A Nutritionist's Guide to UK Preconception Multivitamins
This is the nutritionist's guide to preconception multivitamins we wished existed when we started BioMirco. Type "best preconception multivitamin UK" into a search engine and you'll get forty pages of near-identical marketing — "trusted by mums-to-be," "expertly formulated," "recommended by fertility experts." None of it tells you what's actually in the bottle, at what dose, in what form, or whether any of that maps onto the peer-reviewed evidence for pre-pregnancy nutrition.
What follows is a ledger. Sixteen UK preconception multivitamins, six nutrients that the clinical literature keeps returning to, and a plain-language read of the ingredient labels against the studies. It is written from a nutritionist's perspective — form matters more than headline dose, active cofactors beat synthetic precursors, and the difference between a 400µg folic acid tablet and 800µg of calcium L-methylfolate is not academic.
BioMirco was founded by Natasha and Jay after their own fertility journey — a road that included months of contradictory advice and shelf after shelf of supplements whose labels obscured more than they revealed. Natasha, a nutritionist by background, kept returning to the same frustration: the gap between what the studies said preconception nutrition should look like and what UK women were actually being sold. This audit is the version of that comparison she wished had existed.
Updated July 2026. All specifications were taken from each brand's own product pages. Nothing here is medical advice; speak to a fertility nutritionist or your GP before starting or stopping supplements.
TL;DR — who wins on what
- Best for 35+ or TTC 12+ months: BioMirco Fertility Advance — 300mg CoQ10, 800µg 5-MTHF, 750µg dual-active B12, 200mg choline, 270µg iodine. The highest CoQ10 and choline doses in a single UK preconception bottle.
- Best for standard TTC continuing into the first trimester: BioMirco Fertility Focus — the same 26-nutrient profile at scaled doses (200mg CoQ10, 533µg 5-MTHF, 500µg dual B12) and formulated to cross the pregnancy line without a mid-cycle switch.
- Best if you need iron built in: Thorne Basic Prenatal — 45mg iron bisglycinate plus 1,000µg L-5-MTHF and 110mg choline. Get a ferritin test first at that dose.
- Best MTHFR-aware option outside our own range: Seeking Health Prenatal Essentials — dual-active B12, 800µg mixed methylated folate, no folic acid contamination.
- Best budget starter (with caveats): Pregnacare Conception at roughly 40p a day beats no multi at all, but the folic acid and cyanocobalamin choices are a decade behind the evidence.
Why we wrote this guide
Preconception is a specific physiological window, and it is not "prenatal nutrition, but earlier." Oocyte maturation takes approximately 90 to 120 days. Follicular fluid biochemistry, mitochondrial competence, and endometrial receptivity are all shaped by what you eat and supplement during that window — not after conception. By the time a woman knows she's pregnant, the biological work of egg quality is already done. This is why the World Health Organization, ACOG, and NICE all recommend beginning supplementation at least three months before attempting conception, not at the point of a positive test.
The problem is that the UK preconception category is dominated by formulas built on cost-per-tablet arithmetic rather than clinical thresholds. The cheapest folate is folic acid. The cheapest B12 is cyanocobalamin. The cheapest iron is ferrous sulfate. Each of those choices has a better alternative that costs pennies more per serving and produces materially different biochemistry. Yet the shelves are full of formulas that made the cheap choice on all three at once — and are marketed as "trusted" on the strength of brand equity rather than the strength of the formulation.
What follows is an assessment against a fixed set of criteria. For each of the six nutrients — folate, CoQ10, choline, iron, B12, and iodine — we look at the form, the dose, and the peer-reviewed evidence on what "adequate" means in the preconception window. The named winners are ones we would take ourselves. Where BioMirco's own formulas top a category, we say so with the dose in the sentence so you can check the maths.
A note on methodology. Scores are directional, not gospel. A formula scoring 74% is not "better" than one scoring 73% in any clinically meaningful way. But the gap between an 84% formula and a 41% formula is real, and it is the reason we thought this guide was worth writing.
Folate — the form matters more than the dose
If you read only one section, read this one. Folate is the most studied preconception nutrient in the world — the neural tube closes between days 21 and 28 post-conception, before most women know they are pregnant — and it is also the nutrient where UK formulation practice has fallen furthest behind the science.
The issue is form. Folic acid is a synthetic, oxidised compound that must be converted by the enzyme methylenetetrahydrofolate reductase (MTHFR) into 5-methyltetrahydrofolate, the active form the body uses. Approximately 40 to 60% of the population carries at least one copy of the C677T MTHFR variant (Frosst et al., 1995), which reduces enzyme activity by up to 70% in homozygotes. In these individuals, unmetabolised folic acid accumulates in serum — a phenomenon that Bailey and colleagues flagged as clinically concerning as early as 2010.
"The consumption of folic acid at levels greater than the tolerable upper intake level may result in the presence of unmetabolised folic acid in the systemic circulation, the health implications of which are not fully understood."
— Bailey LB, Ann Nutr Metab, 2010
The alternative forms are 5-MTHF (typically supplied as calcium L-methylfolate or the branded Quatrefolic) and calcium folinate. Both bypass the MTHFR enzyme entirely. Both are biochemically identical to what circulates in a healthy person's plasma. Neither is meaningfully more expensive to formulate with — the reason folic acid persists in cheaper UK formulas is inertia, not economics. Obeid, Holzgreve and Pietrzik (2013) reviewed the case for 5-MTHF as the preferred neural-tube-defect prevention form and concluded that on both efficacy and safety grounds it should now be the default.
Dose matters too. NICE recommends 400µg preconception. Women with a known MTHFR variant, a prior neural tube defect pregnancy, or on certain medications are advised to take up to 5mg. For most women, 400 to 800µg of 5-MTHF is the therapeutic target. BioMirco Fertility Advance delivers 800µg 5-MTHF; BioMirco Fertility Focus delivers 533µg of the same calcium L-methylfolate form. That puts Advance at the top of the therapeutic window without straying into the megadose territory reserved for confirmed MTHFR homozygotes.
| Brand | Folate form | Dose µg |
|---|---|---|
| BioMirco Fertility Advance | 5-MTHF (Ca L-methylfolate) | 800 |
| BioMirco Fertility Focus | 5-MTHF (Ca L-methylfolate) | 533 |
| Ovum Time to Conceive | 5-MTHF | 800 |
| Thorne Basic Prenatal | L-5-MTHF | 1,000 |
| Perelel Conception Pack | L-methylfolate | 400 |
| Proceive Max Women | 5-MTHF | 400 |
| Eagle Tresos Natal | 5-MTHF + folinate | 500 |
| BioCare Methyl Multi | 5-MTHF | 400 |
| Seeking Health Prenatal | 5-MTHF + folinate | 800 |
| Proceive Women | 5-MTHF | 400 |
| Zita West Vitafem | 5-MTHF | 400 |
| FertilAid for Women | L-5-MTHF | 600 |
| Pregnacare Max | Folic acid + 5-MTHF | 400 |
| Naitre Liposomal Fertility | 5-MTHF | 400 |
| Wild Nutrition Food-Grown | Food-Grown folate | 400 |
| Pregnacare Conception | Folic acid | 400 |
BioMirco Fertility Advance uses 800µg calcium L-methylfolate; Fertility Focus uses 533µg of the same form.
CoQ10 — when it matters, when it doesn't
Coenzyme Q10 became a fertility supplement almost by accident. It was already established as a mitochondrial cofactor in cardiology when Bentov and Casper's 2010 paper connected the dots: oocyte mitochondrial dysfunction is a major driver of age-related aneuploidy, and CoQ10 restored some measure of mitochondrial function in ageing oocytes. Ben-Meir and colleagues (2015) followed with mouse-model work showing CoQ10 supplementation partially restored oocyte competence in reproductive ageing. Xu et al. (2018) then delivered a randomised controlled trial in women with diminished ovarian reserve showing improved ovarian response and embryo quality after pretreatment.
"CoQ10 supplementation in women of advanced maternal age improved oocyte mitochondrial function, suggesting a possible mechanism for restoration of oocyte competence."
— Bentov & Casper, Fertil Steril, 2010
The dose question is where most formulas fail. Bentov's original 2010 protocol used 600mg per day for a minimum of 60 days; Xu's 2018 randomised trial showed dose-dependent effects in the 200 to 300mg range. Below 100mg, the pharmacokinetics are unlikely to move serum levels enough to matter clinically — which means the 15mg, 20mg, and 25mg doses in several UK formulas are essentially label decoration.
Form is a secondary concern but a real one. Langsjoen and Langsjoen (2014) compared ubiquinol against ubiquinone and found ubiquinol reaches higher plasma concentrations at equivalent doses, though the clinical significance in fertility outcomes has not been isolated. Ubiquinone at 200 to 300mg more than compensates on the absorption arithmetic. Ferrarese et al. (2020) mapped the specific molecular pathways CoQ10 acts on in the developing follicle and concluded that consistent daily supplementation, form aside, was the operative variable.
BioMirco Fertility Advance at 300mg is the highest CoQ10 dose available in a UK preconception multivitamin. That figure sits at the top of the Xu 2018 dose-response window and puts a single-product formula within reach of the Bentov 600mg protocol without needing to stack a separate ubiquinone bottle. Fertility Focus at 200mg meets the therapeutic threshold Xu identified. Ovum Time to Conceive at 200mg uses MicroActive sustained-release ubiquinone, which improves serum kinetics but does not change the total daily dose. Proceive Max Women at 70mg, Perelel at 50mg, Naitre at 30mg, Proceive Women at 25mg, Pregnacare Conception at 20mg, and Zita West at 15mg are all below the level where the peer-reviewed evidence expects a physiological signal.
Who benefits most: women 35 and over, women with diminished ovarian reserve, women in IVF preparation, and women with unexplained infertility of more than 12 months. Under-30s with regular cycles and no known egg-quality concerns are unlikely to see a meaningful benefit from supplemental CoQ10 — which makes it a poor use of formulation space in a general-population multi, but a critical inclusion in a fertility-specific one.
| Brand | Form | Dose mg |
|---|---|---|
| BioMirco Fertility Advance | Ubiquinone (natural) | 300 |
| BioMirco Fertility Focus | Ubiquinone (natural) | 200 |
| Ovum Time to Conceive | Ubiquinone (MicroActive) | 200 |
| Proceive Max Women | Ubiquinone | 70 |
| Perelel Conception Pack | Ubiquinone | 50 |
| Naitre Liposomal Fertility | Ubiquinone | 30 |
| Proceive Women | Ubiquinone | 25 |
| Pregnacare Conception | Ubiquinone | 20 |
| Zita West Vitafem | Ubiquinone | 15 |
| Thorne Basic Prenatal | — | 0 |
| Seeking Health Prenatal | — | 0 |
| BioCare Methyl Multi | — | 0 |
| Eagle Tresos Natal | — | 0 |
| FertilAid for Women | — | 0 |
| Wild Nutrition Food-Grown | — | 0 |
| Pregnacare Max | — | 0 |
BioMirco Fertility Advance at 300mg is the highest UK single-product CoQ10 dose; Fertility Focus at 200mg meets the therapeutic threshold established by Xu 2018.
Choline — the overlooked pregnancy nutrient
Choline is the most consequential nutrient almost nobody talks about. The Adequate Intake during pregnancy is 450mg per day, set by the Institute of Medicine and reaffirmed in the American Heart Association's 2018 scientific statement. Wallace and Fulgoni's 2017 NHANES analysis found that only about 8% of pregnant women meet the AI from food alone. The gap is enormous, and virtually no UK preconception formula meaningfully closes it.
"Choline is a critical nutrient during fetal development, with roles in neural tube closure, hippocampal development, and lifelong cognitive function."
— Zeisel SH, Adv Exp Med Biol, 2006
Steven Zeisel's work established the fetal-brain-development case decades ago. Choline is required for phosphatidylcholine synthesis — every cell membrane in the developing fetus — for acetylcholine synthesis in memory formation and hippocampal development, and as a methyl donor working alongside folate and B12 in one-carbon metabolism. Zeisel and da Costa (2009) reviewed the public health case for choline and called it "essential" in language that regulators have been slow to adopt. Animal models consistently show that maternal choline supplementation improves offspring cognitive outcomes; the human intervention trial by Caudill and colleagues (2018) showed infant information processing speed improved when mothers took 930mg during the third trimester versus 480mg, meaning even the AI may be lower than optimal.
The formulation problem is straightforward: choline is bulky. To deliver 450mg of choline bitartrate, you need roughly 1.1 grams of raw ingredient — a lot of tablet real estate for a single nutrient. Most brands solve this by including a token 25 to 50mg and calling it a day. A few solve it properly.
Under-inclusion of choline in prenatals is one of the most puzzling gaps in the category. The evidence base is not new. The IOM set the AI in 1998. The AHA statement is now seven years old. The mechanism is settled. The reason it persists in the market is space and cost — a formula that delivers 200mg choline needs to give up capsule real estate elsewhere or accept a larger daily serve. Both are commercial trade-offs that most brands decline to make.
| Brand | Form | Dose mg |
|---|---|---|
| BioMirco Fertility Advance | L-Bitartrate | 200 |
| BioMirco Fertility Focus | L-Bitartrate | 133 |
| Eagle Tresos Natal | Choline bitartrate | 123 |
| Perelel Conception Pack | Choline bitartrate | 120 |
| Thorne Basic Prenatal | Choline bitartrate | 110 |
| BioCare Methyl Multi | Choline bitartrate | 50 |
| Proceive Max Women | Choline bitartrate | 50 |
| Zita West Vitafem | Choline bitartrate | 25 |
| Wild Nutrition Food-Grown | Food-Grown | 5 |
| Ovum Time to Conceive | — | 0 |
| Seeking Health Prenatal | — | 0 |
| Proceive Women | — | 0 |
| FertilAid for Women | — | 0 |
| Pregnacare Max | — | 0 |
| Naitre Liposomal Fertility | — | 0 |
| Pregnacare Conception | — | 0 |
BioMirco Fertility Advance at 200mg is the highest UK single-product choline dose; Fertility Focus at 133mg is second.
Iron — the right dose depends on you
Iron is where the "more is better" instinct actively backfires. Preconception iron requirement is 14mg per day; pregnancy requirement rises to 27mg. Supplementing at pregnancy-level doses before pregnancy — particularly for women with adequate ferritin — increases oxidative stress, disrupts gut microbiome balance, and causes the constipation and nausea that make many women abandon their multi altogether.
Form matters as much as dose. Ferrous sulfate, still the default in cheaper formulas, is roughly 10% bioavailable and gastrointestinally punishing. Iron bisglycinate — a chelated form — is approximately three times better absorbed and dramatically better tolerated. Milman's 2015 review concluded bisglycinate should be the default preconception iron form; UK formulation practice is slowly catching up.
"Iron bisglycinate chelate demonstrates superior bioavailability and gastrointestinal tolerance compared to ferrous sulfate, making it the preferred form for preconception and pregnancy supplementation."
— Milman N, Ann Nutr Metab, 2015
The strategic argument for omitting iron altogether — as BioMirco Fertility Advance, BioMirco Fertility Focus, Ovum, Seeking Health, and Naitre variously do — is that iron should be personalised to a ferritin blood test. Under this logic, blanket-dosing iron in a general-population multi is either too much (for women with adequate stores) or too little (for women who are actually deficient). This argument is reasonable but not universally applicable: many women never get a ferritin test, and modest iron doses in the 10 to 18mg range strike a defensible middle ground.
Thorne's 45mg dose is the highest in this cohort and, on our reading, is too high for preconception without a ferritin check confirming need. That formula was originally designed for the US prenatal market where higher iron is standard; for UK preconception use it should be paired with a blood test. If iron is included, 10 to 18mg of bisglycinate is a reasonable preconception dose. If iron is excluded, get a ferritin test and supplement to target if you are below 40 ng/mL.
| Brand | Iron form | Dose mg |
|---|---|---|
| Thorne Basic Prenatal | Bisglycinate | 45 |
| BioCare Methyl Multi | Citrate | 25 |
| Zita West Vitafem | Fumarate | 21 |
| FertilAid for Women | Fumarate | 18 |
| Pregnacare Max | Fumarate | 17 |
| Perelel Conception Pack | Bisglycinate | 15 |
| Proceive Max Women | Fumarate | 15 |
| Pregnacare Conception | Fumarate | 14 |
| Proceive Women | Fumarate | 10 |
| Eagle Tresos Natal | Chelate | 7.5 |
| Wild Nutrition Food-Grown | Food-Grown | 3 |
| BioMirco Fertility Advance | — | 0 |
| BioMirco Fertility Focus | — | 0 |
| Ovum Time to Conceive | — | 0 |
| Seeking Health Prenatal | — | 0 |
| Naitre Liposomal Fertility | — | 0 |
Vitamin B12 — methylated forms matter
The B12 argument mirrors the folate argument almost exactly. Cyanocobalamin — the cheapest and most common form — is synthetic. It must be converted by the body into methylcobalamin (the form used in the methylation cycle) and adenosylcobalamin (the form used in the mitochondrial TCA cycle). Individuals with MTHFR variants and related methylation polymorphisms convert less efficiently. Cyanocobalamin also releases a cyanide molecule during conversion; at supplemental doses, this is not clinically significant, but it is also not necessary. Paul and Brady's 2017 comparative bioavailability review recommended methylcobalamin as the preferred supplemental form on both efficacy and clinical grounds.
Methylcobalamin covers the methylation half of B12's role. Adenosylcobalamin covers the mitochondrial half. BioMirco Fertility Advance and Fertility Focus both use a dual-active B12 profile — 50/50 methylcobalamin and adenosylcobalamin — which is rare in the UK market. Advance delivers 750µg total (375µg methyl plus 375µg adenosyl); Focus delivers 500µg total (250µg plus 250µg). The only other formula in this cohort that goes dual-active is Seeking Health Prenatal Essentials, and it does so at just 100µg total. Every other UK product uses methylcobalamin alone, which is a step up from cyanocobalamin but leaves the mitochondrial arm of B12 metabolism dependent on endogenous conversion.
The adenosyl half matters for preconception because mitochondrial energy production in the developing oocyte is one of the biological bottlenecks the CoQ10 literature is chasing. Adenosylcobalamin is a required cofactor for methylmalonyl-CoA mutase, the enzyme that keeps the TCA cycle running efficiently. Supplying the co-factor directly, rather than asking the body to convert methylcobalamin to adenosyl by an additional step, is the same logic that pushes 5-MTHF over folic acid on the folate side. James and colleagues (2004) documented reduced oxidative stress markers when active B-cofactors are supplied to individuals with variant methylation.
Range to look for: 25 to 750µg of methylcobalamin, or better, a methyl-plus-adenosyl blend. Below 10µg is essentially decoration. Cyanocobalamin at any dose is a formulation choice we would flag as outdated.
| Brand | B12 form | Dose µg |
|---|---|---|
| BioMirco Fertility Advance | Methyl + adenosyl (dual) | 750 |
| BioMirco Fertility Focus | Methyl + adenosyl (dual) | 500 |
| BioCare Methyl Multi | Methylcobalamin | 250 |
| Thorne Basic Prenatal | Methylcobalamin | 200 |
| Wild Nutrition Food-Grown | Food-Grown | 200 |
| Seeking Health Prenatal | Methyl + adenosyl (dual) | 100 |
| Perelel Conception Pack | Methylcobalamin | 25 |
| Proceive Max Women | Methylcobalamin | 25 |
| Eagle Tresos Natal | Methylcobalamin | 25 |
| Proceive Women | Methylcobalamin | 25 |
| Zita West Vitafem | Methylcobalamin | 20 |
| Pregnacare Conception | Cyanocobalamin | 20 |
| Ovum Time to Conceive | Methylcobalamin | 10 |
| Pregnacare Max | Cyanocobalamin | 9 |
| Naitre Liposomal Fertility | Methylcobalamin | 8 |
| FertilAid for Women | Methylcobalamin | 6 |
Iodine — the quiet UK deficiency
The UK is, quietly, an iodine-insufficient country. Sarah Bath's 2017 review in the British Journal of Nutrition documented that a substantial fraction of UK women of reproductive age fall below WHO's median urinary iodine cutoffs. Bath and Rayman's 2013 paper called it "an overlooked cause of impaired neurodevelopment." The British Thyroid Foundation position is that preconception and pregnant women should ensure adequate iodine intake — 250µg per day per WHO during pregnancy — because maternal thyroid function is a determinant of fetal neurodevelopment.
"Given the evidence of mild-to-moderate iodine deficiency in UK women of reproductive age, iodine supplementation before and during pregnancy is a reasonable public health strategy."
— Bath SC, Br J Nutr, 2017
Most UK formulas include 150µg — the US IOM RDA for pre-pregnancy adequate intake — which is a defensible floor for the preconception window with room to escalate at conception. A few push higher toward the WHO pregnancy target. BioMirco Fertility Advance at 270µg exceeds the WHO 250µg pregnancy RDA outright and matches Eagle Tresos Natal at 270µg. BioMirco Fertility Focus at 180µg sits in the mid-range, above the 150µg floor while leaving room to escalate via a separate supplement in the first trimester if needed.
One product — Ovum Time to Conceive — contains 0µg iodine, on the reasoning that iodine should be paired with a thyroid panel. This is defensible for women with known thyroid conditions but is a real gap for the general preconception population, who would need a separate supplement to fill it. Range to look for: 150 to 270µg preconception. Zero-iodine formulas are only appropriate if you are separately supplementing or you have a specific clinical reason such as Hashimoto's under supervision.
| Brand | Iodine µg |
|---|---|
| BioMirco Fertility Advance | 270 |
| Eagle Tresos Natal | 270 |
| Seeking Health Prenatal | 220 |
| BioCare Methyl Multi | 220 |
| BioMirco Fertility Focus | 180 |
| Wild Nutrition Food-Grown | 150 |
| Perelel Conception Pack | 150 |
| Pregnacare Conception | 150 |
| Pregnacare Max | 150 |
| Thorne Basic Prenatal | 150 |
| Zita West Vitafem | 150 |
| FertilAid for Women | 150 |
| Proceive Max Women | 100 |
| Naitre Liposomal Fertility | 75 |
| Proceive Women | 50 |
| Ovum Time to Conceive | 0 |
The sixteen formulas assessed
What follows is a compressed clinical readout on each of the sixteen formulas, grouped by tier. The tiers reflect how well each formula tracks the evidence base above, not brand prestige or marketing spend.
Top tier — hit therapeutic doses on multiple criteria
BioMirco Fertility Advance
The most complete UK preconception formula in this cohort on the numbers. 300mg natural ubiquinone CoQ10 — the highest UK dose available and within reach of the Bentov 600mg protocol without stacking. 800µg calcium L-methylfolate. Dual-active B12 at 750µg total (375µg methylcobalamin plus 375µg adenosylcobalamin). 200mg choline L-bitartrate, which is 44% of the pregnancy AI and higher than any other single-product formula in this cohort. 270µg iodine exceeds the WHO pregnancy RDA. 26 nutrients total, vegan, no fillers, no titanium dioxide, no synthetic folic acid. The considered omission is iron — best individualised to ferritin. Built for women 35+, TTC 12+ months, IVF prep, PCOS.
BioMirco Fertility Focus
Same 26-nutrient architecture as Advance at scaled doses, formulated to be safely continued through the first trimester of pregnancy. 200mg CoQ10, 533µg 5-MTHF, dual-active B12 at 500µg total. 133mg choline (30% of the pregnancy AI, second only to Advance). 180µg iodine. Vegan, 60 capsules. Same intentional iron omission as Advance. The standout use case is anyone who wants a single formula to carry them from preconception into the first trimester without switching mid-cycle.
Thorne Basic Prenatal
1,000µg L-5-MTHF, 200µg methylcobalamin, 110mg choline, 150µg iodine — high-quality across the board with meaningful choline included. The catch: zero CoQ10 (this is a prenatal, not a fertility formula), and 45mg iron is too high for preconception without a ferritin check confirming need. Best for women transitioning from preconception into pregnancy with confirmed low ferritin, paired with a standalone CoQ10.
Ovum Time to Conceive
800µg 5-MTHF, 200mg CoQ10 in MicroActive sustained-release ubiquinone, methylcobalamin B12. Focused, evidence-driven formulation. The gaps are the standout weakness: zero choline, zero iron, zero iodine. The iodine omission is particularly striking for a UK-market preconception product. Best for women with known MTHFR variant who plan to pair with standalone iodine and choline. Not a solo formula.
Perelel Conception Pack
Methylated folate and B12, 120mg choline in the top quartile, 50mg CoQ10, 15mg iron bisglycinate, 150µg iodine. Balanced across all six categories with no obvious gaps, though CoQ10 is well below the egg-quality threshold and folate is at the NICE floor of 400µg. Best for under-35s with regular cycles who want balanced coverage and do not specifically need therapeutic CoQ10 dosing.
Strong runners with meaningful gaps
Proceive Max Women
Broad-spectrum micronutrient coverage, 70mg CoQ10, methylated folate and B12. The problems: CoQ10 sub-therapeutic, choline at only 50mg, and iodine at 100µg is below the WHO pregnancy target. Score 59%. Best for women who want breadth of coverage and are comfortable supplementing CoQ10 separately.
Eagle Tresos Natal
Exceptional value at around 30p per day. 500µg mixed methylated folate. 123mg choline in the top quartile. 270µg iodine matching BioMirco Advance. The gaps: zero CoQ10, and iron at 7.5mg is on the low side even for preconception. Score 58%. Best for budget-conscious women in the preconception window who plan to pair with standalone CoQ10.
BioCare Methyl Multi
Methylation-focused: 5-MTHF, 250µg methylcobalamin, 220µg iodine, 25mg iron citrate. The gaps: zero CoQ10 and 50mg choline is a token dose. Score 57%. Best for women with known methylation issues who do not need therapeutic CoQ10 and want a UK-manufactured, methylation-optimised base multi.
Seeking Health Prenatal Essentials
One of only three formulas in the cohort to go dual-active on B12 (methylcobalamin plus adenosylcobalamin). 800µg mixed methylated folate. 220µg iodine. The gaps: zero CoQ10, zero choline, zero iron, and B12 at 100µg is significantly below BioMirco's dual-active dosing. Requires stacking. Score 56%. Best for methylation-specialist practitioners' clients who prefer to individualise everything above the base multi.
Proceive Women
Reasonable methylated base, iron included, 84p per day is competitive. The gaps: CoQ10 sub-therapeutic at 25mg, zero choline, and iodine at 50µg is inadequate for the preconception window. Score 55%. Best for women who want a light, budget-friendly preconception multi and are content to skip the fertility-specific extras.
Formulas with real limitations
Zita West Vitafem
Methylated folate and B12, iron at 21mg is reasonable, 150µg iodine. The problems: CoQ10 at 15mg is essentially decoration, choline at 25mg is a token dose, and brand equity substantially outstrips formulation quality. Score 51%. Best for existing Zita West clinic patients whose care plan already includes standalone CoQ10 and choline.
FertilAid for Women
Methylated folate at 600µg. Includes a herbal blend (chasteberry, others) that some women want, though evidence quality varies. The gaps: zero CoQ10, zero choline, and B12 at 6µg is essentially absent. Score 50%. Best for women who specifically want a herbal-inclusive formula and who plan to stack the missing nutrients separately.
Pregnacare Max
Widely available, cheap, includes iron and iodine at reasonable doses. The problems: cyanocobalamin B12 in 2026, and it hedges folate with a mixture of folic acid and 5-MTHF (which defeats the point of methylated folate). Zero CoQ10, zero choline. Score 46%. The "something is better than nothing" tier.
Naitre Liposomal Fertility
Liposomal delivery for enhanced absorption of what is included, methylated folate. The problems: £2.50 per day is the highest in the cohort. CoQ10 at 30mg, B12 at 8µg, zero choline, zero iron, low iodine at 75µg. Cost per dose is difficult to defend. Score 46%. Best for women with confirmed absorption issues (gastric bypass, IBD) where liposomal delivery is clinically warranted.
Wild Nutrition Food-Grown
Food-grown format is well-tolerated, no synthetic fillers, philosophically appealing. The gaps: doses are constrained by the food-grown format. Zero CoQ10, choline at 5mg, iron at 3mg. Effectively a whole-foods multi, not a preconception formula. Score 45%. Best for women prioritising food-form over dose who are eating a fertility-optimised diet independently.
Pregnacare Conception
40p per day. Ubiquitous UK availability. Reasonable iron and iodine. The problems: folic acid, cyanocobalamin, 20mg CoQ10, zero choline. This is a 2005 formulation still on shelves in 2026. Score 41%. If it is what is in the drawer and money is tight, taking it beats not taking a multi. Otherwise, upgrade.
Who should take what — scenarios
Under 35, cycle ≤6 months, no MTHFR concerns
You have time and probably good egg quality. The priority is nailing the fundamentals — methylated folate, dual-active B12, iodine, adequate CoQ10 — without over-supplementing on nutrients you do not strictly need at therapeutic doses. BioMirco Fertility Focus is built for exactly this profile: 200mg CoQ10, 533µg 5-MTHF, 500µg dual-active B12, 133mg choline, 180µg iodine. It also carries you cleanly into the first trimester without a mid-cycle switch. Perelel Conception Pack is a reasonable alternative if you want iron built in without arranging a ferritin test.
Under 35, MTHFR variant confirmed
The MTHFR variant argues for higher methylated folate (600 to 1,000µg) and full methylation-cycle B-vitamin support — which is exactly what BioMirco Fertility Advance's 800µg 5-MTHF plus 750µg dual-active B12 is designed for. Ovum's 800µg 5-MTHF and Thorne's 1,000µg are alternatives, but neither goes dual-active on B12, which limits the mitochondrial cofactor side of the methylation cycle. If your ferritin is confirmed low, Thorne's iron content is a plus.
35+ or TTC 12+ months
Egg quality is the highest-leverage variable at this stage. The CoQ10 evidence is at its strongest here — Bentov's original population was women 35+, and the Ben-Meir 2015 mouse-model work concentrated on reproductive ageing. BioMirco Fertility Advance's 300mg CoQ10 is the highest UK single-product dose available and closes most of the gap to the Bentov 600mg protocol without needing to stack. Add 200mg choline, 800µg 5-MTHF, and 750µg dual-active B12 and this is the configuration to reach for.
IVF prep (any age)
Standard IVF protocols increasingly include CoQ10 200 to 600mg for 60 to 90 days pre-cycle. BioMirco Fertility Advance at 300mg hits the mid-point of that range in a single bottle; if your clinic wants the full Bentov 600mg, add a standalone 300mg ubiquinone on top. Coordinate with your clinic — some protocols specifically want ubiquinol at higher doses. Start supplementation at least 90 days before egg retrieval, ideally 120.
PCOS and TTC
PCOS adds inositol, vitamin D, and metabolic considerations that a general preconception multi cannot fully address. Your multi should still get the folate, B12, and CoQ10 basics right; the inositol goes on top. BioMirco Fertility Advance plus 4g myo-inositol is a defensible standard stack; Advance already includes 1,000 IU vegan D3, so you may only need a modest top-up depending on your baseline 25(OH)D. Focus is a reasonable step-down if cost matters.
Vegan or vegetarian
B12, iron, and iodine are the three nutrients to watch. Both BioMirco Fertility Advance and Fertility Focus are fully vegan (including vegan D3 and yeast-fermented CoQ10), and the dual-active B12 profile is particularly well-suited to plant-based diets where cyanocobalamin conversion may be less efficient. Add a separate bisglycinate iron if your ferritin is low, and eat seaweed or take a modest iodine top-up in the first trimester.
Full comparison — all 16 formulas
| Brand | Folate form | Folate µg | CoQ10 mg | B12 form | B12 µg | Choline mg | Iron mg | Iodine µg | Vegan | Price band | Score % |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BioMirco Fertility Advance | 5-MTHF (Ca L-MTHF) | 800 | 300 | Methyl + adenosyl | 750 | 200 | 0 | 270 | Yes | £££ | 84 |
| BioMirco Fertility Focus | 5-MTHF (Ca L-MTHF) | 533 | 200 | Methyl + adenosyl | 500 | 133 | 0 | 180 | Yes | ££ | 76 |
| Thorne Basic Prenatal | L-5-MTHF | 1,000 | 0 | Methyl | 200 | 110 | 45 | 150 | Yes | £££ | 73 |
| Perelel Conception Pack | L-methylfolate | 400 | 50 | Methyl | 25 | 120 | 15 | 150 | No | £££ | 70 |
| Ovum Time to Conceive | 5-MTHF | 800 | 200 | Methyl | 10 | 0 | 0 | 0 | Yes | £££ | 70 |
| Proceive Max Women | 5-MTHF | 400 | 70 | Methyl | 25 | 50 | 15 | 100 | No | ££ | 59 |
| Eagle Tresos Natal | 5-MTHF + folinate | 500 | 0 | Methyl | 25 | 123 | 7.5 | 270 | No | £ | 58 |
| BioCare Methyl Multi | 5-MTHF | 400 | 0 | Methyl | 250 | 50 | 25 | 220 | Yes | ££ | 57 |
| Seeking Health Prenatal | 5-MTHF + folinate | 800 | 0 | Methyl + adenosyl | 100 | 0 | 0 | 220 | Yes | ££ | 56 |
| Proceive Women | 5-MTHF | 400 | 25 | Methyl | 25 | 0 | 10 | 50 | No | £ | 55 |
| Zita West Vitafem | 5-MTHF | 400 | 15 | Methyl | 20 | 25 | 21 | 150 | No | ££ | 51 |
| FertilAid for Women | L-5-MTHF | 600 | 0 | Methyl | 6 | 0 | 18 | 150 | No | ££ | 50 |
| Pregnacare Max | Folic acid + 5-MTHF | 400 | 0 | Cyano | 9 | 0 | 17 | 150 | No | £ | 46 |
| Naitre Liposomal Fertility | 5-MTHF | 400 | 30 | Methyl | 8 | 0 | 0 | 75 | Yes | £££ | 46 |
| Wild Nutrition Food-Grown | Food-Grown | 400 | 0 | Food-Grown | 200 | 5 | 3 | 150 | No | ££ | 45 |
| Pregnacare Conception | Folic acid | 400 | 20 | Cyano | 20 | 0 | 14 | 150 | No | £ | 41 |
References
- Frosst P, Blom HJ, Milos R, et al. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet. 1995;10(1):111-113.
- Bailey LB. Folate and vitamin B12 recommended intakes and status in the United States. Ann Nutr Metab. 2010;56(3):190-197.
- Obeid R, Holzgreve W, Pietrzik K. Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? J Perinat Med. 2013;41(5):469-483.
- Bentov Y, Casper RF. The aging oocyte — can mitochondrial function be improved? Fertil Steril. 2010;99(1):18-22.
- Xu Y, Nisenblat V, Lu C, et al. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomised controlled trial. Sci Rep. 2018;16(1):29.
- Ben-Meir A, Burstein E, Borrego-Alvarez A, et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. 2015;14(5):887-895.
- Langsjoen PH, Langsjoen AM. Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clin Pharmacol Drug Dev. 2014;3(1):13-17.
- Ferrarese I, Lampugnani MG, Chiusa L, et al. Molecular functionality of coenzyme Q10 in oocyte quality and reproductive health. J Assist Reprod Genet. 2020;37(4):761-776.
- American Heart Association. Scientific statement on choline, dietary intake and cardiovascular health. Circulation. 2018.
- Zeisel SH. Choline: critical role during fetal development and dietary requirements in adults. Adv Exp Med Biol. 2006;229-250.
- Zeisel SH, da Costa KA. Choline: an essential nutrient for public health. Nutr Rev. 2009;67(11):615-623.
- Wallace TC, Fulgoni VL. Usual choline intakes are below recommended levels in most US population subgroups. Nutrients. 2017;9(8):839.
- Caudill MA, Strupp BJ, Muscalu L, et al. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed. FASEB J. 2018;32(4):2172-2180.
- Milman N. Iron in pregnancy — how do we secure an appropriate iron status in the mother and child? Ann Nutr Metab. 2015;59(1):50-54.
- Bath SC. The effect of iodine deficiency during pregnancy on child development. Br J Nutr. 2017;76(4):601-609.
- Bath SC, Rayman MP. Iodine deficiency in the UK: an overlooked cause of impaired neurodevelopment? Proc Nutr Soc. 2013;72(2):226-235.
- Paul C, Brady DM. Comparative bioavailability and utilisation of particular forms of B12 supplements with potential to mitigate B12-related genetic polymorphisms. Integr Med (Encinitas). 2017;16(1):42-49.
- James SJ, Melnyk S, Jernigan S, et al. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. J Nutr Biochem. 2004;15(6):342-346.
- Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. National Academies Press. 1998.
- NICE Clinical Guideline CG62. Antenatal care: routine care for the healthy pregnant woman. National Institute for Health and Care Excellence. Updated 2021.
Frequently asked
What is MTHFR and should I get tested?
MTHFR is the enzyme that converts folic acid into its active form, 5-MTHF. A common gene variant, C677T, reduces this enzyme's activity, affecting roughly 40 to 60% of the population. You do not strictly need to test — the pragmatic move is to take a 5-MTHF formula regardless, since it bypasses the enzyme entirely. Testing is worth doing if you have had prior fertility loss, a family history of neural tube defects, or your clinician recommends it for other reasons.
Do I really need CoQ10 if I am 28?
Probably not in the therapeutic-dose sense. The strongest CoQ10 evidence is in women 35+, in IVF preparation, or with diminished ovarian reserve. If you are 28 with regular cycles and no known egg-quality concerns, Fertility Focus at 200mg gives you sensible insurance without going overboard. A formula without CoQ10 is also reasonable at this age.
When should I start a preconception multi?
Three months before you plan to conceive, at minimum. Oocyte maturation takes approximately 90 to 120 days, and the folate and B12 methylation infrastructure needs weeks to build up. If you are already trying, start now. If you are planning to try in six months, also start now — there is no harm and considerable benefit to the longer window.
Can I take these while trying naturally?
Yes — that is exactly what they are designed for. Preconception multivitamins are formulated for the trying-to-conceive window, not for post-conception. Every day you are in the TTC window is a day the formula is doing what it was designed to do.
What if I am doing IVF — does the timing change?
Slightly. Most IVF-focused protocols want 60 to 90 days of CoQ10 pre-cycle at 200 to 600mg, which is often longer and higher-dose than what a general preconception multi provides. Coordinate with your clinic. Fertility Advance at 300mg CoQ10 gets you inside the therapeutic window in a single bottle; add a standalone ubiquinone if your clinic wants the full 600mg protocol.
Should my partner take something?
Yes. Sperm turnover is roughly 74 days, and sperm quality is highly responsive to zinc, selenium, CoQ10, L-carnitine, and antioxidant intake in that window. Half of unexplained infertility has a male-factor component. A dedicated male preconception multi for the 90 days before conception is one of the highest-leverage things a couple can do together.
Do I need to switch to a prenatal when I get pregnant?
Sometimes. Fertility Focus is specifically formulated to continue through the first trimester without switching. If you are on a formula that does not cross the pregnancy line, check yours against the pregnancy targets — iron 27mg, iodine 250µg, choline 450mg AI — and switch if there is a meaningful gap. Also add a DHA supplement if your multi does not already contain one.
What about food-first over supplements?
Food-first is a good principle and a bad absolute. It is very difficult to hit the preconception folate, choline, iodine, and CoQ10 targets from diet alone, even a diet built around eggs, liver, sardines, seaweed, and dark leafy greens. Supplements are an insurance policy on top of a good diet, not a replacement for one. Both, not either.
How we compared. All specifications were taken from each brand's own product pages in July 2026. This is an editorial assessment based on published ingredient tables, not head-to-head testing. Individual response varies. Speak to a fertility nutritionist or your doctor for advice tailored to you.
See Fertility Advance → · See Fertility Focus → · Compare Advance vs Focus