Not All Folates Are Created Equal

Folate, Folic Acid and MTHFR? Supplementing with the correct form of folate and why it matters.

Folic Acid is the one we’ve all heard of. Recommended by the NHS when trying to conceive and for the first trimester of pregnancy, 400 micrograms is the daily amount required to help prevent birth defects known as neural tube defects, including spina bifida.

Unfortunately, this guidance isn’t up to date with the latest research and OVUM, along with many others, continues to canvass the NHS to update its guidance on this issue given the ramifications for people’s fertility journeys.


Let’s start with Folate itself. This is the name given to the actual vitamin which makes up folate, Vitamin B. From there folate can be manufactured into the synthetic form, known as ‘Folic Acid’, or the natural form known as ‘Methylfolate’. 

Before we delve into their differences and why they matter, let’s walk through why taking folate at all when you’re trying to conceive is so important, more so than previously thought:

It Supports Pregnancy and Fertility Outcomes.

Folate remains important for every stage of fertility, from egg development to ovulation to foetal growth and it is recommended to take for the first 12 weeks of pregnancy. 

We also now understand that folate helps restore ovulation and boosts egg quality, the very founding blocks of maximising your chances of conceiving. The very latest research now shows that taking it at a higher dose can improve fertility and birth outcomes for those trying to conceive. 

Higher intakes of folate have been correlated with a reduced risk of infertility, shorter time to pregnancy, lower risk of pregnancy loss, and better outcomes of fertility treatments

Folate is also indicated to be important for egg quality and maturation. Recent research shows that high folate levels in ovarian follicles are associated with 3x greater odds of becoming pregnant among women undergoing fertility treatment.

Research indicates it may improve IUI, IVF and ICSI Outcomes.

A recent 2019 Harvard Study concluded that women who took 800 micrograms of folate per day while undergoing fertility treatment had an increased probability of live birth.

Live birth rates in a 2014 study were found to be 20% higher in women who took 800 micrograms or more per day, compared to those who took less than 400 micrograms per day. A higher intake of folate was also associated with higher fertilisation rates and lower cycle failure rates before embryo transfer.

So which two forms of folates are there?

Folic Acid

This is a synthetic form of folate made in a laboratory and the form found in nearly every prenatal available today. Your body cannot use this in the form provided, so instead it must work to convert the Folic Acid back into folate which can then be readily absorbed by the body. 

How well people can process synthetic folic acid varies wildly. Common genetic variations mean that for some it will only cause a mild reduction in the ability to process folic acid, whereas others could be affected by as much as 70%. An aside issue with taking folate in this form is it carries the risk of actually masking the symptoms of B12 deficiency which can lead to anaemia. 


This is the natural form of folate and is the most abundant form of folate to be found in the human body. Your body loves it and can immediately make use of this and doesn’t need to first convert it. Methylfolate is the most bioavailable form of folate available and is the form that can be most absorbed by the body. 

Research tells us our bodies far prefer this natural form of folate rather than the synthetic version Folic Acid. Recent research shows a substantial amount of synthetic Folic Acid remains unmetabolized and unable to be used, which means the benefit of taking folate is not reaped, and it is therefore much more effective to use Methylfolate directly. 

And Why Does It Matter Which One I Take?

Not all folates are created equal. Now we’ve explained the two different kinds of folate, let’s run through why Methylfolate is the only form of folate we should be taking.

Up to 25% of the population has a common genetic variant which severely limits their ability to convert folate to methylfolate. This is known as the MTHFR gene and those with this genetic variation are also at a higher risk of having a child with neural tube defects.

The body uses folate to detoxify unwanted byproducts of normal metabolism, such as homocysteine. If taking folic acid, which in its synthetic form can’t be absorbed as well, meaning there’s far less Methylfolate available at the end of the day to do what’s required in your body. That leftover amount is diminished even further if you have the MTHFR gene.

What that then means is levels of homocysteine build up in the body and it is now thought these excess levels contribute to infertility as well as miscarriage risk in those with these MTHFR mutations. All that to say, we don’t advocate anyone taking Folic Acid and instead urge the use of methyl folate.   

The momentous amount of research available all indicates that Methylfolate is the only form of folate to supplement with to ensure you’re receiving the fully stated dose and you don’t have to be concerned as to whether you carry this common genetic variation or not. 

Dosage is again key with Methylfolate and OVUM contains the exact high dose required based on scientific evidence to maximise impact on your fertility. 

Takeaways - what is the best folate for me?

When it comes to taking folic acid, the actual dosage your body ends up consuming is impossible to know as its absorption rate is not uniform for all. 

To ensure you get the folate you need, it’s recommended that all women trying to conceive take Methylfolate rather than Folic Acid. We believe in taking away any concerns about the absorption of folate by simply using the higher quality and most bioavailable to all folate from the very beginning.

So why do we see folic acid used in nearly all fertility and early pregnancy supplements? The issue comes down to cost. Folic Acid is incredibly cheap to manufacture and Methylfolate is not. When OVUM first started and began the process of due diligence on the UK’s leading manufacturers, we remained astonished at how many tried to sway us from using the expensive Methylfolate and to instead opt for the benign Folic Acid. 

What became clear to us throughout the process is that many brands end up using the cheaper versions of nearly every ingredient, with the hope that marketing and the consumer’s lack of knowledge will make up for the product’s shortcomings. 

We know reading this might bring about feelings of frustration, but why isn’t this information more readily available or taught by all medical professionals? Why am I only hearing about this now and why is any supplement brand even using folic acid? That’s why we created OVUM. We’d had enough of the status quo and felt women trying to conceive deserve far better at one of the most vulnerable and emotionally charged times of their lives. 

We respect you, your journey and your time here at OVUM. We understand how badly you want to conceive and we will only ever deliver you the best to help you maximise your chances and shorten your time to pregnancy. OVUM contains a high 800 micrograms dose of methyl folate as recommended by our panel of research scientists and fertility experts. 

Find a full link to all our research here.

Recommended articles

  1. 28 May 2024

    What It Means To Be PIF TICK Verified

    Think of the Patient Information Forum (PIF) TICK as the gold standard in hea...

  2. 21 May 2024

    Let’s Get Back to Biology with Hormones

    Hormones. We learnt about them at school, probably during a dull biology les...

  3. 20 May 2024

    Egg Freezing 101: What You Need to Know

    To freeze your eggs or not freeze your eggs—that is the question! Deciding wh...

  4. 14 May 2024

    A guide to your Fertility Consultation with your GP

    This blog aims to prepare you for your fertility consultation with your GP, o...