How to Increase Fertility

These traits have been shown to improve fertility

Improve Diet
  • Eat a diet of 25% or more protein and 40% or less carbs (improves egg quality and doubles pregnancy rate in IVF)
  • Consume dairy fat (reduces risk of unexplained and anovulatory infertility by 27% and 50%, respectively)
  • Avoid low fat dairy (increases risk of unexplained infertility by 85%)
  • Don't drink alcohol before conception (reduces live birth rate by 21% in IVF patients)
  • Increase monounsaturated fats
  • Increase saturated fats (lowers risk of infertility by 17%)
  • Decrease trans fats
  • Reduce polyunsaturated fats (higher consumption increases risk of infertility by 23%)
  • Reduce intake of refined carbohydrates
  • Reduce dietary fiber (each 5 grams per day increases risk of anovulatory cycle by 78%)
  • Reduce intake of animal protein
  • Replace animal protein with vegetable protein
  • Avoid soy (causes infertility in mice)
Improve Lifestyle
  • Exercise (improved fertility in two studies, although long term exercise was associated with lower fertility in IVF patients)
  • Normalize body weight
  • Boost adiponectin
Improve Hormone Balance
  • Increase estrogen levels (doubles pregnancy rate in IVF)
  • Increase DHEA levels
  • Extend length of menstrual bleeding past 5 days
  • Prolong ovulation past 11 days
  • Reduce menstrual cycle to less than 36 days
  • Engage in stress reduction therapy
  • Lower GnRH
  • Normalize LH
  • Treat PCOS (reduces birth rate by 5%)
Improve Health
Try Supplements
  • Avoid aspirin (interferes with implantation and reduces follicle growth)
  • Take 120 mg black cohosh from days 1 to 12 of menstrual cycle (improved pregnancy rate by 170% in clomid cycles)
  • Take 4 g myo-inositol (improves egg quality and pregnancy rate in IVF patients and PCOS sufferers)
  • Take 500 - 16000 mg l-arginine (improves endometrial thickness and pregnancy rates)
  • Take 600 mg vitamin E (improves endometrial thickness)
  • Take 1200 mg n-acetyl-cysteine if suffering from PCOS (found not helpful in other infertility causes)
  • Avoid supplementing progesterone too early (interferes with implantation)
  • Take a supplement including vitex, l-arginine and vitamins 
  • Normalize selenium and magnesium levels (cured infertility in 100% of women with deficiency)
  • Take vitamin B6 (highest levels associated with 120% higher fertility)
  • Normalize vitamin D levels
  • Normalize zinc levels
  • Avoid flax oil and other sources of alpha-linoleic acid (highest levels associated with 86% lower fertility)
Increase Male Fertility

Diet and Fertility

A diet of more than 25% protein and less than 40% carbs improves pregnancy rate (67% vs 32%)

Women undergoing in vitro fertilization (IVF) treatments who consumed high levels of protein and low levels of carbohydrates had better quality eggs and embryos. Patients whose daily protein intake was 25% or more of their diet and whose carbohydrate intake was 40% or less of their diet had four times the pregnancy rates of patients who ate less protein and more carbs daily before and during IVF cycles. Between January 2010 and December 2011, 120 patients participating in an assisted-reproduction therapy program at DIRM completed a three-day nutritional log and had an embryo transfer. The diet diaries revealed that 48 patients had an average daily protein intake greater than 25% vs. 72% who had less than 25%. No differences were found in body mass index (BMI) in either group. Embryo development was assessed after five days of culture or at the blastocyst stage. An increased blastocyst formation was found in 54.3% of patients whose daily protein intake was greater than 25% vs. 38% blastocyst formation in patients whose daily protein intake was less than 25%. The pregnancy rate was also significantly improved in patients with greater than 25% daily protein intake (66.6 % vs. 31.9%).

Drinking whole milk daily lowers infertility risk by 50%, frequently eating ice cream lowers risk by 38%

Among the high-fat dairy foods, adding a daily serving of whole milk without increasing energy intake was associated with a reduction in the risk of anovulatory infertility of more than 50% after accounting for potential confounders. Likewise, the multivariate-adjusted RRs of anovulatory infertility for women in successively higher intakes of ice cream were 0.85  for women consuming ice cream once a week and 0.62 for women consuming ice cream twice or more each week, when compared with women consuming ice cream less than once weekly.

High-fat dairy products are considered "fertility food" in large study

In a study of some 17,000 women conducted by the Harvard School of Public Health, researchers were able to define a group of "fertility foods" able to improve odds. Consuming moderate amounts of high-fat dairy products -- like ice cream, whole milk, and cheese was a key dietary tenet to increasing fertility.

Consuming > 2 servings low fat dairy increases risk of ovulatory infertility by 85%; high fat dairy helps

We prospectively followed 18,555 married, premenopausal women without a history of infertility who attempted a pregnancy or became pregnant during an 8-year period. Diet was assessed twice during the study using food-frequency questionnaires. RESULTS: The multivariate-adjusted relative risks of anovulatory infertility comparing women consuming > or = 2 servings per day to women consuming < or = 1 serving per week was 1.85 for low-fat dairy foods. The risk ratio comparing women consuming > or = 1 serving per day of high-fat dairy foods to those consuming < or = 1 serving per week was 0.73. There was an inverse association between dairy fat intake and anovulatory infertility. Intakes of lactose, calcium, phosphorus and vitamin D were unrelated to anovulatory infertility. CONCLUSIONS: High intake of low-fat dairy foods may increase the risk of anovulatory infertility whereas intake of high-fat dairy foods may decrease this risk. Further, lactose (the main carbohydrate in milk and dairy products) may not affect fertility within the usual range of intake levels in humans.

Drinking before becoming pregnant lowers live birth rate by up to 21% in IVF patients

In this prospective cohort study, men and women completed a self-administered questionnaire before their first IVF cycle. We conducted multicycle analyses with final models adjusted for potential confounders that included cycle number, cigarette use, body mass index, and age. RESULTS:  Women drinking at least four drinks per week had 16% less odds of a live birth rate compared with those who drank fewer than four drinks per week (odds ratio 0.84). For couples in which both partners drank at least four drinks per week, the odds of live birth were 21% lower compared with couples in which both drank fewer than four drinks per week (odds ratio 0.79). CONCLUSION: Consumption of as few as four alcoholic drinks per week is associated with a decrease in IVF live birth rate.

Increasing monounsaturated fat in diet improves fertility

In a study of some 17,000 women conducted by the Harvard School of Public Health, researchers were able to define a group of "fertility foods" able to improve odds. Eating more monounsaturated fats (like olive oil) and less trans fats (like the kind found in many baked goods or fast foods) was one of the keys to increasing fertility.

Higher saturated fat and lower polyunsaturated fat in diet associated with higher fertility

Infertile women under 50 years consumed more polyunsaturated fat (odds ratio 1.23), less saturated fat (odds ratio 0.83) and had experienced more hangovers during previous year (odds ratio 1.02) than fertile women.

Replacing refined carbohydrates with high fiber foods improves fertility in large study

In a study of some 17,000 women conducted by the Harvard School of Public Health, researchers were able to define a group of "fertility foods" able to improve odds. Eating more high fiber, low-glycemic foods -- like whole grains, vegetables, and some fruits, while reducing the intake of refined carbohydrates and sugars was one of the dietary tenets that were key to increasing fertility.

Every 5 grams/day of dietary fiber increases risk of anovulatory cycle by 78%

Dietary fiber consumption was inversely associated with hormone concentrations (estradiol, progesterone, LH, and FSH) and positively associated with the risk of anovulation by using random-effects models with adjustment for total calories, age, race, and vitamin E intake. Each 5-g/d increase in total fiber intake was associated with a 1.78-fold increased risk of an anovulatory cycle. The adjusted odds ratio of 5 g fruit fiber/d was 3.05.

Swapping meat for vegetable protein improves fertility

In a study of some 17,000 women conducted by the Harvard School of Public Health, researchers were able to define a group of "fertility foods" able to improve odds. Increasing intake of vegetable protein (like soy), while reducing animal protein (like red meat) was a key to increasing fertility.

Methionine more important than other amino acids and nutrients for fertility

Dietary restriction extends healthy lifespan in diverse organisms and reduces fecundity. Adding essential amino acids to the dietary restriction condition increased fecundity and decreased lifespan, similar to the effects of full feeding, with other nutrients having little or no effect. However, methionine alone was necessary and sufficient to increase fecundity as much as did full feeding, but without reducing lifespan.

Soy causes miscarriage and infertility in mice

Female mice were treated with genistein, the primary phytoestrogen in soy, on Neonatal Days 1-5 at doses of 0.5, 5, or 50 mg/kg per day. Soy-treated mice had prolonged menstrual cycles with a dose- and age-related increase in severity of abnormal cycles. Females treated with 0.5 mg/kg genistein or 5 mg/kg genistein bred at 2, 4, and 6 mo showed statistically significant decreases in the number of live pups over time with increasing dose; at 6 mo, 60% of the females in the 0.5 mg/kg genistein group and 40% in the 5 mg/kg group delivered live pups compared with 100% of controls. Mice treated with 50 mg/kg did not deliver live pups. At 2 mo, >60% of the mice treated with 50 mg/kg genistein were fertile as determined by uterine implantation sites, but pregnancy was not maintained; miscarriage was characterized by fewer, smaller implantation sites and increased reabsorptions. Mice treated with lower doses of soy had increased numbers of corpora lutea compared with controls, while mice treated with the highest dose had decreased numbers; however, superovulation with eCG/hCG yielded similar numbers of oocytes as controls. Serum levels of progesterone, estrogen, and testosterone were similar between soy treated and control mice when measured before puberty and during pregnancy. In summary, neonatal treatment with soy caused abnormal menstrual cycles, altered ovarian function, early reproductive senescence, and subfertility/infertility at environmentally relevant doses.

Lifestyle and Fertility

Stress reduction therapy improves fertility

In studies conducted by Alice Domar, PhD, at Harvard's Mind-Body Institute, women who underwent stress reduction therapy saw dramatic increases in their ability to get pregnant. In fact, even women who were already undergoing fertility treatments had more successful outcomes when stress was kept under control.

Previous exercise doubles risk of implantation failure in IVF patients

A total of 2,232 patients were prospectively enrolled before undergoing their first cycle of IVF for the treatment of infertility from 1994-2003 at three IVF clinics in the greater Boston area. The primary IVF outcomes of interest included successful live birth and four points of cycle failure: cycle cancellation, failed fertilization, implantation failure, and miscarriage. RESULTS: Women who reported exercising 4 hours or more per week for 1-9 years were 40% less likely to have a live birth (odds ratio 0.6) and were almost three times more likely to experience cycle cancellation (odds ratio 2.8) and twice as likely to have an implantation failure (odds ratio 2.0) or miscarriage (odds ratio 2.o) than women who did not report exercise. In general, women who participated in cardiovascular exercise had a 30% lower chance of successful live birth (OR 0.7) than women who reported no exercise. CONCLUSION: Regular exercise before in vitro fertilization may negatively affect outcomes, especially in women who exercised 4 or more hours per week for 1-9 years and those who participated in cardiovascular exercise.

Physical activity increases chance of pregnancy by 83% in sperm injection cycles

This study analyzed 436 patients undergoing intracytoplasmic sperm injection cycles. Patients answered a questionnaire and regression analysis examined the relationship between lifestyle and BMI with the intracytoplasmic sperm injection cycles outcomes. RESULTS: No influence of lifestyle and obesity was observed on the number of oocytes recovered. Obesity reduced the normal fertilization rate (coefficient: -16.0) and increased the risk of miscarriage (odds ratio: 14.3). Physical activity positively affected implantation (coefficient: 9.4), increased the chance of pregnancy (odds ratio: 1.83) and tended to decrease the risk of miscarriage (odds ratio: 0.30; p=0.068 not statistically significant). In addition, an inverse correlation was found between physical activity and BMI.

Exercise increases fertility in assisted reproduction

It is still not definitely resolved whether being physically active has any impact on the success of assisted reproduction treatment. To this end, this study used the International Physical Activity Questionnaire short form (IPAQ-sf). Data from the IPAQ-sf were classified into three categories: low, moderate and high physical activity as defined by the IPAQ working group. The subjects in the study were grouped according to their physical activity levels during treatment. None of the subjects met the criteria for high physical activity. The low activity group consisted of 68 women whereas moderate activity group consisted of 63 women. The study showed that women undergoing assisted reproduction treatment significantly decreased their activity level during the treatment period. However, women who were physically more active were more likely to have an increased implantation rate and a live birth.

Higher adiponectin levels is associated with better fertility

Adiponectin, a beneficial adipokine, represents a major link between obesity and reproduction. Higher levels of adiponectin are associated with improved menstrual function and better outcomes in assisted reproductive cycles.

Obesity increases risk of infertility

The endocrinological changes in obesity that may cause these adverse effects are complex and include changes in circulating adipokines and sex steroids as well as insulin resistance. Considerable evidence suggests an adverse effect of obesity on the risk of miscarriage and other maternal and fetal complications. Obese patients are also more prone to infertility. The most important single method to improve reproductive performance in obese women is weight loss that can be achieved with lifestyle changes and diet.

Obesity increases risk of miscarriage, infertility and perinatal mortality

Obesity can affect reproduction through fat cell metabolism, steroids and secretion of proteins such as leptin and adiponectin and through changes induced at the level of important homeostatic factors such as pancreatic secretion of insulin, testosterone synthesis by the ovary and sex hormone-binding globulin (SHBG) production by the liver. WHO estimates that 9 to 25% of women in developed countries are severely obese, and obese mothers are much more likely to have obese children, especially if they have gestational diabetes. Obesity-associated anovulation may lead to infertility and to a higher risk of miscarriage. Management of anovulation with obesity involves diet and exercise as well as standard approaches to ovulation induction. Many obese women conceive without assistance, but pregnancies in obese women have increased rates of pregnancy associated hypertension, gestational diabetes, large babies, Cesarean section and perinatal mortality and morbidity.

Hormones and Fertility

Higher estrogen levels boost fertility

OBJECTIVE: To correlate serum estrogen level on day 10th with the outcome of in vitro fertilization cycles. CONCLUSION: The percent of total mature oocytes and fertilization rate improve with serum levels of estrogen at physiologic values.

High dose luteal phase estrogen supplementation doubles pregnancy rate in IVF

Significantly higher implantation rate and pregnancy rate were recorded in those who received low dose estrogen supplementation during the luteal phase compared with no substitution (pregnancy rate 23.1% vs. 32.8%). The best implantation and pregnancy results were found significantly in the group with high dose estrogen supplementation (pregnancy rate 51.3%).

Higher DHEA boosts fertility

The aim of this study was to evaluate the effect of dehydroepiandrosterone (DHEA) supplementation on in vitro fertilization (IVF) data and outcomes among poor-responder patients. Those in the study group received 75 mg of DHEA once a day before starting the next IVF cycle and during treatment. The DHEA group demonstrated a non-significant improvement in estradiol levels on day of hCG and improved embryo quality during treatment between first and second cycles. Patients in the DHEA group also had a significantly higher live birth rate compared with controls (23.1% versus 4.0%), respectively. CONCLUSION: Dehydroepiandrosterone supplementation can have a beneficial effect on ovarian reserves for poor-responder patients on IVF treatment.

Conception most frequent after menstrual bleeds lasting at least 5 days

We prospectively studied 470 women to determine whether cycle length or bleed length were associated with fertility or miscarriage. Pregnancy was most likely to occur after cycles lasting 30 to 31 days and 40% less likely after shorter cycles. Miscarriage was three times more common after cycles that were either shorter than or longer than 30 to 31 days (for shorter cycles, odds ratio = 3.0 and for longer cycles odds ratio = 3.0). Conception occurred most frequently after menstrual bleeds lasting at least 5 days, and miscarriage was 60 percent less likely after periods lasting greater than 5 days, when compared with 5-day bleeds.

Fertility is 53% lower in women who ovulate before day 11

The present study was designed to evaluate whether there is a lower pregnancy rate in women with short follicular phases, as defined by attaining the peak estrogen level before day 11 of the cycle. Thirty-two early ovulators with mature follicles were matched with 32 women being treated for similar infertility problems, who ovulated between days 12-20. Pregnancies were achieved by 9 (28.1%) of the early ovulators compared to 19 (59.4%) of the controls. The mean number of cycles required to achieve a pregnancy was 8.6 in the early ovulators compared to 6.4 in the controls. Using the clinical life table method, the 12-month pregnancy rate was estimated to be 31.4% for early ovulators as compared to 66.3% for controls.

Menstrual cycles longer than 35 days more than double risk of infertility

Long cycles (36 days or more), irregular cycles, and intermenstrual bleeding were associated with a history of infertility. Long or irregular cycles were each associated with more than twice the odds of infertility. Intermenstrual bleeding was also associated with increased odds of infertility. Having long cycles was associated with a doubling in the adjusted odds of having a miscarriage among women who had been pregnant within the last 5 years (odds ratio = 2.3). Results controlled for current age, age when most recent pregnancy ended, current BMI, and smoking during pregnancy.

Reducing GnRH improves egg quality and improves fertilization rate by 23%

Early and short follicular GnRH antagonist supplementation using flexible GnRH antagonist treatment improves the meiotic status and competence of retrieved oocytes. Women in the study group were additionally supplemented with three injections of GnRH antagonist (0.25 mg/d on days 1, 2, and 3 of the menstrual cycle). Both groups had comparable baseline characteristics.  The fertilization rate was significantly higher in the study as compared with the control group (85% and 69%, respectively). Moreover, the cumulative rate of mature first polar body oocytes was significantly higher in the study group as compared with the control group (93% and 85%, respectively). Concomitantly, day-3 FSH and LH levels after initiation of treatment were significantly lower in the study as compared with the control group (6.1 mIU/mL vs. 7.2 mIU/mL and 2.4 mIU/mL vs. 5.6 mIU/mL, respectively).

High LH disturbs fertility, increases risk of miscarriage, due to premature egg maturation

High tonic serum concentrations of luteinizing hormone (LH) in the follicular phase, frequently witnessed in PCOS, have been associated with decreased reproductive function. Impaired rates of fertilization, conception and miscarriage are obtained when LH levels are high before oocytes are collected, during ovulation induction or in women with regular cycles. Conversely, treatment that decreases LH concentrations, such as GnRH analogue or laparoscopic ovarian puncture, eases induction of ovulation and pregnancy and improves miscarriage rates. Tonic hypersecretion of LH appears to induce premature oocyte maturation, causing the problems with fertilization and miscarriage. Cycle and Miscarriageubmed/10627767

Overall birth rate only 5% lower in PCOS; superior ovarian reserve in PCOS

Among women who had attempted a pregnancy, 86.7% of PCOS patients and 91.6% of controls had given birth to at least one child. Among PCOS patients who had given birth, 73.6% had done so following a spontaneous conception. Mean ovarian volume and the number of antral follicles in PCOS patients were significantly greater than in control women. PCOS patients also had higher serum concentrations of anti-Müllerian hormone and lower follicle-stimulating hormone (FSH) levels. CONCLUSIONS: Most women with PCOS had given birth, and the rate of spontaneous pregnancies was relatively high. Together with the ultrasound findings and the hormonal analyses, this finding could imply that PCOS patients have a good fecundity, and an ovarian reserve possibly superior to women with normal ovaries.

Health and Fertility

NK cell activity higher in those suffering from infertility

NK-cell activity of the infertile group (40.2%) was significantly higher than the control group (31.5%). The increased NK-cell activity was not associated with age, infertile duration, depression scores, treated hyperprolactinemia, or treated endometriosis.

Higher Th1/Th2 ratio found in implantation failure

Elevated Th1/Th2 cytokine ratios were reported in women with a history of recurrent miscarriage and multiple implantation failures.

Fertility is lower, and miscarriage higher, in women with thyroid autoimmunity

Oocyte fertilization, grade A embryos, and pregnancy rates were lower in women with thyroid autoimmunity than in negative controls, while early miscarriage rate was higher. Anti-thyroid antibodies were measurable in follicular fluid in all affected women and were strongly correlated with serum levels. No significant changes in thyroid hormone levels were recorded in any women. Conclusion:  The presence of anti-thyroid antibodies in ovarian follicles, as demonstrated for the first time in this study, may play a critical role in female infertility related to thyroid autoimmunity.

Fertility lower in hypothyroidism

Overall and spontaneous pregnancy rates were highest in women with normal basal and stimulated TSH, high T4 and low microsomal antibodies. Women with normal thyroglobulin antibodies or high thyroxine binding globulin experienced the highest delivery rate (77 versus 30%), while in women with low thyroglobulin antibodies or high microsomal antibodies miscarriage and tubal pregnancies were most frequent.

Fertility lower in Hashimoto's

The prevalence of thyroid autoimmunity in women with unexplained infertility and implantation failure was significantly increased in comparison to those with recurrent miscarriage. There was also a trend towards a higher prevalence of thyroid autoimmunity in the unexplained infertility and implantation failure groups than in the control group.Thyroid autoimmunity is strongly related to unexplained infertility and implantation failure.

Supplements and Fertility

Aspirin does not improve implantation rate and reduces follicle growth

We performed a randomized analysis of 145 infertile women with a mean age of 29.6 years who underwent cycles of IVF. Patients received 100 mg of aspirin or placebo daily. Aspirin was started on the 21st of their preceding menstrual cycle and it was continued until menstruation or a negative pregnancy test. Pregnant women received the medication until 12 weeks of pregnancy. The main outcome measures were number of follicles >or=15 mm, number of oocytes retrieved, serum estrogen levels, cancellation rate, Ovarian Hyperstimulation Syndrome (OHSS) occurrence, number of embryos transferred, and implantation and pregnancy rates. RESULTS: There were statistically significant differences between the treatment group and the control group in the number of follicles (7.4 versus 9.0) and OHSS occurrence (5.6% versus 23.3%) but not in the other measures. CONCLUSION: The addition of aspirin low dose (100 mg/daily) to the standard long protocol for oocyte retrieval did not improve implantation and pregnancy rates in unselected patients undergoing IVF cycles.

Aspirin may interfere with implantation and cause certain birth defects

In theory, aspirin has both positive and negative effects on reproduction. Aspirin, which suppresses cyclooxygenase, has the potential to interfere with implantation, but also has the potential to support the maintenance of pregnancy. Aspirin is prescribed with increasing frequency to reduce the risk of maternal thrombosis and reduce the risk of miscarriage and poor pregnancy outcome. Aspirin alone, however, is not considered sufficient to prevent thrombosis and even in women with the antiphospholipid syndrome, the question as to whether low-dose aspirin improves pregnancy outcomes has not been answered affirmatively. Aspirin has potential risks. Aspirin inhibits platelet function and can contribute to maternal and fetal bleeding. Aspirin crosses the placenta. Although aspirin has not been associated with other congenital anomalies, it has been associated with an increased risk of vascular disruptions, particularly gastroschisis and possibly premature closure of the ductus arteriosus. Nonetheless, large trials demonstrate low-dose aspirin's relative safety and generally positive effects on reproductive outcomes.

Black cohosh from days 1 to 12 improved pregnancy rate by 170%, boosts progesterone

Patients with unexplained infertility and recurrent clomiphene citrate induction failure, were randomly divided into two groups. Both groups received clomiphene citrate 150 mg per day (days 3 to 7). Group I received additional oral phytoestrogen (Cimicifuga racemosa - black cohosh) 120 mg/day from days 1 to 12.  There was a non-significant shortening of induction cycles in group I. Oestradiol and LH concentrations were higher in group I compared with group II. Endometrial thickness, serum progesterone and clinical pregnancy rate were significantly higher in group I (8.9  versus 7.5; 13.3 ng/ml versus 9.3 ng/ml; 36.7% versus 13.6%, respectively). It is concluded that adding Cimicifuga racemosa rhizome dry extract to clomiphene citrate induction can improve the pregnancy rate and cycle outcomes in these couples.

Phytoestrogens during the follicular phase increased progesterone and fertility

Endometrial thickness, serum progesterone and clinical pregnancy rate were significantly higher when phytoestrogens were added to infertility treatment from days 1 to 12.

Myo-inositol restores normal ovulatory activity and fertility in women with PCOS

Myo-inositol combined with folic acid (Inofolic) 4 g a day was administered continuously for 6 months. RESULTS: Twenty-two out of the 25 (88%) patients restored at least one spontaneous menstrual cycle during treatment, of whom 18 (72%) maintained normal ovulatory activity during the follow-up period. A total of 10 singleton pregnancies (40% of patients) were obtained. Nine clinical pregnancies were assessed with fetal heart beat at ultrasound scan. Two pregnancies evolved in miscarriage. CONCLUSION: Myo-inositol is a simple and safe treatment that is capable of restoring spontaneous ovarian activity and consequently fertility in most patients with PCOS.

4 g/day myo-inositol improves egg quality and pregnancy rate in women with failed IVF

Recently, a number of studies have shown that the presence of several compounds in the follicular fluid positively correlates with oocyte quality and maturation (i.e., myo-inositol and melatonin). In the present study, we aim to evaluate the pregnancy outcomes after the administration of myo-inositol combined with melatonin in women who failed to conceive in previous in vitro fertilization (IVF) cycles due to poor oocyte quality. Materials and methods. Forty-six women were treated with 4 g/day myo-inositol and 3 mg/day melatonin (inofolic® and inofolic® Plus) for 3 months and then underwent a new IVF cycle. Results. After treatment, the number of mature oocytes, the fertilization rate, the number of both, total and top-quality embryos transferred were statistically higher compared to the previous IVF cycle, while there was no difference in the number of retrieved oocyte. After treatment, a total of 13 pregnancies occurred, 9 of them were confirmed echographically; four evolved in miscarriage. Conclusion. The treatment with myo-inositol and melatonin improves ovarian stimulation protocols and pregnancy outcomes in infertile women with poor oocyte quality.

Inositol improved pregnancy rate and lowered cancellation rate in PCOS infertility patients

In an attempt to evaluate the role of inositol supplementation in insulin-resistant patients with polycystic ovary syndrome (PCOS), undergoing gonadotropin ovulation induction using the low-dose step-down regimen, we conducted a prospective longitudinal study comparing the stimulation characteristics of 15 patients treated with inositol, to a cohort, matched by age and body mass index (BMI), without inositol. Inositol nutritional supplementation produced very good clinical results with a significant reduction in cancellation rate (0 vs. 40%) and the consequent improvement in clinical pregnancy rate (33.3% vs. 13.3%).

16 grams l-arginine improves outcome in assisted reproduction

Patients undergoing assisted reproduction were randomly assigned to two different stimulation protocols: (1) flare-up GnRHa protocol and elevated pFSH; (2) flare-up GnRHa protocol, elevated pFSH and 16 grams daily oral l-arginine. Only administered until at least one follicle >17 mm in diameter was present. In the l-arginine group the cancellation rate (11%) was lower than in group I (76%). No significant side-effects were reported by patients of l-arginine treated group. The number of oocytes collected and the number of embryos transferred were significantly higher in the l-arginine group (4.1 vs 1.6 and 2.4 vs 1, respectively). Three pregnancies (17%) were obtained in the l-arginine supplemented group, even though all of them resulted in early pregnancy loss. No pregnancies were obtained in group 1 patients.

6 grams l-arginine or 600 mg vitamin E improved thin endometrium in majority of patients

To examine whether thin endometria can be improved by increasing uterine radial artery blood flow. PATIENT(S):Sixty-one patients with a thin endometrium (endometrial thickness <8 mm) and high radial artery-resistance index of uRA (>or=0.81). INTERVENTION(S): Vitamin E (600 mg/day) or l-arginine (6 g/day) was given. RESULT(S):Vitamin E improved radial artery-resistance index in 72% of patients and endometrial thickness in 52% of patients. L-arginine improved radial artery-resistance index in 89% of patients and endometrial thickness in 67% of patients. In the control group, who received no medication to increase uRA-blood flow, only one (10%) patient improved in uterine radial artery blood flow and endometrial thickness. CONCLUSION(S): Vitamin E or l-arginine treatment improves uterine radial artery blood flow and endometrial thickness and may be useful for the patients with a thin endometrium.

500 mg arginine improves sperm counts, motility, and pregnancy rates

Oral administration of 500 mg arginine-HCl per day to infertile men for 6-8 weeks markedly increased sperm counts and motility in a majority of patients, and resulted in successful pregnancies. Similar effects on oligospermia and conception rates have been reported in other preliminary trials. However, when baseline sperm counts were less than 10 million/mL, arginine supplementation produced
little or no improvement.

N-acetyl cysteine boosts pregnancy rates by 40% and lowers miscarriage odds by 60% in PCOS women

Patients with clomiphene citrate-resistant PCOS who underwent unilateral ovarian drilling were assigned randomly to receive either N-acetyl cysteine 1.2 g/d or placebo for 5 days starting at day 3 of the cycle for 12 consecutive cycles. A significant increase in both ovulation and pregnancy rates was observed in the N-acetyl cysteine group, compared with placebo [87% versus 67% (odds ratio = 1.3) and 77% versus 57% (odds ratio 1.4), respectively]. Moreover, miscarriage rates were significantly lower and live birth rates were significantly higher in the N-acetyl cysteine group [8.7% versus 23.5% (odds ratio 0.4) and 67% versus 40% (odds ratio 1.7), respectively]. In conclusion, N-acetyl cysteine is a novel adjuvant therapy after laparoscopic ovarian drilling for clomiphene citrate-resistant women with polycystic ovary syndrome (PCOS) which might help improve overall reproductive outcome.

N-acetyl cysteine boosts ovulation, progesterone and endometrial thickness in PCOS women

Patients had clomiphene citrate tablets alone or with N-acetyl cysteine 1,200 mg/day orally for 5 days starting on day 3 of the menstrual cycle. RESULTS: Ovulation rate improved significantly after the addition of N-acetyl cysteine (17.9% versus 52.1%). Although the number of mature follicles was more in the N-acetyl cysteine group (2.1 versus 3.2), the difference was not statistically significant. The mean estrogen levels at the time of human chorionic gonadotropine injection, serum progesterone levels on days 21-23 of the cycle, and the endometrial thickness were significantly improved in the N-acetyl cysteine group. CONCLUSION: N-Acetyl cysteine is proved effective in inducing or augmenting ovulation in polycystic ovary patients.

N-acetyl cysteine boosts ovulation rate from 1% to 49% in PCOS women

The patients were assigned randomly to receive either N-acetyl cysteine 1.2 g/d or placebo with clomiphene citrate for 5 days starting at day 3 of the cycle. RESULTS: Combination of clomiphene citrate and N-acetyl cysteine significantly increased both ovulation rate and pregnancy rate in women with clomiphene citrate-resistant PCOS (49.3% vs. 1.3% and 21.3% vs. 0%, respectively). No cases of ovarian hyperstimulation syndrome were reported in the N-acetyl cysteine group; two cases of miscarriage (12.5%) were reported. CONCLUSION(S): The N-acetyl cysteine as an adjuvant to clomiphene citrate was more effective than placebo for clomiphene citrate-resistant patients with PCOS. It is safe and well tolerated.

N-acetyl cysteine does not offer any additional benefit to clomid treatment

Patients in the study group were treated with clomiphene citrate (50-mg tablets) twice per day and with N-acetyl cysteine (1,200 mg/d orally) for 5 days starting on day 2 of the cycle. Patients in the control group were treated with clomiphene citrate with sugar powder. RESULT(S): There were no statistically significant differences between the two groups in the number of follicles sized >18 mm, mean estrogen levels, serum progesterone, or endometrial thickness. Pregnancy rate was comparable in both groups (22.2% vs. 27%). Miscarriage rate was comparable in both groups (6.7% in the study group vs. 7.4% in the control group). CONCLUSION(S): N-Acetyl cysteine is ineffective in inducing or augmenting ovulation in patients with unexplained infertility and cannot be recommended as an adjuvant to clomiphene citrate in such patients.

N-acetyl cysteine does not significantly improve pregnancy rate in women with male factor infertility

Women undergoing intracytoplasmic sperm injection cycles due to male factor infertility were randomly assigned to receive either long protocol or long protocol plus N-acetyl cysteine. Clinical pregnancy was the primary outcome. Clinical pregnancy rate was insignificantly higher in N-acetyl cysteine group (52.6%) than control (47.4%).

Early supplemental progesterone prevents implantation

After confirmation of the heat period, adult female mice were mated with mature healthy males to achieve pregnancy. Inseminated females received intraperitoneal injections of progesterone at doses of 0, 1, 3.5, 7, 15, 25, or 50 mg/kg body weight on the first, third, and seventh day of pregnancy (gestation in mice is 21 days). Pregnancy failure was evidenced by reduction in the number of embryos in females injected with 7 (25.12 %), 15 (38.44 %), 25 (100%), and 50 (100%) mg progesterone/kg body weight. In females with a successful pregnancy, the numbers of corpora lutea and postimplantation loss per dam were comparable across all groups. No increase in the incidence of malformed fetuses was found in any progesterone-treated groups. CONCLUSION: Administration of supranormal levels of progesterone during early pregnancy caused a reduction in the number of implantations and an increase in preimplantation loss in mice.

Vitex combined with l-arginine and vitamins improves fertility

Both short and long cycles (< 27 days or > 32 days pretreatment) were normalized in the vitex/l-arginine/vitamin group. Among women starting with short cycles (<27 days), mean cycle length increased significantly in the vitex/l-arginine/vitamin group (from 24.2 to 27.6 days). Among women with longer cycles (>32 days), cycles tended to shorten in the vitex/l-arginine/vitamin group (from 41.6 to 31.7). The average number of days in cycle with basal temperatures over 98F during luteal phase also increased significantly in the vitex/l-arginine/vitamin group (5.5 to 8.1 days). After three months, the vitex/l-arginine/vitamin group demonstrated a trend toward increased mean mid-luteal progesterone (from 8.2 to 10.4 ng/ml). Among women initially low in progesterone (<12 ng/ml), the increase in the vitex group with low progesterone was highly significant (4.9 to 9.3 ng/ml). The placebo group did not show any significant changes in these parameters. After six months, 17 of the 53 women in the vitex/l-arginine/vitamin group were pregnant (32%), and four of the 40 women in the placebo group were pregnant (10%). No significant side-effects were noted.

100% of previously infertile women gave birth after normalizing selenium and magnesium levels

After a further two months of 200 micrograms daily oral selenium as selenomethionine and oral magnesium supplements, all six women normalized their RBC-Mg (P < 0.0001) and RBC-GSH-Px (P < 0.0001) levels. All 12 previously infertile women have produced normal healthy babies all conceiving within eight months of normalizing their red blood cell magnesium levels (600 mg/day magnesium). Selenium supplementation (200mcg) was necessary for 6 of the women to normalize their red blood cell magnesium levels.

Selenium and miscarriage


High vitamin B6 improves fertility by 220%

Homocysteine, folate, and vitamins B6 and B12 were measured in preconception plasma. Relative to women in the lowest quartile of vitamin B6, those in the third and fourth quartiles had higher odds of conception (odds ratio = 2.2; odds ratio = 1.6, respectively), and the adjusted odds ratio for early miscarriage in conceptive cycles was lower in the fourth quartile (odds ratio=0.5). Women with sufficient vitamin B6 had higher odds of conception (odds ratio = 1.4) and a lower adjusted odds ratio of early miscarriage in conceptive cycles (odds ratio=0.7) than did women with vitamin B6 deficiency. Poor vitamin B6 status appears to decrease the probability of conception and to contribute to the risk of early miscarriage in this population.

Low vitamin D leads to failed IVF attempts

Multivariable logistic regression analysis confirmed vitamin D levels as an independent predictor to success of an IVF cycle; adjusting for age, body mass index, ethnicity, and number of embryos transferred, each ng/mL increase in vitamin d increased the likelihood for achieving clinical pregnancy by 6%.

93% of infertile women were low in vitamin D

Here they studied 67 women who had problems conceiving – and found that 93% of them were low in vitamin D. According to researcher Dr Lubna Pal, “ Of note, not a single patient with either ovulatory disturbance or polycystic ovary syndrome (PCOS) demonstrated normal Vitamin D levels; 39% of those with ovulatory disturbance and 38% of those with PCOS had serum vitamin D levels consistent with deficiency.

Bunnies with low fertility found deficient in zinc and phosphate; supplementation restores fertility

A number of does was classified according to their initial litter size to high (> 6 bunnies, group 1) and low (< 5 bunnies, group 2) in New Zealand White rabbits. The number of matings/conception, total mortality, corpora lutea/fetus, number and percentage of resorbed foeti were markedly higher in group 2 than in group 1. The litter weight, number of fetuses, implantation sites, and corpora lutea in group 2 showed a marked decrease over group 1. Serum and urine progesterone levels in pregnant rabbits of group 2 were significantly lower than in group 1. The zinc content in serum, fetal dry weight and uterine horn dry weight, and serum inorganic phosphate in group 2 were significantly lower than in group 1. The litter size was significantly correlated with zinc and inorganic phosphate in group 2, while it was correlated with serum and urine progesterone in the two groups. The treatment of group 2 does with calcium carbonate, sodium phosphate dibasic, and zinc acetate in drinking water improved the serum progesterone, urine progesterone, and non-efficacious progesterone in addition to serum zinc and inorganic phosphate, which led to improvement of the number of matings/conception, litter size and litter weight, and lowered total mortality.

Vitamin C during the luteal phase does not improve implantation rates in IVF

METHODS: Voluntary daily oral intake of either vitamin C (1, 5, or 10 g/day) or Placebo for 14 days after follicle aspiration for IVF-ET procedure.  RESULTS: No differences in clinical pregnancy rate and implantation rate were noted in statistical logistic regression analysis between the four intake groups. CONCLUSIONS: There was no clinical evidence of any beneficial effect, as defined by main outcome measures, of vitamin C on IVF-ET. Our data suggest there is no obvious value of high dosed intake of vitamin C during luteal phase in infertility treatment.

High levels of alpha-linoleic acid reduce fertility by 86%

In unadjusted analyses, women with elevated serum α-linolenic acid (ALA) levels (highest quartile) demonstrated a decreased chance of pregnancy compared with women with the lowest levels (odds ratio 0.24). No associations between other free fatty acids and pregnancy were identified. In a multivariable regression model, associations between elevated serum ALA levels and decreased chance of pregnancy remained after adjusting for patient age, body mass index, and history of endometriosis or previous live birth (adjusted odds ratio 0.139). CONCLUSION(S): Elevated serum ALA levels are associated with decreased chance of pregnancy in women undergoing IVF. Further work is needed to determine whether ALA is involved in early reproductive processes and whether the relationship between ALA and pregnancy is associated with excess ALA intake, impaired ALA metabolism, or both.

Other topics covered under How to Increase Fertility:

How to Increase Male Fertility