A round up of essential nutrients for fertility

There are a bewildering array of supplements, vitamins, minerals, and herbal remedies on sale that claim to enhance fertility. There are varying degrees of evidence, from practically non-existent to peer-reviewed scientific studies to support these claims.

Supplements, minerals and vitamins play an essential part in maintaining a healthy body and ensuring good health but are usually only required in very small amounts.

In fact, it’s never a good idea to exceed the recommended daily dose for these nutrients. Some of them can quickly switch from being useful to being decidedly unhelpful or even poisonous, particularly minerals at high doses.

With this in mind, when considering whether to take a supplement it’s worth applying the Golden Rule. This is the first part of the Hippocratic Oath taken by the medical profession: “First do no harm”. It makes sense to apply this rule to yourself in the first instance!

Should I take supplements?

To answer that in terms of the Golden Rule you need to determine two things:

  1. What do my healthcare professionals advise?
  2. Am I ALREADY getting an effective level of the particular supplement in question as part my diet anyway?

These are very important questions because many supplements have medicinal effects and also side-effects.

What do your healthcare professionals recommend?

The main reason for asking your healthcare professional about potential supplement intake is that they are the ones best placed to ascertain whether a supplement will be helpful to you. But, most importantly whether it might harm you.

In answering they will consider the following:

  1. Your clinical presentation: everything they know about you from a clinical perspective, made up from your medical notes, tests, physical examinations and responses to questions.
  2. Your diet: see below.
  3. Your current medications: remember, SOME supplements can interact with certain medications, which can either nullify their effects or worse.
  4. Their knowledge: your healthcare professionals will have knowledge of and access to current research in the area.

Remember: your healthcare professional will always be acting in your best interests by applying their own Golden Rule to their actions.

Are you already getting good nutritional coverage from your current diet?

The obvious reason to ask this question is that you may not need a particular supplement if your diet already provides it. For instance, someone who regularly eats or drinks plenty of citrus fruit doesn’t need a Vitamin C supplement.

But why bother with a supplement at all if you don’t have to? If you feel that there are one or two important minerals or vitamins missing, you might consider adjusting your diet to accommodate them rather than taking a supplement.

With that thought, let’s take at some essential nutrients commonly sold as supplements and see what they have to offer in terms of fertility.

Vitamin C

Vitamin C is an essential nutrient involved in the repair of tissue and the working of the central nervous system. It is also required for the immune system as well as being an important antioxidant.

The fertility claim: in terms of fertility a 2016 review in the International Journal of Reproductive Medicine  concurred that taking Vitamin C with Vitamin E improved the number, mobility, and quality of sperm in men.

  • Recommended daily allowance (RDA): 90 milligrams (mg) for men and 75 mg for women
  • Alternative dietary source: citrus fruits like oranges, tangerines, lemons and limes.

Calcium

Calcium is important for building bones and is also involved with control of blood flow, muscle function and nerve function.

The fertility claim:  A 2019 study published in the International Journal of Fertility and Sterility suggests that calcium deficiency might be a potential cause of infertility in men, since calcium is involved in the production of sperm.

  • RDA: 1000mg for men and 1200mg for women
  • Alternative dietary source: milk, cheese, yoghurt, cream.

Coenzyme Q10 (CoQ10)

CoQ10 is found throughout the bodies of all living things and plays an important part in respiration. In fact, 95% of the human body’s energy is generated in a pathway involving CoQ10.

The fertility claim: some studies have suggested that CoQ10 supplementation may improve sperm concentration and motility in men with infertility, but further research is definitely needed before this is substantiated.

  • RDA: 100-300mg depending on advice
  • Alternative dietary source: red meat, oily fish, soybeans, whole grains

Acetyl L-carnitine (ALC)

ALC is an amino acid, a protein builder that occurs naturally in the body. It has a particular part to play in helping to turn fat into energy.

The fertility claim: ALC is also a powerful antioxidant, which is thought to slow age-related changes in the female reproductive system. A study in 2018 also noted that supplementing with these types of carnitine amino acids improved symptoms of PCOS, endometriosis and amenorrhea (the absence of a period).

ALC may also have some utility in boosting sperm motility in men.

  • RDA: this one comes with the proviso that it is best to consult your healthcare provider before diving in. This is because there are some question marks over its safety in people suffering from certain conditions such as high blood pressure and epilepsy. However, supplements are usually sold as 200-500mg capsules
  • Alternative dietary source: red meat, chicken, dairy (milk, cheese, cream).

Vitamin D

Vitamin D is responsible for increasing intestinal absorption of calcium, magnesium, phosphate and multiple other biological effects in humans. It is extremely important in maintaining bone and skin health.

The fertility claim:  Vitamin D plays essential roles in both female and male reproductive function. This has been demonstrated by research, which shows that vitamin D deficiency may be associated with infertility in both men and women.

  • RDA: before taking Vitamin D it is wise to get advice from your healthcare provider regarding an appropriate supplemental dose, depending on your levels. It may be necessary to take a routine test to make sure that you are not deficient in this vitamin. Typical daily dose for an adult are is usually around 0.64mg (600 IU)
  • Other dietary sources: eggs, fish, mushrooms

Note: Vitamin D is also produced naturally in the body by exposure to sunlight. So, make sure you take time to enjoy the great outdoors, perhaps as part of daily exercise.

B Vitamins (not including Vitamin B9 –folic acid)

These are a group of eight vitamins that are sometimes called ‘Vitamin B Complex’. You can also find them called by their individual names. e.g. B1 = thiamine, B2 = riboflavin etc. The Vitamin B Complex does not include Vitamin B9, which is an important vitamin in its own right.

The B Vitamins are very important in all kinds of biological processes from conversion of sugars to protein building in muscle and skin. A deficiency of these vitamins leads to serious problems including skin conditions, muscle fatigue and neurological disorders.

The fertility claim: in women these vitamins are thought to help promote egg health and prevent ovulatory infertility. For instance, a study from 2018 found that a higher intake of vitamins B-1, B-2, B-3, B-6, and B-12 was associated with lower risk of ovulatory infertility. For men, Vitamin B Complex may give sperm quality a boost.

  • RDA: each of these vitamins has its own RDA. Therefore, it is best to take them as a complex and this is how they are usually sold. Your healthcare provider can advise you what formulation and intake is best for you.
  • Other dietary sources: meat, beans, and whole grains are good sources of these vitamins.

Vitamin E

Vitamin E is another collective, which is actually a group of eight compounds. It is responsible for nerve function and also for protecting cell membranes from reactive chemicals. As such it a powerful antioxidant.

The fertility claim: Vitamin E is believed to increase sperm motility in men and to boost general reproductive health in women. However, more research is needed to investigate it thoroughly.

  • RDA: usually around 15mg for adults. Note: it is best to check with your healthcare professional before taking Vitamin E supplements. This is because at higher doses Vitamin E can interact with certain medications
  • Other dietary sources: nuts, sunflower seeds/oil, avocados, red peppers, mango and kiwi fruit.

Folic acid (Vitamin B9)

This B vitamin is important enough to have a category of its own. It is required for the body to make DNA and RNA and metabolise amino acids necessary for cell division.  This plays an essential role in growth, repair and replacement in all the cells of the body. It is of paramount importance during pregnancy when the female body is geared towards creating a whole new human!

The fertility claim: Although the role of folic is established in pregnancy, it is less clear with regard to fertility.  Folate supplementation prior to conception HAS been associated with a greater chance for getting pregnant and improved success with fertility treatments, but more research is needed.

  • RDA: Note: It is best to discuss this one with your health professionals so that folate deficiency can be ruled out for you. For pregnant women, the RDA of folic acid is 0.6 mg (600 micrograms). Additionally, it’s recommended that women who are planning to become pregnant or who may become pregnant supplement with a daily dose of 0.4-0.6mg (400 to 800 micrograms) folic acid starting at least 1 month before becoming pregnant.
  • Other dietary sources: chicken liver, peanuts, spinach, eggs.

Iron

Iron is extremely important and is the functioning molecule in oxygen exchange in red blood cells, in fact it is what gives blood its colour. That said, this nutrient comes with the proviso that it is toxic in overdose, and therefore you should ALWAYS discuss any supplements with your healthcare professional.

The fertility claim: ovulatory infertility (one potential barrier to baby-making) can be caused by iron deficiency. One long-term study of more than 18,000 women showed that supplementing with iron appeared to decrease the risk of ovulatory infertility.

  • RDA: this can only be discussed with your healthcare professional as requirements will vary greatly between individuals and overdose can be dangerous.
  • Other dietary sources: most meats, spinach, apricots, wheat germ.

Zinc

Another metal like iron, zinc is an essential trace element for humans and other animals. It is required for the function of over 300 enzymes and 1,000 transcription factors used in protein building.

The fertility claim: zinc is also needed for the formation of sperm. Some studies have suggested that a zinc deficiency might lead to low quality sperm, but at the moment it has not been shown to increase rates of live birth. In women, one study appeared to show that lower levels of this mineral in the blood were associated with longer time trying to conceive.

  • RDA: around 12mg for men and 8mg for women.
  • Other dietary sources: meat, mushrooms, legumes, nuts and seeds.

Omega-3 fatty acids

Omega-3 fatty acids play a major role in lipid metabolism (fat processing) in the body and are essential in the growth of young children.

The fertility claim: Omega-3s are said to boost sperm motility and in women a 2015 study suggested that they MAY improve pregnancy chances in those over age 35.

  • RDA: 1600mg for men, and 1100mg for women, but this can vary
  • Other dietary sources: oily fish (mackerel, herring, salmon), fish oils, hemp oil, eggs, strawberries.

A balanced diet

As can be seen from the above, it is possible to achieve a natural intake of these all-important nutrients by adjusting your diet and making sure that it is properly balanced between a variety of different foods.

One of the other benefits of this is that one can avoid potential overdosage/side-effects. It hard to overdose on spinach but not on supplements!

That’s not to say that supplements have only a limited place. In fact, many healthcare professionals recommend a daily multivitamin tablet for patients who are trying to conceive.  This makes absolutely sure that they get uniform and adequate coverage of all the essential vitamins and minerals.

The best advice before taking any new supplement is to:

(1) check with your health professional

(2) read and carefully follow the advice on the label.

Although these items are generally sold over the counter, they are powerful medicines that have the ability, when not used correctly, to cause as many problems as they fix.

So, remember the Golden Rule: First do no harm! And apply it to yourself.