How Low Ferritin and Iron Deficiency Impact Egg Quality, IVF Success, and Fertility Outcomes

At Fab Fertile, we see iron deficiency as a common issue for clients with low AMH and high FSH, key markers of diminished ovarian reserve and hormonal imbalance. When trying to conceive (TTC), monitoring and optimizing your iron levels is crucial for improving egg quality, ovarian function, and pregnancy outcomes.

Iron Can Lower The Risk Of Ovulatory Infertility

A 2006 study in Obstetrics & Gynecology found that women who took iron supplements had a 40% lower risk of ovulatory infertility. Non-heme iron (from supplements and plant sources) was especially beneficial, while heme iron (from meat) showed no significant effect. This highlights the importance of supporting iron levels for regular ovulation.

Serum Ferritin and Pregnancy Outcomes

A 2020 cohort study published in Fertility and Sterility found that women with recurrent pregnancy loss (RPL) had significantly lower serum ferritin levels compared to women without fertility issues. Lower ferritin was also linked to a greater number of previous miscarriages, suggesting that iron deficiency may play a contributing role in poor pregnancy outcomes. Other studies have similarly highlighted the importance of optimal ferritin levels for successful conception and healthy pregnancy progression. 

Optimal Ferritin for IVF and Egg Health

Studies suggest optimal ferritin levels for IVF between 80-100ng/mL are becoming increasingly recognized as key to success. Ferritin reflects your body’s iron stores, and adequate levels support egg quality, embryo development, and implantation. Both low ferritin and high ferritin can harm fertility, so testing and targeted supplementation to get to this range helps create a healthier environment for conception and improve IVF outcomes. We recommend testing a full iron panel, including ferritin, when preparing for pregnancy or considering fertility treatment like IVF.

While traditional labs examine hemoglobin or general iron panels, ferritin is the first to decline when iron is depleted, especially under chronic stress, inflammation, or heavy menstruation. A case-control study in the International Journal of Reproductive Medicine found that women with unexplained infertility had ferritin levels below 30 µg/L even when they didn’t meet the criteria for iron-deficiency anemia. Read the study here.

This demonstrates how low ferritin levels can have a silent impact on egg quality, ovulation, and uterine lining development, even when other fertility markers appear normal. For those with low AMH, high FSH, or unexplained infertility, getting ferritin levels corrected is key to improving implantation and pregnancy rates.

Iron Deficiency Can Impact Ovulation, Egg Quality, and Implantation

Low ferritin doesn’t just affect energy; it may also impact fertility outcomes. The American College of Obstetricians and Gynecologists (ACOG) highlights in its 2021 Practice Bulletin on Anemia in Pregnancy that iron deficiency is the most common cause of anemia in pregnancy, affecting up to 52% of pregnant individuals globally.

While ACOG focuses on pregnancy, the implications begin preconception. Iron deficiency left unaddressed can impair ovulation, egg quality, and implantation, increasing the risk of early pregnancy loss. This makes testing ferritin and correcting iron levels before TTC (trying to conceive) especially important, particularly for individuals with low AMH or high FSH.

Iron Deficiency and Egg Quality: The Overlooked Link

Research now shows that iron deficiency affects egg quality by disrupting mitochondrial energy production in the oocyte. Low ferritin can disrupt follicular development and hormone balance, especially in women with low AMH or high FSH. Optimising iron levels can improve both natural fertility and IVF success.

What Causes Low Iron?

Heavy Menstrual Bleeding

Many women experience excessive monthly blood loss, whether due to fibroids, endometriosis, clotting disorders, or hormonal imbalance, which can deplete iron over time. If your periods last more than 7 days, involve clotting larger than a quarter, or require frequent pad or tampon changes, you may be losing more iron than your body can replenish. This chronic blood loss can lead to low ferritin, affecting egg quality, ovulation, and the ability to maintain a pregnancy.

Autoimmune Conditions

Autoimmune disorders like Hashimoto’s thyroiditis, celiac disease, or lupus can interfere with iron absorption and regulation. Celiac disease, for example, damages the gut lining and impairs nutrient absorption, including iron, even if you don’t have obvious digestive symptoms. Autoimmunity can also trigger inflammation that raises hepcidin (a hormone that blocks iron uptake), making it harder to rebuild iron stores and support healthy ovarian function.

Dietary Restrictions

If you follow a vegetarian, vegan, or dairy-heavy diet, you may not be getting enough bioavailable (heme) iron. While plant-based iron can help, it’s not as easily absorbed, especially if you’re not pairing it with enhancers like vitamin C or avoiding inhibitors like calcium and tannins (from tea/coffee) around meals. Iron-rich foods like red meat, liver, and sardines can be important tools for restoring fertility-related nutrient levels, especially for those with low AMH or high FSH.

Inflammation and Chronic Stress

Systemic inflammation, often driven by hidden gut infections, food sensitivities, blood sugar imbalances, or unmanaged stress, can block iron absorption and cause the body to sequester iron in storage, making it less available for fertility-related processes. Chronic stress also increases cortisol, which can suppress reproductive hormones and affect ovulation, making iron deficiency worse. Addressing inflammation and calming the nervous system is key to improving iron markers and fertility outcomes.

Download The Ultimate Guide To Getting Pregnant THIS YEAR: With Your Own Eggs With Low AMH/High FSH Without Pumping Your Body Full Of Hormones Or Wasting Time With Fertility Diets and Herbs

Why Supplementing Iron To Improve Egg Quality is Not Enough

Many people experience poor iron absorption, heavy menstrual bleeding, or gut health issues that lead to low iron. If you are experiencing amenorrhea, anovulation, poor egg quality, ovulatory disorders, or miscarriage, it’s important to get a full iron panel to uncover any underlying causes. Iron deficiency is more than just supplementation; while iron supplements, patches, and infusions can be helpful tools, they are only part of the solution. Sometimes, just taking iron alone is not enough to restore hormonal balance or improve pregnancy outcomes. Addressing underlying imbalances like absorption difficulties, chronic bleeding, or inflammation is key to long-term fertility success.

Client Success Story with Low AMH and High FSH

When Valerie came to Fab Fertile her ferritin was 21 ng/mL and she had low AMH, high FSH and recurrent miscarriage. After following our personalized Fab Fertile Method including functional testing, targeted supplementation, diet changes and emotional support she was able to conceive naturally at 43. Her story reminds us that low ferritin can be a signal that something is out of balance and further testing is warranted.  Check out her story here.

What’s Next?

So, how do we address iron deficiency to improve fertility and increase your chances of pregnancy success?

In this episode, you’ll learn:

• Symptoms of low iron and how to increase iron and ferritin levels naturally

• Functional reference ranges for the iron panel (hint: a conventional physician may have told you that your iron ranges are “normal” – but has a healing opportunity been missed?)

• Reasons WHY your iron markers are out of balance (i.e., gut infections, autoimmunity, low stomach acid, and more) and what this matters if you are preparing for pregnancy

• Medications and foods that interfere with iron absorption

• Diet, lifestyle, and iron supplement recommendations to improve iron markers, which all help natural fertility

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TIMESTAMPS - How to Improve Iron Deficiency with Low AMH and High FSH

* Optimal Range for Ferritin prior to IVF is 80-100 ng/ mL.

• Iron as a marker on its own can fluctuate quite a bit, making it an unreliable marker on its own.
• What each marker represents and what they mean in relation to each other

22:31 THYROID MARKERS

• Inflammation disrupts the iron stores and iron levels in the body
• We need to have enough iron to produce our thyroid hormones.
• You always need to dig deeper to determine why iron levels are low.

24:16 BLOOD LOSS

• Blood loss is one of the key reasons why your iron could be low.
• Why stool testing is essential

25:39 DIET & IRON ABSORPTION

• If you’re not having animal sources of iron, you may be at higher risk of deficiency.

• It’s not you are what you eat, it’s you are what you absorb. Check out our blog on which foods to eat to improve low AMH and high FSH

• Iron is a complex mineral for your body to absorb
• H. pylori is a huge driver for a number of nutritional and digestive issues
• Common factors impairing people’s ability to absorb iron
• Gut health and addressing chronic infections are key to your fertility.
• Iron connects with so many functions in the body

29:44 PREGNANCY & LACTATION WITH LOW IRON

31:29 SUPPLEMENTATION

• Excessive turmeric supplementation can deplete iron stores.
• Supplementation should always be done under the guidance of an experienced practitioner
• Too much of a good thing isn’t always a good thing 

32:18 CANCER & LOW IRON

33:05 MEDICATIONS, FOODS & DRINKS THAT CAN IMPACT IRON ABSORPTION

• You can usually still take these things, but you may not want to take them at the same time as iron supplements

34:57 HIGH-QUALITY SOURCES OF DIETARY IRON

• The difference between animal and plant sources of iron
• Organ meats are very nutrient-dense.

40:07 IRON SUPPLEMENT RECOMMENDATIONS

• The iron patch can be a great option for people working on their gut health.

How to Get Started With Functional Fertility Support

Book your call here to get your personalized plan and options to help improve pregnancy success either naturally or with IVF treatment. 

Check out our Fab Fertile functional fertility program here and learn how to improve AMH levels naturally.  We work with couples that have low AMH, high FSH, diminished ovarian reserve, premature ovarian insufficiency, and recurrent pregnancy loss.

"My ferritin was 21 ng/mL—and now we’re pregnant naturally at 43" Read more about Valerie's story

Frequently Asked Questions About Iron, Ferritin, AMH, and FSH

How can I increase my ferritin naturally for fertility?

Boosting ferritin isn’t just about taking an iron supplement. From a functional fertility perspective, we need to address the why behind low iron, and for many of our clients, that starts with the gut.

Key strategies include:

• Testing for parasites, bacteria, and pathogens: Hidden gut infections (like Blastocystis hominis or H. pylori) can block iron absorption and drive inflammation. We often use comprehensive stool testing to find these culprits.

• Healing the gut lining: Iron is absorbed in the small intestine. Leaky gut or dysbiosis can impede absorption even if you’re eating iron-rich foods.

• Balancing heavy periods: Excessive menstrual bleeding depletes ferritin. We look at hormone imbalances (especially low progesterone or estrogen dominance) that drive this.

• Prioritize heme iron foods: Grass-fed beef, liver, lamb, and sardines are well-absorbed sources of iron. Eat them with vitamin C-rich foods to boost absorption naturally.

Should I take iron supplements to boost ferritin for fertility?

Iron supplements can help, but only if you’re absorbing and utilising them effectively and only if guided by testing. Functional fertility looks at the bigger picture:

• Start with a full iron panel: Ferritin, serum iron, TIBC, and transferrin saturation all tell us different things. We aim for ferritin between 80–100 ng/mL for optimal fertility and IVF prep.

• Don’t ignore gut issues: If you have a parasite, bacterial overgrowth, or poor stomach acid, you may not absorb oral iron properly. These must be addressed first. Check out our gut health article here, and why gut health is important for low AMH and high FSH.

• Not all supplements are created equal: We prefer gentle, well-absorbed forms like iron bisglycinate and sometimes consider infusions or patches if oral forms aren’t tolerated.

• Don’t supplement blindly: Too much iron can create oxidative stress and impair fertility rather than support it. Always work with a qualified practitioner.

RESOURCES:

Fab Fertile Method - https://fabfertile.com/pages/what-we-do

Ultimate Guide to Getting Pregnant This Year If You Have Low AMH/High FSH

Best Diet for Low AMH and High FSH

Eating for your fertility does not have to suck, and it is not about deprivation. It’s about eating food that tastes amazing and nourishes your body as you prepare for pregnancy success.

I’m excited to announce that our Fertility Recipe Guide is ready! In this 5-day challenge, you’ll learn how food impacts your body while enjoying delicious meals - no, you will not be drinking green juice and starving! Start this challenge today with your partner.

Your free guide includes a meal plan, grocery shopping list, and everything you need to get started with nourishing foods that improve your chances of pregnancy success.

Get Pregnant Naturally | Related Episodes

• Episode 407: The Ultimate Diet For Egg And Sperm Health
• Episode 389: Want to get pregnant this year?

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