Folate, homocysteine and selected vitamins and minerals status in infertile women

Abstract

Objectives: Diet has been recognised as a crucial factor influencing fetal and maternal health. Adequate levels of substances such as homocysteine, folate and vitamin B₁₂ have been associated with a higher rate of success in infertility treatments. Few data, however, are available on the average levels of micronutrients in the blood of reproductive-aged women, and specific values for adequate levels are not available. The aim of this cross-sectional study was to measure levels of folate, homocysteine and selected vitamins and minerals in women attending the infertility unit of an academic hospital for in vitro fertilisation (IVF).

Methods: Fasting venous blood samples were taken in the morning during routine screening before IVF in order to measure: serum folate, red blood cell (RBC) folate, total plasma homocysteine, vitamin B₁₂, vitamin A, vitamin E, serum iron and serum ferritin.

Results: Among 269 women aged 37 ± 4 years, only 69% and 44% showed adequate levels of homocysteine and vitamin B₁₂, respectively. Serum folate was appropriate in 78% of the study participants, but only a minority (12%) had a concentration of RBC folate regarded as optimal for the prevention of fetal neural tube defects. Serum levels of vitamin A, vitamin E, iron and ferritin were, however, appropriate in the vast majority of participants (>80%).

Conclusion: Folate levels were largely inadequate among women attending an infertility clinic for IVF. Vitamin B₁₂ levels were also found to be inadequate.

Chinese abstract

目的：饮食已被认为是影响胎儿与母体健康的关键因素。适当水平的物质如：同型半胱氨酸、叶酸和维生素B12与治疗不孕的高成功率有关。然而几乎没有数据可反映出育龄妇女血液中微量营养元素的平均水平, 更没有具体的数值来界定适当水平。此横断面研究的目的是测定女性血液中的叶酸、同型半胱氨酸和选定的维生素和矿物质水平, 这些女性因做体外受精（IVF）到医学院的不孕单元就诊。

方法：在行IVF之前, 常规筛查空腹静脉血, 测量：血清叶酸和红细胞（RBC）、叶酸、血浆总同型半胱氨酸、维生素B12、维生素A、维生素E、血清铁、血清铁蛋白。

结果：在269名年龄在37 ± 4岁的女性当中, 仅有69%的女性显示体内有足够的同型半胱氨酸, 仅有44%的女性显示体内有足够的维生素B12。体内有足够的血清叶酸所占比例接近研究参与者的78%, 但只有少数（12%）有RBC叶酸浓度, 因此认为RBC叶酸浓度是预防胎儿神经管缺陷的最佳指标。而血清维生素A, 维生素E, 血清铁和铁蛋白的水平, 在绝大多数参与者（> 80%）都有显示。

结论：去不孕诊所有IVF需求的女性体内叶酸水平大部分都不足。并且发现她们体内维生素B12的水平也不足。

Keywords:

• Folate
• folic acid
• homocysteine
• infertility
• micronutrients
• preconceptional period

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This research was partly supported by a non-restricted grant from Bayer SpA, Milan, Italy.