I sat on the toilet, head slumped, watching a single pink line materialize. I recalled the sensation of the IV entering my left arm: it pinched as it punctured my vein, and I felt like a hospital patient - hooked up and hostage. A translucent substance and tempered hope poured into me. When it ended, I felt no different than before.
I snapped back to the present, pleading with the white plastic. The single pink line was giving me the finger, per usual. I walked away and then returned. Was something happening next to the pink line - or was it my imagination?
Journalist Amanda Lauren lamented the single pink line. After a pregnancy loss, three failed IUIs, and two rounds of IVF, she was "willing to do anything for healthy eggs." Lauren discovered a video from Aimee Eyvazzadeh, MD, MPH, a reproductive endocrinologist. Known to patients as the "egg whisperer," Dr. Aimee informed viewers about a supplement called NAD. "I was about to do my final egg retrieval and wanted to throw anything I could at it. That way, I knew I tried everything," Lauren recalls. "It was too late to start taking pills, so I decided to get NAD through an IV infusion."
After her infusion, Lauren felt the same. What changed was her egg count, which more than doubled. "We planned to make embryos, but the night before my egg retrieval, my husband was diagnosed with COVID. We had to wait six weeks," she says. "During that time, I became pregnant and carried a healthy baby girl to term. I absolutely believe it was the NAD."
Lauren's IVF doctor didn't know much about NAD, but supported her receiving the infusion. "They will never study it thoroughly because big pharma can't make money from it," Lauren says. "It's sad because it could mean major innovations for women suffering from infertility. That's why I encourage all women with infertility to get an infusion."
I'm one of the women Lauren encouraged; I met her serendipitously at a work event in LA, where my fertility woes leaked out through the grief in my eyes. I scrutinized her advice about NAD because while I sometimes woo, LA woo-woos, and I had never heard of NAD. My initial research surfaced compelling clinical studies from esoteric science journals and articles written for consumers from med spas. Science journals and med spas: a chasm gaping enough to cement my morose gaze.
I decided to interview five doctors, including Dr. Aimee (the egg whisperer), to elicit their thoughts on NAD supplements and fertility. I also tried an IV infusion of NAD (from the brand Tru Niagen) and took capsule supplements for three months. Here's what I learned about NAD's potential to bolster fertility - and why benevolent strangers are spreading the word.
Experts Featured in This Article
Aimee Eyvazzadeh, MD, MPH, is a Harvard-trained reproductive endocrinologist in the Bay Area and host of "The Egg Whisperer Show" podcast. As of 2024, she partners with TruNiagen, a brand of NAD supplements.
Sheeva Talebian, MD, is a board-certified reproductive endocrinologist at CCRM in New York City.
Amanda Kahn, MD, is a board-certified internist and longevity specialist in New York City.
Carolina Sueldo, MD, MSc, FACOG, is a double-board-certified fertility specialist and the founder of Ceibo Fertility Center in Fort Lauderdale, FL. She's also faculty at the University of California San Francisco Fresno Department of Obstetrics and Gynecology.
Sabrina Solt, PHD, NMD, is a naturopathic doctor and the founder of Stem Cell Therapy Professionals.
What Is NAD?
NAD (nicotinamide adenine dinucleotide) is not a foreign or exotic substance; it's a derivative of vitamin B3 and natural coenzymes in your body. "NAD plays a critical role in supporting mitochondrial function, DNA repair, and optimizing cellular activity," says internist Amanda Kahn, MD.
Our natural levels decrease with aging, contributing to "oxidative stress, inflammation, and reduced production of cellular energy called ATP. Decreased ATP can accelerate the aging and degeneration of all tissues in the body. NAD activates proteins that promote cellular repair and reduce inflammation, both of which contribute to slowing down and possibly reversing the aging process, says Dr. Kahn.
Since NAD - or its dearth - is evident everywhere in your body, its supplemental potential is comprehensive: clinical studies on everything from cognitive decline to Parkinson's and PCOS are underway. Celebrities like Hailey Bieber take it in hopes of preventing skin aging. According to clinical research, NAD is required for over 500 enzymatic reactions and regulates nearly all major biological processes. "The potential for NAD to enhance both reproductive and overall health is incredibly intriguing," says Carolina Sueldo, MD, a Fort Lauderdale-based fertility specialist.
How Can NAD Impact Fertility?
Women are born with their lifetime supply of eggs already inside their ovaries. The fastest-aging organs in the body, ovaries receive the least amount of aging research, according to Columbia University. And older ovaries are more active than ever: CDC data crowns 30 to 34 year olds as the largest birthing demographic, with births at 40 and older now surpassing teenage births.
As we age and NAD declines, there's less energy available for egg development. "This decline may contribute to poor egg quality, DNA abnormalities, and decreased fertility," says Dr. Kahn. "NAD also supports DNA repair mechanisms, which are crucial for maintaining the integrity of eggs as they mature. Emerging research suggests that boosting NAD levels may improve mitochondrial function, enhance egg quality, and increase the chances of successful fertilization and healthy embryo development. While human studies are ongoing, early findings and animal research suggest that maintaining optimal NAD levels could mitigate age-related fertility decline and improve reproductive outcomes."
Studies also suggest boosting NAD can improve fetal and placental development during pregnancy. "NAD can potentially decrease the risk of congenital malformation," says Dr. Aimee. An October 2024 study found increasing NAD led to decreased maternal hypertension and fetal and placental restriction. "It's also being looked at as a way to treat or prevent preeclampsia, which is the leading cause of maternal morbidity and mortality in this country," Dr. Aimee adds.
It takes two to reproductively tango, and while sperm cells don't mature until boys hit puberty, they can still diminish and vary in quality over time. "Declining levels [of NAD] during aging are functionally linked to declining spermatogenesis and male fertility," reports a 2022 study. "Optimizing NAD levels before conception could potentially support reproductive health, hormone balance, and mitochondrial function in both parents," says Sabrina Solt, PHD, NMD, a naturopathic doctor specializing in regenerative medicine.
How Women Are Driving NAD Awareness
NAD isn't currently recommended or even discussed in the vast majority of public health resources on infertility and, thus, the protocol followed by most fertility doctors. Unlike a host of other drugs and supplements, you're also unlikely to be peppered with advertising for NAD, leaving most people unaware of the prospective connection to reproductive health. Education is driven by women conducting their own research, taking a chance, and sharing their experience - commanding even fertility doctors to pay attention.
After completing a round of IVF with a 43-year-old patient, Dr. Aimee couldn't believe the results. "She had tried many [IVF] cycles with no blast, no euploid. She did a cycle with me, and it knocked my socks off: we had at least three embryos, and she got pregnant on the first transfer. I said to her, 'What did you do? What was different about this?'" Her patient revealed she took Tru Niagen capsules after reading clinical studies about NAD. "Ever since then," says Dr. Aimee, "if you have a pulse and you're in my office, I'm asking if you're on Tru Niagen."
The word "potential" appears in this story 26 times, not because of lazy journalism but because it defines the clinically proven assessment of NAD supplementation in humans.Dr. Talebian was surprised by two of her patients' results. One produced "beautiful, healthy" embryos in her first cycle of IVF, but subsequent rounds yielded lower-quality eggs. She honed in on what could have distinguished the first cycle: her patient had received NAD drips for two months before that cycle only. Another longtime patient was freezing her eggs and not yet trying to conceive. "Over several years, she'd squeeze out one good embryo each time," says Dr. Talebian. "But then in her last cycle, at her oldest age, she made three gorgeous, tested embryos. She was doing NAD injections."
This information loop has inspired field research: Fertility doctors, patients, and naturopathic specialists working together to document the effects of NAD in real time. "In my network of other fertility doctors, endometriosis specialists, naturopaths, and Eastern specialists that I work with, we're trying to collaborate and keep databases of the patients that we know that are using it, and then look at their outcomes pre and post-treatment," Dr. Talebian says.
How To Boost NAD Levels
The NAD molecule itself is too large to enter our cells: it has to be broken down exogenously (outside of the cell), which can cause inflammation and post-injection side effects such as headache and nausea. Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are precursors to NAD that spur your body's production of the molecule, and clinical research has deemed them orally bioavailable. Because of this distinction, it's imperative to ascertain a provider's formula to ensure your body can process the supplement.
NAD supplements are available in pill or powder form for daily use or can be administered by monthly injections or IV drips. For daily dosage, Dr. Aimee recommends working up to 1,000 milligrams a day, which she believes most people can tolerate.
You can also aim to boost NAD naturally: "The more oxidative stress our bodies face from pollution, microplastics, and toxins that accumulate with age, the more we harness our NAD stores to protect our cells," says Dr. Kahn. "Leading a healthy lifestyle, including exercise, adequate sleep, and a balanced diet, to combat some of these external stressors can help preserve NAD reserves."
While poor diet, chronic stress, lack of sleep, excessive alcohol consumption, or a sedentary lifestyle are risk factors that contribute to an accelerated decline, NAD will not deplete uniformly for everyone. "Genetics or environmental factors may also influence the depletion rate," says Dr. Sueldo.
If you become pregnant, Dr. Talebian recommends ceasing NAD supplementation due to the lack of definitive safety data. There isn't a general consensus, however, and Dr. Aimee suggests continuing until the heartbeat ultrasound (around seven weeks) when nausea can ensue. Some patients, for example, don't experience nausea and don't want to stop. "I support them because of data surrounding NAD potentially decreasing the risk of congenital malformations and preeclampsia," Dr. Aimee says. "I want you to stay on it until you're done having babies and even beyond. It can support mitochondrial health, not just for this baby, but for your second or third baby."
The Issues With NAD
Long-term NAD use in animals has been well-tolerated, but there isn't enough data on long-term use for humans. "We believe there is low risk overall," says Dr. Talebian. Since NAD boosts cellular function, could it actually proliferate malicious cells in the body? Its effects on cancer are complex, require further studies, and depend on the type of cancer.
Some clinical studies demonstrate that supplementing NAD can help treat particular cancers, but others show that targeted NAD repletion can treat other kinds. "A theoretical concern is that we want to avoid boosting cancer cells," says Dr. Kahn. "I do a thorough review of personal and/or family history of cancer and make sure all routine and advanced cancer screenings are up to date." Dr. Talebian, a breast cancer survivor, researched before trying NAD: "I was looking for any data that suggests that the NAD could stimulate cancer cells or trigger growth. I couldn't find anything. Given the fact that I was 10 years out and cured, I made the decision to try it."
In the US, supplements are largely unregulated, so anyone's Amazon shop concoction can claim to boost your NAD levels. It's crucial to vet both the type and source of a supplement by looking for clinical studies with the exact formulation. Side effects may include nausea, headaches, or feeling anxious and jittery. "I felt like I was having a panic attack when I first started it," says Dr Aimee. "I started at 150 milligrams and took breaks before I became tolerant."
NAD isn't a blanket panacea for anyone dealing with infertility. "Supplements can be an incredible tool in fertility care, but they should always be used as part of a comprehensive, individualized approach rather than a standalone solution," says Dr. Sueldo.
If you're having trouble conceiving or contemplating freezing your eggs, your first stop should be your doctor's office. "A lot of unexplained infertility is actually silent endometriosis, which is a pelvic inflammatory condition," says Dr. Talebian. "NAD may not be appropriate for individuals undergoing fertility treatment for structural issues, such as blocked fallopian tubes, severe male factor infertility, or uterine abnormalities, where egg quality is not the primary concern," Dr. Sueldo says.
Why Isn't Healthcare Investing in NAD?
All five physicians interviewed for this story take or have taken NAD, which was coincidental and not a prerequisite for inclusion. (Only Dr. Aimee partners with a NAD brand, Tru Niagen.) Dr. Kahn enjoys better sleep and mental clarity; Dr. Solt describes it as a game changer for energy and cognitive function, and Dr. Talebian felt she was in her best shape and logged her fastest marathon time while on it.
Despite promising clinical and anecdotal evidence, health resources aren't investing in NAD. Lauren's characterization that the pharmaceutical industry can't profit from it, therefore stunting expensive clinical studies, has merit: NAD is a naturally occurring molecule that can't be patented. However, proprietary formulations and compositions can be, such as Tru Niagen's patented precursor, NR. "The science around NAD is still relatively new in the consumer wellness space, and like many longevity-related therapies, it takes time for mainstream medicine to catch up," says Dr. Solt.
"There's not much focus on preventative care in research," says Dr. Talebian. "Medicine is reactionary. 'Let's treat the disease.' Money is poured into the research on all the medications and chemotherapies. There needs to be a much bigger emphasis on understanding how to prevent disease first." Western medicine is also risk-averse and heavily predicated on lengthy human clinical studies.
The Bottom Line on NAD For Fertility
The word "potential" appears in this story 26 times, not because of lazy journalism but because it defines the clinically proven assessment of NAD supplementation in humans. Human clinical studies are underway - many double-blind, independent studies funded by Tru Niagen's parent company. Conclusive studies may take time or prove elusive. "There are so many variables, like different practices, labs, and protocols, it's difficult to compare cycle to cycle. It's hard to do excellent, controlled studies in this field [fertility] in general," says Dr. Talebian.
For some women on fertility journeys, NAD's potential is enough. Back in my bathroom, I returned to my test: it was negative, and I tossed it into the stick graveyard. The following month, a second pink line appeared and grew bolder each day. Anyone who has seen pregnancy tests go from positive to negative in less than nine months knows they can be devastatingly mercurial. But seven months later, those two pink lines - a growing baby girl - remain.
Related: I Froze My Eggs After Being Diagnosed With Breast Cancer - Here's What No One Tells You Alana Peden is an award-winning executive storyteller, strategist, and brand shaper. She cut her teeth in print (at magazines like InStyle and More) before holding senior digital positions (at Penske Media Corporation and Bustle Digital Group). In 2017, she conceived and launched Elite Daily's fashion and beauty verticals. More recently, she served as the editor in chief at StyleCaster. Read More Details
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