Folic acid is one of the most widely recommended dietary supplements for pregnancy, but does it also have an affect on fertility and wider reproductive health?
This article covers the science behind folic acid and fertility, and why you should consider taking a supplement even way before actively trying to get pregnant.
What You Need To Know
Folic acid is the synthetic form of folate
Folic acid is a naturally occurring B vitamin
All women of reproductive age should get 400 mcg of folic acid every day
Our bodies do not produce folic acid; it must be obtained through dietary intake
First Up, What Exactly IS Folic Acid?
Folic acid is the synthetic form of folate, which is a naturally occurring B vitamin. Folate helps make DNA and other genetic material. It is especially important in prenatal health.
This is all good and well, but what exactly does folic acid do? Our bodies use folic acid to make new cells. Think about your skin, hair, and nails. These–and other parts of the body – make new cells each day.
Folic Acid vs Folate
Although the words folate and folic acid are often used interchangeably, these vitamins are distinct and quite different.
Synthesized folic acid differs structurally from folate and has slightly different biological effects on our body. That said, both are considered to contribute to an adequate dietary intake.
Where Are Folic Acid/Folate Found?
Folate is found in several plants and animal foods, including spinach, kale, broccoli, avocado, citrus fruits, eggs, and beef liver.
Folic acid, on the other hand, is a man-made supplement added to fortified versions of some foods like flour, ready-to-eat breakfast cereals, and bread. Since 1998, folic acid has been added to cold cereals, flour, bread, pasta, bakery items, cookies, and crackers, as required by federal law.
Although there are various to consume folic acid through foods, folic acid is also sold in concentrated form in a range of dietary supplements.
What Does Folic Acid Do in the Body?
Folate is important for a range of functions in our body.
For instance, it helps our body make healthy new red blood cells. If you are deficient in folic acid, these blood cells may form to be abnormally large and not function as they should.
Red blood cells carry oxygen throughout our body, and problems with them can lead to anemia, constant fatigue, weakness as well as a pale complexion.
Does Folic Acid Impact Fertility?
Folic acid can have a powerful effect on female fertility, both before and after conception.
The reason it is widely taken in supplement form when planning pregnancy, or already pregnant, is that in the early stages of fetal development, folic acid can help prevent birth defects known as neural tube defects, including spina bifida.
But additionally, for women who are struggling to conceive, folic acid has been shown to help prevent early pregnancy complications that can lead to miscarriage, and is essential for the healthy development of baby’s brains and spinal cords.
“Without enough folic acid, the cells... can’t function or grow properly and the tube doesn’t close. The spine, skull, and brain can be affected, with open or closed abnormalities. Two of the most common types of NTDs are spina bifida and anencephaly.” - Stanford Children’s Health
Folic acid and female fertility benefits don’t stop there.
Folic acid may help with cell metabolism throughout our body, including in ovaries.
One study on supplementation for women who were trying to conceive found that:
“Use of a folic acid supplement in women undergoing IVF helped optimize the homocysteine pathway in follicular fluid, which was associated with better embryo quality and a greater chance of becoming pregnant; a 2-fold increase of monofollicular fluid folate was associated with a 3.3 times greater chance of becoming pregnant.”
So, in layman’s terms, it sets the right conditions in the fluid that bathes eggs whilst they are maturing in the ovaries - which could lead to higher quality embryos and more chance of pregnancy.
Does Folic Acid Affect Male Fertility?
While there is clear research on the benefits of folic acid for fertility in women, the research is mixed when it comes to folic acid and male fertility.
Some studies have suggested a link between folic acid intake and male fertility.
In particular, a study found that those who had been taking folic acid and zinc supplements for 26 weeks experienced a 74% increase in the amount of normal sperm in their semen.
This study suggests that folic acid can improve the quality of a man’s sperm while lowering the risk of sperm abnormalities that could interfere with conception.
Folate and Inflammation
Folate also plays a large role in oxidative stress and inflammation in our body.
Increased levels of stress consequently results in our bodies needing more folate.
Biological stressors, including lifestyle habits such as smoking, can impact a woman’s ability to conceive. Appropriate amounts of folic acid in our diet can help counteract the effects of this type of cellular stress.
When Should You Consider Folic Acid Supplements?
The recommendation is that women of reproductive age should get 400 mcg of folic acid every day to get enough folic acid to help prevent some birth defects because;
About half of U.S. pregnancies are unplanned, and
Major birth defects of the baby’s brain or spine occur very early in pregnancy (3-4 weeks after conception) before most women know they are pregnant.
This is widely recommended by professional medical associations and bodies, including the NHS and CDC.
How Much Folic Acid is Recommended?
the RDA for folic acid is:
400 mcg per day for adults
600 mcg for pregnant women
500 mcg for breastfeeding women
Although these needs can theoretically be met through diet, taking a supplement is a convenient and more assured way to meet folate needs for many people, especially those already at risk of deficiency, including pregnant women.
What Are Natural Sources Of Folic Acid
If you aren't really one for supplements there are many food groups that are rich in folate, these include but are not limited to;
Leafy vegetables
Okra
Asparagus
Beans
Yeast
Mushrooms
Taking Folic Acid or Folate Supplements
Folic acid is also available as a supplement and is often used in combination with other B vitamins.