Sangrado (externo)

Alpha-lipoic acid is a mitochondrial antioxidant studied in combination with myo-inositol and folic acid in infertile women with obesity undergoing IVF. An RCT in 23 women found this combination normalized pregnancy rates to those of normal-weight women undergoing IVF. It reduces oxidative stress relevant to oocyte quality.

Ashwagandha (Withania somnifera) is the most clinically validated adaptogen for HPA axis dysregulation. By reducing cortisol and stress-mediated hormonal disruption, it supports menstrual regularity and ovulation. It is used in Ayurveda for female reproductive vitality and emerging clinical studies show benefits in stress-related hormonal imbalance affecting fertility.

A 2023 triple-blind RCT in women with endometriosis undergoing ART showed ASX reduced oxidative stress, inflammation, and improved reproductive outcomes. In PCOS, a 60-day treatment modulated ER stress in granulosa cells. A 2025 systematic review confirmed ASX downregulated ER stress-related apoptotic pathways and improved oocyte and embryo quality in women with PCOS or endometriosis.

Epimedium promotes estrogen production in ovarian granulosa cells and has been studied for premature ovarian failure (POF) in animal models, where it restores ovarian function via PI3K/AKT signaling. Preclinical evidence also suggests ICA reduces inflammatory signaling (NF-κB) involved in spontaneous abortion. Traditional TCM use includes female reproductive deficiency and menstrual irregularities.

Berberine has been evaluated in multiple RCTs for improving fertility outcomes in women with PCOS, primarily by improving insulin sensitivity and reducing androgen levels. Meta-analyses show significant improvements in ovulation rate, endometrial thickness, and clinical pregnancy rate when combined with conventional treatment.

Black cohosh (Actaea/Cimicifuga racemosa) has demonstrated fertility-relevant effects in women with PCOS: a systematic review of 15 clinical studies including 8 RCTs found evidence for ovulation regulation and improved fertility outcomes. Combined with clomiphene, it improved pregnancy rates (43.3% vs. 20.3%) versus clomiphene alone in PCOS.

Bovine liver provides folate, B12, heme iron, vitamin A, zinc, and choline — nutrients essential for female reproductive health, ovulation, implantation, and prevention of nutrient depletion associated with oral contraceptive use. Folate is a WHO-recognized essential prenatal nutrient. Iron deficiency impairs ovulatory function.

Multiple RCTs document improved pregnancy rates and normalized luteal-phase hormones in women with fertility disorders treated with Vitex. A widely cited placebo-controlled trial (Mastodynon preparation) found superior outcomes in amenorrhea and luteal insufficiency vs. placebo. The mechanism involves prolactin reduction and LH-driven progesterone restoration.

Choline is an essential nutrient for one-carbon metabolism, oocyte development, and fetal neural tube formation. Choline deficiency is associated with impaired ovarian function; it is included in NHANES infertility nutrient gap analyses and multi-micronutrient fertility formulations. Adequate intake is recommended periconceptionally.

Multiple RCTs and meta-analyses show CoQ10 supplementation increases clinical pregnancy rates in infertile women undergoing ART, with one meta-analysis (5 RCTs) reporting 28.8% vs. 14.1% clinical pregnancy rate vs. placebo (OR 2.44, 95% CI 1.30–4.59). It reduces reactive oxygen species in oocytes and supports mitochondrial energy production. Evidence is strongest in women with diminished ovarian reserve or poor ovarian response.

D-alpha tocopherol has been studied for its effects on endometrial thickness, uterine blood flow, and implantation support in women undergoing assisted reproduction. Pilot studies show improvements in endometrial receptivity with vitamin E, particularly in women with thin endometrium.

DHA is a key omega-3 fatty acid found in follicular fluid and oocyte membranes; higher follicular DHA correlates with improved oocyte and embryo quality. Studies in ART populations show DHA supplementation supports oocyte maturation and embryo development, and it is a standard component of fertility-oriented omega-3 supplements.

DHEA supplementation has been studied in women with diminished ovarian reserve (DOR) undergoing assisted reproductive technology. Clinical studies report improvements in AMH levels, follicular development, and pregnancy rates in DOR patients treated with DHEA prior to IUI or IVF. Evidence is promising but limited by small samples and lack of controls in some studies.

Cuscuta chinensis is documented as the most commonly prescribed herb for female infertility in TCM, used for menstrual disorders, recurrent miscarriage, polycystic ovary syndrome, and thin uterine lining. Pharmacological research confirms estrogen-like effects and increased LH receptor binding in ovarian tissue. A cohort study showed that 96.17% of infertile Taiwanese women seeking TCM received Cuscutae Semen.

EGCG has been shown to improve oocyte maturation quality and developmental capacity in vitro, support ovarian function, and reduce oxidative stress in female reproductive tissues. Preclinical evidence also suggests benefits for pregnancy complications such as preeclampsia via the eNOS/Nrf2/HO-1 pathway.

EPA is an omega-3 fatty acid with anti-inflammatory and steroidogenic effects relevant to female fertility. Granulosa cell studies show EPA increases IGF-1 and reduces pro-inflammatory COX-2, supporting follicular development. EPA supplementation is associated with improved hormonal markers including reduced FSH in women with poor ovarian reserve.

Fenugreek extract has shown potential to improve female fertility markers in the context of PCOS by modulating LH and FSH levels, reducing cyst size, and normalizing menstrual cycles in clinical research. Its phytoestrogenic compounds may support ovarian hormone balance relevant to fertility.

Preclinical studies show fisetin supports ovarian function by reducing oxidative stress, inflammation, and cellular senescence in the ovary. It modulates ovarian aging pathways and hormonal balance. A 2026 Johns Hopkins review identifies its relevance to female fertility in preclinical contexts.

Omega-3 fatty acids from fish oil may improve female fertility outcomes including egg quality, embryo morphology, endometrial receptivity, and IVF success rates. A 2024 meta-analysis of 13 studies involving over 4,000 women found omega-3 intake was associated with higher fertilization and pregnancy rates in both natural conception and ART contexts.

Folic acid (vitamin B9) is the most firmly established periconception supplement. Higher folate intake is associated with lower risk of anovulation and ovulatory infertility, shorter time to pregnancy, and greater success with infertility treatment. US and global guidelines recommend 400–800 mcg/day for all women of reproductive age.

Myo-inositol, alone or combined with melatonin, improves oocyte quality, hormonal balance, and IVF pregnancy rates in women with PCOS and poor ovarian response. Multiple RCTs show benefits in insulin signaling, ovulation induction, and embryo development. An umbrella review reported a relative risk of 1.52 for clinical pregnancy rates versus placebo.

Iron deficiency is linked to ovulatory infertility. A long-term study of more than 18,000 women (Nurses' Health Study) found supplemental iron intake was associated with decreased risk of ovulatory infertility. Deficiency impairs ovarian oxygen delivery, disrupting ovulation. Supplementation benefits women with confirmed deficiency.

L-carnitine facilitates mitochondrial fatty acid oxidation in oocytes and is among the supplements showing increased clinical pregnancy rates (OR 11.14) in women with PCOS undergoing MAR in meta-analyses, though evidence certainty is very low. It may also support endometrial blood flow.

NAC has been tested in RCTs for female infertility, notably in PCOS, where it has been shown to improve ovulation and pregnancy rates, partly by reducing insulin resistance and oxidative stress. A double-blind RCT of 150 women with clomiphene-resistant PCOS found that NAC added to clomiphene significantly increased both ovulation and pregnancy rates.

Vaginal dominance by L. crispatus is associated with favorable gestational outcomes, including lower rates of preterm birth. A North Carolina cohort study (n=824 women) found high L. crispatus abundance significantly reduced preterm birth risk. A longitudinal Japanese cohort (Nature Communications, 2025) confirmed early-pregnancy L. crispatus dominance correlated with favorable gestational parameters. Depletion of vaginal L. crispatus is linked to spontaneous preterm birth, prompting active clinical trials of L. crispatus supplementation in high-risk pregnancies.

Maca (Lepidium meyenii/peruvianum) has been used for centuries in the Andes for fertility. Clinical evidence shows it modulates the HPA axis to support hormonal balance, improve FSH levels, and support menstrual regularity. Combined with Vitex and folate in a 189-woman uncontrolled trial, a 37% pregnancy rate was achieved.

Magnesium is an essential cofactor for hundreds of enzymatic reactions and plays a role in insulin sensitivity and hormone regulation. In PCOS, magnesium co-supplementation (with zinc, calcium, vitamin D) improves insulin sensitivity, CRP, lipid profiles, and glucose metabolism relevant to fertility. Magnesium gaps are documented in infertile women.

A published randomized open trial in 80 women with PCOS found maitake SX-fraction (MSX) induced ovulation in 76.9% of treated women, comparable to clomiphene citrate (93.5%). Combination therapy of MSX plus clomiphene further rescued ovulation in women who failed monotherapy with either agent alone. Evidence is limited to this single industry-affiliated trial.

Manganese is listed by the NIH ODS as involved in reproduction, and peer-reviewed mineral-fertility reviews identify it as contributing to hormonal regulation, ovarian function, and protection against oxidative-stress-driven infertility. Direct clinical trial evidence for supplementation improving fertility outcomes is lacking.

Melatonin, a potent free-radical scavenger concentrated in follicular fluid, improves oocyte and embryo quality when combined with myo-inositol or vitamin D in IVF settings. Clinical trials show benefits in clinical pregnancy rates. Women with PCOS have lower follicular melatonin, and supplementation partially corrects this deficit.

NAC, a precursor to glutathione, has shown clinical benefit for fertility in women with PCOS. A 2015 meta-analysis of 8 RCTs (n=910) found women receiving NAC had three times higher odds of pregnancy and live birth compared to placebo. Evidence is primarily in PCOS-related infertility at doses of 1200–1800 mg/day.

Animal studies show NMN restores ovarian NAD+ levels, prevents ovarian atrophy, improves oocyte quality and quantity, and reduces ovarian inflammation in aging mice. A retrospective clinical analysis in women with diminished ovarian reserve showed NMN pretreatment significantly improved follicle size, endometrial thickness, and pregnancy rates compared to controls.

C. rotundus extracts have been shown to significantly upregulate expression of LIF-mediated integrins (αVβ3 and αVβ5) in endometrial cells, which are essential for trophoblast attachment and blastocyst implantation. Modern studies suggest improved pregnancy rates with C. rotundus. This is supported by mechanistic cell-based evidence.

Omega-3 fatty acids (EPA and DHA) support fertility through hormonal balance, anti-inflammatory effects, and improved oocyte quality. A meta-analysis confirmed significantly improved pregnancy and fertilization rates in women. An observational study found omega-3 supplement use was associated with approximately twice the probability of conception.

Progesterone is essential for embryo implantation and early pregnancy maintenance, and luteal phase deficiency is a recognized treatable cause of infertility and recurrent pregnancy loss. Vaginal and oral progesterone are standard-of-care luteal phase support in IVF. A 2017 Cochrane-linked meta-analysis of 9 RCTs (n=913) found progesterone supplementation reduced miscarriage incidence from 21.7% to 13.0% in threatened miscarriage.

One published clinical report found higher pregnancy rates in women using intravaginal RJ plus honey versus conventional insemination. Animal data show RJ supports follicular development and normalizes reproductive hormones. RJ's phytoestrogenic and antioxidant properties provide mechanistic support. Robust placebo-controlled RCT evidence in women is absent.

Selenium is a trace mineral critical for antioxidant defense via glutathione peroxidase (GPx). Low serum and follicular selenium levels are associated with higher infertility occurrence. A double-blind RCT of antioxidant supplementation including selenium improved viable pregnancy rates in women undergoing ICSI.

Limited clinical and preclinical evidence supports tribulus for improving ovulatory function and follicular development, particularly in women with oligo/anovulatory infertility and PCOS. A small number of clinical trials and animal studies show TT promotes FSH-dependent follicle development and ovulation.

Tribulus terrestris has been used in Ayurvedic and traditional Chinese medicine for reproductive health. Clinical trials show its steroidal saponins (protodioscin) stimulate LH and FSH, improving ovulation in women with anovulatory cycles. One clinical trial found ovulation induction equivalent to clomiphene (60% vs. 47%) in oligo/anovulatory infertility.

Clinical evidence supports CoQ10/ubiquinol's role in improving oocyte quality, ovarian response, and IVF outcomes, particularly in women of advanced reproductive age or with diminished ovarian reserve. Ubiquinol supports mitochondrial energy supply critical for oocyte maturation and fertilization. Evidence from IVF-setting RCTs and a 2024 systematic review and meta-analysis confirms benefits for poor ovarian responders.

Low vitamin B12 status is associated with reduced embryo quality, impaired oocyte competence, and lower clinical pregnancy rates in women undergoing assisted reproductive technology (ART). B12 deficiency elevates homocysteine, which is associated with infertility. A retrospective ART study found that B12 supplementation was linked to higher likelihood of clinical pregnancy and live birth.

Folate (naturally occurring vitamin B9) supports ovulatory function and early embryo development. Higher intake correlates with reduced anovulation risk, shorter time to pregnancy, and better ART outcomes in observational and RCT evidence. The standard preconception recommendation is 400–800 mcg/day.

5-Methyltetrahydrofolate (5-MTHF) is the bioactive form of folate. In women with MTHFR gene variants (affecting 25–60% of the population), it bypasses impaired folic acid conversion, reducing homocysteine accumulation associated with recurrent pregnancy loss and supporting ovulatory function.

Vitamin C is a water-soluble antioxidant present in high concentrations in follicular fluid, protecting oocytes from oxidative damage. It is studied as part of antioxidant supplement combinations for female fertility, particularly in ART populations. Deficiency is associated with impaired ovarian function.

Low vitamin D levels are associated with reduced oocyte quality, impaired ovarian reserve, and poorer IVF outcomes. Multiple systematic reviews document that vitamin D supplementation is among the interventions increasing clinical pregnancy rates in infertile women. Evidence is strongest in vitamin D-deficient women undergoing ART.

Vitamin D3 (cholecalciferol) is the most bioavailable supplemental form of vitamin D. Low vitamin D3 is associated with impaired oocyte quality, reduced ovarian reserve, and poorer IVF outcomes. An RCT combining vitamin D3 with myo-inositol, folic acid, and melatonin significantly improved IVF clinical pregnancy rates (42% vs. 24%).

Vitamin E is a fat-soluble antioxidant that protects oocyte membranes from oxidative damage. In PCOS, it is combined with other antioxidants and micronutrients to improve hormonal profiles and fertility outcomes. Co-supplementation with omega-3 fatty acids or magnesium had optimal effects on hormonal profiles and glycemic indices.

Vitex agnus-castus (chasteberry/chaste tree) acts on the pituitary to reduce prolactin and extend the luteal phase, supporting fertility in women with hyperprolactinaemia and luteal phase defects. A clinical trial of 96 women with fertility disorders found pregnancy occurred more than twice as often in the chasteberry group than placebo over 3 months.

Zinc is essential for ovulation, follicular development, and oocyte maturation. Zinc deficiency impairs ovulation; co-supplementation studies (zinc with magnesium, calcium, vitamin D/E) show improvements in insulin sensitivity and hormonal profiles in PCOS. Zinc is included in international fertility nutrition recommendations.

Asparagus racemosus (Shatavari), a species of asparagus, is the central female reproductive herb in Ayurvedic medicine, traditionally used for fertility, menstrual irregularity, and reproductive vitality. Its steroidal saponins (shatavarins) have phytoestrogenic activity. Preliminary clinical data shows improvements in serum estradiol and FSH balance.

Damiana has a documented traditional use in Latin American medicine for menstrual and reproductive disorders, including fertility support. It is listed in ethnobotanical records from the Dominican Republic for women's health conditions. No clinical studies on fertility outcomes have been conducted.

Dong Quai (Angelica sinensis) is a foundational herb in Traditional Chinese Medicine used for thousands of years to regulate menstrual cycles, address blood deficiency (xue xu), and support uterine tone in women with menstrual irregularities and fertility concerns. Scientific evidence in humans is limited; most support is traditional.

Morinda officinalis has been used in TCM for centuries to treat women's reproductive conditions including infertility, menstrual irregularities, and uterine coldness, framed as 'kidney-yang deficiency.' It appears as an ingredient in traditional TCM polyherbal formulas for PCOS-related infertility, though standalone clinical evidence is limited.

In TCM, mugwort ('Ai Ye') is specifically used for cold-type infertility combined with kidney yang tonics, and moxibustion at BL 67 is used for uterine positioning to support fertility. The plant's estrogenic and uterotonic properties support this traditional use. No human clinical fertility trials with oral mugwort exist.

PABA has been used historically for female infertility, reportedly by enhancing estrogenic activity. A 1942 uncontrolled case series by Sieve reported that 16 women with fertility problems who took 100 mg four times daily for 3–7 months had a 75% pregnancy rate. No rigorous controlled trials have replicated or followed up on this finding.

Infertility is explicitly listed as a traditional indication for feverfew in authoritative herbal medicine sources, including the PMC systematic review and the NCCIH. The herb's emmenagogue and uterine-tonic properties are historically associated with promoting conditions for conception. No clinical evidence exists.

Pituitary substance has a documented traditional use in glandular therapy for female infertility, based on the pituitary's role in secreting FSH and LH, which govern follicular development and ovulation. Early 20th-century organotherapy practitioners included pituitary extracts in formulas for ovulatory dysfunction. No modern clinical trials of oral supplementation exist.

Red clover contains isoflavones (formononetin, biochanin A) with phytoestrogenic activity that may support follicular development and cervical mucus in women with relatively low estrogen. It has been used traditionally for female reproductive support. Limited clinical evidence exists specifically for fertility; most is in menopausal symptom management.

In TCM, rehmannia is a primary blood and Kidney Essence tonic used to nourish the uterus, regulate menstrual cycles, and support reproductive vitality. It is the principal ingredient in Liu Wei Di Huang Wan, widely prescribed for women's reproductive health. No standalone human RCTs for female fertility exist.

Solomon's seal is used across indigenous North American, Ayurvedic, and Western herbal traditions for female fertility support, including nourishing reproductive secretions, supporting uterine health, and addressing conditions such as vaginal dryness and hormonal irregularity. No human clinical trial has been conducted.

Squawvine has documented traditional use as a tonic to support female fertility, particularly by toning the uterus and ovaries over several menstrual cycles. It appears in ethnobotanical records and naturopathic herbal texts as an adjunct for infertility related to uterine weakness or hormonal irregularity. No human clinical evidence exists.

Wild yam has a traditional role in supporting female reproductive health, with use for uterine and ovarian conditions. Preclinical animal studies suggest dioscorin proteins from Dioscorea species can stimulate estradiol biosynthesis in ovarian cells and upregulate aromatase, but human clinical evidence for fertility improvement is absent.