Essential Fertility Support Supplement Protocol
Natalie Crawford, M.D.’s
Essential Fertility Support
Protocol overview
Last updated: May 13, 2025
5 Nutrients
Folic Acid
400mcg
Folic acid, vitamin B9, is an essential for DNA synthesis and cell division. Grains are typically fortified with folic acid, but with an avoidance of processed grains, many people need other dietary sources and supplementation. If you are trying to conceive, folic acid is important for healthy fetal neural tube development, and many people aim to get about 400 mcg of folic acid daily. (For a precise explanation of why folic acid is recommended instead of methylated folate, and additional information relating to the MTHFR gene, please review the Warning section later in the Protocol). [1]
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Download the appVitamin D3
25mcg
Vitamin D plays a critical role in reproductive health by supporting ovarian function, hormone regulation, and endometrial receptivity. Adequate vitamin D status has been associated with more favorable reproductive measures, including ovulation-related markers and some assisted-reproduction outcomes. [2]
Omega-3 fatty acids
300mg
Omega-3 fatty acids support reproductive health by reducing inflammation and enhancing cell membrane function. Research suggests omega-3 status and supplementation may be associated with fecundability in some populations, which may support reproductive health while trying to conceive. [3]
Vitamin C
85mg
Vitamin C is an antioxidant that improves immune function and is important in egg selection and ovulation. In some studies, higher vitamin C intake has been associated with a healthier inflammatory profile and more favorable reproductive measures, including some assisted-reproduction endpoints. Research suggests vitamin C supplementation may help support healthy progesterone levels, ovulatory function, and certain sperm quality measures in some people. [4]
Coenzyme Q10
200mg
CoQ10 supports mitochondrial function and healthy oxidative balance, and research suggests it may support egg- and sperm-quality-related measures in some people. In human studies, CoQ10 supplementation has been associated with favorable changes in some ovarian-reserve markers and assisted-reproduction measures, particularly in certain groups. [5]
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Warnings
Many new prenatal vitamins have entered the market which have methylated folate instead of folic acid. Methylated folate is a downstream metabolite of folic acid. Although some people may have difficulty metabolizing folic acid (associated with MTHFR variants), folic acid is the form with the strongest evidence for supporting healthy neural tube development early in pregnancy. Although methylated folate has been shown to raise blood folate levels, it has not been directly studied for supporting neural tube development outcomes in the same way as folic acid. Because folic acid is already the standard approach for supporting healthy neural tube development, direct head-to-head pregnancy outcome trials versus methylated folate are unlikely. I recommend you take at least 400 mcg of folic acid, in the form of folic acid. If you love a prenatal that has methylated folate, take an additional folic acid supplement. Methylated folate may help a small group of people who have problems metabolizing folic acid when they are not pregnant, but if you are trying to conceive, I recommend adding folic acid as well.
These nutrients are generally safe and well-tolerated at the listed doses.
Lifestyle Improvements
When you’re trying to conceive, every piece of your health puzzle matters. That includes your environment, nutrition, sleep, and stress. While supplements can be powerful tools, true fertility support begins with how you live each day.
Let’s start with environmental exposures. Endocrine disruptors like BPA, phthalates, and PFCs are common in plastics, food packaging, cosmetics, and even receipts. These chemicals can interfere with hormone function, egg quality, and embryo development. Easy swaps include avoiding microwaving food in plastic, switching to glass or stainless steel containers, limiting processed foods, and choosing fragrance-free personal care products.
Nutrition is a cornerstone. A whole food, mostly plant based diet rich in fiber, healthy fats, and antioxidants supports hormone balance and egg health. Limit refined sugar, soda, and processed carbohydrates as these increase insulin resistance and inflammation. Choose complex carbs like quinoa or steel cut oats, add legumes and leafy greens, and prioritize healthy fats like avocado, nuts, and olive oil. If you eat animal protein, choose organic and focus more on plant based sources.
Omega 3 fatty acids found in flax, chia, walnuts, and fish oil offer anti inflammatory benefits and support reproductive hormones. If eating fish, limit to two or three servings per week due to mercury exposure.
Sleep and stress matter too. Poor sleep can disrupt circadian rhythms and hormone regulation. Aim for seven to nine hours per night and keep a consistent sleep schedule. Prioritize stress management, whether through movement, meditation, or talking with a therapist. Your nervous system plays a key role in hormone signaling.
Finally, movement is essential. Regular, moderate exercise improves insulin sensitivity, reduces inflammation, and supports mental well being. Think daily walks, gentle strength training, or yoga. Overexercising or intense restriction can work against your hormones, so find balance.
You can’t control everything, but focusing on these key lifestyle factors helps create the healthiest foundation for conception.
Disclaimer
These statements have not been evaluated by the Food and Drug Administration. Any products and informational content displayed on this page are not intended to diagnose, treat, cure, or prevent any disease.
While this Protocol has been created by health experts, it is educational in nature and not a substitute for personalized medical advice. Always consult with your healthcare provider before starting any new supplement regimen, especially if you have underlying health conditions or take medications.
- Viswanathan, M., Peragallo Urrutia, R., Hudson, K. N., Middleton, J. C., & Kahwati, L. C. (2023). Folic acid supplementation to prevent neural tube defects: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 330(5), 460–466. https://doi.org/10.1001/jama.2023.9864
- Meng X, Zhang J, Wan Q, Huang J, Han T, Qu T, Yu LL. Influence of Vitamin D supplementation on reproductive outcomes of infertile patients: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2023 Feb 3;21(1):17. doi: 10.1186/s12958-023-01068-8. PMID: 36737817; PMCID:
- Stanhiser J, Jukic AMZ, McConnaughey DR, Steiner AZ. Omega-3 fatty acid supplementation and fecundability. Hum Reprod. 2022 May 3;37(5):1037-1046
- Zhou, X., Shi, H., Zhu, S., Wang, H., & Sun, S. (2022). Effects of vitamin E and vitamin C on male infertility: A meta-analysis. International Urology and Nephrology, 54(8), 1793–1805. https://doi.org/10.1007/s11255-022-03237-x
- Nie X, Dong X, Hu Y, Xu F, Hu C, Shu C. Coenzyme Q10 Stimulate Reproductive Vatality. Drug Des Devel Ther. 2023 Aug 30;17:2623-2637