MTHFR and Fertility - What You Need to Know

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If you’ve been trying to conceive without success you may have come across the acronym MTHFR and perhaps you’ve been given a diagnosis. It (and methylation in general) have been hot topics in the fertility world for the past few years. You may have read that it could be the cause of recurrent pregnancy loss (RPL.) So how can you parse through all of the information out there; what do you need to know about this crucial gene and how can you increase your odds of conceiving and carrying a baby to term?

MTHFR (MethyleneTetraHydroFolate Reductase) is an enzyme that breaks down the amino acids homocysteine and folate. There’s a gene that codes for this enzyme (…called, you guessed it, the MTHFR gene…) and it can mutate. This can do one of two things: either decrease the enzyme’s ability to function or completely inactivate it. Everyone has two copies of the MTHFR gene - one copy from each parent. If you’ve got a variant it means you’ve got a difference in either one (heterozygous) or both (homozygous) copies. The two most common MTHFR variants are C677T and A1298C. These mutations can lead to higher than normal homocysteine levels in the blood - which is thought to be a contributor to a number of issues. 

There have been a lot of claims made regarding MTHFR and its supposed involvement in a host of health issues, including its affect on fertility. What we can definitely say is that MTHFR has been associated with recurrent pregnancy loss (RPL.) Does this mean that MTHFR will definitely cause multiple miscarriages - no. What it does mean is that there is a correlation between the two- and a mutation could put you at increased risk. Many women who have had repeated losses have tested positive for MTHFR mutations. That being said - many women who have the mutations have never had a miscarriage and go on to give birth to healthy babies. Remember that correlation does not equal causation. If you have a mutation it doesn’t mean that you won’t conceive and carry a baby to term. It may just mean that you have to work a little harder to allow your body to methylate properly in order to support an optimal reproductive environment.

Fortunately there are some key things you can do to encourage your body to methylate optimally:

  • Consider an anti-inflammatory diet - decreased inflammation can increase methylation. In particular you may want to increase your consumption of green, leafy and cruciferous vegetables such as broccoli, Brussels sprouts and asparagus as well as avocado, legumes and rice

  • Decrease stress - acupuncture, exercise and meditation are all great ways to lower stress

  • Work out regularly - a healthy amount of exercise may increase methylation - results from studies have been unclear but moderate and regular exercise is certainly helpful in decreasing stress and keeping your body functioning at its best

  • Consider a homocysteine blood test - this will help you learn how much folate your body may require

  • See your acupuncturist and herbalist - acupuncture and herbs can help address imbalances and normalize your hormonal and reproductive environment

  • Get the right nutrients. I often recommend 7 supplements to increase methylation - even if your body has a mutation that slows down the methylation cycle. It’s important to take these under the guidance of your doctor, naturopath or acupuncturist-herbalist who is specialized in treating MTHFR mutations and fertility. I usually recommend the following from Thorne - but there are many reputable suppliers to choose from:

5-MTHF (active folate)

Methylcobalamin (active vitamin B12)

Pyridoxal 5’-Phosphate (active vitamin B6)

Riboflavin 5’-Phosphate (active vitamin B2)

Betaine (also known as trimethylglycine)

Vitamin D

Magnesium

One thing to consider for those who do have a MTHFR mutation is that birth control pills should be utilized with extreme caution - the synthetic estrogens found in BC pills can put you at greater risk for blood clots and stroke.

As with so many things, knowledge is powerful - and knowing how to achieve optimal methylation can be one important step on your fertility journey.