Iron deficiency and fertility: what your iron stores mean for conception
- Rachael Robinson
- Jun 19
- 6 min read
By Rachael Robinson, Fertility Nutritionist. Updated June 2026.
Table of Contents
3 Key Takeaways
Iron deficiency and fertility are closely linked: low stores can reduce oxygen delivery to your ovaries and affect implantation and early pregnancy.
Ferritin, haemoglobin, transferrin saturation, and red blood cells all matter; many women have “normal” blood counts but suboptimal iron for fertility.
Food, timing, and the right supplement form can rebuild iron stores, but checking levels before stimulation and transfer is essential.
Introduction
In my clinic, iron deficiency and fertility go hand in hand far more often than most people realise. Many women are not technically anaemic, yet their iron stores are still too low to fully support egg quality, implantation, and early pregnancy. Iron helps deliver oxygenated blood to your ovaries and uterus, and research suggests that having very low ferritin can be linked with poorer outcomes in fertility treatment. This post will walk you through why iron matters, who is most at risk, how I test it, and what you can do through food and supplements.
Why iron deficiency matters for fertility
Iron is a key part of haemoglobin, the protein in red blood cells that carries oxygen around your body. For fertility, that means iron helps deliver oxygen and nutrients to your ovaries, endometrium, and developing follicles. It also supports energy production, thyroid function, and immune balance—all important when you are trying to conceive. When iron is low, you may feel tired, short of breath on exertion, or notice hair shedding and paler skin. However, some people have very few obvious symptoms and only discover low iron when we test for it.
Ferritin, thresholds, and what the research suggests
Ferritin is your iron storage protein, and it is one of the main markers I look at in clinic. Many labs still flag anything above 15–20 µg/L as “normal,” but that is not necessarily optimal when you are trying to conceive.
A growing body of research links low ferritin and iron deficiency to reduced fertility and poorer outcomes in IVF. For example, recent work has reported that ferritin levels below around 30 µg/L are associated with unexplained infertility, and that treating iron deficiency can improve birth rates in women undergoing fertility treatment.
There were some very interesting findings:
In practice, many fertility clinicians and nutritionists now aim for ferritin comfortably above 30 µg/L before you go into a stimulation cycle or embryo transfer.
Who is most at risk of iron deficiency?
Some women are particularly prone to low iron and low ferritin.I see this often in:
Women with endometriosis or adenomyosis.
Anyone with heavy menstrual bleeding or long periods.
Vegetarians and vegans, especially if they do not focus on iron‑rich plant foods.
Those with gut issues affecting absorption, such as coeliac disease or inflammatory bowel disease.
If you recognise yourself in that list, it is especially important to check iron before embarking on an IVF cycle or embryo transfer.
How I test iron in clinic
Iron is much more than one number. When I assess iron deficiency and fertility, I look at a panel rather than a single marker.
Key markers include:
Ferritin: your iron storage.
Haemoglobin: how much oxygen‑carrying protein is in your blood.
Transferrin saturation: how much of the iron‑transport protein is actually carrying iron.
Red blood cell count and indices: size and shape can hint at iron issues before haemoglobin drops.
It is possible to have ferritin on the low side, normal haemoglobin, and still have symptoms or concerns for fertility. That is why I do not rely on a basic “normal” tick box from a standard blood test.
Food sources of iron: haem and non‑haem
Iron comes in two main forms: haem and non‑haem.They are absorbed differently, and this matters when we plan your diet.
Haem iron
Found in animal products and is more easily absorbed.
Sources include:
Red meat (beef, lamb, venison).
Poultry, especially dark meat like thigh and drumstick.
Liver and liver pâté. (Please only consume this pre transfer due to the vitamin A content).
Oily fish such as sardines and mackerel.
Non‑haem iron
Found in plant foods and fortified products.
It is generally harder for the body to absorb.
Sources include:
Beans, lentils, chickpeas.
Tofu and tempeh.
Spinach and other dark leafy greens.
Pumpkin seeds, sunflower seeds, sesame (tahini).
Quinoa, oats, and fortified breakfast cereals.
Because non‑haem iron is less efficiently absorbed, I always test iron and ferritin levels in my vegetarian and vegan clients.
Pairing iron with vitamin C
You can boost iron absorption significantly by pairing iron‑rich foods with vitamin C. This is especially helpful if you rely more on plant‑based sources.
Examples of useful pairings include:
Lentil or chickpea salad with peppers, parsley, and lemon juice.
Beef or lamb stew served with a side of steamed broccoli or cabbage.
Spinach and egg omelette with a glass of orange or kiwi smoothie.
Tofu stir‑fry with pak choi, sugar snap peas, and a squeeze of fresh lime.
In contrast, try to avoid having dairy or caffeine at the same time as your main iron‑rich meals. Calcium, coffee, and tea can reduce iron absorption when consumed together with iron‑heavy foods.
When food is not enough: iron supplements
Sometimes, diet alone is not enough to correct iron deficiency, especially if you are bleeding heavily or your levels are very low. In these cases, supplementation can be very helpful alongside dietary changes. In my clinic, I often suggest iron supplements in the form of bisglycinate. This form is generally better absorbed and tends to be less constipating than traditional ferrous fumarate or ferrous sulphate. Splitting the dose across the day and taking it with a glass of orange juice (for vitamin C) can further improve absorption and reduce side effects.
However, it is important not to supplement blindly. Too much iron can be harmful, and some conditions (such as haemochromatosis) make iron overload more likely. Always test first, and work with a practitioner to decide on the right dose and duration.
Timing your iron check around IVF and transfer
From a fertility perspective, the timing of iron testing really matters. You want to know your levels well before you start a stimulation cycle, and absolutely before a fresh or frozen transfer.
If ferritin or haemoglobin are low, giving yourself time to correct them can support:
Better oxygen delivery to ovaries during stimulation.
A healthier endometrial environment for implantation.
More stable energy and resilience during an already stressful process.
This is not about perfection or chasing a single “magic” number.It is about removing a very common, very fixable obstacle to conception and healthy pregnancy.
My Final Thoughts
Iron deficiency and fertility are more closely linked than many standard check‑ups acknowledge.
You can feel “fine” and still have iron stores that are suboptimal for egg quality, implantation, and early pregnancy.
By checking a full iron panel, prioritising both haem and non‑haem food sources, pairing them with vitamin C, and using the right supplement form when needed, you can give yourself a stronger foundation before IVF or a natural conception.
Next Steps
If you are planning a stim cycle, preparing for an embryo transfer, or have symptoms that make you worry about iron, now is the time to check.
Book a consultation so we can create a realistic plan that supports both your body and your nervous system through these early weeks. You can reach out via the contact form or explore my nutrition resources to receive tailored, evidence based support through every stage of pregnancy. You can also join my newsletter for evidence based guidance and gentle emotional support.
Arrange a 1:1 session via the contact form and we can work on a plan that supports you, whatever your situation and whatever you have been through.
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