Optimizing Health during Preconception

By Dr. Valerie Penton-Power, MSc, ND

As a Naturopathic Doctor, patients often ask how soon they should be thinking about making any necessary changes to improve their chances of becoming pregnant. My answer is “as soon as possible.” It takes approximately 3 months for both an egg and sperm to fully mature. During this time, it is important to focus on ways to enhance the overall health and quality of both.

For patients wanting to get pregnant in the near future, I inquire about diet and micronutrient supplementation, physical activity, weight, smoking, recreational drug and alcohol use, exposure to environmental toxins, mental health, and chronic health and medical conditions. It is important to explore these areas to help optimize the fertility journey.

Preconception health is relevant to both women and men. The aim of this article is to share some basics of prenatal supplementation for women, including the forms of each nutrient to look for, as well as what ingredients to avoid.

Supplement Forms

There are many forms of supplements (tablet, capsule, liquid, powder, softgel or chewable). Tablets are the most difficult form for absorption in the body and often include a number of fillers, stabilizers, dyes, coatings and flavourings (non-therapeutic ingredients). For people who may have certain dietary restrictions, allergies and sensitivities, these extra, non-medicinal ingredients may pose a big problem. In addition, you may need to take more tablets each day, as it is harder to absorb nutrients in this form, in order to get a therapeutic amount absorbed into the body.

Capsules, liquids, and powders are often a better option for absorption and tend to have fewer extra ingredients.

Ask your health care professional about supplement companies that advertise their manufacturing standards to ensure the highest level of purity for your body.

Prenatal Vitamins

During preconception, prenatal vitamins are essential. Choosing prenatal vitamins can be challenging when there are so many brands available. To help with this choice, here are some optimal forms of vitamins and minerals to look for in a prenatal. For example,

  1. Folate – look for a prenatal that contains either folate or the active form, L-5-methyltetrahydrofolate (L-5-MTHF), instead of synthetic folic acid. The reason for this is that some people are unable to convert folate to the active form which will limit the absorption and may increase the risks of miscarriage and neural tube defects. Folate is important to take before a woman knows she is pregnant, and throughout the pregnancy.
  2. B12 – optimal form is Methylcobalamin instead of cyanocobalamin.
  3. Iron – optimal forms are citrate or glycinate instead of ferrous fumarate.
  4. Magnesium – optimal forms are citrate, malate, or glycinate instead of oxide.
  5. Zinc – optimal forms are citrate or picolinate instead of oxide.
  6. Calcium – optimal forms are citrate or malate instead of carbonate.


Antioxidants help support the mitochondria of the cell, which is vital to proper cell function. Mitochondrial function affects the quality of both eggs and sperm. Coenzyme Q10 (CoQ10), or ubiquinone, is an enzyme naturally produced by our cells and functions as an antioxidant. If CoQ10 levels are less than optimal in the body, then mitochondrial function may decline, affecting fertility, especially as a woman ages. Therefore, especially after the age of 30, women may want to consider CoQ10 as a supplement to enhance fertility.

* Note: Ubiquinol is the active form of coenzyme Q10 and is shown to be absorbed significantly better in the body. This means you may be able to take a little less ubiquinol than CoQ10 to get a similar result.


Probiotics are important bacteria that help in digestion and immune function. They assist with proper absorption of nutrients and have been shown to benefit fertility in women with certain autoimmune conditions, such as Hashimoto’s thyroiditis, rheumatoid arthritis and in other conditions such as allergies, eczema and asthma.

Things to look for in a probiotic:

  1. Type: Multi-strain is best. Especially, the strains of Lactobacillus (rhamnosus) and Bifidobacterium.
  2. Dose: approximately 10 billion cultures per capsule
  3. Storage: best to purchase a probiotic that is kept in the refrigerator to keep the bacteria alive for maximal benefit.

Essential Fatty-Acids

Essential fatty acids are fats we need to get in our diet because our bodies do not make them on our own. Omega-3 and omega-6 are fatty acids considered essential.  We generally have an adequate intake of omega-6 fatty acids in a typical North American diet. However, we often do not consume enough omega-3 fatty acids.

In women, omega-3 fatty acids play an important role in regulating hormones and assisting in a healthy pregnancy. When looking for an omega-3 supplement, you want to assess for quality and look for companies that advertise independent test results for levels of contaminants such as mercury, lead and other pollutants.

Vitamin D

Research has shown an important link between vitamin D and fertility. Studies show that vitamin D deficiency is a risk for reduced fertility and various adverse pregnancy outcomes. In North America, the majority of us have low vitamin D levels. For patients thinking about getting pregnant, or struggling to get pregnant, I advise they have their vitamin D levels checked to see if they need a supplement.

If you have more questions about supplementation, please speak with your Naturopathic Doctor for more information.

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