The Importance of Folic Acid

Folic AcidAre you a reproductive age female? Are you thinking about getting pregnant?Are you taking folic acid supplementation? You should be! Let’s talk about why…

Folic acid supplementation reduces the risk that you could have a baby with a neural tube defect (i.e., an abnormality of the brain or spine). Neural tube defects occur in about 2 in 1,000 pregnancies and are the second most common major congenital anomaly worldwide. Neural tube defects result in either fetal death or an infant with a severe disability. BUT don’t stress…if you take folic acid supplementation starting the month before attempting pregnancy, you can reduce the risk of a defect by 70%.

Studies suggest that there are also additional benefits to taking folic acid including potentially decreasing your risk of premature birth, low birth weight, preeclampsia, miscarriage, and ovulatory infertility. If you have a history of ovulatory dysfunction or infertility, please contact one of our Vios REI physicians who are trained in treating this disorder. It is unlikely that taking folic acid will correct the issue, but research suggests it may help!

What is the research around fertility and folate?
Folate is required for the synthesis of DNA, transfer RNA, cysteine, and methionine, which are required during periods of rapid cell growth. Given the peri-conceptional period is a time of cellular growth, it was postulated that folate supplementation may improve reproductive outcomes. In a prospective cohort study of 232 women, live birth rates in women undergoing IVF were 20% higher among women with the highest amount of supplemental folate intake (>800 mcg/day) compared to women taking the lowest amount (<400 mcg/day). This study also suggested that folate supplementation was superior to dietary folate.

Similarly, a prospective cohort study of women undergoing IVF in the Netherlands found that a doubling in the follicular folate level was associated with three-fold increase in pregnancy. From this data, women should be advised to take 800 mcg/day of folate during fertility treatments and throughout pregnancy.

Why do you need at least a month of supplementation before getting pregnant?
The neural tube is one of the first structures to form in a fetus. In fact, the neural tube is nearly formed by the time of the first missed period, so starting supplementation at that time may be too late. The US Public Health Service and the American College of Obstetricians and Gynecologists recommend all women capable of getting pregnant take 400 mcg of folic acid daily starting at least one month prior to attempting pregnancy. However, your OB/GYN may recommend a higher dose depending on your specific health history.

Does this mean you have to take several pills before you get pregnant?
Nope! Just one! Most prenatal vitamins contain at least the required amount of folic acid. I like the following vitamins, but feel free to pick any one you prefer but make sure you check the label!

  • OB Complete One or OB Complete Petite- both contain 1mg folic acid
  • Prenate Mini- contains 1mg folic acid
  • Brainstrong Prenatal- contains 800 mcg

Are there other ways to increase your folic acid intake?
The FDA actually mandates folic acid be added to enriched grain products, such as breakfast cereals, bread, pasta, and rice. Other foods that are an excellent source of folic acid:

  • Lentils
  • Avocado
  • Dried beans, peas, nuts
  • Green vegetables
  • Egg noodles

If you have more questions about folic acid or other supplements and how they may impact your fertility contact us today!