The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility

Abstract

In industrialized countries, fertility has declined in recent years to the lowest recorded levels. Identifying modifiable factors that influence human fertility, such as diet, is therefore of major clinical and public health relevance. Micronutrient status is a modifiable risk factor that may have an impact on female fertility, as essential vitamins and minerals have important roles in the physiological processes that are involved. Adequate levels are important for oocyte quality, maturation, fertilization, and implantation, whereas antioxidants are vital to reduce oxidative stress, a process known to impair fertility. In women who are diagnosed as infertile, lower than recommended levels of certain micronutrients have been reported. A similar scenario has been found in a proportion of women of childbearing age in general, some of whom may be struggling to conceive. Supplementation studies with multiple micronutrients are still scarce, but the literature suggests that supplementation before conception can help restore micronutrient status to recommended levels and reduce oxidative stress when antioxidants are included. Overall, supplementation has a small but beneficial effect on fertility in healthy and infertile women, including a shorter time to pregnancy and an increased chance of becoming pregnant. Nevertheless, many studies are small or observational, and adequately powered randomized controlled trials of supplementation with multiple micronutrients are necessary to confirm any definite effects on fertility. This review substantiates the potential benefits of micronutrient supplementation beyond the prevention of neural tube defects, the traditionally viewed value of prenatal vitamin use.

Effects of Periconceptional Multivitamin Supplementation on Folate and Homocysteine Levels Depending on Genetic Variants of Methyltetrahydrofolate Reductase in Infertile Japanese Women

“…MTHFR gene mutations do not contribute to clinical pregnancy rates in ART treatment [ 33 , 34 ]; therefore, its polymorphisms may not cause infertility. However, multivitamin supplementation containing folic acid decreases the risk of pregnancy loss [ 35 ] and has a beneficial effect on female fecundity [ 21 , 32 ]. Furthermore, in the women with a history of RPL, MTHFR 677TT mutation is associated with vitamin D deficiency [ 16 ].…”

“…Moreover, MTHFR polymorphisms expectedly influence the therapeutic effects of multivitamin supplementation; however, the methods of optimal supplementation, depending on MTHFR genotypes, remain unknown. In addition, multiple-micronutrient supplementation including vitamins and minerals has potential benefits on female fecundity with antioxidant effects [ 21 ]. Therefore, multivitamin supplementation may improve pregnancy outcomes in fertility treatment.…”

Female Fertility and the Nutritional Approach: The Most Essential Aspects

“…The proper concentration of minerals is essential for many physiological processes, including maintaining the normal quality of oocytes and embryo fertilization, maturation, and implantation ( 115 ). A deficiency of minerals may disturb fertility; therefore, women should pay attention to the proper intake of minerals and supplement the elements that could be deficient.…”

Dietary Approaches to Women’s Sexual and Reproductive Health

“…99 Vitamins A, B6, B12, C, E, D, zinc, selenium, Coenzyme Q10, and various additional antioxidants are among the many micronutrients that have been investigated. 100,101 At this time, the data are mixed and most strongly support a healthy diet with the goal of avoiding gross micronutrient deficiencies. A typical Western diet lacks several important nutrients, including magnesium, iodine, calcium, and vitamin D. 102,103 It may well be through the impact of these micronutrient deficiencies, as well as proinflammatory states induced by animal products, that the impact on fertility is realized.…”