Can Iron Deficiency Cause Infertility? 

It is estimated that approximately 10 million Americans suffer from some form of iron deficiency. Of the 10 million Americans, about 5 million Americans will experience iron deficiency anemia. Although iron deficiency is common, the U.S Preventive Services Task Force currently only recommends screening for iron deficiency anemia in pregnant women. This means that unless you are specifically asking your doctor to check your iron status, chances are, they aren’t testing it routinely. This is unfortunately a big issue especially in women trying to conceive as iron deficiency appears to play an important potential role in fertility including egg quality and may even play a role in endometrial receptivity. In other words, the ability for an embryo to properly implant.

Not only could addressing your iron deficiency improve egg and therefore embryo quality but, it has been associated with an increase in pregnancy rates. Iron deficiency has not only been linked to infertility but miscarriages, low birth weight and preterm labor. It has also been associated with anovulatory cycle, making it hard to get pregnant. 

Now although iron deficiency, especially in women, can be associated with heavy periods, it can also be associated with certain medications as well as dietary factors including vegan and vegetarian diets and celiac disease. Iron deficiency can also be associated with endometriosis, as well as, may be associated with some genetic factors.

Luckily for us, when iron deficiency is properly diagnosed and treated, whether through the use of supplementation or IV infusion (in more severe cases), this can reduce your risk of infertility by what researchers believe is up to 40%!. So, what tests should you ask your doctor about and when is supplementation needed? 

I’m glad you asked. Let’s dive in. 

Iron vs. Ferritin 

When completing an iron panel there are a few important biomarkers that should be included such as: 

  • Serum Iron - how much iron is in your blood

  • Serum Ferritin - storage form on iron found in organs like your liver and spleen 

  • Total Iron- Binding Capacity (TIBC)- how well your iron moves throughout your body 

  • Percent Saturation (transferrin saturation) - how saturated your blood is with iron

Iron is an important mineral that your body uses to make hemoglobin. Hemoglobin is the protein molecule found in your red blood cells that carries oxygen around your body. If you don’t have enough iron, you may not have enough hemoglobin. This is known as iron deficiency anemia. Although iron deficiency is often the most common cause of anemia in the United States, if your doctor tells you that you are anemic and assumes it is because you are iron deficient, make sure to ask them to test your iron levels. This is extremely important because there are other causes of anemia and if we are not properly addressing the root cause of your anemia, not only will your anemia not improve but you could continue to struggle to conceive. We also want you to complete a comprehensive iron panel (including the tests listed above) because if you are iron deficient, we now have a tool to monitor how well supplementation is working to fix your deficiency. Not everyone absorbs iron very well, which means that some people may not respond to oral iron supplementation and they may instead require IV infusions. (We generally repeat an iron panel about 4-6 weeks after initiating treatment to evaluate your progress). 

Although some patients may present with iron deficiency symptoms, some may be completely asymptomatic which is why at NMD Wellness of Scottsdale, all of our patients, symptomatic or not, will undergo an iron panel. Some of the most common symptoms with iron deficiency include: 

  •  Fatigue 

  • Swelling of the tongue 

  • Craving ice 

  • Struggling to keep up at school or work 

  • Feeling cold all the time 

  • Frequent infections 

  • Feeling weak 

  • Hair thinning or hair loss 

Now, it is important to mention that you can have iron deficiency without being anemic. This is extremely important because too often doctors won't test your iron if you aren’t anemic when in reality, in our clinic, we have seen iron deficiency alone be a cause of infertility. By addressing iron deficiencies, we have helped women who previously struggled to conceive or experienced recurrent miscarriage conceive naturally simply by addressing their iron deficiency. 

Not to mention, iron panels are extremely inexpensive. In fact, a comprehensive iron panel in our office is under $30.00 (that’s without insurance!). This is where asking your doctor if they offer cash-pay pricing for lab tests can be extremely helpful. At NMD Wellness of Scottsdale, we have negotiated with some of the biggest lab companies to provide our patients with the lowest possible pricing for lab tests. 

What do your test results mean? 

Your results will depend on a few important factors including gender and age. In fact, normal serum iron levels can include: 

  • 60 to 140mcg/dL for women

  • 50-120mcg/dl for children 

  • 65-175mcg/dl for men 

Normal levels of TIBC are generally between 250-450mcg/dl for men and women. The normal range for serum ferritin for men is 24-336 micrograms/liter and 11 to 307 micrograms/liter in women. 

Iron Supplementation  

Now although iron is essential for your general health and especially during pregnancy, too much iron can be toxic. The recommended dietary allowance (RDA) of iron will vary based on age and gender .


  • 14-18 years old: 15mg/day 

  • 19-50 years old: 18mg/day 

  • 51 years and over: 8mg/day 

  • Pregnant: 27mg/day

  • Breastfeeding: 

    • Under 19 years old: 10mg/day 

    • 19 years and over: 9mg/day 

Exceeding 45 mg of iron per day can be toxic. If you are struggling to increase your serum iron levels with oral supplementation alone, it may be worth discussing iron IV infusion with your doctor. Iron IV infusions are an effective way to bypass GI absorption and often can increase  your iron status within days to weeks rather than months using oral supplementation. Discussing your options with your doctor can be extremely helpful. Again, if you are experiencing push back from your healthcare provider, make sure they are testing and monitoring your iron levels as you begin supplementation in order to properly track your progress. If you are trying to conceive, having optimal iron status is extremely important as you transition into pregnancy. During pregnancy, you have almost 50% more blood than usual, which means in order to properly oxygenate your blood and baby’s, you need sufficient iron levels.

About the Author: Meet Dr. ZenAlissia Zenhausern- Pfeiffer, NMD, FABNE, (commonly known by her patients as Dr. Zen), is a licensed naturopathic doctor board certified in naturopathic endocrinology and the founder of NMD Wellness of Scottsdale, a premier naturopathic medical practice that focuses on helping women to take a proactive approach to their hormone and fertility health. Dr. Zen has been featured as a lead expert in Forbes, Shape Magazine, and Instyle and is deeply passionate about bridging the gap between traditional and natural medicine in the world of fertility. She works with a variety of hormone related issues including PCOS, endometriosis and unexplained infertility. Her goal is to help more women get back into the driver’s seat of their own health to make lasting transformational changes to their health to bring more cute and adorable babies into this world. Read More About Dr. Zen...