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  • Writer's pictureJen Walpole

Folate Supplementation Supports Fertility

How does folate support fertility in men and women?

We all know that folate reduces the risk if neural tube defects in pregnancy, but outside of this, it supports several other processes when it comes to fertility. Let’s take a closer look:

Female Fertility

Folate plays a critical role in female fertility and pregnancy, with numerous studies underscoring its importance. Its most well-known benefit is the prevention of neural tube defects (NTDs) in developing foetuses. NTDs, which include conditions like spina bifida and anencephaly, occur in the early stages of pregnancy, often before a woman knows she is pregnant. For this reason, it is recommended that women of childbearing age consume 400 micrograms (mcg) of folic acid or folate daily, which can reduce the risk of NTDs by up to 70%. Folate’s role in fertility and pregnancy extends beyond NTD prevention. It is essential for DNA synthesis and repair, processes crucial for the healthy development of the foetus. Research suggests that adequate folate intake is associated with increased fertility in women undergoing assisted reproductive technologies such as IVF. This is likely because folate supports the maturation of the ovum (egg), the quality of the embryo, and implantation processes. Moreover, folate plays a role in reducing the risk of other congenital anomalies. Research indicates that sufficient folate levels can lower the risk of heart defects, cleft lip and palate, and urinary tract anomalies. These benefits are attributed to folate’s role in genetic expression and cellular growth. The importance of folate is further emphasised by its impact on homocysteine levels. Elevated homocysteine is a recognised risk factor for complications such as preeclampsia and miscarriage. Folate helps metabolise homocysteine, therefore maintaining its levels within a normal range, crucial for a healthy pregnancy.

So, folate’s multifaceted role in female fertility and pregnancy is well-supported by scientific research. Its impact ranges from reducing the risk of neural tube defects and other congenital anomalies to supporting the maturation of the egg and overall embryo health. These findings highlight the importance of adequate folate intake for women planning pregnancy and during pregnancy itself.

Male Fertility

Folate is also essential for men when it comes to fertility and reproductive health. Adequate folate levels have been associated with healthier sperm and may improve fertility outcomes.

Folate is involved in the synthesis, repair, and functioning of DNA in both men and women. A study reported that men with lower folate intake had higher rates of chromosomal abnormalities in their sperm. Folate plays a critical role in DNA methylation, a biochemical process essential for normal chromosomal structure and function. Research suggests that men with adequate folate levels have a lower risk of producing sperm with aneuploidy, a condition where sperm have too few or too many chromosomes, which can lead to infertility, miscarriages, or congenital disabilities. Studies have indicated that folate can influence the stability of sperm DNA. A research article found that low folate levels are associated with increased sperm DNA damage, which might impact fertility and the health of the offspring. What’s more, sufficient folate intake may contribute to sperm count and motility, essential factors in male fertility. The integrity of sperm DNA is paramount for healthy reproduction. Finally, high levels of homocysteine in men have been linked to poor sperm health. Folate helps to regulate homocysteine levels, thereby possibly improving sperm quality and reducing the risk of infertility.

So, folate's role in DNA synthesis and repair extends to the health of sperm, where it may improve sperm count, motility, and reduce the risk of chromosomal abnormalities. Men considering fatherhood may benefit from ensuring adequate dietary intake of folate for optimal reproductive health.

Some of the studies used in this post:

Chen H, Qin L, Gao R, Jin X, Cheng K, Zhang S, Hu X, Xu W, Wang H. Neurodevelopmental effects of maternal folic acid supplementation: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2023;63(19):3771-3787. doi: 10.1080/10408398.2021.1993781. Epub 2021 Oct 21. PMID: 34672229.

Cirillo M, Coccia ME, Attanasio M, Fatini C. Homocysteine, vitamin B status and MTHFR polymorphisms in Italian infertile women. Eur J Obstet Gynecol Reprod Biol. 2021 Aug;263:72-78. doi: 10.1016/j.ejogrb.2021.06.003. Epub 2021 Jun 15. PMID: 34167037.

Miraglia N, Dehay E. Folate Supplementation in Fertility and Pregnancy: The Advantages of (6S)5-Methyltetrahydrofolate. Altern Ther Health Med. 2022 May;28(4):12-17. PMID: 35653630.

Schisterman EF, Sjaarda LA, Clemons T, Carrell DT, Perkins NJ, Johnstone E, Lamb D, Chaney K, Van Voorhis BJ, Ryan G, Summers K, Hotaling J, Robins J, Mills JL, Mendola P, Chen Z, DeVilbiss EA, Peterson CM, Mumford SL. Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial. JAMA. 2020 Jan 7;323(1):35-48. doi: 10.1001/jama.2019.18714. Erratum in: JAMA. 2020 Mar 24;323(12):1194. PMID: 31910279; PMCID: PMC6990807

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