DR Marina OBGYN Fertility Highlights 2026

A New Way to Support Fertility: Low-Dose Naltrexone

When women struggle to get pregnant, we often think first about hormones, ovulation, or blocked tubes. But for many women with PCOS or endometriosis, the real problem is something deeper: chronic inflammation and an overactive immune system.

This is where a small, unexpected medication called low-dose naltrexone (LDN) is starting to make a difference.

LDN has been used safely for many years in other areas of medicine, but doctors are now discovering that in very low doses, it can help calm the immune system and support the body’s natural healing, including the parts of the body that help a woman get pregnant.

What is LDN?

Naltrexone was first used to help people with alcohol and opioid addiction. But when doctors give it in very small doses (usually 1–4.5 mg), it works in a completely different way.

At low doses, LDN:

Helps the body make more natural endorphins
Reduces inflammation
Helps calm an overactive immune system

This matters because both PCOS and endometriosis are now known to be inflammatory conditions, not just hormone problems.

How PCOS Affects Fertility

Women with PCOS often have:

Irregular or missing periods
High male hormones
Trouble ovulating
Insulin resistance
Ongoing inflammation

All of these make it harder to release healthy eggs and get pregnant.

LDN may help by:

Improving communication between the brain and ovaries
Lowering inflammation
Supporting more regular ovulation

Some early research and clinical experience show that naltrexone can help women with PCOS have more regular cycles and better hormone balance. When ovulation becomes more regular, pregnancy becomes more likely.

How Endometriosis Affects Fertility

Endometriosis happens when tissue like the lining of the uterus grows outside the uterus. This causes pain and also creates constant inflammation inside the pelvis.

That inflammation can:

Damage eggs
Interfere with sperm
Make it hard for an embryo to implant

LDN helps by calming immune cells that drive this inflammation. Doctors who treat endometriosis have seen that some women have:

Less pelvic pain
Less swelling and irritation
A healthier environment for pregnancy

A large clinical trial is now studying LDN in women with endometriosis, showing how seriously this approach is being taken.

LDN and Implantation

Getting pregnant is not just about making an embryo — it’s about whether the uterus is ready to welcome it.

In 2025, a study looked at women who had many failed IVF attempts because their immune systems attacked or rejected embryos. When these women took LDN:

Their uterine lining became thicker
Their immune markers improved
More embryos implanted
More pregnancies happened

This is very exciting, because it shows that LDN may help the uterus become more welcoming to life.

Is LDN Safe?

LDN is:

Non-hormonal
Low-cost
Not addictive
Very well tolerated

Some women notice vivid dreams or mild sleep changes at first, but serious side effects are rare. Many fertility doctors continue LDN into early pregnancy to support immune balance.

The Big Picture

LDN is not a replacement for IVF, surgery, or ovulation drugs. But it works in a different way — it helps fix the environment inside the body so those treatments can work better.

For women with PCOS, endometriosis, or repeated pregnancy loss, LDN may help turn the body from a place of inflammation into a place that supports new life.

This is what modern fertility care is moving toward: working with the body, not just overriding it.

References

International Endometriosis Society. “Interview with Dr. Andrea Vidali: Low-Dose Naltrexone in Endometriosis, Pelvic Pain and Infertility.” InternationalEndo.com, April 13, 2025.
Fulghesu, A. M., et al. “Naltrexone Treatment in Clomiphene-Resistant Women with Polycystic Ovary Syndrome.” Human Reproduction 14, no. 11 (1999): 2753–2758.
ClinicalTrials.gov. “Low-Dose Naltrexone in Combination with Norethindrone Acetate for Endometriosis-Associated Pain.” NCT03970330.
Koshkina, O., et al. “The Effect of Low-Dose Naltrexone on Immunological Infertility in Women with Recurrent Implantation Failure.” Reproductive Health of Woman 83, no. 6 (2025): 152–160.
Towers, C. V., et al. “Use of Naltrexone in Pregnancy.” Obstetrics & Gynecology 143, no. 2 (2024): 305–312.