So what’s the answer? A combined approach. Taking a comprehensive prenatal multivitamin/mineral supplement and focusing on specific nutrients in your diet are both important in supporting fertility and a healthy pregnancy.
Research shows that certain nutrients are absolutely necessary in the formation of a woman’s eggs and optimal fetal development. Not only do these nutrients impact development before and during pregnancy, they can have a profound impact on the health of your child years after they are first placed into your arms.
- 1) Here are the top five non-negotiable nutrients for fertility and pregnancy:
- Folate (Vitamin B9 in the activated form: L-methylfolate, 5-methylterahodryfolate, or 5-MTHF)
Folate takes the lead role in both fertility, like ovulation and egg quality, and baby development, while also supporting the body’s ability to detoxify. Folate and its activated forms are not the same as folic acid, which is the synthetic form. Folic acid requires additional steps to break down and is poorly absorbed. Additionally, if you are like 60% of the population and have a genetic variation of your MTHFR gene, you will have even less ability to absorb folic acid. Inadequate folate intake or supplementing with folic acid in the setting of a genetic variation increases the risk of neural tube defects.
The best food sources of folate are:
- Green leafy vegetables, especially spinach
- Liver and organ meats
- Green peas
- 2) Vitamin B12 (in the activated form: Methylcobalamin and/or Adenosylcobalamin)
Vitamin B12 is foundational to many biological processes, including gene expression, cell differentiation and organ development. It’s also linked to the baby’s brain and cognitive function into childhood and reduces the risk of pregnancy loss, neural tube effects and preterm delivery.
Newer studies indicate that the current recommended daily allowance (RDA) for vitamin B12 may be set too low. This means relying only on supplementation or diet alone during pregnancy may not be enough, and in most cases, it should come from both.
Meat and dairy are the sources of B12, so those following a strict vegetarian diet may be coming up short.
The best food sources of B12 are:
- Organ meat
- Muscle meat
- Grass -fed dairy
3) Vitamin D3 (in the form of Cholecalciferol)
With Vitamin D, we get a little help from the sun, which accounts for 90% of vitamin D in the body. However, statistics show that many women with regular sun exposure will still be vitamin D deficient.
Vitamin D helps balance estrogen in women and supports blood sugar regulation, ovarian function, implantation and sleep regulation. It also plays an important role in thyroid function and may prevent or help treat autoimmune thyroid conditions.
Deficiency increases the risk for preeclampsia, gestational diabetes, and having a low birth weight infant. Current research is showing that optimal supplementation for pregnant women is 4,000IU daily, while the average prenatal offers only 800-2,000IU.
The best dietary sources of vitamin D are:
- Oily fish, especially the skin
- Red meat
- Liver and organ meats
- 4) Choline (in the form of Choline Bitrate or Sunflower lecithin)
Choline is related to the B complex vitamins and involved in the development, structure and function of every cell in the body. It is particularly important in the brain development and genetic expression of a growing baby. Building choline stores before getting pregnant is crucial because adequate levels support healthy neural tube closure, which happens in weeks 4-5 of gestation.
Up to 90% of women do not meet the recommended daily intake of choline through diet alone. Getting enough on a vegetarian diet becomes even more difficult because the best sources are animal-based.
The best dietary sources of choline are:
- Egg yolks
- Beef and beef liver
- Chicken breast
- 5) Iodine
Iodine is essential for the thyroid to make hormones and comes from our diet. It’s also one of the most common deficiencies around the world. An underactive thyroid can negatively impact fertility and have adverse effects on pregnancy outcomes and brain development in the growing baby. For a healthy adult female, the RDA for iodine is 150mcg, but during pregnancy the requirements increase to at least 220mcg/day since thyroid hormone production increases to support baby’s development and mother’s metabolism.
It is important to note that certain foods contain compounds called goitrogens which block the uptake of iodine in the thyroid gland. Avoid soy products for this reason, even organic, and limit intake of raw cruciferous vegetables (broccoli, kale, cabbage, brussel sprouts, daikon radish, cauliflower, etc.) and instead consume them cooked or fermented.
The best dietary sources of Iodine are:
- Sea vegetables
- Seafood, especially scallops and cod
- Grass-fed dairy
- Iodized salt
- Fleming, T. P., Watkins, A. J., Velazquez, M. A., Mathers, J. C., Prentice, A. M., Stephenson, J., Barker, M., Saffery, R., Yajnik, C. S., Eckert, J. J., Hanson, M. A., Forrester, T., Gluckman, P. D., & Godfrey, K. M. (2018). Origins of lifetime health around the time of conception: causes and consequences. The Lancet, 391(10132), 1842–1852. https://doi.org/10.1016/s0140-6736(18)30312-x
- Enciso, M., Sarasa, J., Xanthopoulou, L., Bristow, S., Bowles, M., Fragouli, E., Delhanty, J., & Wells, D. (2016). Polymorphisms in the MTHFR gene influence embryo viability and the incidence of aneuploidy. Human Genetics, 135(5), 555–568. https://doi.org/10.1007/s00439-016-1652-z
- Gaskins, A. J., Mumford, S. L., Chavarro, J. E., Zhang, C., Pollack, A. Z., Wactawski-Wende, J., Perkins, N. J., & Schisterman, E. F. (2012). The Impact of Dietary Folate Intake on Reproductive Function in Premenopausal Women: A Prospective Cohort Study. PLoS ONE, 7(9), e46276. https://doi.org/10.1371/journal.pone.0046276
- Chavarro, J. E., Rich-Edwards, J. W., Rosner, B. A., & Willett, W. C. (2008). Use of multivitamins, intake of B vitamins, and risk of ovulatory infertility. Fertility and Sterility, 89(3), 668–676. https://doi.org/10.1016/j.fertnstert.2007.03.089
- A. (2021, April 7). Vitamin D and Pregnancy. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/vitamin-d-and-pregnancy-4915/
- Zeisel, S. H. (2006). Choline: Critical Role During Fetal Development and Dietary Requirements in Adults. Annual Review of Nutrition, 26(1), 229–250. https://doi.org/10.1146/annurev.nutr.26.061505.111156
- Choline: The Underconsumed and Underappreciated Essential Nutrient. (2018). Nutrition Today, 53(6), E1–E2. https://doi.org/10.1097/nt.0000000000000311
- Office of Dietary Supplements – Choline. (2021). National Institutes of Health. https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
- World Health Organization. (2019, January 25). Iodine in pregnancy and lactation. https://www.who.int/elena/titles/bbc/iodine_pregnancy/en/
- Office of Dietary Supplements – Iodine. (2021). National Institutes of Health. https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/