Basic Prenatal

One of the best prenatal multivitamins is Garden of Life Vitamin Code Raw Prenatal. It has 800 mcg of folate (rather than the synthetic form, folic acid, which must be converted to folate in the liver using the DHFR enzyme. The efficiency of this enzyme varies greatly between different people). It also has the active forms of vitamin D and B12, and good amounts of thyroid-supporting zinc, iodine, and selenium. It is also very well tolerated, with few side effects.

Additional Supplements

As explained in the book, there are many different supplements with the potential to improve egg quality, but not every supplement is right for every situation. (And you should always discuss your supplement plan with your doctor.) If you decided to add a particular supplement, the following are good-quality brands to choose.

Ubiquinol (CoQ10):  Jarrow Formulas Ubiquinol QH-absorb

N-Acetyl Cysteine:  Jarrow Formulas N-A-C Sustain

Myo-Inositol:  Now Foods Inositol Capsules

DHEA:  Fertinatal DHEA

Alternative Folate Options for MTHFR Mutations

If you have a significant mutation in the MTHFR gene, which encodes an enzyme that converts folate to the biologically active methylfolate, you may want to consider adding a stand-alone folate supplement to reach a higher dose of folate, or choosing a prenatal that has folate already in the methyl form.

MTHFR mutations have long been associated with recurrent miscarriage. A study published in May 2016 found that MTHFR mutations are also much more common in women with failed IVF cycles and chromosomally abnormal embryos. Your Doctor can order an MTHFR blood test or you can order DNA analysis yourself through 23andme and have the data analyzed through the free website Genetic Genie. Note that methylfolate can sometimes cause side effects such as mood changes and joint pain.  For this reason, you may prefer to just take a higher dose of folate.   Even people with two copies of a mutation in the MTHFR gene (“homozygous” mutations) can still perform the conversion from folate to methylfolate, just less effectively.  Government bodies recommend no more than 1000 mcg/day of synthetic folic acid (or 4000 mcg for those with a history of neural tube defects), but have not set an upper dose limit for natural folate because no adverse effects have been observed.  Discuss your plan with your doctor, but 800 mcg folate from your prenatal  plus 800 mcg folate from a stand-alone supplement would seem reasonable.

Good prenatals containing L-methylfolate:

Add-on folate supplement:

Country Life organic chewable Folate