Folic Acid and Nutrition Before Pregnancy

Folic acid is the one nutrient with a clear, well-established recommendation before and during early pregnancy, because it reduces the risk of neural tube defects. It should be started before conception rather than when a pregnancy is confirmed, since the neural tube closes in the first weeks, often before a woman knows she is pregnant. Beyond that, nutrition in pregnancy is managed through antenatal care, which is where advice specific to you and your pregnancy should come from.

Folic acid, and why timing matters

Folic acid supplementation before conception and in early pregnancy reduces the risk of neural tube defects such as spina bifida. The timing is the point most often missed: the neural tube forms and closes very early, so starting when a pregnancy test is positive is often already late.

If you are trying to conceive, or planning fertility treatment, that is the point to start rather than later. Ask your doctor what dose is right for you, since a higher dose is advised in some circumstances, including where there is a relevant medical history or a previous affected pregnancy.

Folate also occurs naturally in green leafy vegetables, legumes and citrus fruit. Dietary folate is worth having, but it is not a substitute for the supplement, which is what the recommendation is based on.

What else is generally advised

• A varied, balanced diet rather than eating for two.
• Iron, calcium, iodine and vitamin D all have roles in pregnancy. Whether you need supplements, and at what dose, depends on your circumstances and should be advised individually rather than assumed.
• Foods to avoid, including some fish with high mercury levels, unpasteurised dairy, raw or undercooked meat and eggs, and limits on caffeine and alcohol. Your antenatal care provider will give you the current list.

We have deliberately not reproduced detailed prenatal nutrition guidance here. It changes, it varies with individual circumstances, and it belongs with the team managing your pregnancy rather than with a fertility clinic's blog.

Before conception rather than after

The window where diet and supplementation matter most begins before conception. For anyone planning fertility treatment, that means it is worth raising at your consultation rather than waiting for a positive test.

The same applies to reviewing medication. Some medications need changing before pregnancy, and that is a conversation to have in advance.

For diet in relation to conceiving rather than to pregnancy, see our articles on fertility foods for women and foods that nourish sperm.

We at Millennium IVF Clinic can discuss preconception preparation as part of planning treatment. You can arrange a consultation with our team.

Frequently asked questions

When should I start taking folic acid?

Before conception, not when a pregnancy is confirmed. The neural tube closes in the first weeks, frequently before a pregnancy is known.

Can I get enough folate from food alone?

Dietary folate is beneficial, but the recommendation to prevent neural tube defects is based on supplementation. Take the supplement as well.

Do I need other supplements?

It depends on your circumstances. Discuss it with your doctor rather than starting supplements independently, particularly if you are also on prescribed medication.

Should I change my diet during fertility treatment?

Eat well, and start folic acid. Beyond that no specific diet has been shown to improve treatment outcomes.