What to watch with MTHFR and fertility?

MTHFR variants (C677T, A1298C) are common and affect folate metabolism. In fertility contexts, they are often linked to elevated homocysteine, neural tube defects, and recurrent pregnancy loss. However, the evidence is mixed: many studies show weak or inconsistent associations. A DNA test alone is insufficient – measuring homocysteine, folate, and vitamin B12 in blood provides more actionable data. Supplementing with methylfolate instead of folic acid is frequently suggested, but clinical support is limited. Key caution: do not self-prescribe high-dose folate without checking homocysteine levels and consulting a healthcare provider. Overall, MTHFR testing for fertility is of uncertain clinical utility; it offers clues, not definitive answers.