Supplement Use Among Couples Seeking Fertility Treatment and Associations with Live Birth and Pregnancy Loss

Naria R.Z. Sealy; Sunni L. Mumford; Ellen C. Caniglia; Julia D. DiTosto; Erica Boiman Johnstone; Jim Hotaling; Bradley J. Van Voorhis; Ginny Ryan; Pauline Mendola; Enrique F. Schisterman; Stefanie N. Hinkle

doi:10.1016/j.fertnstert.2026.04.008

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Supplement Use Among Couples Seeking Fertility Treatment and Associations with Live Birth and Pregnancy Loss

Journal article

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Supplement Use Among Couples Seeking Fertility Treatment and Associations with Live Birth and Pregnancy Loss

Naria R.Z. Sealy, Sunni L. Mumford, Ellen C. Caniglia, Julia D. DiTosto, Erica Boiman Johnstone, Jim Hotaling, Bradley J. Van Voorhis, Ginny Ryan, Pauline Mendola, Enrique F. Schisterman, …

Fertility and sterility

04/22/2026

DOI: 10.1016/j.fertnstert.2026.04.008

PMID: 42031092

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Abstract

To assess the supplement use patterns among couples seeking fertility treatment and to assess the association between supplement use and live birth and pregnancy loss. A secondary analysis using Folic Acid and Zinc Supplementation Trial (FAZST) and Impact of Diet, Exercise, and Lifestyle on Fertility Study (IDEAL) of couples seeking fertility treatment, followed for up to 18 months. Couples seeking fertility treatment. Multivitamin and five most common supplements used among females (calcium, fish oil, folic acid, vitamin B12, vitamin C) and males (coenzyme Q10, fish oil, vitamin B12, vitamin C, and zinc) collected at baseline. Live birth and pregnancy loss were ascertained via self-report and medical records. Poisson models with robust variance estimates were used to estimate risk ratios (RR) and 95% CI, adjusting for confounders and weighted for selection bias. Among 2370 couples, 37% of males and 67% of females used a multivitamin at baseline. Overall, 35% of couples achieved a live birth. Multivitamin use in female (adjusted RR=1.22; 95% CI: 1.05-1.41), but not the male (aRR=1.00; 0.89-1.12) partner was associated with an increased chance of live birth. When stratified by fertility treatment, female multivitamin use was associated with live birth only amongst partners who underwent no treatment (aRR = 1.44; 1.00-2.08). Among females, folic acid (aRR=1.18; 0.95-1.48) and fish oil (aRR=1.09; 0.86-1.36) showed no live-birth association; males showed null findings for fish oil and vitamin C. 1054 (44%) conceived and of those, 218 (21%) had a pregnancy loss. There was no association between multivitamin use in either partner and pregnancy loss. Among couples seeking infertility treatment, supplement use was common among both female and male partners, with the majority taking a multivitamin. There was evidence that multivitamin use in female partners was associated with increased likelihood of live birth.

Infertility

Pregnancy

Live Birth

Supplements

Vitamins

Details

Title: Subtitle: Supplement Use Among Couples Seeking Fertility Treatment and Associations with Live Birth and Pregnancy Loss
Creators: Naria R.Z. Sealy - University of Pennsylvania
Sunni L. Mumford - University of Pennsylvania
Ellen C. Caniglia - University of Pennsylvania
Julia D. DiTosto - University of Pennsylvania
Erica Boiman Johnstone - University of Utah
Jim Hotaling - University of Utah
Bradley J. Van Voorhis - University of Iowa
Ginny Ryan - University of Washington
Pauline Mendola - University at Buffalo, State University of New York
Enrique F. Schisterman - University of Pennsylvania
Stefanie N. Hinkle - University of Pennsylvania
Resource Type: Journal article
Publication Details: Fertility and sterility
DOI: 10.1016/j.fertnstert.2026.04.008
PMID: 42031092
ISSN: 0015-0282
eISSN: 1556-5653
Publisher: Elsevier Inc
Language: English
Electronic publication date: 04/22/2026
Academic Unit: Obstetrics and Gynecology
Record Identifier: 9985157515002771

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