Essential: Folic Acid
Folic acid is the one supplement that is universally recommended for all women trying to conceive. It reduces the risk of neural tube defects (like spina bifida) by up to 70%. Take 400mcg daily, starting at least one month before conception and continuing through the first trimester. Women with certain conditions (previous neural tube defect pregnancy, diabetes, BMI over 30, or taking anti-epileptic medication) need higher doses (5mg). Folic acid can be taken alone or as part of a prenatal vitamin. Some people have genetic variations (MTHFR) that affect folic acid processing and may benefit from methylfolate, though standard folic acid works for most.
Well-Evidenced Supplements
Vitamin D: Deficiency is common and associated with reduced fertility and pregnancy complications. Get tested and supplement if deficient. Most adults need 1000-2000 IU daily.
Omega-3 fatty acids (DHA/EPA): Support egg quality and fetal brain development. Consider if you do not eat oily fish regularly. Look for quality fish oil or algae-based supplements.
Iron: Important for ovulation and to build stores for pregnancy. Women with heavy periods or vegetarian/vegan diets may need supplementation. Get tested first.
Iodine: Essential for thyroid function and fetal brain development. Many prenatal vitamins include it. Important if you use non-iodised salt.
Moderate Evidence
CoQ10 (Coenzyme Q10): An antioxidant that supports cellular energy production in eggs. Some evidence suggests benefit for egg quality, particularly in women over 35 or during IVF. Typical dose: 200-600mg daily.
DHEA: A hormone precursor that may benefit women with diminished ovarian reserve or poor response to IVF. Should only be used under medical supervision as it can have side effects.
Myo-inositol: Particularly beneficial for women with PCOS. May improve ovulation, egg quality, and insulin sensitivity. Often combined with d-chiro-inositol.
Vitamin E: An antioxidant that may support egg and sperm quality. High doses may have risks; 15mg daily is adequate for most.
Zinc: Important for both male and female fertility. Most people get enough from diet. Supplement if deficient or for male factor.
Selenium: An antioxidant important for thyroid function and sperm health. Brazil nuts are an excellent source.
Supplements for Male Fertility
Zinc: Important for testosterone and sperm production. 25-50mg daily if not getting enough from diet.
Selenium: Supports sperm motility and reduces DNA fragmentation. 55-100mcg daily.
Folate: Yes, men benefit too. Supports sperm quality and reduces DNA damage.
CoQ10: May improve sperm count and motility. 200-300mg daily.
L-carnitine: Supports sperm energy production and motility. Some evidence for benefit.
Vitamin C and E: Antioxidants that protect sperm from oxidative damage.
Omega-3 fatty acids: Support sperm membrane integrity.
Overhyped or Unproven
Royal jelly: Popular in fertility circles but lacking human evidence.
Maca root: May have some hormone effects but fertility benefits unproven in humans.
Fertility teas and herbal blends: Most lack evidence and some may be harmful.
High-dose antioxidant blends: More is not necessarily better and may cause harm.
Pine bark extract (pycnogenol): Limited evidence for fertility benefits.
Be wary of products marketed specifically as fertility boosters with unsubstantiated claims. Quality matters - choose reputable brands and avoid megadoses.
Practical Advice
Start with the essentials: folic acid, and vitamin D if deficient.
Add a quality prenatal vitamin for convenience.
Consider CoQ10 if over 35 or preparing for IVF.
Men can take a male fertility supplement or individual antioxidants.
Get tested before supplementing iron - excess can be harmful.
Allow 3 months for supplements to affect egg and sperm quality.
Supplements cannot replace a healthy diet and lifestyle.
Discuss with your doctor, especially if you have health conditions or take medications.