Abstract
Infertility is the condition of about 15% of couples that cannot get a conception after one year of unprotected sexual intercourse. In females, the reduced reproductive capacity underlies the most varied causes. Dietary supplements (DS) might be used to improve the pregnancy rate and a wide range of DS are proposed today to support female fertility. Although many authors demonstrated the positive effect of some of these products, the real efficacy of this approach is still debated. In order to evaluate the potential efficacy of DS for female infertility, we analysed the products marketed in Italy, using an original approach. A review of literature was performed to evaluate the effect of nutraceuticals on various female reproductive outcomes and to detect the minimal effective daily dose (mED) able to improve at least one of these. Thereafter, we conceived a formula to classify the expected efficacy of each DS. Each DS was scored and included into three classes of expected efficacy: higher, lower, and none. Ten out of 24 supplements (41.7%) resulted in the higher and 8 (34.3%) in the lower efficacy group, the remaining 6 DS (25.0%) were expected to have no efficacy. DS marketed in Italy are usually blends of many substances that are frequently employed at a negligible dose or without any evidence of efficacy. These findings raise serious doubt about the potential effectiveness of most commercial DS for female infertility.
Highlights
Infertility is a global health problem affecting 20–30% of the female population of reproductive age in modern society [1,2]
Selected articles allowed the identification of effective ingredients (EI), namely those substances considered as beneficial for female infertility based on available evidence
In a recent article, considering both randomized clinical trials (RCTs) and reviews on dietary supplements (DS) for male infertility, we suggested a formula derived from studies of Kuchakulla et al [27], in order to evaluate the possible efficacy of DS based on their composition
Summary
Infertility is a global health problem affecting 20–30% of the female population of reproductive age in modern society [1,2]. Ovulatory disorders account for approximately 25% of infertility diagnoses; 70% of women with anovulation have PCOS [7] Such a syndrome is a multifactorial disorder and is characterized by a combination of clinical (anovulation and hyperandrogenism), biochemical (excessive androgen and luteinizing hormone concentrations), and ovarian morphological (polycystic ovaries) features [8]. Even though PCOS etiology is complex and controversial, including genetic, environmental, and lifestyle factors, the role of insulin resistance is a key etiological component. According to these premises, several nutrients have been proposed as new therapeutic strategies for PCOS infertile patients [9]
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