When you are preparing for IVF, your mind is naturally consumed by appointments, scan dates, injections, and timelines. Nutrition can feel like a secondary concern. But there is one nutrient that fertility specialists across the world agree on — one that most patients underestimate and some overlook entirely — and that is folic acid.
This is not just another wellness recommendation. The evidence behind folic acid and IVF outcomes is strong, consistent, and deeply important for anyone beginning or planning their fertility journey.
Folic acid is the synthetic form of folate — also known as Vitamin B9. It is a water-soluble B vitamin that the body uses to make new cells, synthesise DNA, and support rapid cell division. Because it is water-soluble, it cannot be stored in the body for long periods, which means it must be consumed regularly and consistently.
Folate occurs naturally in food. Folic acid is the supplemental, manufactured form found in tablets and fortified foods. Both serve similar functions, but research suggests that supplemental folate is preferable to food folate for reproductive benefits — particularly during the pre-IVF phase — because dietary sources alone rarely provide enough.
One of the most significant concerns for any woman preparing for IVF is the quality of her eggs. Women who take folic acid supplements before IVF treatment have been found to have a higher proportion of mature eggs as well as eggs of higher quality.
Egg maturation is a complex biological process. Folate plays a direct role in DNA synthesis within the developing egg — significant amounts of reduced folates are required to accumulate in the oocyte during gametogenesis, to support the exponential increase in DNA synthesis that occurs during early embryo development.
Simply put — without adequate folic acid, the building blocks for a healthy, mature egg are incomplete.
The benefits of folic acid do not stop at egg quality. Research shows a clear connection between folate levels and the likelihood of successful fertilisation. Higher supplemental folate intake was associated with higher fertilisation rates and lower cycle failure rates before embryo transfer.
For IVF patients in particular, this is critically important. Every percentage point of improvement in fertilisation rate translates directly into a better chance of having viable embryos to transfer.
In a prospective study of women having IVF, pre-treatment of more than 800 mcg per day of folate was associated with a higher probability of live birth due to higher fertilisation rates, lower cycle failure before embryo transfer, improved embryo survival, and higher implantation rates.
This is perhaps the most compelling finding of all. Not just a positive test — a live birth. For couples who have been on a long and difficult fertility journey, that distinction matters enormously.
After fertilisation, the embryo undergoes rapid and extraordinary cell division. Folate is essential to this process. Folic acid regulates ovarian function, thus decreasing the risk of infertility due to ovulation issues, and aids in the production of healthy new cells through DNA synthesis, which is especially important for egg maturation before ovulation, embryo development, and pregnancy establishment.
A deficiency in folic acid at this stage does not just reduce the chance of pregnancy — it can affect the structural integrity of the developing embryo itself.
This is perhaps the most widely known role of folic acid — and it remains critically important. Folic acid reduces the risk of neural tube defects, which can occur in the brain and spine. According to the CDC, at least half of the 300,000 cases of neural tube defects worldwide each year can be prevented by taking folic acid.
The neural tube — which becomes the brain and spinal cord — begins forming in the very first weeks of pregnancy, often before a woman even knows she is pregnant. This is precisely why folic acid must be started before conception, not after a positive test.
Folic acid is not just a woman's supplement. Male fertility is equally important in an IVF cycle. A study published in the Human Reproduction journal found that men who consumed high doses of folic acid through their diet reduced their risk of sperm aneuploidy by up to 30 percent. Dutch researchers also showed that men who took 5 mg of folic acid and 66 mg of zinc increased their total sperm count by 74 percent.
For couples undergoing IVF with ICSI due to male factor infertility, high-dose folic acid supplementation in men was associated with an increase in the biochemical pregnancy rate compared to placebo
Folic acid is not a trendy fertility supplement. It is one of the most thoroughly researched, consistently recommended, and biologically critical nutrients in reproductive medicine. For IVF patients, starting it early — ideally three months before your cycle — and taking it at the right dose is one of the most meaningful steps you can take to support your treatment.
It supports your egg quality. It improves embryo development. It increases fertilisation and live birth rates. It protects your baby's nervous system from the very first days of development. And it benefits both partners — not just women.
If you have not already started folic acid, speak with your fertility specialist today. It is one of the simplest, most affordable, and most evidence-backed changes you can make on your path to parenthood.
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