Folic acid supplementation and methylenetetrahydrofolate reductase (MTHFR) gene variations in relation to in vitro fertilization pregnancy outcome

2014 ◽  
Vol 94 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Tiina Murto ◽  
Theodora K. Kallak ◽  
Annica Hoas ◽  
Signe Altmäe ◽  
Andres Salumets ◽  
...  
2019 ◽  
Vol 7 ◽  
pp. 2050313X1985043 ◽  
Author(s):  
Dominique Cornet ◽  
Arthur Clement ◽  
Patrice Clement ◽  
Yves Menezo

A 41-year-old Caucasian woman with a history of infertility dating from 2011 was identified as wild-type (no mutations) for methylenetetrahydrofolate reductase single nucleotide polymorphisms (MTHFR-SNPs). Previous treatment included three failed in vitro fertilization/intracytoplasmic sperm injection cycles as well as one failed cycle of in vitro fertilization/intracytoplasmic sperm injection with donated oocytes. Counseling for a further oocyte donation cycle included advice to take high doses of folic acid (5 mG per day). Prior to initiation of this cycle, in October 2017 she attended our unit for general gynecological assessment and was found to have a slightly increased level of homocysteine, 12.2 µmol/L. A further test in February 2018 showed an increase to 17.2 µmol/L. Folic acid was stopped, and she was treated with 5-MTHF (500 µG daily), which supports the one-carbon cycle. After 5 days of treatment, her homocysteine level dropped to a baseline level of 8.2 µmol/L. As previously described in mice, high doses of folic acid can induce a “pseudo MTHFR” syndrome in wild-type patients, leading to an elevated unmetabolized folic acid syndrome which results in increased serum levels of homocysteine.


2005 ◽  
Vol 83 (4) ◽  
pp. 908-913 ◽  
Author(s):  
Takahiro Suzuki ◽  
Shun-ichiro Izumi ◽  
Hidehiko Matsubayashi ◽  
Hideo Awaji ◽  
Kikuo Yoshikata ◽  
...  

1998 ◽  
Vol 13 (6) ◽  
pp. 1514-1518 ◽  
Author(s):  
I. Govaerts ◽  
F. Devreker ◽  
I. Koenig ◽  
I. Place ◽  
M. Van den Bergh ◽  
...  

2021 ◽  
Author(s):  
Chun-Xiao Wei ◽  
liang zhang ◽  
Cong-Hui Pang ◽  
Ying-Hua qi ◽  
Jian-Wei Zhang

Abstract BackgroundThe outcome of in vitro fertilization-embryo transfer is often determined according to follicles and estradiol levels following gonadotropin stimulation. However, there is no accurate indicator to predict pregnancy outcome, and it has not been determined how to choose subsequent drugs and dosage based on the ovarian response. This study aimed to make timely adjustments to follow-up medication to improve clinical outcomes based on the potential value of estradiol growth rate. MethodsSerum estradiol levels were measured on the day of gonadotrophin treatment (Gn0), four days later (Gn4), seven days later (Gn7), and on the trigger day (HCG). The ratio was used to determine the increase in estradiol levels. According to the ratio of estradiol increase, the patients were divided into four groups: group A1 (Gn4/Gn0≤6.44), group A2 (6.44˂Gn4/Gn0≤10.62), group A3 (10.62˂Gn4/Gn0 ≤21.33), and group A4 (Gn4/Gn0>21.33); group B1 (Gn7/Gn4≤2.39), group B2 (2.39˂Gn7/Gn4≤3.03), group B3 (3.03˂Gn7/Gn4≤3.84), and group B4 (Gn7/Gn4>3.84). We analyzed and compared the relationship between data in each group and pregnancy outcome. ResultsIn the statistical analysis, the estradiol levels of Gn4 (P = 0.029, P = 0.042), Gn7 (P< 0.001, P = 0.001), and HCG (P< 0.001, P = 0.002), as well as the ratios of Gn4/Gn0 (P = 0.004, P = 0.006), Gn7/Gn4 (P = 0.001, P = 0.002), and HCG/Gn0 (P< 0.001, P< 0.001) both had clinical guiding significance, and the lower one significantly reduced the pregnancy rate. The outcomes were positively linked to groups A (P = 0.040, P = 0.041) and B (P = 0.015, P = 0.017). The logistical regression analysis revealed that group A1 (OR = 0.440 [0.223–0.865]; P = 0.017, OR = 0.368 [0.169–0.804]; P = 0.012) and B1 (OR = 0.261 [0.126–0.541]; P< 0.001, OR = 0.299 [0.142–0.629]; P = 0.001) had opposite influence on outcomes. ConclusionMaintaining a serum estradiol increase ratio at least above 2.39 on Gn7/Gn4 may result in a higher pregnancy rate. When estradiol growth is not ideal, gonadotrophin dosage should be adjusted appropriately to ensure the desired outcome.


2007 ◽  
Vol 77 (1) ◽  
pp. 66-72 ◽  
Author(s):  
McEneny ◽  
Couston ◽  
McKibben ◽  
Young ◽  
Woodside

Raised total homocysteine (tHcy) levels may be involved in the etiology of cardiovascular disease and can lead to damage of vascular endothelial cells and arterial wall matrix. Folic acid supplementation can help negate these detrimental effects by reducing tHcy. Recent evidence has suggested an additional anti-atherogenic property of folate in protecting lipoproteins against oxidation. This study utilized both an in vitro and in vivo approach. In vitro: Very-low-density lipoprotein (VLDL) and low density lipoprotein (LDL) were isolated by rapid ultracentrifugation and then oxidized in the presence of increasing concentrations (0→ μmol/L) of either folic acid or 5-methyltetrahydrofolate (5-MTHF). In vivo: Twelve female subjects were supplemented with folic acid (1 mg/day), and the pre- and post-VLDL and LDL isolates subjected to oxidation. In vitro: 5-MTHF, but not folic acid, significantly increased the resistance of VLDL and LDL to oxidation. In vivo: Following folic acid supplementation, tHcy decreased, serum folate increased, and both VLDL and LDL displayed a significant increase in their resistance to oxidation. These results indicated that in vitro, only the active form of folate, 5-MTHF, had antioxidant properties. In vivo results demonstrated that folic acid supplementation reduced tHcy and protected both VLDL and LDL against oxidation. These findings provide further support for the use of folic acid supplements to aid in the prevention of atherosclerosis.


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