Nicotinamide adenine dinucleotide (NAD) is an essential coenzyme involved in many pathophysiological processes. Supplementation with NAD and its precursors has been demonstrated as an emerging therapeutic strategy for the diseases. NAD also plays an important role in the reproductive system. Here, we summarize the function of NAD in various reproductive diseases and review the application of NAD and its precursors in the preservation of reproductive capacity and the prevention of embryonic malformations. It is shown that NAD shows good promise as a therapeutic approach for saving reproductive capacity.