Choosing a Prenatal

My top recommendations for prenatals are:

All of these contain natural folate (Garden of Life) or methylfolate (the other 4 brands).  This is preferred over standard prenatals, which typically contain poorly absorbed synthetic folic acid.  These prenatals also contain preferred forms of other B vitamins, such as B6 and B12, along with iodine and selenium – two minerals that are important for fertility and are not always included in prenatal supplements.

Deciding between the options

Question 1: Do You Need Methylfolate ? 

If testing shows that you have an MTHFR gene variant, it is best to choose a prenatal that contains methylfolate, to compensate for your reduced ability to convert folate into the active methyl form.

For the reasons discussed in the book, if you haven’t had any genetic testing done, but have a history of miscarriage or infertility,  the best approach is still to choose a prenatal containing methylfolate, just in case you do have a mutation.  The only downside to this is that some people experience side effects from methylfolate. You can always start with methylfolate and switch to another option if side effects bother you.

If you know that you do not have a significant MTHFR mutation, then a prenatal containing natural food folate, such as Garden of Life Organic Prenatal Multivitamin is likely sufficient, but you may also decide to take a prenatal with methylfolate, since this reflects the form naturally found in many foods.

Question 2: Would You Rather Take Your Prenatal Once or Three Times Per Day?

The suggested dose of the Thorne Basic Prenatal and Naturelo is three tablets per day, and Ovaterra’s Advanced Prenatal is 4 capsules (which can be taken all at once) whereas Theranatal Core Preconception is one tablet per day.  Some nutrients may be absorbed slightly better if divided over the course of the day, but for those who are likely to forget some of the doses, taking the full dose once per day is a better plan.  In addition, some people have trouble sleeping if they take B vitamins later in the day.

Question 3: Do Iron Supplements Disrupt Your Digestive System? 

Ovaterra’s Advanced Prenatal and Thorne’s basic prenatal contain a superior form of iron that is less likely to cause digestive problems, so this may be the best choice if you experience side effects from iron supplements. If you have high ferritin levels and need to completely avoid iron in supplements, Mama Bird’s Iron & Iodine free prenatal is a good choice.

Question 4:  Do You Need a Higher Dose of B12? 

Another main difference between the Thorne prenatal and the other options is that it contains a much higher dose of vitamin B12. (7000% of the RDI). B12 is often included in higher doses because it is very difficult to absorb and important for fertility, particularly for those with anemia, celiac disease, high homocysteine, or MTHFR mutations. Yet excessive amounts can sometimes cause side effects such as itching skin and anxiety.  For this reason, some people prefer to avoid the higher dose B12 in Thorne’s Prenatal.  Ovaterra’s Advanced Prenatal has what I believe to be the optimal B12 dose for fertility – 50 mcg (2000% RDI).

Question 5: Are You Located Outside the U.S? 

Naturelo’s Prenatal  is one good option available outside the U.S. Another alternative is to take a standard prenatal and add on a 400-800 mcg methylfolate supplement.  Ovaterra’s Advanced Prenatal will soon be available in the UK from Zen Pharmacy (see UK Supplement Guide).

Comparative Costs

Theralogix Core Preconception is one of the most cost-effective options, at $29 for a 90-day supply.  Thorne’s Basic Prenatals is approximately $25 for a one month supply, while Naturelo is $40 for a two-month supply.  Ovaterra is $89 for a 4-week supply.

If you are on a particularly tight budget, one option is to take a standard prenatal and add on 400-800 mcg of methylfolate (this will only cost around $5).

The Bottom Line

Although different options will suit different individuals, my top recommendation is Ovaterra’s Advanced Prenatal because it is the most complete prenatal and has the preferred forms and quantity of each nutrient, including folate, B6, and B12. It is the only prenatal capsule on the market to include the full recommended daily value for pregnant and nursing mothers of Choline, a key ingredient for the formation of baby’s brain.

If you need a lower-cost option or a single capsule per day, my next choice would be  Theralogix Core Preconception

Additional Option for Women over 35:

Ovaterra has now released an alternative preconception multivitamin specifically designed for women over 35,  the Advanced Prep 35-39.  This includes all of the important nutrients in their prenatal, plus 25mg of DHEA.  DHEA naturally declines with age and plays an important role in the earliest stages of egg development.  See FAQs about DHEA 

Comparison of Supplement Facts

Thorne Basic Prenatal Supplement Facts: 

Thorne basic prenatal

Theralogix Core Preconception

Theralogix Core preconception

Ovaterra’s Advanced Prenatal