Fertility: A Comprehensive Guide to Male and Female Reproductive Health
Jul 17, 2026
KNOWLEDGE HUB
Fertility: A Comprehensive Guide to Male and Female Reproductive Health
Understanding the biological mechanisms that regulate fertility means understanding one of the most complex aspects of human health.
In this guide, we explore the role of hormonal balance, metabolism, gamete quality, nutrition and lifestyle in light of the latest scientific evidence.
Reading time: 10 minutes
Last updated: July 2026
Scientific review: GP Nutraceuticals Scientific Team
Primary sources: Based on guidelines from the WHO, ASRM and ESHRE.
At a Glance
Fertility is one of the most important indicators. It does not depend solely on the reproductive system but on the interaction between hormonal balance, metabolism, gamete quality, immune function and lifestyle.
In recent years, reproductive medicine has broadened its perspective, recognising that metabolic, nutritional and environmental factors may influence normal reproductive function in both women and men.
In this guide, we examine the main biological mechanisms involved in fertility, the factors that can affect reproductive health, and the latest scientific evidence on the role of nutrition, lifestyle and the nutrients that have been most extensively studied.
Key Takeaways
- Fertility depends on the interaction between reproductive health, endocrine balance and metabolism.
- Age is one of the main biological determinants of fertility.
- Nutrition, lifestyle and metabolic health may influence normal reproductive function.
- Oxidative stress is one of the most extensively studied biological mechanisms in reproductive medicine.
- Fertility assessment always requires an individualised approach.
What You'll Find in This Guide
- What fertility is.
- How female fertility works.
- How male fertility works.
- The main factors influencing reproductive health.
- The role of nutrition and lifestyle.
- Oxidative stress and reproductive function.
- The nutrients and bioactive compounds most widely studied.
- Frequently asked questions.
- Related scientific insights.
This guide is intended for educational and informational purposes only and does not replace the advice of a physician or other qualified healthcare professionals.
What Is Fertility?
Fertility is the biological ability of an individual or a couple to conceive a pregnancy through the union of a viable egg and a viable sperm in conditions that support fertilisation, embryo implantation and the early stages of pregnancy.
Fertility is not a fixed characteristic but a dynamic biological function that changes throughout life. It can be influenced by age, overall health, hormonal balance, lifestyle and environmental factors. In women, the likelihood of conception is highest during the so-called fertile window, which includes the days leading up to and immediately following ovulation.
Today, fertility is no longer regarded as an isolated function of the reproductive system but as the result of the interaction between numerous biological systems. The proper functioning of the endocrine system, energy metabolism, the immune system and oxidative balance all contribute to creating the physiological conditions required for successful reproduction.
Fertility is also a characteristic of the couple. The ability to conceive depends on the interaction between female and male reproductive health, and when pregnancy does not occur as expected, the clinical evaluation should involve both partners.
Conception requires a highly complex sequence of biological events:
- gamete development and maturation;
- ovulation;
- spermatogenesis;
- fertilisation;
- embryo transport;
- implantation into the endometrium;
- maintenance of early pregnancy.
A disruption at any stage of this process may reduce the likelihood of conception.
For this reason, fertility is now considered an important indicator of both overall health and reproductive function.
The Evolution of Reproductive Medicine
In recent years, reproductive medicine has adopted an increasingly multidisciplinary approach.
The latest recommendations from the American Society for Reproductive Medicine (ASRM) and the World Health Organization (WHO) emphasise that fertility assessment should not be limited to gynaecological or andrological aspects alone, but should also include metabolic, nutritional, endocrine and environmental factors.
At the same time, scientific research has highlighted the role of oxidative stress, mitochondrial function, gamete quality and metabolic balance as key elements closely linked to reproductive health.
This broader perspective allows fertility to be understood in a more comprehensive way, considering the individual as a whole rather than focusing solely on the function of the reproductive organs.
How Female Fertility Works
Female fertility depends on the interaction between ovarian function, hormonal balance, oocyte quality, endometrial receptivity and the integrity of the reproductive system.
During each menstrual cycle, the hypothalamic–pituitary–ovarian axis coordinates the maturation of ovarian follicles through a complex hormonal regulation process. In most cases, a single follicle completes its development and releases a potentially fertilisable oocyte during ovulation.
For conception to occur, several physiological conditions must take place simultaneously:
- regular ovulation;
- adequate oocyte quality;
- patent Fallopian tubes;
- successful fertilisation;
- appropriate endometrial receptivity;
- early embryonic development.
For this reason, female fertility does not depend on a single parameter but on the overall balance of numerous biological mechanisms.
Age and Ovarian Reserve
Among all the factors affecting female fertility, age is the one most consistently supported by scientific evidence.
Women are born with a finite ovarian reserve, which gradually declines throughout life. As age increases, both the number and quality of oocytes decrease, leading to a higher likelihood of chromosomal abnormalities and a progressive reduction in the chances of conception.
The decline in fertility generally becomes more evident after the age of 35 and tends to accelerate after the age of 40, although considerable individual variation exists.
The assessment of fertility by a specialist may include measurement of anti-Müllerian hormone (AMH), together with an ultrasound assessment of the antral follicle count (AFC) and other clinical parameters.
AMH is one of the main indicators of ovarian reserve, but it does not directly measure oocyte quality and cannot, on its own, predict the likelihood of achieving a spontaneous pregnancy. Its interpretation should always be considered within the context of a comprehensive clinical assessment.
Endocrine Balance and Metabolism
In recent years, increasing evidence has shown that fertility and metabolism are closely interconnected.
Ovarian function is influenced by the balance between reproductive hormones, insulin sensitivity, nutritional status, body composition and systemic inflammation.
Metabolic disorders, thyroid dysfunction, obesity, being underweight and insulin resistance may interfere with regular ovulation and the quality of the reproductive environment.
For this reason, modern reproductive medicine considers the maintenance of healthy endocrine and metabolic balance to be one of the key factors in preserving normal ovarian function.
PMOS: A Broader Perspective on Reproductive Health
Among the conditions that may affect female fertility is Polycystic Ovary Syndrome (PCOS), one of the most common endocrine and metabolic disorders affecting women of reproductive age.
In recent years, some research groups have proposed the term Polyendocrine Metabolic Ovarian Syndrome (PMOS) to better reflect the systemic nature of the condition. The aim is to emphasise that the disorder extends beyond the ovaries, involving metabolism, insulin sensitivity, hormonal balance and cardiovascular health.
It is important to note that PCOS remains the term predominantly used in international guidelines and clinical practice. PMOS is currently a proposed terminology that remains under discussion within the scientific community and has not yet been adopted by the major international clinical guidelines.
Clinical manifestations may include menstrual irregularities, ovulatory dysfunction, hyperandrogenism and metabolic disturbances of varying severity. Diagnosis and management should always be based on an individualised specialist assessment.
How Male Fertility Works
Male fertility depends on the body's ability to produce functional, genetically intact sperm in sufficient numbers to enable fertilisation of the egg.
This process, known as spermatogenesis, takes place within the seminiferous tubules of the testes and requires approximately 70–75 days to be completed. During this period, germ cells undergo a series of developmental stages before becoming fully mature sperm cells.
Spermatogenesis is regulated by a delicate balance of hormones, cellular metabolism, mitochondrial function and environmental factors. Consequently, the sperm produced today reflect, at least in part, the physiological conditions of the previous three months.
To maintain fertility, sperm should possess appropriate characteristics in terms of:
- concentration;
- motility;
- morphology;
- vitality;
- genetic integrity.
For this reason, semen quality is the result of the interaction between numerous biological mechanisms and cannot be described by a single parameter.
Semen Analysis
The primary test used to assess male fertility is the semen analysis, performed according to the criteria established by the World Health Organization (WHO).
This examination evaluates several key parameters, including:
- sperm concentration;
- progressive motility;
- total motility;
- morphology;
- semen volume;
- sperm vitality.
Semen analysis represents the starting point of the andrological assessment, but it does not provide a complete picture of an individual's reproductive potential.
Men with apparently normal semen parameters may still present abnormalities that cannot be detected by this test, while others with mild abnormalities may naturally achieve conception.
For this reason, semen analysis results should always be interpreted in the context of the couple's clinical history and the overall specialist evaluation.
Sperm Quality
In recent years, scientific research has progressively shifted its focus from the number of sperm cells to their biological quality.
A functional sperm cell should possess:
- an intact cell membrane;
- efficient energy metabolism;
- good motility;
- stable and properly compacted DNA;
- normal mitochondrial function.
These characteristics contribute to the sperm's ability to reach the egg, penetrate it and support the earliest stages of embryonic development.
For this reason, reproductive medicine now considers sperm quality to be a much broader concept than the values measured by semen analysis alone.
Sperm DNA Fragmentation
One of the most extensively studied aspects of male fertility in recent years is Sperm DNA Fragmentation (SDF).
During sperm maturation, genetic material is progressively condensed and protected by specialised proteins. When this process is disrupted, or when DNA damage occurs—for example, as a consequence of oxidative stress—the degree of DNA fragmentation may increase.
Several studies have reported an association between high levels of sperm DNA fragmentation and reduced semen quality, as well as possible effects on reproductive outcomes. However, the clinical significance of SDF should always be interpreted alongside the other findings of the andrological assessment.
For this reason, Sperm DNA Fragmentation testing is not considered a first-line investigation but may be recommended by a specialist in selected situations, such as unexplained infertility, recurrent miscarriage or repeated failure of medically assisted reproduction treatments.
Oxidative Stress and Male Reproductive Health
Oxidative stress is currently recognised as one of the main biological mechanisms involved in male infertility.
Under physiological conditions, small amounts of reactive oxygen species (ROS) play an essential role in several processes required for normal sperm function, including sperm maturation and fertilisation.
However, when ROS production exceeds the body's antioxidant defence capacity, an imbalance develops that may compromise several components of the sperm cell.
The main targets of oxidative stress include:
- cell membranes;
- mitochondria;
- sperm DNA;
- structural proteins.
In recent years, oxidative stress has become one of the principal areas of research in reproductive medicine, as it may help explain a proportion of cases of idiopathic male infertility.
Mitochondrial Function
Sperm cells are among the most highly specialised cells in the human body and require substantial amounts of energy to reach the egg.
This energy is produced primarily by the mitochondria, small organelles located in the midpiece of the sperm cell.
Proper mitochondrial function is essential for maintaining sperm motility and fertilising capacity.
For this reason, numerous studies have investigated the role of mitochondrial function in male reproductive health and the potential contribution of nutrients involved in cellular energy production, such as Coenzyme Q10 and L-carnitine, which will be discussed in more detail in the section dedicated to bioactive compounds.
Age and Male Fertility
Although men generally retain their reproductive capacity for longer than women, male fertility also changes with age.
Numerous studies have reported a gradual decline in certain semen parameters, particularly sperm motility and morphology, together with a possible increase in sperm DNA fragmentation.
These changes vary considerably between individuals and do not allow a specific age to be identified at which fertility is lost.
For this reason, age should be considered as one of several factors contributing to the overall assessment of male reproductive health, alongside lifestyle, metabolic status and any associated medical conditions.
A Comprehensive View of Male Reproductive Health
Male fertility does not depend on a single biological parameter.
Sperm production, sperm quality, DNA integrity, mitochondrial function and oxidative balance are all closely interconnected.
For this reason, reproductive medicine now adopts an increasingly integrated approach aimed at understanding the overall picture of male reproductive health and identifying potentially modifiable factors that may influence normal fertility.
What Does Current Research Tell Us?
In recent years, research has progressively shifted from an exclusively quantitative assessment of semen towards a broader evaluation of sperm biological quality.
Mitochondrial function, sperm DNA integrity and oxidative stress are now among the most extensively investigated areas in reproductive medicine. Although many findings are promising, their role in routine clinical practice continues to evolve and requires individual interpretation by a specialist.
The Main Factors Influencing Fertility
Fertility is the result of the interaction between numerous biological, endocrine, metabolic, environmental and behavioural factors. In most cases, reduced reproductive capacity cannot be attributed to a single cause but rather to a combination of elements that may influence normal reproductive function.
Among the main factors recognised in the scientific literature are:
- age;
- hormonal balance;
- metabolic health;
- nutrition;
- body weight;
- physical activity;
- sleep quality;
- cigarette smoking;
- alcohol consumption;
- exposure to environmental substances;
- physical and psychological stress;
- underlying medical conditions.
The importance of each factor varies from one individual to another. For this reason, fertility assessment should always adopt an individualised approach that considers the person's overall clinical profile.
Nutrition and Reproductive Health
A balanced diet is one of the cornerstones of overall health and contributes to the normal functioning of the body, including the reproductive system.
The cells involved in reproduction have high metabolic demands and require an adequate supply of energy, vitamins, minerals and other essential nutrients.
Although no specific diet can guarantee conception, numerous studies have shown that dietary patterns rich in:
- vegetables;
- fruit;
- whole grains;
- legumes;
- fish;
- extra virgin olive oil;
- nuts;
are generally associated with better metabolic health, which may contribute to maintaining normal reproductive function.
Conversely, a diet characterised by a high intake of ultra-processed foods, added sugars and poor-quality fats may promote metabolic and inflammatory alterations that can, over time, affect multiple biological systems.
Did You Know?
Reproductive health often reflects an individual's overall state of health. For this reason, nutrition, regular physical activity, adequate sleep and good metabolic health are fundamental not only for fertility but also for the prevention of many chronic diseases.
Body Weight and Metabolic Balance
Maintaining a healthy body composition is one of the most extensively studied aspects of reproductive medicine.
Both underweight and overweight conditions may affect endocrine and metabolic balance, altering the production of hormones involved in reproductive function.
In women, these alterations may contribute to changes in ovulation and ovarian function.
In men, they may influence testosterone production, semen quality and oxidative balance.
The objective is not simply to achieve an "ideal" body weight, but rather to maintain a metabolic state that supports overall health.
Physical Activity and Lifestyle
Regular physical activity is one of the most effective ways to maintain metabolic health.
Moderate and consistent exercise helps preserve insulin sensitivity, healthy body composition and cardiovascular health, all of which are closely linked to normal reproductive physiology.
Conversely, prolonged physical inactivity or excessively intensive training programmes may negatively affect hormonal balance in susceptible individuals.
Sleep also plays a fundamental role.
Getting enough sleep and maintaining a regular sleep–wake cycle contribute to the proper functioning of numerous endocrine systems involved in reproductive health.
Smoking, Alcohol and Environmental Factors
Among the most extensively studied modifiable risk factors are cigarette smoking, excessive alcohol consumption and exposure to potentially harmful environmental substances.
Numerous studies have reported associations between these factors and alterations in oocyte quality, semen quality and oxidative balance.
Occupational or environmental exposure to pesticides, organic solvents, heavy metals and other contaminants also continues to be investigated for its potential impact on reproductive health.
The effects of these exposures depend on many variables, including intensity, duration, individual susceptibility and the presence of other risk factors.
Maintaining good sleep quality, effectively managing metabolic disorders and reducing exposure to toxic substances and endocrine-disrupting chemicals may also contribute to preserving reproductive health.
Oxidative Stress and Reproductive Function
Oxidative stress is one of the main biological mechanisms currently being investigated in reproductive medicine.
Under physiological conditions, cells continuously produce reactive oxygen species (ROS), molecules that play an essential role in numerous biological processes.
The body possesses sophisticated antioxidant defence systems that help maintain this delicate balance.
However, when the production of ROS exceeds the body's antioxidant capacity, a state of oxidative stress may develop.
Numerous studies suggest that this imbalance may influence several aspects of reproductive health.
In women, oxidative stress has been associated with changes in the follicular environment, oocyte quality and the early stages of embryonic development.
In men, it may contribute to damage affecting cell membranes, mitochondria and sperm DNA.
For this reason, oxidative stress is now considered one of the main areas of research in reproductive medicine.
Key Takeaways
✔ Oxidative stress is not a disease but a biological imbalance.
✔ Small amounts of reactive oxygen species (ROS) are essential for normal cellular function.
✔ Excessive levels of free radicals may interfere with several processes involved in normal reproductive physiology.
✔ Nutrition and lifestyle play an important role in maintaining oxidative balance.
Nutrients and Bioactive Compounds of Scientific Interest
In recent years, numerous nutrients have been investigated for their potential role in supporting reproductive health.
It is important to note that research in this field is still evolving, and the strength of the available evidence varies depending on the nutrient and the specific clinical context.
Below are some of the compounds that have been most extensively studied.
Myo-Inositol
Myo-inositol is involved in intracellular signalling pathways and has been widely investigated in relation to ovulatory function and metabolic balance, particularly in women with Polycystic Ovary Syndrome (PCOS).
Folic Acid
Folic acid contributes to maternal tissue growth during pregnancy, normal amino acid synthesis and normal cell division, in accordance with the health claims authorised by the European Food Safety Authority (EFSA).
Coenzyme Q10
Coenzyme Q10 plays a key role in mitochondrial energy production and has been the subject of numerous studies investigating male and female reproductive health.
L-Carnitine
L-carnitine is involved in the transport and metabolism of fatty acids within the mitochondria and has been studied primarily for its potential role in sperm function.
Zinc
Zinc contributes to normal fertility and reproduction, helps maintain normal testosterone levels in the blood, and contributes to the protection of cells from oxidative stress, in accordance with authorised EFSA health claims.
Selenium
Selenium contributes to normal spermatogenesis and to the protection of cells from oxidative stress, according to authorised EFSA health claims.
Vitamin D
Vitamin D has attracted increasing scientific interest for its potential role in ovarian function, endometrial receptivity and overall reproductive health.
Although several studies have reported associations between vitamin D status and certain reproductive parameters, the clinical significance of these findings continues to be investigated.
Astaxanthin
Astaxanthin is a naturally occurring carotenoid that has been studied for its antioxidant properties.
Some studies have investigated its potential role in protecting cells from oxidative stress and supporting certain aspects of male fertility. However, further research is required before definitive conclusions can be drawn.
What Does Current Scientific Research Show?
In recent years, reproductive medicine has made significant progress in understanding the biological mechanisms that regulate fertility.
Research has gradually moved beyond an exclusively anatomical view of the reproductive organs towards a broader perspective that includes metabolism, mitochondrial function, oxidative balance, nutrition and lifestyle.
At the same time, numerous studies have investigated the role of specific nutrients and bioactive compounds in supporting reproductive health. Although many findings are promising, not all of them currently allow definitive conclusions to be drawn.
For this reason, the latest international guidelines recommend an individualised approach based on each person's clinical assessment and on the integration of the best available scientific evidence.
Frequently Asked Questions About Fertility
What Is Fertility?
Fertility is the biological ability of an individual or a couple to conceive a pregnancy through the union of a viable egg and a viable sperm under conditions that support fertilisation, embryo implantation and the early stages of pregnancy.
Fertility is not a fixed characteristic but a dynamic biological function that changes throughout life. It can be influenced by age, overall health, hormonal balance, metabolism, immune function, lifestyle and environmental factors. Today, fertility is regarded as the result of the interaction between numerous biological systems rather than solely the function of the reproductive organs.
Fertility is also a characteristic of the couple. The ability to conceive depends on the interaction between female and male reproductive health, and when pregnancy does not occur as expected, the clinical evaluation should involve both partners.
Infertility and sterility are not synonymous. Infertility refers to the difficulty in achieving pregnancy after a period of regular unprotected intercourse or the need for medical assistance to conceive. Sterility, by contrast, describes a condition in which spontaneous conception is biologically impossible. In modern clinical practice, the term infertility is the one most commonly used.
Can Fertility Be Improved?
Fertility is influenced by both non-modifiable factors, such as age and certain genetic conditions, and modifiable factors.
Maintaining a healthy lifestyle, following a balanced diet, engaging in regular physical activity, achieving a healthy body weight and appropriately managing underlying medical conditions may help preserve normal reproductive function.
However, every individual is different and requires a personalised clinical assessment.
At What Age Does Fertility Begin to Decline?
Fertility gradually declines with age in both women and men.
In women, the decline generally becomes more evident after the age of 35, owing to the progressive reduction in both the number and quality of oocytes.
In men, the decline is usually more gradual and tends to become more apparent after the age of 45–50, with possible changes in semen quality and sperm DNA integrity.
What Is AMH?
Anti-Müllerian hormone (AMH) is a hormone produced by ovarian follicles during the early stages of their development.
It is used as an indicator of ovarian reserve, reflecting the number of follicles remaining in the ovaries.
AMH does not directly measure oocyte quality and, on its own, cannot predict the likelihood of achieving a spontaneous pregnancy.
What Is PCOS?
Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine and metabolic disorders affecting women of reproductive age.
It may be associated with ovulatory dysfunction, hormonal imbalance and metabolic disturbances.
In recent years, the term Polyendocrine Metabolic Ovarian Syndrome (PMOS) has also been proposed to emphasise the systemic nature of the condition. However, PCOS remains the terminology most widely used in clinical practice and in the international scientific literature.
What Is Sperm DNA Fragmentation?
Sperm DNA fragmentation refers to the presence of damage within the genetic material carried by sperm cells.
In selected clinical situations, it may provide additional information alongside a conventional semen analysis and contribute to the assessment of male reproductive health.
The interpretation of the results should always be carried out by a specialist.
Are There Nutrients That Have Been Studied in Relation to Fertility?
Yes. In recent years, numerous nutrients have been investigated for their potential role in reproductive health.
Among the most extensively studied are:
- myo-inositol;
- folic acid;
- Coenzyme Q10;
- L-carnitine;
- zinc;
- selenium;
- vitamin D;
- astaxanthin.
The available scientific evidence varies considerably depending on the specific nutrient and the clinical context.
When Should You Consult a Fertility Specialist?
It is advisable to consult a fertility specialist if pregnancy does not occur after an appropriate period of regular unprotected intercourse or when known conditions that may affect reproductive health are present, such as menstrual irregularities, endometriosis, suspected abnormalities in semen quality or other endocrine and metabolic disorders.
An early assessment may help identify potentially modifiable factors and determine the most appropriate clinical pathway.
Are Fertility and Fecundity the Same Thing?
No. In scientific terminology, the two concepts are not exactly the same.
Fertility refers to the biological capacity to conceive, whereas fecundity describes the probability or actual achievement of conception over a given period.
In everyday language, however, the two terms are often used interchangeably.
Are Infertility and Sterility the Same Thing?
No. Infertility refers to the difficulty in achieving pregnancy or the need for medical assistance to conceive, whereas sterility describes a condition in which spontaneous conception is biologically impossible.
For this reason, the term infertility is predominantly used in modern clinical practice.
Summary
Fertility is the result of a complex interaction between reproductive health, endocrine function, metabolism and lifestyle.
Scientific advances over recent years have shown that reproductive capacity depends on the interplay of numerous biological and environmental factors, many of which can be assessed and, in some cases, optimised through an individualised approach.
Understanding these mechanisms provides a broader perspective on health, where prevention, nutrition, physical activity and metabolic wellbeing all play a central role alongside specialist medical care.
Knowledge Hub Insights
This guide is the starting point of the GP Nutraceuticals Knowledge Hub section dedicated to reproductive health.
In future articles, we will explore the following topics in greater detail:
- Female fertility
- Male fertility
- PMOS (Polyendocrine Metabolic Ovarian Syndrome)
- Endometriosis
- Ovarian reserve and AMH
- Ovulation
- Spermatogenesis
- Oxidative stress
- Sperm DNA fragmentation
- Myo-inositol
- Folic acid
- Coenzyme Q10
- L-carnitine
- Vitamin D
- Astaxanthin
Each article will provide an in-depth analysis of a specific topic, based on the best available scientific evidence, and will form an integral part of the GP Nutraceuticals Knowledge Hub.
The GP Nutraceuticals Approach to Nutraceutical Science
Research in the field of nutraceuticals has increasingly focused on the role of specific nutrients and bioactive compounds in supporting reproductive health.
GP Nutraceuticals develops formulations inspired by the latest scientific evidence, carefully selecting high-quality ingredients and paying particular attention to formulation design, ingredient dosages and raw material quality.
Among the formulations dedicated to reproductive wellbeing are:
GoFertil® – a formulation developed to support male fertility, containing carefully selected ingredients recognised for their role in reproductive physiology and in protecting cells from oxidative stress.
GoFertil Pink® – a formulation developed to support female reproductive wellbeing, containing nutrients of scientific interest for ovulatory function, metabolism and reproductive health.
To learn more about these formulations, please refer to the individual product pages and the articles dedicated to each ingredient within the Knowledge Hub.
Scientific References
This guide has been prepared on the basis of the principal international guidelines and the peer-reviewed scientific literature available at the time of publication.
The main references include:
- World Health Organization (WHO). Infertility. World Health Organization. (Consultare la documentazione ufficiale WHO).
- European Society of Human Reproduction and Embryology (ESHRE). Guideline on Female Fertility Assessment.
- American Society for Reproductive Medicine (ASRM). Definitions of Infertility and Recurrent Pregnancy Loss: A Committee Opinion.
- Agarwal A, Baskaran S, Parekh N, et al. Male infertility. Lancet. 2021;397(10271):319-333. PMID: 33308486.
- Agarwal A, Aponte-Mellado A, Premkumar BJ, et al. The effects of oxidative stress on female reproduction: a review. Reproductive Biology and Endocrinology. 2012;10:49. PMID: 22748101.
Revision History
Version 1.0 – July 2026
First publication of this guide.
This page will be updated periodically to incorporate new scientific evidence, revisions to international guidelines and advances in research in the fields of reproductive medicine and nutraceutical science.
