Resveratrol for Fertility
Resveratrol should NOT be routinely recommended for treating fertility issues, as current evidence is insufficient to support its clinical use, and there are significant safety concerns regarding its anti-deciduogenic effects on the endometrium that could impair implantation and pregnancy outcomes. 1, 2
Evidence Quality and Guideline Recommendations
The most recent and authoritative guidelines explicitly address antioxidant therapy for male infertility, which directly applies to resveratrol as a polyphenolic antioxidant:
The 2025 European Association of Urology guidelines state that evidence for antioxidant therapy in male infertility remains conflicting, with a Cochrane review of 61 studies showing that when high-risk-of-bias studies were removed, the apparent increase in live birth rates disappeared 1
The quality of evidence supporting antioxidant use is low, and no conclusive recommendations can be drawn for their use in idiopathic infertility 1, 2
The American Urological Association/American Society for Reproductive Medicine (2021) explicitly advises clinicians to inform patients that supplement benefits have questionable clinical utility in treating male infertility 2
Critical Safety Concerns for Female Fertility
While resveratrol may theoretically improve ovarian function through SIRT1 upregulation and antioxidant effects, there are serious contraindications:
Resveratrol has anti-deciduogenic actions in the uterine endometrium, downregulating the CRABP2-RAR pathway and suppressing decidual changes essential for embryo implantation and placentation 3
Resveratrol should be avoided during the luteal phase and pregnancy due to its potential to impair implantation and because teratogenicity has not been ruled out 3
This creates a problematic clinical scenario where any potential benefit on ovarian function is offset by harm to endometrial receptivity 4, 3
Limited and Contradictory Research Evidence
The available research does not support clinical use:
Only one clinical trial in women undergoing IVF has ever been reported, representing an extremely limited evidence base 3
A 2020 pilot study of 20 men showed improvements in sperm concentration and motility with resveratrol-based supplements, but this was a small, uncontrolled study without pregnancy or live birth outcomes 5
Methodological quality of most studies on antioxidants and herbal therapies for infertility is poor, with lack of standardization in measuring oxidative stress and DNA damage 2
The heterogeneity of available studies makes meaningful meta-analysis impossible 2
Clinical Algorithm for Decision-Making
When patients inquire about resveratrol for fertility:
For women seeking fertility: Do NOT recommend resveratrol due to anti-implantation effects and unknown teratogenicity 3
For men with idiopathic infertility: Inform them that evidence is insufficient and benefits are questionable, prioritizing instead:
For patients already taking resveratrol: Advise discontinuation during fertility treatment, especially in the luteal phase and pregnancy 3
Common Pitfalls to Avoid
Do not recommend resveratrol based on its antioxidant properties alone, as the theoretical mechanism does not translate to clinical benefit and may cause harm 1, 2, 3
Do not assume safety in pregnancy or during conception attempts, as the compound has documented anti-deciduogenic effects 3
Avoid recommending any antioxidant therapy without first optimizing lifestyle factors and treating identifiable causes of infertility 1
Do not rely on small pilot studies or animal research when counseling patients about supplements, as these do not meet the evidence standards required for clinical recommendations 2, 5