Adequate supplementation of macro and micronutrients are important for women undergoing fertility treatment. Macronutrients are replenished from our food intake of protein, carbohydrate and fat following the daily recommendations.
One of the most important supplements to begin prior to attempting pregnancy is prenatal vitamins which contain folic acid. Folic acid decreases the chance of offspring born with neural tube defects such as spina bifida.. The consumption of at least 0.4mg or 400mcg of folic acid is recommended daily. Women with past history of a neural tube defect in offspring would require a higher dose of 4mg daily prior to conception. Iron is also included in most prenatal vitamins because it is crucial for both fetal and placental development; this is an important supplement for women who are iron deficient. Iron also increases the blood cell mass for mother and baby during pregnancy.Iron deficiency is prevalent in about 19 percent of pregnant women in the United States and the supplementation with prenatal vitamins is key to prevention (Garner, 2021).
The American College of Obstetrics and Gynecology recommends routine supplementation of vitamin D. Vitamin D has been suggested to support immune function, healthy cell division and bone health (APA, n.d.) . Several studies have also reported improved IVF outcomes in women with sufficient vitamin D levels of >30ng/ml. Vitamin D supplementation may also improve serum lipids level and increased endometrial thickness in women with PCOS. Some studies have also suggested that supplementation might be protective against endometriosis (Lerchbaum & Rabe, 2014). We recommend 2000IU of vitamin D daily.
Omega 3 or fish oil supplementation is also recommended. Omega 3 fatty acids may provide improved oocyte quality even with short-term dietary treatments. Life-long supplementation may also delay ovarian aging in advanced maternal age. Omega-3 rich diet is also found to be safe for long term consumption. It is also considered to be a building block of fetal brain and retina development (Nehra et al., 2012).
CoQ10 is an antioxidant which reduces the damage to mitochondria and mitochondrial DNA. This allows for increased number of mitochondria for female eggs thus increasing egg quality. A meta-analysis concluded that oral supplementation of CoQ10 may increase the clinical pregnancy rate compared to women undergoing fertility treatment who received placebo or no treatment (Florou et al., 2020). The recommended dose is 300mg daily.
Other supplementations may be recommended based on the individual’s indications for infertility. For more information or to schedule a consultation with one of our physicians, please contact us at 808-545-2800 or visit our website at https://www.ivfcenterhawaii.com
- American Pregnancy Association. (n.d). Why do I need vitamin D during pregnancy? https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/vitamin-d-and-pregnancy/
- Florou P, Anagnostis P, Theocharis P, Chourdakis M, Goulis DG. Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. J Assist Reprod Genet. 2020 Oct;37(10):2377-2387. doi: 10.1007/s10815-020-01906-3. Epub 2020 Aug 7. PMID: 32767206; PMCID: PMC7550497.
- Garner, C. (2021). Nutrition in pregnancy. UpToDate. https://www.uptodate.com/contents/nutrition-in-pregnancy?search=prenatal%20vitamins&source=search_result&selectedTitle=2~72&usage_type=default&display_rank=1#H717781762
- Lerchbaum E, Rabe T. Vitamin D and female fertility. Curr Opin Obstet Gynecol. 2014 Jun;26(3):145-50. doi: 10.1097/GCO.0000000000000065. PMID: 24717915.
- Nehra D, Le HD, Fallon EM, et al. Prolonging the female reproductive lifespan and improving egg quality with dietary omega-3 fatty acids. Aging Cell. 2012;11(6):1046-1054. doi:10.1111/acel.12006