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Folic acid supplementation and methylenetetrahydrofolate reductase (MTHFR)gene variations in relation to IVF pregnancy outcome
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
University of Granada, Competence Centre on Reproductive Medicine and Biology, Tartu.
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2015 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, no 1, 65-71 p.Article in journal (Refereed) Published
Abstract [en]

Objective:

To study folic acid intake, folate status and pregnancy outcome afterinfertility treatment in women with different infertility diagnoses in relation tomethylenetetrahydrofolate reductase (MTHFR) 677C>T, 1298A>C and 1793G>A genevariations. Also the use of folic acid supplements, folate status and the frequency ofdifferent gene variations were studied in women undergoing infertility treatment andfertile women.

Design:

Observational study. Setting: University hospital. Population:Women undergoing infertility treatment and healthy, fertile, non-pregnant women.

Methods:

A questionnaire was used to assess general background data and use ofdietary supplements. Blood samples were taken to determine plasma folate andhomocysteine levels, and for genomic DNA extraction. A meta-analysis of four studieswas performed to assess pregnancy outcome in relation to MTHFR 677 TT vs. CC, and1298 CC vs. AA polymorphisms.

Main outcome measures:

Folic acid supplementintake, and plasma folate, homocysteine and genomic assays.

Results:

Women in theinfertility group used significantly more folic acid supplements and had better folatestatus than fertile women, but pregnancy outcome after fertility treatment was notdependent on folic acid intake, folate status or MTHFR gene variations. However, ameta-analysis demonstrated that MTHFR 1298AA polymorphism was related topregnancy outcome.

Conclusion:

Folic acid supplementation seems to play only a minorrole in the context of pregnancy outcome after in vitro fertilisation, and other variablesin folate metabolism are of more importance. In particular, MTHFR 1298AA genevariation appears to have a positive association with the success of fertility treatment

Place, publisher, year, edition, pages
2015. Vol. 94, no 1, 65-71 p.
Keyword [en]
Folate, folic acid, homocysteine, infertility, MTHFR, pregnancy outcome
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-220246DOI: 10.1111/aogs.12522ISI: 000346704100012PubMedID: 25283235OAI: oai:DiVA.org:uu-220246DiVA: diva2:704490
Available from: 2014-03-12 Created: 2014-03-12 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Folate, Hormones and Infertility: Different factors affecting IVF pregnancy outcome
Open this publication in new window or tab >>Folate, Hormones and Infertility: Different factors affecting IVF pregnancy outcome
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Various hormones have been studied as regards prediction of pregnancy outcome after infertility treatment, but no ideal candidate has been found. Folate and genetic variations in folate metabolism have also been associated with infertility, but it remains unclear how these factors affect IVF pregnancy outcome. It is known that infertility is associated with active folic acid supplement use, but the effect of socioeconomic and lifestyle factors on folic acid supplement use in infertile women has not been well investigated. The overall aim of this work was to obtain information on the prediction of live birth, and to study factors affecting the role of folate and folic acid intake in relation to IVF pregnancy outcome. Infertile women with various infertility diagnoses were studied. Healthy, fertile non-pregnant women were used as controls in three of the studies. Blood samples were taken for assay of eight different hormones, folate and homocysteine, and for genomic DNA extraction. A questionnaire was used to assess background data and use of folic acid supplements. Twenty-four-hour recall interviews were performed for validation of the questionnaire. The studied hormones were not good predictors of live birth. The best predictor was age of the women, together with ovulatory menstrual cycles, and thyroid-stimulating hormone and anti-Müllerian hormone (AMH) status. Well-educated women, high-status employed women, and married and infertile women used the most folic acid supplements. Infertile women had better folate status than fertile women. However, pregnancy outcome after infertility treatment was not dependent on folic acid intake, folate status, genetic variation of 5,10-methylenetetrahydrofolate reductase or socioeconomic status. In conclusion, AMH levels vary less than those of other hormones during the menstrual cycle, and AMH could be used as a predictive marker of live birth together with age and ovulation. Folate might play a minor role in IVF pregnancy outcome, but the importance of folate as regards other health perspectives should not be forgotten.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 57 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 987
Keyword
Folate, folic acid supplement, homocysteine, hormones, infertility, IVF, lifestyle factor, MTHFR, predictive value, socioeconomic factor, women
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-220476 (URN)978-91-554-8919-9 (ISBN)
Public defence
2014-05-22, Gustavianum, Auditorium Minus, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
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Available from: 2014-04-29 Created: 2014-03-15 Last updated: 2014-06-30

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Murto, TiinaKunovac Kallak, TheodoraSkoog Svanberg, AgnetaWånggren, KjellStavreus-Evers, Anneli

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Murto, TiinaKunovac Kallak, TheodoraSkoog Svanberg, AgnetaWånggren, KjellStavreus-Evers, Anneli
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