Effect of B vitamins and genetics on success of in-vitro fertilisation: prospective cohort study
Effect of B vitamins and genetics on success of in-vitro fertilisation: prospective cohort study
复制标题
DOI：
10.1016/s0140-6736(06)68651-0
复制
发表时间：
2006-05-06
期刊：
影响因子：
168.9
通讯作者：
Bhattachayra, S
中科院分区：
文献类型：
--
作者：
Haggarty, P;McCallum, H;Bhattachayra, S
背景 有必要了解影响体外受精 (IVF) 成功率和双胞胎出生率的因素，以便提高妊娠率并避免多胎妊娠。我们的目的是评估 B 族维生素和遗传学的作用。方法我们对 602 名接受生育治疗的女性进行了一项前瞻性队列研究。我们通过问卷评估了叶酸和维生素 B12 的摄入量，并通过放射免疫测定法测量了它们的血浆和红细胞浓度。我们在接受治疗的女性和 932 名自然受孕的女性中测量了 5 种 B 族维生素相关基因变异。 结果 随着血浆叶酸 (1.52, 1.01-2.28; p=0.032) 和红细胞叶酸 (1.28, 1.00-1.65; p=0.039) 浓度的增加，体外受精后双胞胎出生的可能性也随之增加。叶酸和维生素 B12 水平与成功怀孕的可能性之间没有关联。亚甲基四氢叶酸还原酶 (MTHFR) 1298 CC 变体（而不是 AA 变体）纯合的女性在 IVF 后活产的可能性较小 (0.24, 0.08-0.71; p=0.003) 或以前怀孕过的可能性 (0.42, 0.21-0.81; p=0.008)。 解释 我们的研究结果表明，MTHFR 基因型与女性产生健康胚胎的潜力有关（可能通过与 DNA 甲基化相关基因的相互作用）。对于可能成功体外受精妊娠的女性，高叶酸状态会增加多胚胎移植后双胞胎出生的可能性。用叶酸强化英国饮食的提议可能会导致体外受精后出生的双胞胎数量增加。
Background There is a need to understand what affects the success of in-vitro fertilisation (IVF) and the rate of resulting twin births so that pregnancy rates can be improved and multiple gestations avoided. Our aim was to assess the role of B vitamins and genetics.Methods We did a prospective cohort study of 602 women undergoing fertility treatment. We assessed intake of folate and vitamin B12 with a questionnaire and measured their plasma and red-blood-cell concentrations by radioimmunoassay. We measured five B-vitamin-related gene variants in women who received treatment and in 932 women who conceived naturally.Findings The likelihood of a twin birth after IVF rose with increased concentrations of plasma folate (1.52, 1.01-2.28; p=0.032) and red-cell folate (1.28, 1.00-1.65; p=0.039). There was no association between folate and vitamin B12 levels and likelihood of a successful pregnancy. Women homozygous for the 1298 CC variant of methylenetetrahydrofolate reductase (MTHFR), rather than the AA variant, were less likely to produce a livebirth after IVF (0.24, 0.08-0.71; p=0.003) or to have had a previous pregnancy (0.42, 0.21-0.81; p=0.008).Interpretation Our findings suggest that MTHFR genotype is linked to a woman's potential to produce healthy embryos (possibly through interaction with genes related to DNA methylation). In women likely to have a successful IVF pregnancy, high folate status increases the likelihood of twin birth after multiple embryo transfer. Proposals to fortify the UK diet with folic acid could lead to an increase in the number of twins born after IVF.