Folic Acid and Fertility

Intervention #5 Folic Acid
Fact Check

  • Women must take 400 micrograms (mcg) of folic acid each day, in addition to consuming food with folate from a varied diet.

Folic Acid and Fertility

Folate (vitamin B9) is an essential nutrient that is required for DNA replication and as a substrate for a range of enzymatic reactions involved in amino acid synthesis and vitamin metabolism.

Demands for folate increase during pregnancy because it is also required for growth and development of the foetus. Folate deficiency has been associated with abnormalities in both mothers (anaemia, peripheral neuropathy) and foetuses (congenital abnormalities).

  • Reduce the risk of neural tube defects. A neural tube defect is when the foetus's spinal cord (part of the body's nervous system) does not form normally. 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.
  • Prevention of congenital heart disease and oral clefts.
  • Prevention of preterm birth.

Folate or Folic Acid?

  • Folate, or vitamin B9, is one of the 13 essential vitamins. It cannot be synthesized by the body and must be obtained either from diet or supplementation.
  • Dietary folate is a naturally occurring nutrient found in foods such as leafy green vegetables, spinach, legumes, egg yolk, liver, citrus fruit, asparagus, avocados, beets, brussels sprouts, broccoli.
  • Folic acid is a synthetic dietary supplement that is present in artificially enriched foods and pharmaceutical vitamins. Folic acid is ideal to use for food fortification because it is more heat-stable than types of natural food folate. Heat and light can easily break down types of natural food folate. Folic acid is better suited for food fortification because many fortified products, such as bread and pasta, are cooked.
  • Neither folate nor folic acid is metabolically active. Both must be reduced to participate in cellular metabolism. l-5-Methyltetrahydrofolate (l-methylfolate) is the predominant micronutrient form of folate that circulates in plasma and that is involved in biologic processes.

  • Recommendations

    It’s recommended that women of reproductive age who could become pregnant consume at least 400 micrograms (mcg) of folate every day.
    However, it’s difficult to get 400 mcg of folate through diet alone. You can get 400 mcg of folic acid each day by taking a vitamin with folic acid in it, eating fortified foods, or a combination of the two, in addition to consuming a balanced diet rich in natural food folate.

    Some women are advised to take a higher dose supplement of 5 milligram (5mg) every day. You may need to take a 5mg supplement of folic acid if:

    • You or the baby's biological father have a neural tube defect
    • You previously had a pregnancy affected by a neural tube defect
    • You or the baby's biological father have a family history of neural tube defects
    • You have diabetes
    • You take anti-epilepsy medicine.
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