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NAD+ Injections, Fertility, and Egg quality

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Nicotinamide adenine dinucleotide (NAD+) is a naturally occurring metabolic cofactor in mammals that declines with age. Evidence suggests boosting NAD+ levels could improve egg quality and ovarian function (1,2,3,4). NAD+ is a large molecule and poorly absorbed through digestion, so injections or IV infusions are a preferred way to increase levels. Our team at Lily + Horn has collaborated with Reproductive Endocrinologists in New York City, as well as experienced physicians who have been using NAD+ for years, to create a dosage and protocol targeting ovarian function and egg quality.

People experiencing fertility struggles, especially women over 35 who have had poor outcomes with previous attempts to create healthy embryos, are great candidates for trying NAD+. Ideally, patients should receive injections once a week for 12 weeks before an egg retrieval, especially in cases where previous retrievals resulted in no blastocysts or mostly abnormal (aneuploid) embryos. We suggest a 12-week course, as this is the amount of time it takes for a follicle (containing an egg) to go through all stages of maturation before ovulation/retrieval. It is during this time that body chemistry can influence the health of the resulting egg(s). These 12 weeks are also a great time to optimize your diet and lifestyle and incorporate weekly acupuncture to have the greatest impact on improving body chemistry and egg quality. For this reason, we are offering acupuncture sessions at a discounted rate after getting an NAD+ injection. While we are suggesting a 12 week course, benefits may be seen in less time. More research is needed to further understand the ideal timeline. Meta analysis suggests that while emerging evidence is ongoing for efficacy, NAD+ supplementation is very likely safe (5).

NAD+ injections have been in use for years as an agent to slow aging, improve cellular health, and target degenerate disease processes. It is a cofactor for many metabolic reactions, helping cells produce energy optimally (6). It is also a co-substrate used in multiple pathways that repair DNA damage (7). Mammalian fertility studies have looked mostly at murine and porcine models, but clinically, we have witnessed successful improvement in patients' IVF outcomes enough that we are excited to offer access to NAD+. In our almost two decades of supporting women trying to conceive, we have seen that nothing can drastically change egg quality for everyone. It is more common that multiple factors such as changing diet, incorporating regular acupuncture, using targeted customized supplements, herbs, appropriate medications and procedures like IVF, etc. combine to change outcomes and improve live birth rates (8).

Dr. Rebecca Summers, MD, of Hummingrock Healing, administers NAD+ injections at Lily + Horn after an initial screening (which can be in-person or virtual).

 

1 Michael J. Bertoldo, Dave R. Listijono, et.al., NAD+ Repletion Rescues Female Fertility during Reproductive Aging. Cell Rep. 2020 Feb 11; 30(6): 1670–1681.e7

2 Lan Li, Xin Zhou, Wene Liu, Zhen Chen, Xiaoqin Xiao, Guiming Deng. Supplementation with NAD+ and its precursors: A rescue of female reproductive diseases. Biochemistry and Biophysics Reports. Volume 38, July 2024, 101715

3 Guo, Z., Yang, J., Yang, G. et al. Effects of nicotinamide on follicular development and the quality of oocytes. Reprod Biol Endocrinol 20, 70 (2022). https://doi.org/10.1186/s12958-022-00938-x

4 Liang, J., Huang, F., Song, Z. et al. Impact of NAD+ metabolism on ovarian aging. Immun Ageing 20, 70 (2023). https://doi.org/10.1186/s12979-023-00398-w

5 Radenkovic D, Reason, Verdin E. Clinical Evidence for Targeting NAD Therapeutically. Pharmaceuticals (Basel). 2020 Sep 15;13(9):247

6 Xie, N., Zhang, L., Gao, W. et al. NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential. Sig Transduct Target Ther 5, 227 (2020). https://doi.org/10.1038/s41392-020-00311-7

7 Francisco Alejandro Lagunas-Rangel. Current role of mammalian sirtuins in DNA repair. DNA Repair. Volume 80, August 2019, Pages 85-92

8 Lee E Hullender Rubin, Michael S Opsahl, Klaus E Wiemer, Scott D Mist, Aaron B Caughey. Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes. Reprod Biomed Online. 2015 Jun;30(6):602-12. Epub 2015 Feb 24

 

 

 


Testimonials

“Mary Sabo is my miracle worker! It’s really incredible to think that I get to see my eastern doctor every week and have her really listen and do things that help. She is so warm and I feel like because of her, I can achieve my goals. I am not sure if this is the case for others, but my cycles have since gone from 60+ days to 35 days the first month, 30 the second and we’re on track for a 28 day cycle!!”

— T.S

I adore Mary. I have been seeing her for 4 years through a tough miscarriage, a roller coaster pregnancy, and every issue and ailment (fertility and other) along the way. She is so knowledgeable in both eastern and western medicine. I always leave her office feeling amazing, both physically and emotionally. She is kind, caring, patient, and seems to know everything about everything. Her skill in acupuncture is unparalleled - this is evident not only through my own experience, but also the doctors who work with her, the panels she's so often asked to speak on, and the incredibly successful business she so quickly grew. My visits with Mary are the highlight of my week. I cannot recommend her enough.

— M.J.

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— Ray