Best fertility supplements for PCOS

PCOS and Fertility

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among people of childbearing age. The condition has a very high prevalence and up to 10% of people of reproductive age are affected by PCOS. In addition to increased androgens and metabolic disturbances such as insulin resistance, individuals affected commonly suffer from impaired fertility as a result of anovulation. Lifestyle factors, including diet play an important role in the management of PCOS and the severity of the symptoms. Therefore, it may not be surprising that there is emerging research into the field of supplementation to aid PCOS management, in particular for fertility.

Inositol

Inositol is sugar alcohol belonging to B complex vitamins, it has 9 stereoisomers, with 2 in particular found to be beneficial for PCOS. Inositol-derived metabolites have been shown to play an essential role in insulin sensitivity, amongst other functions. Randomized control studies have found supplementing with inositol has improved a variety of pathological conditions in PCOS, including reproductive abnormalities, decreased androgen levels and improved insulin levels.

As mentioned there are two inositol isomers in particular that are of interest for PCOS. Firstly, Myo-inositol, which is involved in the function of FSH (follicle-stimulating hormone), and ovulation, has been found to improve egg quality and increase the chances of conception. Secondly, D-chiro inositol, which is involved in the synthesis of androgens, has been found to regulate testosterone production and reduce the risk of metabolic diseases.

Research suggests supplementing with both isomers of inositol, at a 40:1 ratio of Myo-inositol to D-chiro inositol as this most closely mirrors the ratio in the body. Check out our article on buying inositol in the UK.

Vitamin D

Vitamin D is a fat-soluble hormone created within our bodies from direct sunlight on the skin. Whilst some foods contain a small amount, throughout autumn and winter in the UK, daily supplementation is recommended. Research has found vitamin D deficiency is more common in people with PCOS, compared to the general population.

Low levels of vitamin D can negatively impact symptoms associated with PCOS, including menstrual irregularities and infertility. Emerging research has begun to examine the effects of vitamin D supplementation in PCOS, for fertility in particular. One randomized controlled trial looked at surrogate markers of fertility in 180 PCOS people compared to 150 non-PCOS people. After 24 weeks, they found vitamin D supplementation had a significant effect on fertility markers, whereas no effect was seen in non-PCOS people.

An additional study looked at vitamin D supplementation in 40 people with PCOS who were found to be infertile. It was hypothesized supplementation may influence metabolic profiles and as a result, affect fertility outcomes. They found after 8 weeks there were beneficial effects on both insulin metabolism and lipid profile, however, this could not be concluded in those with pre-existing sufficient vitamin D levels.

Overall, more well-designed studies are required for vitamin D to be recommended to support infertility in those with PCOS. However, due to the increased risk of deficiency, daily supplementation may still be recommended. Plus, if you live in the UK, the NHS recommends daily supplementation during the Autumn and Winter months.

N-acetyl-cysteine

N-acetyl-cysteine, known as NAC, is a mycolytic drug found to increase cellular levels of antioxidant and reduce glutathione at higher doses. Therefore, it has the potential to improve insulin receptor activity and insulin secretion in response to glucose. A systematic review and meta-analysis found that people with NAC had a higher chance of ovulation and getting pregnant compared to placebo. However, this was less likely when compared with metformin. Although interesting results, the analysis found the findings need further confirmation from well-designed randomized controlled trials.

Folic Acid

Folic acid (folate) is an essential nutrient for a baby’s development during preconception and conception. To reduce the risk of problems in the early weeks of pregnancy supplementation is recommended during preconception and up until you’re twelve weeks pregnant.

One study of 54 people with PCOS found that up to 70% were at risk of insufficient intake of folic acid. Furthermore, another study found in those who suffered with infertility, when 2 x 2000 mg of myo-inositol and +2 x 200 μg folic acid daily, had improved symptoms and infertility. 70% of people had restored ovulation, and better fertilisation rates as well as embryo quality.

Although further research may be required for PCOS in particular, folic acid supplementation is recommended by the NHS for conception.

What are the best supplements to buy for PCOS fertility in the UK?

Overall there is some promising evidence for supplementation to support fertility, amongst other symptoms in PCOS. If you are considering supplementation, please consult with a healthcare professional beforehand.

We have curated a list of recommended PCOS fertility supplements below you could try:

New & Improved: Inositol Complex | Myo & D Chiro Inositol with Folate by Time Health