{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:09:29Z","timestamp":1785424169399,"version":"3.56.0"},"reference-count":96,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006304","name":"Aalborg University Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006304","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/02jk5qe80","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Although current research suggests beneficial effects of dietary supplements on female infertility, existing evidence is often inconsistent and of limited certainty. This systematic review and meta-analysis aimed to investigate the effect of dietary supplements on female infertility in terms of endometrial thickness, pregnancy, live birth, and miscarriage compared to placebo (primary objective) and compared to placebo or a no-treatment comparator (secondary objective). Methods: PubMed, Embase, and CENTRAL were searched up to March 2025. Randomized controlled trials assessing the effect of dietary supplements compared to placebo or a no-treatment comparator among infertile women were included. Screening, data extraction, risk of bias, and certainty of evidence assessments were conducted by two independent reviewers. Data was synthesized quantitatively using random effects restricted maximum likelihood models. Results: Twenty placebo-controlled and 20 no-treatment comparator studies were included. Most studies had some concerns in risk of bias. Primary analyses showed an improvement in endometrial thickness following N-acetyl-cysteine supplementation compared to placebo, while no effect was found for supplements on pregnancy-related outcomes. Certainty of evidence of primary analyses was low. Secondary analyses indicated positive differences in endometrial thickness and pregnancy-related outcomes following supplementation with different supplements compared to placebo and no treatment. Conclusions: This review found no high-certainty evidence that dietary supplements improve female infertility outcomes when compared with placebo. Secondary analyses combining placebo and no-treatment comparator studies generated hypotheses for myo-inositol, N-acetyl-cysteine, vitamin D, vitamin E, and \u22653 substance dietary supplements, but these are at higher risk of bias and require confirmation in adequately powered placebo-controlled trials with live birth as the primary outcome.<\/jats:p>","DOI":"10.3390\/nu18121942","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:58:38Z","timestamp":1781661518000},"page":"1942","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Dietary Supplements on Female Infertility in Terms of Endometrial Thickness, Pregnancy, Live Birth and Miscarriage: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2799-2855","authenticated-orcid":false,"given":"Mette Peters","family":"Michaelsen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Aalborg University Hospital, 9000 Aalborg, Denmark"},{"name":"Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9335-0111","authenticated-orcid":false,"given":"Michelle","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Aalborg University Hospital, 9000 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9302-3548","authenticated-orcid":false,"given":"Maria","family":"Borgstr\u00f8m","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Herlev and Gentofte University Hospital, 2730 Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5033-0833","authenticated-orcid":false,"given":"Helena Birk","family":"Wisby","sequence":"additional","affiliation":[{"name":"Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0628-5292","authenticated-orcid":false,"given":"Anne Ahrendt","family":"Bjerregaard","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark"},{"name":"Department of Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3868-106X","authenticated-orcid":false,"given":"Ulrik Schi\u00f8ler","family":"Kesmodel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Aalborg University Hospital, 9000 Aalborg, Denmark"},{"name":"Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"hoac051","DOI":"10.1093\/hropen\/hoac051","article-title":"Infertility prevalence and the methods of estimation from 1990 to 2021: A systematic review and meta-analysis","volume":"2022","author":"Cox","year":"2022","journal-title":"Hum. Reprod. Open"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pandey, C., Maunder, A., Liu, J., Vaddiparthi, V., Costello, M.F., Bahri-Khomami, M., Mousa, A., and Ee, C. (2024). The Role of Nutrient Supplements in Female Infertility: An Umbrella Review and Hierarchical Evidence Synthesis. Nutrients, 17.","DOI":"10.3390\/nu17010057"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3435","DOI":"10.1007\/s10815-025-03625-z","article-title":"Investigating perceptions and usage of fertility supplements: A mixed methods analysis of a large online forum","volume":"42","author":"Tomlinson","year":"2025","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Murphy, R.A., Reider, C.A., Grant, R.W., and Hazels Mitmesser, S. (2026). Nutrient gaps are prevalent among women experiencing infertility, a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES), 2013\u20132020. PLoS ONE, 21.","DOI":"10.1371\/journal.pone.0341444"},{"key":"ref_5","first-page":"Cd007807","article-title":"Antioxidants for female subfertility","volume":"8","author":"Showell","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_6","first-page":"2","article-title":"Infertility: A review on causes, treatment and management","volume":"5","author":"Anwar","year":"2016","journal-title":"Womens Health Gynecol."},{"key":"ref_7","first-page":"1","article-title":"Unexplained infertility, the controversial matter in management of infertile couples","volume":"16","author":"Sadeghi","year":"2015","journal-title":"J. Reprod. Infertil."},{"key":"ref_8","first-page":"1","article-title":"The Impact of Lifestyle Risk Factors on Female Infertility","volume":"44","author":"Cox","year":"2007","journal-title":"Women Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s40265-023-01853-0","article-title":"Effectiveness of Nutritional Therapies in Male Factor Infertility Treatment: A Systematic Review and Network Meta-analysis","volume":"83","author":"Zafar","year":"2023","journal-title":"Drugs"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1179562x19843868","DOI":"10.1177\/1179562X19843868","article-title":"The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility","volume":"12","author":"Schaefer","year":"2019","journal-title":"Clin. Med. Insights Womens Health"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Grieger, J.A., Grzeskowiak, L.E., Wilson, R.L., Bianco-Miotto, T., Leemaqz, S.Y., Jankovic-Karasoulos, T., Perkins, A.V., Norman, R.J., Dekker, G.A., and Roberts, C.T. (2019). Maternal Selenium, Copper and Zinc Concentrations in Early Pregnancy, and the Association with Fertility. Nutrients, 11.","DOI":"10.3390\/nu11071609"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"943","DOI":"10.3945\/ajcn.115.112185","article-title":"Association between serum folate and vitamin B-12 and outcomes of assisted reproductive technologies","volume":"102","author":"Gaskins","year":"2015","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1093\/humrep\/dex326","article-title":"Vitamin D and assisted reproductive treatment outcome: A systematic review and meta-analysis","volume":"33","author":"Chu","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12958-018-0324-3","article-title":"Whether vitamin D was associated with clinical outcome after IVF\/ICSI: A systematic review and meta-analysis","volume":"16","author":"Zhao","year":"2018","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.fertnstert.2020.05.040","article-title":"How vitamin D level influences in vitro fertilization outcomes: Results of a systematic review and meta-analysis","volume":"114","author":"Cozzolino","year":"2020","journal-title":"Fertil. Steril."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1080\/14647273.2020.1807618","article-title":"Women\u2019s vitamin D levels and IVF results: A systematic review of the literature and meta-analysis, considering three categories of vitamin status (replete, insufficient and deficient)","volume":"25","author":"Iliuta","year":"2022","journal-title":"Hum. Fertil."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zhou, X., Wu, X., Luo, X., Shao, J., Guo, D., Deng, B., and Wu, Z. (2022). Effect of Vitamin D Supplementation on In Vitro Fertilization Outcomes: A Trial Sequential Meta-Analysis of 5 Randomized Controlled Trials. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.852428"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12958-023-01068-8","article-title":"Influence of Vitamin D supplementation on reproductive outcomes of infertile patients: A systematic review and meta-analysis","volume":"21","author":"Meng","year":"2023","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s10815-012-9714-1","article-title":"Vitamin e effect on controlled ovarian stimulation of unexplained infertile women","volume":"29","author":"Cicek","year":"2012","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.1007\/s10815-020-01906-3","article-title":"Does coenzyme Q(10) supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials","volume":"37","author":"Florou","year":"2020","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Cirillo, M., Fucci, R., Rubini, S., Coccia, M.E., and Fatini, C. (2021). 5-Methyltetrahydrofolate and Vitamin B12 Supplementation Is Associated with Clinical Pregnancy and Live Birth in Women Undergoing Assisted Reproductive Technology. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182312280"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1007\/s00404-012-2237-2","article-title":"The effect of micronutrient supplements on female fertility: A systematic review","volume":"285","author":"Grajecki","year":"2012","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e8842","DOI":"10.1097\/MD.0000000000008842","article-title":"Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET","volume":"96","author":"Zheng","year":"2017","journal-title":"Medicine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"World Health Organization (2021). WHO fact sheet on infertility. Glob. Reprod. Health, 6, e52.","DOI":"10.1097\/GRH.0000000000000052"},{"key":"ref_26","unstructured":"(2025). Canada\u2019s Drug Agency Search Filters Database, Canada\u2019s Drug Agency. Available online: https:\/\/searchfilters.cda-amc.ca\/link\/108."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014A web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Thomsen, L.H., Humaidan, P., Erb, K., Overgaard, M., Andersen, C.Y., and Kesmodel, U.S. (2018). Mid-Luteal 17-OH Progesterone Levels in 614 Women Undergoing IVF-Treatment and Fresh Embryo Transfer-Daytime Variation and Impact on Live Birth Rates. Front. Endocrinol., 9.","DOI":"10.3389\/fendo.2018.00690"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1093\/humrep\/dey226","article-title":"The impact of luteal serum progesterone levels on live birth rates-a prospective study of 602 IVF\/ICSI cycles","volume":"33","author":"Thomsen","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1411","article-title":"Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2020","journal-title":"Res. Synth. Methods"},{"key":"ref_32","unstructured":"Higgins, J.P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., Welch, V., and Flemyng, E. (2024). Analysing data and undertaking meta-analyses (last updated November 2024). Cochrane Handbook for Systematic Reviews of Interventions, Version 6.5, Cochrane."},{"key":"ref_33","unstructured":"Higgins, J.P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., Welch, V., and Flemyng, E. (2024). Assessing risk of bias due to missing evidence in a meta-analysis (last updated August 2024). Cochrane Handbook for Systematic Reviews of Interventions, Version 6.5, Cochrane."},{"key":"ref_34","unstructured":"StataCorp (2023). Stata Statistical Software: Release 18, StataCorp LLC."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1136\/bmj.39490.551019.BE","article-title":"What is \u201cquality of evidence\u201d and why is it important to clinicians?","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref_36","unstructured":"McMaster University and Evidence Prime (2025). GRADEpro Guideline Development Tool [Software], McMaster University and Evidence Prime."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1093\/humrep\/17.3.659","article-title":"Adjuvant L-arginine treatment in controlled ovarian hyperstimulation: A double-blind, randomized study","volume":"17","author":"Battaglia","year":"2002","journal-title":"Hum. Reprod."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1093\/humrep\/14.7.1690","article-title":"Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients","volume":"14","author":"Battaglia","year":"1999","journal-title":"Hum. Reprod."},{"key":"ref_39","first-page":"73","article-title":"Effect of melatonin on the outcome of assisted reproductive technique cycles in women with diminished ovarian reserve: A double-blinded randomized clinical trial","volume":"42","author":"Jahromi","year":"2017","journal-title":"Iran. J. Med. Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s10815-011-9604-y","article-title":"Melatonin improves the oocyte and the embryo in IVF patients with sleep disturbances, but does not improve the sleeping problems","volume":"28","author":"Eryilmaz","year":"2011","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_41","first-page":"555","article-title":"Effect of the treatment with myo-inositol plus folic acid plus melatonin in comparison with a treatment with myo-inositol plus folic acid on oocyte quality and pregnancy outcome in IVF cycles. A prospective, clinical trial","volume":"14","author":"Rizzo","year":"2010","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Espino, J., Macedo, M., Lozano, G., Ortiz, \u00c1., Rodr\u00edguez, C., Rodr\u00edguez, A.B., and Bejarano, I. (2019). Impact of Melatonin Supplementation in Women with Unexplained Infertility Undergoing Fertility Treatment. Antioxidants, 8.","DOI":"10.3390\/antiox8090338"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s12958-021-00741-0","article-title":"The effect of Myo-inositol on fertility rates in poor ovarian responder in women undergoing assisted reproductive technique: A randomized clinical trial","volume":"19","author":"Mohammadi","year":"2021","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1007\/s00404-019-05064-5","article-title":"The effectiveness of inositol and metformin on infertile polycystic ovary syndrome women with resistant to letrozole","volume":"299","author":"Pourghasem","year":"2019","journal-title":"Arch. Gynecol. Obs."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"643","DOI":"10.18502\/ijrm.v20i8.11753","article-title":"Myo-inositol effect on pregnancy outcomes in infertile women undergoing in vitro fertilization\/intracytoplasmic sperm injection: A double-blind RCT","volume":"20","author":"Seyedoshohadaei","year":"2022","journal-title":"Int. J. Reprod. Biomed."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1080\/09513590.2017.1296127","article-title":"Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome: A prospective, controlled, randomized trial","volume":"33","author":"Okyay","year":"2017","journal-title":"Gynecol. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"256","DOI":"10.36129\/jog.33.04.06","article-title":"The effect of inofolic supplementation on women with polycystic ovarian syndrome (Pcos): A randomized clinical trial study","volume":"33","author":"Soufizadeh","year":"2021","journal-title":"Ital. J. Gynaecol. Obstet."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"375","DOI":"10.3109\/09513590.2012.743020","article-title":"Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study","volume":"29","author":"Artini","year":"2013","journal-title":"Gynecol. Endocrinol."},{"key":"ref_49","first-page":"996","article-title":"Effect of supplementing myoinositol and vitamin D3 on clomiphene citrate induced ovulation in infertile women with polycystic ovarian syndrome\u2014A randomized control trial","volume":"6","author":"Rajan","year":"2024","journal-title":"Afr. J. Biol. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1111\/j.1447-0756.2012.01844.x","article-title":"N-acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome","volume":"38","author":"Salehpour","year":"2012","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.fertnstert.2004.07.960","article-title":"N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome","volume":"83","author":"Rizk","year":"2005","journal-title":"Fertil. Steril."},{"key":"ref_52","first-page":"134","article-title":"The Use of N-Acetyl Cysteine Versus Chromium Picolinate as an Adjuvant to Clomiphene Citrate and Metformin in PCOS Women to Improve Ovulation Induction and Insulin Resistance: A Pilot Randomized Controlled Trial","volume":"18","author":"Alalfy","year":"2022","journal-title":"Curr. Women\u2019s Health Rev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"185","DOI":"10.15296\/ijwhr.2019.31","article-title":"Comparison of pregnancy rate in patients with polycystic ovary syndrome treated with clomiphene alone and in combination with n-acetyl cysteine: A randomized clinical trial","volume":"7","author":"Ghomian","year":"2019","journal-title":"Int. J. Women\u2019s Health Reprod. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"203","DOI":"10.29252\/ijrm.15.4.203","article-title":"N-acetyl cysteine in ovulation induction of PCOS women underwent intrauterine insemination: An RCT","volume":"15","author":"Hajshafiha","year":"2017","journal-title":"Int. J. Reprod. Biomed."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1186\/s13048-024-01528-8","article-title":"N-acetylcysteine supplementation improves endocrine-metabolism profiles and ovulation induction efficacy in polycystic ovary syndrome","volume":"17","author":"Fang","year":"2024","journal-title":"J. Ovarian Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.ijgo.2007.08.018","article-title":"Effect of vitamins C and E supplementation on peripheral oxidative stress markers and pregnancy rate in women with endometriosis","volume":"100","year":"2008","journal-title":"Int. J. Gynaecol. Obs."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S0015-0282(03)00657-5","article-title":"Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect","volume":"80","author":"Henmi","year":"2003","journal-title":"Fertil. Steril."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.clnesp.2017.01.002","article-title":"Role of vitamin E and D3 supplementation in Intra-Cytoplasmic Sperm Injection outcomes of women with polycystic ovarian syndrome: A double blinded randomized placebo-controlled trial","volume":"18","author":"Fatemi","year":"2017","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_59","first-page":"18","article-title":"Effect of Vitamin D Supplementation on Intracytoplasmic Sperm Injection Outcomes: A Randomized Double-Blind Placebo-Controlled Trial","volume":"13","author":"Abedi","year":"2019","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_60","first-page":"213","article-title":"Efficacy of Vitamin D3 Insufficiency Treatment on Pregnancy Rate: Clinical Trial","volume":"11","author":"Fahad","year":"2020","journal-title":"J. Cardiovasc. Dis. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/S1028-4559(09)60275-8","article-title":"The Effects of Calcium-Vitamin D and Metformin on Polycystic Ovary Syndrome: A Pilot Study","volume":"48","author":"Rashidi","year":"2009","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"111259","DOI":"10.1016\/j.humimm.2025.111259","article-title":"The effect of vitamin D supplementation and vaginal probiotics on fertility in women with recurrent implantation failure: A randomized clinical trial","volume":"86","author":"Badihi","year":"2025","journal-title":"Hum. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1111\/jog.14467","article-title":"Randomized controlled open-label study of the effect of vitamin E supplementation on fertility in clomiphene citrate-resistant polycystic ovary syndrome","volume":"46","author":"Morsy","year":"2020","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.rbmo.2011.10.004","article-title":"Prospective randomized trial of multiple micronutrients in subfertile women undergoing ovulation induction: A pilot study","volume":"24","author":"Agrawal","year":"2012","journal-title":"Reprod. Biomed. Online"},{"key":"ref_65","first-page":"8529","article-title":"The effect of myo-inositol, vitamin D3 and melatonin on the oocyte quality and pregnancy in in vitro fertilization: A randomized prospective controlled trial","volume":"24","author":"Wdowiak","year":"2020","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_66","first-page":"1667","article-title":"Oxidative stress and outcome of antioxidant supplementation in patients with polycystic ovarian syndrome (PCOS)","volume":"7","author":"Saidu","year":"2018","journal-title":"Int. J. Gynecol. Obstet. Gynecol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1007\/s10815-023-02847-3","article-title":"Follicular homocysteine as a marker of oocyte quality in PCOS and the role of micronutrients","volume":"40","author":"Kucuk","year":"2023","journal-title":"J. Assist. Reprod. Genet."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"38","DOI":"10.3109\/14647273.2014.927595","article-title":"Oral antioxidants supplementation for women with unexplained infertility undergoing ICSI\/IVF: Randomized controlled trial","volume":"18","author":"Youssef","year":"2015","journal-title":"Hum. Fertil."},{"key":"ref_69","first-page":"131","article-title":"Omega-3 Intake Improves Clinical Pregnancy Rate in Polycystic Ovary Syndrome Patients: A Double-Blind, Randomized Study","volume":"25","author":"Heifetz","year":"2023","journal-title":"Isr. Med. Assoc. J."},{"key":"ref_70","first-page":"128","article-title":"The Effects of Thiamine Supplementation on General Health and Infertility Treatment Outcomes in Women with Polycystic Ovary Syndrome: A Triple-Blinded Randomized Placebo-Controlled Clinical Trial","volume":"18","author":"Moti","year":"2024","journal-title":"Int. J. Fertil. Steril."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.clnesp.2022.07.017","article-title":"The effects of selenium supplementation on glycemic control, serum lipoproteins and biomarkers of oxidative stress in infertile women diagnosed with polycystic ovary syndrome undergoing in vitro fertilization: A randomized, double-blind, placebo-controlled trial","volume":"51","author":"Asemi","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Rostami, S., Alyasin, A., Saedi, M., Nekoonam, S., Khodarahmian, M., Moeini, A., and Amidi, F. (2023). Astaxanthin ameliorates inflammation, oxidative stress, and reproductive outcomes in endometriosis patients undergoing assisted reproduction: A randomized, triple-blind placebo-controlled clinical trial. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1144323"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"111220","DOI":"10.1016\/j.humimm.2024.111220","article-title":"The role of probiotics in restoring the Th1 to Th2 ratio in women experiencing recurrent implantation failure; a double-blind randomized clinical trial","volume":"86","author":"Kamrani","year":"2025","journal-title":"Hum. Immunol."},{"key":"ref_74","first-page":"979","article-title":"Enhancing fertility with patented proprietary sirtuins and NRF2 Activator (EQOQ\u00ae) Intervention on oocyte, embryo quality, and implantation rates in females with diminished ovarian reserve seeking fertility treatment after the age of 30 years: A multicentre, randomized, double-blind, controlled clinical trial. (Fertsirt Trial)","volume":"6","author":"Gohadkar","year":"2024","journal-title":"Int. J. Acad. Med. Pharm."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"100400","DOI":"10.1016\/j.obmed.2022.100400","article-title":"Clomiphene citrate (CC) plus L-Carnitine improves clinical pregnancy rate along with glycemic status and lipid profile in clomiphene-resistant polycystic ovary syndrome patients: A triple-blind randomized controlled clinical trial","volume":"34","author":"Taheripanah","year":"2022","journal-title":"Obes. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1080\/09513590.2021.1974378","article-title":"Oral melatonin supplementation during in vitro fertilization treatment: A systematic PRISMA review and meta-analysis of randomized controlled trials","volume":"37","author":"Mejlhede","year":"2021","journal-title":"Gynecol. Endocrinol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.fertnstert.2013.09.036","article-title":"Melatonin supplementation during controlled ovarian stimulation for women undergoing assisted reproductive technology: Systematic review and meta-analysis of randomized controlled trials","volume":"101","author":"Seko","year":"2014","journal-title":"Fertil. Steril."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Zhang, J., Zhang, H., Zhou, W., Jiang, M., and Lin, X. (2025). Effect of myo-inositol supplementation in mixed ovarian response IVF cohort: A systematic review and meta-analysis. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1520362"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Yang, M., Shen, X., Lu, D., Peng, J., Zhou, S., Xu, L., and Zhang, J. (2023). Effects of vitamin D supplementation on ovulation and pregnancy in women with polycystic ovary syndrome: A systematic review and meta-analysis. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1148556"},{"key":"ref_80","first-page":"817849","article-title":"N-acetylcysteine for polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled clinical trials","volume":"2015","author":"Thakker","year":"2015","journal-title":"Obs. Gynecol. Int."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ogrm.2022.06.001","article-title":"Polycystic ovarian syndrome: Diagnosis and management of related infertility","volume":"32","author":"Yadav","year":"2022","journal-title":"Obstet. Gynaecol. Reprod. Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e116","DOI":"10.1097\/j.pbj.0000000000000116","article-title":"Infertility management in women with polycystic ovary syndrome: A review","volume":"6","author":"Cunha","year":"2021","journal-title":"Porto Biomed. J."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1111\/aogs.70051","article-title":"Health behaviors in women conceiving by medically assisted reproduction vs natural conception: A cross-sectional study of 23,334 nulliparous women","volume":"104","author":"Hansen","year":"2025","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Ku, C.W., Ku, C.O., Tay, L.P.C., Xing, H.K., Cheung, Y.B., Godfrey, K.M., Colega, M.T., Teo, C., Tan, K.M.L., and Chong, Y.S. (2022). Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study. Nutrients, 14.","DOI":"10.3390\/nu14235110"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"McKenna, E., Hure, A., Perkins, A., and Gresham, E. (2017). Dietary Supplement Use during Preconception: The Australian Longitudinal Study on Women\u2019s Health. Nutrients, 9.","DOI":"10.3390\/nu9101119"},{"key":"ref_86","unstructured":"World Health Organization (2025, July 03). Periconceptional Folic Acid Supplementation to Prevent Neural Tube Defects. Available online: https:\/\/www.who.int\/tools\/elena\/interventions\/folate-periconceptional."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2137328","DOI":"10.1155\/nrp\/2137328","article-title":"Nutritional Interventions for Enhancing Female Fertility: A Comprehensive Review of Micronutrients and Their Impact","volume":"2025","author":"Mashhadi","year":"2025","journal-title":"Nurs. Res. Pract."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Kaltsas, A., Zikopoulos, A., Moustakli, E., Zachariou, A., Tsirka, G., Tsiampali, C., Palapela, N., Sofikitis, N., and Dimitriadis, F. (2023). The Silent Threat to Women\u2019s Fertility: Uncovering the Devastating Effects of Oxidative Stress. Antioxidants, 12.","DOI":"10.3390\/antiox12081490"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Vi\u00f1a, I., Vi\u00f1a, J.R., Carranza, M., and Mariscal, G. (2025). Efficacy of N-Acetylcysteine in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis. Nutrients, 17.","DOI":"10.3390\/nu17020284"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12978-021-01073-3","article-title":"Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies","volume":"18","author":"Merviel","year":"2021","journal-title":"Reprod. Health"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"17930","DOI":"10.18632\/aging.203231","article-title":"Research progress of melatonin (MT) in improving ovarian function: A review of the current status","volume":"13","author":"Guo","year":"2021","journal-title":"Aging"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Md Amin, N.A., Sheikh Abdul Kadir, S.H., Arshad, A.H., Abdul Aziz, N., Abdul Nasir, N.A., and Ab Latip, N. (2022). Are Vitamin E Supplementation Beneficial for Female Gynaecology Health and Diseases?. Molecules, 27.","DOI":"10.3390\/molecules27061896"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.1093\/advances\/nmab068","article-title":"Female Fertility and the Nutritional Approach: The Most Essential Aspects","volume":"12","author":"Skoracka","year":"2021","journal-title":"Adv. Nutr."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Cristodoro, M., Zambella, E., Fietta, I., Inversetti, A., and Di Simone, N. (2024). Dietary Patterns and Fertility. Biology, 13.","DOI":"10.3390\/biology13020131"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.ajog.2017.08.010","article-title":"Diet and fertility: A review","volume":"218","author":"Gaskins","year":"2018","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1002\/biof.1835","article-title":"Gut microbiome-micronutrient interaction: The key to controlling the bioavailability of minerals and vitamins?","volume":"48","author":"Barone","year":"2022","journal-title":"Biofactors"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/12\/1942\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:00:38Z","timestamp":1781845238000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/12\/1942"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":96,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["nu18121942"],"URL":"https:\/\/doi.org\/10.3390\/nu18121942","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]}}}