Fertility supplements
Which supplements should I take before pregnancy?
The short answer
The CDC's figure is 400 micrograms of folic acid a day, starting at least a month before you conceive. Its job is preventing serious birth defects of your baby's brain and spine (neural-tube defects), not speeding up conception. The choline numbers below are nutrition targets, not fertility treatments. Ask a clinician to check everything you're taking for pregnancy safety, and if you've had a pregnancy affected by a neural-tube defect, your folic-acid dose is theirs to set.
What can I do with this?
If you're planning a pregnancy, folic acid is the one item here with clear backing, and you'll find the authorities' own figures below.
What those figures don't tell you is whether folate or choline helps you conceive sooner. The intake recommendations were not trials of faster conception.
The separate antioxidant and CoQ10 answers are answering different questions from different evidence, so don't read one as backing for the other.
And bring the list of what you're already swallowing to a clinician before you change it. That's the step, not picking a section off this page.
But does this apply to me?
Check which figure you're actually reading, because they cover different stages.
The CDC's 400 micrograms of folic acid is for before you conceive. The FDA's 600 micrograms of dietary folate equivalents (DFE), a unit that counts different folate sources together, is for during pregnancy, and 500 while you're breastfeeding.
The 425 mg choline figure is the general adequate intake for women aged 19 to 50 who aren't pregnant. It goes to 450 mg in pregnancy. Neither is a fertility target.
None of these are fertility-treatment protocols.
Two things change what applies to you: a medicine that affects how you handle folate, and a dose your clinician has set. If you've had a pregnancy affected by a neural-tube defect, your recommended amount can be much higher than the number on this page.
Care and safety
When should I bring in a clinician?
Here's the honest limit of what you're reading.
These are intake recommendations, set to meet a nutritional requirement. The intake-guidance records behind them do not establish an effect on conception, confirmed pregnancy or live birth, so they can't tell you what folate or choline does to your chances.
The separate CoQ10 answer rests on treatment studies instead, and it has its own limits which it states.
The choline figures each rest on a single authority, which makes them weaker than the folate ones.
Talk to a clinician before you start or change anything you take. Sooner if you're on medication, if you have a diagnosed condition, or if you've had a pregnancy affected by a neural tube defect.
Understand the answer
So what does this mean for me?
What does the research actually say?
The research asks a different question from an intake guideline. A 2018 diet-and-fertility review described associations between supplemental folic acid and some ovulation, pregnancy-loss and treatment outcomes, including at intakes above those used for birth-defect prevention. These observations are reasons for further study. They don't establish that a higher dose makes you conceive sooner, and they don't change the clinician-led dose advice on this page.
A 2019 review of multiple-micronutrient supplementation reported some favorable fertility findings while noting that adequately powered trials were scarce. One trial it summarized compared a particular multinutrient product with a trace-element supplement: confirmed pregnancy was reported in 64.6% versus 62.3% of women, and time to conception was 3.8 versus 4.0 menstrual cycles. Those are product-and-comparator-specific results, not a live-birth finding or evidence that every prenatal or blend works the same way. Many other studies in the review were small or observational.
The antioxidant story depends on which research and outcome you mean. The 2018 review described uncertain female-treatment findings and promising male findings, with weak reporting and very different products. That isn't a current verdict that antioxidants never help women or reliably help men. The later reviews in the separate supplement answers retain low or very low certainty and conflicting live-birth findings.
Coenzyme Q10, or CoQ10, also has a plausible biological explanation. A 2015 study found age-related changes in the mitochondria, the energy-producing parts of egg cells, and in CoQ-producing enzymes in mouse and human eggs. Supplementing CoQ10 reversed several reproductive-aging findings in mice. The treatment result was in mice; the human part was a tissue observation. Human treatment trials also exist and have their own answer, but their outcomes and populations don't establish that someone trying naturally in her forties will have more babies by taking it.
How does this compare with the official guidance?
The intake guidance and the research need to stay separate. ASRM and the CDC recommend folic acid before conception for helping prevent neural-tube defects, serious birth defects of the brain and spine. The fertility findings discussed above do not establish a different dose or turn that recommendation into a promise of faster conception.
The authority sources reviewed here don't establish a universal fertility recommendation for CoQ10, an antioxidant blend or vitamin D in someone without deficiency. That is a limit of this source set, not a claim that no authority anywhere has discussed them. A biological mechanism, a promising treatment finding and a recommendation for your own medicines are different things.
The practical answer is to use the established preconception guidance and bring proposed additions to your clinician. The separate supplement answers explain where the evidence is promising, uncertain or conflicting.
Why is this our answer?
The intake guidance uses eleven source records plus guidance from ASRM, the CDC and ACOG. Three research papers supply the separate research context.
Most of them are health authorities stating a figure, one is several authorities agreeing, and two are systematic reviews. You should know the two halves aren't equally strong: the choline numbers rest on fewer authorities than the folate ones.
The separate answers carry their own sources, and the CoQ10 one keeps egg counts, embryo measures, confirmed pregnancy and live birth apart rather than rolling them together.
Sources for each main claim
-
The 2018 diet review reports folate associations but does not establish a personal higher-dose fertility recommendation; its dated antioxidant findings are limited by varied products and weak reporting.
-
The 2019 micronutrient review reports limited intervention evidence; one product-versus-trace-elements trial reported confirmed pregnancy 64.6% versus 62.3% and time to conception 3.8 versus 4.0 menstrual cycles, not a universal product or live-birth effect.
The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility
-
The 2015 CoQ10 study reports reproductive-aging treatment findings in mice and enzyme-expression observations in human egg cells; it is not a human natural-conception trial.
Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging
-
CDC recommends 400 micrograms of folic acid each day starting at least one month before conception to help prevent neural-tube defects; this is not evidence that it speeds conception.
About Folic Acid · Optimizing Natural Fertility (patient education fact sheet)
-
FDA publishes 600 micrograms of dietary folate equivalents (DFE) per day in pregnancy and 500 while breastfeeding.
-
One microgram of folic acid taken on an empty stomach counts as 2 micrograms DFE; from fortified food or a supplement taken with food, it counts as about 1.7 micrograms DFE.
-
The adequate intake for choline is 425 mg per day for nonpregnant women aged 19 to 50 and 450 mg in pregnancy; the 425 mg figure is not a fertility target.
NIH National Library of Medicine · NIH Office of Dietary Supplements
-
The main-answer evidence does not establish that folate or choline improves the chance of conception.
-
During prepregnancy care, ACOG says to review all medicines and nutritional or herbal supplements and their pregnancy safety.
-
A previous pregnancy affected by a neural-tube defect can change the recommended folic-acid dose.
What else are you wondering?
Check the evidence
How sure can I be?
See the full evidence snapshot and sources
Evidence snapshot
The same fields appear on every Gyna answer, including when the research did not report something reliably.
- Question and decision
- Which supplements should I take before pregnancy? The decision is what, if anything, to start taking in the months before trying to conceive.
- Who was studied
- Women planning a pregnancy, and women in early pregnancy. Not women in fertility treatment specifically, and not a treatment protocol.
- What was compared
- Folate/folic acid and choline at the intakes health authorities publish. There is no comparator: these are intake recommendations, not a trial of one supplement against another or against nothing.
- Outcome measured, and over what period
- Nutrient adequacy during conception and early pregnancy. Not conception, not confirmed pregnancy, not live birth. The intake-guidance records do not establish a conception effect. The separate research context reports product-specific fertility findings with their own limits.
- Kinds of evidence included
- Health-authority guidance (ACOG, ASRM, CDC, NIH Office of Dietary Supplements, FDA, WHO/FAO, NASEM) plus two systematic reviews in the register and three research papers supplying separate fertility context.
- Studies and participants
- Not reliably reported in the evidence.
- What the evidence shows
- Before pregnancy, CDC recommends 400 micrograms of folic acid each day, starting at least one month before conception. Other figures are reported as the authorities state them, in DFE. That stands for dietary folate equivalents, the unit authorities use so folate from food and folic acid from supplements can be counted together. Folate: 600 mcg DFE a day in pregnancy, 500 while breastfeeding (FDA). Supplemental folic acid taken on an empty stomach counts double; 1 mcg of folic acid from fortified food or a supplement taken with food is about 1.7 mcg DFE (ODS). Choline: the adequate intake is 425 mg a day for nonpregnant women aged 19 to 50 (a group that includes most women trying to conceive) and 450 mg in pregnancy (NASEM/ODS). The 425 mg figure is a general adequate intake, not a fertility target. These are the authorities' figures, not our instruction.
- Consistency and disagreement
- FDA and ODS publish complementary folate intake and conversion figures, while ASRM and CDC support folic acid before pregnancy for neural-tube-defect prevention. The selected WHO/FAO passage supports folate's biological role, not these intake figures. The two choline figures each rest on a single authority, and no second independent authority was found for either. That is a real difference in strength between the two halves of this page.
- Confidence in this answer
- moderate: high that these are the published intakes, low that taking them changes your chance of conceiving from these intake figures; the separate research context does not turn a nutrition target into a proven fertility treatment
- Strength of the sources
- Health-authority guidance for the preconception recommendation and the intake figures. Of the eleven records behind it, eight are a single authority stating a figure, one is several authorities agreeing, and two are systematic reviews of the underlying studies
- Review status
- Sources are linked. Not yet reviewed by a clinician.
- Who this does and does not describe
- Describes women planning or in early pregnancy. Does not describe women in IVF cycles, women on medication affecting folate metabolism, or anyone given a different dose by a clinician. A previous pregnancy affected by a neural tube defect changes the folate figure substantially and is a clinician's call.
- Harms, trade-offs and when to seek care
- Folate from food alone is very hard to overconsume (ODS). Supplements are a different matter and prenatal products vary, so totals should be added up rather than assumed. The gap this page cannot close is whether any of it affects your chance of conceiving; if that is the question, it is a conversation with a clinician, not a supplement choice.
- Last searched, and the records behind this
- Last evidence search 2026-09-02. The source links are listed below.
Sources
Open the original guidance or study rather than taking our summary on trust.
- NIH Office of Dietary Supplements
- WHO (FAO/WHO joint, Human Vitamin and Mineral Requirements 2001/2004, Chapter 4 Folate and folic acid)
- US Food and Drug Administration
- PubMed Central
- NIH Office of Dietary Supplements
- NIH National Library of Medicine
- PubMed
-
Optimizing Natural Fertility (patient education fact sheet)
ASRM / ReproductiveFacts.org · Revised 2023
-
About Folic Acid
CDC · Last reviewed May 20, 2025
-
Prepregnancy Counseling (Committee Opinion No. 762)
ACOG · January 2019; Reaffirmed 2024
-
Diet and Fertility: A Review
pmc.ncbi.nlm.nih.gov
-
The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility
pmc.ncbi.nlm.nih.gov
-
Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging
pmc.ncbi.nlm.nih.gov
How we looked, and what we found
We read the main-answer sources on 2026-09-02 across guidance from ACOG, ASRM, NICE, Cochrane, the CDC, NIH, WHO and the NHS, plus pre-specified PubMed searches for systematic reviews.
Every record below was checked against its own source passage. The test we used was whether that passage, read on its own, supports the sentence the way you would take it.
Records that failed that check aren't on this page.
Who wrote this, and when will we revisit it?
Written by the Gyna evidence team from the listed sources. The source links below show what supports each main claim.
- Last updated
- 2026-09-09