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Fertility Health
If you are thinking about becoming pregnant, here are the key nutrients you should look for in your fertility supplements.

As you start to think about growing your family, you prepare yourself mentally and emotionally for the challenges of pregnancy and parenthood. But it’s also important to prepare yourself physically to support a healthy pregnancy.

An overall healthy, balanced diet can help you get the nutrients your body needs, but preconception vitamins can help you fill in any gaps. You’ve probably heard about the importance of folate before pregnancy, but there are several other critical nutrients to look for in your fertility supplements. Along with folate, your fertility vitamins should also contain a healthy dose of vitamin D, iodine, choline, and iron. 

Learn more about five nutrients your pre-pregnancy vitamins should contain and how these nutrients help support your body before pregnancy and beyond.  

1. Folate

The term “folate” refers to:  

  • Folate in food. This form of folate occurs naturally in foods like leafy green vegetables, beans, peanuts, and oranges.  
  • Folic acid. This is the synthetic form of folate found in many supplements and added to foods like grains and cereals.  
  • Methylated folate. This is the active form of folate (the form your body can use) found in some supplements. Folate from food and folic acid are also converted into this form within your body so they can be used for essential functions.  

Folate is essential for many processes in the body. It is particularly important for women during their childbearing years and is necessary for the proper neural tube formation during the earliest weeks of pregnancy.  

Folate needs during early pregnancy

The Recommended Dietary Allowance (RDA) for folate is 400 mcg dietary folate equivalents (DFE) before pregnancy and 600 mcg DFE during pregnancy. You want to be sure that this nutrient is in good supply during the earliest weeks of pregnancy to support healthy neural tube development. Healthful diets with adequate folate may reduce a woman’s risk of having a child with a brain or spinal cord birth defect. 

How to get enough folate daily

Folate is naturally found in leafy green vegetables, fruit, dried beans, peas, and nuts. These are great foods to include in your pre-pregnancy diet. However, naturally occurring folate in food is not as well absorbed as folic acid or methylated folate, so it may be difficult for some to rely solely on natural food sources of folate to meet their needs.  

Fortified foods can help. In 1998, the United States Department of Agriculture (USDA) started to require food manufacturers to add folic acid to certain food products that do not naturally contain folate. These foods include enriched bread, flour, cornmeal, rice, pasta, and other grain products.  

In addition to natural food sources of folate and fortified foods, most healthcare providers recommend taking a high-quality pre-pregnancy vitamin with at least 400 mcg of folate to ensure you get enough of this essential nutrient. 

2. Vitamin D

Healthy vitamin D levels in the blood may promote your fertility and are associated with having a healthy pregnancy. However, many women have difficulty achieving a healthy vitamin D level. There are not many vitamin D-rich foods available, so it’s hard to get enough vitamin D through your diet alone. Your body can also make vitamin D from the sun, but healthcare providers recommend limiting sun exposure and wearing sunscreen to protect your skin from UV rays. Additionally, women with darker skin have more melanin, which reduces the skin’s ability to produce vitamin D from sunlight. It’s easy to see how many women fall short when it comes to vitamin D. 

Vitamin D needs during pregnancy 

Most reproductive health professionals believe that maintaining a healthy vitamin D level during pregnancy is critical. Although the RDA for vitamin D is 15 mcg (600 IU), most experts agree that the amount needed to achieve healthy vitamin D levels is much higher. Research shows that daily doses of 50-100 mcg (2,000 to 4,000 IU) of vitamin D3  before and during pregnancy are safe and can help women achieve healthy vitamin D blood levels.  

How to maintain healthy vitamin D levels

Most experts suggest achieving and maintaining a vitamin D blood level of at least 30 ng/mL to support fertility. Women with vitamin D levels above 30 ng/mL during preconception also tend to have healthier pregnancies.  

Between food, the sun, and supplements, you have three ways to help you meet your vitamin D needs – take advantage of all of them. Choose plenty of vitamin D-rich foods, like salmon, milk, and eggs, get plenty of safe sun exposure, and consider getting your vitamin D level tested to find out if you would benefit from a high-quality vitamin D supplement.  

3. Iodine

Folate and vitamin D are pretty well-known, but you may be less familiar with iodine. During pregnancy, both you and your baby need enough iodine for your thyroid to do its job and regulate several important body processes. You also need enough iodine to ensure that your baby’s brain develops to its fullest potential. 

Iodine in foods

Elizabeth Ward, MS, RD, author of Expect the Best: Your Guide to Healthy Eating Before, During, and After Pregnancy, states: “Research suggests that women in their childbearing years in the US are probably at the greatest risk for insufficient iodine consumption. Adequate intake is important for a baby’s brain development during pregnancy and breastfeeding … Certain foods are better sources of the mineral than others, but levels can vary. Seafood and sea vegetables, such as kelp and nori, are reliable iodine sources. Fruits and vegetables contain iodine, but the amount varies depending on the soil’s iodine content and other factors. Iodized salt is also a source, but it is not typically used in processed foods.” 

How to get enough iodine daily

The RDA for iodine is 150 mcg before pregnancy and 220 mcg during pregnancy. Ward recommends taking pre-pregnancy vitamins to get the iodine you need. She states: “It’s not always easy to fulfill your daily iodine quota with food … The ATA (American Thyroid Association) suggests that pregnant and breastfeeding women take 150 mcg of iodine as a dietary supplement every day to fill in possible iodine gaps. Choose a multivitamin with potassium iodide, as this form of iodine is well absorbed by the body.” 

4. Iron

Iron becomes increasingly important during the later stages of pregnancy, but it’s still important for fertility health. Iron helps produce red blood cells and maintain healthy muscle and connective tissue. As pregnancy progresses, your body uses iron to make more blood to deliver oxygen and nutrients to your developing baby.   

Before pregnancy, you need about 18 mg of iron per day. During pregnancy, your requirements increase to 27 mg of iron daily. Animal sources of iron are better absorbed – lean meat, seafood, and poultry are great options. If you’re vegetarian or don’t eat meat often, plant-based sources of iron include fortified grain products, beans, lentils, and spinach. You can also look for a pre-pregnancy vitamin that contains iron to help you meet your needs.  

5. Choline

Choline is a vitamin-like compound that your body needs for cell membrane signaling, lipid transport, and many other body functions. Along with folate, choline is essential during pregnancy for healthy neural tube and brain development.   

Despite choline’s importance, few women get enough in their diet. The American Medical Association supports the addition of choline to all prenatal vitamins. Most prenatal vitamins do not contain any choline because it is difficult to put into a tablet or softgel. 

 The goal is to get at least 425 mg of choline each day while trying to conceive and at least 450 mg per day during pregnancy. Include choline-rich foods, such as egg yolks, fish, chicken, broccoli, and brussels sprouts, and consider a high-quality prenatal vitamin with adequate choline to help you meet your needs.

When you’re thinking about getting pregnant, it’s essential to get enough of these nutrients. Many people are aware of the need for folic acid. However, there is not much attention to iodine, iron, choline, or vitamin D related to pregnancy. In addition to a balanced diet, consider adding a high-quality pre-pregnancy vitamin to your routine to make sure you get adequate amounts of these critical nutrients to prepare your body for pregnancy.   


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