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.