Circulating Divalent Cations in Asymptomatic Ovarian Hyperstimulation and in vitro Fertilization Patients

Abstract

It is known that ovarian hyperstimulation and in vitro fertilization are accompanied by a steady increase in circulating estrogen and progesterone far beyond what is normal for young women. We have recently demonstrated that the biologically active fractions of calcium and magnesium in blood are altered depending on when in the menstrual phase a blood sample is drawn in normal cycling women. The serum ionized Ca/Mg ratio is also altered in accordance with the menstrual cycles. This suggests that the sex steroid hormones may modulate serum levels of ionized Mg and the ionized Ca/Mg ratio. We therefore studied the relationships between sex steroid hormones and the concentrations of ionized magnesium and calcium in the blood of hyperstimulated patients. We were able to demonstrate that with each increment in estrogen, a decrease in ionized Mg occurred, and as the progesterone rose in the blood, the ionized Ca/Mg ratio increased. Our results support the idea that serum estrogen and progesterone levels in women modulate the blood levels of circulating ionized Mg and the serum ionized Ca/Mg ratio.

Divalent Cation Levels in Serum and Preovulatory Follicular Fluid of Women Undergoing in vitro Fertilization Embryo Transfer

“…Mg 2+ serum levels showed a decline throughout the IVF cycle, unlike Ca 2+ whose levels exhibited a trend towards increasing. These findings are in accordance of those of O'Shaughhnessy et al [5] and Muneyyirci-Delale et al [6] who reported an inverse relationship between sex steroids and the concentrations of Mg 2+ and the Ca 2+ /Mg 2+ ratio circulating in the blood in the follicular phase as a reflection of COH. The continuing decrease in serum Mg 2+ levels was attributed to the increase in serum progesterone in the luteal phase [1][2].…”

“…The continuing decrease in serum Mg 2+ levels was attributed to the increase in serum progesterone in the luteal phase [1][2]. The changes in Mg 2+ and Ca 2+ were attributed to several mechanisms: Fachinetti et al [12] offered intracellular movement of the Mg as one explanation, while O'Shaughhnessy et al [5] suggested the involvement of other mechanisms, such as the use of Mg 2+ in some enzymatic reactions and, therefore, its being bound to some anionically charged molecule and lost to the body. Barak et al [13] reported a wide interfollicular variation in a study in which they examined the levels of IK-2 in FF, which they explained as indirect reflection of interfollicular asynchrony found during ovulation induction.…”

“…In a study on controlled ovarian hyperstimulation (COH) patients, O'Shaughnessy et al [5] demonstrated that a decrease in ionized Mg occurred with each increment in estrogen and that the ionized Ca/Mg ratio increased as the progesterone rose in the blood. The authors attributed these changes to serum estrogen and progesterone.…”

NCCTG N10C2 (Alliance): A double-blind, placebo-controlled study of magnesium supplements to reduce menopausal hot flashes.

“…The results from these two studies were comparable to the results of pilot studies of other agents that subsequently showed efficacy in phase III trials. Several in vitro studies suggest possible relationship between the homeostasis of intracellular magnesium and estrogen and progesterone [26][27][28][29][30] . While the pathophysiology of hot flashes is still unclear, magnesium appeared to be a reasonable link between vasomotor symptoms and menopause.…”

Emerging role of epigenetics in cardiovascular diseases: importance of ionized hypomagnesemia

“…22 In order to gain insight into our hypothesis of the critical importance of adequate dietary intake of Mg in development of CVDs, we have recently measured the levels of DNA methylation, histone modifications and micro-RNAs along with the levels of telomerase in ventricular, atrial and vascular smooth muscle cells (i.e., coronary, cerebral, mesenteric, aortic, etc.) excised from rats placed on different Mg-deficient diets for up to 21 days[for review, see 23].In addition, using newly designed specific, sensitive electrodes to quantify serum, whole blood, plasma and cerebral spinal fluid ionized Mg levels, 24-31 we measured [Mg 2+ ] in bloods and CSF of women throughout pregnancy and at delivery in healthy and preeclamptic women, as well as in women with diseases specific to women (e.g., gestational diabetes; menopause,; PCOS; ovarian hyperstimulation) [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] and newborn healthy and diseased infants.…”