Iron is often associated with energy levels and is a crucial dietary requirement during pregnancy. But its role in fertility is just as critical and frequently overlooked.
Can iron deficiency affect women’s fertility?
The short answer is yes.
If you’re often feeling tired, weak, or short of breath, low iron levels could be the hidden reason affecting your fertility.
Iron produces haemoglobin, the protein in red blood cells that carries oxygen throughout the body. When iron levels are low, less oxygen reaches vital organs, including the reproductive system. This can trigger a range of fertility challenges.
For women, iron deficiency can disrupt menstrual cycles, leading to irregular periods or even amenorrhea (absence of menstruation), which directly affects ovulation. The study published in January 2025 found that women have a higher conception rate, and the risk of a miscarriage was 68% lower after treatment of iron deficiency.
Low iron levels are linked to several reproductive issues, including:
• Anovulation (the absence of ovulation)
• Poor egg quality
• Increased risk of miscarriage
• Low birth weight
• Preterm labour
During pregnancy, iron demands triple as the body must produce extra for the developing fetus. If iron stores are insufficient, the foetus may not receive adequate oxygen and nutrients, increasing the risk of complications.
How iron deficiency affects men’s fertility
It maintains the proper consistency and pH of semen, which are essential for healthy sperm. Additionally, specific cells in the testes depend on iron to support sperm development and protect reproductive tissue.
When iron levels are low, the blood carries less oxygen, creating a low-oxygen environment in the testes, which could interfere with sperm production and overall reproductive health.
A study by Soliman et al. (2014) found that treating iron deficiency in men improved sperm quality and increased key reproductive hormones, including LH, FSH, and testosterone.
Signs you might have iron deficiency
Iron deficiency often develops gradually and can be difficult to detect without a blood test. Common symptoms include:
• Fatigue and weakness
• Pale skin
• Shortness of breath
• Dizziness
• Cold hands and feet
• Headaches
If you’re experiencing these symptoms and trying to conceive, discuss it with your fertility specialist.
Treatment for Iron deficiency
Fertility specialists typically recommend consuming more foods rich in iron and other essential vitamins. You can find iron naturally in many foods such as lean meats and poultry, seafood like salmon, white beans, kidney beans, lentils, peas, nuts, dried fruits, green leafy vegetables like spinach, fortified bread, and breakfast cereals.
Your body can absorb iron from plant foods better when you eat them with meat, poultry, seafood, and foods that are high in vitamin C. Foods that contain a lot of vitamin C include fruits and vegetables such as oranges, strawberries, tomatoes, and broccoli.
In addition to eating foods that are rich in iron, you may have to take an oral iron supplement. The benefit of an oral iron supplement is that it treats your symptoms by increasing the levels of iron and haemoglobin in your body. However, a common side effect of
taking iron supplements is constipation. So, drink plenty of water. You may need to take a stool softener in addition to the supplement. Consult your fertility specialist before taking any oral supplements.
When too much iron becomes harmful
Iron is vital for health, but in excess, it can lead to serious health issues if left unmanaged.
Iron overload or hemochromatosis occurs when the body absorbs and stores more iron than it needs. The condition can be genetic or caused by other factors such as frequent blood transfusions or excessive iron supplementation.
When iron builds up, it is stored in key organs, like the liver, heart, and pancreas, where it can cause long-term damage. It may also impact hormone-regulating glands, leading to:
• Erectile dysfunction in men
• Early menopause in women
• Thyroid and adrenal gland disorders.
Symptoms usually appear slowly and may include:
• Persistent fatigue
• Loss of sex drive
• Abdominal pain
• Signs of diabetes
Early detection and treatment are crucial to prevent irreversible damage. If you’re taking iron supplements or have a family history of iron overload, let your fertility specialist know.
Know your iron
Whether you are just at the start of your conception journey or have been trying for a while, checking your iron levels and optimising your diet can make a meaningful difference. By nourishing your body with iron-rich foods and seeking medical guidance from your fertility specialist when needed, you are laying the groundwork for a healthier, more fertile future.
Reference
Tulenheimo-Silfvast, A., Ruokolainen-Pursiainen, L., & Simberg, N. (2025). Association between iron deficiency and fertility. Acta Obstetricia et Gynecologica Scandinavica, 104(7), 738–745. https://doi.org/10.1111/aogs.15046
Stevens, R., Alvergne, A., & Vitzthum, V. J. (2024). Low haemoglobin in arduous seasons is associated with reduced chance of ovulation among women living in the Bolivian altiplano. Evolution, Medicine, and Public Health, 12(1), 191–203. https://doi.org/10.1093/emph/eoad024
