By Hilary Metcalfe
When I was preparing for IVF, my kitchen cupboard turned into a mini-pharmacy. Bottles of CoQ10, inositol, melatonin, vitamin D, each promising to be the missing link between failure and success. I felt overwhelmed, and I wasn’t alone. In fertility forums, women compared their supplement stacks as if they were secret recipes for conception.
Years later, after research, conversations with doctors, and my own long IVF journey, I know this: supplements can be powerful allies. But they are not magic. They work best when guided by testing, timing, and medical oversight. Here are the ten supplements with the strongest evidence for supporting egg quality, hormone balance, and implantation.
Coenzyme Q10: Energy for Your Eggs
Eggs are extraordinary cells, the largest in the body and among the most energy-demanding. Their maturation depends on mitochondria, the tiny batteries within each cell. As women age, mitochondrial function declines, and with it, egg quality. Coenzyme Q10 (CoQ10) helps mitochondria generate ATP, the energy currency eggs need for division and fertilisation.
A randomised controlled trial found that women with diminished ovarian reserve who supplemented CoQ10 had improved ovarian response and embryo quality. This is why many fertility specialists suggest starting CoQ10 several months before IVF, it’s not a quick fix but a long-term investment in the cell’s ability to function optimally.
DHEA: A Precursor with Potential
Dehydroepiandrosterone, or DHEA, is a naturally occurring hormone that can be converted into both testosterone and oestrogen, hormones crucial for follicle development. For women with poor ovarian reserve, DHEA may provide the hormonal nudge needed to recruit better-quality eggs.
Meta-analyses suggest DHEA supplementation improves pregnancy rates in “poor responders” to IVF. But this supplement comes with caveats: too much can cause acne, hair growth, or hormonal imbalance. It is one to consider only under close medical supervision.
Omega-3 Fatty Acids: Calming the Fire
In today’s diets, omega-6 fats (pro-inflammatory) often outnumber omega-3s (anti-inflammatory) by ten to one. This imbalance fuels chronic inflammation, a quiet but persistent threat to fertility. Inflammation influences follicle quality, endometrial receptivity, and embryo development.
Data from the EARTH study showed that women with higher omega-3 intake had embryos of better morphology and higher chances of live birth in IVF cycles. Correcting the omega balance with fish oil or algae oil supplementation is one of the simplest and most evidence-backed steps before IVF.
Vitamin D: The Hormone Misnamed a Vitamin
Vitamin D isn’t just for bones, it functions like a hormone, influencing immune tolerance, endometrial receptivity, and embryo implantation. Deficiency is common, particularly in northern latitudes or women with darker skin tones.
Studies consistently link sufficient vitamin D levels with higher pregnancy and live birth rates in IVF. Testing is essential, because both deficiency and excess can affect outcomes. Optimising levels into the mid-range (30–50 ng/mL) is often recommended before stimulation begins.
Myo-Inositol: A Key Player in PCOS
Inositol, sometimes called vitamin B8, is crucial for insulin signalling. For women with polycystic ovary syndrome (PCOS), who often struggle with insulin resistance, myo-inositol has shown promise in improving ovulatory function and egg quality.
Clinical trials demonstrate that myo-inositol supplementation can reduce the amount of medication needed in IVF and improve ovarian response. It has become one of the most trusted fertility supplements, particularly for women managing PCOS.
Melatonin: Antioxidant Protection from Within
Melatonin is best known as the sleep hormone, but it also acts as a potent antioxidant inside ovarian follicles. During the stimulation phase of IVF, when oxidative stress is high, melatonin can protect fragile eggs from damage.
Research shows that melatonin supplementation can improve fertilisation rates and embryo quality. And beyond reproduction, better sleep and circadian rhythm regulation also reduce cortisol, another quiet disruptor of fertility.
A Quality Prenatal: Building the Foundation
If supplements are a house, the prenatal multivitamin is the foundation. A comprehensive prenatal should provide methylated folate, B12, iron, iodine, and ideally choline. Folate is critical: deficiencies are linked to neural tube defects, and methylated forms may work better for women with MTHFR genetic variants.
Starting a prenatal at least three months before IVF ensures both egg and sperm are supported through their full maturation cycles.
Vitamin B12: Folate’s Essential Partner
B12 and folate work together in methylation, the process that drives DNA synthesis. Low B12 can quietly impair fertility and increase miscarriage risk. A review found strong associations between B12 deficiency and both infertility and recurrent pregnancy loss.
Vegetarians, vegans, and women with absorption issues should be particularly mindful, as deficiency is common.
Antioxidants: Guarding Against Oxidative Stress
Eggs and sperm are highly vulnerable to oxidative damage, but the antioxidant story is complicated. While diets rich in antioxidants clearly support fertility, supplementation is less clear.
A Cochrane review concluded that antioxidant supplements may increase live birth rates in ART, but the evidence is inconsistent and dosage matters. The safest approach? Focus on antioxidant-rich whole foods first, with supplements like NAC, vitamin C, or vitamin E added strategically under guidance.
Probiotics: Fertility’s Microbiome Frontier
Perhaps the most exciting area of fertility research right now is the microbiome. Gut bacteria influence hormone metabolism and nutrient absorption, while the vaginal and uterine microbiome directly affect implantation.
One study found that women with a Lactobacillus-dominant endometrium had higher implantation and pregnancy rates during IVF. This makes probiotics, especially targeted strains like Lactobacillus crispatus, a promising tool. Beyond supplements, supporting gut health with herbs, fibre, and rituals like our SABI’s Digestive Infusion or Gentle Period can calm inflammation and nurture the estrobolome, the gut microbes that recycle oestrogen.
Support your journey
When I look back at my supplement journey during IVF, I wish I had known less is often more. I would have built a foundation with a strong prenatal, vitamin D, omega-3s, and CoQ10. I would have added others only after testing and with medical guidance.
Supplements are not silver bullets. They are tools to support the extraordinary biology already happening in your body. Used wisely, they don’t just boost your chances, they give you the sense that in a process where so much feels out of your hands, you are actively supporting your future.
ABOUT HILARY
Hilary is the Co-Founder of the SABI, a Holistic Nutritionist, natural, whole foods Chef, product developer and advocate for women getting to know their bodies, cycles and selves better. Born in Los Angeles, California and raised in Baja California, Mexico, she now lives in Los Cabos with her partner Kees, a curly-tailed rescue dog from Curacao, Flint and her rainbow babies Paloma and Bea.
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HORMONAL & PROUD
Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum — and practically every stage of life, the SABI aims to change the narrative around our hormones from one of taboo, embarrassment and loneliness, to awareness and even pride. Much more than a wellness brand, SABI offers a carefully crafted line of products to carry you through your hormonal journey; a set of rituals, supportive tools, and ancient herbal remedies that have been tested time and again by women and now, backed by medicine. SABI is a blend of science and nature conceived by women who have experienced the joys and deep implications of bringing a child into the world, the pains of a heavy and difficult period, miscarriage and difficulty conceiving
Here is an invitation to get to know your body and its cycles better and to really understand what is going on inside. Learn to use your hormonal cycle to your advantage no matter your stage of life, and know that you can always support and balance your hormone levels. Look for the right sources of information, know that there is help, and know that you’re supported.
DISCLAIMER
The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation
