Why prenatal vitamins matter - even before you start trying

If you’re thinking about having a baby, one of the most impactful steps you can take right now has nothing to do with timing or tracking - it’s simply starting a good prenatal multivitamin. Here’s what the research says, and why it matter more than most people realise.

Start earlier than you think

Most people know prenatal vitamins are important during pregnancy — but the research is clear that starting them before conception makes a meaningful difference. Eggs begin maturing three to four months before ovulation, which means the nutritional environment your eggs develop in starts well before you ever try to conceive.

The general recommendation is to begin at least three months before trying, though earlier is always better.The key to making things happen isn’t waiting for the perfect moment; it’s starting with what you have, where you are. Big goals can feel overwhelming when viewed all at once, but momentum builds through small, consistent action. Whether you’re working toward a personal milestone or a professional dream, progress comes from showing up — not perfectly, but persistently. Action creates clarity, and over time, those steps forward add up to something real.

"Women who took a multivitamin every day were significantly less likely to experience infertility related to ovulation problems — a finding from the large Nurses' Health Study, which followed over 18,000 women trying to conceive."

Folate: the most important nutrient in your prenatal

Folate is a B vitamin long associated with preventing neural tube defects like spina bifida — and this is still a critical role. But research has expanded our understanding considerably. Folate also supports egg development, ovulation, and embryo quality. In one IVF study, women with higher levels of folate in their ovarian follicles were three times more likely to conceive.

What's less well known is that how folate is delivered in your supplement matters as much as whether you're taking it at all.

Folic acid vs. methylfolate — what's the difference?

Most standard prenatal vitamins contain folic acid — the synthetic form of folate. To be useful to the body, folic acid needs to be converted into the active form, called methylfolate. The problem is that a significant portion of the population carries variations in a gene called MTHFR that reduce the efficiency of this conversion.

These MTHFR variants are associated with higher levels of homocysteine — a compound that can damage eggs and embryos and may increase miscarriage risk. Taking very high doses of folic acid to compensate can actually make things worse, as unmetabolised folic acid appears to interfere with the body's ability to use methylfolate at all.

A more effective approach for most women is to choose a prenatal that already contains methylfolate — the form your body can use directly. The typical recommended amount is around 800–1,000 mcg per day.

Other key nutrients to look for

Beyond folate, a good prenatal should include:

• B12

  Works alongside folate to reduce homocysteine. May help reduce miscarriage risk, particularly in those with MTHFR variants.

• B6

  Linked to improved conception rates and lower miscarriage risk. Look for the active form (pyridoxal 5'-phosphate) if you're sensitive to standard B6.

• Zinc & selenium

  Both play important roles in antioxidant protection for ovarian cells. Selenium is especially relevant for those with thyroid autoimmunity or low ovarian reserve.

• Iron

  Important, but worth testing rather than assuming you need more. Both deficiency and overload can contribute to fatigue and may affect fertility.

What about CoQ10 and other supplements?

A good prenatal is the foundation, but it's not the whole picture. Depending on your individual circumstances — age, cycle history, ovarian reserve, whether IVF is on the horizon — additional targeted supplements may be worth considering. CoQ10 is one that comes up frequently in the fertility research, particularly around egg quality and cellular energy production.

A note on choosing the right supplement for you

Not every supplement suits every person, and getting the form, dose, and timing right matters. If you'd like guidance on which prenatal vitamins and additional supplements might be most appropriate for your situation, this is something we can discuss in clinic.

This information is general in nature and is not intended as personalised medical advice. Please consult a qualified health professional before starting any new supplement regimen.