What to know about using supplements for fertility—and when to start taking them in preconception

During my last pregnancy, my healthcare provider used the term “geriatric” when describing special testing and accommodations that would need to be made given my age. I nearly fell out of my chair. I didn’t feel old; far from it. At 35, I was thriving, healthier than I had been during my 20s, proud of all the choices I had made for my career, for my financial security and for my business. And now it felt like my doctor was telling me those decisions were putting my reproductive health at risk. 

But, the reality is, I’m far from alone. Your biological clock doesn’t always line up with your life clock. Maybe you had more to cross off your list before you took the leap to start a family. Maybe you wanted to build your career, travel to new places, or wait until you found the right partner. Kids are also expensive and a lot of responsibility and it’s also just OK to not know if parenting is right for you. 

And while science can’t give us total freedom yet, it’s gotten better. And as the Founder & CEO of Ritual, I’m passionate about using science-backed supplements to help support your fertility journey on your own timelines, without watching the clock. So, let’s dive in.

Supplements to consider during preconception

• A high-quality prenatal multivitamin is foundational. It’s important to help maintain essential nutrient levels before pregnancy, especially since those initial first weeks are critical (and someone might not even realize they’re expecting yet). Look for nutrients like folate and choline, which play a key role in supporting neural tube development, which starts forming early on and closes during the fourth week of pregnancy. Omega-3 DHA, iron and vitamin D are also important nutrients to look for in a prenatal. 

• Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant found in every cell of the human body that helps cells produce energy and we know that the process of egg maturation is an energy-intensive process. Research also shows that higher levels of CoQ10 in the follicular fluid (the complex biological fluid that surrounds and nourishes the developing egg) are associated with higher grade embryos during assisted reproductive technologies.
  
  Clinical research has found that supplementing with 200 mg of CoQ10 per day can increase follicular fluid levels of CoQ10 and CoQ10 can help support fertility outcomes. 

• N-acetylcysteine (NAC) is produced from the amino acid cysteine and is a precursor to glutathione, an important antioxidant in the body. Due to its antioxidant properties, NAC may help counter the effects of aging and oxidative stress on egg quality and support ovulation. Additionally, higher glutathione levels in a woman’s follicle can have a positive impact on fertilization rates for women undergoing IVF.
  
  Clinical research has found that supplementing with 1.2g of NAC per day can help support ovarian health and fertility outcomes. And NAC, in combination with CoQ10 is another way to help optimize the follicular environment and support egg health. 
  
• Myo-Inositol is a form of sugar that is naturally present in the human body and in many foods like fruits, beans, grains, and nuts. It also has been found to be important for supporting fertility, due to its role in helping regulate key reproductive hormones and assisting the body utilize insulin more efficiently. Similar to CoQ10, research has found that higher concentrations of myo-inositol in the follicular fluid are correlated with higher oocyte quality. 
  
  Clinical research has found supplementing with 4g of myo-inositol per day can help support egg health, healthy hormone levels, and ovulation, and to help support fertility outcomes. Ritual’s Fertility Support packs a 3-in-1 punch of CoQ10, NAC and myo-inositol in one drinkable mix.

When to start taking supplements for your fertility journey

Everyone is different, with different factors to consider, but some clinical trials evaluate ingredients over a three month period. With this in mind, it’s recommended to start taking a fertility support supplement three months prior to trying-to-conceive, or another fertility event like egg freezing or IVF.

Potential limitations of supplementation 

Fertility is complex and multifactorial, and while supplementation can help, it is not a magic pill. There are many different factors that can contribute to infertility—age, reproductive system issues, ovulatory disorders, hormonal imbalances, male factor infertility—and it is important to work with your dedicated healthcare care team to understand if supplementation can be beneficial.

Other lifestyle factors to help with fertility 

Preconception nutrition should be the primary focus. It’s important to focus on eating foods from a variety of food groups to ensure nutrient stores are adequate going into the nutritionally demanding period of time that is pregnancy. 

This includes eating foods that are rich in key nutrients like iron as many women have low iron stores. Iron is found in animal foods like beef, dark meat poultry, and fish and shellfish as well as plant-based sources like legumes (black beans, pinto beans, and peas), whole grain bread products, and iron-enriched white bread, pasta, rice, and cereals.

Calcium is another important nutrient as it is required for healthy bones, and if there’s not enough calcium in mom’s diet during pregnancy, the fetus can draw calcium from mom’s bones. Good sources of calcium include fortified tofu, soybeans, dairy products, and leafy greens like spinach, kale, turnip greens. 

In addition to good nutrition, other lifestyle factors to consider during the preconception period are quitting smoking, limiting alcohol intake, engaging in regular physical activity, avoiding exposure to certain substances like bisphenol A (BPA), and talking to your doctor about prescription medication.