NAD+ & Fertility
We see fertility as a highly sensitive topic. The speculation that upwards 20% of all pregnancies end in miscarriage and 1 in 5 women, 15-49 (CDC 2023), will struggle with fertility at some point.
The difficulty if you’ve struggled with infertility is the compounding emotions that accompany infertility. As a woman, you may feel like something is inherently wrong with you and at odds with your body. We believe this is a topic of conversation that needs to be openly discussed.
Most importantly, what can we do to support women’s bodies to intuitively heal and adapt to create the best possible climate to nourish, sustain, and grow life.? Additionally, how can we illuminate misconceptions and educate ways to support healthy fertility function? Reproductive age is shifting and slowly rising as the average age of first time moms is increasing. We think this is healthy as women aren’t feeling as bound by a “biological clock”.
The tricky truths to navigate through the complications of fertility may seem endless, but there are several we want to highlight. What may come as a surprise is that men and women struggle with fertility equally (Office of Women’s Health),meaning that both you and your partner influence the likelihood of conceiving, so the responsibility does not lie solely with the woman. Secondly, reduced inflammation and an increase in overall health is correlated to your likelihood of conception. Lastly, the concept of a “biological clock” is becoming an outdated metric for conception.
We perceive infertility as a symptom rather than a diagnosis (Dickey, 2000), and if we can support you and your partner's journey towards lower systemic inflammation and optimal health, we hope to begin to shift the needle on conception rates and the myths surrounding fertility.
Despite the increase in the average conceiving age of women, most OB-GYN practices still identify 35 as the period when a woman’s fertility begins to decline. Offensively, the medical community labels women after 35 as “advanced maternal age”, “elderly”, or “geriatric”. But why? We believe the medical community needs to shift their position of pregnant women beyond their 30’s, treat infertility as a symptom rather than diagnosis, and identify ways to support women of all ages in their efforts to conceive and carry healthy babies.
Where exactly did the focus on 35 come? This number was derived decades ago, during a very different reproductive era.
Most people assume we use age 35 because studies show that the risk for genetic conditions in babies increases. Early population studies demonstrated that risks associated with infertility, miscarriage, and chromosomal abnormalities, did increase after 35 (Gomez, 2009). But the population of women becoming pregnant after 35 was significantly lower, so the sample size was smaller.
“However, the primary issue is that the origin of the number 35 comes from an essentially outdated line of clinical reasoning.(McClelland, 2020) ”
Fertility age limits have become a subjective way of defining what should be objective. Moreover, comparing the original studies this number was determined by is complicated by design.
The origin of the number 35 comes from a very specific and outdated method of clinical reasoning. It was borne out of the desire to counsel women clearly on their options regarding testing for an abnormal number of chromosomes in the fetus. Since, in the mid 70’s the only option for genetic testing was amniocentesis (a highly invasive procedure where a needle is inserted to draw amniotic fluid containing fetal cells). The benefit to some was knowing if there were chromosomal abnormalities, however the risk was loss of pregnancy - then a 7.6% chance of loss. (McClelland, 2020)
At the time, it would only factor in women who were willing to risk their loss of pregnancy for the test, not the entirety of successfully pregnant women who were 35 or older.
One of the most significant studies discovered 78 percent of women aged 35 to 40 will conceive within a year, compared with 84 percent of women aged 20 to 34 (Rothman, 2013). That is a small difference, in light of how fertility decline is so commonly perceived.
CDC data demonstrates an increase in birth rate trends in women in their 30s and 40s (births per 1000 people). In 2018, for women in their 30s and 40s the birth rate was 165 compared to 156.8 in 2008 and 129.9 in 1998 (CDC, 2024). This represents a 25% increase in older females having children in “advanced maternal age” (can you sense the sarcasm?).
Additionally, there is still developing data on the effect of Covid has had on fertility trends, with some speculation that the increase in inflammation potentially impacting the higher rates of miscarriage we’ve been recently seeing.
This comes back to our primary issue we see when addressing fertility as a diagnosis rather than a symptom, in men and women.
Instead of fear mongering pregnancy after 35 or resigning you to a constant battle with fertility, we want to equip you with the knowledge, tools, and methods to fortify your body and enhance your probability of conceiving.
Fertility does decrease with age for several reasons, however we believe it's not to the same extent that most people expect. First, every woman is born with a lifetime supply of eggs in her ovaries. Starting from puberty, the eggs are used until they run out, simply speaking. Additionally, the quality of the eggs can deteriorate over time, but to what extent really varies from person to person and we believe can be influenced primarily by chronic inflammation.
While there may be fewer eggs as women age, we believe the viability of these eggs are individual to each woman, based primarily on her overall health which then influences the health and viability of eggs. Exposure to environmental factors, chronic inflammation, stress, and disease are primary factors we see compromising the health of available eggs.
As a result, there is growing evidence to suggest reducing chronic inflammation and aging, primarily through NAD+ may be successful in creating better egg quality and healthier pregnancies.
NAD+, or nicotinamide adenine dinucleotide, is a coenzyme that consists of adenine and nicotinamide. NAD+ is a cell nuclear energy producer in the mitochondria, its role is vital as it creates cellular energy ATP. It is also important in DNA repair and telomere maintenance. As we age, there is a natural decline of NAD+, so replenishment and supplementation of NAD+ is extremely beneficial.
Published research is demonstrating NAD+ repletion may increase female fertility in aging in animals (Bertoldo, 2020). As females age, there can sometimes be an irreversible decline of fertility associated with egg quality. The research suggests that the egg quality is partly due to declining levels of NAD+.
Studies are concluding that replenishment of NAD+ may be an effective, non-invasive strategy for restoring and maintaining fertility for women as they age. This makes sense to us as we know NAD+ reduces inflammation and increases cellular function.
NAD+ may then address and improve egg quality, helping eggs repair DNA damage and improving fertility rates as a result (Bertoldo, 2020). There are promising results emerging from studies concluding that increased NAD+ levels improve egg quality and thereby fertility.
We believe NAD+ has powerful effects on reducing inflammation, and the benefits can be for women of all ages attempting to conceive.
The best and most effective way to boost your NAD+ levels is intravenously, since it is difficult for your system to ingest and digest, and absorb enough NAD+ to make a difference on the cellular level. We suggest beginning with a 100mg dose as an IV.
Since NAD+ goes after cellular damage and inflammation in the body, you can experience slight discomfort during the IV. However, we take this as a good sign, as we use NAD+ infusions as a diagnostic to indicate your inflammation levels. Most people who receive an NAD+ treatment can experience a wide and varying range of discomfort. The most common forms of discomfort we see are flushing to the face, heart racing, chest pressure, leg cramps, sinus pressure/head pressure, or slight nausea. As a result, we are very diligent to monitor your specific response and adjust your IV to your personal tolerance and comfort level. Now while we can't promise with NAD+ you will experience healthy conception as even tried and true fertility treatments still fail, what we can acknowledge is as you start to help bring your body to restoration and health you will begin to notice differences, and hopefully increase your probability of healthy conception and gestation.
If you are working towards lowering your inflammation, we recommend a weekly NAD+ IV at a dose of your preference and increasing the dose with your tolerance. We recommend it in combination with Mercier Therapy massages and acupuncture to direct blood flow and healing to your uterus and ovaries to help optimize what your body already has - the perfect environment to conceive and grow your baby.
We are excited about this emerging research and the potential benefits for women of all ages who are attempting to conceive. As always, we want to support you on your health journey and in your efforts to build a healthy family.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063679/
https://www.sciencedaily.com/releases/2023/10/231018161914.htm
https://rbej.biomedcentral.com/articles/10.1186/s12958-022-00938-x
https://www.asapivs.com/blog/is-nad-helpful-for-ivf
https://www.springfieldwellnesscenter.com/nad-blog/can-nad-supplements-help-with-fertility/
https://www.fertstert.org/article/S0015-0282%2813%2900339-7/fulltext
https://www.fertstert.org/article/S0015-0282(00)00604-X/fulltext
https://www.cdc.gov/nchs/products/databriefs/db232.htm
https://www.uq.edu.au/news/article/2020/07/women%E2%80%99s-egg-quality-dependent-metabolic-factors
https://www.womenshealth.gov/a-z-topics/infertility
https://www.fertstert.org/article/S0015-0282(00)00604-X/fulltext
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087554/
https://slate.com/technology/2020/08/fertility-cliff-advanced-maternal-age-outdated.html