Impact of folic acid and active folate supplementation on red blood cell folate levels in patients with unexplained recurrent pregnancy loss and MTHFR 677TT genotype

Abstract

Objective·To study the effects of folic acid and active folate supplementation on red blood cell folate levels in patients with unexplained recurrent pregnancy loss (URPL) and methylenetetrahydrofolate reductase (MTHFR) 677TT genotype.Methods·A total of 45 patients with MTHFR 677TT genotype and URPL in the Center for Reproductive Medicine of Peking University Third Hospital from January to December 2021 were selected. They were divided into three groups according to folic acid supplementation, including 16 cases in Group A (who had not received any form of folic acid supplementation before the study began, but received active folic acid supplementation after the study began),15 cases in Group B (who had received ordinary folic acid supplementation before the study began, and active folic acid supplementation after the study began),and 14 cases in Group C (ordinary folic acid was supplemented before the start of the study, and after the start of the study, ordinary folic acid and active folic acid were supplemented together). The concentration of 5-methyltetrahydrofolate (5-MTHF) in red blood cells was measured and compared at the time of enrollment (first measurement) and after supplementation (second measurement).Results·There was no statistically significant difference in the first measurement of 5-MTHF concentrations in red blood cells between any two groups of patients in the three groups. Compared with the first measurement of 5-MTHF concentrations in red blood cells, the second increased (all P=0.000); the increase in 5-MTHF concentrations in red blood cells in Group B was higher than that in Group A (all P=0.000); the increasing 5-MTHF concentration in Group B was higher than that in Group A (t=2.373, P=0.049), but there was no significant difference between Group B and Group C.Conclusion·Compared with folic acid supplementation, active folate supplementation can better improve red blood cell folate levels in patients with MTHFR 677TT genotype and URPL in a short period.

Keywords

• methylenetetrahydrofolate reductase (mthfr)
• unexplained recurrent pregnancy loss (uprl)
• 5-methyltetrahydrofolate (5-mthf)