Written by the Nuvirox Research Team
Key Points
- Multiple mouse studies show NAD+ precursors (NMN, NR) can improve oocyte quality and ovarian reserve, especially in aged or diabetic animal models.
- Human evidence is limited to a small preliminary conference report and mechanistic reasoning — not a completed, peer-reviewed randomized trial.
- Some fertility clinics already recommend NAD+ precursors before IVF stimulation, ahead of definitive human trial data.
Short answer: NAD+ precursors reliably improve egg quality in aging mice, and there’s one small, preliminary human report pointing the same direction — but a completed, peer-reviewed human randomized trial doesn’t exist yet. If you’re researching this because you’re trying to conceive, especially with diminished ovarian reserve or at a later reproductive age, it’s worth understanding exactly how far the science has actually gotten, separate from what fertility clinic marketing implies.
Why would NAD+ matter for egg quality at all?
Oocytes (eggs) contain more mitochondria than almost any other human cell, and that mitochondrial density exists for a reason: an egg needs an enormous amount of cellular energy to complete meiosis, support fertilization, and drive the first several rounds of embryonic division before the embryo’s own genome takes over. NAD+ is central to how those mitochondria generate that energy, and it also fuels sirtuins involved in DNA repair and chromosome segregation during egg maturation.
NAD+ levels in oocytes decline with age, which lines up with the well-documented decline in egg quality and euploidy rates as women get older. That correlation is what has driven a wave of research into whether restoring NAD+ with a precursor could meaningfully slow or reverse some of that decline. It's a related question to the ovarian and hormonal changes we cover in our articles on NAD+ and PCOS and NAD+ and menopause, since ovarian function connects fertility, PCOS, and the menopausal transition even though each involves distinct biology.
What does the animal research actually show?
This is where the evidence is genuinely strong — in mice. A 2020 study in Cell Reports found that NAD+ repletion in aging female mice restored ovulation rates, egg quality, and litter sizes to levels closer to young mice. A separate 2023 study found that deleting genes needed for the body’s own NAD+ production accelerated ovarian aging in mice, and that supplementing with nicotinamide riboside increased ovarian reserve and oocyte quality in those same animals. A 2025 study extended this to a diabetes model, showing NR supplementation protected oocyte quality and early embryo development in diabetic mice by lowering reactive oxygen species and preserving normal mitochondrial function and spindle structure.
What human studies actually show
Bertoldo et al. 2020, Cell Reports — aging mouse model. NAD+ repletion in reproductively aged female mice restored ovulation, oocyte quality markers, and fertility outcomes toward youthful levels (Bertoldo MJ, Listijono DR, Ho WH, et al. NAD+ repletion rescues female fertility during reproductive aging. Cell Rep. 2020;30(6):1670-1681. doi:10.1016/j.celrep.2020.01.058). This is one of the foundational papers in the field and is frequently cited as the rationale for human interest, but it is a mouse study, not a human one.
Wei et al. 2025, Reproduction — diabetic mouse model. NR supplementation (400 mg/kg/day for 14 days) restored NAD+ levels in diabetic mouse ovaries and oocytes, improved superovulation response, and reduced oxidative stress markers in the eggs (Wei C, Zeng X, Wang K, et al. Nicotinamide riboside supplementation protects against maternal diabetes-associated decline in oocyte quality. Reproduction. 2025. doi:10.1530/REP-24-0350). Again, a mouse model — diabetes-induced ovarian aging, not natural age-related decline in humans.
The human evidence: preliminary and unpublished in full. A conference abstract presented at a European fertility meeting (2025) reported that women undergoing IVF who received NAD+ supplementation had roughly double the fertilization and clinical pregnancy rates of those who didn’t, in a retrospective analysis of women with diminished ovarian reserve. This is a real, presented finding — but it is a retrospective analysis, not a randomized trial, and conference abstracts have not gone through the same peer review as a full published paper. Retrospective data is also more vulnerable to selection bias: women who elected to take a supplement may differ from those who didn’t in ways that affect outcomes independent of the supplement itself.
The honest counterweight. No completed, peer-reviewed, randomized controlled trial of NAD+ precursor supplementation and IVF or natural conception outcomes in women currently exists in the published literature. General human safety data for NR is well established (Conze D, Brenner C, Kruger CL. Safety and metabolism of long-term administration of NIAGEN (nicotinamide riboside chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults. Sci Rep. 2019;9:9772. doi:10.1038/s41598-019-46120-z, Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9(1):1286. doi:10.1038/s41467-018-03421-7), but none of those trials measured fertility endpoints, egg quality, or reproductive hormones.
What NAD+ Restore won't do
NAD+ Restore is not a fertility treatment and does not test, measure, or guarantee any change to ovarian reserve, egg quality, or IVF outcomes. It has not been studied in a fertility trial. It is not a substitute for AMH testing, ovarian reserve assessment, or any protocol your reproductive endocrinologist recommends.
See a fertility specialist if you’ve been trying to conceive for 12 months without success (or 6 months if you’re over 35), or sooner if you have known risk factors for diminished ovarian reserve, irregular cycles, or a prior diagnosis affecting fertility. Timing matters more in fertility than in most areas of health, and self-directed supplement trials can cost months that a specialist could use more productively.
Dosing and realistic timelines
The animal studies used doses scaled to mouse body weight that don’t translate directly to a human dose. The human conference report did not detail an exact protocol in publicly available materials. General human NR safety data supports doses of 300–1000 mg daily for up to several months (Conze D, Brenner C, Kruger CL. Safety and metabolism of long-term administration of NIAGEN (nicotinamide riboside chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults. Sci Rep. 2019;9:9772. doi:10.1038/s41598-019-46120-z); NAD+ Restore provides 500 mg NR per serving, within that range. If you are actively pursuing IVF, bring any supplement — including this one — to your fertility clinic before your stimulation cycle, since some clinics have their own supplement protocols and timing preferences.
Frequently asked questions
Do fertility clinics actually recommend NAD+ precursors?
Some do, often alongside CoQ10, typically starting 4–8 weeks before an IVF stimulation cycle — but this practice is currently ahead of completed human trial data, based on animal research and preliminary reports.
Is NMN or NR better studied for fertility?
Most of the aging-mouse fertility research used NMN, while more of the general human safety data exists for NR; neither has a completed human fertility trial, so 'better studied for fertility' isn't really answerable yet for either.
Can NAD+ reverse diminished ovarian reserve?
Not based on current human evidence. Mouse data shows restored ovarian function with NAD+ repletion, but ovarian reserve in humans is not something a supplement has been shown to restore in a controlled trial.
How long before I’d expect to see any effect on egg quality?
Because oocyte maturation takes roughly 90 days from early follicle recruitment, any plausible effect (were one to exist) would need consistent supplementation over at least that window, which is also roughly the timeframe some clinics use when recommending pre-IVF supplementation.
A note before considering any supplement: Fertility treatment decisions, especially around IVF cycle timing and stimulation protocols, should be made with a reproductive endocrinologist. This article is general education, not a substitute for guidance from your fertility clinic, and nothing here should delay or replace recommended fertility testing or treatment.
From Nuvirox
Why we formulated NAD+ Restore
Each 2-capsule serving delivers 500 mg nicotinamide riboside chloride (NR) — one of the two most-researched NAD+ precursors, within the dose range used in published human trials — alongside 150 mg trans-resveratrol and 50 mg quercetin, polyphenols studied alongside NAD+ pathways for cellular health support, plus 10 mg fenugreek-derived galactomannans to support absorption.
Backed by a 60-day money-back guarantee — long enough to actually evaluate it the way the research says you should.
Learn more about NAD+ Restore →The bottom line
The biological logic connecting NAD+ to egg quality is sound, and the mouse data is some of the more convincing animal research in the NAD+ field. But for a decision as high-stakes and time-sensitive as fertility, the honest position is that human evidence hasn’t caught up to the animal data yet. If you’re considering an NAD+ precursor as part of a fertility plan, do it in coordination with your reproductive endocrinologist, not instead of their guidance.
References
- Bertoldo MJ, Listijono DR, Ho WH, et al. NAD+ repletion rescues female fertility during reproductive aging. Cell Rep. 2020;30(6):1670-1681. doi:10.1016/j.celrep.2020.01.058
- Wei C, Zeng X, Wang K, et al. Nicotinamide riboside supplementation protects against maternal diabetes-associated decline in oocyte quality. Reproduction. 2025. doi:10.1530/REP-24-0350
- Conze D, Brenner C, Kruger CL. Safety and metabolism of long-term administration of NIAGEN (nicotinamide riboside chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults. Sci Rep. 2019;9:9772. doi:10.1038/s41598-019-46120-z
- Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9(1):1286. doi:10.1038/s41467-018-03421-7
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is for informational purposes only and is not a substitute for professional medical advice.