And do they really work?
Once baby is on the way, a world of dietary changes and prenatal vitamins await you. But what about when you're trying to conceive? Are fertility supplements just cleverly marketed placebos, or are they helpful remedies containing extra nutrients vital to conceiving and supporting a healthy pregnancy? And do you need to start taking prenatals before you actually conceive? Let's break it down.
Do fertility supplements really work?
A quick Google search suggests many prospective mothers have the same question—typing in 'fertility supplements' returns more than 201 million hits. One site sings the praises of a certain nutrient that boosts fertility, while the next site declares there isn't a smidge of scientific evidence suggesting said nutrient is worth your precious time or money. What's a person to do with all of this contradictory information?
I'm often asked if over-the-counter fertility supplements can actually boost a patient's chances of conception, or if they are simply smoke and mirrors. What I tell my patients is that, yes, supplements are worth your time, because what the best fertility supplements actually do is provide you with necessary nutrients that are lacking in today's culture of processed and fast foods.
What supplements should I take to increase my fertility?
Of course, check in with your healthcare provider before adding any supplements or vitamins to your diet, especially if you're trying to conceive. Certain vitamins, minerals or herbs may be dangerous if you take other medications or have certain underlying conditions. If you get the green light from your doctor, here's what to look for when choosing a fertility supplement and prenatal vitamin:
1. Folic acid + folate
Any prenatal supplement should have a minimum of 800 mcg of folate or folic acid. Check to see that your prenatal contains the form of folate known as 5-MTHF, the active form of folate that's easier for your body to absorb.
Folic acid helps to prevent spinal tube defects. It works best when you start taking it before you get pregnant, as the spinal tube is formed within the first four weeks of pregnancy—often before many people even discover that they're pregnant.
Coenzyme Q10 (CoQ10), also known as ubiquinone, is an enzyme that can help your body repair damage caused by free radicals (read: stress) and gives mitochondria, the powerhouse of the cell (said in a *science teacher voice*), a rejuvenating boost.
Many fertility experts consider CoQ10 helpful for egg health—one study from 2017 showed that having a high level of CoQ10 in the follicular fluid was associated with a higher rate of pregnancy.
Useful for menstrual cycle regulation and blood sugar stability, inositol is particularly beneficial for women with polycystic ovary syndrome (PCOS), which is a common cause of fertility issues. Inositol is a member of the B-vitamin complex and has some evidence behind its use for fertility support: One meta-analysis discovered that subjects taking myo-inositol had a higher pregnancy rate than the control group. However, a Cochrane review study asserted that more research is needed.
4. Vitamin D
Before you start trying to conceive, I recommend getting your blood levels of vitamin D tested, as most of us do not get anywhere near enough sunshine to fill our body's vitamin D quota. Although the reasons are still being evaluated, healthy levels of vitamin D have been linked to improved outcomes in pregnancy. If you're tested and found you have low levels, talk to your doctor about the most effective supplements to try and boost your stores.
A good probiotic supplement should be on everyone's list, whether you're trying to conceive or not. Many illnesses start in the gut, and an influx of healthy gut flora helps prevent viruses and bacteria from taking hold. This is especially important if you are taking antibiotics or have had gut issues in the past. When we take proper care of our digestive system, the whole body benefits—and this includes the reproductive organs.
And because pregnancy is by default a state of immunosuppression, building up your immune system before you conceive is a smart idea, so you're stronger going in.
Omega-3 fatty acids are a powerful anti-inflammatory nutrient that are well-studied for heart health as well as baby's brain and eye development during pregnancy. Researchers in 2016 also found that omega-3 supplementation during pregnancy significantly reduces preterm births. While your best source of these potent nutrients is via consuming high-quality, low-mercury fish several times a week, an omega-3 supplement can also be helpful for preconception if you're not eating fish regularly. Look for a vegan source from algae, which is better for the environment.
Because magnesium is so helpful in regulating the menstrual cycle and is vital to more than 300 different chemical reactions in the body, I recommend adding magnesium to your fertility supplement regimen. Also, if stress is a factor for you, magnesium can be incredibly soothing and balancing. For most people, magnesium helps decrease stress and improve sleep (take it right before bed for maximum benefits).
What is the best fertility supplement?
When choosing fertility supplements, be sure to do your brand research. The companies that you want to put your trust in will be reputable and focused on research, quality control and superior ingredient sourcing so make sure you ask your healthcare provider if questions arise. They can help you identify natural versus synthetic ingredients. For example, in prenatal vitamins, folate is naturally occurring while folic acid is a synthetic compound—this means thats the body processes folate better than folic acid. There are subtle but important differences in many supplements, even if the labels have the same claim.
There are a few things to watch out for. Be aware of fillers used by larger companies, such as artificial coloring, GMOs and even hydrogenated oils. Be mindful of all-in-one claims as well, as a supplement that has everything you need in one pill will ultimately end up sacrificing something. As far as I know, there is not a magic pill that contains all of the nutrients needed for fertility.
What is the best male fertility supplement?
Male partners should absolutely be taking fertility supplements during the preconception period to boost sperm quality, as well. L-carnitine and L-arginine have both been shown to increase both sperm count and motility, and zinc boosts testosterone levels in studies. Ask your male partner to talk to their primary care doctor about testing their vitamin D levels, too.
Other ways to boost fertility
Beyond fertility supplements, make sure your self-care basics are a priority:
- Focus on making sure you are properly hydrated
- Aim to get as many nutrients as possible from the food you eat
- Sleep for at least seven hours each night.
- Set aside time daily to do something you love that gives you a sense of peace, like exercising and/or meditation.
These stress-releasing factors will help you get into alignment, physically and mentally, and help give you the energy needed to create life.
Once pregnant, make sure you see your trusted health care provider to determine exactly what your unique body needs for a healthy pregnancy and joyful baby. Happy conceiving!
Akarsu S, Gode F, Isik AZ, Dikmen ZG, Tekindal MA. The association between coenzyme Q10 concentrations in follicular fluid with embryo morphokinetics and pregnancy rate in assisted reproductive techniques [published correction appears in J Assist Reprod Genet. 2017 May;34(5):607]. J Assist Reprod Genet. 2017;34(5):599-605. doi:10.1007/s10815-017-0882-x
Cuciureanu MD, Vink R. Magnesium and stress. In: Vink R, Nechifor M, editors. Magnesium in the central nervous system. Adelaide (AU): University of Adelaide Press; 2011.
Kareva I. Immune suppression in pregnancy and cancer: parallels and insights. Transl Oncol. 2020;13(7):100759. doi:10.1016/j.tranon.2020.100759
Shireman TI, Kerling EH, Gajewski BJ, Colombo J, Carlson SE. Docosahexaenoic acid supplementation (DHA) and the return on investment for pregnancy outcomes. Prostaglandins Leukot Essent Fatty Acids. 2016;111:8-10. doi:10.1016/j.plefa.2016.05.008
Showell MG, Mackenzie-Proctor R, Jordan V, Hodgson R, Farquhar C. Inositol for subfertile women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews. 2018, Issue 12. Art. No.: CD012378. DOI: 10.1002/14651858.CD012378.pub2
Zheng X, Lin D, Zhang Y, et al. Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET. Medicine (Baltimore). 2017;96(49):e8842. doi:10.1097/MD.0000000000008842
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