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Supplements to Support Egg Health When You Have Endometriosis

Last updated March 28, 2022

Having endometriosis can not only make it difficult to get pregnant, but also make your supplement strategy a little tricky. There are two pieces of good news: First, endometriosis does not make pregnancy outright impossible – and the impact may not be large (depending on which study you look at). And there are nutritional supplements compatible with the condition that can support egg health. This Endometriosis Awareness Month, read on for our endometriosis-safe tips on supplements to help you maintain your egg health.

 

Endometriosis’ impact on women’s health and fertility

Endometriosis is a common condition, affecting an estimated 10-15% of reproductive-age women in the US. If that sounds low, here’s the impact in absolute numbers: Endometriosis affects up to 8.7 million women in the US, out of the 58 million who are between 18 and 44. Doctors have estimated that potentially 1 in 2 women with endometriosis experience trouble getting pregnant.

 

Endometriosis’ impact on women’s reproductive health

While it’s clear from epidemiological data that endometriosis negatively impacts female reproductive health, the mechanisms are still being investigated. It’s also possible that endometriosis impacts multiple aspects of the reproductive processes. The theories include:

 

Supplements to support egg health when you have endometriosis

 

1. Coenzyme Q10 (CoQ10)

Studies have linked oxidative stress (an imbalance between reactive oxygen species and antioxidants) in the blood, as well as in the ovarian environment, to the quality of eggs among women with endometriosis. CoQ10, a powerful antioxidant and one of the most common supplements used by reproductive endocrinologists to support egg health, may play a role in maintaining the antioxidant balance.

While studies specifically examining CoQ10 and egg health in women with endometriosis are rare, one in vitro study found an interesting association. The 2020 study observed that when eggs are cultured with the follicluar fluid of women with endometriosis, they didn’t as well. The difference in maturation rate was up to 36%. Based on this observation, the study authors hypothesized that CoQ10 may be a tool to protect eggs from exposure to endometriosis.

Though we need more studies to understand CoQ10’s potential role in egg health specifically in the context of endometriosis, this is one supplement that women with endometriosis can consider.

 

2. Folate (folic acid)

Similar to CoQ10, the egg health-supporting role of folate specific to endometriosis hasn’t been studied. However, studies have found that women (in general) who take multivitamins that include folate before pregnancy have higher-quality eggs than those who don’t, possibly because of folate’s role in maintaining the health of the ovarian environment where eggs go through the final maturation process.

Given this potential connection between folate (an active form of folic acid) and egg health, taking prenatal vitamins with at least 800 mcg of folate may be another way to support egg health for women with endometriosis – aside from the benefits of folate on the brain health of the baby.

 

3. Vitamins C & E

Vitamin C and Vitamin E are both antioxidants that work synergistically in reducing oxidative stress, which has been suggested to negatively impact eggs’ developmental competence and embryo quality. Whether these two vitamins may support egg health for women with endometriosis is under-explored  - and remains unclear. Here’s where the science stands:

First, scientists have known that women with endometriosis have lower levels of Vitamin C and Vitamin E in the follicular fluid that surrounds mature eggs. Secondly, several studies have also found that these two vitamins potentially play important roles in managing endometriosis itself and risks toward the condition.

Based on this knowledge, a group conducted a randomized controlled trial of 377 women in an IVF setting, with some of them taking 1,000 mg/day of Vitamin C for 2 months while others didn’t. The study found that women who received Vitamin C had slightly better outcomes, including fertilization rate, high-grade embryo rate, implantation rate and pregnancy rate (39.4% vs. 33.3%) compared to women who didn’t. However, none of these differences were statistically significant, meaning that the association is inconclusive until confirmed by other, larger studies. 

 

DHEA for women with endometriosis?

Some reproductive endocrinologists recommend DHEA to women on the fertility journey who are looking to support a healthy ovarian environment. But is DHEA right for women with endometriosis?

To answer the question, it’s important to understand that DHEA is a precursor to multiple reproductive hormones, including estrogen. This is where things get a little tricky: Estrogen can worsen the impact and symptoms of endometriosis. For example, an in vitro study of the endometriosis tissue showed a marked increase in the inflammatory response from the endometriosis tissue when estrogen levels were high. Women experience more pain from endometriosis with higher estrogen levels, too.

For this reason, many doctors don’t recommend DHEA to women with endometriosis – and our scientific team agrees. If you have endometriosis and want to support ovarian health with DHEA, the first step is to talk to your doctor. They may run some blood tests, like AMH, testosterone and DHEA-S, to see if you may benefit from DHEA, and how you can manage the risk from the estrogen increase from DHEA.

 

How to support egg health with endometriosis

Endometriosis potentially impacts multiple aspects of female fertility, including egg health. To support egg health:

  • Consider taking a CoQ10 supplement to maintain your antioxidant balance.
  • Make sure you are taking prenatal vitamins while trying, and that your prenatals contain at least 800 mg/day of folate.
  • Include plenty of Vitamin C and Vitamin E in your diet. Prenatal vitamins with these two vitamins can also help fill the gap.
  • Ask your doctor if DHEA is an option for you. Don’t start on it on your own.

For more general support for endometriosis and actions you can take during the Endometriosis Awareness Month, check out Endometriosis.org. Please also reach out to us if any questions come up. We are with you.

 

 

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