Homocysteine increases uterine artery blood flow resistance in women with pregnancy loss

Yang, Xin; Xia, Tian; Liu, Haoxin; Wang, Juan; Wang, Fang

doi:10.1016/j.jogoh.2023.102533

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…To our knowledge, this is the first interventional study of folic acid in the IVF/ICSI program to reduce the miscarriage rate while monitoring serum homocysteine levels. In addition, a recent report described that miscarriages were recurrent in the next pregnancy if women with a history of miscarriages were HCY > 10 µmol/L [64]. In this interventional study, the mean of homocysteine in which 800 µg of folic acid prevented miscarriage was 10.1 µmol/L, which is consistent with their study.…”

Section: Discussionsupporting

confidence: 89%

Impact of Homocysteine as a Preconceptional Screening Factor for In Vitro Fertilization and Prevention of Miscarriage with Folic Acid Supplementation Following Frozen-Thawed Embryo Transfer: A Hospital-Based Retrospective Cohort Study

Ogawa,

Ota,

Takahashi

et al. 2023

Nutrients

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Homocysteine is an amino acid naturally produced in the body and metabolized via the methionine cycle. High homocysteine levels can increase the risk of infertility and pregnancy complications, such as preeclampsia, preterm delivery, miscarriage, and low birth weight. Preconceptional homocysteine levels may be reduced by taking folic acid supplements to reduce the risk of such complications. This cross-sectional, hospital-based study was conducted to examine the role of homocysteine in 1060 infertile women with a history of IVF/intracytoplasmic sperm injection (ICSI) failure. We analyzed whether folic acid intervention altered homocysteine levels and influenced reproductive outcome. We found that a higher homocysteine level was statistically associated with a lower fertilization rate in patients with a history of IVF/ICSI failure. There was an inverse relationship between homocysteine levels and serum 25(OH)VD, and a trend towards lower anti mullerian hormone in the group with higher homocysteine levels. This is the first interventional study to identify that folic acid supplementation improved pregnancy outcomes following freeze embryo transfer (FET) in women with a history of FET failure by monitoring the reduction in homocysteine levels. Therefore, folic acid supplementation and homocysteine level monitoring may constitute a novel intervention for improving IVF/ICSI pregnancy outcomes.

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Section: Discussionsupporting

confidence: 89%

Impact of Homocysteine as a Preconceptional Screening Factor for In Vitro Fertilization and Prevention of Miscarriage with Folic Acid Supplementation Following Frozen-Thawed Embryo Transfer: A Hospital-Based Retrospective Cohort Study

Ogawa,

Ota,

Takahashi

et al. 2023

Nutrients

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“…However, most studies on the relationship between HCY and pregnancy diseases have focused on the first trimester, ignoring the effect of HCY before pregnancy. Research from our team found that for women with a previous miscarriage, HCY can increase the uterine artery resistance in the non-pregnant state and is associated with the abortion rate of subsequent pregnancy [ 35 ]. The present study found that pre-pregnancy HCY plays an important role in the recurrence of RPL in women based on pre-pregnancy data, suggesting that pre-detection of HCY levels in women trying to become pregnant has a positive effect on preventing the recurrence of RPL.…”

Section: Discussionmentioning

confidence: 99%

Predicting risk of the subsequent early pregnancy loss in women with recurrent pregnancy loss based on preconception data

Yang,

Wang,

Zhang

et al. 2024

BMC Women's Health

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Background For women who have experienced recurrent pregnancy loss (RPL), it is crucial not only to treat them but also to evaluate the risk of recurrence. The study aimed to develop a risk predictive model to predict the subsequent early pregnancy loss (EPL) in women with RPL based on preconception data. Methods A prospective, dynamic population cohort study was carried out at the Second Hospital of Lanzhou University. From September 2019 to December 2022, a total of 1050 non-pregnant women with RPL were participated. By December 2023, 605 women had subsequent pregnancy outcomes and were randomly divided into training and validation group by 3:1 ratio. In the training group, univariable screening was performed on RPL patients with subsequent EPL outcome. The least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were utilized to select variables, respectively. Subsequent EPL prediction model was constructed using generalize linear model (GLM), gradient boosting machine (GBM), random forest (RF), and deep learning (DP). The variables selected by LASSO regression and multivariate logistic regression were then established and compared using the best prediction model. The AUC, calibration curve, and decision curve (DCA) were performed to assess the prediction performances of the best model. The best model was validated using the validation group. Finally, a nomogram was established based on the best predictive features. Results In the training group, the GBM model achieved the best performance with the highest AUC (0.805). The AUC between the variables screened by the LASSO regression (16-variables) and logistic regression (9-variables) models showed no significant difference (AUC: 0.805 vs. 0.777, P = 0.1498). Meanwhile, the 9-variable model displayed a well discrimination performance in the validation group, with an AUC value of 0.781 (95%CI 0.702, 0.843). The DCA showed the model performed well and was feasible for making beneficial clinical decisions. Calibration curves revealed the goodness of fit between the predicted values by the model and the actual values, the Hosmer–Lemeshow test was 7.427, and P = 0.505. Conclusions Predicting subsequent EPL in RPL patients using the GBM model has important clinical implications. Future prospective studies are needed to verify the clinical applicability. Trial registration This study was registered in the Chinese Clinical Trial Registry with the registration number of ChiCTR2000039414 (27/10/2020).

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“…Given the vasodilatory effects of H 2 S ( 58 , 92 , 93 ), this function has been investigated concerning the regulation of blood flow in uterine vessels, which affects the exchange of nutrients and respiratory gases between the mother and the fetus, consequently influencing fetal growth and health ( 94 , 95 ). It appears that the activity of H 2 S-producing enzymes and the subsequent effect of uterine blood vessel vasodilation are essential, as elevated levels of Hcy (and thus a probable deficiency in H 2 S-producing enzymes) lead to uterine artery blood flow resistance ( 96 ). Vasodilatory effects of H 2 S have been confirmed in human ( 97 ), sheep ( 98 ), and rat ( 99 ) uterine arteries, as well as in human umbilical arteries and veins, with this effect occurring primarily during the proliferative phase of the menstrual (estrus) cycle and in gravidity ( Figure 4 ) ( 20 ).…”

Section: Detection Of H 2 S-producing Enzymes and ...mentioning

confidence: 99%

Hydrogen sulfide and its role in female reproduction

Pilsova,

Klusackova

et al. 2024

Front. Vet. Sci.

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Hydrogen sulfide (H2S) is a gaseous signaling molecule produced in the body by three enzymes: cystathionine-β-synthase (CBS), cystathionine-γ-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3-MST). H2S is crucial in various physiological processes associated with female mammalian reproduction. These include estrus cycle, oocyte maturation, oocyte aging, ovulation, embryo transport and early embryo development, the development of the placenta and fetal membranes, pregnancy, and the initiation of labor. Despite the confirmed presence of H2S-producing enzymes in all female reproductive tissues, as described in this review, the exact mechanisms of H2S action in these tissues remain in most cases unclear. Therefore, this review aims to summarize the knowledge about the presence and effects of H2S in these tissues and outline possible signaling pathways that mediate these effects. Understanding these pathways may lead to the development of new therapeutic strategies in the field of women’s health and perinatal medicine.

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Homocysteine increases uterine artery blood flow resistance in women with pregnancy loss

Cited by 4 publications

References 23 publications

Impact of Homocysteine as a Preconceptional Screening Factor for In Vitro Fertilization and Prevention of Miscarriage with Folic Acid Supplementation Following Frozen-Thawed Embryo Transfer: A Hospital-Based Retrospective Cohort Study

Impact of Homocysteine as a Preconceptional Screening Factor for In Vitro Fertilization and Prevention of Miscarriage with Folic Acid Supplementation Following Frozen-Thawed Embryo Transfer: A Hospital-Based Retrospective Cohort Study

Predicting risk of the subsequent early pregnancy loss in women with recurrent pregnancy loss based on preconception data

Hydrogen sulfide and its role in female reproduction

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