As one of important B vitamins, folate is an essential nutrient for the body and involves in various biochemical and metabolic reactions. Studies have shown that as an important methyl donor in the carbon metabolism cycle, folate has an important impact on pregnancy, pregnancy complications, and birth defects. Further studies have shown that in the folate metabolic pathway, the gene polymorphism and folic acid metabolism of a key enzyme, 5,10- methylenetetetrahydrofolate reductase (MTHFR), play an important role in ovarian function. Gene polymorphism and the high homocysteine levels caused by it can lead to the damage of reproductive function and endocrine function, including follicular development, embryonic development, and hormone secretion. Gene polymorphism is also associated with the occurrence and development of ovarian disease and its response to treatment. With the deep understanding of folate metabolism, MTHFR gene polymorphism may become a new genetic marker for predicting the risk of disease and a new target for related gene therapies