It’s Not Just Hormones: Why Mitochondrial Health Matters for Fertility

When it comes to fertility, most people think of hormones like estrogen, progesterone, and testosterone as the main players. But hormones are outputs of deeper cellular processes. The real foundation of fertility starts with mitochondria—the tiny powerhouses within every cell. When mitochondrial function is compromised, fertility can be affected, even if your hormone levels appear “normal.” In this post, we’ll explore how mitochondrial health influences egg and sperm quality, hormone production, and early embryo development.

1. What Mitochondria Do and Why They're Essential for Fertility

Mitochondria produce ATP, the energy that fuels nearly every process in the body, including hormone production, cell division, and tissue repair. In reproductive cells and early embryos, the demand for ATP is especially high.

• Eggs (oocytes) contain more mitochondria than any other cell in the body. They need large amounts of ATP to mature properly, support fertilization, and sustain early embryo development (Wang et al., 2022).

• Sperm cells rely on mitochondria in their midpiece to power motility, capacitation, and fertilization processes (Dutta et al., 2024).

When mitochondria function properly, reproductive cells can do their job. When they don't, fertility struggles often follow.

2. Mitochondria and Egg Quality (Female Fertility)

Aging, mtDNA, and Oocyte Decline

As women age, the number and integrity of mitochondrial DNA (mtDNA) in their eggs decline. This leads to lower ATP production and higher oxidative stress, contributing to ovarian aging and reduced fertility potential (Zhang et al., 2025).

How Mitochondrial Dysfunction Affects Fertility

• Low mtDNA copy numbers are associated with diminished ovarian reserve and poor egg quality (Wang et al., 2022).

• Damaged mitochondria interfere with follicle maturation, ovulation, and embryo viability, increasing the risk of miscarriage and IVF failure (Zhang et al., 2025).

Mitochondrial Impairment in Common Conditions

• In PCOS, researchers have found evidence of disrupted mitochondrial biogenesis in oocytes and granulosa cells (Yang et al., 2023).

• Inflammation and oxidative damage linked to obesity and endometriosis can also impair mitochondrial function in eggs.

Supporting mitochondrial health is essential for improving egg quality and supporting successful conception.

3. Mitochondria and Sperm Health (Male Fertility)

Nearly half of infertility cases involve male factors, and mitochondrial dysfunction plays a critical role.

Sperm Motility and ATP Production

Sperm require large amounts of ATP to move efficiently. That energy is generated by mitochondria located in the midpiece of the sperm tail (Dutta et al., 2024).

Mitochondria and DNA Integrity

Sperm with mitochondrial dysfunction produce excessive reactive oxygen species (ROS), which can damage DNA and decrease sperm viability (Khadem Nia et al., 2023).

Genetic Impacts

Mutations in mitochondrial genes or defects in proteins like ANT4 have been linked to reduced sperm production and quality (Escribá et al., 2016).

Improving mitochondrial function can lead to healthier sperm and increased chances of conception.

4. Embryo Development and Mitochondrial Health

Once an egg is fertilized, the developing embryo depends entirely on the mitochondria present in the oocyte. These mitochondria supply energy until the embryo starts producing its own mtDNA.

Low-quality mitochondria can result in:

• Poor embryo development and implantation failure

• Increased risk of miscarriage

• Reduced IVF success rates (Turnbull et al., 2025)

Researchers are now using mitochondrial biomarkers to predict embryo quality during IVF. In experimental cases, mitochondrial replacement therapy (MRT) has been used to enhance egg quality in women with repeated IVF failure (Gammage et al., 2022).

5. Why Hormone Testing Alone Isn’t Enough

Most conventional fertility workups focus on hormone levels like AMH, FSH, TSH, and LH. While these are useful, they don’t uncover why hormones may be low or imbalanced.

Hormones are downstream effects of deeper cellular processes. If the mitochondria can’t produce energy, hormone production often falters—even if the gland itself is healthy. Functional Medicine looks beyond hormone levels to assess mitochondrial energy output, oxidative stress, and nutrient status.

6. How to Support Mitochondrial Function for Fertility

Here are key steps to support mitochondria for both women and men:

1. Reduce Oxidative Stress

• Avoid environmental toxins

• Incorporate antioxidant-rich foods and nutrients like CoQ10, NAC, and vitamin C

2. Encourage Mitochondrial Biogenesis

• Engage in moderate exercise

• Use targeted nutrients such as PQQ, carnitine, and B vitamins

• Support healthy circadian rhythms and sleep

3. Stabilize Blood Sugar and Inflammation

• Use a whole-food, anti-inflammatory diet

• Minimize insulin resistance and high cortisol levels

4. Consider Advanced Testing

• Look beyond standard labs to evaluate mitochondrial markers, nutrient status, and metabolic pathways through Functional Medicine testing

5. Work with a Specialist

• A practitioner trained in Functional Medicine can build a personalized plan to optimize fertility from the inside out. Check my schedule to see if I am accepting new functional medicine patients and to schedule a consult: BalancedHealthKS.janeapp.com

Final Thoughts

If you’re trying to conceive and not getting answers from traditional labs, it’s time to look deeper. Fertility isn’t just about hormones—it’s about the health of every cell, especially the mitochondria. By addressing this root cause, you can improve reproductive function, embryo quality, and your chances of a healthy pregnancy.

Your body was designed to create life. Sometimes, it just needs the right support at the cellular level to do so.

References

1. Wang Q et al. The Role of Mitochondria in Human Fertility and Early Embryo Development. PubMed Central. PMID: 34997390

2. Dutta S et al. Impact of Mitochondrial Impairments on Sperm Function. Reproductive Biology and Endocrinology. PMID: 36900157

3. Zhang Y et al. Mitochondrial Dysfunction in Ovarian Aging. PubMed. PMID: 37221033

4. Escribá MJ et al. Genetics of Mitochondrial Dysfunction and Infertility. PubMed. PMID: 27799056

5. Khadem Nia A et al. Mitochondria Quality Control and Male Fertility. MDPI. PMID: 36831392

6. Yang L et al. Mitochondrial Dysfunction in PCOS. PubMed. PMID: 36890795

7. Turnbull D et al. Mitochondrial Replacement Techniques to Resolve Infertility. PubMed. PMID: 37120050

8. Gammage PA et al. Mitochondria in Human Fertility and Infertility. PMC. PMID: 35570067