Can You Get Pregnant with MTHFR Gene Mutation?

Reviewed on 6/3/2021

Genetic disease
While women can get pregnant with an MTHFR gene mutation, they may have an increased risk of complications during pregnancy, including preeclampsia, congenital birth defects, and polycystic ovarian disease (PCOD).

While women can get pregnant with an MTHFR gene mutation, they may have an increased risk of complications during pregnancy, including: 

Women with multiple pregnancy losses often test positive for MTHFR gene mutation. However, there is no scientific evidence that MTHFR gene mutations cause recurrent pregnancy loss.

What does the MTHFR gene do?

MTHFR stands for methylenetetrahydrofolate reductase, which is an enzyme that helps the body break down and use folate. It is responsible for converting dietary folate (methylenetetrahydrofolate) to active folate (methylfolate). Methylfolate plays an active role in converting homocysteine (an amino acid that helps maintain cells) to methionine (helps with growth and tissue repair). 

When there is an MTHFR gene mutation, it can prevent the conversion of inactive folate to methylfolate. As a result, homocysteine levels build up in the blood, leading to:

How can you know if you are at increased risk of MTHFR gene mutation?

A mutated MTHFR gene can be passed down from your parents. You may also be at increased risk of a positive MTHFR gene mutation if you have had:

  • Recurrent pregnancy losses
  • An infant with a neural tube defect, such as spina bifida or anencephaly
  • A history of preeclampsia

What precautions should you take if you have a MTHFR gene mutation?

If you have a positive MTHFR gene mutation and are planning to become pregnant, you should consume 400 mcg of folic acid the day you start planning for the baby. Consuming 400 mcg of folic acid each day can help prevent neural tube defects even with MTHFR gene mutations. 

Your doctor may recommend taking more than 400 mcg a day if you are in the high-risk category. 

What are treatment options if you are pregnant with a positive MTHFR genetic mutation?

Treatment options include:

  • Lovenox or heparin injections: These injections can help prevent blood clots from forming between the developing placenta and the uterine wall, which is caused by the mutated MTHFR gene.
  • Daily aspirin: Doctors may recommend this to prevent blood clot formations, but there isn’t any large-scale scientific evidence supporting its effectiveness.
  • Prenatal vitamin with L-methyl folate: Some doctors may prescribe this supplement instead of folic acid. Studies have shown that L-methyl folate reduces the risk of anemia in pregnant women.

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References
Turgal M, Gumruk F, Karaagaoglu E, Beksac MS. Methylenetetrahydrofolate Reductase Polymorphisms and Pregnancy Outcome. Geburtshilfe Frauenheilkd. 2018;78(9):871-878. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138472/

Medline Plus. MTHFR Gene. https://medlineplus.gov/genetics/gene/mthfr/

Centers for Disease Control and Prevention. MTHFR Gene, Folic Acid, and Preventing Neural Tube Defects. https://www.cdc.gov/ncbddd/folicacid/mthfr-gene-and-folic-acid.html

American Pregnancy Association. Folate and Folic Acid in Pregnancy. https://americanpregnancy.org/getting-pregnant/infertility/folate-vs-folic-acid-68699/

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