Folate-mediated one-carbon metabolism and its effect on female fertility and pregnancy viability.
This review summarizes current knowledge of the effect of folate-mediated one-carbon metabolism and related genetic variants on female fertility and pregnancy viability. Insufficient folate status disrupts DNA methylation and integrity and increases blood homocysteine levels. Elevated levels of follicular fluid homocysteine correlate with oocyte immaturity and poor early embryo quality, while methylenetetrahydrofolate reductase (MTHFR) gene variants are associated with lower ovarian reserves, diminished response to follicular stimulation, and reduced chance of live birth after in vitro fertilization. Embryos carrying multiple MTHFR variants appear to have a selective disadvantage; however, the heterozygous MTHFR 677CT genotype in the mother and fetus provides the greatest chance for a viable pregnancy and live birth, possibly due to a favorable balance in folate cofactor distribution between methyl donor and nucleotide synthesis. The results of previous studies clearly emphasize that imbalances in folate metabolism and related gene variants may impair female fecundity as well as compromise implantation and the chance of a live birth.
Laanpere
Margit
M
Department of Biotechnology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia.
Altmäe
Signe
S
Stavreus-Evers
Anneli
A
Nilsson
Torbjörn K
TK
Yngve
Agneta
A
Salumets
Andres
A
D019175:DNA Methylation / Q000187:drug effects; D005260:Female; D005298:Fertility / Q000187:drug effects*; D047109:Fetal Development / Q000187:drug effects; D005492:Folic Acid / Q000378:metabolism* / Q000494:pharmacology; D005494:Folic Acid Deficiency / Q000150:complications; D014644:Genetic Variation; D006710:Homocysteine / Q000097:blood; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D011247:Pregnancy; D011255:Pregnancy Maintenance / Q000187:drug effects; D011256:Pregnancy Outcome
D006710:Homocysteine; D005492:Folic Acid; D042965:Methylenetetrahydrofolate Reductase (NADPH2)