What is an NAD⁺ infusion?
NAD⁺ (Nicotinamide Adenine Dinucleotide) is an endogenous coenzyme that plays a central role in mitochondrial energy metabolism (ATP synthesis) and cellular repair mechanisms. NAD⁺ supports enzymes responsible for DNA repair, cell regeneration, and protection against oxidative stress. With increasing age or elevated oxidative stress, NAD⁺ levels in the body decrease. Energy-intensive tissues such as heart muscle, nerve cells – and also oocytes – are particularly affected.
Since oocytes have a very high energy requirement for their maturation, and mitochondrial function as well as cellular NAD⁺ levels physiologically decrease with advancing age, a possible connection with egg quality is scientifically discussed. Whether they can improve egg quality or increase the chances of pregnancy and live birth has not yet been proven by robust clinical studies.
During an NAD⁺ infusion, NAD⁺ is administered slowly intravenously. The underlying approach is to influence the availability of this coenzyme. Whether this actually achieves an effect relevant to oocyte maturation in the ovary is not yet sufficiently clear.
When can NAD⁺ infusions be considered for fertility treatment?
Questions about complementary treatments often arise with increasing age, reduced ovarian reserve, or after IVF/ICSI treatment with abnormal oocyte maturation or embryonic development. However, such findings are not automatically a reason for an NAD⁺ infusion. Since it is not an established standard procedure, its application can only be discussed as part of an individual therapeutic trial and as a purely complementary option in specific constellations, such as:
- advanced maternal age (especially from 40 years)
- reduced ovarian reserve (e.g., very low AMH value)
- repeatedly low embryo quality or abnormal development in previous IVF or ICSI treatments
In a personal consultation, we review your findings and previous treatments. We also explain what is known about complementary measures and where their limitations lie.
What does research know about NAD⁺ and egg quality?
Animal and laboratory studies indicate that NAD⁺ metabolism is related to oocyte function and aging. NAD⁺ precursors such as nicotinamide mononucleotide (NMN) have often been investigated. Initial studies on human oocytes in the laboratory are also available. However, these results do not constitute proof of efficacy for infusion treatment in women seeking fertility (Bertoldo et al. Cell Rep. 2020; Zhang et al. Front Endocrinol (Lausanne). 2025).
Scientifically valid, statistically significant evidence (proof) that NAD⁺ infusions improve egg quality, increase embryonic development rates, or raise live birth rates in humans is currently not available. The method is in the stage of clinical research.
Medical Assessment of NAD⁺ Infusions
Innovative therapy
We closely follow new approaches in fertility medicine. At the same time, it is important for us to distinguish scientific considerations from proven benefits for our patients.
For oocyte maturation and early embryonic development, a functioning cellular energy supply is important. NAD⁺ plays a central role in the metabolism of mitochondria, the cell’s “powerhouses.” In addition, certain enzymes require NAD⁺ for cellular protection and repair processes. Therefore, it is being investigated whether influencing NAD⁺ metabolism could support the function and maturation of oocytes.
An important research approach is provided by a study published in 2020 by Bertoldo and colleagues: In older mice, improvements in oocyte function and fertility were observed through the administration of the NAD⁺ precursor nicotinamide mononucleotide (NMN). The study also showed beneficial effects on early embryonic development. These results indicate that NAD⁺ metabolism plays a role in age-dependent changes in oocytes (Bertoldo et al. 2020).
However, results from animal experiments cannot be directly transferred to human treatment. Even initial studies on human oocytes in the laboratory do not yet answer the question of whether infusion treatment benefits patients.
Whether NAD⁺ infusions improve egg quality or increase the chances of pregnancy and live birth has not yet been proven by robust clinical studies. Initial clinical observations are not yet sufficient for a reliable assessment (Tandulwadkar et al. 2026).
Therefore, we consider NAD⁺ infusions to be a complementary, experimental therapeutic approach with unproven benefits. Before a possible application, we discuss with you the scientific considerations, the limits of current knowledge, as well as potential risks and costs. An NAD⁺ infusion is not a necessary component of fertility treatment and should neither replace nor delay established therapy.
Procedure for NAD⁺ Infusion for Fertility
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Medical Consultation and Information
First, we discuss your medical history, previous fertility treatments, pre-existing conditions, and medications. We explain the experimental nature of the treatment and check for any contraindications to an infusion.
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Individual Planning
If you decide to proceed with the treatment after the consultation, the dosage (e.g., 250 mg or 500 mg), number, and intervals of infusions will be agreed upon in advance. There is currently no scientifically proven treatment regimen to improve fertility.
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Infusion Administration
The infusion is administered slowly intravenously in a calm atmosphere. Depending on the dosage and individual tolerance, the treatment usually takes between 2.5 and 4 hours.
What Our Patients Say
Costs for an NAD⁺ Infusion
The cost for an NAD⁺ infusion is 385 Euros and depends on the dosage and number of infusions, which will be discussed individually.
To the cost overviewThe actual costs depend on the dosage and the agreed scope of treatment. Before starting, you will receive an overview of the estimated costs. Billing is done according to the German Medical Fee Schedule (GOÄ).
Make an appointmentNo fixed or flat-rate prices: We bill on the basis of the official scale of fees for doctors (GOÄ). According to the GOÄ, we are not allowed to quote fixed or flat-rate prices for medical services. The prices mentioned are intended to provide orientation and are typical for the treatments mentioned.
Possible VAT liability: Medical services may be subject to VAT (currently 19%). This applies if, after diagnostics have been carried out, no medical indication or confirmed diagnosis is present and it is therefore not a medical treatment in the strict sense. This can be the case in particular with social freezing treatments, but also with the treatment of single moms and same-sex couples.
We would be happy to provide you with detailed cost information for the planned treatment in advance. This allows you to clarify cost coverage with your private health insurance (PKV) as best as possible beforehand. Statutory health insurance (GKV) does not cover costs at our center.
Frequently Asked Questions about NAD⁺ Infusions for Fertility
Can NAD⁺ infusions improve egg quality?
This has not yet been sufficiently proven. The approach is based on the theoretical importance of NAD⁺ for cellular energy metabolism and initial promising laboratory studies. Whether an infusion actually improves the maturation and developmental capacity of human oocytes in the body cannot yet be reliably deduced from the current research results.
For whom might a trial treatment be beneficial?
Since this is not a standard therapy, its application as a purely complementary measure (add-on) can be discussed in selected individual cases. This usually concerns women of advanced maternal age (from 38 years) or with a demonstrably severely reduced ovarian reserve (low AMH value), or if previous IVF cycles have shown significant abnormalities in embryonic development.
How many NAD⁺ infusions are advisable for fertility treatment?
There is no scientifically proven recommendation regarding the number or frequency. If a treatment is agreed upon, we will discuss its scope and limitations beforehand. More infusions do not automatically mean greater benefit.
How long does it take for NAD⁺ to affect oocytes?
There is no reliable timeframe for this. Since a clinical benefit of NAD⁺ infusions for oocyte maturation in humans is not yet established, no scientifically proven onset of action can be stated.
Are NAD⁺ infusions a substitute for fertility treatment?
No. NAD⁺ infusions are not an independent fertility therapy and do not replace reproductive medical treatment. They can be discussed as a complementary measure within the framework of an individual treatment concept.
What side effects can occur with NAD⁺ infusions?
NAD⁺ infusions are generally well-tolerated under medical supervision, as NAD⁺ is an endogenous coenzyme. However, if the infusion flows too quickly, temporary symptoms such as a feeling of warmth (flush), pressure in the head or chest area, and mild nausea often occur. These symptoms are harmless and quickly subside after slowing down the infusion rate. A bruise may develop at the injection site. The infusion must not be used during pregnancy.
References:
Bertoldo MJ, Listijono DR, Ho WJ, Riepsamen AH, Goss DM, Richani D, Jin XL, Mahbub S, Campbell JM, Habibalahi A, Loh WN, Youngson NA, Maniam J, Wong ASA, Selesniemi K, Bustamante S, Li C, Zhao Y, Marinova MB, Kim LJ, Lau L, Wu RM, Mikolaizak AS, Araki T, Le Couteur DG, Turner N, Morris MJ, Walters KA, Goldys E, O’Neill C, Gilchrist RB, Sinclair DA, Homer HA, Wu LE. NAD+ Repletion Rescues Female Fertility during Reproductive Aging. Cell Rep. 2020 Feb 11;30(6):1670–1681
Zhang Q, Yang H, Yang D, Lu H, Xiong M, Xie L, Fan Y, Zhang K, Zhang C, Ye T, Ding D, Zou W, Ji D, Chen B, Wang Q, Zou H, Zhang Z. NADH supplementation improves human oocyte maturation and developmental competence of resulting embryos in controlled ovarian hyperstimulation cycles: a pilot study implicating the CDK2/GAS6 signaling pathway. Front Endocrinol (Lausanne). 2025 Sep 3;16:1627679
Tandulwadkar, S. (2026). Intravenous NAD⁺ as an Adjunct to IVF in Diminished Ovarian Reserve: The first Indian within-Subject (Before-After) Study of Oocyte Yield, Oocyte Competence, and Day‑3 Embryo Quality. Ruby Hall Clinic. ResearchGate