What vitamins should I take 2 months before embryo transfer?

Recommended Vitamins Before Embryo Transfer

For optimal outcomes, women planning for embryo transfer should take a daily multivitamin and mineral supplement containing copper (2 mg), zinc (15 mg), selenium (50 μg), folic acid (5 mg), iron (45-60 mg), thiamine (>12 mg), vitamin E (15 mg), and beta-carotene (vitamin A, 5000 IU) starting at least 2-3 months before the procedure. 1

Core Vitamin Recommendations

• A comprehensive multivitamin and mineral supplement should be taken daily, ideally starting 3-6 months before embryo transfer 1
• Folic acid: 0.4 mg daily for women with BMI <30 kg/m², or 4-5 mg daily for women with BMI >30 kg/m² or diabetes 1
• Vitamin D: At least 1000 IU (40 mcg) daily to maintain serum concentration above 50 nmol/L 1, 2
• Vitamin B12: 1 mg daily orally or 1 mg every 3 months via intramuscular injection 1, 3
• Iron: 45-60 mg of elemental iron daily 1
• Calcium: 1200-1500 mg daily (including dietary intake) in divided doses 1

Additional Important Vitamins and Minerals

• Thiamine: >12 mg daily 1
• Vitamin E: 15 mg daily 1
• Vitamin A: 5000 IU daily (should be in beta-carotene form, not retinol) 1
• Copper: 2 mg daily 1
• Zinc: 15 mg daily (maintain ratio of 8-15 mg zinc per 1 mg copper) 1
• Selenium: 50 μg daily 1
• Vitamin K: 90-120 μg daily 1

Monitoring Recommendations

• Begin nutritional monitoring at least 2-3 months before planned embryo transfer 1

• Check the following every 3 months before conception:

  • Serum folate or red blood cell folate 1
  • Serum vitamin B12 or transcobalamin 1
  • Serum ferritin and iron studies (including transferrin saturation) 1
  • Full blood count 1
  • Serum vitamin A levels 1

• Check the following every 6 months:

  • Serum 25-hydroxyvitamin D with calcium, phosphate, magnesium, and parathyroid hormone 1
  • Serum protein and albumin 1
  • Renal and liver function tests 1
  • Serum vitamin E 1
  • Serum zinc, copper, and selenium 1
  • Prothrombin time and INR 1

Special Considerations

• Vitamin A supplementation should be in beta-carotene form, not retinol, due to potential teratogenicity risk 1
• For women with previous bariatric surgery, additional monitoring and supplementation may be required 1
• Avoid alcohol consumption as it can precipitate dumping syndrome and is contraindicated during pregnancy preparation 1
• Riboflavin (vitamin B2) has been associated with improved embryo quality and clinical pregnancy rates 3

Important Caveats

• Separate calcium supplements from iron supplements by at least 2 hours as they can interfere with each other's absorption 1
• While vitamin D deficiency has been associated with lower pregnancy rates in some studies 2, other research has not found significant differences in outcomes based on vitamin D status 4, 5, 6
• The evidence for vitamin supplementation's impact on IVF outcomes is stronger for certain vitamins (folate, B12) than others 3
• Begin supplementation at least 2 months before embryo transfer, but ideally 3-6 months prior to optimize nutritional status 1