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Hyperhomocysteinemia: a risk factor in unexplained infertility

Preeti Dubey, Neena Gupta, Seema Dwivedi, Neelam Swaroop, Pavika Lal, Vandana Thawani.

Abstract
Background: To study the role of hyperhomocysteinemia in unexplained infertility and the impact of its correction with vitamin and mineral supplementation.
Methods: Total of 60 patients were included with 30 patients in case and 30 patients in control groups. Cases included patients with history of inability to conceive with frequent regular unprotected intercourse for at least 1 year. Controls included age matched parous females with at least one live birth and no history of abortions. Among the patients of unexplained infertility with hyperhomocysteinemia, homocysteine lowering agents were given and outcome studied in the form of lowering of homocysteine levels and number of conceptions.
Results: The mean age was 28.1 years in study and 29.5 years in the control group .Mean level of serum homocysteine was significantly higher in study group than normal fertile women i.e.20.5Ámol/l and 10.9 Ámol/l respectively. Among the patients of unexplained infertility, 22(73.3%) were found to have range above the normal healthy levels. In these patients homocysteine lowering agents were given for 6 weeks and lowering of mean homocysteine levels was observed which was 10.4 Ámol/l. Six (27.3%) patients conceived spontaneously during the follow up period.
Conclusions: Serum homocysteine levels are inversely correlated with infertility. Homocysteine lowering agents have a favourable impact on the outcome of infertility and their use is suggested in cases of unexplained infertility associated with hyperhomocysteinemia.

Key words: Hyperhomocysteinemia, Unexplained infertility, Homocysteine lowering agents, Female infertility



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