Best prenatal vitamins to get pregnant (What actually matters)

Not every prenatal is created equal. Some contain outdated nutrient forms your body can barely absorb. Others skip key ingredients entirely. Here's what the evidence says actually matters when you're choosing prenatal vitamins to get pregnant.

Folate (vitamin B9) is the single most important nutrient in any prenatal. ACOG, the CDC, and the U.S. Preventive Services Task Force all recommend that anyone who could become pregnant take 400–800 mcg daily — ideally starting at least one month before conception. The reason is urgent: the neural tube, which becomes your baby's brain and spinal cord, forms within the first 28 days after conception. That's before most women even know they're pregnant.

Here's where it gets nuanced. Most prenatal vitamins contain synthetic folic acid, which your body must convert into its active form — methylfolate — through an enzyme called MTHFR. Research estimates that 30–60% of women carry a genetic variation in the MTHFR gene that reduces their ability to make that conversion efficiently. For those women, unmetabolized folic acid can build up without delivering the benefit.

A prenatal with methylated folate (labeled as L-methylfolate, 5-MTHF, or Quatrefolic) skips that conversion step entirely. Your body can use it directly.

Does that mean folic acid doesn't work? No. Folic acid has decades of population-level evidence behind it and remains the standard recommendation from ACOG. But many reproductive health practitioners now suggest methylated folate as a reasonable choice — particularly if you don't know your MTHFR status or want a form your body can use without an extra metabolic step.

Pregnancy increases your blood volume significantly, and iron is essential for making the red blood cells that deliver oxygen to your baby. Before conception, adequate iron also supports healthy ovulation and regular menstrual cycles. Look for a prenatal with 18–27 mg of iron. If you have heavy periods or follow a plant-based diet, ask your provider to check your ferritin levels — you may need more.

One practical note: iron and calcium compete for absorption when taken together. If your prenatal contains both, consider taking them at different times of day, or look for a formula that separates them.

Low vitamin D levels have been associated with a higher risk of fertility challenges in both natural conception and IVF cycles. Research also links vitamin D deficiency during pregnancy to increased risk of miscarriage, preterm birth, and other complications. Most prenatals contain 400–1,000 IU, but many providers recommend 1,000–2,000 IU daily, particularly if your levels are low. A simple blood test (25-hydroxyvitamin D) can tell you where you stand.

Choline is one of the most overlooked nutrients in prenatal vitamins — and one of the most important. It supports your baby's brain development and works alongside folate in neural tube closure. The recommended intake during pregnancy is 450 mg per day, yet fewer than 10% of women meet that through diet alone. Many prenatal vitamins contain zero choline or only a token 50–55 mg. Check the label carefully. If your prenatal falls short, you can supplement separately or prioritize dietary sources like eggs, liver, and cruciferous vegetables.

DHA is critical for your baby's brain and eye development, and emerging research suggests omega-3 fatty acids may also support a healthy inflammatory response during implantation. Look for at least 200–300 mg of DHA from fish oil or an algae-based source. Some prenatals include it; others require a separate softgel.

A solid prenatal covers your nutritional foundation. But depending on your age, health history, or how long you've been trying, your provider may recommend a few targeted additions. Here's what the research says about the most commonly discussed fertility supplements for women.

Coenzyme Q10 is a naturally occurring antioxidant that powers your cells' energy production — and your eggs are among the most energy-demanding cells in your body. As you age, natural CoQ10 levels decline, and so does mitochondrial function in your eggs.

A 2025 review published in Frontiers in Cell and Developmental Biology found that CoQ10 supplementation can improve ovarian function and egg quality by boosting mitochondrial energy production and reducing oxidative stress. Clinical trials have shown improved ovarian response and higher-quality embryos in women with diminished ovarian reserve, particularly those preparing for IVF.

That said, major medical societies including ASRM and ESHRE haven't yet made CoQ10 a routine recommendation — the evidence is promising but still developing. If you're over 35 or have been told you have low ovarian reserve, this is worth discussing with your provider. Typical dosing ranges from 200–600 mg daily, ideally started two to three months before conception to give the supplement time to support egg maturation.

If you're preparing for a fertility treatment cycle, our guides on how to prepare for IUI and how to prepare for IVF cover the supplements many reproductive endocrinologists recommend during treatment prep.

If your prenatal only includes 400 IU and your blood levels come back low, a separate vitamin D3 supplement may help. Your provider can test your 25-hydroxyvitamin D level and recommend a dose — often 1,000–4,000 IU daily depending on the degree of deficiency. Some women are surprised to find their levels are low even in sunny climates.

If your prenatal doesn't include DHA, a standalone fish oil or algae-based omega-3 is worth adding. Look for at least 200 mg of DHA. Quality matters here — choose a product that's third-party tested for heavy metals and purity.

If you have PCOS, your provider may suggest myo-inositol and D-chiro-inositol. Research shows these can support ovulation and improve insulin sensitivity in women with polycystic ovary syndrome. This isn't a blanket recommendation for everyone trying to conceive — it's a targeted option. Talk to your provider about whether it's appropriate for your situation.

It's tempting to add everything you've read about online. But more isn't always better. A high-quality prenatal covers most of what you need. Beyond that, focus on what your body specifically requires — based on blood work, your age, and your provider's guidance. Adding five extra supplements without knowing whether you're actually deficient can create imbalances and unnecessary cost.

Finding a prenatal that checks all the boxes — methylated folate, adequate choline, iron, vitamin D, DHA, and third-party testing — is harder than it should be. After comparing ingredient panels, bioavailability, and what women in our community have told us they actually tolerate, here are two options worth considering at different price points.

If your provider has suggested CoQ10 or a standalone omega-3 — or if your prenatal doesn't include DHA — these are the two products we'd point you toward. Both are high-quality, well-tolerated, and widely used by women in the TTC community.

For CoQ10, the form matters. Ubiquinol is the active, body-ready form — meaning your body can use it without an extra conversion step, similar to how methylfolate works compared to folic acid. If your provider has recommended CoQ10 for egg quality, especially if you're over 35 or preparing for IVF, look for ubiquinol rather than ubiquinone. Needed's CoQ10 uses Kaneka Ubiquinol — the most clinically studied form — at 200 mg per softgel, so a single capsule gets you to the starting range most fertility specialists suggest (200–600 mg daily). It's specifically formulated for reproductive health, third-party tested, and recommended in It Starts with the Egg, which many women in the TTC community have read. Start two to three months before conception to give the supplement time to support egg maturation. CoQ10 is a supplement to discuss with your provider, not a routine recommendation for every woman trying to conceive.

For omega-3s, the key question is whether your prenatal already includes DHA. If you chose Ritual, it does — so you likely don't need a standalone omega-3 unless your provider recommends a higher dose. If you chose Nature Made or another prenatal without omega-3s, adding a separate DHA supplement is worth considering. Look for at least 200 mg of DHA in triglyceride form, and choose a product that's third-party tested for heavy metals and purity.

There's something that shifts when you start taking a prenatal vitamin intentionally — when it stops being just a pill and becomes part of a daily practice of showing up for yourself and the baby you're hoping for. It's a quiet act of faith.

That's why we created our fertility affirmation candles. They're not medicine. They won't change your hormone levels or improve your egg quality. But lighting one while you take your prenatal — letting yourself sit in that small moment of "I'm doing this, I'm showing up for this" — can be a grounding part of your routine.

Sometimes the hardest part of trying to conceive isn't the medical side. It's the emotional weight of waiting, of not knowing, of wondering whether your body is cooperating. These candles were designed to give you a gentle anchor during that wait.

This is one of the most common questions I hear, and the answer is simpler than you might expect: start now.

ACOG recommends beginning a prenatal at least one month before trying to conceive. Many fertility specialists suggest three months — and there's a biological reason for that. The egg you ovulate in any given cycle actually started maturing over three months ago. During that entire development window, its quality is influenced by your nutritional status, your environment, and your overall health.

Folate, specifically, takes time to build up to protective levels in your system. The neural tube closes within the first 28 days after conception — often before a pregnancy test would even turn positive. If you wait until you see two lines, you've already passed the window when folate matters most.

And if your pregnancy wasn't planned? Start the moment you find out. The earlier, the better. But there's no point in guilt about the timing. Your body is resilient, and starting now is always the right choice.