Supplements-are you taking the good ones?

We know we are born with our ovarian reserve, and the number of our “eggs” can only decrease, from the moment we are born until we completely run out of them, by the time we get to menopause. We also know the quality of our oocytes starts to decrease by the time we reach our thirties, and the chances of ovulating abnormal eggs unable to create normal embryos are higher the older we get. But is there really nothing we can do to improve this egg quality?

The truth is, this a very controversial subject. The efficiency of a treatment, be it a subscription med or a dietary supplement, can only be proven by studies. While medicines benefit from multiple studies, dietary supplements receive far less attention from the part of the medical community. Therefore less studies are performed and easier to say “we don’t know if this supplement really improves oocyte quality, because there are not enough studies out there to confirm it”. Lots of REs though, consider that even if there is not enough proof some supplements help to improve your fertility, they don’t hurt either, so you might as well take them, if only for your peace of mind. And that’s already a great starting point, in my opinion, for having the impression of doing something, instead of just playing the wait and see game, means a lot for an infertility patient. There are some supplements out there who are more spoken about, and who also benefit from some studying. Those are the ones we will discuss today.

COENZYME Q10 – is one of the most important coenzymes. It is a substance made naturally in the body and it plays a critical role in the creation of cellular energy. CoQ10 is found inside the tissue of  organs such as the brain, heart, liver and kidneys (which demand more energy) but  it exists in virtually all our cells and tissues. There are two main forms of this coenzyme, and this creates confusion.

Ubiquinone is the conventional form of CoQ 10. That is what we used to take before 2007, when a better form of CoQ10 was discovered, the Ubiquinol. The problem with Ubiquinone (the basic form of CoQ10) is that your body needs to convert it into Ubiquinol before it can improve the cellular energy your organs need to function at best levels. As we age, the body struggles harder to convert the Ubiquinone in Ubiquinol, hence the recommendation to use directly the Ubiquinol form, for better results.

Ubiquinol is known to be a very strong antioxidant and its main role is to neutralise the free radicals that can harm your cells.

I started using this Ubiquinol brand lately. Why? Because most brands will offer 100 or 200 mg pills and if I can get my 400 mg from one pill, considering the huge amount of other supplements I am taking, well…I won’t say no 🙂 Also, 10 USD monthly value sounds good to me considering I have tried more expensive brands and I had to swallow two or three pills to get me the recommended quantity.

Click on image to be redirected to Amazon for details.

MYO INOSITOL- initially used in PCOS patients and for fighting insulin resistance, this nutrient has become the golden weapon in the infertility battle. It has been proven that, at a dosage of 4 g daily (most studies use this amount as reference) it has improved the ovarian function and number of oocytes retrieved in patients undergoing IVF cycles, and who have previously been considered poor responders.

The following is a link to a 2011 study aiming to evaluate the pregnancy outcome after the administration of myo-inositol combined with melatonin (will talk about it later in this article) in women who failed to conceive in previous IVF cycles, because of low egg quality. The results were crystal clear, everything was better post treatment : number of mature oocytes retrieved, fertilization rate, number of total embryos and number of top quality embryos.

Here is a more recent study (2015) showing Myo-Inositol supplementation might be beneficial for previous poor responders during IVF cycles.

And here we go again. I personally haven’t found a brand to sell 4 g pills. I think that’s a pity. Out of all the supplements I am taking, Myo Inositol is the one that I struggle with the most. At one point I was taking 4 one gram pills a day. And big ones too.

Lately I have switched for this brand. I only take two pills a day, and the value, compared to other brands, is really great: less than 5 USD per month.

Click on image to be redirected to Amazon for details.

MELATONIN is a hormone produced by the pineal gland, and it regulates sleep and wakefulness. Many of its biological effects in humans and animals are produced through activation of melatonin receptors, while others are due to its role as an antioxidant. As a medicine it is used to treat insomnia, and is usually sold over the counter in many countries. The negative effect of the oxidative stress on fertility is no longer a secret. Clinical studies have tried to prove the effect of melatonin as an antioxidant on egg quality. The results of those studies suggest that melatonin supplementation (in conjunction with Myo-Inositol or not) may lead to better pregnancy rates in IVF cycles. Amazingly, not only egg quality was improved in  patients who were administered melatonin during the follicular period, but progesterone levels were also significantly higher in patients who received melatonin during the luteal phase.

Here is a review of several studies with very interesting findings

The majority of the studies have used 3mg of Melatonin every evening as standard dosage. You will also want to be very careful when taking melatonin during a natural cycle, not to go over the standard dose. It has been proven that taken at high doses (6mg and more) melatonin actually prevents ovulation.

I personally am in love with Melatonin. Yes I appreciate its antioxidant values, but I also appreciate the way my sleep has improved since I have started taking it. I may sometimes take a break from some of the other supplements, but wherever I go, my Melatonin goes 🙂

I am a huge fan of this brand. And yes, it is related to the fact that I get my 3 mg out of only one pill.

Click on image to be redirected to Amazon for details.

DHEA– naturally existing hormone, the most abundant circulating steroids in humans, that the female body converts into androgens, mainly testosterone. That means DHEA already exists in our bodies, we are producing it, but its levels decrease with age. It is sometimes used as an androgen in hormone replacement therapy for menopause. Lately it has been more and more used particularly during IVF cycles to treat women with DOR (diminished ovarian reserve).

Clinical studies have proven that at a dosage of 75 mg daily for a period of at least 3 months, DHEA increased IVF pregnancy rates, increased antral follicle counts, increased quality and quantity of eggs and embryos, decreased risk of miscarriage and chromosomal abnormalities. DHEA supplementation works by restoring the abnormally low androgen levels in patients with DOR due to advanced maternal age or premature ovarian failure.

Here is one link to two of these studies

As far as I am concerned, I have tried two over the counter brands of DHEA and frankly, none of them made any difference. Then I tried a pharmacy compound, on prescription from my RE. Sure, the price was higher. But so was my Antral Follicle Count. I truly believe this one is a great supplement. Beware though, if you ever knew yourself to have high testosterone levels, or PCOS, by all means have your DHEA levels tested before supplementing!

L-ARGININE- is an amino acid that plays an important role in cell division, the healing of wounds, removing ammonia from the body, immune function, and the release of hormones. It can be found in almost all dietary protein : eggs, meat, fish, nuts and supplementation has been proven efficient in improving fertility in both women and men. How does it work ? Arginine is believed to improve blood circulation to the uterus, promote healthy sperm production, improve the production of cervical mucus and increase the libido. There are not many studies focusing on L-arginine, more research needs to be done, but many fertility specialist recommend this « miracle mollecule » which is already included in most prenatal vitamins anyway. If you are vegetarian or vegan and your protein intake is lower, you should benefit even more from supplementing. The recommended dosage is of 1000 to 2000 mg daily. Bonus points: here is one supplement that you can share with your make partner. The effects on sperm quality are really amazing! If you wish to add L Arginine to your supplements list, this brand offers good value and is also organic.

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ROYAL JELLY-Royal Jelly is a strong nutrient produced by young worker bees in the hive. For 2-3 days, these bees are fed only on royal Jelly until they reach maturation and produce enough Royal Jelly to feed the female larva, which develops into Queen Bee. Queen bees are fed their entire life only Royal Jelly while worker bees are feed Royal Jelly for only the first three days of their life. This diet is responsible for making the queen bee 40 to 60 percent larger than a worker bee. There are not many studies on humans, but there some on animals and their conclusions suggest Royal jelly might improve fertility. Beware of adverse reactions thouugh : those with allergies to bee products are to avoid this supplement.

I have tried liquid Royal Jelly but I found it complicated to break the vials and dilute the liquid with water or fruit juice. So now I am using a NOW foods product, 1500 mg daily.

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FOLIC ACID (Folate, Vitamin B9) is a form of Vitamin B. It is no longer a secret for anyone trying to conceive, that the first supplement you will be recommended by your doctor is going to be the Folic acid. It has been proven for years and years to prevent neural tubes defects and congenital heart defects in newborns, and actually low levels in early pregnancy are believed to be the cause for more than half of babies born with neural tube defects. There are no common side effects, even if taken for long periods of time. Humans can not produce it so it is important to get it from diet (and supplements). Food supplement manufacturers often use the term folate for something different from “pure” folic acid: in chemistry, folate refers to the deprotonated ion, and folic acid to the neutral molecule—which both coexist in water. Mind you: of you have been diagnosed with MTFHR gene mutation, you will need to take FOLATE instead of FOLIC ACID, since the mutation reduces your ability to metabolize folic acid.

There have been lots of studies proving the importance of Folic Acid intake before and during early pregnancy.

Here is one you might want ot read

and also the reccommendation of the World Health Organization on this subject

For those diagnosed with MTFHR mutation, here is one study that might interest you.

Since I have not bee diagnosed with the mutation, I am a forever fan of Folic Acid under this form

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There are of course, other supplements more or less proven to increase fertility: Vitamin D (previously discussed in the article about the AMH), Vitamin E (used usually during the follicular phase in order to thicken the lining), DHA (not to be confounded with DHEA), Maca, Vitex…and many more.

I tried to focus on the ones who have been more or less medically proven to actually help on improving pregnancy outcomes after administration, during natural or medicated cycles.

Obviously,   not everything is for everyone, and in order to avoid doing more harm it is best to discuss supplements intake with your doctor. In case your doctor is not very pro-supplements, you can always pull out “the study” and show him you did your research. That is what I did, and frankly…it worked 🙂





Tafuri, Laura & Servy, Edouard & Menezo, Yves. (2018). The hazards of excessive folic acid intake in MTHFR gene mutation carriers: An obstetric and gynecological perspective. Clinical Obstetrics, Gynecology and Reproductive Medicine. 4. 10.15761/COGRM.1000215.

3 thoughts on “Supplements-are you taking the good ones?”

  1. If someone has tested positive for MTHFR, folic acid is actually bad for women trying to conceive, and folate should be substituted.

    Also just because you took a cocktail of vitamins does not mean that’s why you got pregnant. There are lots of us out there who have done the same who have seen multiple IVF failures. Be careful of trying to tell women that if they take vitamins they will suddenly have good eggs….that’s just not how it works.


    1. The World health Organization urges ALL women to take folic acid- their words, not mine, as written black on white in the document I provided in the article.
      As for the mutation you mentioned (that obviously doesn’t affect the general population) my following sentence in the end of the article refers to precisely this type of situations “Obviously, not everything is for everyone, and in order to avoid doing more harm it is best to discuss supplements intake with your doctor”
      I wrote this article because the topic of supplements came up more than once these days among the over 3000 women in the two FB groups on infertility I am an administrator of.
      Its aim is to make a presentation of the most used supplements, and BACK IT UP with medical studies.
      I am not sure where is it you have seen I suggested if you take vitamins you get pregnant for sure. Because I haven’t ever implied such thing, and whatever I have said in favor of a certain supplement is backed up by a real study whose link I added for everyone to see.
      So while I thank you for your comment, I suggest you read the article again, you must have misunderstood things 😉

      Liked by 1 person

  2. Your post is a great summarization of research that many reproductive endocrinologist fail to share with their patients.
    It’s good to point out that DHEA is supplementing our own, and it’s a level that should be checked before supplementing (or at least as soon as possible after you begin) and then monthly throughout the treatment. Most women supplement for 3 months prior to treatment, therefore that’s are least 3 trips to the lab.

    Regarding folic acid: it’s true, obstetricians in the United States can only share medical information that is backed by standards of practice, and so far that standard is 800mcg of *folic acid*. However, be aware if you have had frequent miscarriages or a child with neural tube defects like spina bifida , MTHFR mutation can be the culprit. Advocate for yourself to your physician, have a genetics test to rule out or diagnose MTHFR mutation, and treat accordingly. Part of treatment is reducing intake of grains enriched with folic acid and supplementing with Methylfolate (and usually Methylated B12 as well) at a much higher dosage, up to as high as 5000mcg. This disorder is the exception, not the rule, for the general population. However, the percentage of the population affected greatly increases when we include women pursuing IVF because they would not be doing so had it not been for pregnancy failures, most likely related to their MTHFR mutation.

    Liked by 1 person

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