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Folic Acid for Female and Male Fertility

How Folic Acid May Improve Fertility and Help You Have a Healthier Pregnancy

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Updated April 23, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Folic Acid for Female and Male Fertility

A morning bowl of fortified cereal is one easy way to get more folic acid.

Photo (c) User annette of Stock.xchng.

If you've been looking at supplements for fertility, you've likely come across recommendations for folic acid. One of the B-vitamins, folate (or folic acid, as it's known in supplement form) is needed for the development of red blood cells and DNA production. Folate also plays an important role in cell division. Low folate blood levels are associated with a form of anemia.

Folic acid is clearly an essential nutrient in the body. But can folic acid help you conceive? Should men also be taking folic acid? Should you take a supplement, or can you get what you need from diet alone?

What Role May Folic Acid Play in Female Fertility?

Women who don't get enough folic acid in their diet are at a higher risk for having a baby with a neural tube defect. Neural tube defects, which occur in about 3,000 pregnancies per year in the United States, include spina bifida, anencephaly, and encephalocele. At best, these birth defects can lead to lifelong disability, and at worst, they can lead to early death. If you have a family history of neural tube defects, you have an even higher risk of having a child with one of these birth defects.

While folic acid can't eliminate these birth defects, folic acid supplementation started before conception and continued through early pregnancy has been found to cut the occurrence of these birth defects by up to 60%. (More on supplementation below.)

Other possible benefits of folic acid supplementation include:

What Role May Folic Acid Play in Male Fertility?

As was written above, folate is an essential nutrient when it comes to cell division and DNA synthesis. When we consider how a baby begins - a single cell that divides and divides - it makes sense that folic acid could help ensure the cell division, and therefore fetal development, goes well. But how could folic acid improve male fertility?

Before we get an embryo, we need an egg and a sperm. While women are born with all the eggs they will ever have, the man's body creates sperm on a daily basis. In fact, 1,500 new sperm cells are "born" every second. The process from germline stem cell to sperm cell takes about 60 days.

Folate levels measured in semen have been associated with sperm count and health. One study found that low folate levels in semen were associated with poor sperm DNA stability. Another study found that combined supplementation of folic acid and zinc for a period of 26 weeks increased total sperm count in fertile and subfertile men.

While research is still ongoing, there does seem to be a correlation between folic acid and semen health.

What Foods Are Rich in Folic Acid?

For your reference, the recommended intake for folic acid is:

  • 400 mcg for men and women 14 years and up
  • 500 mcg for breastfeeding women
  • 600 mcg for pregnant women

Because of the connection between birth defects and folate deficiency, most breads and cereals in the United States and Canada are enriched with folic acid. Enriched cereals and breads are likely the easiest way to get more folic acid into your diet.

Beyond your morning bowl of fortified cereal, here are 10 foods high in folic acid:

  • Beef liver, 3 oz.: 215 mcg
  • Spinach, 0.5 cup boiled: 131 mcg
  • Black-eyed peas, 0.5 cup boiled: 105 mcg
  • White rice, 0.5 cup cooked: 90 mcg
  • Asparagus, 4 spears boiled: 89 mcg
  • Brussels sprouts, 0.5 cup boiled: 78 mcg
  • Romaine lettuce, 1.0 cup shredded: 64 mcg
  • Avocado, 0.5 cup raw: 59 mcg
  • Spinach, 1 cup raw: 58 mcg
  • Broccoli, 0.5 cooked: 52 mcg

Other foods with folate include mustard greens, green peas, kidney beans, peanuts, wheat germ, tomato juice, crab, orange juice, turnip greens, oranges, papaya, and bananas.

Should I Take a Folic Acid Supplement?

Despite bread and cereal fortification, most women still don't get enough folic acid in their diet. Because many pregnancies are unplanned, and because this vitamin must be present before you get pregnant, the March of Dimes recommends that all women of childbearing age take a daily supplement that includes at least 400 mcg of folic acid. When pregnant, the recommended daily folic acid supplementation raises to 600 mcg.

Your doctor may recommend a prenatal vitamin to take while trying to conceive, or simply a daily multivitamin. Just check to be sure the multivitamin contains at least 400 mcg of folic acid.

If you have a family history of neural tube defects, your doctor may recommend you take 4,000 to 5,000 mcg of folic acid. However, because these levels are above the recommended upper limits, you should only take this high of a dose under the supervision of your doctor.

For men, you can get a boost of folic acid through a daily multivitamin, or you may consider taking a "male prenatal" vitamin. ConceptionXR®: Reproductive Health Formula comes highly recommended, and contains folic acid along zinc, vitamin C, vitamin D, selenium, and lycopene, all nutrients found to improve male fertility.

Unless your doctor prescribes it, your daily supplements shouldn't include more than 1,000 mcg of folic acid.

Taking large doses of folic acid may cover up a vitamin B-12 deficiency, which can cause irreversible damage if not caught early on. Your doctor should test your B-12 levels before putting you on high dose folic acid supplements.

Folic acid is a water soluble vitamin, which means it must be replaced on a daily basis in the body. To get the best results, be sure to take your supplement daily. One study found that the benefits of folic acid supplementation didn't occur when taken on two or fewer days per week.

Folic acid may interact with other medications. For example, folic acid may reduce the effectiveness of the anti-seizure drug phenytoin. Also, some fertility blends include herbs that can interact with fertility drugs. So be sure to speak with your doctor before beginning any supplementation.

Articles on improving health and fertility:

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Sources:

Azizollahi G, Azizollahi S, Babaei H, Kianinejad M, Baneshi MR, Nematollahi-mahani SN. "Effects of supplement therapy on sperm parameters, protamine content and acrosomal integrity of varicocelectomized subjects." J Assist Reprod Genet. 2013 Apr;30(4):593-9. doi: 10.1007/s10815-013-9961-9. Epub 2013 Feb 24.

Berry RJ, Bailey L, Mulinare J, Bower C; Folic Acid Working Group. "Fortification of flour with folic acid." Food Nutr Bull. 2010 Mar;31(1 Suppl):S22-35.

Boxmeer JC, Smit M, Utomo E, Romijn JC, Eijkemans MJ, Lindemans J, Laven JS, Macklon NS, Steegers EA, Steegers-Theunissen RP. "Low folate in seminal plasma is associated with increased sperm DNA damage." Fertil Steril. 2009 Aug;92(2):548-56. doi: 10.1016/j.fertnstert.2008.06.010. Epub 2008 Aug 22.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. "Use of multivitamins, intake of B vitamins, and risk of ovulatory infertility." Fertil Steril. 2008 Mar;89(3):668-76. Epub 2007 Jul 10.

Dell'Amore, Christine. "How a Man Produces 1,500 Sperm a Second." National Geographic Daily News. Published March 18, 2010. Accessed September 24, 2013. http://news.nationalgeographic.com/news/2010/03/100318-men-sperm-1500-stem-cells-second-male-birth-control/

De-Regil LM, Fernández-Gaxiola AC, Dowswell T, Peña-Rosas JP. "Effects and safety of periconceptional folate supplementation for preventing birth defects." Cochrane Database Syst Rev. 2010 Oct 6;(10):CD007950. doi: 10.1002/14651858.CD007950.pub2.

Gaskins AJ, Mumford SL, Chavarro JE, Zhang C, Pollack AZ, Wactawski-Wende J, Perkins NJ, Schisterman EF. "The impact of dietary folate intake on reproductive function in premenopausal women: a prospective cohort study." PLoS One. 2012;7(9):e46276. doi: 10.1371/journal.pone.0046276. Epub 2012 Sep 26.

Folate: Dietary Supplement Fact Sheet, Health Professional. Office of Dietary Supplements. National Institutes of Health. Accesses September 24, 2013. http://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

Folic Acid. March of Dimes. Accessed September 24, 2013. http://www.marchofdimes.com/pregnancy/folic-acid.aspx

Folate. NYU Langone Medical Center. Accessed September 24, 2013. http://www.med.nyu.edu/content?ChunkIID=21717

Neural Tube Defects. March of Dimes. Accessed September 24, 2013. http://www.marchofdimes.com/baby/neural-tube-defects.aspx

Wong WY, Merkus HM, Thomas CM, Menkveld R, Zielhuis GA, Steegers-Theunissen RP. "Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial." Fertil Steril. 2002 Mar;77(3):491-8.

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