MTHFR and Fertility

When it comes to fertility, many factors can play a role in your ability to conceive, and one often-overlooked gene mutation is the MTHFR gene. This genetic variation can impact your body’s ability to process folate and other nutrients, which in turn may affect hormone levels, fertility, and pregnancy outcomes. 

What is MTHFR?

MTHFR stands for methylenetetrahydrofolate reductase, an enzyme responsible for converting folic acid (the synthetic form of folate) into its active form. This active form is needed for numerous bodily functions, including DNA synthesis, repair, and cell division—critical processes when trying to conceive and maintain a healthy pregnancy.

However, some people inherit mutations of the MTHFR gene, which can reduce the efficiency of this enzyme. As a result, they may struggle with inadequate folate conversion, which could lead to elevated homocysteine levels in the blood.

Signs MTHFR Could Be Impacting Your Fertility:

• Elevated homocysteine levels: High homocysteine is a common side effect of MTHFR mutations. Homocysteine is a sulfur-containing amino acid, and high levels are associated with cardiovascular issues, fertility challenges, and an increased risk of pregnancy complications. Check out my fertility lab guide for more insight into your lab levels and fertility journey.

• Difficulty getting pregnant or recurrent miscarriages: Elevated homocysteine levels caused by poor folate metabolism can impact egg quality and implantation, potentially making it harder to conceive or increasing the risk of miscarriage. If you have more questions about this one, you may benefit from my Fueling Your Fertility course - all about preparing for a healthy pregnancy.

• Fatigue or unexplained health issues: MTHFR mutations can cause a range of symptoms due to poor nutrient absorption. If you're experiencing chronic fatigue, brain fog, or low energy despite eating a healthy diet, it could be a sign of poor folate conversion.

Understanding MTHFR Polymorphisms and Their Risks

Not all MTHFR mutations are the same—there are different polymorphisms (variations) that can impact how efficiently your body processes folate. The two most well-known mutations occur at C677T and A1298C. Having one or two copies of these mutations can influence your risk factors differently:

• C677T Mutation: A heterozygous (one copy) mutation may result in a 30-40% reduction in MTHFR enzyme activity, while a homozygous (two copies) mutation can lead to a 60-70% reduction. This is associated with higher homocysteine levels, which can increase the risk of blood clotting, miscarriage, preeclampsia, and neural tube defects in pregnancy.

• A1298C Mutation: This variant has a milder impact on folate metabolism but may still affect neurotransmitter production and hormone balance, contributing to infertility, recurrent pregnancy loss, and mood disorders.

• Compound Heterozygous (C677T + A1298C): If you inherit one copy of each mutation, the combined effect can be significant, potentially leading to elevated homocysteine levels and increased methylation challenges, making it even more important to support your body with the right nutrients.

Understanding which MTHFR polymorphism you carry can provide crucial insight into how your body processes folate and whether you may be at a higher risk for fertility complications.

How Can Nutrition Help with MTHFR?

If you’ve been diagnosed with an MTHFR mutation, you don’t need to panic. There are several dietary and lifestyle adjustments that can support your body’s ability to process folate and maintain healthy levels of homocysteine.

1. Prioritize Folate-Rich Foods: Instead of synthetic folic acid, focus on foods high in natural folate. Leafy greens like spinach, kale, and Swiss chard, as well as legumes, beets, and avocados, are great sources. These foods are easily absorbed and support optimal fertility.

2. Choose Methylated Folate Supplements: If you have difficulty converting folic acid, methylated folate (5-MTHF) is a bioavailable form of folate that is more easily absorbed by individuals with MTHFR mutations. Here is my favorite high quality prenatal that includes active folate (use code WELLWOMEN)

3. Support with B Vitamins: B vitamins, especially B6, B12, and B2, are crucial for homocysteine metabolism. Ensuring you get enough of these vitamins through foods like eggs, fish, poultry, and fortified cereals can help balance your homocysteine levels. 

4. Incorporate Anti-Inflammatory Foods: Chronic inflammation can worsen MTHFR-related issues. Adding anti-inflammatory foods like turmeric, ginger, berries, and fatty fish to your diet can help reduce inflammation and support your overall reproductive health.

5. Limit Processed Foods and Toxins: High levels of processed foods, sugars, and environmental toxins can further impair methylation and exacerbate fertility problems. By focusing on whole, nutrient-dense foods, you can reduce the burden on your body and optimize your chances of conceiving.