Polycystic ovarian syndrome (PCOS) is one of the most common causes of female infertility. PCOS symptoms vary for each individual, but interfering with a woman’s ability to get pregnant is a very common characteristic of the condition.
Fertility-specific supplements can help regulate hormonal imbalances, promote ovulation, and improve fertility in women with PCOS. This article will cover the best fertility supplements for PCOS.
Certain supplements that promote egg quality and hormone balance are critical for women with PCOS. While prenatal vitamins are a must when trying to conceive, targeted fertility supplements can help normalize periods and induce ovulation in women with PCOS.
Keep reading to discover the relationship between PCOS, infertility, and nutritional supplementation!
What is PCOS?
PCOS is one of the most common endocrine conditions affecting reproductive-aged females. In fact, it affects up to one in five young women and often leads to fertility issues.
PCOS typically involves insulin resistance, hormonal imbalances, and metabolic abnormalities, all of which significantly increase the risk of infertility.
There are two schools of thought when it comes to diagnosing PCOS:
- According to the 2003 Rotterdam criteria, a female must present with at least two of the following symptoms: hyperandrogenism (i.e., too much testosterone), irregular menstruation, or polycystic ovaries.
- According to the 2009 Androgen Excess & PCOS Society criteria, a female must present with hyperandrogenism AND either irregular menstruation or polycystic ovaries.
Common symptoms of PCOS include:
- Insulin resistance
- Increased risk of diabetes
- Weight gain
- Elevated cholesterol
- Fatty liver
- Hirsutism (or excess hair growth on the face, stomach, and back)
- Alopecia (or loss of hair on the top of the scalp)
- Mood disorders such as anxiety and depression
- Anovulation (or the absence of ovulation)
- Difficulty conceiving
- Increased risk of pregnancy complications
Related Post: From A PCOS Fighter: The Optimal Diet & Exercise Regimen For Insulin Resistant PCOS
How Does PCOS Affect Fertility?
Approximately 70% of women with PCOS have insulin resistance. Insulin resistance occurs when the cells in the body resist or ignore the signal from insulin, a hormone that controls your body’s glucose or blood sugar level.
The result is that your body produces excess insulin levels in an effort to escort glucose into the cell (glucose comes primarily from your diet in the form of carbohydrates), which in turn leads to excess insulin AND glucose in the bloodstream.
- Excess insulin in the bloodstream can then cause the ovaries to produce more androgen hormones like testosterone. In turn, an overproduction of testosterone can impair egg development and lead to anovulation, or the failure to release an egg from the ovary. An egg is required for a successful pregnancy. Unfortunately, this cascade of events has a direct effect on fertility.
- Excess glucose in the bloodstream can also lead to significant issues such as weight gain, diabetes, and non-alcoholic fatty liver disease. All of these complications can further affect fertility outcomes as well.
While PCOS is the leading cause of anovulatory infertility, or infertility due to the lack of ovulation, dietary and lifestyle changes, along with fertility supplements, can aid in bringing hormones back into balance and, ultimately, help restore ovulation, improve egg quality, and increase the chances of a successful pregnancy.
PCOS and Fertility Management
The first step for a woman with PCOS who wants to conceive is to establish a healthy diet and exercise routine.
A whole foods diet high in fiber and low in refined carbohydrates as well as moderate exercise three times a week is immensely beneficial for most women with PCOS. These lifestyle changes can lead to balanced hormones in women with PCOS and improved fertility outcomes.
The second step includes the use of fertility supplements, which can essentially expedite the hormone healing process. Fertility supplements can further aid in bringing PCOS hormones back into balance and, in turn, restoring fertility.
Ultimately, the goal of PCOS fertility management is to reverse the symptoms of the condition, establish a regular menstrual pattern, and promote optimal egg quality.
What are Fertility Supplements?
Fertility supplements are dietary supplements that contain specific nutrients designed to support aspects of reproductive health. Fertility supplements can include vitamins, minerals, amino acids, herbs, antioxidants, whole foods, and other nutrients.
Who Should Take Fertility Supplements?
PCOS women who want to support the health of their eggs, restore ovulation, or improve general reproductive and hormonal health should consider taking fertility supplements.
Moreover, fertility supplements encompass more than a prenatal vitamin. For PCOS women, fertility supplements can have a positive impact on ovarian health, the endometrial lining (to support implantation), immune system health, and overall well-being.
As a reminder, each individual has unique dietary and nutritional needs, so please consider working with a functional medicine nutritionist or physician before adding any new supplements to your daily regimen.
The Best Fertility Supplements for PCOS
Here is a list of the best fertility supplements for PCOS:
Myo-inositol is one of the best fertility supplements to take if you want to get pregnant with PCOS. In fact, myo-inositol is an excellent PCOS supplement to consider even if you’re not planning to get pregnant.
Myo-inositol can improve insulin receptor activity and reverse insulin resistance. Supplementing with myo-inositol has also been shown to restore ovarian activity and improve fertility in women with PCOS.
Another study found that myo-inositol improves IVF protocols for women with PCOS. In fact, PCOS participants who underwent inositol therapy had better fertilization rates and embryo quality than the control group.
An effective daily dosage for myo-inositol appears to be 2000 mg of myo-inositol (MI) and 50 mg of d-chiro-inositol (DCI), another member of the inositol family. Studies have found this ratio of 40:1 MI to DCI to be the optimal combination to help restore ovulation in PCOS women.
Coenzyme Q10 (CoQ10)
Coenzyme Q10 is a potent antioxidant that is naturally produced by the human body. This critical nutrient also supports the mitochondria, the energy powerhouse of the cell, to help generate cellular energy. Proper mitochondrial function is essential for fertility. Unfortunately, CoQ10 levels begin to decline in your 30s.
Regarding fertility, a 2015 study on female reproductive health found that suboptimal levels of CoQ10 were associated with decreased numbers of oocytes (or eggs) and other age-associated factors known to impact fertility.
Another study found that pre-supplementation with CoQ10 may improve ovarian response and embryo quality in women with low ovarian reserve (egg count).
While CoQ10 supports overall fertility, it also promotes fertility in women with PCOS. In fact, supplementing with CoQ10 has been shown to positively affect insulin and testosterone levels in PCOS women.
CoQ10 is one of the best fertility supplements, as it can combat age-related and PCOS-related causes of infertility. Studies show an effective dose of CoQ10 is somewhere between 100-200 mg per day.
N-Acetyl-Cysteine (NAC) helps to protect ovarian cells from oxidative stress. It also serves as a precursor, or building block, for glutathione, the body’s most critical antioxidant. Low glutathione stores are associated with infertility in women with PCOS. NAC supplementation can help restore glutathione levels and improve fertility outcomes.
NAC is a powerful supplement for women with PCOS. It can also help reduce insulin resistance, lower testosterone levels, regulate ovulation, and improve fertility.
Some research shows that NAC is more effective than metformin (a common prescription drug for PCOS) in improving insulin resistance. Moreover, NAC may help induce ovulation and regulate the menstrual cycle by reducing testosterone levels.
Furthermore, a review of several studies found that PCOS participants who supplemented with NAC had greater odds of ovulation, getting pregnant, and having live births as compared to the placebo group.
The therapeutic dose of NAC based on published studies is 1.8 g per day.
Vitamin D is one of the best fertility supplements to consider when diagnosed with PCOS.
While the research is still unfolding around the exact mechanism between vitamin D and fertility, several studies now suggest there are vitamin D receptors all throughout the female reproductive system, including the uterus and ovaries. This indicates a clear relationship between vitamin D and reproductive health.
Research also shows that vitamin D is correlated with positive effects on female fertility, as well as pregnancy and lactation. In PCOS women, vitamin D supplementation has also been shown to have beneficial effects on menstrual regularity and ovulation.
Unfortunately, vitamin D deficiency is very common in women with PCOS. Approximately 65-85% of women with PCOS are vitamin D deficient. Low vitamin D levels may intensify PCOS symptoms, including insulin resistance, period irregularities, hyperandrogenism, obesity, and infertility.
Because vitamin D is difficult to obtain from sunlight alone, I often recommend vitamin D supplementation to my PCOS clients. The RDA for vitamin D is 600 IU per day, but as a functional medicine nutritionist, I often find dosages of 2000-5000 IU necessary to bring vitamin D levels back into the optimal range.
Testing your vitamin D levels prior to supplementation is advised.
Zinc is a potent antioxidant that regulates the function of many different enzymes in the body. It also supports cell growth, hormone balance, and reproduction. Zinc deficiency is more common in women with PCOS and is associated with symptoms like insulin resistance and abnormal cholesterol levels.
Supplementing with zinc positively affects many parameters related to PCOS. Zinc supplementation may help reduce insulin resistance, lower excess androgen levels, improve egg quality, and restore ovulation. Further, zinc may help improve other common PCOS symptoms as well, like acne, hair growth, hair loss, and weight management.
Adding a zinc supplement to your daily routine is a great way to support fertility and manage your overall PCOS picture.
While the RDA for zinc is 8 mg per day, I often find success with dosages up to 30 mg per day for the purpose of optimizing fertility. Be careful–doses greater than 30 mg may deplete other essential minerals such as copper and iron. Zinc supplementation is best taken with food for enhanced absorption.
Recommended Product: Check out my PCOS fertility protocol through my online supplement dispensary!
Work with a Functional Medicine Nutritionist
If you are interested in getting pregnant with PCOS, I recommend consulting with a functional medicine nutritionist. My one-on-one consultation program takes a functional medicine approach to PCOS and fertility. I can help you get to the root cause of your PCOS and recommend the best fertility supplements based on your unique symptoms and lab findings. Apply to become a client here!