I hear this from patients all the time. They are eating well, taking their prenatal vitamin every day, doing everything they were told to do. And yet something still feels off. Their labs are not improving. Their cycle is not responding the way they hoped. And they wonder why.
Here is the truth I share with them: after 40, a standard multivitamin is often not enough.
That is not a criticism of anyone who is taking one. It is simply the reality of what your body needs at this stage. A basic multivitamin was designed to prevent deficiencies. It was not designed to support egg quality, embryo development, implantation, hormone balance, or mitochondrial function. Those are very different goals.
What Changes After 40
Fertility after 40 is affected by far more than age alone. In my practice, I see the cumulative impact of mitochondrial decline, oxidative stress, chronic inflammation, insulin resistance, poor sleep, thyroid dysfunction, toxin exposure, immune imbalance, and reduced egg quality. These are not problems a daily multivitamin was formulated to address.
And yet, many women are relying on exactly that.
The Problem With Most Prenatals
Many prenatals and multivitamins also rely on cheaper, less absorbable nutrient forms. Synthetic folic acid is one of the most common examples. Many women carry a genetic variation that prevents them from efficiently converting folic acid into its usable form. This is why I almost always prefer methylated folate for my patients. Methylated folate supports implantation, embryo development, and proper methylation in a way that synthetic folic acid simply cannot replicate for many women.
Beyond folate, many formulas are missing the nutrients that matter most after 40. I am talking about choline, magnesium, omega-3 fatty acids, CoQ10, NAC, PQQ, NMN, alpha-lipoic acid, selenium, zinc, antioxidants, and vitamin D. These nutrients support mitochondrial energy production, hormone balance, insulin sensitivity, inflammation regulation, egg quality, and embryo development. They are not extras. For women over 40, they are foundational.
Watch for red flags in the formulas you choose: artificial colors, low-quality nutrient forms, unnecessary fillers, synthetic sweeteners, and high doses of folic acid where methylated folate would serve you better.
What I Recommend for Women Over 40
In my experience, a prenatal or multivitamin alone is rarely sufficient for women in this age group who are trying to conceive. This is exactly why Rejoova Eggs and Rejoova Repair were developed. These formulas were created with a specific purpose: to provide more targeted support for egg quality, oxidative stress, mitochondrial decline, inflammation, and hormone balance.
I want every woman who walks through my door to feel supported in every dimension of her care. Nutrition and supplementation are a real part of that. When you understand what your body actually needs after 40, you can stop guessing and start giving it what will genuinely help.
You deserve more than a one-size-fits-all approach. So does your fertility.
Dr. Zaher Merhi is a Co-Founder of Rejoova and the founder of Rejuvenating Fertility Center, with locations in Manhattan, Connecticut, Long Island, Westchester, and Brooklyn. He specializes in less-invasive IVF, ovarian rejuvenation, and personalized fertility care for women of all ages.