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  • Dr. Singh, ND

Prostaglandin E2: the vital Fertility Modulator

There is a common belief that, in general, inflammation is a "bad" thing. That it is harmful for the body, it is what causes pain and other chronic health issues. And while many of these points are in fact true, not all inflammatory molecules are created equal.

There is a very important reason why anti-inflammatory drugs (such as ibuprofen, salicylic acid, etc.) are discourage when trying to conceive. The cyclo-oxygenase (COX) enzyme in the body converts a fatty acid known as Arachidonic Acid (AA) to different molecules which have different roles in the body. One of the important molecules produced by the COX enzyme is Prostaglandin E2 (PGE2).

PGE2 facilitates every step of fertility, from proper egg maturation and development, ovulation, fertilization, and implantation. So when PGE2 is reduced, one or many of these processes can be inhibited.

How does PGE2 actually support Fertility?

1. PGE2 amplifies the chemical signals inside of the dominant developing follicle/egg to make sure that it matures

2. PGE2 helps develop the Cumulus-Oocyte-Complex (COC). The COC is like the cushion (of cells) that surrounds the egg as it ovulates and travels down the Fallopian tube.

3. It softens the cellular structures outside of the egg to make it easier for sperm cells to penetrate the COC and reach the Egg for fertilization

4. It stimulates the uterine lining to help support implantation and therefore pregnancy

5. PGE2 has an important role in ensuring that the corpus luteum is able to continue producing progesterone to support early pregnancy

The idea is to reduce the unnecessary suppression of the COX enzyme through medications. The recommended lifestyle changes for longevity and fertility still include a balanced diet, healthy amounts of exercise, and reducing lifestyle choices that cause chronic inflammation (i.e. sedentary lifestyle, maintaining excessive weight/fat tissue, etc).

So when it comes to preconception and trying to conceive, it is worth discussing with your health care provider suitable alternatives to anti-inflammatory medications that you may be using for headaches, joint pain, menstrual cramps, or for any other reason.


Niringiyumukiza, J. D., Cai, H., & Xiang, W. (2018). Prostaglandin E2 involvement in mammalian female fertility: Ovulation, fertilization, embryo development and early implantation. Reproductive Biology and Endocrinology, 16(1).

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