Preconception folic acid treatment affects the microenvironment of the maturing oocyte in humans
Received 18 April 2007; received in revised form 15 June 2007; accepted 15 June 2007. published online 08 October 2007.
Objective
To investigate the influence of folic acid supplementation on the follicular fluid concentrations of folate and total homocysteine and their relationship to the diameter of the follicle.
Design
Observational study.
Setting
Tertiary referral fertility clinic at the Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Patient(s)
Thirty-seven women undergoing IVF or intracytoplasmic sperm injection treatment.
Intervention(s)
No interventions other than routine stimulation treatment and the recommendation of folic acid supplementation.
Main Outcome Measure(s)
Concentrations of folate and total homocysteine in monofollicular and pooled follicular fluid and the diameter of the follicle.
Result(s)
Folic acid supplementation significantly increased folate and decreased total homocysteine concentrations in pooled follicular fluid. In monofollicular fluid, folate concentrations only were significantly increased in supplemented women. The total homocysteine concentration appeared to be significantly correlated with the diameter of the follicle (r = 0.27). Samples from single follicles were less prone to artifacts in the measurements of the folate and total homocysteine concentration.
Conclusion(s)
Preconception folic acid supplementation significantly alters both folate and total homocysteine concentrations in follicular fluid. The correlation between the diameter of the follicle and total homocysteine concentration in follicular fluid warrants further investigation.
aDepartment of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
bDepartment of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
cDepartment of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands
dDepartment of Epidemiology and Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
eDepartment of Pediatric Cardiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
fDepartment of Clinical Genetics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
Reprint requests: Régine P.M. Steegers-Theunissen, M.D., Ph.D., Associate Professor in Reproductive Epidemiology, Erasmus MC, University Medical Center, Department of Obstetrics and Gynecology/Division of Obstetrics and Prenatal Medicine, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands (FAX: 31-10-4636815).
ABSTRACT