What vitamins and supplements should a woman take when trying to conceive?

Essential Vitamins and Supplements for Women Trying to Conceive

Women trying to conceive should take a daily prenatal multivitamin containing 400-800 μg (0.4-0.8 mg) of folic acid, starting at least 1-3 months before conception and continuing throughout pregnancy. 1, 2

Core Recommended Supplements

Folic Acid

• Standard dose: 400-800 μg (0.4-0.8 mg) daily 1
• Higher risk groups requiring 4-5 mg daily:
  • Women with previous NTD-affected pregnancy
  • Women who themselves have an NTD
  • Women with first or second-degree relative with an NTD
  • Women with type 1 diabetes
  • Women with BMI >30 kg/m² (obesity)
  • Women taking anti-seizure medications (valproate, carbamazepine) 1, 2
• Begin supplementation at least 1-3 months before conception and continue through at least the first trimester 2

Iron

• 45-60 mg elemental iron daily 2
• Particularly important for:
  • Vegetarians/vegans
  • Women with multiple pregnancies
  • Non-Hispanic black and Mexican American women 2
• Take with vitamin C to enhance absorption
• Separate from calcium supplements by at least 2 hours 1

Vitamin D

• At least 1000 IU (40 μg) daily 2
• Essential for calcium absorption and immune function
• Many women have insufficient levels, especially those with limited sun exposure 2

Calcium

• 1200-1500 mg daily (including dietary intake) 2
• Important for maternal bone health and fetal development
• Single doses should not exceed 600 mg 1

Vitamin B12

• 4 μg daily (included in most prenatal vitamins) 2
• Higher doses (1 mg daily orally or 1 mg IM injection every 3 months) for:
  • Vegans
  • Women with history of bariatric surgery 2

Additional Important Nutrients

Iodine

• 100-150 μg daily 2
• Essential for fetal brain development
• Limited in vegan diets without iodized salt or seaweed

Zinc

• 15 mg daily 1, 2
• Supports immune function and fertility
• Often insufficient in average dietary intake

DHA (Omega-3)

• Consider algae-based DHA supplements
• Essential for fetal brain and eye development 2

Special Considerations

For Women with History of Bariatric Surgery

• Higher supplementation needs:
  • Folic acid: 800-1000 μg daily
  • Iron: 45-60 mg daily
  • Vitamin B12: 1 mg daily oral or IM injection
  • Vitamin D: 3000 IU daily
  • Calcium: 1200-1500 mg daily
  • Monitor levels every 3 months 1

Vitamin A Considerations

• Choose prenatal vitamins with beta-carotene form of vitamin A rather than retinol
• Retinol form should be avoided due to teratogenicity risk 1, 2

Monitoring Recommendations

• For women planning pregnancy, consider checking:
  • Serum folate or red blood cell folate
  • Serum vitamin B12
  • Serum ferritin and iron studies
  • Full blood count
  • Serum vitamin D with calcium, phosphate, and magnesium 1, 2

Common Pitfalls to Avoid

1. Starting supplementation too late: Begin at least 1-3 months before conception for maximum neural tube defect prevention
2. Taking excessive vitamin A (retinol): Can be teratogenic; choose beta-carotene form instead
3. Inadequate iron absorption: Take iron supplements separately from calcium and with vitamin C
4. Relying solely on diet: Food sources alone are often insufficient to meet increased demands during conception and pregnancy 3
5. Inconsistent supplementation: Daily supplementation is crucial for maintaining adequate levels

By following these supplementation guidelines, women can optimize their nutritional status before conception, significantly reducing the risk of neural tube defects and supporting overall maternal and fetal health.