Does NAD+ Improve Egg Quality? What the Evidence Actually Shows

Recently, a 27-year-old woman died after receiving an intravenous NAD+ infusion at a lifestyle center in the Bronx. We do not yet know what killed her. The medical examiner’s finding is still pending, and the cause could have been the NAD+ itself, contamination, an allergic reaction, or something else entirely.

The case has brought up an important conversation with many of my patients about the efficacy and safety of a growing trend: using NAD for fertility, particularly NAD IV therapy, in an effort to improve egg quality. This is not the first intervention marketed this way. We have seen similar promises surrounding PRP for ovarian rejuvenation. Anyone who has followed me for a while, or has read my book, knows that I am skeptical of any fertility treatment that is not backed by real, data-driven science. While this unfortunate death is why people are asking about this now, my concern with this treatment boils down to those same 4 words that I will never get tired of saying: show me the data! My concern with the use of NAD IV therapy in the hopes of improving egg quality is not just the exorbitant money patients are spending on an unproven treatment, but also that it’s another avenue for wasting your most precious commodity: time.

I’m Dr. Lucky Sekhon, a double board-certified Reproductive Endocrinologist and Infertility specialist practicing in New York City. Through this blog, my Instagram platform, and my book, The Lucky Egg: Understanding Your Fertility and How to Get Pregnant Now, I help patients cut through fertility misinformation, overhyped wellness treatments, and expensive IVF add-ons with (what I hope is) clear, compassionate, and scientifically grounded guidance. If you are interested in staying up to date with my latest updates on fertility and reproductive health, consider subscribing to my monthly newsletter or following me on Instagram. In this post, I’ll walk you through what NAD+ is, what we actually know (and don’t know) about its role in fertility, and how to think critically about whether treatments like this are truly worth your time, money, and hope.

The Biological Theory Behind NAD+ Is Genuinely Plausible

Let me start by being generous to the science, because the theory behind NAD for fertility is not absurd. NAD+, oftens imply written as NAD, is present in every cell in the body and is essential to normal cellular function. It acts as a cofactor that helps mitochondria produce energy. It is also consumed by enzymes involved in repairing damaged DNA.

Both of those functions are highly relevant to eggs.

Eggs are unusually dense in mitochondria because they require an enormous amount of energy to mature, organize and separate their chromosomes, undergo fertilization, and support the earliest stages of embryo development.

Think of an egg as a spacecraft preparing for launch. Its chromosomes contain the flight plan, but the mitochondria provide the fuel. If the energy system is faltering, it makes biological sense to ask whether improving that system could help the egg function more effectively.

This is the premise behind NAD+ and egg quality. If aging disrupts mitochondrial energy production and DNA repair, increasing NAD+ availability could theoretically improve the cellular environment within an aging egg.

I understand why this is appealing. I also understand why patients going through IVF are willing to try it. During my own fertility journey, I experienced canceled cycles, disappointing ovarian responses, and a retrieval that yielded only two mature eggs, neither of which became an embryo. Even as a fertility doctor who knew the science, I felt the same desperation my patients describe: the urge to find one more thing I could do to change the outcome.

When a theory offers the possibility of improving egg quality, it can feel like being handed a new lever to pull on the fertility slot machine. But a plausible theory is not the same thing as a proven treatment. A 2026 review in Biology of Reproduction concluded that fundamental questions remain unanswered, including how NAD+ and its precursors enter ovarian cells and which precursor forms are actually biologically effective.

I believe that before we, as physicians, prescribe an expensive infusion to patients, we should at least know whether the compound reaches the tissue we are trying to treat.

Right now, we do not.

We Do Not Know Whether NAD+ Declines Inside Aging Ovaries

One of the major claims used to promote NAD IV therapy is that NAD+ levels decline as we age and therefore need to be replenished.

A 2026 study by Trętowicz and colleagues examined that assumption across seven independent human cohorts involving 303 participants in three countries. Whole-blood NAD+ levels remained stable across age. All six age comparisons were null. NAD+ levels were also stable across differences in frailty and elite-athlete status.

The test itself was able to detect change. When participants received nicotinamide riboside supplementation, their whole-blood NAD+ levels increased. That means the age-related null result cannot simply be dismissed as a failure of the test to pick up differences.

There is an important caveat, and I do not want to gloss over it: this study measured whole blood, not ovarian tissue. NAD+ levels within the ovary could still decline with age. The study does not rule that out. But it also does not support the broad claim that everyone’s NAD+ levels are steadily falling and require intravenous replacement. It tells us that the story is more complicated than the marketing language makes it sound.

This distinction matters. “We do not know what is happening inside aging ovaries” is scientifically honest. “Your NAD+ is low and this infusion will restore your egg quality” is not supported by the available human evidence.

The Evidence Gets Weaker as It Moves Closer to Human Fertility

When I evaluate a fertility treatment in my practice, I look at the hierarchy of evidence.

Does it work in cells?
Does it work in animals?
Does it work in humans?
Does it improve the laboratory result we care about?
And ultimately, does it help more patients have healthy babies?

For NAD+, the evidence becomes thinner at every step.

Lab Studies Suggest NMN Can Affect Egg Function, but Only Under Specific Conditions

A 2025 study published in Scientific Reports examined what happened when researchers added nicotinamide mononucleotide, or NMN, directly to cow eggs in a laboratory dish. NMN is a precursor that cells can use to produce NAD+.

The treatment improved measures of mitochondrial function and reduced chromosome errors. That sounds encouraging, but the results were not consistent across all doses or outcomes. Blastocyst formation improved only at the highest concentration tested. At a concentration ten times lower, there was no effect on blastocyst formation. Egg maturation rates were no different between the groups.

This study is valuable because it supports the biological theory. It suggests that directly exposing eggs to a sufficient concentration of NMN may influence mitochondrial function and chromosome organization.

But an egg immersed in a specific concentration of NMN inside a laboratory dish is not equivalent to a human ovary after an intravenous NAD+ infusion. A concentration in a dish has no direct corresponding dose in a human bloodstream. We do not know how much of an infusion remains intact, how much reaches the ovary, or whether any of it enters the egg.

Mouse Research Supports the Theory, Not NAD+ Infusions in Humans

The strongest fertility data supporting the concept come from a 2020 study in aged mice. In that study, NMN restored egg quality, improved ovulation, and recovered fertility in older animals. This was an exciting result. It offered a genuine proof of concept that manipulating the NAD+ pathway could influence reproductive aging in a living organism.

But there are two major gaps between this experiment and the treatment being sold to patients.

First, and this is a pretty big one: these were mice, not humans. While animal research is an essential step in understanding biology, but reproductive treatments that work in mice do not automatically work in women. Mouse ovaries, metabolism, reproductive lifespan, and medication exposure are not interchangeable with ours.

Second, the mice received NMN, a precursor the body converts into NAD+. They did not receive an intravenous NAD+ infusion. That may sound like a minor technical distinction, but it is not. Different molecules can be absorbed, transported, broken down, and used by cells in very different ways. Evidence for NMN in mice cannot be used as direct proof that IV NAD+ improves egg quality in humans.

It is like showing that watering a plant at its roots helps it grow, then assuming that misting the air somewhere nearby must have the same effect. The underlying ingredient may be related, but the delivery system matters.

The Only Reported Human Fertility Study Cannot Show That NAD+ Improves IVF Outcomes

The only reported human fertility study involved 112 women who received 200 milligrams of IV NAD+ once a week for ten weeks between a baseline IVF cycle and a second cycle.

Each woman served as her own comparison.

The average number of mature eggs increased from 4.06 during the first cycle to 6.06 during the second. That works out to approximately two more mature eggs per cycle.

This same result has been described elsewhere as a nearly 50 percent increase. Both descriptions can be mathematically true. But as a fertility doctor, I care less about how the result is framed and more about what it meant clinically.

Did those two additional eggs create blastocysts? Were the embryos chromosomally normal? Did more women undergo embryo transfer? Did anyone become pregnant or have a baby?

We do not know.

The study stopped at day three. It did not report chromosome testing, embryo transfers, pregnancies, or live births.

It also had no control group and no blinding. This is the same problem I ran into when I looked at the evidence behind the Mucinex fertility myth. Each participant underwent one IVF cycle, received the infusions, and then underwent another cycle.

Back-to-back IVF cycles inherently create a bias in favor of the second attempt. After a first cycle, your fertility doctor has more information. We may adjust the medication dose, change the stimulation protocol, alter the trigger shot, or modify the timing of retrieval based on what happened the first time.

That is exactly what happened during my own IVF experience. After a canceled cycle and a retrieval with a disappointing outcome, adjustments were made to my protocol. A later cycle went better. That does not mean every change I made between those cycles caused the improvement. IVF outcomes can vary, sometimes dramatically, from one attempt to the next.

Without a placebo group, blinding, or controls for protocol changes, we cannot confidently attribute the additional eggs to NAD+.

Most importantly, this study has not been peer-reviewed or published. It should not be cited as established proof that NAD IV therapy improves human fertility.

Two extra eggs observed on day three may sound promising, particularly to someone with diminished ovarian reserve. But two eggs tell us nothing about whether anyone ultimately had a baby.

Nobody Has Measured Whether Infused NAD+ Reaches the Ovaries

Before asking whether IV NAD+ improves the ovary, we need to know what happens after it enters a vein. The entire human evidence base describing the metabolism of infused NAD+ comes from one pilot study involving 11 men. No woman has ever been studied The study found that much of the infused dose was rapidly broken down into byproducts. Some of those byproducts were excreted in urine. No tissue concentrations were measured anywhere in the body.

The authors themselves called for further research to determine where the infusion goes and how it is processed. This study does not prove that IV NAD+ fails to reach the ovaries. It does not prove that it is cleared before it gets there. It does not prove that it has no biological effect.

The honest statement is more limited: nobody has ever measured whether infused NAD+ reaches a human ovary.

That is an enormous unanswered question for a treatment being marketed specifically to improve egg quality.

NAD+ Infusion Safety Appears to Depend on How and Where It Is Administered

Unproven and unsafe are two different accusations. A treatment can lack evidence of benefit without necessarily being dangerous. It can also appear safe under one set of conditions and become much harder to tolerate under another. In a slow, six-hour NAD+ infusion administered under clinical supervision, no adverse events were recorded, and there were no clinically significant changes in liver function.

A separate 2026 study performed at a commercial wellness clinic used a faster infusion protocol and found a very different experience. Every participant reported moderate-to-severe symptoms, including abdominal cramping, diarrhea, nausea, vomiting, increased heart rate, throat pain, and chest pressure. The infusions had to be slowed substantially to become tolerable. Symptoms resolved once the infusions ended, and bloodwork did not show significant changes.

Taken together, these studies suggest that infusion rate may be an important variable. That is not a minor logistical detail. It is a concrete reason why a slow infusion administered under an established clinical protocol is not necessarily equivalent to a treatment delivered in a wellness storefront.

The recent death in New York does not prove that NAD+ itself is dangerous. We do not yet know what caused that young woman’s death. But the case does underscore why the setting, qualifications of the person administering the infusion, sourcing of the product, sterility, dosing, and emergency protocols matter.

There are currently no long-term safety data for NAD IV therapy in fertility patients. There is no established fertility dose. There is no standardized infusion rate or protocol.

In New York, NAD IV therapy requires a prescription from a licensed medical professional. That regulatory requirement matters in the context of what state investigators are finding in the wellness industry. The New York Department of State has completed 337 inspections of med spas, shut down 24 by emergency order, and revoked 16 licenses. Investigators reportedly found expired drugs, counterfeit products, and fentanyl. In January 2026, the state issued a public warning about unlawful med spas. This is not a theoretical concern. It is evidence that the environment in which an infusion is prescribed, sourced, and administered can carry risks of its own.

When a treatment lacks both an established benefit and a standardized method of administration, “it probably cannot hurt” is not a sufficient safety argument.

Commercial Interests Are Tied to Much of the Existing Evidence

Whenever I review a small evidence base, I also look at who funded the work and whether the people or institutions involved have a commercial interest in the outcome.

This does not mean industry-funded research should automatically be discarded. Many important medications and technologies are developed with commercial funding. The relevant issue is transparency and whether the findings are independently replicated.

The landmark aged-mouse study disclosed sponsored research funding from a company founded to commercialize NAD+ fertility treatments! One author was an employee of that company!!

The only human study examining what happens after an NAD+ infusion was funded by an NAD+ research company. It was conducted at a wellness center that sells IV NAD+ therapy, and the NAD+ used in the study was donated by a compounding pharmacy.

These are disclosures the authors made themselves.

This pattern is not unique to NAD+. I have written before about why undisclosed financial stakes in the products being recommended should make us look more closely at how fertility advice is presented and what evidence supports it.

This is how you read an evidence base critically. You do not dismiss the research solely because a commercial interest exists. But you also do not ignore that two of the three major pillars supporting the intervention come from parties with a financial stake in NAD+ products or services.

Independent replication matters, especially before asking patients to spend thousands of dollars.

The Bottom Line

If a patient sitting in my office asked whether she should pay for NAD IV therapy before her next IVF cycle, I would tell her that the biological theory is interesting and genuinely reasonable. I would also tell her that we do not yet have the human evidence needed to recommend it.

We have data from cow eggs exposed directly to NMN in a dish. We have a compelling study in aged mice that received an NAD+ precursor. We have one unpublished, non-peer-reviewed study in women that reported approximately two additional mature eggs but stopped before chromosome testing, embryo transfer, pregnancy, or birth.

We do not know whether infused NAD+ reaches the ovary. We do not have an established fertility dose, a standardized protocol, or long-term safety data. That is not the same as saying NAD+ will never have a role in reproductive medicine. I hope it does.

Fertility doctors, like myself, want reproductive aging solved more than anyone. We sit across from patients after canceled IVF cycles, failed retrievals, abnormal embryo results, and pregnancy losses. I have also experienced the disappointment of failed and canceled cycles personally. I understand the pull to do something, anything, that might improve the next result.

What makes this trend difficult to watch is not the possibility that NAD+ might eventually work. It is watching the marketplace move ahead of its own evidence.

The recent death in New York is a tragedy, and it has understandably focused attention on the safety of NAD IV therapy. But even before that happened, the scientific argument remained the same: patients deserve proof before they are asked to invest their money, time, and hope.

For now, focus on the things you can meaningfully control. Seek a thorough fertility evaluation. Work with a double board-certified fertility specialist and an experienced IVF laboratory. Address correctable health factors. Avoid smoking. Be thoughtful about supplements, and do not delay time-sensitive fertility treatment for an intervention that has not been shown to improve live birth.

Your fertility journey already asks so much of you. You should not also have to carry the burden of sorting scientific evidence from expensive promises alone.

If you found this post helpful, follow me on Instagram or subscribe to my monthly newsletter, The Lucky Egg Drop, for clear, evidence-based updates on fertility and reproductive health. If you are in the New York City area and are looking for personalized guidance on egg quality, diminished ovarian reserve, or your IVF treatment plan, you can also book a consultation with me to discuss the options that make sense for your individual circumstances.