Do you know which variation you have? I have homozygous c677t MTHFR. As to what to expect, that depends on your Dr. When I found out about my diagnosis, I threw myself into research on it. MTHFR mutations inhibit your body's ability to process synthetic B vitamins, in particular folic acid, B12, and B6. There are bio active vitamins available over the counter (as well as some prescription ones) that are in a form that doesn't need to be broken down and therefore bypasses the issues of the MTHFR mutations. The forms of vitamins that you want are L-methylfolate instead of folic acid, methylcobalamin instead of B12, and p5p instead of B6. There is a prescription medical food called Metanx that has high doses of L-methylfolate, methylcobalamin, and p5p, and I know for me, it's been great (and so much cheaper then buying them all separately!). For prenatals, the best I've found are Thorne Basics Prenatal (available otc but only online) and Emerald Labs Prenatal (sometimes available in local health food stores, but also available online).
From my research, I also found that often times gluten intolerance goes hand in hand with MTHFR mutations. I was having gut issues after my first miscarriage and they never went away. Once I cut gluten from my life, they've gone away completely!
I also made the decision to be on lovenox for my next pregnancy. Lovenox is a blood thinner and many MANY ladies with MTHFR mutations of all sorts have had luck with pregnancies after going on lovenox. I was very on the fence about this at first because I am so needle phobic, but after finding out that my husband also has MTHFR and he actually has 3 separate mutations (one each in c677t, a1298c, and p39p), I felt that I didn't want to take the chances. I know that homocysteine levels aren't a great indicator of clotting issues for MTHFR and I know that pregnancy often exacerbates potential issues into actual issues.
All of these are personal decisions that I've made based on what I've read, found out from personal experience, etc. I'd very much encourage you to read up on things for yourself! Here are some links to get you started:
On one of the reasons why I don't like synthetic vitamins anymore: https://www.doctorsresearch.com/naturalvssyntheticvitamins4.html
One of the most comprehensive and helpful sites that I've found on MTHFR. I was able to get sooo many answers through Dr. Ben's site! https://mthfr.net/
Another very comprehensive and helpful site on MTHFR:
www.mthfrsupport.com They also have a facebook page called mthfrsupport (of which I am an admin - name is Leandra Anor on there) that has even more great information coming in on it on a daily basis.
Don't think of this as a death knell on carrying to term. This is just something that needs to be worked around and a LOT of ladies have gone on to have successful pregnancies after finding out about MTHFR. I'm still working on my rainbow, but I feel pretty confident that I'm on the last part of my journey now. This is scary information to get, but I hope you can come to see it like I have as a gift of knowledge. This is something that has the power to really affect the rest of your life (not just ttc) if you don't treat it, but now you know about it and the power is in your hands! Please feel free to ask me anything! I'm happy to help however I can. *hugs*
So I take a women's multi, an rx for 1mg Folic Acid, b6, b12, OTC folic acid, and then my normal scripts like levoxyl for hypothyroidism, singulair for asthma/allergy, and zyrtec-d for my nasal polyps.
Life Extension is another one that you are likely to find in stores and I've found them to be good for me. 
What a small world right?
I think I'm just excited. 
