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Your Fertility Questions, Answered by Hertility’s Clinical Team-image

Your Fertility Questions, Answered by Hertility’s Clinical Team

In our recent webinar, we unpacked the science behind fertility, explaining how hormones regulate ovulation, why timing matters, and how ovarian reserve naturally changes with age. We explored evidence-based ways to optimise egg and sperm health through nutrition, sleep, stress management, and reducing exposure to endocrine disruptors. But as always, the most important part of the session was your questions. Many of them couldn’t be answered fully in the time we had live. So we’re starting something new. Welcome to the Hertility Expert Q&A series,  a new post-webinar blog series where our clinical and research team answer your most pressing women’s health questions in depth. This edition covers the questions submitted during our fertility science webinar, including: This edition’s questions were answered by Emily Moreton, Clinical Services Manager at Hertility, fertility nurse, and registered nutritionist specialising in reproductive health. Emily holds a Master’s degree in Clinical Nutrition and Public Health from UCL and is a trained nutrition counsellor. Her work focuses on health-promoting behaviours, empowering individuals to improve their relationship with food, movement, and their body without restrictive dieting. ​​Her clinical expertise supports individuals in optimising fertility, managing PCOS and hormonal symptoms, maintaining a healthy pregnancy, and navigating menopause with confidence. We’ve rounded up every answer here so nothing gets lost in your inbox. Folic acid vs methylfolate: what’s the difference and which should you take? If you’re trying to conceive, you’ve likely been told that folic acid is non-negotiable. But then you see supplements advertising “methylfolate” or “5-MTHF” and suddenly the choice feels far less straightforward. Here’s what you actually need to know. The basics first. Folate is the natural form of vitamin B9 found in food. Folic acid is the synthetic version used in most prenatal supplements and fortified foods. Methylfolate, also known as 5-methyltetrahydrofolate (5-MTHF)  is the biologically active form your body ultimately uses. When you take folic acid, your body converts it into methylfolate through a series of enzymatic steps. For most people, this happens efficiently. The official recommendation is . 400mcg of folic acid for all women from three months before conception through the first 12 weeks of pregnancy to reduce the risk of neural tube defects (NTDs) like spinal bifida. This recommendation is backed by major health bodies including the NHS and CDC, and is supported by decades of large-scale clinical trial data. Folic acid is currently the only form of folate clinically proven in human trials to significantly reduce NTD risk. So why does methylfolate exist as an alternative? Some people carry variations in a gene called MTHFR, which can reduce how effectively the body converts folic acid into its active form. For those individuals, methylfolate may raise blood folate levels more efficiently because it bypasses this conversion step entirely. The catch is that methylfolate has not been put through the same rigorous, large-scale trials as folic acid for NTD prevention and at this point, it would be unethical to design such a trial, because it would require withholding a known protective intervention from pregnant women.  Which is better absorbed: Folic Acid or Methylfolate? Folic acid is actually very well absorbed, and crucially it is the form used in the large clinical trials that proved it prevents neural tube defects like spina bifida. That is why public health bodies, including the NHS, recommend 400 micrograms of folic acid daily before conception and during the first trimester. However, this dose needs to be increased to 5 milligrams daily (prescription-only in the UK) in certain higher-risk situations. When is a higher 5mg dose of Folic Acid recommended? A higher 5mg dose (prescription-only in the UK) may be recommended if you: When might methylfolate be worth considering?  It may be appropriate in cases of known MTHFR variants, recurrent pregnancy loss, recurrent implantation failure, or where a previous pregnancy was affected by a neural tube defect despite folic acid supplementation. Hertility’s in-house clinical team or registered nutritionists and dieticians if you’d like some advice but ultimately it should be up to the individual to make an informed decision. A large number of fertility supplements now use methylfolate rather than folic acid and that shift isn’t without reason. The reality is that experts are divided. Folic acid remains the gold standard in public health guidelines because it’s backed by decades of clinical trial data. Methylfolate is a promising and increasingly popular alternative, but it doesn’t yet carry the same evidence base for preventing neural tube defects in large-scale trials.  Which foods are richest in folate? Supplementation is important, but dietary sources matter too. Good sources include spinach, kale, Brussels sprouts, broccoli, beans and lentils, eggs, oranges, fortified breakfast cereals, nuts and seeds, and wholegrains. Because folate is water-soluble and lost during cooking, steaming or microwaving vegetables rather than boiling helps preserve it. The bottom line: for most women, folic acid remains the evidence-backed standard. If you have reason to believe methylfolate may be more appropriate for you, whether due to a genetic variant or a history of pregnancy complications, speak with your GP or Hertility’s clinical team before switching. What is the best nutrition approach for PCOS and improving ovulation? PCOS is one of the most common hormonal conditions affecting women of reproductive age and one of the most common causes of irregular ovulation. Search online for the “best diet for PCOS fertility”  or “how to improve ovulation naturally with PCOS,”  and you’ll be met with extremes: cut carbs, go keto, eliminate gluten, try fasting. The evidence doesn’t support most of it. There is no single recommended PCOS diet. The goal of nutrition in PCOS is not restriction, it’s choosing foods that stabilise blood sugar and reduce inflammation, consistently, over time. Understanding the link between PCOS and insulin. At its core, PCOS is often linked to insulin resistance. When insulin levels stay elevated, the ovaries produce more androgens such as testosterone, which can interfere with follicle development and regular ovulation. Managing insulin through diet is therefore one of the most evidence-based nutritional targets in PCOS. A Mediterranean-style […]

16 Lifestyle Tips to Help Boost Fertility-image

16 Lifestyle Tips to Help Boost Fertility

If you’re looking to conceive soon, nutrition can have a big impact on your fertility and reproductive health—both positive and negative. Get to know which foods are natural fertility boosters and valuable lifestyle changes that can improve your journey to conception. Quick facts: Why are diet and nutrition important for fertility? As the saying goes, we really are what we eat. Our diets and nutrition impact almost all of our body’s processes—all the way from our metabolism to our mental health. But one often overlooked area is how food can impact our fertility. When trying to conceive, you’ll need a high-nutritional diet. This can increase your chances of conceiving and help to create a healthy home for your baby during their vital first 9 months. Even making small changes to your lifestyle and nutrition choices can go a long way. Here are 16 evidence-backed tips from our Registered Nurse and Associate Nutritionist, Emily Moreton to help prepare your body for pregnancy. You can also book an appointment with a Hertility Nutritionist for a personalised plan. 1. Follow a Mediterranean-style diet Whilst there are no specific guidelines for a recommended fertility diet, the Mediterranean diet, is associated with improved fertility in both women and men. Known for its abundance of fruits, vegetables, nuts, whole grains, fish and healthy fats, the Mediterranean diet is rich in antioxidants. These have been shown to protect sperm and eggs from DNA damage and oxidative stress. A study involving 15,396 participants, which looked at how different diets affect fertility, showed that sticking to the Mediterranean diet improved birth and pregnancy rates significantly, with a 91% higher chance of success. This diet is also high in fibre and rich in vitamins and minerals that support fertility and pregnancy. Think lots of veg, whole grains, nuts, seeds, beans, pulses, olive oils, avocados and oily fish. 2. Eats foods high in antioxidants Eating a diet rich in a variety of colourful fruits and vegetables can provide a wide range of antioxidants that support fertility and overall health. Think making a rainbow on your plate. Foods high in antioxidants include fruits (such as berries, apples, and citrus fruits), vegetables (such as broccoli, spinach, kale, and carrots), nuts, seeds, and whole grains. 3. Increase intake of plant-based proteins In general, you should focus on lowering your intake of red and processed animal meats and focus on adding plant-based protein sources into your diet.  This can include fertility-friendly and micronutrient-rich beans, lentils, peas, soya beans, and chickpeas. Plant-based protein sources help to support healthy ovulation and are high in antioxidants and nutrients, such as iron and fibre, which are really important during pregnancy.  Low iron levels can add to your tiredness or even could cause iron deficiency anaemia. Iron deficiency during pregnancy can increase the risk of pregnancy complications. It is also important to keep your iron uptake up postpartum too, to replace any iron lost at birth.  You’ll also find some protein in whole grains such as quinoa. If you are opting for plant-based meat alternatives (‘fake meats’), choose a brand that is not ultra-processed and low in additives. 4. Cut down on sugar Cutting down on sugar can be beneficial for fertility. This is because too much sugar can lead to insulin sensitivity, disrupting certain reproductive hormones and causing inflammation. Insulin spikes have been associated with poor egg quality and sperm production and could affect implantation. A study published in the American Journal of Clinical Nutrition in 2018 found that women who consumed two or more servings of sugary drinks per day had a 50% higher risk of ovulatory infertility compared to those who consumed less than one serving per month. Reducing sugar intake and opting for a balanced, low-glycemic index diet can help improve insulin sensitivity and overall reproductive health. Limit sugary foods and high glycemic index foods such as cakes, biscuits, fizzy drinks, energy drinks, sweets, white rice and white bread. Check the labels for high sugar content. 5. Take pregnancy supplements Folic acid Folic acid is an important supplement during pregnancy because it decreases a risk called neural tube defects. This is a defect that can occur during the development of the baby’s brain and spine.  If you are currently trying to become pregnant, it is advised to take at least 400 mcg of folic acid supplement every day for 12 weeks before conception and for at least three months after conceiving. Some people are at an increased risk of their baby having a neural tube defect and so it is advisable to speak with your doctor as they may recommend and prescribe you a higher dose.  Prenatal vitamins Prenatal vitamins typically contain a combination of various vitamins and minerals that are important for both maternal and foetal health. While folic acid is a main component of prenatal vitamins, these vitamins usually contain a range of other nutrients as well.  These include iron, calcium, vitamin D and other essential vitamins and minerals needed to support maternal health and the baby’s development during pregnancy. Tip: More often than not, doctors will suggest taking prenatal vitamins instead of just folic acid supplements because they cover a wider range of needs for both mum and baby’s health. However, it’s essential to consult with your doctor to determine the most appropriate approach for your unique needs.  6. Take Vitamin D for pregnancy  A previous study has shown that both men’s and women’s vitamin D levels impact fertility and IVF results. It showed that Vitamin D supplements reduce risks for mums and babies, might prevent bone problems, and play a role in foetal development.  How much Vitamin D should I take? It’s recommended that all adults at all stages of life should supplement with 10 micrograms a day of Vitamin D, in the UK. This is particularly true if you are trying to conceive, or you are pregnant—so be sure to supplement right through from the preconception period to breastfeeding.  Prenatal vitamins often contain vitamin D, but the amount can vary […]