Infertility

Infertility is usually defined as the inability to have a pregnancy that does not result in stillbirth or miscarriage after trying for at least one year.

Quick Answer

What it is

Infertility is usually defined as the inability to have a pregnancy that does not result in stillbirth or miscarriage after trying for at least one year.

Key findings

  • Grade A: LH Surge Prevention (Cetrorelix (Cetrotide))
  • Grade A: Clinical Pregnancy Rate (Cetrorelix (Cetrotide))
  • Grade A: OHSS Prevention (Cetrorelix (Cetrotide))

Safety

  • Phase 2 clinical trial showed kisspeptin-54 effectively triggered oocyte maturation in 95% of women at high risk of OHSS, with embryo formation in 90%.
  • Only 7% of kisspeptin-treated women developed mild OHSS, with no moderate, severe, or critical cases - a significant improvement over standard hCG triggers in high-risk patients.
  • Studies have high heterogeneity and risk of bias.
ℹ️ Quick Facts

Quick Facts: Infertility

  • Supplements Studied:26
  • Research Trials:34
  • Total Participants:12,966
  • Top Supplement:Maca (B)
34 trials
12,966 ppts
26 supps · 134 outcomes

Evidence-Based Protocol

Supplement stack ranked by research quality

Moderate Evidence

Primary Stack (Tier 1)

200-600mg daily

Supports mitochondrial function in sperm and eggs, improving motility and oocyte quality

18 studies | 1,200 participants
2-3g daily (as L-carnitine or acetyl-L-carnitine)

Transports fatty acids for energy production in sperm; improves sperm motility and morphology

22 studies | 1,800 participants

Supporting Stack (Tier 2)

400-800mcg daily (both partners)

Essential for DNA synthesis in rapidly dividing cells; supports sperm production and early embryonic development

15 studies | 2,500 participants
25-45mg daily (for deficient individuals)

Critical for testosterone synthesis, sperm production, and maintaining sperm membrane integrity

20 studies | 900 participants

How It Works

Infertility affects about 15% of couples and can have male, female, or combined factors. For men, sperm quality (count, motility, morphology) is key. For women, egg quality and ovarian function matter most. Both sperm and eggs are highly dependent on mitochondrial energy production, which declines with age and oxidative stress.

Coenzyme Q10 is crucial for both male and female fertility. In men, it improves sperm motility by enhancing mitochondrial energy production. In women, particularly those over 35 or undergoing IVF, CoQ10 can improve egg quality and ovarian response. The ovaries have among the highest CoQ10 requirements of any tissue.
L-Carnitine transports fatty acids into mitochondria for energy production—sperm cells are highly dependent on this process for motility. Meta-analyses consistently show improved sperm concentration, motility, and pregnancy rates. Acetyl-L-carnitine may provide additional antioxidant benefits.
Folate is essential for DNA synthesis and cell division, making it critical for sperm production and early embryonic development. Both partners should supplement, not just women. Low folate in men is associated with poor sperm quality and chromosomal abnormalities.
Zinc is concentrated in the prostate and is essential for testosterone production and sperm development. Deficiency is common in infertile men. Zinc also protects sperm DNA from oxidative damage.

Expected timeline: Sperm production takes about 74 days, so improvements in male parameters take 2-3 months. Women should supplement for at least 3 months before conception attempts or IVF cycles.

Generated from peer-reviewed researchSchema v2.0

Supplements for Infertility

Sorted by strength of evidence

BMaca
1
EstrogenWorsensFollicle-Stimulating HormoneImprovesLuteinizing HormoneImproves
BFolic Acid (Vitamin B9)
1
Seminal MotilityImprovesSperm CountImproves
CZinc
1
Seminal MotilityImprovesSperm CountImproves
CSaffron
1
Blood PressureImprovesSeminal MotilityImprovesSperm CountImproves
CCoenzyme Q10
1
Anti-Oxidant Enzyme ProfileImprovesSperm QualityImprovesOxidative Stress BiomarkersImproves
CVitamin C
1
Seminal MotilityImprovesSperm QualityImproves
CAshwagandha
1
CortisolImprovesSperm QualityImprovesTestosteroneImproves
CShilajit
1
Follicle-Stimulating HormoneImprovesLuteinizing HormoneOxidative Stress BiomarkersImproves
CCangfu Daotan Decoction
1
Ovulation RateImprovesPregnancy RateImproves
CBerberine
1
Blood glucoseImprovesLuteinizing HormoneImprovesTestosteroneImproves
CL-Carnitine
1
DNA DamageImprovesFertilityImprovesSperm CountImproves
CAspartate
1
Sperm MotilityImproves
CInositol
1
FertilityImprovesPCOS SymptomsImprovesOocyte QualityImproves
CGinger (Zingiber officinale)
1
Anti-Oxidant Enzyme ProfileImprovesEjaculate VolumeImprovesFollicle-Stimulating HormoneImproves
DAstaxanthin
1
Ejaculate VolumeOocyte QualityImprovesOocyte QuantityImproves
DVitamin D
1
Seminal MotilitySex Hormone Binding GlobulinImprovesSperm QualityImproves
DTribulus Terrestris
1
Body FatSperm CountImprovesFree TestosteroneImproves
DVitamin E
1
Seminal MotilitySperm CountImprovesSperm QualityImproves
DAlpha-Lipoic Acid
1
Seminal MotilitySperm CountImprovesSperm QualityImproves
DSpirulina
1
Sperm CountSperm QualityImproves

Detailed Outcomes

Grade:
Effect:
Size:
Sort:
|
A
LH Surge Prevention
~100% prevention of premature LH surge across multiple RCTs. Single 3mg dose or daily 0.25mg both effective. Gold standard for IVF protocols.
largeImproves
A
Clinical Pregnancy Rate
Phase 2/3 trials: 184 pregnancies from 732 patients (25.1%). Comparable to or better than GnRH agonist protocols.
moderateImproves
A
OHSS Prevention
Nearly 100% prevention of ovarian hyperstimulation syndrome. Major safety advantage over GnRH agonist protocols.
largeWorsens
A
Follicle Development
Allows controlled ovarian stimulation without interference. Fewer injections required vs ganirelix in flexible protocols.
moderateImproves
A
LH Surge Prevention
Phase III: 0.25mg is minimal effective dose for LH surge prevention. Comparable efficacy to leuprolide and triptorelin protocols.
largeImproves
A
Pregnancy Rate
Ongoing pregnancy rate 31.0% (ganirelix) vs 33.9% (triptorelin). Implantation rate identical at 22.9%. Comparable to GnRH agonist protocols.
moderateImproves
A
OHSS Prevention
2.4% OHSS incidence vs 5.9% with buserelin. Preferred protocol for high responders and oocyte donors.
moderateWorsens
A
Treatment Duration
5 days treatment vs 26 days with buserelin. Fewer injections required. Enhanced patient convenience and compliance.
largeImproves
A
Oocyte Maturation (IVF)
Phase 2 clinical trial showed kisspeptin-54 effectively triggered oocyte maturation in 95% of women at high risk of OHSS, with embryo formation in 90%.
largeImproves
A
Ovarian Hyperstimulation Syndrome Prevention
Only 7% of kisspeptin-treated women developed mild OHSS, with no moderate, severe, or critical cases - a significant improvement over standard hCG triggers in high-risk patients.
largeImproves
A
Egg Maturation Trigger
Kisspeptin-54 successfully triggers egg maturation sufficient for fertilization, embryo implantation, and live birth in IVF patients.
largeImproves
B
IVF Pregnancy Rate
A single injection of kisspeptin-54 resulted in mature eggs successfully fertilized and transferred, with pregnancy achieved in 23% of subfertile patients undergoing IVF.
moderateImproves
B
Seminal Motility
Small Improvement
5 studies
smallImproves
?
Sperm Count
1 study
Improves
B
Estrogen
Small Increase
2 studies
smallWorsens
?
Follicle-Stimulating Hormone
2 studies
Improves
?
Luteinizing Hormone
2 studies
Improves
?
Sperm Count
2 studies
Improves
?
Testosterone
2 studies
Improves
?
Prolactin
1 study
Improves
?
Serum T4
1 study
Improves
?
Sperm Quality
1 study
Improves
?
Thyroid-Stimulating Hormone
1 study
Improves
C
Ovulation Rate
Meta-analyses of Chinese RCTs: CFDTD + clomiphene improved ovulation rates vs clomiphene alone in PCOS patients. Evidence quality is low due to methodological limitations.
15 studies
moderateImproves
C
Pregnancy Rate
Meta-analysis: Higher pregnancy rates when CFDTD added to clomiphene treatment for PCOS-related infertility. Studies have high heterogeneity and risk of bias.
12 studies
moderateImproves
C
Sperm Motility
2660mg DAA + ubiquinol + zinc improved progressive sperm motility and testosterone (p=0.009) over 3 months
2 studies
moderateImproves
C
Fertility
Small Improvement
2 studies
smallImproves
?
PCOS Symptoms
2 studies
Improves
?
Oocyte Quality
1 study
Improves
?
Oocyte Quantity
1 study
Improves
C
Seminal Motility
Small Improvement
1 study
smallImproves
?
Sperm Count
1 study
Improves
C
Blood Pressure
Small Improvement
1 study
smallImproves
?
Seminal Motility
2 studies
Improves
?
Sperm Count
2 studies
Improves
?
Sperm Quality
2 studies
Improves
?
Ejaculate Volume
1 study
Improves
?
Follicle-Stimulating Hormone
1 study
Improves
?
Hemoglobin
1 study
Improves
?
Luteinizing Hormone
1 study
Improves
?
Prolactin
1 study
Improves
?
Testosterone
1 study
Improves
?
White Blood Cell Count
1 study
Improves
C
Anti-Oxidant Enzyme Profile
Small Increase
1 study
smallImproves
?
Sperm Quality
4 studies
Improves
?
Oxidative Stress Biomarkers
2 studies
Improves
?
Seminal Motility
2 studies0
Improves
?
Sperm Count
2 studies0
Improves
?
Follicle-Stimulating Hormone
1 study
Improves
?
Luteinizing Hormone
1 study
Improves
?
Testosterone
1 study
Improves
C
Seminal Motility
Moderate Improvement
1 study
moderateImproves
?
Sperm Quality
1 study
Improves
C
Cortisol
Moderate Decrease
1 study
moderateImproves
?
Sperm Quality
4 studies
Improves
?
Testosterone
4 studies
Improves
?
Luteinizing Hormone
3 studies
Improves
?
Seminal Motility
3 studies
Improves
?
Sperm Count
3 studies
Improves
?
Follicle-Stimulating Hormone
2 studies
Improves
C
Follicle-Stimulating Hormone
Small Increase
1 study
smallImproves
D
Luteinizing Hormone
No effect
1 study
none
?
Oxidative Stress Biomarkers
1 study
Improves
?
Sperm Quality
1 study
Improves
?
Testosterone
1 study
Improves
C
Blood glucose
Large Improvement
1 study
largeImproves
?
Luteinizing Hormone
8 studies
Improves
?
Testosterone
8 studies
Improves
?
Body Mass Index (BMI)
7 studies
Improves
?
Follicle-Stimulating Hormone
7 studies
Improves
?
Total cholesterol
6 studies
Improves
?
Waist-Hip Ratio
5 studies
Improves
?
Sex Hormone Binding Globulin
3 studies
Improves
?
Fertility
2 studies
Improves
C
DNA Damage
Small Improvement
1 study
smallImproves
?
Fertility
5 studies
Improves
?
Sperm Count
4 studies0
Improves
?
Seminal Motility
3 studies0
Improves
?
Sperm Quality
2 studies0
Improves
C
Anti-Oxidant Enzyme Profile
Small Increase
1 study
smallImproves
?
Ejaculate Volume
1 study
Improves
?
Follicle-Stimulating Hormone
1 study
Improves
?
Luteinizing Hormone
1 study
Improves
?
Oxidative Stress Biomarkers
1 study
Worsens
?
Seminal Motility
1 study
Improves
?
Sperm Count
1 study
Improves
?
Sperm Quality
1 study
Improves
?
Testosterone
1 study
Improves
D
Seminal Motility
No effect
4 studies0
none
?
Sex Hormone Binding Globulin
4 studies
Improves
?
Sperm Quality
4 studies0
Improves
?
Testosterone
4 studies
Improves
?
Sperm Count
3 studies0
Improves
D
Seminal Motility
No effect
3 studies0
none
?
Sperm Count
2 studies0
Improves
?
Sperm Quality
2 studies0
Improves
D
Seminal Motility
No effect
2 studies0
none
?
Sperm Count
2 studies0
Improves
?
Sperm Quality
2 studies0
Improves
D
Seminal Motility
No effect on sperm motility
2 studies
none
?
Sperm Count
2 studies0
Improves
?
Sperm Quality
2 studies0
Improves
D
Body Fat
No effect
1 study
none
?
Sperm Count
3 studies
Improves
?
Free Testosterone
2 studies
Improves
?
Luteinizing Hormone
2 studies
Improves
?
Sperm Quality
2 studies
Improves
?
Testosterone
2 studies
Improves
?
DHT
1 study
Improves
?
Erections
1 study
Improves
?
Fatigue Symptoms
1 study
Improves
?
Follicle-Stimulating Hormone
1 study
Improves
?
Libido
1 study
Improves
?
Muscle Mass
1 study
Improves
?
Prolactin
1 study
Improves
?
Seminal Motility
1 study
Improves
?
Serum DHEA
1 study
Improves
D
Sperm Count
No effect
1 study
none
?
Sperm Quality
1 study
Improves
D
Ejaculate Volume
No effect
1 study
none
?
Oocyte Quality
3 studies
Improves
?
Oocyte Quantity
3 studies
Improves
?
Fertility
1 study
Improves
?
Follicle-Stimulating Hormone
1 study
Improves
?
Inhibin B
1 study
Improves
?
Oxidative Stress Biomarkers
1 study
Worsens
?
Seminal Motility
1 study
Improves
?
Sperm Count
1 study
Improves
?
Sperm Quality
1 study
Improves
?
Superoxide Dismutase Activity
1 study
Improves
?
Testosterone
1 study
Improves
?
Total Antioxidant Capacity (TAC)
1 study
Improves
?
Fertility
1 study
Improves
?
Testosterone
1 study
Improves

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