Iron deficiency: an underrecognized cause of reproductive failure

DOI

https://dx.doi.org/10.18565/aig.2026.50

Bondarenko K.R., Ermolaeva A.S.
1) Clinic of Modern Ozone Therapy LLC, Moscow, Russia; 2) Haven LLC, Lapino City Medical Center, Moscow, Russia

Iron deficiency is the most common micronutrient disorder in women of reproductive age and has traditionally been linked to obstetric and gynecological complications. However, the role of iron deficiency in the pathogenesis of subfertility and reproductive failure is still not fully understood.
Objective: To evaluate the effect of correcting latent iron deficiency on pregnancy rate in women with repeated implantation failure in frozen embryo transfer cycles using euploid embryos.
Materials and methods: The pilot study included eight patients with primary unexplained infertility who had repeated failure of implantation in ART programs. These patients had a decrease in serum ferritin (SF) of less than 30 µg/L with normal hemoglobin levels (more than 120 g/L). For correcting latent iron deficiency, the patients were administered a drug containing 50 mg of iron fumarate and 500 mcg of folic acid (Ferretab), one capsule a day for three months until the target values of SF exceeded 30 µg/L. The women had a transfer of one thawed euploid embryo at the blastocyst stage of optimal quality.
Results: At the end of the three-month course of treatment, all participants in the pilot study reached the target values of SF (more than 30 µg/L): a statistically significant increase was recorded in SF levels from 20 (16.5-20.5) µg/L to 40 (37-43.5) µg/L. None of the participants in the pilot study had any adverse events. After embryo transfer, five out of eight patients achieved clinical pregnancy (62.5%).
Conclusion: The findings indicate the potential clinical significance of identifying and correcting iron deficiency in women with reproductive failure. Screening for iron deficiency and replenishing iron stores in tissues prior to conception may be a promising component of subfertility treatment in women. However, these preliminary results require confirmation in randomized placebo-controlled studies.

Authors’ contributions: Bondarenko K.R., Ermolaeva A.S. – developing the concept and design of the study, collecting and processing the material, writing the text, editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patients provided an informed consent to the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Bondarenko K.R., Ermolaeva A.S. Iron deficiency: an underrecognized cause of reproductive failure.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (3): 136-144 (in Russian)
https://dx.doi.org/10.18565/aig.2026.50

latent iron deficiency

serum ferritin

female infertility

recurrent implantation failure

assisted reproductive technologies

preconception care

Full text (in Russian)

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Received 10.02.2026

Accepted 03.03.2026

Karina R. Bondarenko, Dr. Med. Sci., Obstetrician-Gynecologist, Clinic of Modern Ozone Therapy LLC, 6 Starokachalovskaya str., Moscow, Russia, karinabond@mail.ru,
SPIN-code: 9976-0735, AuthorID: 798660, https://orcid.org/0000-0003-4147-1151
Anna S. Ermolaeva, MD, Obstetrician-Gynecologist, Reproductive Specialist, Head of the Department of Reproductive Technologies, Haven LLC, Lapino City Medical Center, anna.ermolaeva@mcclinics.ru
Corresponding author: Karina R. Bondarenko, karinabond@mail.ru

Iron deficiency: an underrecognized cause of reproductive failure

Bondarenko K.R., Ermolaeva A.S.

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