Iron Deficiency and Fertility: Your Ability to Conceive

Many women struggling with fatigue, brain fog, hair loss, poor exercise tolerance or difficulty conceiving are told their blood tests are “normal”. But in many cases, the real issue may be iron deficiency or low ferritin, even without anaemia.

In our latest Revive & Reset video, Dr Susan Jain is joined by leading fertility specialist Dr Sara Mathews to discuss the link between iron deficiency and fertility, why low ferritin can affect ovulation and pregnancy, and when iron infusion treatment may be worth considering.

This is an important conversation for anyone trying to conceive, preparing for IVF, struggling with heavy periods, or feeling unwell despite being told their results are within range.

What is the link between iron deficiency and fertility?

Iron is essential for energy production, oxygen transport, muscle function, brain health and normal reproductive function. If iron levels fall, the body can start to conserve energy and prioritise vital functions, which may affect the reproductive system.

As discussed in the video, iron deficiency can affect fertility in several ways, including:

• Reduced ovulation
• Poorer egg quality
• Reduced implantation potential
• Compromised function of the uterus
• Increased miscarriage risk
• Low energy and poor physical resilience during pregnancy

Dr Sara Mathews explains that when the body is under stress, whether from low iron, weight loss or illness, reproduction can be one of the first systems to be affected. That means low iron may reduce the chances of conception even before pregnancy begins.

Can you have iron deficiency without anaemia?

Yes, and this is one of the most important points in the discussion.

Many people assume that if their haemoglobin is normal, their iron status must be fine. But iron deficiency without anaemia is very common, especially in women.

A person may have a normal haemoglobin level but still have low ferritin, which means their iron stores are depleted. Ferritin is the main blood marker used to assess stored iron, although it must be interpreted carefully, especially if there is inflammation or infection.

At Revive & Reset, we often speak to patients who have symptoms of iron deficiency but have been reassured because they are “not anaemic”. In reality, low ferritin can still cause significant symptoms and may still affect fertility, wellbeing and pregnancy.

What ferritin level is considered low?

In the video, Dr Susan Jain explains that, in general health, a ferritin below 30 is widely recognised as being consistent with iron deficiency.

However, many women experience symptoms well before levels fall dramatically. Low ferritin can still affect how you feel, even if your result has been reported as technically within the local reference range.

This matters because laboratories often report a broad “normal” range, but that does not always reflect what is optimal for energy, hair health, exercise tolerance or fertility.

Low ferritin symptoms in women

Women with low ferritin or iron deficiency may experience:

• Fatigue and exhaustion
• Brain fog and poor concentration
• Hair loss or thinning
• Feeling cold
• Shortness of breath
• Poor exercise tolerance
• Restless legs and dizziness
• Low mood and increased susceptibility to infections

Because these symptoms are so common, they are often blamed on stress, hormones, the menopause, poor sleep or a busy lifestyle. That is one reason iron deficiency in women is so frequently missed.

Why are women trying to conceive more at risk of low iron?

Women are more likely to develop iron deficiency because of menstrual blood loss. Heavy periods are a major cause of low iron stores, but many women do not realise their periods are heavy because they have no real point of comparison.

If conception takes time, iron stores can gradually fall month after month, particularly in women who:

• Have heavy periods
• Follow a vegetarian or low iron diet
• Cannot tolerate oral iron
• Have digestive issues affecting absorption
• Have fibroids or other gynaecological causes of blood loss

This is why checking ferritin before pregnancy can be so valuable.

How can low iron affect pregnancy?

The effects of iron deficiency do not stop once pregnancy begins. In fact, iron requirements rise significantly throughout pregnancy as the body supports the growing baby, placenta and increased blood volume.

If a woman becomes pregnant with low iron stores, she may be at greater risk of developing iron deficiency anaemia in pregnancy. Low iron in pregnancy has been associated with:

• Worsening fatigue
• Reduced physical resilience
• Low birth weight
• Premature delivery
• Impaired maternal wellbeing

This makes iron and pregnancy an important topic not just for women who are struggling to conceive, but also for those who want to prepare for a healthy pregnancy.

Should ferritin be checked in fertility investigations?

In many cases, yes.

When people are trying to conceive, attention is often focused on hormones, ovulation, thyroid function and semen analysis. All of these matter, but ferritin is a simple blood test that can provide important additional information.

As discussed in the video, iron can be relevant to:

• Ovulation and egg development
• Implantation
• Miscarriage risk
• General energy and recovery
• Resilience during fertility treatment

For some patients, identifying and treating low ferritin before IVF or pregnancy may be an important part of improving their overall health and readiness.

Iron tablets for low ferritin: do they work?

Oral iron tablets can help, but they are not always easy to tolerate. Common side effects include:

• Nausea and constipation
• Abdominal discomfort
• Bloating and digestive upset

This is a major reason many people stop taking them or take them inconsistently. The video also explains that only a limited amount of oral iron is actually absorbed, particularly if digestion is already compromised or if other medications interfere with uptake.

For some patients, oral iron is appropriate. For others, especially those with symptoms, poor tolerance, or a need to improve iron stores more quickly, iron infusion treatment may be a better option.

When should you consider an iron infusion for low ferritin?

In the discussion, Dr Susan Jain and Dr Sara Mathews explore when an iron infusion for low ferritin may be helpful.

This may be worth considering if:

• Ferritin is low and symptoms are significant
• Oral iron causes side effects
• Ferritin is not improving with tablets
• Pregnancy is planned or IVF is approaching
• Time is an important factor

An iron infusion delivers iron directly into the bloodstream, making it fully available to the body. This can raise iron stores more effectively than tablets and avoids the digestive side effects many women struggle with.

For some patients, particularly those preparing for fertility treatment or trying to improve their health before pregnancy, this can be a very practical option.

Are iron infusions safe?

The video explains that iron infusions are generally safe when given in the right clinical setting with appropriate medical supervision.

At Revive & Reset, patient safety is central to everything we do. Dr Susan Jain explains what patients can expect, including:

• Stopping oral iron for around 48 hours beforehand
• Attending well hydrated
• A short infusion time, usually around 25 minutes
• A period of observation afterwards
• Possible short-term flu-like symptoms in the following days

Iron infusions can also be used in pregnancy when clinically appropriate, typically after the first trimester.

Why this conversation matters

One of the strongest messages from the video is that iron deficiency is common, easy to test for, and often fixable. Yet many women are still told they are fine when they are exhausted, foggy, losing hair, or struggling with fertility.

If you are trying to conceive, preparing for IVF, coping with heavy periods, or wondering whether low ferritin could be affecting your health, it may be worth looking at your iron status more closely.

Watch our video on iron deficiency and fertility

In this expert-led discussion, Dr Susan Jain and Dr Sara Mathews cover:

• The link between iron deficiency and fertility
• Why low ferritin matters even without anaemia
• How low iron can affect ovulation, egg quality and implantation
• The impact of heavy periods on iron stores
• Oral iron versus iron infusion treatment
• The role of iron in pregnancy
• When to consider treatment for low ferritin before pregnancy

the impact of heavy periods on iron stores oral iron versus iron infusion treatment the role of iron in pregnancy when to consider treatment for low ferritin before pregnancy

If you have been told your blood tests are normal but you still do not feel right, this video is well worth watching.

At Revive & Reset, we offer consultant-led assessment for patients concerned about iron deficiency, low ferritin, fatigue and related symptoms. Where appropriate, we also offer iron infusion treatment in London in a calm, medically supervised setting.

If you would like to understand your results, symptoms and treatment options more clearly, we are here to help.