NAD+ and Assisted Reproduction: Interpreting Emerging Evidence in Egg Quality
Egg quality remains one of the most important — and often most limiting — factors in assisted reproduction. While ovarian reserve influences how many eggs are retrieved, the ability of those eggs to mature, fertilise, and develop into viable embryos is equally critical.
A recent preprint by Tandulwadkar et al. (2026) has explored the use of intravenous NAD+ as an adjunct in assisted reproductive treatment, specifically in women classified as expected poor responders under POSEIDON criteria.
It is important to be clear from the outset: this is early-stage research, it has not yet been peer reviewed, and it does not establish NAD+ as a proven fertility treatment.
Why NAD+ is being explored
NAD+ (nicotinamide adenine dinucleotide) plays a central role in cellular energy production, mitochondrial function, redox balance, and DNA repair.
Oocytes are highly dependent on mitochondrial activity, and age-related declines in mitochondrial function have been associated with reduced oocyte competence and reproductive ageing. This has led to growing interest in NAD+ as a potential metabolic target in reproductive medicine.
While preclinical research has suggested a possible role, robust human data remain limited.
What the study involved
This was a single-centre, self-controlled pre–post study conducted at the IVF Department of Ruby Hall Clinic, with 112 participants included in the final analysis.
Each participant underwent:
one ICSI cycle prior to NAD+ therapy
one ICSI cycle following treatment
The ovarian stimulation protocol was kept consistent between cycles to allow for comparison.
NAD+ protocol
According to the preprint, the intervention consisted of:
weekly intravenous NAD+
for 10 weeks
at a dose reported as “200 units”
with ovarian stimulation commenced approximately 6 weeks after completion of therapy
This is an important distinction. The study did not evaluate short-term NAD+ administration immediately prior to egg retrieval. Instead, it assessed a protocol delivered over several weeks before the subsequent stimulation cycle.
Why the timeline matters
Egg quality is not determined on the day of retrieval. Follicular development occurs over a prolonged biological timeframe, and key stages of oocyte maturation take place in the weeks leading up to ovulation.
This study is notable for its long lead-in design: a 10-week course of NAD+ therapy followed by a further 6-week interval before ovarian stimulation commenced.
This suggests the authors were targeting a broader developmental window, rather than attempting to influence oocyte quality acutely around the time of collection. It also means the protocol described cannot be directly extrapolated to short-term or peri-retrieval NAD+ administration.
What the study found
Following NAD+ therapy, the authors reported an association with improvements in several early embryology outcomes, including:
increased mature (MII) oocyte yield
increased normally fertilised (2PN) embryos
increased Grade A embryos
increased total good-quality embryos (Grade A + B)
These findings relate to laboratory-based embryology parameters and suggest a potential effect on oocyte competence and early embryo development.
It is also important to understand how these comparisons were made. Each participant served as her own control, with outcomes compared between a cycle performed before NAD+ therapy and a subsequent cycle after treatment. While this approach allows comparison within the same individual, it does not fully account for natural cycle-to-cycle variability.
Important considerations
While the findings are clinically interesting, several limitations should be considered:
The study is a preprint and has not yet undergone peer review
It is a self-controlled before–after design, rather than a randomised controlled trial
Outcomes are limited to early embryology markers
There is currently no established clinical evidence that NAD+ improves pregnancy, implantation, or live birth outcomes
The reported NAD+ dose of “200 units” is not clearly defined in milligram equivalents
This lack of standardisation limits reproducibility and clinical translation
We have reached out to the authors to clarify the dosing and protocol details.
What this means in practice
This study is best interpreted as preliminary clinical evidence.
It suggests that if NAD+ has a role in assisted reproduction, it may depend on:
timing, particularly a longer lead-in period before stimulation
cumulative exposure, rather than short-term administration
At present, there is insufficient evidence to conclude that NAD+ improves meaningful IVF outcomes.
Our perspective
At Elevate IV Drips, we are increasingly seeing patients enquire about NAD+ therapy in the context of fertility.
The biological rationale is compelling, and early clinical data are beginning to emerge. However, the current evidence base remains limited, and we believe it is important to present this information with clarity and restraint.
We do not position NAD+ as a fertility treatment.
At this stage:
NAD+ should be considered an experimental adjunct — not a proven fertility treatment.
Further peer-reviewed research is required to clarify:
optimal dosing
timing of administration
mechanism of action
and impact on clinically meaningful outcomes
Considering NAD+ in the Context of Fertility?
We are increasingly approached by patients undergoing assisted reproductive treatment who are interested in emerging therapies such as NAD+.
While current evidence remains limited, some patients choose to explore NAD+ as part of a broader, medically supervised approach to their health.
At Elevate IV Drips, we focus on providing:
clear, evidence-informed information
a structured consultation process
coordination with your existing healthcare team where appropriate
If you are currently undergoing treatment, we recommend discussing any adjunctive therapies with your fertility specialist.
For general information about our services or to arrange a consultation, you can contact our team below.
Disclaimer
NAD+ therapy is not a treatment for infertility and is not recognised as a standard fertility intervention. The information presented above is for educational purposes only and is based on early-stage research that has not yet undergone peer review. Current evidence in humans remains limited, and no conclusions can be drawn regarding its impact on pregnancy or live birth outcomes.
This content should not be interpreted as medical advice, nor as a recommendation to pursue or avoid any specific treatment. Individual fertility circumstances vary significantly, and outcomes are influenced by a range of factors including age, ovarian reserve, underlying medical conditions, and treatment protocols.
All fertility-related decisions should be made in consultation with a qualified fertility specialist. Any consideration of adjunctive or emerging therapies should be discussed with a treating doctor who is familiar with your medical history and current treatment plan.
Elevate IV Drips does not provide fertility treatment or replace specialist reproductive care.
References
Curious about ways to support your wellness journey? Visit Elevate IV Drips to explore our range of treatments, discover how our offerings can fit into your self-care routine, and find the approach that feels right for you.
