/day) improved sperm count, motility, morphology, and reduced DNA fragmentation.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 600 mg/day
- Population
- Infertile men
- Ages
- 25–40
RCTEfficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: a double-blind, placebo controlled, randomized study2009
A 30-week double-blind RCT of 468 infertile men found NAC (600 mg/day), selenium, or both significantly improved sperm motility and morphology versus placebo.
- Effect
- Benefit
- Duration
- 30 weeks
- Dose
- 600 mg/day
- Population
- ALL patients
Vitamin DView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is unclear if taking vitamin D helps women who have trouble getting pregnant.
- Studies in women doing IVF found that eating more vitamin D does not improve egg quality or pregnancy success.
- However, some reviews show that taking vitamin D supplements can increase the chance of clinical pregnancy by about half, mainly in women who don’t have quite enough vitamin D. Taking between 1000 and 10,000 IU daily for one to three months may help.
- One study found vitamin D helped more women get a positive pregnancy test, but it did not increase pregnancies confirmed by ultrasound.
Browse 3 studies·2 meta-analyses
MetaInfluence of Vitamin D supplementation on reproductive outcomes of infertile patients: a systematic review and meta-analysis2023n=2,352
A meta-analysis of 12 studies (2,352 infertile patients) found vitamin D supplementation increased clinical pregnancy rate (OR 1.70), with best results at moderate daily dosing for 30–60 days.
- Effect
- Benefit
- Duration
- 30–60 days
- Dose
- 10000 IU/day
- Population
- Women
- Participants
- 2,352
ObservationalVitamin and Carotenoid Intake and Outcomes of In Vitro Fertilization in Women Referring to an Italian Fertility Service: A Cross-Sectional Analysis of a Prospective Cohort Study2023n=494
In 494 women undergoing IVF, dietary intake of lutein and other carotenoids showed no significant associations with oocyte quality, clinical pregnancy, or live birth after adjustment.
- Effect
- No Benefit
- Population
- Women
- Participants
- 494
MetaEffect of Vitamin D Supplementation on In Vitro Fertilization Outcomes: A Trial Sequential Meta-Analysis of 5 Randomized Controlled Trials2022
A meta-analysis of 5 IVF trials found vitamin D supplementation improved chemical pregnancy rate (RR 1.53) but not clinical pregnancy or secondary outcomes in vitamin D-deficient women.
- Effect
- Benefit
- Population
- Women
AstaxanthinView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is uncertain if astaxanthin helps with infertility caused by endometriosis or PCOS.
- Small studies found that taking astaxanthin before assisted reproduction improved some measures of egg and embryo quality but did not increase pregnancy rates.
Browse 2 studies
RCTAstaxanthin ameliorates inflammation, oxidative stress, and reproductive outcomes in endometriosis patients undergoing assisted reproduction: A randomized, triple-blind placebo-controlled clinical trial2023n=25
In 50 infertile women with endometriosis undergoing ART, astaxanthin 6 mg/day for 12 weeks lowered inflammation, improved antioxidant markers, and increased oocytes retrieved and high-quality embryos versus placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 6 mg/day
- Population
- Women
- Participants
- 25
- Ages
- 20–40
RCTRandomized controlled trial of astaxanthin impacts on antioxidant status and assisted reproductive technology outcomes in women with polycystic ovarian syndrome2022
In PCOS women undergoing ART, astaxanthin 8 mg/day for 40 days raised serum catalase and TAC, activated Nrf2 pathway genes, and improved mature oocyte and embryo rates versus placebo.
- Effect
- Benefit
- Duration
- 40 days
- Dose
- 8 mg/day
- Population
- Women
Green TeaView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if drinking green tea by itself helps improve fertility.
- Some early studies have looked at green tea combined with other natural ingredients like herbs, vitamins, and minerals.
- One small study showed that women who took a supplement containing green tea extract along with other nutrients were more likely to become pregnant after three months compared with those who didn’t take it.
- More research is needed to understand if green tea alone can help with fertility and how it might work.
Browse 1 study
RCTDouble-blind, placebo-controlled study of Fertilityblend: a nutritional supplement for improving fertility in women2006n=53
In 53 women (ages 24–42) trying to conceive, FertilityBlend (chasteberry, green tea, L-arginine, vitamins) increased pregnancy rate versus placebo over 3 months.
- Effect
- Benefit
- Population
- Women
- Participants
- 53
- Ages
- 24–42
Vitex agnus-castusView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is unclear if vitex agnus-castus helps women with infertility.
- Small studies found that taking vitex extracts or homeopathic versions for several months did not increase the odds of pregnancy in women with irregular or absent menstrual periods.
Browse 2 studies
RCT[The efficacy of the complex medication Phyto-Hypophyson L in female, hormone-related sterility. A randomized, placebo-controlled clinical double-blind study]2000n=67
In an RCT of 67 participants, for 3 months, however, there was no significant effect when viewing the whole group.
- Effect
- No Benefit
- Duration
- 3 months
- Population
- Women
- Participants
- 67
RCTMastodynon(R) bei weiblicher Sterilität1998n=7
In an RCT of 7 participants, for 3–6 months, In women with sterility due to secondary amenorrhoea and luteal insufficiency, a treatment with Mastodynon can be recommended over a period of 3 to 6 months.
- Effect
- Benefit
- Duration
- 3–6 months
- Population
- Women
- Participants
- 7
Vitamin B9 (Folate)View supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is currently uncertain whether taking 5-methyltetrahydrofolate (5-MTHF) with vitamins B6 and B12 provides greater benefits than folic acid alone for women undergoing assisted reproductive technology.
- A study from Italy found that women taking 5-MTHF along with these vitamins had higher pregnancy and live birth rates compared to those taking folic acid, particularly among women under 40 years of age.
- However, this study was retrospective, which means it looked back at existing data, and it is not clear if these findings apply in countries where folic acid is added to foods.
- More research is needed to confirm these results.
Browse 1 study
5-Methyltetrahydrofolate and Vitamin B12 Supplementation Is Associated with Clinical Pregnancy and Live Birth in Women Undergoing Assisted Reproductive Technology2021
A study in women found that 400 mcg vitamin B complex supplementation remained independently associated, after multivariable adjustment, with clinical pregnancy (OR 2.03, p = 0.008) and live birth (OR 1.83, p = 0.03).
- Effect
- Benefit
- Dose
- 400 mcg
- Population
- Women
Milk ThistleView supplement →
Do not purchase·★★★★★
How we scored this▸
- It is not clear whether milk thistle helps people undergoing in vitro fertilization.
- Early research shows that taking milk thistle with hormone treatment reduces some cell death in the ovary during IVF for male infertility, but it does not change how many eggs are collected or the thickness of the womb lining.
Browse 1 study
RCTEvaluation of effect of silymarin on granulosa cell apoptosis and follicular development in patients undergoing in vitro fertilization2010n=40
An RCT of 40 IVF patients found silymarin (70 mg three times daily) reduced granulosa-cell apoptosis and improved follicular development versus placebo.
- Effect
- No Benefit
- Dose
- 210 mg/day
- Population
- Women
- Participants
- 40
LuteinView supplement →
Do not purchase·★★★★★
How we scored this▸
- Eating foods rich in lutein does not appear to affect important IVF outcomes such as egg quality, embryo transfer success, pregnancy, or having a healthy baby in couples undergoing IVF treatment.
Browse 1 study
ObservationalVitamin and Carotenoid Intake and Outcomes of In Vitro Fertilization in Women Referring to an Italian Fertility Service: A Cross-Sectional Analysis of a Prospective Cohort Study2023n=494
In 494 women undergoing IVF, dietary intake of lutein and other carotenoids showed no significant associations with oocyte quality, clinical pregnancy, or live birth after adjustment.
- Effect
- No Benefit
- Population
- Women
- Participants
- 494
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Inositol | ★★★★★52% | 8 | 1 | 26% |
| Melatonin | ★★★★★52% | 8 | 2 | 26% |
| N-Acetyl Cysteine (NAC) | ★★★★★52% | 4 | 1 | 13% |
| Vitamin D | ★★★★★52% | 3 | 2 | 10% |
| Astaxanthin | ★★★★★44% | 2 | 0 | 6% |
| Vitex agnus-castus | ★★★★★44% | 2 | 0 | 6% |
| Green Tea | ★★★★★44% | 1 | 0 | 3% |
| Lutein | ★★★★★28% | 1 | 0 | 3% |
| Milk Thistle | ★★★★★32% | 1 | 0 | 3% |
| Vitamin B9 (Folate) | ★★★★★40% | 1 | 0 | 3% |