It's well known that egg quality declines with age. A woman’s lifetime supply of eggs is created while she is still a fetus in the womb. Because these eggs don’t divide or regenerate, they’re especially vulnerable to age-related damage, such as DNA mutations and oxidative stress. Over time, this damage can lead to lower egg quality, reduced fertilization and blastocyst formation rates, and a higher risk of Aneuploid embryos compared to eggs from younger individuals. Until recently, there were no options to slow or reverse this natural aging process, but that may be changing.
New Research on NAD+
In recent years, researchers have been studying a coenzyme called NAD+ (nicotinamide adenine dinucleotide) and its role in aging and fertility. NAD+ is found in all living cells and plays a key part in cellular metabolism and energy production, DNA repair, and other vital cellular functions. Levels of NAD+ are high in young, healthy cells but naturally decline with age. This decrease has been shown to contribute to age-related conditions such as cancer, cognitive decline, and metabolic diseases, and researchers are hypothesizing that low NAD+ may have a negative effect on fertility as well.
How might NAD+ help boost fertility?
NAD+ plays a key role in cellular metabolism and DNA repair. Boosting NAD+ levels may help prevent and repair the cellular damage that leads to poor egg quality and abnormal embryos–both of which can reduce the chances of a healthy pregnancy.
Although rigorous human studies on the effects of NAD+ on fertility are still in the early stages, animal studies have shown promising results. In these studies, restoring NAD+ levels appeared to preserve, and in some cases reverse, the effects of aging on egg cells, leading to improved fertility outcomes. Researchers achieved this by giving mice supplements of NMN (nicotinamide mononucleotide) or NR (nicotinamide riboside), both of which are NAD+ precursors that the body can convert into NAD+. Encouragingly, eggs from mice given these supplements had higher fertilization rates and produced more blastocyst-stage embryos compared to similarly aged mice that didn’t receive the supplements.
What does this research mean for human fertility?
So far, evidence supporting the idea that increasing NAD+ can improve fertility comes from animal studies. The next step is to determine through clinical trials whether these benefits also apply to humans. A few of these early-stage human studies are now underway, but results haven’t been published yet.
Even without definitive evidence in humans, some fertility specialists and integrative medicine providers have started using NAD+ treatments, especially for patients with diminished ovarian reserve, a history of poor IVF outcomes, and those who are seeking fertility treatment at an older age. If a strong causal relationship between NAD+ and improved fertility outcomes in humans is established, NAD+ supplementation could become a routine recommendation for certain types of fertility patients in the months leading up to a fertility treatment cycle.