How long have you been supplementing and what was your starting ferritin level and your most recent one? Also, how long have you been seriously trying to get pregnant?

A doctor would be the best person to tell you how much iron you should be taking. It sounds like your PCP thinks you don't need to supplement because your ferritin values are within low-normal range (or "borderline") rather than actually low. Does he know that you're trying to get pregnant? If not, you should tell him! And you can also mention research showing borderline ferritin as a possible cause of infertility, and low pre-pregnancy iron stores leading to increased risk of anemia during pregnancy and increased risk of bad outcomes (such as low birth weight). If you weren't trying to get pregnant, supplementation would not be strictly necessary, but if you explain to your doctor that you're trying to optimize your fertility (and general health), rather than simply meet the lowest laboratory requirement to be considered "normal", he should help you get there! I don't know your situation or what your PCP is like, but PCPs aren't really experts on optimizing fertility. I'd probably ask my gynecologist rather than my PCP, because there's a greater chance that the gynie will be knowledgable about what you should do.

Are you sure you're taking the iron as efficiently as possible? You want to take iron on an empty stomach, because all sorts of foods can decrease absorption. Coffee, tea, dairy products, and antacids are big culprits in reducing absorption. If you're taking a multivitamin supplement, take it at least a few hours apart, because other vitamins and minerals can interfere with absorption (e.g. calcium, magnesium, vitamin E, zinc). The easiest way to boost absorption would be by taking a vitamin C supplement with the iron. There are other vitamins that may help a bit, but none have an effect like vitamin C.

Rebuilding iron stores can be slow - I'd give it at least 6 months (and the longer you've been supplementing, the slower stores may replenish. If you are anemic, once hemoglobin is normal again, absorption starts to slow down). If that didn't increase iron stores, I'd start asking WHY. With iron deficiency, it basically comes down to either (1) you're not getting enough (which may not have to do with how much you're supplementing. Inadequate intake is the major cause of iron deficiency, but right now, you're taking enough! Occasionally people have other reasons for not getting enough, such as malabsorption), or (2) you're losing too much (usually due to blood loss. Heavy menstrual losses, GI bleeding that you might not even know exists, etc).

Unless you're also anemic due to iron deficiency (low hemoglobin and/or hematocrit, usually low MCV), doubling your iron dose probably isn't necessary (plus, the more iron you take in, the less you absorb percentage-wise). Taking a bit more probably isn't dangerous, so long as you can tolerate it (increased risk of side effects with higher dosages), but it may not help that much. I would try adding vitamin C and taking it on an empty stomach (if you're not already doing so), before I would double the dose.

Fertility treatments (such as in vitro) are ridiculously expensive, often not covered by insurance, and (like everything else!) don't always work. If you've been trying for a long time (say, a year and a half or 2 years) and still haven't gotten pregnant, it may be worth speaking to an expert. Even if you can't afford the treatments or don't want them, the doctor may be able to give you useful advice on optimizing fertility. If you have more time than money, you can probably find a lot of information online on this topic that may be helpful.

Another alternative: there have been some preliminary studies on supplements that may help fertility, and are much cheaper and less invasive than in vitro. If you've been trying for a while without success, and are willing to spend $100 or so (which is probably less than a consultation with any sort of fertility professional!), this product, fertilityblend, may help (there's some research behind it, unlike many of the supplements that claim to help fertility but haven't been tested): The clinical trial results are here, and you can find other information about it on the same page: fertilityblend dot com


It probably can't hurt you no matter what, but if I were you, I'd probably try to conceive for at least a year before I concluded that I needed assistance with fertility.

Good luck!