Folate deficiency means that your body doesn’t have enough folic acid to function as it should. Folic acid is the synthetic form of folate (vitamin B9). If a deficiency continues over time, it may turn into folic acid deficiency anemia, a condition where the body doesn’t have enough red blood cells.

This article has been verified by a medical professional

Impact of folate deficiency on fertility

Folic acid is very important when you’re trying to conceive. Research shows that folic acid supports egg maturation, and a deficiency may interfere with regular ovulation. During pregnancy, it’s very important to have enough folic acid as it helps prevent severe complications including chromosomal disorders and neural tube defects, which can lead to pregnancy loss. A deficiency can also lead to high blood pressure during pregnancy (preeclampsia).

Potential causes of folate deficiency

The main reason for a folic acid deficiency is not getting enough of this vitamin through your diet. It may also be due to the following factors:

  • Excessive alcohol drinking
  • Digestive problems that make your body not absorb folic acid as it should, such as Crohn’s disease or celiac disease 
  • Certain medications including those used to treat seizures
  • Gluten intolerance
  • Liver disease
  • Genetic diseases
  • Hyperthyroidism (overactive thyroid)

Even if you eat a healthy, balanced diet with lots of fruits and veggies, it’s possible to have a deficiency if you overcook your food, as the heat destroys the natural folate.


Symptoms of a folic acid deficiency include:

  • Fatigue
  • Headaches
  • Irritability


Healthcare providers diagnose a deficiency in folate through a blood test that measures the amount of folate in your blood. If you have a low level, you will be diagnosed as folate deficient.

Treatment to improve fertility

It’s easy to fix a folic acid deficiency by taking supplements. Current medical guidelines recommend that all women of reproductive age take a 400 microgram folic acid supplement each day, on top of eating a healthy diet containing folate. Some women may require a higher dose, for instance if they are at higher risk of having a pregnancy affected by neural tube defects. Talk to your doctor about the dose that’s right for you.

Studies show that folic acid supplementation is associated with higher pregnancy rates and better embryo quality.

In addition to supplementation, here are foods containing folate that you can eat more of:

  • Leafy green vegetables
  • Broccoli
  • Brussels sprouts
  • Eggs
  • Beets
  • Citrus fruits
  • Lentils
  • Seeds
  • Nuts
  • Asparagus

For more nutritional advice for your journey to pregnancy, check out our article on fertility foods.  

This article has been verified by a medical professional

  • Folate Deficiency. Cleveland Clinic. Accessed 13 September 2022.
  • Gaskins AJ et al.: The Impact of Dietary Folate Intake on Reproductive Function in Premenopausal Women: A Prospective Cohort Study. PLoS One. 2012;7(9):e46279.
  • B vitamins and folic acid. NHS. Accessed 13 September 2022.
  • Schaefer E & Nock D: The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility. Clin Med Insights Womens Health. 2019;12:1179562X19843868
  • Recommendations: Women & Folic Acid | CDC. Accessed 06. November 2021. Folic Acid Homepage, Center for Disease Control and Prevention, U.S. Department of Health & Human Services.
  • Sadler T: Embryology of neural tube development. Am. J. Med. Genet. 2005;135C: 2-8.
  • Accessed 06. November 2021.
  • Hill, M.A. (2021, November 5) Embryology Week 3. Retrieved from UNSW Embryology.
  • What Are the Mesoderm, Ectoderm and Endoderm Tissue? ( Accessed 06. November 2021.
  • Kandel ER, Schwartz JH, Jessel TM, eds. (2000). “Ch. 17: The anatomical organization of the central nervous system”. Principles of Neural Science. McGraw-Hill Professional. ISBN 978-0-8385-7701-1.
  • Gilbert SF. Developmental Biology. 6th edition. Sunderland (MA): Sinauer Associates; 2000. Formation of the Neural Tube. Available from:
  • Colas JF, Schoenwolf GC: Towards a cellular and molecular understanding of neurulation. Dev Dyn. 2001;221(2): 117–145.
  • Greene ND, Copp AJ: Neural tube defects. Annu Rev Neurosci. 2014;37:221-42.
  • Copp AJ et al: Spina bifida. Nat Rev Dis Primers. 2015;1:15007.
  • Facts about Anencephaly | CDC. Accessed 06. November 2021.Birth Defects Homepage. Center for Disease Control and Prevention, U.S. Department of Health & Human Services.
  • Nikolopoulou E et al: Neural tube closure: cellular, molecular and biomechanical mechanisms. Development. 2017 Feb 15;144(4):552-566. Sato K: Why is folate effective in preventing neural tube closure defects?, Medical Hypotheses, 2020;134,109429,ISSN 0306-9877.
  • Grieger JA et al: ,Pre-pregnancy fast food and fruit intake is associated with time to pregnancy. Hum Reprod. 2018 Jun 1;33(6):1063-1070. doi: 10.1093/humrep/dey079. PMID: 29733398.
  • Riboflavin | Linus Pauling Institute | Oregon State University. Accessed 06. November 2021. Linus Pauling Institute, Micronutrient Information Center, Oregon State University.
  • ESHRE Guideline Group on RPL, Bender Atik R, Christiansen OB, et al. ESHRE guideline: recurrent pregnancy loss. Hum Reprod Open. 2018;2018(2):hoy004. Published 2018 Apr 6. doi:10.1093/hropen/hoy004.
  • Genetic Screening for Birth Defects ( Accessed 07. November 2021. American Society for Reproductive Medicine, Genetic Screening for Birth Defects, Fact Sheets.

You might also like...

Excess vitamin B12 and pregnancy

Excess vitamin B12 during pregnancy can increase the risk of health complications for the baby. Vitamin B12 is an essential vitamin that...

Macrocytic hyperchromic anemia

Macrocytic hyperchromic anemia means that your bone marrow produces unusually large and dark red blood cells. These cells don’t have the nutrients...


Leukopenia means that you have a low white blood cell count. White blood cells, or leukocytes, are vital to your immune system....


Endometriosis is a condition where tissue like your uterine lining grows outside the womb: on the ovaries, fallopian tubes, pelvic tissues, or...

Excess folic acid and pregnancy

Folic acid is the synthetic form of folate (vitamin B9). Folate is an essential vitamin that your body needs for cell and...

Microcytic hypochromic anemia

Microcytic hypochromic anemia means that your body has too few red blood cells and these cells are smaller and paler than usual....

Normocytic normochromic anemia

Normocytic normochromic anemia means that you have a low red blood cell count, but your red blood cells have a normal shape,...

Vitamin B12 Deficiency

Vitamin B12 is an essential nutrient that our bodies need to work properly. It helps with nerve function, cell metabolism, and the...


Ja, ich möchte mich kostenfrei für den LEVY Fertility Code anmelden und den LEVY Newsletter abonnieren. Ich erhalte auf mich abgestimmte Informationen und weitere Details zum LEVY Fertility Code an die angegebene E-Mail-Adresse.

[contact-form-7 id="371" title="Contact form 1"]