The Role of Nutrient Supplements in Female Infertility: An Umbrella Review and Hierarchical Evidence Synthesis.

Women struggling with infertility often turn to vitamin and mineral supplements hoping to improve their chances of getting pregnant, either naturally or through fertility treatments like IVF. Researchers reviewed multiple studies to determine whether these supplements actually work and if they're safe. The review examined various nutrients including antioxidants, vitamin D, CoQ10, L-carnitine, melatonin, myo-inositol, and NAC (N-acetylcysteine). They found that some supplements, particularly combinations of multiple vitamins and antioxidants, may increase live birth rates in women undergoing fertility treatments. Several individual supplements also showed potential for improving clinical pregnancy rates, especially in women with PCOS or those using assisted reproduction. However, the researchers emphasized that the quality of evidence was very low, meaning we cannot be confident in these findings. The supplements did not appear to increase risks like miscarriage, ectopic pregnancy, or multiple births, which is reassuring. The bottom line is that while these supplements are likely safe, there isn't strong enough evidence yet to definitively recommend them for treating infertility. Women considering supplements for fertility should discuss their individual situation with their healthcare provider. For those interested in a holistic approach to fertility, consulting with a qualified acupuncture practitioner may provide complementary support alongside conventional fertility care.

This umbrella review evaluated nutrient supplementation for female infertility by analyzing four meta-analyses of RCTs published between August 2017 and January 2024. Primary outcomes included live birth and pregnancy rates; secondary outcomes examined adverse effects. Using AMSTAR 2 and GRADE assessments, researchers found multiple micronutrients and antioxidants increased live birth rates (OR 2.59 and 1.81 respectively) in women utilizing MAR or conceiving spontaneously versus controls, though with very low certainty evidence. Individual supplements (L-carnitine OR 11.14, CoQ10 OR 2.49, melatonin OR 1.66, myo-inositol RR 1.52, NAC OR 2.15, vitamin D OR 1.49) demonstrated increased clinical pregnancy rates in PCOS and/or MAR patients with very low certainty evidence. No significant effects on miscarriage, ectopic, or multiple pregnancy rates were observed (low to very low certainty). Clinical takeaway: Current evidence is insufficient to recommend nutrient supplementation for female infertility, though no significant safety concerns were identified.