Fertivor Information Catalog

Information Catalog

Fertivor®

Fertivor® is a nutritional female fertility supplement intended to be used as an adjuvent treatment for patients taking ovulation inducing medication such as Clomiphene Citrate. Fertivor® has shown to promote the production of cervical mucus, supports the ‘thinning’ of the mucus, increases hydration of the mucin, promotes a healthy uterine lining and mucus alkalinity.

Fertivor® is a specialized product which is recommended for ovulation support as well as with the use of prescription medication such as clomiphene citrate, Letrozole, Metformin and Medroxyprogesterone. The ingredients contained in Fertivor® have shown to counteract the side-effects of longterm use of prescription medication. These side effects include thinning of uterine lining, mucus acidity and vaginal dryness.

Prescription medication and potential side effects

Although ovulation inducing medication has shown to be of great benefit, some of these medications do have some side effects which can often impair fertility or successful conception. Fertivor ® has been developed to not only help with ovulation but also to act as an adjuvant treatment which can counter these side effects.

Clomiphene Citrate

Clomiphene Citrate is a prescription medication (ovulatory stimulant) that is often prescribed to patients diagnosed with PCOS or/and patients who suffer from anovulation (Nasseri & Ledger, 2009). Some women might encounter some side-effects from Clomiphene Citrate treatment. One of these side effects are the thinning of the uterine lining due to Clomiphene Citrate’s antiestrogenic effect (Takasaki, et al., 2013). Studies show that a thin endometrium is one of the most common factors of implantation failure (Takasaki, et al., 2013). If the uterine lining of the patient is not thick enough (+- 8mm) it may be difficult for a fertilized egg to attach to the uterine lining (this side effect occurs between 25% to 30% of Clomiphene citrate users) (The Prelude Network, 2020).

Clomiphene Citrate has also been known to have a negative effect on cervical mucus (Youssef, et al., 2006). Clomiphene citrate has shown to reduce production of cervical mucus as well as thickening of cervical mucus; this is due to its anti-estrogenic effect (The Prelude Network, 2020). Sperm cells need a sperm friendly environment (clear, watery mucus) and a thicker cervical mucus makes it difficult for sperm to pass through and fertilize the egg (The Prelude Network, 2020).

Fertivor® promotes the production of Cervical mucus, hydrates cervical mucus due to its mucolytic properties, and assists in the formation of a thick uterine lining for attachment of the fertilized egg. Therefore Fertivor® is a great supportive treatment to take with Clomiphene citrate to counteract the side effects mentioned.

Medroxyprogesterone

Medroxyprogesterone is used to help regulate ovulation and menstrual periods. As Medroxyprogesterone is used to regulate menstrual periods and is so prescribed for patients trying to fall pregnant who do not have regular menstrual cycles (Seli & Arici, 2021). It is recommended for use for 10 days and after that, a patient can expect bleeding from 2-10 days later. This regimen is often used for women who are trying to conceive and who fail to have regular menstrual cycles. This process is aimed at initiating an artificial cycle for Clomiphene Citrate treatment to be initiated (Seli & Arici, 2021).

Fertivor® is suited for use with Medroxyprogesterone as it assists in keeping the uterine lining thick enough as well as creating a perfect uterine environment for intended ovulation to follow either naturally or by way of Clomiphene citrate treatment.

Letrozole

Letrozole is an aromatase inhibitor that is prescribed for ovulation induction (Yang, Cui, Sun, & Hao, 2021). Letrozole blocks an enzyme in the body which converts male hormones to female hormones- this will result in a decrease level of estrogen. This decrease in estrogen tells the pituitary gland to make more Follicle Stimulating Hormone (FSH)- this will stimulate the ovary to produce eggs and follicles (Requena, et al., 2008). Whilst Letrozole is used for ovulation induction and less reported side effects as Clomiphene Citrate, patients still need a prescription for letrozole which is an indication that the patient has not been able to fall pregnant for some time.

Fertivor® should be taken with Letrozole to create the perfect vaginal and uterine environment for conception, as conception at the point of being prescribed Letrozole has become increasingly difficult. Fertivor ® promotes the production of healthy fluid mucus, promotes thickening of uterine lining, and create a sperm-friendly environment for fertilization.

Metformin

Metformin was initially developed for patients with type 2 diabetes but has now commonly been prescribed for patients who suffer from PCOS due to its ability to improve insulin sensitivity (Haas & Bentov, 2017). Metformin is also prescribed to patients with PCOS who are resistant to Clomiphene Citrate (Johnson, 2014). Furthermore, the inclusion of N-Acetyl-Cysteine in Fertivor® reduces insulin resistance and restores ovulation rates in patients with PCOS (Youssef, et al., 2006).

Fertivor® and Metformin are a good combination in as far as insulin resistance is concerned but also many women who suffer from PCOS often have thick cervical mucus that makes it difficult for sperm to pass through to fertilize the egg. Fertivor ® hydrates cervical mucus and increases fluidity of mucus for sperm to pass through for fertilization.

Fertivor® Ingredients

The ingredients below all play a crucial role in the important features of Fertivor® which is the fluidity and production of cervical fluids, mucosal thinning and hydration of mucin, healthy vaginal pH balance, and healthy uterine lining for attachment of blastocyte.

N-Acetylcysteine (NAC)

NAC is a nutritional supplement that has significant antioxidative effects in vivo and in vitro (Mokhtari, Afsharian, Shahhoseini, Kalantar, & Moini, 2017). NAC has insulin-sensitizing properties, increases ovulation and pregnancy rates, as well as have a mucolytic action cervical mucus. (Mokhtari, Afsharian, Shahhoseini, Kalantar, & Moini, 2017).

NAC and Polycystic Ovary Syndrome (PCOS)

PCOS is a ‘’syndrome,’’ or group of symptoms that affects the ovaries and ovulation. Its three main features are presence of cysts in the ovaries, high levels of male hormones and irregular menstrual cycles (Carmina & Lobo, 1999).

rates and ovulation in patients that have clomiphene resistant PCOS (Youssef, et al., 2006). NAC is seen to have a mucolytic action that can counter the negative effects that clomiphene citrate has on mucous in the cervix (Youssef, et al., 2006).

Furthermore, NAC has also an insulin sensitizing effect that may help patients with PCOS and ultimately lead to positive pregnancy rates (Youssef, et al., 2006). NAC and Ovulation

Women with PCOS produce higher-than-normal amounts of male hormones. This hormone imbalance causes them to skip menstrual periods and makes it harder for them to get pregnant.

Studies have shown that NAC can improve ovulation rates (Mokhtari, Afsharian, Shahhoseini, Kalantar, & Moini, 2017). A study where clomiphene was used with and without NAC indicated that ovulation rate increased by 52% with the addition of NAC and this is compared to a previous cycle when the women took clomiphene citrate alone where ovulations rates improved by a mere 18% (Badawy, 2007).

A common medication option for women with PCOS is usually clomiphene citrate. However, one of the most common problems with clomiphene citrate treatment is that up to 40% of women with PCOS are resistant to clomiphene citrate (Nasr, 2009). However, NAC has been seen to be a mucolytic drug with insulin-sensitizing effects that has been used as an adjuvant therapy in PCOS patients that are clomiphene citrate resistant (Youssef, et al., 2006). It is known that the combination of NAC and clomiphene citrate can increase pregnancy

Furthermore, studies also suggest that NAC provides a beneficial role in endometrial thickening while used in conjunction with Clomiphene citrate (Salehpour, Sene, Saharkhiz, Sohrabi, & Moghimian, 2012).

Within a study of 180 infertile PCOS patients, the group of women that took Clomiphene citrate with NAC had higher ovulation and pregnancy rates than the group that only took Clomiphene citrate without NAC (Salehpour, Sene, Saharkhiz, Sohrabi, & Moghimian, 2012).

NAC and Egg Quality

NAC has also been shown to improve egg quality (Cheraghi, Mehranjani, Shariatzadeh, Esfahani, & Ebrahimi, 2016). This is particularly important if patients are going through IVF treatments or are trying to fall pregnant after the age of 35. In a study of women suffering from PCOS, the group who received a NAC supplement saw a decrease in the amount of abnormal ovarian cells and the most significant increase in embryo quality when compared to other groups and therefore NAC can improve the quality of your eggs and their chances of fertilization (Cheraghi, Mehranjani, Shariatzadeh, Esfahani, & Ebrahimi, 2016).

NAC and Premature birth or pregnancy loss

Intrauterine and Maternal infections are some of the causes of preterm birth- this is a significant risk factors for preterm birth and neonatal brain injury (Buhimschi, Buhimschi, & Weiner, 2003). Rising infections with bacterial vaginosis during pregnancy is related to a risk factor for preterm delivery and low birth weight (Hillier, et al., 1995). NAC by having an anti-inflammatory outcome can affect human term and preterm labors as NAC restrains the inflammatory response with no respect whether infection is started before or after treatment initiation with the drug (Buhimschi, Buhimschi, & Weiner, 2003).

Folic Acid

Folic Acid and Neural Tube Defects

It has become a commonly known fact that the use of Folic Acid (which is part of the B vitamin group) before pregnancy prevents neural tube defects (Laanpere, et al., 2010). Therefore, public health authorities all over Europe recommend an intake of 400 ug folate per day for women of reproductive age (Regidor, Schindler, Lesoine, & Druckman, 2018).

L-Arginine

Folic acid is important to take during and before pregnancy as Folic acid can help grow and protect cells in the patient’s body as well as assist in the development of DNA and this is important for the uterus to expand, the placenta to develop, blood circulation to increase, and the foetus to grow (Laanpere, et al., 2010).

Studies have shown that L-Arginine can help thicken the uterine lining. The thinning of the uterine lining occurs in many women and is often caused by ovulation enhancing drugs such as clomiphene citrate or women who suffer from, often undiagnosed, polycystic ovary syndrome (PCOS). Clomiphene Citrate is an estrogen suppressing medication which is often prescribed by doctors to trigger ovulation. During a normal menstrual cycle, estrogen works to thicken the uterine lining to prepare for implantation of the fertilized embryo. Reproductive endocrinologists prefer the endometrial lining to be at least 8mm thick during infertility treatment. The anti-estrogenic effect of clomiphene citrate can prevent endometrium thickening in 25-30% of women (Gadalla, et al., 2017)

For women with a thin uterine lining, L-arginine may help improve the thickness of the lining (Takasaki, et al., 2010). Adequate thickness of the endometrium, or uterine lining, is important for supporting a pregnancy (Zhao, Zhang, & Li, 2012). A thin lining is less than 8mm and L-arginine treatment has been shown to increase the thickness of the endometrial lining as shown in a study where 6 of 9 patients with a thin lining who took L-arginine, the endometrial lining increased to greater than 8 mm (Takasaki, et al., 2010)

Furthermore, L-Arginine may improve ovarian response, endometrial receptivity and pregnancy rate- within a study the group who took L-Arginine had increased number of oocytes and embryo transfer was observed (Battaglia, et al., 1999).

Ascorbic Acid (Vitamin C)

Studies have shown that Vitamin C helps improve the amount and constancy of the cervical mucus. It works by increasing the amount of water that the mucus contains. It also increases blood flow to the uterus which makes the uterine lining hospitable for implantation (Thakor, Herrera, Seron-Ferre, & Giussani, 2010).

Grape Seed Extract

Grape Seed Extract has been included in Fertivor® to act as a powerful antioxidant to counteract oxidative stress and inflammation in the female reproductive system. The ovarian processes are regulated by various hormonal signalling molecules that are themselves controlled by several physiological regulators including reactive oxygen species (ROS) which are produced in the ovarian follicle and corpus luteum.

Vitamin C plays a critical role in the rearranging of the cervical mucus fibers during ovulation. Without adequate Vitamin C, changes in cervical mucus around ovulation that create the sperm pathway cannot adequately occur. Vitamin C in the blood stream has also been found to penetrate cervical mucus where it can support sperm function and vaginal immunity.

Zinc Gluconate

Zinc is the most widely studied nutrient in terms of fertility for both men and women. It is an essential component of genetic material, and a zinc deficiency can cause chromosome changes in either you or our partner, leading to reduced fertility and an increased risk of miscarriage (Favier, 1992). Zinc is necessary for the body to ‘attract and hold’ (utilize efficiently) the reproductive hormones, estrogen, and progesterone (Ebisch, Thomas, WHM, Braat, & Steegers, 2007).

ROS play a crucial role in follicular development and survival. The effects of oxidative stress on female reproduction have been widely researched - ROS molecules are important in regulating cell signalling of excess ROS production and that can induce oxidative damage leading to poor ovulation rates and infertility (Agarwal, Gupta, Sekhon, & Shah, 2008).

Furthermore, Grape seed extract has been recognized for its capabilities of improving egg quality (Barbe & al., 2020).

L-Histadine

L-Histadine is important when undergoing IVF for the regulation of human endometrial endothelial cell angiogenesis (forming of new blood vessels) (Lindgren, 2016).

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