(Dr. Sunitha Mahesh, Medical Director & Senior Consultant – Infertility and Maternal Fetal Medicine, Milann – Fertility & Birthing Hospital, Bengaluru)
When couples struggle to conceive, attention often turns to age, hormonal imbalances, stress or lifestyle habits such as smoking and obesity. However, an often-overlooked factor is micronutrient deficiency. Three essential nutrients: Vitamin D, Vitamin B12 and Folate play a critical role in reproductive health, and their deficiency can quietly affect fertility in both men and women.
In India, nutritional gaps remain common despite abundant sunlight and diverse food choices. Many individuals may not realise that their bodies lack these key nutrients until they undergo testing. Addressing these deficiencies early can significantly improve fertility outcomes and support healthier pregnancies.
Vitamin D or “Sunshine Vitamin”
Vitamin D is widely recognised as sunshine vitamins plays a role in maintaining bone health, but it has a quite important role for reproductive health. In women, Vitamin D supports ovarian function, influences egg quality and helps in embryo implantation. Studies also have shown that adequate Vitamin D levels may improve outcomes in assisted reproductive treatments such as IVF.
For men, Vitamin D contributes to sperm motility and overall semen quality. Low levels have been associated with reduced testosterone and poorer sperm parameters.
Despite living in a tropical country, Vitamin D deficiency is widespread in India. Indoor lifestyles, limited sun exposure, pollution and sunscreen use reduce the body’s ability to produce adequate Vitamin D. Since symptoms such as fatigue, body aches or reduced immunity are often mild, the deficiency frequently goes unnoticed.
Role of Vitamin B12, the overlooked nutrient
Vitamin B12 plays a crucial role in DNA synthesis, red blood cell formation and nerve health. Its importance in fertility is often underestimated. Low Vitamin B12 levels in women can interfere with ovulation and may increase the risk of implantation failure or early pregnancy loss. In men, deficiency has been linked to reduced sperm count and poor sperm motility.
Vegetarians are particularly vulnerable because Vitamin B12 is primarily found in animal-based foods such as meat, eggs and dairy products. However, even individuals who consume these foods may develop deficiency due to digestive issues that affect nutrient absorption.
While many couples focus on folic acid during pregnancy planning, maintaining adequate Vitamin B12 levels is equally important. An imbalance, especially high folate levels combined with low B12 can sometimes mask symptoms and delay diagnosis. Also, Vitamin B12 is water soluble and hence cannot be stored in the body, therefore it must be replenished with regular food.
Folate and Folic Acid
Folate, or Vitamin B9, is well known for preventing neural tube defects in babies, but its importance begins even before pregnancy. It plays a vital role in DNA formation, cell division and early embryonic development.
Low folate levels can affect egg quality in women and contribute to DNA damage in sperm among men. Although folic acid supplements are commonly recommended during pregnancy planning, dietary sources such as green leafy vegetables, legumes, citrus fruits and fortified grains also play an important role.
Nutrient Deficiencies After 50
The risk of certain deficiencies increases with age, particularly among women after menopause. Once women cross 50, declining estrogen levels can affect calcium and Vitamin D metabolism.
Lower estrogen reduces the body’s ability to absorb calcium and utilise Vitamin D efficiently, leading to decreased bone mineralisation. As a result, women may become more vulnerable to fractures and bone-related problems.
Estrogen also plays a key role in bone metabolism. Its decline can contribute to joint pain, narrowing of joint spaces and postural changes associated with bone loss, increasing the risk of falls.
However, deficiencies such as Vitamin B12 and iron are usually related to gastrointestinal absorption and age-related digestive changes. These can occur in both men and women and are not directly linked to hormonal changes.
Figuring early signs & symptoms
One of the challenges with micronutrient deficiencies is that their symptoms often develop gradually and may be mistaken for normal ageing. Persistent fatigue, joint pain, weakness, reduced stamina or frequent infections are sometimes ignored or attributed to lifestyle factors.
However, untreated deficiencies can lead to long-term health problems. Reduced bone strength, increased risk of fractures and declining overall health may be early consequences.
The Importance of Screening
Fertility reflects overall health, and micronutrients play a vital role in maintaining the body’s balance. Routine screening for Vitamin D, Vitamin B12 and Folate can help identify deficiencies early.
Correcting these deficiencies through appropriate diet, sunlight exposure and supplementation can support reproductive health and improve fertility outcomes.
Sometimes, the smallest nutrients can make the biggest difference in the journey towards parenthood.
