Folic Acid for Fertility: How Much Folic Acid is Enough? (2023)

Almost every woman knows that folic acid is one of the most important vitamins for pregnancy.

But what if you're trying to conceive?

What is often overlooked is that the standard dose of folic acid recommended for pregnancy may NOT be appropriate
enough if you are trying to increase your fertility potential.

Let's take a closer look at folic acid in relation to your reproductive health.

Here's a quick overview of what you'll discover:

• Folic acid vs. folate
• The importance of folic acid in your body
• Folic acid for female fertility
• Folic acid for male fertility
• Getting enough folic acid to get pregnant
• Foods rich in folic acid
• Risks of Supplementation
• MTHFR and folic acid

If you're wondering what the difference is between folic acid and folate, or maybe you haven't even realized there's a difference, you're not alone. Many medical professionals confuse the terms or use them interchangeably. So you're not the only one confusing it.

To keep things simple (We firmly believe in keeping it simple here), folic acid is the synthetic form (d.h., artificial version), while folic acid occurs naturally in food. You may see these two names also referred to as vitamin B9, one of the many B vitamins found in the body.

So if folic acid is found naturally in food, why do we have a synthetic version and why do we consume so much of it?

That's because more than 20 years ago (1998 to be exact) the FDA prohibited the addition of folic acid to processed grain products (d.h., bread, pasta, rice and muesli).

This was deemed necessary due to the overwhelming evidence that folic acid supplementation before and during early pregnancy can protect against neural tube defects (NTDs). Neural tube defects are problems with the development of the spinal cord (z.B., spina bifida) and brain development (z.B., anencephaly) that occur during early growth in the womb.

We know it goes without saying, but this is a big deal!

In fact, according to the Centers for Disease Control and Prevention (CDC), at least half of the 300,000 neural tube defects worldwide each year can be prevented by taking folic acid.

Aside from protecting against neural tube defects, folate or folic acid is essential for the synthesis of DNA, the production of new cells in the body (z.B., red blood cells) and supporting proper brain and immune function.

Folic acid also works with vitamins B6 and B12 to control blood levels of the amino acid homocysteine. High homocysteine ​​levels have been linked to heart disease and recurrent miscarriages. But, alas, we digress… back to folic acid and fertility.

Now that you understand the difference between folic acid and folate and why they get a lot of attention during pregnancy, let’s look at an often overlooked benefit of folic acid –increased fertility.

The EARTH (Environment and Reproductive Health) study, conducted at Harvard Medical School, was one of the first studies to use aassociation betweenhigher levels of folate in the bloodand an increased chance of live birth, particularly in women undergoing assisted reproductive treatment.

In case you're curious about the details, the researchers found a 62% higher likelihood of live birth in women with the highest levels of folate in their bodies (>26.3 ng/mL) compared to women with the lowest levels of folate (<16, 6 ng/ml).

And as you just learned, folate occurs naturally in food, which raises an important question..."What happens when you add withfolic acid?”

Two different studies, one based onHarvardand another from theUniversity of Buffalo, both have shown that supplementation with folic acid before pregnancy is associated with a lower risk of ovulatory infertility and a shorter time to pregnancy. Great news if you are struggling to conceive as anovulation is one of the leading causes of infertility.

What if you are already undergoing infertility treatment? So,some research showsthat women who take folic acid supplements prior to IVF treatment have a higher percentage of mature oocytes and higher quality oocytes.

Now, before we move on to our action points for this post, let's take a look at folic acid and the male factor. And yes, although we're confident you know who rules the world (Sing es Beyoncé), would like Dr. Haas ensure that men also make their contribution.

In a study published in the journalhuman reproductionfound that men who consumed high levels of folic acid (over 700 mcg/day) in their diet reduced their risk of sperm aneuploidy (abnormalities in genetic material) by up to 30 percent. This means less chance of problems that can lead to miscarriage or birth defects.

switch to the supplementary side of things,researchers in the Netherlandshave shown that men who took a combination of 5 mg of folic acid and 66 mg of zinc increased their total sperm count by 74 percent.

Keep in mind that this was a very high dose of folic acid compared to the recommended daily dose of 400 mcg (and zinc was also included). So make sure your man speaks to his doctor before supplementing with such a high dose. Don't forget to ask about the need for extra copper when using a zinc supplement!

As you have just read, one of the few studies of folic acid supplementation in men used an exceptionally high dose to optimize fertility parameters. Studies of supplementing folic acid in women trying to conceive, on the other hand, have used much more moderate doses with positive results800 micrograms per day.

In fact, women who took 800mcg of supplemental folic acid daily — instead of the standard 400mcg found in most prenatal vitamins — have shown significantly better fertility outcomes, includinghigher implantation rates, higher clinical pregnancy rates and a 20% greater chance of live birth.

And in women undergoing fertility treatment involving in vitro fertilization (IVF), higher levels of folic acid supplementation have been associatedhigher fertilization rates and lower cycle failure rates prior to embryo transfer.

Another quick but super relevant fact about taking folic acid… it's a water-soluble vitamin, which means it needs to be replenished in the body on a regular basis. To get the maximum benefit from this vitamin,Make sure you take your supplement daily.

For your information, we have listed the recommended daily intake of folic acidoutside ofFertility Optimization below:

• 

  600 mcg for pregnant women

• 

  500 mcg for breastfeeding women

• 

  400 mcg for men and women aged 14 and over

Any time you think about taking a dietary supplement, treat it with the same respect as you would using a prescription drug - there are always potential side effects if used incorrectly.

As a general word of caution, DO NOT take more than 1,000 mcg of folic acid per day across all of your supplements without first checking with your doctor.

High doses of folic acid can mask vitamin B12 deficiency, which can lead to irreversible nerve damage. It's a good idea to have your doctor test your B12 levels if you need to start on a high dose of folic acid.

Unless you have a family history of neural tube defects or are taking certain medications, you will generally not be instructed to take high doses of folic acid, so this shouldn't be a problem for most women.

You should also know that folic acid can interact with other medications, most commonly antiepileptic drugs (z.B., phenytoin) and methotrexate (an immunotherapy drug). And while folic acid doesn't typically interact with fertility drugs, some folic acid supplement combinations contain other herbs that may affect those drugs.

So, at the risk of sounding like a broken record, always check with your doctor before starting any supplement, including a multivitamin. And don't forget to get your supplement from a trusted source.

If you need a little more folic acid as a supplement, there are many foods rich in this vitamin.

As mentioned at the beginning of this article, most breads and cereals in the United States are fortified with folic acid. This means that you are likely getting some amount of folic acid in your body when you eat these types of foods.

For those of you who have joined usBoost your fertility, you know why we do not recommend eating these types of foods and how they can harm your reproductive health. So instead of relying on folic acid in processed foods, try incorporating some of these elements into your daily healthy diet:

Need a little more guidance? Consider one of these simple substitutions to boost your folic acid:

• 

  Use leafy greens like spinach instead of iceberg lettuce in your wraps

• 

  Sprinkle chickpeas on your salad instead of bacon or eggs

• 

  Instead of butter, spread avocado puree on your toast

• 

  Add lentils to your stew instead of beef or chicken

Curious about the other essential nutrients to boost your fertility?
Discover the power of fertility superfoods today!

Some of you may be familiar with MTHFR and others are probably wondering what foreign language we speak. A detailed summary of the enzyme methylenetetrahydrofolate reductase (MTHFR) is a bit beyond the scope of this post, but it is one of the important topics that needs to be mentioned as you will see it being talked about if you spend enough time in the to search internet.

In short, it has been suggested that some people may not benefit from folate or folic acid due to a genetic problem. More specifically, due to mutations in the genes that code for MTHFR. If the MTHFR enzyme is not working optimally, folic acid cannot be converted into its biologically active form.

We've encountered some excitement around the use of pre-activated folic acid (5-methyltetrahydrofolate or 5-MTHF) for women who are having trouble conceiving.

This has largely centered arounda small case series publication. For those of you familiar with statistics (a source of excitement for Dr. Eskew and a source of pain for Dr. haas), you will realize that this is not the best kind of study to make bold statements.

Over and beyond,other research suggeststhat high folic acid intake and variations in the MTHFR gene are not associated with helping women achieve pregnancy during or after fertility treatment.

With that in mind, we think there might be a little more to the story of 5-MTHF use than thatAnother well-designed study found a strong link between an MTHFR gene mutation and recurrent miscarriage.

All in all, there is a lot to learn about the use of 5-MTHF in women struggling with pregnancy before we recommend you replace it with traditional folic acid.

Folic acid is an important vitamin for both men and women, especially when trying to have children. In addition to protecting against the risk of certain birth defects, folic acid can optimize many aspects of your fertility and help your body prepare for a healthy pregnancy.

Keep in mind that folate and folate are not exactly the same type of B vitamins, and despite the need for folate supplementation, there are many healthy food sources of folate.

Disclaimer Warning… Always talk to your doctor before starting any supplement and make sure they understand the potential risks and benefits of their use. The aim is to optimize your fertility and your general health and not to endanger it.