Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin B9, particularly in the form of calcium methylfolate (a bioactive and stable form of folate), is supported by scientific evidence for its role in fertility, though the strength of evidence is moderate rather than definitive. Folate is essential for DNA synthesis, repair, and methylation, processes that are crucial for oocyte (egg) quality and embryonic development. Deficiency in folate has been linked to infertility and poor reproductive outcomes in both women and men. Supplementation with folate, including methylfolate, is commonly recommended before and during pregnancy to reduce the risk of neural tube defects, but it may also positively impact fertility by supporting healthy cell division and reducing homocysteine levels, which are associated with poor reproductive outcomes.

Several observational studies and some clinical trials suggest that women with higher folate status or those who take folate supplements have improved fertility outcomes, including higher rates of conception and live births. In men, folate supplementation may improve sperm quality. While most studies focus on folic acid, methylfolate is increasingly used, especially in individuals with MTHFR polymorphisms who metabolize folic acid less efficiently. Guidelines from organizations such as the American College of Obstetricians and Gynecologists support folate supplementation for women planning pregnancy, but direct evidence linking methylfolate to increased fertility rates is still emerging. Thus, while there is a scientifically plausible rationale and some supportive data, more high-quality randomized controlled trials are needed for stronger recommendations.

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