Can Nutritional Supplements Help With Infertility?
Infertility affects approximately 75 million couples in the United States alone representing up to 30% of the female population at some point in their lives. There are many causes of infertility and it is viewed as multifactorial. Technology and standard medicine has advanced in great leaps and bounds over the past decades making family building a reality for the vast majority of our patients.
Beyond traditional fertility treatments, many couples turn to alternative or complementary medical (CAM) modalities as adjunctive care. For the purposes of this article we will focus on dietary supplements. Reports document that up to 50% of women are using dietary or herbal supplements in their fight with infertility with the notion that this is more natural and holistic as compared to fertility hormones and lab manipulation of gametes.
DHEA 75 mg daily (as a single or in three divided doses) in combination with IVF had no significant effect over two cycles in pregnancy rates. Another study showed a trend in egg and embryo quality but did not report out pregnancy rates. Limited studies are conflicted in terms of efficacy making absolute recommendations difficult. However, there seems to be no harm in the intention to treat group.
Fertility Blend, a proprietary nutritional supplement, did show an improvement in luteal phase progesterone levels but due to the small sample size it is again difficult to reflect on pregnancy outcome and live birth rates.
There were several supplements with positive evidence in more than two studies supporting use in male infertility, including Co-Q10 , Vitamin E and L-carnitine.
There are an increasing number of patients who use dietary supplements in fertility treatments. There is some evidence to suggest that supplement use may be beneficial in male and female infertility, but data that address actual pregnancy outcomes are conflicting or limited. Clinicians should consider all the potential benefits and risk of dietary supplements for individual patients when counseling on the appropriate indication, timing, and duration of use. Additional well-designed studies in lab and clinical settings are needed to provide data to be guide clinical care.
One note of caution: these supplements need to be viewed as adjunctive care or an embellishment of a central core comprehensive management program for the fertility issues and not as a stand -alone treatment modality.