Magnesium, choline & emerging options
Promising but watch the evidence grade
Magnesium: Supports oocyte maturation and endometrial smooth-muscle relaxation. However, a PCOS RCT of 250mg/day magnesium oxide showed no significant improvement in hormones or hirsutism — an important counterbalance to overclaiming. If you test, request RBC magnesium, not serum — serum measures only 1% of body stores.
Choline: Trial doses range 480–2000mg/day (adequate intake: 450mg/day in pregnancy). Evidence for neurodevelopmental benefit remains “insufficient to confirm or refute” as of 2025, despite strong mechanistic rationale. Eggs, liver, and cruciferous vegetables are the richest sources.
Royal jelly: A small pilot RCT found vaginal royal jelly comparable to IUI for pregnancy rate in male-factor subfertility — intriguing but far too preliminary for a recommendation.
These options are worth knowing about but should be weighed with clear-eyed evidence grading.