Folic acid intake and ovarian reserve in fertility patients
What it found
In 552 women at a fertility clinic, higher folate intake from supplements was linked to a slightly higher ovarian reserve, measured as antral follicle count.
The link was modest and only seen up to certain intake levels.
What they found
Studies in people
Ovarian reserve and folate
Higher total and supplemental folate intake had a non-linear relationship with antral follicle count. There was a positive link up to about 1,200 micrograms per day for total folate and up to 800 micrograms per day for supplemental folate, with no extra benefit above those levels.
Size of the effect
The difference was modest. For example, a woman taking 800 micrograms per day of supplemental folate had about 1.5 more follicles than a woman taking 400 micrograms per day.
Food folate vs supplements
The link was driven by supplemental folate, not folate from food. Food folate intake showed no significant relationship with antral follicle count.
Other B vitamins
Higher intake of other B vitamins (B1, B2, B3, B5, B6, B12) was not significantly linked to antral follicle count when looked at in quartiles.
Smoking and supplemental folate
There was a suggestion that the link between supplemental folate and antral follicle count was stronger among women who had ever smoked.
What the authors conclude
“Higher intake of folate, particularly from supplements, was associated with modestly higher ovarian reserve as measured by AFC among women attending a fertility center.”
Also in their conclusions
- They conclude that higher intake of folate, particularly from supplements, was associated with modestly improved ovarian reserve as measured by antral follicle count.
- They say the positive link was only present for intakes between 0 and 1200 micrograms per day, with little to no benefit at higher intakes.
- They note that their results support current recommendations that women planning pregnancy consume at least 400 micrograms per day of folic acid and suggest additional benefit may be seen with up to 800 micrograms per day.
How it was done
The authors wanted to see if folate affects fertility through ovarian reserve, since diet is a modifiable factor and little research has been done on this topic.
They studied 552 women attending a fertility center between 2007 and 2019. Folate intake was measured with a food questionnaire, and ovarian reserve was measured by ultrasound as part of routine care.
What it can’t tell you
- This was an observational study, so it can show a link but not prove that folate causes higher ovarian reserve.
- The women studied were mostly older, White, and of high socioeconomic status, so the results may not apply to all women.
- The authors say their findings need to be confirmed by others, ideally with a randomized trial.
Who paid
- Funding
- Funded by NIDDK NIH HHS; NIEHS NIH HHS (from the PubMed record).
- Authors work at
- Emory University, Georgia; Harvard T.H. Chan School of Public Health, Massachusetts; Massachusetts General Hospital Fertility Center and Harvard Medical School, Massachusetts
The paper
- Title
- Folate intake and ovarian reserve among women attending a fertility center
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Kadir M, Hood RB, Mínguez-Alarcón L, et al (2022). Folate intake and ovarian reserve among women attending a fertility center. Fertility and sterility. doi:10.1016/j.fertnstert.2021.09.037Free full textPubMed 34809974DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error