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不明原因不孕症女性补充叶酸与体外受精妊娠结局

Folic acid supplementation and IVF pregnancy outcome in women with unexplained infertility.

作者信息

Murto T, Skoog Svanberg A, Yngve A, Nilsson T K, Altmäe S, Wånggren K, Salumets A, Stavreus-Evers A

机构信息

Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden.

Department of Women's and Children's Health, Uppsala University, 751 85 Uppsala, Sweden.

出版信息

Reprod Biomed Online. 2014 Jun;28(6):766-72. doi: 10.1016/j.rbmo.2014.01.017. Epub 2014 Feb 25.

Abstract

Folic acid supplements are commonly used by infertile women which leads to a positive folate status. However, the effect of folic acid supplements on pregnancy outcome in women with unexplained infertility has not been well investigated. This study evaluated folic acid supplement use and folate status in women with unexplained infertility in relation to IVF pregnancy outcome. In addition, use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile, nonpregnant control women. Women with unexplained infertility used significantly more folic acid supplements and had higher median total folic acid intake from supplements compared with fertile control women (both P < 0.001). Women with unexplained infertility also had significantly higher median plasma folate and lower median plasma homocysteine concentrations than fertile women (both P < 0.001), but folic acid supplementation or folate status were not related to pregnancy outcome in women with unexplained infertility. In conclusion, folic acid supplementation or good folate status did not have a positive effect on pregnancy outcome following infertility treatment in women with unexplained infertility. Folate is one of the B vitamins which has been suggested to be related to infertility. Folic acid is an artificial form of folate which is commonly used in dietary supplements. Folic acid supplementation has been shown to increase folate concentrations and decrease concentrations of the amino acid homocysteine in the blood. Folic acid supplementation is commonly used by infertile women, but the effect on pregnancy outcome in women with a diagnosis of unexplained infertility has not been thoroughly investigated. In the present study, folic acid supplement use and folate status (concentrations of folate and homocysteine) in women with unexplained infertility were evaluated in relation to pregnancy outcome. In addition, the use of folic acid supplements and folate status were compared between women with unexplained infertility and fertile control women. Our results showed that women with unexplained infertility used considerably more folic acid supplements and had higher total folic acid intake from supplements compared with fertile control women. Women with unexplained infertility had better blood folate and homocysteine concentrations than fertile women, but folic acid supplementation or folate status were not related to pregnancy outcome following the infertility treatment. In conclusion, high folic acid intake or good folate status did not increase the possibility of a birth of a healthy baby after infertility treatment in women with unexplained infertility.

摘要

叶酸补充剂常用于不孕女性,这会使叶酸状态呈阳性。然而,叶酸补充剂对不明原因不孕症女性妊娠结局的影响尚未得到充分研究。本研究评估了不明原因不孕症女性使用叶酸补充剂的情况及其叶酸状态与体外受精妊娠结局的关系。此外,还比较了不明原因不孕症女性与有生育能力的未孕对照女性在叶酸补充剂使用和叶酸状态方面的差异。与有生育能力的对照女性相比,不明原因不孕症女性使用叶酸补充剂的情况显著更多,且从补充剂中摄入的总叶酸中位数更高(两者P均<0.001)。不明原因不孕症女性的血浆叶酸中位数也显著高于有生育能力的女性,血浆同型半胱氨酸中位数则显著低于有生育能力的女性(两者P均<0.001),但叶酸补充或叶酸状态与不明原因不孕症女性的妊娠结局无关。总之,叶酸补充或良好的叶酸状态对不明原因不孕症女性不孕治疗后的妊娠结局没有积极影响。叶酸是一种B族维生素,有人认为它与不孕症有关。叶酸是叶酸的人工合成形式,常用于膳食补充剂中。已证明补充叶酸可提高血液中的叶酸浓度并降低氨基酸同型半胱氨酸的浓度。叶酸补充剂常用于不孕女性,但对诊断为不明原因不孕症女性的妊娠结局的影响尚未得到彻底研究。在本研究中,评估了不明原因不孕症女性的叶酸补充剂使用情况和叶酸状态(叶酸和同型半胱氨酸浓度)与妊娠结局的关系。此外,还比较了不明原因不孕症女性与有生育能力的对照女性在叶酸补充剂使用和叶酸状态方面的差异。我们的结果表明,与有生育能力的对照女性相比,不明原因不孕症女性使用叶酸补充剂的情况要多得多,且从补充剂中摄入的总叶酸更高。不明原因不孕症女性的血液叶酸和同型半胱氨酸浓度比有生育能力的女性更好,但叶酸补充或叶酸状态与不孕治疗后的妊娠结局无关。总之,高叶酸摄入量或良好的叶酸状态并未增加不明原因不孕症女性不孕治疗后生下健康婴儿的可能性。

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