NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme that contributes to cell function and DNA health, which exists naturally in the human body. Like most things, it declines as we age, and research on the effects of NAD+ has been a hot topic in areas of age-associated health concerns, like cardiovascular disease, diabetes, dementia, anti-aging related to beauty, and, of course, fertility. Read more to learn about what NAD is, whether it's safe, and what we know about how it helps with fertility. How is NAD related to aging and fertility? We know aging plays a major role in fertility (for both eggs and sperm). As we get older, the health of our DNA and mitochondria (the “powerhouses” that produce cell energy) declines. Both structures are key for influencing egg and sperm quality, and our natural ability to protect and repair them isn’t as strong or efficient as when we’re younger. This makes them more susceptible to damage and poorer function as we age. The use of antioxidants and cell-energy boosters is common in fertility preparation and treatment, since they support mitochondrial function and protect egg and follicle cells (or testicular and sperm cells) from oxidative damage. Many cofactors can help restore mitochondrial function in cell energy production, and the newest one on our radar in the fertility world is NAD+. Read More About How Aging Affects Fertility → What is NAD+? NAD+ is known as a cell regulator, and contributes to reactions in our cells involving DNA, proteins, cell signalling. It helps cells adapt to changes in nutrient status, infections, and inflammation, and has a role in making cell energy (also known as ATP). ATP carries out everything in the body that requires energy, including DNA/RNA synthesis, ion transport, muscle contractions, and nerve-cell signaling (among others). (Ever heard “the mitochondria is the powerhouse of the cell”? Well, that’s because the mitochondria makes ATP.) What also makes it special for supporting fertility is its ability to activate compounds called sirtuins. What is a sirtuin? Sirtuins are one of the reasons we often say that a particular supplement is "anti-aging". Sirtuins protect mitochondria, regulate cell division, improve DNA repair, and can delay changes associated with aging, by preventing DNA damage. When we have low sirtuin activity, we tend to see poor immune function, abnormal energy regulation, and more oxidative stress. All of which can cause damage to DNA and mitochondria, and reduce egg and sperm quality. How does NAD+ affect fertility? Based on their activities and influence, NAD+ precursors (more on that in a minute) may have positive effects on age-related fertility issues. Most of the current research studied in fertility using NAD+ precursors is focused on ovarian aging and egg quality. How to Improve Egg Quality → What are NAD+ precursors? NAD+ precursors are the compounds used by the body to create NAD+. While all of the precursors can contribute to the production of NAD+, some are considered better than others because they require fewer steps to be converted. NR (Nicotinamide Riboside) NMN (Nicotinamide Mononucleotide) NA (Nicotinic Acid) NAM (Nicotinamide) How does NAD+ affect female fertility? Ovarian aging causes a decline in egg quality, both from poorer mitochondrial function, and genomic instability (increased mutations in a cell’s DNA). Although researchers are still exploring NAD+ precursors in human fertility, supplementation in animal fertility models has been shown to improve fertility, including: Improve mitochondrial function Protect eggs from environmental toxin damage Improve chromosomal alignment in pre-ovulated, mature eggs Improvement in reproductive hormone function Improve embryo development Increases antral follicle development Help preserve ovarian follicles Reduced free radicals that cause oxidative damage Though we don’t have human studies that look at NAD+ supplementation on fertility outcomes, we do know how boosting NAD+ affects the cellular processes that influence fertility. One of the major factors affecting fertility is age, and the age-related changes that occur in our cells. Cell energy naturally declines as we age, and supplementation with NAD+ precursors helps provide additional cell energy. This supports better cell division, better cell function, and helps protect those eggs. How does NAD+ affect male fertility? Although not as widely talked about, sperm count and quality are also subject to the negative effects of aging. However, the research on NAD+ precursors in male fertility is severely lacking. In a pilot study, 51 males were assessed for NAD+ levels and semen quality. Researchers found that the amount of NAD+ in sperm was similar among the different age groups, but that those who had lower levels of NAD+ in sperm also had lower sperm counts and higher DNA-fragmentation index (DFI) values. Similar to female fertility, we know the aging process affects male fertility, too, and providing cell energy can help support and protect sperm health. Where can you get NAD+ from? Our body can naturally make some NAD+ from tryptophan in dietary sources like meat, milk, and soy, but it’s not a very efficient process, and we can’t make a lot of it this way. Another way we can increase NAD+ is by recycling or transforming other molecules like Nicotinamide Riboside (NR), Nicotinamide Mononucleotide (NMN), and Nicotinamide (NAM)—those NAD+ precursors we mentioned. Since dietary sources tend to provide some, but very low amounts, you’re most likely to get therapeutic doses (AKA, doses that will actually provide the studied benefits) through supplementation. (For example, one of the highest dietary sources is edamame—but you’d need to consume about 150 cups of edamame beans a day to get close to a 250 mg dose of NAD.) How much NAD+ can I take? NAD+ precursors are currently being studied in human clinical trials for prediabetes, high blood pressure, mild cognitive impairment, Alzheimer’s disease, Parkinson’s disease, and ovarian aging, in addition to overall safety in healthy aging adults. Of the trials that have been completed, the dosing of an NAD+ precursor ranges from 500 mg to 3,000 mg daily, depending on the precursor. The good news is that at every level studied, the precursors were shown to be safe and well-tolerated. Is there a natural way to boost NAD+? One way to boost NAD+ levels is to tip the energy scales by exercising or fasting. But, adding in a NAD+precursor supplement may have a bigger impact (especially since fasting may not be recommended if you’re trying to conceive). Supplementing with NAD+ can help improve some of those age-related fertility issues that can make it harder to conceive, including antioxidant activity, cell energy production, and supporting DNA stability, allowing more protection for our vital cell components.
