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  • Writer's pictureDr. H. Singh, ND

A Nutrient Deficiency Associated with Higher Risk for Unexplained Infertility

A very common nutrient deficiency found in the reproductive aged population is iron deficiency. Iron deficiency is usually diagnosed by measuring serum ferritin levels. According to the world health organization, a serum ferritin level below 15 µg/L is suggestive of iron deficiency.

Is Iron Deficiency Diagnosed Accurately?

The issue with using ferritin levels to diagnose iron deficiency is that ferritin measurements are not entirely accurate. They can be falsely elevated for a variety of reasons, including chronic inflammation. As a result, updated research has now suggested that we consider iron deficiency in patients with ferritin levels below 30 µg/L. For patients with suspected iron deficiency, further specialized tests can be done to confirm the diagnosis so we do not have to rely when serum ferritin levels alone.

Impact of Iron on Reproductive Health and Fertility

This is a crucial component in fertility care because iron deficiency is a well-established factor for elevated risk for miscarriage. And preliminary research is now suggesting that iron deficiency is also correlated with an elevated risk of being diagnosed with unexplained infertility. There is some limited research that has even suggested that iron deficiency might affect the development of the eggs/oocytes in the ovary.

Considering that iron has such a fundamental role in supporting reproductive health, it is concerning that we are potentially missing the iron deficiency diagnosis in a number of patients that have falsely elevated ferritin levels. Therefore, careful consideration is required and individuals with ferritin levels below 30, and further investigation may be warranted if iron deficiency is truly suspected.

Improving Iron Status in Patients of Reproductive Age:

Occasionally, we see patients that regardless of the dose of iron supplements that they take, their levels will continue to remain low. One of the obstacles that can affect iron absorption is actually the gut microbiome. Supporting digestive tract function and the gut microbiome may be supportive of iron absorption as well. Another common issue is that many forms of iron found in multivitamins or prenatals, may not be the optimal type of iron to supplement with. For example, certain forms of iron supplements only have 20-30% elemental iron of the total iron supplement dose. It is best to speak with your naturopathic doctor to help determine what your current iron status is, and what the optimal form of supplementation may be, and if supportive care for the gut microbiome would be beneficial.

Limitations of the study

The study that reviewed the relationship between iron deficiency and unexplained infertility is a case-control study that can establish correlation, but falls short of establishing causation. Considering the frequency iron deficiency is encountered in Patients trying to conceive and its impact on overall health, further investigation may be warranted if levels of ferritin are below 30 µg/L.

This article is being shared as educational content and is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healthcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance and supervision.


  1. Holzer, I., Ott, J., Beitl, K., Mayrhofer, D., Heinzl, F., Ebenbauer, J., & Parry, J. P. (2023). Iron status in women with infertility and controls: A case-control study. Frontiers in Endocrinology, 14.

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