Ovēa Protocols · Fertility Edition
You have been trying.
Your body deserves support.
"I am doing everything right. Why isn't it working?"
This protocol was built for women who are navigating infertility — whether you are trying naturally, preparing for IUI, or heading into IVF. Every recommendation here is evidence-based, clinically grounded, and chosen with 19 years of reproductive imaging experience behind it.
What your scan shows shapes what your body actually needs. This protocol gives you the foundation — your imaging gives us the precision.
Section 01 · Foundation
Before anything else,
build the base.
"I don't know where to start — there are so many supplements."
Every fertility protocol begins here. These are the non-negotiables — the nutrients that support egg quality, implantation, early neural development, and hormonal signalling before conception. They are not optional. They are the ground that everything else is built on.
The non-negotiable foundation for every woman trying to conceive
Why it matters
Here is something most women are never told: standard folic acid cannot be used directly by many women's bodies. Up to 40% of us carry a common gene variation that makes it hard to convert folic acid into the form your cells actually need. A methylated prenatal skips that conversion step entirely — delivering the active, ready-to-use form of folate straight to your cells. This is the very first thing I ask about when a woman comes to me for fertility support.
What to look for on your imaging
When I see a thin or irregular uterine lining on a mid-cycle scan — one that has never reached the 7–8mm needed for a healthy implantation environment — one of the first questions I ask is: what prenatal are you on, and is the folate form right for your body?
The most under-tested, most consequential fertility nutrient
Why it matters
Vitamin D receptors are present in the ovaries, uterus, and fallopian tubes. Deficiency is associated with poor ovarian response, implantation failure, and increased miscarriage risk. The K2 pairing ensures calcium is directed to bone — not soft tissue. Optimal fertility levels are 50–80 ng/mL — most women are well below this.
Dosage guidance
2,000–5,000 IU daily depending on baseline serum levels — always test before dosing high. Ask your provider for a 25-OH Vitamin D blood test. Pair with K2 (90–180mcg MK-7 form) for cardiovascular safety at higher doses.
Section 02 · Egg Quality & Ovarian Reserve
Your AFC is low.
It is not the end of the story.
"My doctor told me my ovarian reserve is diminished. I feel like time is running out."
Antral follicle count and AMH tell us about quantity — they say less about quality. Egg quality is profoundly influenced by mitochondrial function, oxidative stress, and cellular energy. These are the supplements with the strongest evidence base for supporting the eggs that are there.
The most evidence-supported supplement for egg quality — form matters enormously
Why it matters
Think of your eggs as requiring a constant power supply to mature, fertilise, and divide into a healthy embryo. CoQ10 is what keeps that power running — it is the fuel source for the tiny energy-producing structures inside every egg. As we get older, especially after 35, that fuel supply naturally starts to drop off. Ubiquinol is the form your body can actually use straight away. The cheaper ubiquinone version requires conversion first — and women over 35 often do that conversion poorly.
Dosage guidance
200–600mg ubiquinol daily. For IVF preparation or AFC below 7, some reproductive endocrinologists recommend up to 600mg in the 3 months before retrieval. Begin at least 90 days before attempting conception — eggs take 90 days to mature. Take with a fat-containing meal for absorption.
A powerful antioxidant that reduces oxidative stress in the ovarian environment
Why it matters
NAC is the building block your body uses to make glutathione — your most powerful internal antioxidant, and the one responsible for protecting your eggs from damage at the cellular level. When oxidative stress is high (which it often is during the infertility journey itself), eggs are more vulnerable and implantation becomes harder. NAC helps neutralise that damage. It is also one of the most useful supplements for women with PCOS or endometriosis, and it is genuinely underused.
Dosage guidance
600–1,800mg daily in divided doses. For PCOS: 1,200–1,800mg alongside Inositol. For endometriosis or oxidative stress: 600mg twice daily. Note: NAC should be discontinued 2 weeks before egg retrieval as it may affect uterine contraction signalling.
Section 03 · Cycle Regulation & Ovulation
Your cycle is telling you something.
Let's learn its language.
"My cycles are irregular. I don't know when — or if — I'm ovulating."
Irregular cycles, absent ovulation, and luteal phase dysfunction are among the most common and treatable causes of infertility. These supplements address the hormonal signalling that governs ovulation — with different mechanisms for different presentations.
The most studied supplement for PCOS-related anovulation and insulin resistance
Why it matters
Inositol is a naturally occurring compound that helps your cells respond to insulin properly. Women with PCOS are frequently deficient in it at the cellular level — and this has a direct knock-on effect on ovulation, because insulin and the hormones that drive egg development are closely connected. The 40:1 blend of these two forms mirrors exactly what healthy ovaries produce on their own. This is not a tentative recommendation — the evidence behind it is some of the strongest we have in the supplement world for PCOS.
What I look for on imaging
When I see the classic PCOS picture on a scan — multiple small follicles lined up around the edge of the ovary (the "string of pearls" pattern), enlarged ovarian volume, or a thickened, bright-looking ovarian centre — this is one of the very first protocols I recommend. It works best when combined with reducing refined carbohydrates and sugar in the diet, which addresses the insulin piece from both directions.
For luteal phase support and progesterone insufficiency — but only when your imaging confirms it
Why it matters
Vitex works by gently lowering a hormone called prolactin — which, when elevated even slightly, can interfere with progesterone production and shorten the second half of your cycle. Think of the luteal phase (the two weeks after ovulation) as the window your body uses to prepare for a possible pregnancy. If progesterone is too low during that window, implantation becomes difficult. Vitex helps stabilise that. It is best suited for women with short cycles, spotting before their period starts, or confirmed low progesterone — not for women with already-regular cycles or those currently on fertility medications.
What I look for on imaging
Thin endometrial stripe in the luteal phase (under 7mm), absent or poorly defined corpus luteum on post-ovulation scan, irregular follicular recruitment. Vitex is powerful — timing and contraindications matter significantly. This is one I never recommend without first understanding what your imaging shows.
Progesterone cofactor, luteal phase support, and homocysteine regulation
Why it matters
B6 in its active form is one of those quiet workhorses that most women are not getting enough of. It is directly involved in making progesterone — the hormone that holds a pregnancy in place in early weeks. It also helps keep a compound called homocysteine at healthy levels; when homocysteine builds up in the blood (which is more common than most doctors check for), it can interfere with implantation and is linked to early pregnancy loss. Always take B6 as part of a full B-complex rather than in isolation, so the other B vitamins stay balanced.
Dosage guidance
25–50mg P-5-P daily as part of a methylated B-complex. Standalone high-dose B6 above 100mg daily long-term carries peripheral neuropathy risk — use only as part of a balanced complex. If your prenatal already contains active B6, an additional complex may not be necessary.
Section 04 · Inflammation & Implantation
Inflammation is one of the
quietest causes of infertility.
"I have endometriosis / fibroids / unexplained infertility. My scans look 'okay.' But it still isn't happening."
Systemic inflammation disrupts ovulation, impairs endometrial receptivity, compromises sperm function, and creates a hostile environment for implantation. It is implicated in endometriosis, PCOS, unexplained infertility, and recurrent pregnancy loss — often without obvious symptoms.
Anti-inflammatory foundation for endometriosis, cycle pain, and implantation support
Why it matters
Omega-3s are the raw material your body uses to make the specific signalling molecules that calm inflammation in and around the uterus. For women with endometriosis, fibroids, or any kind of pelvic pain, inflammation is almost always part of the picture — and these fatty acids work at the source. Beyond fertility, DHA is one of the most critical nutrients for your baby's brain and eye development starting in the very first weeks of pregnancy, well before most women even know they are pregnant.
Form and dosage
Triglyceride form absorbs 70% better than ethyl ester form. Look for 2,000–3,000mg combined EPA+DHA daily — not total fish oil. Third-party tested for mercury is non-negotiable. Algae-based DHA is equally effective for women who prefer a non-fish source.
Targeted endometriosis and pelvic inflammation support — bioavailability is everything
Why it matters
Curcumin — the active compound in turmeric — works by switching off one of the body's key inflammation signals at the source. Research specifically in endometriosis has shown it can slow the growth of the tissue that forms endometrial implants. The catch is that standard turmeric powder or cheap capsules are almost completely absorbed before they reach your bloodstream. The BCM-95 or phytosome versions are specifically designed to bypass that problem — they are absorbed 6 to 8 times more effectively, which is why the form matters so much here.
What I look for on imaging
When I see endometriomas (the chocolate-coloured cysts that form in endometriosis), a thickened or patchy uterine wall that suggests adenomyosis, or other signs of chronic pelvic inflammation on a scan, I consider anti-inflammatory support essential — not optional. Curcumin is the botanical I reach for first because the research behind it is the most specific and consistent.
Section 05 · Stress & HPA Axis Regulation
Chronic stress is not a mindset problem.
It is a hormonal one.
"I've been told to 'just relax.' I need something that actually helps."
Understanding the terms
HPA Axis (Hypothalamic-Pituitary-Adrenal Axis) — This is the name for the communication pathway between your brain and your adrenal glands — the glands that produce cortisol, your main stress hormone. When you are under chronic stress, this pathway stays switched on, keeping cortisol elevated day after day. The problem for fertility is that high cortisol directly competes with progesterone (they share the same building blocks), and it signals to the body that now is not a safe time to conceive. Supporting the HPA axis means helping your body dial that stress response back down to a level where your reproductive hormones can function properly.
GnRH (Gonadotropin-Releasing Hormone) — GnRH is the hormone your brain releases in a precise, rhythmic pulse to trigger the rest of your reproductive hormone cascade — the chain reaction that leads to ovulation each month. When cortisol is chronically elevated, it directly disrupts that rhythm, causing pulses to become irregular or suppressed. When GnRH pulses are off, the downstream hormones (FSH and LH) that tell your ovaries to develop and release an egg are also affected. This is the biological mechanism behind why chronic stress can delay or stop ovulation — even when nothing else appears wrong.
The infertility journey itself is one of the most stressful experiences a woman can endure — and that stress creates its own compounding hormonal disruption. The supplements in this section support your body's stress response system without sedation or hormonal interference, so your reproductive hormones have the space to do their job.
The most gentle, most overlooked fertility mineral — required for over 300 enzymatic reactions
Why it matters
Magnesium is involved in over 300 processes in the body, and two of the most important for fertility are: it helps your body make progesterone, and it calms the stress response system so that cortisol does not run so high. Deficiency is genuinely common — stress, alcohol, sugar, and years of hormonal birth control all deplete it. The glycinate form (not the cheap oxide form most products use) is the version that actually absorbs well and does not cause the digestive upset that other forms can.
What I look for on imaging
Magnesium itself is not something I can see on a scan — but what chronic stress and depleted minerals do to a cycle often is. When I see multiple small follicles that never quite develop into a dominant one, or cycles where the second half is consistently short and poorly defined, I think about the whole-body picture. Magnesium is one of the foundational pieces of that.
An adaptogen with clinical evidence for cortisol reduction and thyroid support
Why it matters
KSM-66 ashwagandha is the most thoroughly studied herbal stress-support supplement available for women. In clinical trials it has been shown to meaningfully lower cortisol — the main stress hormone that competes with progesterone and disrupts your cycle when it stays elevated for too long. It also gently supports thyroid function, which is worth noting because even a mildly underactive thyroid (something many fertility specialists now check) can interfere with implantation. It does not make you feel sedated, and it does not suppress ovulation.
Dosage and cautions
300–600mg KSM-66 daily, taken with food. Discontinue at confirmed positive pregnancy test — insufficient safety data in first trimester. Not appropriate for women with Hashimoto's thyroiditis without specialist guidance — ashwagandha can stimulate thyroid activity and worsen autoimmune reactivity in susceptible women.
Section 06 · Male Factor & Partner Support
Infertility is not a women's issue.
Half the equation matters too.
"His semen analysis was 'borderline.' The doctor said to try IUI. I want to know what we can do first."
Male factor contributes to infertility in 40–50% of cases — yet it is consistently the less-discussed half of the equation. Here is the encouraging part: sperm quality responds to nutritional support relatively quickly. It takes about 74 days for a completely new batch of sperm to be produced, which means that what your partner does today can meaningfully change the sperm quality in just over two months. Starting now matters.
Sperm quality is profoundly influenced by oxidative stress — the right antioxidants change outcomes
Core protocol
CoQ10 (ubiquinol) 200–400mg: Powers sperm motility (ATP-dependent) and reduces sperm DNA fragmentation.
Zinc 15–30mg: Critical for testosterone synthesis, sperm formation, and DNA integrity.
Selenium 100–200mcg: Protects sperm from oxidative damage — selenoprotein P is required for normal sperm morphology.
Vitamin C 500–1,000mg: Reduces sperm DNA fragmentation by neutralising reactive oxygen species in seminal fluid.
What to expect
Sperm take 74 days to fully mature. Any intervention should be sustained for a minimum of 3 months before a follow-up semen analysis. Results vary significantly based on baseline — men with high DNA fragmentation or poor motility show the greatest response to antioxidant protocols.
Lifestyle factors amplify protocol efficacy: heat avoidance, reduced alcohol, weight management, and sleep are foundational.
"Every supplement here is chosen because evidence supports it — not because the wellness industry sells it."
A protocol built from a list
is good. A protocol built from
your scan is personal.
This guide gives you the evidence-based foundation. What your imaging shows — your follicle count, your endometrial stripe, your ovarian morphology — tells us which of these categories matter most for your body specifically. That precision is what an Ovēa Clarity Consult provides.
Join Ovēa
You do not have to
navigate this alone.
Inside Ovēa, this protocol becomes personal. Submit your imaging, ask your questions live at Open Hours, and build a supplement plan that reflects what your body is actually showing — not what the internet says it should be.
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Educational disclaimer: This supplement protocol is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. All supplement decisions should be discussed with a licensed healthcare provider before beginning. Individual responses to supplementation vary. Brand mentions are for informational purposes — Ovēa may use affiliate links. This guide does not replace a clinical fertility evaluation or specialist care. Hannah is an ARDMS-certified sonographer operating in an educational capacity.
