Tru Niagen (Nicotinamide Riboside) for Fertility
Tru Niagen is not recommended as a fertility treatment because no major fertility guidelines from the American Urological Association, American Society for Reproductive Medicine, American Society of Clinical Oncology, or National Comprehensive Cancer Network include nicotinamide riboside or NAD+ precursors in their evidence-based fertility preservation or treatment protocols. 1, 2
Why Guidelines Don't Support This Approach
The most authoritative fertility guidelines explicitly state that supplements for male infertility have "questionable clinical utility" and that "existing data are inadequate to provide recommendation for specific agents" 1. For female fertility preservation, established methods include embryo/oocyte cryopreservation and sperm banking for males—not experimental supplements like nicotinamide riboside 2.
The American Urological Association specifically advises that clinicians should counsel patients that benefits of supplements (including antioxidants and vitamins) are of questionable clinical utility in treating male infertility 1. This recommendation applies broadly to all non-evidence-based supplements, including NAD+ precursors like Tru Niagen.
What the Research Shows (But Guidelines Ignore)
While animal studies suggest potential benefits, they have not translated to guideline recommendations:
- A 2020 mouse study showed nicotinamide mononucleotide (NMN, a related NAD+ precursor) improved oocyte quality in aged mice 3
- A 2025 mouse study demonstrated nicotinamide riboside improved ovarian function in PCOS mice 4
- A 2022 study found nicotinamide (a different form) correlated with better follicular development in humans, but this was observational only 5
These findings remain experimental and have not been validated in human clinical trials with pregnancy or live birth outcomes 4, 3.
Critical Safety Concerns
The 90-day toxicity studies of nicotinamide riboside identified target organs of toxicity including ovaries and testes at doses of 1000 mg/kg/day and above 6. While the no observed adverse effect level was 300 mg/kg/day in rats, the long-term reproductive safety in humans attempting conception remains unknown 6.
What You Should Do Instead
For Male Infertility:
- Pursue assisted reproductive technology (IVF/ICSI) as first-line treatment, which directly addresses sperm quality issues regardless of the underlying cause 1
- Consider hormonal therapies (aromatase inhibitors, hCG, or SERMs) only for documented low testosterone with preserved fertility goals 1
- Never use testosterone replacement therapy if fertility is desired, as it suppresses spermatogenesis completely 1
For Female Infertility:
- Embryo or oocyte cryopreservation represents the gold standard for fertility preservation, requiring ovarian stimulation 2
- Immediate referral to a reproductive specialist is essential—within 24 hours for cancer patients 2
- Age is the most critical factor; women over 38 should optimize ovarian reserve assessment and proceed directly to assisted reproductive technology 2
The Bottom Line on Supplements
A 2020 critical analysis of dietary supplements for male infertility found that 71.4% of marketed products contained ingredients at insufficient doses or with no demonstrated efficacy 7. Most supplements include substances below the minimal effective dose or with unproven benefits 7. This pattern applies to nicotinamide riboside, which lacks the clinical trial evidence required for guideline inclusion.
If you're facing fertility challenges, invest your time and resources in proven interventions with established pregnancy and live birth rates rather than experimental supplements 1, 2.