Fertility Supplements for Women

What Links Nutrition to Female Reproductive Health?

Adequate nutrition supports multiple stages of female reproduction - from follicle development to endometrial receptivity to early embryo survival. When key micronutrients are deficient, hormonal signaling, oocyte quality, and implantation can all be disrupted. Infertility is classified as a disease of the reproductive system by the World Health Organization (WHO), defined as the failure to achieve a pregnancy after 12 months of regular, unprotected sexual intercourse. It affects an estimated 17.5%, or one in six individuals, globally.^[1] Supplements are not a substitute for a balanced diet. But deficiencies in specific nutrients are genuinely common, particularly among women with reproductive conditions like PMOS (polyendocrine metabolic ovarian syndrome, the 2026 term that replaced polycystic ovary syndrome [PCOS]),25 endometriosis, or diminished ovarian reserve - and targeted supplementation can make a clinical difference.^[1][2][13] That said, more is not always better. A supplement that helps correct a deficiency can cause harm when taken without one.

→ Learn more: Female Infertility

Which Supplements Have the Strongest Evidence?

Folic Acid - The One That’s Not Optional

Folic acid - the synthetic form of vitamin B9, is the best-evidenced pre-conception supplement for women planning a pregnancy. The U.S. Preventive Services Task Force awarded it an “A” grade recommendation in its 2023 guidance, recommending that anyone planning to or who could become pregnant take a daily supplement of 0.4 to 0.8 mg (400–800 µg), starting at least one month before anticipated conception.^[3] Why does it matter? Folate is necessary for nucleotide synthesis and DNA replication. Inadequate levels impair cell division during early fetal development and may lead to incomplete neural tube closure (critical embryonic process that forms the central nervous system), causing conditions such as spina bifida (when a baby’s spine and spinal cord do not fully develop in the womb) and anencephaly (severe condition in which major parts of the brain and skull do not develop).^[3][4][26] The neural tube closes within the first 28 days of pregnancy - often before a person knows they’re pregnant. That’s why folate supplementation should begin before conception, not after a positive test.^[3] The upper tolerable intake limit for folic acid is 1,000 µg per day. Women in countries with mandatory food fortification programs who also take a standard supplement may already be exceeding this threshold.^[5] Women at higher risk - including those with a previous neural tube defect-affected pregnancy, those taking certain anti-seizure medications, or those with pre-existing diabetes - may require 4-5 mg per day, but only under medical supervision.^[3][4][28] Side effects from folate are uncommon at recommended doses. At very high doses, unmetabolized folic acid may accumulate, and this is associated with potential masking of a vitamin B12 deficiency - a relevant concern in older women or those with restricted diets.^[5]

What Does Vitamin D Do for Fertility?

Vitamin D behaves more like a hormone than a conventional vitamin, and its receptors are found throughout female reproductive tissue - most consistently in the ovaries and uterus, with more limited evidence in the fallopian tubes.^[6] Deficiency is strikingly common: up to 40–50% of healthy pregnant women have insufficient vitamin D levels, which has been associated with reproductive and pregnancy outcomes in specific populations and clinical settings.^[6][9] In women with PMOS, deficiency is especially prevalent. Between 67-85% of women with PMOS have serum 25-hydroxy vitamin D levels below 20 ng/mL. Randomized controlled trials (RCTs) and meta-analyses have shown that vitamin D supplementation in these women is linked to improved insulin sensitivity, reduced androgen levels, and enhanced ovulatory function.^[6] In endometriosis, laboratory and animal studies suggest vitamin D has anti-inflammatory effects that may limit endometriotic lesion growth, but human trials have not shown a significant benefit for pelvic pain or dysmenorrhea (painful menstrual periods).^[8] Evidence also links supplementation to improvements in endometrial thickness and menstrual cycle regularity in women who are deficient.^[7]

Key Insight:
Vitamin D supplementation appears most beneficial for women who are demonstrably deficient. In women with normal levels, additional supplementation has not been shown to significantly improve fertility outcomes.^[6] The recommended dietary allowance is 600 IU per day for general health, but the fertility trials, showing benefit, corrected deficiency with substantially higher doses - on the order of 1,000–10,000 IU per day for 30–60 days - individualized to blood levels under clinical supervision.^[9][12] Timing matters, too: high vitamin D concentrations at the wrong point in the ovarian cycle may have a detrimental effect on oocyte development and embryo quality.^[6] Side effects of excessive vitamin D include hypervitaminosis D (elevated blood calcium) which can cause nausea, vomiting, weakness, and kidney problems.^[12] The established tolerable upper limit is 4,000 IU per day, a threshold that many high-dose commercially available vitamin D supplements approach.^[10] Much of vitamin D’s benefit to ovarian function is mediated through calcium. Vitamin D deficiency causes secondary hypocalcemia (low blood calcium that occurs due to an underlying condition), and animal studies show that correcting calcium levels alone can restore follicular development and oocyte maturation impaired by vitamin D deficiency - pointing to calcium as a key downstream effector. Still, there are no human RCTs showing that oral calcium supplementation alone improves fertility outcomes in women who are not deficient. Calcium’s role in reproductive health is real, but it operates through adequate vitamin D status and a balanced diet, not standalone supplementation. 6,18

→ Learn more: Endometriosis

Do Omega-3 Fatty Acids Improve Fertility?

Omega-3 fatty acids are essential polyunsaturated fats that the body cannot synthesize independently - they must come from diet or supplements. The three relevant forms are alpha-linolenic acid (ALA, from plants), and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in fatty fish and fish oil supplements. The body can convert ALA to EPA and DHA, but this conversion is not efficient.^[11] A 2024 meta-analysis found that omega-3 intake improved pregnancy and fertilization rates in women. However, the high heterogeneity across the included studies somewhat limits the interpretation of this review. The proposed mechanisms include improved hormonal balance, better oocyte quality, enhanced embryo implantation, and reduced inflammation that might otherwise interfere with reproductive organ function. In women with PMOS, omega-3 supplementation was associated with a higher likelihood of achieving pregnancy in several studies.^[11] Omega-3 deficiency - and excessive omega-6 exposure relative to omega-3 - is associated with an increased risk of miscarriage and preterm birth.^[11] During pregnancy, at least 200 mg of DHA per day is recommended to support fetal brain and eye development.^[12] For women trying to conceive, fatty fish (one to two servings per week) provides a solid baseline. But seafood also carries a risk of organic mercury and polychlorinated biphenyls (PCBs), which are harmful to fetal development.^[12] Side effects at standard doses are mild: fishy aftertaste, gastrointestinal discomfort, and loose stools. At high doses, omega-3s have a mild blood-thinning effect and can interact with anticoagulant medications.^[11]

How Does Coenzyme Q10 Support Egg Quality?

Coenzyme Q10 (CoQ10) is an antioxidant produced naturally in the body, central to mitochondrial energy production - the process that powers cellular function.^[13] Oocytes are among the most mitochondria-rich cells in the body, and their energy demands increase sharply during the final stages of maturation. CoQ10 levels decline with age.^[13] Because CoQ10 is involved in mitochondrial energy production and its levels decline with age, reduced CoQ10 availability may contribute to poorer oocyte competence, lower ovarian response, and an increased risk of chromosomal errors.^[30] This makes CoQ10 particularly relevant for women with diminished ovarian reserve (DOR) or those over 35 who are trying to conceive or undergoing assisted reproductive technology (ART).^[13] A 2024 systematic review and meta-analysis of six RCTs involving 1,529 participants with DOR undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) found that CoQ10 pretreatment significantly improved the number of oocytes retrieved, fertilization rates, and proportion of high-quality embryos compared with controls.^[13] A separate randomized trial in young women (under 35) with poor ovarian reserve found that 60 days of CoQ10 pretreatment before IVF/ICSI improved ovarian response and produced more high-quality embryos, though clinical pregnancy and live birth rates did not differ significantly between the groups, as the trial was not powered to detect a difference in pregnancy rates 14 CoQ10 also appears to benefit women with PMOS, with studies showing it can raise FSH (follicle-stimulating hormone) levels, lower testosterone, and improve metabolic markers.^[15] The typical dose studied in fertility research ranges from 200 to 600 mg per day, taken with a fat-containing meal to improve absorption.^[13] Side effects of CoQ10 are rare and mild. Very high doses may cause gastrointestinal discomfort. CoQ10 can interact with anticoagulant medications such as warfarin, so women on blood-thinning therapy should disclose its use to their clinician before starting.^[13]

→ Learn more: Fertility and Age

Who Benefits From Myo-Inositol?

Myo-inositol is a naturally occurring compound that plays a role in insulin signaling - a relevant target in PMOS, where insulin resistance is a key driver of hormonal imbalance and ovulatory dysfunction.^[16] The evidence is more nuanced than its popularity suggests. A 2024 systematic review and meta-analysis, conducted to inform the International Evidence-based PMOS Guidelines included 30 trials involving 2,230 participants and concluded that the evidence supporting inositol use in the management of PMOS is limited and inconclusive. Clinicians and patients are encouraged to weigh this uncertainty when making shared decisions.^[16] Even so, more recent work continues to support a reproductive benefit: a 2023 randomized study found that myo-inositol with lactalbumin improved hormonal and reproductive parameters in most women with PMOS, while noting that roughly 28–38% are resistant to myo-inositol alone.^[17] The standard studied dose is 2,000 mg twice daily, often combined with folic acid (200 µg). A formulation with a 40:1 ratio of myo-inositol to D-chiro-inositol more closely mirrors the body’s natural plasma ratio and has been used in several trials. Side effects are generally mild and include gastrointestinal symptoms such as nausea, flatulence, and soft stools.^[16]

Source: Pandey C, et al. Nutrients. 2025;17(1):57.^[1] Alrashidi AS, et al. Cureus. 2024;16(8):e67028.^[2] Lin G, et al. Ann Med. 2024;56(1):2389469.^[13] Fitz V, et al. J Clin Endocrinol Metab. 2024;109(6):1630-1655.^[16]

→ Learn more: Polyendocrine Metabolic Ovarian Syndrome

What Role Do Minerals Play?

Minerals don’t typically headline fertility discussions, but several have clear mechanistic roles in the reproductive system. A 2024 systematic review concluded that without a confirmed deficiency or medical indication, mineral supplementation can cause more harm than benefit.^[18]

Zinc - Hormones and Egg Protection

Zinc is involved in the production of luteinizing hormone (LH) and follicle-stimulating hormone, both critical for ovulation, and it protects oocytes from reactive oxygen species (ROS) - a form of oxidative damage that disrupts egg quality.^[18] Zinc deficiency is linked to abnormal LH and FSH synthesis, irregular ovarian growth, menstrual cycle disruptions, and pre-eclampsia (sudden, high blood pressure and signs of organ damage). A 2024 systematic review found that higher follicular fluid zinc levels were associated with faster embryo development in IVF patients, and that women undergoing IVF had significantly lower serum zinc levels than fertile controls.^[18] Side effects of excessive zinc supplementation include nausea, vomiting, stomach cramps, and with long-term high intake - copper deficiency, which can impair immune function and nerve health.

Selenium - Thyroid, Ovulation, and Oocytes

Selenium is required to produce selenoproteins, which convert the thyroid hormone thyroxine into its biologically active form, triiodothyronine (T3). Because thyroid dysfunction can disrupt menstrual cycles and impair conception, adequate selenium is considered important for reproductive hormonal balance.^[18] A large prospective study found that women with lower plasma selenium levels had a 46% greater risk of subfertility and a longer time to pregnancy, after adjusting for a range of maternal and paternal factors. This association persisted even among women not undergoing ART.^[19] Side effects: selenium has a narrow therapeutic range. Excessive intake - above the tolerable upper limit of 400 µg per day - causes selenosis, characterized by hair loss, brittle nails, gastrointestinal disturbance, and nerve damage.^[18]

Iron - Critical Before Pregnancy, Risky in Excess

Iron supports oxygen delivery to reproductive tissue and is essential for fetal development. Iron deficiency is one of the most common nutritional deficiencies in women of reproductive age and can suppress ovulatory function, but the relationship with fertility is not linear.^[1][2] Excess iron in the follicular fluid has been associated with increased oxidative stress, which may impair oocyte quality. Studies in IVF patients have shown that women who received multi-nutrient supplementation had lower follicular fluid iron levels compared with those who did not supplement, and this was associated with better reproductive outcomes. Routine iron supplementation is not recommended unless a deficiency has been confirmed.^[18] Side effects of iron supplementation include constipation, nausea, dark stools, and at high doses - serious gastrointestinal injury. Iron supplements can also interfere with the absorption of zinc and calcium.^[18]

Iodine - Overlooked but Essential

Iodine is required for the production of thyroid hormones, which regulate metabolism, ovulation, and early embryonic development. Iodine deficiency during preconception and early pregnancy is associated with impaired fertility, increased risk of miscarriage, and in severe cases - congenital hypothyroidism (inadequate production of thyroid hormones) in the newborn. Deficiency is more common than many clinicians expect, particularly in women who avoid iodized salt or dairy products.^[12] The NIH Office of Dietary Supplements recommends 220 µg per day during pregnancy and 150 µg per day for non-pregnant women of reproductive age. Most prenatal multivitamins include iodine, but many standard multivitamins do not. Women who are vegan, avoid dairy, or use non-iodized salt are at the highest risk of deficiency and should confirm their multivitamin contains it.^[12] Side effects: excessive iodine intake can paradoxically suppress thyroid function. The tolerable upper limit is 1,100 µg per day for adults. High-dose supplementation without confirmed deficiency is not recommended, particularly in women with underlying thyroid conditions.^[12]

Source: Kapper C, et al. The Impact of Minerals on Female Fertility: A Systematic Review. Nutrients. 2024;16(23):4068.^[18] Prenatal multivitamins are formulated to close nutritional gaps during preconception and pregnancy, typically containing folic acid, iron, iodine, calcium, and vitamin D - nutrients where dietary intake commonly falls short. Prescription and over-the-counter versions differ in composition: prescription products tend to contain higher folate levels, while non-prescription products often include higher amounts of vitamin A, calcium, and vitamin D.12

Which Supplements Can Harm Female Reproductive Health?

Not all supplements promoted for fertility are benign. Several carry real risks, particularly at doses commonly found in over-the-counter products. Vitamin A (preformed retinol): excessive intake of preformed (the active, already-converted form) vitamin A during pregnancy from supplements or high-dose fortified foods is associated with congenital malformations (birth defects), including abnormalities of the eye, skull, lungs, and heart. The risk applies specifically to preformed retinol, not to beta-carotene (the plant-based precursor), which has not been found to cause reproductive toxicity. Women who are pregnant or planning a pregnancy should avoid supplements containing high doses of preformed vitamin A.^[12] High-dose folic acid: while folate is essential, excess unmetabolized folic acid in the bloodstream is associated with potential masking of vitamin B12 deficiency, which can cause irreversible nerve damage if left untreated.^[5] High-dose vitamin D: vitamin D toxicity causes elevated blood calcium, leading to nausea, vomiting, kidney damage, and in severe cases, cardiac arrhythmias.^[12] High-dose iodine: both deficiency and excess are harmful. Intake above the tolerable upper limit of 1,100 µg per day can paradoxically suppress thyroid hormone synthesis, cause goiter (abnormal enlargement of the thyroid gland), and trigger thyroid dysfunction. During pregnancy, the risk is compounded: the fetal thyroid cannot self-regulate against iodine overload the way an adult thyroid can, meaning excessive maternal intake can cause fetal goiter and neonatal hypothyroidism (a deficiency of thyroid hormone present at birth). Women with a history of thyroid disease are especially vulnerable and can develop thyroid dysfunction even at standard supplemental doses. Herbal supplements: Several herbal products - including chasteberry (Vitex agnus-castus), maca, and goji berry - are marketed for fertility, but clinical evidence remains limited. A study at an academic infertility practice found that only about a third of supplements used were disclosed to a healthcare provider, creating a significant risk of unrecognized drug interactions.^[20]

Important:
Many herbal fertility supplements can interact with prescription medications, including fertility drugs, blood thinners, and thyroid medications. Always disclose any supplement use to your clinician before starting fertility investigation or treatment. 20,23

Are Herbal Supplements Worth Considering?

Over two-thirds of women seeking infertility treatment report past use of herbal supplements. Most are buying them over the counter based on advice from friends, family, or the internet - only 7.9% first heard about these products from a healthcare provider, and only about a third of supplements were disclosed to a provider. That’s a significant gap. Several of the most popular herbal supplements carry real risks in the context of fertility treatment and pregnancy, and the interaction profile with prescription fertility drugs is largely uncharacterized.^[20]

→ Learn more: Supplements for Men

Vitex agnus-castus (Chasteberry) - The Most Studied Herb for Female Hormones

Chasteberry - the fruit of Vitex agnus-castus is one of the most widely used herbal supplements for female reproductive complaints, and it has more clinical research behind it than most. It acts primarily through dopaminergic mechanisms, suppressing prolactin release and influencing the hypothalamic-pituitary-ovarian axis (the primary endocrine system that regulates female reproduction, menstruation, and puberty). This makes it theoretically relevant for women with elevated prolactin or luteal phase deficiencies that disrupt ovulation.^[21] A 2025 narrative review covering research from 1995 to 2024 reported that chasteberry can up-regulate ovarian cycle function and fertility through a spectrum of mediators spanning hypothalamic, pituitary, and ovarian hormones.^[21] One frequently cited trial involving women with infertility found that a supplement containing chasteberry produced a pregnancy rate of 26% compared with 10% in the placebo group. The data tell a more complicated story, though: the supplement contained multiple other ingredients, which means the effect cannot be attributed to chasteberry alone.^[24][27]

Key Insight:
The evidence for chasteberry is most consistent for premenstrual syndrome (PMS) and premenstrual dysphoric disorder. For direct fertility outcomes such as clinical pregnancy rates, the evidence remains limited by small trials and combination products that make it difficult to isolate chasteberry’s contribution.^[21][24] Side effects at standard doses are generally mild: headache, nausea, and skin reactions. But the safety profile during pregnancy is a concern. Chasteberry is classified as “possibly unsafe in pregnancy” due to evidence of estrogenic, progestogenic, and potential uterotonic activity. It can also interact with medications that act on dopamine receptors, including antipsychotics and some Parkinson’s disease treatments. 21

Ashwagandha (Withania somnifera) - Stress Reduction and Indirect Hormonal Support

Ashwagandha is an adaptogenic root with a long history in Ayurvedic medicine and an increasingly robust clinical trial base. Its primary mechanism is cortisol reduction. This is where its relevance to female fertility lies: chronically elevated cortisol suppresses GnRH (gonadotropin-releasing hormone) release from the hypothalamus, impairing LH pulsatility and ovulation. By lowering cortisol, ashwagandha may indirectly support hormonal balance rather than acting on reproductive hormones directly.^[23] A 2022 prospective, randomized, placebo-controlled trial found that ashwagandha root extract significantly improved sexual function in healthy women, including arousal, lubrication, and satisfaction scores compared with placebo.^[22] A 2025 systematic review of sex-specific hormonal and fertility outcomes found that in women with PMOS, ashwagandha’s cortisol-lowering effect may reduce adrenal androgen production and improve insulin sensitivity - both key therapeutic targets in PMOS.^[23] But evidence for ashwagandha directly improving clinical pregnancy rates in women remains limited. Most compelling data come from small trials, and the results have not yet been replicated at scale. The dose most studied in human trials is 300–600 mg of standardized root extract per day. Side effects are generally mild - gastrointestinal discomfort and drowsiness, but ashwagandha should be avoided during pregnancy due to potential uterotonic effects (the ability of a substance to induce, stimulate, or increase contractions of the uterus) and thyroid-stimulating activity, which may affect thyroid medication dosing.^[23]

Maca Root (Lepidium meyenii) - Limited Evidence for Fertility Specifically

Maca root is a cruciferous vegetable native to the Peruvian Andes, marketed aggressively for fertility and libido. Maca does not appear to act hormonally: multiple studies have found that it does not significantly alter serum levels of estradiol, testosterone, FSH, or LH. Its proposed mechanisms are adaptogenic and nutritional rather than endocrine, involving bioactive compounds called macamides and macaenes.^[24] A 2022 systematic review of 57 studies (14 clinical and 43 pre-clinical) reported positive effects of maca across a range of conditions, including sexual function and menopausal symptoms. 29 But most of the fertility evidence comes from animal models, and human clinical data on direct fertility outcomes such as pregnancy rates in reproductive-age women trying to conceive - remains insufficient. Where maca shows the most consistent benefit is in women with antidepressant-related sexual dysfunction and in postmenopausal women experiencing low libido.^[24] At standard doses (1.5–3 g per day of dried powder), maca is generally considered safe for non-pregnant women. It has not been studied in pregnancy, so use during conception cycles is not recommended. The current evidence does not support maca as a fertility-specific supplement in reproductive-age women trying to conceive.^[24]

Source: Friedman J, et al. F&S Rep. 2023;4(1):104–111.^[20] Vitex agnus-castus: Phytother Res. 2025. DOI:10.1002/ptr.8438.^[21] Safia, et al. J Health Rehabil Res. 2024;4(2):427–438. DOI:10.61919/jhrr.v4i2.834.^[24]

So, What Should You Do Now?

The evidence supports targeted supplementation - not blanket use of everything on the fertility supplement shelf. Here’s a practical sequence.

Step 1: Start Folic Acid Now - Before Conception

If you’re planning a pregnancy or not actively preventing one, consider starting to use folic acid daily.Do not wait for a positive pregnancy test. Women with a previous neural tube defect-affected pregnancy, diabetes, or who take certain medications should speak to a clinician about whether 5 mg per day is appropriate.

Step 2: Get Your Vitamin D Levels Checked

Ask your GP or gynecologist for a 25-hydroxy vitamin D blood test. If you’re deficient, supplementation is supported by evidence, particularly if you have PMOS or endometriosis. Avoid self-prescribing high-dose formulations without confirmed deficiency.

Step 3: Consider Your Dietary Omega-3 Intake

If you eat fatty fish fewer than twice a week, a daily fish oil supplement is a reasonable addition. Choose molecularly distilled brands with third-party quality certification to minimize mercury exposure.

Step 4: Discuss CoQ10 or Myo-Inositol If Relevant to Your Situation

If you have diminished ovarian reserve or are over 35, ask a fertility specialist about CoQ10. If you have PMOS and insulin resistance, myo-inositol (2,000 mg twice daily with folate) may be worth discussing with realistic expectations about the strength of the evidence.

Step 5: Have Minerals Assessed Before Supplementing

Do not take standalone zinc, selenium, or iron supplements without a confirmed deficiency. Request blood tests, including a ferritin level for iron stores before starting any of these.

Step 6: Review All Supplement Use with a Fertility Specialist

→ Compare fertility clinics worldwide: MedicalNavigator.com/clinics/reproductive-medicine

Too Long, Didn’t Read

• Folic acid (0.4–0.8 mg daily) is the only pre-conception supplement with an “A” grade from major health bodies; start it before conception.
• Vitamin D deficiency affects up to 40–50% of pregnant women and is linked to ovulatory dysfunction, PMOS, and endometriosis.
• A 2024 meta-analysis found that omega-3 supplementation significantly improved pregnancy and fertilization rates in women, but evidence remains heterogeneous.
• CoQ10 has the strongest evidence for women with diminished ovarian reserve or age-related decline in egg quality.
• Excess preformed vitamin A during pregnancy is associated with congenital malformations; high-dose vitamin D can cause kidney damage.
• Minerals such as zinc, selenium, iron and iodine should only be supplemented when a deficiency has been confirmed by blood test.
• Popular herbal supplements - chasteberry, ashwagandha, and maca have limited fertility evidence and carry real risks including drug interactions and pregnancy safety concerns.

References

1. Pandey C, Maunder A, Liu J, et al. The Role of Nutrient Supplements in Female Infertility: An Umbrella Review and Hierarchical Evidence Synthesis. Nutrients. 2025;17(1):57. ↩
2. Alrashidi AS, Feraih Aljaghwani L, Saleh AlMohimeed R. The Effect of Nutrient Supplementation on Female Fertility: A Systematic Review. Cureus. 2024;16(8):e67028. ↩
3. US Preventive Services Task Force. Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA. 2023;330(5):454–459. ↩
4. Seyoum Tola F. The concept of folic acid supplementation and its role in prevention of neural tube defect among pregnant women: PRISMA. Medicine. 2024;103(19):e38154. ↩
5. Ledowsky C, Mahimbo A, Scarf V, Steel A. Women Taking a Folic Acid Supplement in Countries with Mandatory Food Fortification Programs May Be Exceeding the Upper Tolerable Limit of Folic Acid: A Systematic Review. Nutrients. 2022;14(13):2715. ↩
6. van Tienhoven XA, Ruiz de Chávez Gascón J, Cano-Herrera G, et al. Vitamin D in Reproductive Health Disorders: A Narrative Review Focusing on Infertility, Endometriosis, and Polycystic Ovarian Syndrome. Int J Mol Sci. 2025;26(5):2256. ↩
7. Katyal G, Kaur G, Ashraf H, et al. Systematic Review of the Roles of Inositol and Vitamin D in Improving Fertility among Patients with Polycystic Ovary Syndrome. Clin Exp Reprod Med. 2024;51(3):181–191. ↩
8. Kalaitzopoulos DR, Samartzis N, Daniilidis A, et al. Effects of Vitamin D Supplementation in Endometriosis: A Systematic Review. Reprod Biol Endocrinol. 2022;20:176. ↩
9. Meng X, Zhang J, Wan Q, et al. Influence of Vitamin D Supplementation on Reproductive Outcomes of Infertile Patients: A Systematic Review and Meta-analysis. Reprod Biol Endocrinol. 2023;21(1):17. ↩
10. Cilar Budler L, Spevan M, Ivanisevic K, Budler M. Evidence-Based Recommendations for Dietary Supplementation During Pregnancy: Is It Time for a Product Recall? Reprod Female Child Health. 2025;4:e70011. ↩
11. Trop-Steinberg S, Gal M, Azar Y, Kilav-Levin R, Heifetz EM. Effect of Omega-3 Supplements or Diets on Fertility in Women: A Meta-analysis. Heliyon. 2024;10(8):e29324. ↩
12. National Institutes of Health, Office of Dietary Supplements. Dietary Supplements and Life Stages: Pregnancy - Health Professional Fact Sheet. Updated 2025. ↩
13. Lin G, Li X, Jin Yie SL, Xu L. Clinical Evidence of Coenzyme Q10 Pretreatment for Women with Diminished Ovarian Reserve Undergoing IVF/ICSI: A Systematic Review and Meta-analysis. Ann Med. 2024;56(1):2389469. ↩
14. Xu Y, Nisenblat V, Lu C, et al. Pretreatment with Coenzyme Q10 Improves Ovarian Response and Embryo Quality in Low-Prognosis Young Women with Decreased Ovarian Reserve: A Randomized Controlled Trial. Reprod Biol Endocrinol. 2018;16(1):29. ↩
15. Jiang Y, Han Y, Qiao P, Ren F. Exploring the Protective Effects of Coenzyme Q10 on Female Fertility. Front Cell Dev Biol. 2025;13:1633166. ↩
16. Fitz V, Graca S, Mahalingaiah S, et al. Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines. J Clin Endocrinol Metab. 2024;109(6):1630–1655. ↩
17. Kamenov Z, Gateva A, Dinicola S, Unfer V. Comparing the Efficacy of Myo-Inositol Plus α-Lactalbumin vs. Myo-Inositol Alone on Reproductive and Metabolic Disturbances of Polycystic Ovary Syndrome. Metabolites. 2023;13(6):717. ↩
18. Kapper C, Stelzl P, Oppelt P, et al. The Impact of Minerals on Female Fertility: A Systematic Review. Nutrients. 2024;16(23):4068. ↩
19. Grieger JA, Grzeskowiak LE, Wilson RL, et al. Maternal Selenium, Copper and Zinc Concentrations in Early Pregnancy, and the Association with Fertility. Nutrients. 2019;11(7):1609. ↩
20. Friedman J, Sheeder J, Lazorwitz A, Polotsky AJ. Herbal Supplement Use Among Reproductive-Aged Women in an Academic Infertility Practice. F\&S Rep. 2023;4(1):104–111. ↩
21. Sirotkin AV. Effects, Mechanisms of Action and Application of Vitex agnus-castus for Improvement of Health and Female Reproduction. Phytother Res. 2025;39(3):1484–1493. (subscription required) ↩
22. Ajgaonkar A, Jain M, Debnath K. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract for Improvement of Sexual Health in Healthy Women: A Prospective, Randomized, Placebo-Controlled Study. Cureus. 2022;14(10):e30787. ↩
23. Shokoohi M, et al. Effects of Ashwagandha on Reproductive Health: A Systematic Review of Sex-Specific Hormonal and Fertility Outcomes. Phytother Res. 2025. doi:10.1002/ptr.70128. (subscription required) ↩
24. Safia, Lashari S, Khan T, et al. Herbal Supplements and Fertility: A Comprehensive Review. J Health Rehabil Res. 2024;4(2):427–438. doi:10.61919/jhrr.v4i2.834. ↩
25. Teede HJ, Bahri Khomami M, Morman R, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. 00717-8) Lancet. Published online May 12, 2026. ↩
26. Gole RA, Meshram PM, Hattangdi SS. Anencephaly and its associated malformations. J Clin Diagn Res. 2014;8(9):AC07–AC09. ↩
27. Westphal LM, Polan ML, Trant AS. Double-blind, placebo-controlled study of FertilityBlend: a nutritional supplement for improving fertility in women. Clin Exp Obstet Gynecol. 2006;33(4):205–208. ↩
28. Zhu X, et al. Best Evidence Summary of Folic Acid Supplementation for Prevention of Neural Tube Defects in Women of Childbearing Age. Nutrients. 2026;18(4):641. ↩
29. Bower-Cargill C, Yarandi N, Petróczi A. A Systematic Review of the Versatile Effects of the Peruvian Maca Root (Lepidium meyenii) on Sexual Dysfunction, Menopausal Symptoms and Related Conditions. Phytomedicine Plus. 2022;2(4):100326. *This guide is for informational purposes only. Always consult qualified healthcare providers for personalized recommendations.* ↩