Women with epilepsy account for about half of the patients, and one of the major problems they face is the issue of marriage and childbearing. In addition, now that the country is liberalizing the two-child policy, some well-controlled patients also have the intention of having a second child and are worried about the effect of drugs on the fetus. Often come to consult this aspect of the problem. In fact, the marriage and parenthood of epilepsy patients is a very complex issue, individuality is very strong, now on the preparation for pregnancy and the use of folic acid, to answer. Do people with epilepsy who are preparing for pregnancy need to take folic acid supplements? Yes. Common birth defects in China include neural tube malformation, congenital heart disease, cleft lip and palate, and hypospadias. The reasons for the occurrence of birth defects are very complex, some of which are not yet recognized by human beings, but are mainly due to genetic factors, environmental factors or a combination of both. Some experts point out that “China is a country with a high incidence of neural tube malformations globally, the most common of which are spina bifida and anencephaly, which are caused by maternal folic acid deficiency. Folic acid deficiency is more common in Chinese women of childbearing age, with one in three women of childbearing age lacking folic acid.” Therefore, everyone in preparation for pregnancy, including women and their spouses, and of course people with epilepsy, (because of individual anti-epileptic medications, which may affect folate metabolism.) They should be screened for normal folate metabolism and an individualized folate supplementation program should be developed on a case-by-case basis. When is the right time to supplement folic acid? How long to supplement? In general, women with epilepsy should start from 3 months before conception and develop a supplementation program during pregnancy based on the individual’s level of folate metabolism, depending on how much and how long to supplement depending on the individual’s genotype. Do men who are preparing for pregnancy need to take folic acid supplements? Yes. Scientific research has proved that a lack of folic acid in the male body will lead to lower sperm quality and an abnormal number of chromosomes carried by sperm in semen, causing birth defects in newborns. Low level of folic acid in the body is also one of the major causes of infertility and spontaneous abortion. Therefore, before a newlywed couple prepares to get pregnant, they should do at least one genetic test for “folic acid requirement during pregnancy (for women)” and “hyperhomocysteinemia (for men)”, which is more conducive to optimal pregnancy. Is there any problem if I take too much folic acid? An overdose of folic acid can also pose a serious health risk. It is not necessary to take as much folic acid as possible. Numerous studies have found that an overdose of folic acid can lead to a variety of negative consequences. For example, it can lead to zinc deficiency in the body. Zinc is an activator of many enzymes, so oversupplementation in pregnant mothers can lead to slow fetal growth and low birth weight. In men, oversupplementation can instead lead to reduced sperm activity in men; mask vitamin B12 deficiency as well as increase the risk of adenomatous lesions in the colon. Therefore, it must be a scientifically individualized folic acid supplementation program.