Guide
Preparing your body to conceive, and what folic acid actually does
Last updated: October 2026
Time decides most of conceiving, and very little of it is in your hands. A short list of things helps. The first, folic acid, is worth starting three months before you try and not on the day you decide.
How much folic acid should I take before pregnancy?
The National Health Service recommends 400 micrograms of folic acid every day, ideally from three months before you conceive and through the first twelve weeks of pregnancy. Taking it reduces the chance of a neural tube defect. That is a problem with the baby's brain or spine, such as spina bifida.
Timing is the part people miss. The neural tube closes in the first month, often before a woman knows she is pregnant. By the time a test shows two lines, the window this supplement protects is largely past. So start it before you try.
You cannot reliably get this amount from food alone, so it comes as a supplement. It is cheap and sold over the counter in pharmacies.
Who needs a 5mg dose of folic acid?
Some women are advised to take 5 milligrams instead of 400 micrograms. That is more than ten times the standard dose, and it needs a prescription. The National Health Service lists the situations: if you or the baby's father has a neural tube defect or a relative with one, if a previous pregnancy was affected, if you have diabetes, if you take medicine for epilepsy or HIV, or if you have a blood condition such as sickle cell anaemia or thalassaemia.
Sickle cell deserves its own mention. It is common enough in Nigeria that a meaningful number of women reading this fall into the higher-dose group without knowing it. If you have sickle cell disease, or you are unsure of your genotype, ask a doctor before you start and do not default to the standard tablet.
Can folic acid boost fertility?
No. Many people believe it, and the evidence does not support it. Folic acid protects the development of a pregnancy once it exists. It does not make conception more likely, it does not improve egg quality on demand, and taking more of it will not speed anything up.
Do not skip it. Take it for what it does, and look elsewhere for the rest of what you were hoping for.
Does folic acid treat hormonal imbalance?
No. Folic acid is a B vitamin. It does not regulate hormones, it does not treat polycystic ovary syndrome, and it will not restore a cycle that has stopped or become erratic. Irregular or absent periods need investigating. The cause changes the treatment, and a vitamin will not find it.
What are the benefits of folic acid when you are not pregnant?
Folate does real work in the body outside pregnancy. It is needed to make red blood cells, and a shortage causes folate deficiency anaemia. The National Health Service describes it as treatable and worth catching early, because some of its effects can become permanent if left.
The signs are easy to blame on ordinary life. They include tiredness, breathlessness, low energy, pale skin and mouth ulcers. None of them proves a deficiency, because all of them have a dozen other causes. Only a blood test does. If you are tired all the time, get tested instead of guessing which supplement to buy.
What else helps before I try to conceive?
- Stop smoking, and stop alcohol. Both affect fertility and both affect an early pregnancy you do not yet know about. This applies to him as well as to you.
- Aim for a steady weight. Being very underweight or very overweight can affect fertility. A crash diet while trying to conceive works against you on both counts.
- Review every medicine and supplement with a pharmacist. Some need changing well before you try, so ask early. This includes herbal products. They act like medicines.
- Get the checks done while it is easy. A pre-pregnancy check matters most if you have a long-term condition. Dental work is far simpler now than later. Know your genotype and your blood group.
- Have him tested too, early. A semen analysis is cheap and quick, and many couples skip it. Testing only one person tells you about one person.
Nothing on that list is dramatic. The preparation that works is boring, and the things sold as exciting have very little behind them.
Although both women and men can experience infertility, women in a relationship with a man are often perceived to suffer from infertility, regardless of whether they are infertile or not.
When to see a doctor
See a doctor before you start trying if you have a long-term condition, take regular medication, have sickle cell disease, or have had a pregnancy affected by a neural tube defect. See one after twelve months of trying, or six months if you are over 35. See one sooner if your periods are very irregular or absent, or you have had two or more miscarriages. Go together.
Common questions
How much folic acid should I take before pregnancy?
Can folic acid boost fertility?
Does folic acid treat hormonal imbalance?
What are the benefits of folic acid when not pregnant?
What are the signs that you need folic acid?
Who needs a 5mg dose of folic acid?
When should we see a doctor about not conceiving?
Sources
- Vitamins, supplements and nutrition in pregnancy, including the 400 microgram and 5mg folic acid doses, National Health Service
- Trying to get pregnant: what to do before you start, National Health Service
- Vitamin B12 or folate deficiency anaemia: symptoms, diagnosis and why early treatment matters, National Health Service
- Infertility: causes in both partners, and who is assumed to be the problem, World Health Organization
- Good health before pregnancy: prepregnancy care, American College of Obstetricians and Gynecologists
Go further
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