Evidence-Based Fertility Supplements: Nutrients for Egg Quality to support natural fertility in women with diminished ovarian reserve (DOR)
Written by fertility nutrition expert, Dr. Conor Kerley
Dr. Conor Kerley is a multi-award winning nutrition researcher, leading clinician as well as a member of the European Fertility Society and European Society of Human Reproduction and Embryology (ESHRE).
What is DOR
Low ovarian reserve
Reduced ovarian reserve
Poor ovarian reserve
Age-related ovarian decline (when linked to aging)
Occult ovarian failure (older/less common term)
Early ovarian aging
diminished ovarian reserve (DOR) should not be confused with Primary Ovarian Insufficiency (POI) which is a more severe condition where ovarian function stops earlier than normal. The older name for POI was Premature Ovarian Failure (POF).
HOW IS DOR diagnosed?
Emerging human research suggests that specific nutrients can influence
· Ovulation (regular periods)
· Regulation of hormone (e.g. androgens)
· Insulin Resistance and insulin sensitivity,
· Inflammation,
· Oxidative stress,
· Mitochondrial dysfunction,
· Fertility difficulties
Therefore specific nutrients in specific doses offer non-hormonal support for women with DOR
fertility supplements for natural conception in DOR
The nutrients which have been shown in human research studies in women with DOR to hav benefits include:
Coenzyme Q 10
A 2015 study from Toronto Canada reported that with advancing age, mitochondrial function decreased and the body’s ability to make co-enzyme Q10 decreased which was related to poorer egg (oocyte) quality. However, The age-related decline in oocyte quality and quantity could be reversed by the administration of CoQ10.
A 2016 rat study from Turkey reported that CoQ10 supplementation may protect ovarian reserve by counteracting both mitochondrial ovarian ageing and physiological programmed ovarian ageing.
The first human report of coenzyme Q10 and DOR comes from 2016. Research from Canada examined the effect of Q10 + the hormone DHEA and found increases in AFC and improved ovarian responsiveness during IUI and IVF.
A 2018 study from China examined the effects of coenzyme Q10 supplementation in low-prognosis young women with decreased ovarian reserve and reported
o improved ovarian response (lower gonadotrophin medication requirements)
o higher E2 levels
o increased number of retrieved eggs (oocytes)
o higher egg fertilization rate
o more high-quality embryos
o higher birth rates
A 2024 review (a systematic review and meta-analysis) of 6 trial with coenzyme Q10supplementation reported that: CoQ10 pretreatment is an effective intervention in improving IVF/ICSI outcomes for women with DOR.
Vitamin B9 or folate
A 2022 from the Environment and Reproductive Health Study among 552 women (average age 35) and reported that ‘higher intake of folate, particularly from supplements, was associated with higher ovarian reserve as measured by AFC (antral follicle count).
Vitamin D
Omega 3
Studies in 2016 and 2019 study reported that omega 3 supplementation could decrease blood FSH levels and urinary FSH levels as well as inflammation. The authors concluded that omega-3 supplementation might beneficial in women with decreased fertility and/or diminished ovarian reserve.
A 2024 Chinese study among women with decreased ovarian reserve reported that omega 3 supplementation could:
· Improve ovarian response
· improve the quality of oocytes
· improve the fertilization rate
· improve high-quality embryo rate
An interesting 2017 study included 49 women with 3 to 7 years of fertility issues, at least 2 unsuccessful two assisted reproductive technology treatments (e.g. IVF, IUI or ICSI) and low AMH levels. These women were given supplementation for 4 months including vitamins B2, B3, B6, B9, and B12, zinc and N acetyl cysteine. Supplementation resulted in increased AMH levels and 17% of patients spontaneously conceived naturally within 3 months
Key take aways
Frequently asked questions
Note, regardless of PCOS, fertility issues are NOT female only. Approximately 40–50% of infertility cases involve male factors. These figures highlight the importance of assessing both partners and the importance of a healthy fertility supportive lifestyle for both partners.
If you are a woman trying to conceive, make sure your male partner has been tested, is following a fertility friendly lifestyle and check our these blogs:
Nutrients for Male Fertility, Sperm Quality and sperm count - The Science
Nutrients for Male Fertility, Sperm Quality and sperm motility - The Science
Nutrients for Male Fertility, Sperm Quality and sperm morphology - The Science
Nutrients for Male Fertility, Sperm Quality and sperm DNA fragmentation - The Science
Nutrients for Male Fertility, Sperm Quality and varicocele - The Science
In addition to PCOS, other common conditions contributing to fertility issues in women, include:
Assisted reproduction i.e. IVF, ICSI, IUI
Advanced age
Antiphospholipid syndrome
Diminished ovarian reserve (DOR)
Endometriosis
Egg quality
Fibroids
Hypothalamic amenorrhea
Low AMH
Lupus
Overweight & obesity
PCOS
Premature ovarian insufficiency (POI)
Thyroid issues, especially Hashimoto's or autoimmune thyroiditis
Miscarriage and recurrent pregnancy loss
Please note: This article is for educational purposes only and does not replace personalised medical advice. Nutritional strategies support ovulatory function but do not replace ovulation induction medications (e.g., letrozole) when clinically indicated.
· Not all supplements are appropriate for everyone. Always consult your GP or fertility specialist before starting supplements, particularly if undergoing assisted reproductive treatment.
· Timing matters – lifestyle changes, including supplements are recommended for at least 3 months before conception. This is because a woman’s eggs take approximately 3 to 4 months (roughly 90-120 days) to mature before ovulation, in a process known as folliculogenesis.
· Dosing matters – scientific research has reported benefits of certain doses. It is important to seek out and consume these doses to get the same benefits.
