Vitamins for Fertility: What Should You Be Taking?

Vital Micronutrients for Male and Female Fertility

Various vitamins
Michela Ravasio/Stocksy United

What vitamins do you need for fertility? Food is life. Our bodies get the vitamins and minerals we need from our daily diet. Creating a new life­—which is exactly what fertility health is all about—also requires micronutrients.

We don’t completely understand yet how diet and micronutrients directly influence fertility, but researchers are learning more daily. We know that some deficiencies can cause fertility problems.

We also know that some diseases that impact the body’s ability to absorb nutrients (like untreated Celiac disease) can increase the risk of infertility.

It’s important to get the nutrients you need through a healthy diet, or with the help of supplements, if that’s what your doctor recommends. For those with specific vitamin deficiencies, taking a supplement may help.

But what if you’re not really missing anything nutritionally? Will vitamin supplement boost your fertility? This isn’t clear.

Some studies say yes. For example, a study from Harvard found that women who took a daily vitamin were less likely to experience ovulatory infertility. However, other studies have not found that supplements improve fertility factors more than a placebo. Also, many studies on micronutrients are small or not well designed. With that said, below are vitamins and minerals thought to be essential to fertility health.

Note: If you’re considering taking a supplement or multivitamin, talk to your doctor. Some supplements don’t mix with prescription medications, and it is possible to overdose on some vitamins and minerals.  

B-Vitamins, Especially Vitamin B-6 and Folic Acid (B-9)

The B-vitamins include B-3 (niacin), B-6 (pyridoxine), B-9 (folate or folic acid), and B-12.

All the B-vitamins play vital roles in the formation and proper functioning of red blood cells. A B-12 deficiency can cause anemia. Proper nerve function and cell energy are also dependent on healthy levels of B-vitamins.

When it comes to fertility, B-6 and B-9 (better known as folic acid or folate) are most essential.

Studies have found that women with higher blood levels of B-6 are more likely to be fertile. Does that mean infertile women can be treated with B-6? That has not been studied.

One possible reason for the B-6 connection to fertility may be due to homocysteine. Homocysteine is a common amino acid found in the blood stream. At high levels, it’s associated with an increased risk of stroke and heart disease. High homocysteine levels are also associated with ovulation problems. Low homocysteine levels may improve the odds of pregnancy.

A few studies looked at the effect B-vitamins had on homocysteine levels. They found that the B-vitamins, but especially B-6, helped reduce homocysteine. Theoretically, this implies the odds of pregnancy may be improved by taking B-vitamins. (At this point, however, it’s still a theory and not proven.)

Perhaps one of the most important B-vitamins to fertility and healthy fetal development is folate, or B-9.

Also known as folic acid, folate is vital to both male and female fertility. Many people don't know that there is a difference between folic acid and folate.

Folic acid is the synthetic form of B-9. When foods are fortified with B-9, it's almost always in the folic acid form. Also, the vast majority of vitamin supplements contain folic acid. This is because folic acid is inexpensive and easy for manufacturers to use.

Folate is the more readily bioavailable form of B-9. When you take folic acid supplements, your body must transform folic acid into folate. Otherwise, your cells can't make use of the nutrient.

Folate is the form of B-9 found naturally in foods, like lentils, chickpeas, dark leafy greens, asparagus, and broccoli. You can get vitamin supplements with folate and not folic acid, but it's less common and usually more expensive.

For women, we know that low intakes of folate are associated with an increased risk of neural tube birth defects, like spina bifida. Research has also found that proper folate intake may impact progesterone levels, and low levels of B-9 may lead to irregular ovulation.

For men, low levels of folate in semen are associated with poor sperm health. Men with low dietary folate are more likely to have a higher percentage of DNA-damaged sperm. Folate supplementation may also help improve semen analysis results, in certain cases. One research study found that treating men with a zinc and folate supplement resulted in a 74 percent increase in sperm concentration.

Ideally, you should take folate and not folic acid, if you decide to supplement. (Look for 5-methyltetrahydrofolate or 5-MTHF, and not "folic acid," on the label.) High doses of folic acid are suspected to be associated with an increased risk of cancer.

Also, some people's bodies can't properly absorb B-9 in the folic acid form. This means they can be getting the right dosage of folic acid through fortified foods or supplements, but because their cells can't make use of the vitamin, they still aren't getting what they need.

Those with the genetic MTHFR mutation can experience this. Women with the MTHFR genetic mutation may be at a higher risk of miscarriage, some pregnancy complications, and having a child with a neural tube defect. This may be related to poor folic acid/folate absorption. 

Vitamin C

Vitamin C is best found through fruits and vegetables, especially citrus fruits, berries, and peppers. This vitamin helps maintain healthy connective tissue. It is also important for wound healing and proper immune function.

Vitamin C is also a powerful antioxidant. These antioxidant properties play a major role in fertility. Antioxidants reduce the negative impact of free radicals, reducing cellular damage in the body. Often combined with vitamin E in research studies, vitamin C has been found to improve sperm health and decrease sperm DNA fragmentation. Animal studies have found that vitamin C supplements may increase testosterone levels.

A small study of 13 men with low sperm counts found that supplementation of vitamin C improved sperm concentration and sperm motility (how sperm swim) after just two months of treatment.

In women, vitamin C may help with low progesterone levels. One study found a significant improvement in progesterone levels when women with PCOS were treated with high-dosage vitamin C supplements. Another study of 259 women involved evaluating the blood levels of micronutrients and hormone levels throughout the menstrual cycle. They found that women with higher levels of ascorbic acid (vitamin C) were more likely to have higher levels of progesterone and lower levels of FSH.

Calcium

You probably already know that calcium is a mineral we need for healthy bone function, but did you know it also plays a role in heart health, muscle function, nerve transmission, and hormonal balance?

Research has found that women who consume more dairy products are at a lower risk of having endometriosis and ovulatory problems. Dairy products are high in calcium. This may imply that calcium is an important fertility mineral. That said, currently, there’s no specific research on calcium supplementation and fertility.

Coenzyme Q10 (CoQ10)

Coenzyme Q10, more commonly referred to as CoQ10, is an antioxidant that our cells require for proper functioning. CoQ10 aids cells in creating energy.

CoQ10 may help improve sperm function. Men with higher levels of CoQ10 in their semen are more likely to have better sperm motility. CoQ10 supplementation has also been found to improve male fertility.

In a study of 287 men who had been previously diagnosed as infertile, a year of CoQ10 supplementation improved their sperm concentration, morphology (the shape of sperm), and motility. During the study, 34.1 percent of the couples conceived. (However, the study didn’t include any controls, so it’s not possible to know if pregnancy rates were really improved by the treatment.) With CoQ10 supplementation, at least 12 weeks of treatment is needed to see improvements.

In women, CoQ10 fertility research is lacking. Research on rats has found that CoQ10 may counteract the effects of aging and have a positive influence on ovarian reserves. However, no studies in humans have found female fertility benefits yet.

Vitamin D

Vitamin D is found in few foods and primarily obtained through sun exposure. Vitamin D works along with calcium to help maintain strong bones. But it also is important for cell growth, immune function, and regulation of inflammation in the body.

Low levels of vitamin D are associated with infertility. Both the female and male reproductive organs contain vitamin D receptors and metabolizing enzymes, giving us clues that vitamin D may be vital to healthy fertility. Low levels of vitamin D are associated with ovulation problems and an increased risk of endometriosis. IVF success rates tend to be higher in men and women with higher levels of vitamin D.

All that said, we don’t currently have any evidence that supplementing with vitamin D will improve fertility.

Vitamin E

Vitamin E is one of the most commonly studied antioxidants, and most of the science on Vitamin E and fertility was researched in men.

Vitamin E seems to play an important role in the maturation of sperm cells. Men with low sperm counts have 65 percent less vitamin E found in their semen, compared to men with normal sperm counts.

Getting more vitamin E through dietary sources or supplementation seems to improve male fertility factors. In a study of 690 men with impaired fertility, increasing their intake of vitamin E improved sperm motility or morphology by 5 percent. It also resulted in a 10.8 percent pregnancy rate.

A small but important study looked at the pregnancy rates when infertile men were either treated with Clomid and vitamin E supplementation, or given a placebo. For the men receiving the placebo, the pregnancy rate for their female partners was 13.3 percent. The men in the Clomid and vitamin E group had a 36.7 percent pregnancy rate. IVF success rates have also been improved by vitamin E supplementation. 

What about for female fertility? There is a theory vitamin E may play an important role in oocyte (egg) development, but there are few studies on supplementation and female fertility.

Iron

Iron is a mineral we need for healthy blood cell creation and function. Low iron can lead to anemia, and anemia can cause infertility.

According to one study, women who took iron and multivitamin supplements were 73 percent less likely to experience infertility. Another study found that women who took iron supplements and consumed higher levels of plant-based iron sources were less likely to experience ovulatory infertility. While iron is typically a mineral we get from animal consumption, you can also get iron from beans, lentils, spinach, and fortified cereals.

Selenium

Selenium is a trace element that is vital to health. It plays a role in proper thyroid function, DNA synthesis, protection from oxidative stress, and reproduction. Brazil nuts contain very high levels of selenium, but more commonly, you can also get it from tuna, halibut, sardines, ham, and shrimp.

Animal studies have found that low intake of selenium increases the risk of infertility.

Selenium is needed for sperm maturation and plays a role in the changes a sperm cell goes through before fertilizing an egg. Selenium levels in semen are lower in men with infertility.

In a randomized control study of 69 patients, men treated with selenium were found to have improved sperm motility after treatment. Eleven percent of the men were able to father a child, compared to none in the control group.

Another study, this one of 468 men, found that selenium supplementation improved sperm health and also hormonal levels. There were decreases in FSH, and increases in testosterone and inhibin B—all positive fertility improvements for the men.

In women, having inadequate dietary intake of selenium-rich foods increased the risk of a luteal phase defect. There are currently no studies on selenium supplementation and female fertility.

Zinc

Zinc is an essential mineral, responsible for proper cellular function, immunity, wound healing, DNA synthesis, and cell division. It’s also necessary for healthy growth and development, from pregnancy through adulthood.

There have been numerous studies on male fertility and zinc. Zinc is vital to male hormone health and normal sperm development and maturation. Zinc deficiency is associated with low sperm counts and hypogonadism. Men with poor semen analysis results tend to also have low levels of zinc both in their semen and blood serum tests.

Zinc supplementation has been found to improve sperm concentration and motility. In a study of 108 fertile men and 103 infertile men, treatment with zinc supplements improved sperm counts by 74 percent (for the infertile men.)

Zinc supplements have also been found to improve IVF success rates. A randomized control study found that couples given zinc plus other antioxidants had an increased pregnancy rate of 38.5 percent, compared to 16 percent in the no supplement group.  

Sources:

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Andrews MA1, Schliep KC2, Wactawski-Wende J3, Stanford JB4, Zarek SM5, Radin RG2, Sjaarda LA2, Perkins NJ2, Kalwerisky RA2, Hammoud AO6, Mumford SL7. “Dietary factors and luteal phase deficiency in healthy eumenorrheic women.Hum Reprod. 2015 Aug;30(8):1942-51. doi: 10.1093/humrep/dev133. Epub 2015 Jun 16.

Buhling KJ1, Grajecki D. “The effect of micronutrient supplements on female fertility.Curr Opin Obstet Gynecol. 2013 Jun;25(3):173-80. doi: 10.1097/GCO.0b013e3283609138.

Polackwich Jr., Alan Scott; Sabanegh, Edmund S. “Chapter 33 – The Role of Over-the-Counter Supplements in Male Infertility.Handbook of Fertility: Nutrition, Diet, Lifestyle and Reproductive Health. Pages 369–381.

Zeinab H, Zohreh S, Samadaee Gelehkolaee K1. “Lifestyle and Outcomes of Assisted Reproductive Techniques: A Narrative Review.” Glob J Health Sci. 2015 Feb 24;7(5):11-22. doi: 10.5539/gjhs.v7n5p11.

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