In trying to conceive (TTC) circles, pomegranate juice is recommended on the daily, usually for endometrium support. It isn’t surprising that when I started TTC over 40 and my lining proved to be thin, pomegranate juice is the first thing I turned to. It didn’t do anything for my scant lining, but I still have mad respect for the long-revered and celebrated “fertility fruit”.

One of the pomegranate trees growing in my mother in law’s yard in Turkey

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brief historical overview

For at least five thousand years, humans have been cultivating pomegranate (punica granatum). Over the millennia, its various parts have been used for treating a plethora of illnesses, from expelling parasites and managing diabetes to treating diarrhea and ulcers. Pomegranate is rich with “polyphenols such as anthocyanins, punicalagin, ellagic, and gallic acids. Pomegranate seeds contain phytoestrogens likes genistein, daidzein, coumestrol, glutamic amino acids, and aspartic acids” (Akbaribazm). Furthermore, pomegranate has anti-inflammatory, antioxidative and antimicrobial properties (Kandylis).

The pomegranate has long been a symbol of physical health, including sexual and reproductive wellness. In ancient Mesopotamian and Near Eastern art, the pomegranate often appears as an attribute of female deities associated with abundance, fecundity and fertility. Throughout millennia, the pomegranate appears with “fertility goddesses” such as Ishtar, Astarte, Artemis, Demeter, Aphrodite and the Virgin Mary (ASOR).

While studying for my masters degree in ancient history, my field of study was the worship of female goddesses throughout the Near East (Anatolia, Egypt, Syria) from 5,000 BCE to present day. I became very familiar with a vast number of goddesses, many whom shared the aspect of being depicted with a ripe, succulent pomegranate.

I wrote my master’s thesis on the adolescent goddess Anat, daughter of Astarte, mother of the gods. This particular pantheon of gods was worshipped during the Bronze Age (c. 3000 – 1000 BCE) within in the extinct city of Ugarit, situated on the coast of present-day, northern Syria. My research led me to hundreds of goddesses, fertility and other, often depicted with the pomegranate. In 2014, I was fortunate to win a scholarship that helped pay for my flight to Kouklia, Cyprus. I went there to do an internship at the city museum that happened to be located on the grounds of one of the oldest sanctuaries devoted to the goddess Aphrodite (later named Venus). Pomegranates were everywhere…

Around 1000 BCE “images of pomegranates continued to be reproduced on textiles, wood, ivory, precious metals, as well as in symbolic ornaments” (ASOR). Symbolism associated with the pomegranate found its way into Greek culture where it became “the symbol of deities responsible for nature and the reproduction of human, animals, and plants. The pomegranate is represented as an attribute of the goddesses” (ASOR).

We do not know exactly why divine female figures associated with sex, fertility, life and death are shown holding pomegranates. Did the fruit represent life? Is it the infamous “tree of life”? Was it a symbol of divinity? Royalty? Did eating the fruit help barren women become pregnant? Perhaps the pregnant belly of the exotic pomegranates filled with their juicy, sweet pods packed full of health-promoting properties just symbolically represented fertility… I think it is safe to say that pomegranates could have represented any of these aspects.

The Abduction of Persephone

The Greeks were great writers. They were concerned with recording history, but it isn’t exactly how we practice historical writing today. They “borrowed” stories from lands far away (further east) and rewrote them to fit their culture and beliefs. One of the most well known stories involving a pomegranate and a goddess is the abduction of Persephone, daughter of Demeter, goddess of nature and the harvest.

In the Homeric Hymn to Demeter (600 BCE), Homer tells how Hades, ruler of the Dead, is completely enamored with Persephone to the point he abducts the young girl and drags her, kicking and screaming, to the Underworld to be his Queen. Demeter searches for her daughter to the ends of the earth. In her excruciating grief, she starves the humans by drying up their lands and prohibiting crop growth.

The gods meet and agree that Demeter’s grief must be remedied. Hades agrees to let Persephone go back to her mother, but first he gives her a few pomegranate seeds to eat, thereby tricking her into believing she is happy as the Bride of Death for six months out of every year. Each year, while Persephone is underground, her mother rages, punishing all that lives, thus no crops grow due to her grief (winter). While Persephone is above ground with her mother, they rejoice, the earth is abundant and the crops thrive (summer). This is how the ancients explained and justified the climate patterns.

composition of punica granatum (Pomegranate)

Pomegranate is known as a super food. The compounds found within the plant have been studied often and in various ways. The analyses so far have proven that many properties of pomegranate promote health benefits and protect against diseases. The bioactive health effects of pomegranate have been attributed to the various phytochemicals that it contains. The two most abundant phytochemicals in pomegranate are hydrolysable ellagitannins (Ellagic Acid) and anthocyanins (ATs) (Kandylis).

Seeds

Pomegranate seeds make up about 20% of the whole fruit and they contain a range of health-promoting properties. The seeds contain proteins, fiber, pectin, sugars, polyphenols and isoflavones. The oil that is derived from the pomegranate seeds has a high content of polyunsaturated fatty acids (PUFA) such as linolenic acids, as well as other lipids (punicic acid, oleic acid, stearic acid, and palmitic acid) (Kandylis, Nikseresht). Ellagic Acid (EA), one of pomegranate’s star components, is most abundant in the seeds. (Kandylis).

Juice and Peel

Pomegranate juice can help prevent and treat diseases such as high blood pressure, high cholesterol, oxidative stress, hyperglycemia, and inflammation. Anthocyanins (ATs) are water-soluble plant pigments that belong to the family of flavonoids that give pomegranates there succulent red color (including peel). They have been thoroughly studied for their positive health benefits which include antioxidant, anti-inflammatory and antiproliferative properties (Kandylis, Achraf).

Ellagitannins (ETs) are responsible for more than 50% of the antioxidant effect of pomegranate juice! Pomegranate peel is also a powerful source of bioactive phenolic compounds, minerals and complex polysaccharides (Kandylis).

Health-PROMOTING Benefits of Pomegranate

The antioxidant activity of wild pomegranate seed extract has significant antioxidant and anti-ulcer properties (Jadon). Jadon reports on the comparison of the antioxidant activity of commercial pomegranate juices compared red wine and green tea. The results are amazing! Commercial pomegranate juices showed an antioxidant activity three times higher than those of red wine and green tea. This review concludes that commercial pomegranate juices contain the tannin punicalagin which is responsible for its antioxidant affect (Jadon).

Moneim studied the affect that pomegranate supplementation has on the liver and kidney of male rats. After administering pomegranate juice to a group of rats for 21 days and pomegranate peel to another group of rats for the same time period, he concluded that both juice and peel reduced the lipid peroxidation and nitric oxide in both liver and kidney tissue. Also observed was a significant increase in superoxide dismutase and catalase activities of the rats who received juice and peel, once again demonstrating pomegranate’s potent antioxidant powers! (Jadon) In a study that screened the brains of adult rats, it was found that treatment with pomegranate methanol peel extract resulted in a reduction in oxidative stress (Jadon).

Fertility

There is a plethora of information attesting to the overall health benefits of pomegranate consumption, but we are trying to conceive here! I was shocked to find very little research directly linking pomegranate consumption to an increase in fertility markers. I found a small number of articles discussing general fertility benefits to animals after consuming pomegranate, but even less information about the benefits to human fertility.

Having said that, and I hate discussing this because I am quite firm in my disgust for the practice of using animals for research, certain animals respond very similar to humans and/or have similar reproductive aspects, and we can be excited about the following “preliminary” results for future human studies. In a nutshell, I want you to know when I am talking about an animal study. A lot of people quote medical research and fail to mention it was done on animals. However, I get just as jacked up if a study was done on mice as I would if it were done on humans because their reproductive processes are so similar to ours.

Animal Studies

In animal studies, pomegranate extract has been shown to relieve PCOS-related symptoms in rats. The extract, a wealth of phytoestrogens, was shown to increase the thickness of the uterine wall as well as mucus secretion (cervical mucus) by increasing uterine blood flow. The implantation rate in female rats with PCOS was increased (Akbaribazm). I do want to point out that by increasing blood flow, the endometrial lining was likely positively affected. Whether the lining got “thicker” than it normally would have been was not mentioned.

Nikseresht and colleagues investigated the effects of pomegranate seed oil (PSO) on the sperm of male rats. Their data showed no toxicity to the male rats after feeding them with PSO for 48 days. Also, PSO supplementation improved the rate of rat embryo development, likely by its ability to decrease oxidative stress in sperm (Nikseresht).

Pomegranate’s ability to lessen the damage caused by oxidative stress was evaluated in chick embryos. Adriamycin (ADR), a chemotherapeutic drug, causes irreversible toxicity to human organs due to oxidative stress. Amniotic fluid (AF) and biochemical parameters were studied in groups of chick embryos, some treated with ADR alone and some pretreated with pomegranate fruit extract before treatment with ADR. The adverse effects seen in the ADR alone group – reduction in body weight, increase in deformities and significant changes in the levels of biochemical parameters – were significantly lessened in the pomegranate pre-treated group (Kishore).

A study was conducted to discover which antioxidants are most effective at protecting ram sperm from damage while in storage. Treating the medium with ellagic acid (EA) resulted in a higher motility and the percentage of viable sperm in comparison to the control groups with no EA. Ram spermatozoa are quite susceptible to oxidative-induced damage, but treatment with EA prior to liquid storage prevents these damages. Türk also reported EA increased sperm motility in rats (Bucak).

Human Studies

In a randomized controlled triple-blind parallel trial study on 23 women with PCOS, it was found that pomegranate extract improved the serum levels of sex hormones by reducing testosterone levels (Akbaribazm). In a study that looked at adult men with reduced semen quality, after three months of treatment with pomegranate extracts, there was a statistically significant increase in total motile sperm count (Sharifi-Rad).

Wait, What About Pomegranate Juice for lining growth?

Everyone believes that pomegranate juice can thicken your endometrial lining, but can it? Throughout the summer of 2020, for the first few cycles after my first IVF retrieval, I suffered from an extremely thin lining. It was severe and didn’t get above 5-6mm by the time of HCG administration. I talk about it in greater detail here. Unfortunately, pomegranate extract had no affect on my lining.

“8/21/20 So I keep coming back to my stim cycle and ivf… why was my lining at 9mm DAYS before trigger. Unheard of for me! I tried the daily FSH this cycle because we thought it was that. No difference. Then I had an Aha moment!!! I had primed with Omnitrope for over 6 weeks. I have been reading studies confirming that using HGH (omnitrope) along with stims results in a thicker lining. Bingo!! I just ordered a vial. If I get it tomorrow, I’ll start tomorrow. Baseline is Monday and I’ll start meds Monday. I will start 6IU omnitrope tomorrow and continue through trigger
8/26/20 – 15 follicles!!!! 😱😱 It has got to be because of the LLLT therapy.”

After much research, I could not find one study directly proving that pomegranate consumption can increase your endometrial lining. There are several components that undoubtedly have a positive affect on blow flow and inflammation so I cannot say that pomegranate juice will not help your lining get thicker. Unfortunately, and not until more research has been done on human participants, I cannot say without a doubt that pomegranate juice can increase your endometrium.

The component in pomegranate that likely has the most affect on increasing the endometrium is EA. This acid has positive effects on many reproductive properties. However, you would have to eat a lot of pomegranate to get a clinical dosage. Taking EA as a supplement might make more sense.

There are various properties found in pomegranates that promote a healthy cardiovascular system (Eghbali). It is likely via these mechanisms that blood flow is improved, thereby giving the endometrium more nutrients and possibly resulting in increased thickness.

Remember the female rats with induced PCOS, after treatment with pomegranate extract they showed an increase in blood flow and subsequent increase in the thickness of the uterine wall and mucus production. The study concluded that these positive effects increased the implantation rate. As I mentioned above, the endometrium is positively affected by more blood flow, but this definitely doesn’t always correlate to an increase in lining thickness as seen in my case.

Eating pomegranate and drinking pomegranate juice daily is not something I would do to increase lining thickness once linking thickness has become a problem. It is something I took as a supplement while TTC because it obviously helps improve womb environment and keep it healthy. I think that regularly consuming pomegranates over time could help promote healthy blood flow and support a receptive lining. I do not think it helps enough when much help is needed.

Ellagic Acid

Ellagic Acid (EA) is an ellagitannin, a polyphenol found in abundance in pomegranates. It is one of the most beneficial components of the entire plant. EA has been associated with a variety of health benefits. It can regenerate after metabolism, making it a fierce fighter against oxidative stress (Sharifi-Rad). In addition, to being a unique antioxidant, EA increases the activity of antioxidant enzymes (superoxide dismutase, glutathione peroxidase, glutathione reductase, and catalase) (Sharifi-Rad).

Iovine reported on the powerful anti-inflammatory and antiproliferative affects of EA. His analyses showed that EA has a “consistent protective effect on DNA integrity, as well as on sperm vitality and motility, by counteracting generation of intracellular ROS” (free radicals) (Iovine). The results of this study suggest EA can protect sperm DNA from damage due to oxidative stress. We can only assume it can protect oocytes from the same type of damage.

Wrap Up

Pomegranate’s positive effect on the cardiovascular system, improved blood flow and nutrients transportation along with its strong anti-inflammatory components is enough reason for anyone trying to conceive to make a habit of drinking pomegranate juice daily. There is no concrete evidence that pomegranate extract can increase the endometrial lining directly, but it can definitely increase the wellness of your womb.

“A pomegranate a day keeps the RE away!”
That was all me, baby!

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