5-methyltetrahydrofolic acid

Abstract

The homocysteine pathway in the preconception period should be evaluated to highlight micronutrient deficiencies and warrants optimal multivitamin supplementation, before Assisted Reproduction, as preconception care. We conducted a retrospective study aimed at investigating the role of vitamin B complex (5-methyltetrahydrofolate, vitamin B12, vitamin B6) supplement use compared with the role of only folic acid supplement use, in relation to clinical pregnancy and live birth in infertile women undergoing homologous ART. We investigated 269 Caucasian women referred to the Centre for Assisted Reproductive Technology for homologous ART. In these women, 111 (Group A) were daily supplemented with vitamin B complex and 158 (Group B) with only folic acid. In group A the mean number of Metaphase II oocytes and the 2PN Fertilization Rate were higher in comparison to group A (p = 0.04; p = 0.05, respectively). A higher percentage of women in group A had a clinical pregnancy and live birth in comparison to group B (p = 0.01; p = 0.02, respectively). Vitamin B complex supplementation remained independently associated, after multivariable adjustment, with clinical pregnancy (OR 2.03, p = 0.008) and live birth (OR 1.83, p = 0.03). Women supplemented with 5-MTHF and vitamin B12, have a higher chance of clinical pregnancy and live birth in comparison to those supplemented with only folic acid.

2.1. Study Population

In this retrospective study, we investigated Caucasian women referred to the Internal Medicine Clinic (which consists of a multidisciplinary team focused on the prevention of cardiovascular risk) at the Centre for Assisted Reproductive Technology, Careggi University Hospital (Florence, Italy) from May 2018 to April 2020, for homologous ART. Included in the study were 269 women supplemented with vitamin B complex (400 µg 5-methyltetrahydrofolate, 5 µg vitamin B12, 3 mg vitamin B6) or only folic acid (400 µg) (according to gynecologist’s prescription).

3. Results

A total of 269 infertile women participated in this study, mean age 36.9 (±3.7) yrs. We observed that 111 women (Group A) were daily supplemented with vitamin B complex (400 µg 5-MTHF, 5 µg vitamin B12, 3 mg vitamin B6) and 158 women (Group B) supplemented with only folic acid (400 µg folic acid). In terms of markers of ovarian reserve, mean AMH was 2.9 (±3.2) ng/mL, mean FSH was 8.6 (±4) IU/mL and mean AFC was 10.1 (± 6.9).