Fertility Decoded

Supplements for fertility

Most fertility supplements are marketed far ahead of their evidence. A few have a genuine role, several show weak or mixed signals, and a handful carry documented safety risks. Here is what the evidence says about 24 common fertility supplements, vitamins, and Ayurvedic herbs, grouped by how strong the evidence is.

Written by Fertility Decoded. Reviewed by D R, MS (OBG), FRM. Review date: 31 August 2026.

By evidence tier

  • Standard preconception care — take these: folic acid, vitamin D, iron, vitamin B12 — worth taking to cover deficiencies (B12 especially in India), though none is a "fertility booster".
  • Weak but real signal (Cochrane-reviewed): myo-inositol (PCOS), DHEA, antioxidants — widely used, but high-quality evidence of a live-birth benefit is lacking.
  • Limited / mixed evidence: CoQ10, zinc, selenium, L-carnitine, omega-3, melatonin, NAC, L-arginine — mostly surrogate-marker improvements, not proven live-birth gains.
  • Documented safety concerns — caution: ashwagandha, tribulus, concentrated green tea extract (liver injury); shatavari, evening primrose oil (pregnancy-exposure signals); royal jelly (anaphylaxis).
  • Ayurvedic herbs — a safety brief: widely sold in India; heavy-metal contamination is a category risk and third-party testing matters.

Frequently asked questions

Which supplements actually help you get pregnant?
None is a guaranteed booster. Folic acid, vitamin D, iron and B12 are standard preconception care; myo-inositol (PCOS), DHEA and CoQ10 show weak or surrogate-level signals. Most others are unproven for live birth.
What fertility supplements should I avoid?
Take extra care with ashwagandha, tribulus and concentrated green tea extract (documented liver injury), evening primrose oil and shatavari (pregnancy-exposure signals), and royal jelly (anaphylaxis risk).
Are Ayurvedic fertility herbs safe?
They're widely sold in India but carry a category risk of heavy-metal contamination, and several (ashwagandha, tribulus) have documented liver-injury reports. Third-party testing matters, and anyone with a liver condition should avoid them.
Do I need supplements for IVF?
Beyond standard preconception vitamins, most 'IVF support' supplements aren't proven to improve live birth. Discuss any supplement with your clinic, especially before a cycle.
Check a supplement you were offered

Standard preconception care

Folic acidStandard preconception care — take it, but it isn't a "fertility booster."
Standard care
Vitamin DStandard-dose supplementation is universally recommended; no solid evidence extra amounts improve fertility beyond correcting deficiency.
Standard care
IronStandard treatment for iron-deficiency anaemia, which itself impairs ovulation; the specific claim that supplementing beyond correcting deficiency boosts fertility rests on one unreplicated observational study.
Standard care
Vitamin B12Deficiency is very common in India and is linked to infertility and pregnancy loss in observational studies; correcting a real deficiency is reasonable and currently underserved by standard public health guidance here.
Standard care

Cochrane-reviewed

Antioxidants (women, mixed/combo formulas)Low/very-low-quality evidence of a modest pregnancy-rate signal; live birth uncertain.
Cochrane review (weak)
Antioxidants (men, mixed/combo formulas)Very low-certainty live-birth signal that disappears when lower-quality trials are excluded; ASRM calls benefit unproven.
Cochrane review (weak)
Myo-inositol (PCOS)Widely prescribed for PCOS, but Cochrane finds no high-quality evidence backing routine use.
Cochrane review (weak)
DHEA (dehydroepiandrosterone)Little to no effect on live birth or clinical pregnancy in poor responders — and if you're taking this on your own rather than as part of a monitored clinic protocol, that adds a supervision risk the underlying trials don't fully capture.
Cochrane review (weak)

Other common supplements

CoQ10 (coenzyme Q10)Smaller trials suggest better egg/embryo numbers (women) and sperm parameters (men); no live-birth-level evidence yet.
Non-Cochrane evidence
ZincMay modestly improve some sperm-quality markers; not shown to raise pregnancy or live-birth rates.
Non-Cochrane evidence
SeleniumEssential for sperm production; supplementation trials mixed, one combo study showed some markers worsening.
Non-Cochrane evidence
L-carnitine / L-acetyl-carnitinePromising for sperm motility/morphology in men with idiopathic infertility, but few trials, high heterogeneity, low-quality evidence.
Non-Cochrane evidence
L-arginineSmall/older studies suggest a role in sperm quality and IVF response; not established.
Very limited evidence
N-acetylcysteine (NAC)Mixed results as an add-on to standard PCOS ovulation induction; not reliably effective across trials.
Very limited evidence
Omega-3 fatty acidsInconsistent evidence for fertility specifically (stronger, separate evidence exists for pregnancy outcomes like preterm birth).
Non-Cochrane evidence
MelatoninSome signal for egg maturation/fertilization rate; not shown to increase live birth; strongest evidence is lab-based, not patient-supplement-based.
Non-Cochrane evidence

Ayurvedic herbs — a safety brief

These are heavily marketed in India specifically to people trying to conceive, in early pregnancy, or breastfeeding. Several have real, peer-reviewed safety findings independent of whether they work — we're covering them because you're likely to be offered one, not because we recommend them.

Ashwagandha (Withania somnifera)Documented, NIH-recognized risk of serious liver injury (including deaths in patients with pre-existing liver disease) — this outweighs the sperm-count promise from a single, since-delisted-journal trial. Avoid entirely with any liver condition; discuss with a doctor otherwise.
Documented harm
Shatavari (Asparagus racemosus)An animal pregnancy-exposure study found estrogenic tissue changes on the exact gestation window a trying-to-conceive user could unknowingly be in; its main real-world use (as a lactation aid) rests on weak or manufacturer-funded human evidence, not independent proof it works.
Documented harm
Tribulus terrestris (Gokshura)Multiple peer-reviewed case reports of severe liver and kidney injury exist alongside some evidence for sperm parameters in infertile men — this is a real safety trade-off, not a minor caveat. Testosterone-boosting claims are separately not well supported.
Documented harm
Safed Musli (Chlorophytum borivilianum)Popular traditional aphrodisiac; evidence for effectiveness is limited to animal studies — no human clinical trials found — but a dedicated safety check found no documented human liver-injury signal and reassuring (if limited) toxicity/contamination data, unlike several of the other Ayurvedic herbs in this list.
Contamination risk
ShilajitA few small, manufacturer-funded human trials show promising sperm/testosterone effects; as a mineral product its heavy-metal risk is a sourcing/geology issue, not a processing one — third-party heavy-metal testing matters more here than for any other item in this list.
Contamination risk

Other flagged items

Green tea extract (EGCG)No fertility-specific evidence found for this item at all; separately, concentrated green tea extract is one of the best-documented, occasionally fatal causes of drug-induced liver injury among all dietary supplements — this is a distinct and serious safety concern independent of any fertility claim.
Documented harm
Evening primrose oil (EPO)No quality evidence it helps the fertility outcome it's marketed for (cervical mucus); a systematic review found real pregnancy-complication risk with oral use, which is exactly the scenario an unknowingly-pregnant TTC user could be in.
Documented harm
Royal jellyNo credible fertility evidence found for this item; separately, it carries a real, well-documented anaphylaxis risk in anyone with bee-product sensitivity — a distinct safety mechanism from the liver/pregnancy risks flagged elsewhere in this dataset.
Documented harm

Sources last reviewed . Sources on each supplement's page.