08 Jan Folic Acid and Fertility – The Full Story
We all know that folic acid is important for pregnancy, but did you know there are different forms of folic acid and that the form you choose can affect your fertility?
The majority of women know that folic acid (B9), is essential for the normal development of a baby in utero. It is particularly important in the first trimester when the nervous system is developing, as it reduces the risk of neural tube defects such as spina bifida. But more recent research has uncovered a genetic defect that makes it extremely difficult for up to 1in 4 people to effectively absorb folic acid, which is the synthetic form contained in most supplements.
Folic acid has many roles within the body to name but a few:
- Formation of red blood cells
- Protein production
- DNA transcribing
- Methylation, which is essential to support the liver breaking down toxins and preparing them for removal from the body
- Cellular energy production
It can be very confusing differentiating between the terms folic acid and folate, and it’s important to ensure you are taking folate in a form that is easily utilised by the body.
- Folate: found in natural (unfortified foods), with raw leafy greens being one of the best sources. Folate is also found in grass fed meats and eggs in smaller amounts.
- Folic acid: this is the synthetic form of Folate, manufactured in the lab and used in B vitamin supplements, which will not be converted effectively with people with an MTHFR defect.
- Folinic acid: This is an intermediary step in the conversion of folic acid to the active form of the vitamin.
- L-Methyl folate. This is a supplemental form of folate that is well-utilized by those with the copying defect, as it bypasses the initial stages of metabolism.
So let’s try to simplify the complex biochemistry and the implications in relation to fertility. The gene in question is MTHFR which stands for Methylentertrahydrofolate reductase (it’s a mouthful!). This gene is found on the short arms of chromosome 1, of which there are 2 short arms, one inherited from the mother and one from the father.
The function of the gene is to produce the MTHFR enzyme which is essential for various processes within the body. If this MTFHR gene is mutated it will produce a distorted enzyme, which is like missing a piece of a puzzle, therefore you can’t see the whole picture.
So let’s take a look at the implications for fertility. The MTHFR gene is often found in cases of sub fertility for both partners due to the risk of birth defects, reoccurring miscarriage and poor sperm parameters. High homocysteine levels due to low levels of methylation can also increase your risk factors for preclampsia, placental abruption, miscarriage and small low birth weight babies. A problem with Methylation increases your susceptibility to chemical sensitivities and allergies which in turn affects not only conception but the health of the baby in utero. Low methylation also affects the production of neurotransmitters, detoxification of oestrogen and the production of bioavailable B12.
There are several important lifestyle changes that you need to make if you are positive for the MTHFR mutation such as:
- Eliminating sugar
- Cutting out alcohol
- Reducing your exposure to pesticide
- Avoiding processed food
- Increasing your intake of antioxidant rich foods, healthy fats and grass fed meat.
- Elimingating gluten
- And change to the bioavailable form of folate – L- methyl folate,(avoid folic enriched foods).
Synthetic folic acid needs to be avoided due to the fact that UMFA, (unmetabolised folic acid) binds to folic binding proteins and folate receptors which reduces the availability of the usable form This in turn leads to a reduction in the production of folate binding protein, which if you are pregnant or planning to conceive it means that the baby will not get or is not getting enough bioavailable folate to drive their own methylation therefore DNA production is negatively affected, contributing to an increase in infertility, pregnancy complications and higher risk of birth defects.
So the end result is that your body is not able to detoxify effectively, or produce enough energy to sustain a pregnancy which means increasing oxidative stress for both partners. If you have any fertility issues, or in fact any autoimmune or chronic health issues I strongly recommend getting tested for The MTFHR mutation, (which is performed by a blood test, or saliva swab ) as part of your preconception care plan.
I have found that this testing is not routine, even after failed IVF cycles, so do your research and demand it!