Fertility Supplements for Women: What I Use in Practice and What the Research Actually Says

If you’re trying to conceive, you can spend a small fortune on supplements before anyone asks the most useful questions: Are you ovulating? Are you eating enough? Are your nutrient stores where they need to be? Has your partner been evaluated, too?

I’m a functional medicine dietitian, and I do use supplements in fertility care. I just want each one to have a job. Some nutrients help prepare your body for pregnancy. Others have promising research in specific groups, such as women with PCOS or those preparing for IVF. 

Here’s what’s in my women’s fertility protocol and how I decide what belongs in an individual plan.

TLDR: Here is a direct link to all of the supplements discussed in this article, but please do read on as not everyone needs every single thing on my list! 

When a new fertility client comes to me and hasn't had basic bloodwork yet, I always start with my Fertility Foundations Panel. This helps me to screen for things like inflammation, low vitamin D status, low ferritin, and insufficient progesterone as well as some metabolic and nutrient markers that may have been missed. As an RD who has helped hundreds of women get pregnant, stay pregnant, and have beautiful healthy babies, I refuse to accept "unexplained infertility" as a diagnosis. Usually this just means you haven't looked in the right place yet. 

1. A High Quality Prenatal: start with the foundation

What I use: WeNatal for Her (on their site) or on Fullscript here

I want a prenatal in place before pregnancy because early development begins before many women know they’re pregnant. This is the foundation of my protocol, with attention to folate, choline, iodine, iron, vitamin D, B12, and other nutrients.

The strongest direct preconception evidence here is for folic acid and prevention of neural tube defects. The CDC recommends 400 mcg of folic acid daily before and during early pregnancy. WeNatal uses methylfolate which is the ideal form for bioavailability.

I also pay particular attention to choline.  Adequate intake during pregnancy is 450 mg daily, and WeNatal for Her provides 400 mg. I actually like intake to look more like 900mg plus during pregnancy. The prenatal also includes 150 mcg iodine, 60 mcg selenium, 18 mg iron, 100 mg magnesium, and 4,000 IU vitamin D to cover a lot of ground in just 3 capsules.

A prenatal helps cover nutrient needs. It cannot correct every nutrient deficiency, and it cannot resolve an ovulation problem or another underlying cause of infertility, but it's a great start. 

If nutrient deficiency or depletion is a suspicion, I like diving deeper with advanced testing. I like to run an HTMA (hair tissue mineral analysis) and/or a Micronutrient Panel, especially on anyone who has been trying for over a year without success and for women dealing with secondary infertility.

2. Omega-3s: start with food and fill in the gaps

What I use: Nordic Naturals ProOmega 2000

EPA and DHA are fats I want women thinking about before conception and during pregnancy. I start by asking how often they eat fish and shellfish. Someone eating seafood several times a week has a different starting point from someone who rarely eats it. Ideally I have my clients strive for seafood 2-3 times per week, sticking with smaller fatty fish like salmon, sardines, mackerel, anchovies and herring.

In a prospective study of 501 couples, those in which both partners ate at least eight servings of seafood per menstrual cycle had 61% higher per-cycle chances of conception than couples eating less. That’s roughly two servings a week for each partner.

The blood-level data are compelling, too. Among women undergoing fertility treatment, each one-percentage-point increase in serum long-chain omega-3s was associated with an 8% higher probability of live birth per treatment cycle. In a separate fertility-treatment cohort, women in the highest group for EPA and DHA intake had an estimated 54% live-birth probability, versus 36% in the lowest group. 

I use fish oil when someone isn’t eating enough seafood or needs a practical way to increase EPA and DHA intake. Once pregnant, I swap for a higher DHA version to meet the increasing demands that come with baby's brain and neurological development. 

3. Egg-quality supporting antioxidants: CoQ10, NAC, alpha-lipoic acid, carnitine, and PQQ

What I use: WeNatal Egg Quality+ (on their site) or here on Fullcsript. 

An egg needs an enormous amount of energy to mature, fertilize, and support early embryo development. That’s why I pay attention to mitochondrial function and oxidative stress in a preconception plan, especially when someone is older, has diminished ovarian reserve, has PCOS, or is preparing for fertility treatment. This is the thinking behind WeNatal Egg Quality+: its ingredients address related parts of that process, and several have been studied in women undergoing fertility treatment.

CoQ10 is the anchor. A 2024 analysis pooled six randomized trials involving 1,529 women with diminished ovarian reserve. CoQ10 pretreatment was associated with higher clinical pregnancy rates (odds ratio 1.84), an average of 1.3 more eggs retrieved, and fewer canceled IVF cycles. In one of the trials, women taking CoQ10 had more high-quality embryos and were less likely to reach retrieval but have no usable embryo to transfer. 

NAC helps replenish glutathione, one of the body’s major antioxidant defenses. Its fertility research extends beyond a mechanism on paper. In a randomized pilot study of 60 women with PCOS undergoing ICSI, NAC improved oocyte and embryo quality. Another randomized trial involving 180 women with PCOS found better ovulation and pregnancy rates when NAC was added to clomiphene. A review also reported a positive live-birth result in one small trial. 

Carnitine helps move fatty acids into mitochondria so they can be used for energy. In a 2024 study of women undergoing repeat IVF cycles, those who received oral L-carnitine had higher cumulative clinical pregnancy rates (68.4% versus 59.8%) and live-birth rates (59.8% versus 47.4%) in the matched comparison. They also had better oocyte maturation, fertilization, and blastocyst measures. 

Alpha-lipoic acid (ALA) is both an antioxidant and a participant in cellular energy metabolism. In a randomized pilot study of women without PCOS who were overweight or obese and undergoing IVF, a combination of myo-inositol, ALA, and folic acid improved measures of oocyte morphology and embryo development. A separate preliminary study of ALA plus myo-inositol found a better oxidative environment around the egg and a possible increase in pregnancy rates. 

PQQ is the most emerging ingredient here, but the ovarian research is interesting. In a study of reproductively aged mice, PQQ improved ovarian function, egg maturation, fertilization capacity, and early embryo development, alongside changes in mitochondrial function. I see it as an addition aimed at the same egg-energy pathway as CoQ10.