The Benefit of Active Folate (5-MTHF) in Fertility for Man and Woman

Majority of the world have strong cultural beliefs that children increase the well-being of parents, and especially women, and these beliefs have bolstered norm about the desirability of having children.

The Benefit of Active Folate (5-MTHF) in Fertility for Manand Woman


Majority of the world have strongcultural beliefs that children increase the well-being of parents, andespecially women, and these beliefs have bolstered norm about the desirability ofhaving children. Parenthood changes lives in both positive and negative ways,many of them unexpected by the parents themselves. Having a child deepens joy,strengthens social ties with family and friends (Gallagher and Gerstel 2001; Umbersonand Gove 1989), and creates new roles for adults that carry rights,responsibilities, and a sense of adulthood (Sieber 1974; Hoffman and Manis1979).

People who were raised in a positivehome environment with a stable family want to create impactful life each other.They want to create a family that is full of joy and love where they can beaffectionate towards their children.

Infertility is a multidimensionalproblem with social, economic and cultural implications, which can takethreatening proportions in countries with strong demographic problems. Infertilityis a medical condition that can cause psychological, physical, mental,spiritual, and medical detriments to the patient.

Cause of infertility vary: 1 in 3infertile women have problem with the female reproductive system, 1 in 3infertile men have a problem with the male reproductive system, and 1 in 3couples have a problem that affects both of them or an undetermined issue. Theunique quality of this medical condition involves affecting both the patientand the patient’s partner as a couple.

 

Female Infertility

Infertility is a common disease.At least 10% of women deal with infertility of some kind. The chances of beinginfertile increases as a woman age. The World Health Organization (WHO)performed a large multinational study to determine gender distribution andinfertility etiologies.

Infertilityhappens when cannot conceiving after 12 months of regular sexual intercoursewithout use of birth control. It may be that one partner cannot contribute toconception, or that a woman is unable to carry a pregnancy to full term. In 37%of infertile couples, female infertility was the cause; in 35% of couples, bothmale and female causes were identified; in 8% there was male factorinfertility.

 

Sign of Potential Infertilityin Women

In women, changes in themenstrual cycle and ovulation may be a symptom of a disease relatedinfertility. The symptoms are:

·     Abnormal periods. Bleeding is heavier or lighterthan usual

·     Irregular periods. The number of days in betweeneach period varies each month

·     No periods. You have never had a period, orperiods suddenly stop

·     Painful periods, back pain, pelvic pain, andcramping may happen.

The causes of femaleinfertility

There are many possible causes ofinfertility. However, it can be difficult to pinpoint the exact cause, and somecouples have “unexplained” infertility. Some possible causes of female factorinfertility can include:

·     Problems with the uterus: This includespolyps, fibroids, septum or adhesions inside the cavity of the uterus. Polypsand fibroids can form on their own at any time, whereas other abnormalities(like a septum) are present at birth.

·     Problems with the fallopian tubes: Themost common cause of “tubal factor” infertility is pelvic inflammatory disease,usually cased by chlamydia and gonorrhea.

·     Problems with ovulation: There are manyreasons why a woman may not ovulate (release an egg) regularly. Hormonalimbalances, thyroid conditions, severe stress and pituitary tumors are allexamples of things that affect ovulation.

·     Problems with egg number and quality:Women are born with all the eggs they will ever have, and this supply can “runout” early before menopause. In addition, some eggs will have the wrong numberof chromosomes and cannot fertilize or grow into a healthy fetus.

Who is at risk for femaleinfertility?

Many factors can increase awoman’s risk of female infertility. General health conditions, genetic (inherited)traits, lifestyle choices and age can all contribute to female infertility.Specific factors can include:

·     Age

·     Hormone issue that prevents ovulation

·     Abnormal menstrual cycle

·     Obesity or being underweight

·     Endometriosis

·     Structural problems (problems with the fallopiantubes, uterus or ovaries)

·     Autoimmune disorders (lupus, rheumatoidarthritis, Hashimoto’s disease, thyroid gland conditions).

·     Polycystic Ovary Syndrome (PCOS)

How does age impact femaleinfertility?

As a woman ages, her chances ofbecoming pregnant decreases. Age is becoming a more common factor in femaleinfertility because many couples are waiting to the have children until their30s or 40s. Women over age 35 have a higher risk of having fertility issues.The reasons for this include:

·     Overall number of eggs is lower

·     More eggs have an abnormal number of chromosomes

·     An increased risk of other health conditions.

 

Male Infertility

To conceive a child, a man’s sperm mustcombine with a woman’s egg. The testiscles make and store sperm, and the mostcommon issues that lead to infertility in men are problems that affect how thetesticles work. Other problems are hormone imbalances or blockages in the malereproductive organs. In about 50% of cases, the cause of male infertilitycannot be determined.

 

A complete lack of sperm occurs in about 10%to 15% of men who are infertile. A hormone imbalance or blockage of spermmovement can cause a lack of sperm. In some cases of infertility, a manproduces less sperm than normal. The most common cause of this condition isvaricocele, an enlarged vein in the testicle. Varicocele is present in about40% of men with infertility problems.

 

Common Signs of Infertility in Men

1.       Changes in Sexual Desire

2.       Pain or Swelling; Small and Firm Testicles

3.       Problems Maintaining Erection

4.       Issues with Ejaculation

5.       Sperm Disorders

Sperm may be immature, abnormallyshaped, or unable to swim. In some cases, you may not have enough sperm or youmay not make any sperm. This problem may be caused by many differentconditions, including:

·        Infections or inflammatory conditions. Oneexample is infection with the mumps virus after puberty

·        Hormone or pituitary gland problems

·        Immune problems in which you make antibodiesagainst your own sperm

·        Environmental and lifestyle factors. Theseinclude tobacco use, heavy alcohol use, use of drugs or steroids, or exposureto toxins

·        Genetic diseases, such as cystic fibrosis orhemochromatosis

 

Hyperhomocysteinemia

Homocysteine is an amino acid notsupplied by the diet that can be converted into cysteine or recycled intocysteine recycled into methionine, an essential amino acid, with the aid ofspecific B vitamins. Homocysteine levels is vary between men and women, withnormal range typically between 5 to 15 micromol/L.

When homocysteine levels aregreater than normal limits, it signifies a disruption in the metabolism ofhomocysteine. Elevated levels of homocysteine have been associated withincreased cardiovascular, cerebrovascular, and thromboembolic disease bycausing endothelial layer injury, promoting inflammation, and increasingoxidative stress. Elevated total homocysteine levels in the third trisemesterof pregnancy may cause subtle damage to the vasculature of the placenta, whichcan limit oxygen to the fetus and may have a direct effect on the brainstructure of the fetus and thus increase the risk of developing schizophrenia.

Homocysteine values have beenfound to be elevated significantly in patients with unexplained infertility.The study gives an indication that infertility and recurrent pregnancy loss area part of continuum of hyperhomocysteine induced adverse effects on femalereproductive system.

 

Vitamin B9 or Folate

Vitamin B9 is an essential nutrientthat occurs as folate. It serves many important functions in your body. Forexample, it plays a crucial role in cell growth and DNA formation. Low levelsof vitamin B9 are associated with an increased risk of several healthconditions, including:

·     Elevated homocysteine: High homocysteinelevels have been associated with and increased risk of heart disease and stroke

·     Birth defects: Low folate levels inpregnant women have been linked to birth abnormalities, such as neural tubedefects.

·      Cancerrisk: Poor levels of folate are also linked to increased cancer risk.

 

What is Folate?

Folate is the naturally occurring formof vitamin B9. Its name is derived from the Latin word “folium”, which meansleaf. In fact, leafy vegetables are among the best dietary sources of folate.The active form of vitamin B9 is a type of folate known as levomefolic acid or5-methyltetrahydrofolate (5-MTHF). In your digestive system, most dietaryfolate is converted into 5-MTHF before entering your bloodstream.

 

Folic acid is a synthetic form of vitaminB9 and used in supplements and added to processed food products, such as flourand breakfast cereals. Unlike folate, not all of the folic acid you consume isconverted into the active form of vitamin B9 (5-MTHF) in your digestive system.Instead, it needs to be converted in your liver or other tissues. Yet, thisprocess is slow and inefficient in some people. After taking a folic acidsupplement, it takes time for your body to convert all it to 5-MTHF. Even asmall dose, such as 200 to 400 mcg per day may not be completely metabolizeduntil the next dose is taken. As a result, unmetabolized folic acid is commonlydetected in people’s bloodstreams, even in the fasted state and high levels ofunmetabolized folic acid have been associated with several health problems. Severalstudies indicate that chronically elevated levels of unmetabolized folic acidmay be adverse health effects, including increased cancer risk.

 

                        

What is an MTHFR mutation?

Methylenetetrahydrofolate reductase(MTHF) is an enzyme that breaks down the amino acid homocysteine. The MTHFRgene that codes this enzyme has the potential to mutate, which can eitherinterfere with the enzyme’s ability to function normally or completelyinactivate it. People have two MTHFR genes, inheriting one from each of theirparents. There are two common types, or variants of MTHFR mutations: C677T andA1298C. These gene mutations are relatively common.

 

Mutation in the MTHFR gene can affectthe body’s ability to process amino acids, like homocysteine which can lead tosome adverse health outcomes. Conditions that have associated with MTHFR genemutations include:

·          Hyperhomocysteinemia, which is the term forabnormally high levels of homocysteine in the blood or urine

·          Ataxia, which is a neurological condition thataffects coordination

·          Peripheral neuropathy, which is a neurologicalcondition that damage the nerves

·          Microcephaly, which is a condition present atbirth in which the head is smaller than usual

·          Anemia, which means that there is a lack ofhealthy red blood cells in the body

·          Cardiovascular diseases, such as blood clots,stroke, and heart attack

·          Mental health conditions, such as depression

·          Behaviour disorders, such as attention deficithyperactivity disorder

 

 

Is Unmetabolized Folic Acid (UMFA)harmful?

Folic acid at the dosage above 200 mcgper day can increase unmetabolized folic acid in the plasma. As a result,unmetabolized folic acid is commonly detected in people’s bloodstreams. Severalstudies indicate that chronically elevated levels of unmetabolized folic acidmay have adverse health effects, including increased cancer risk. So, theactive form of Folate (as 5-MTHF) can use as the best choice for replace folicacid supplementation.

 

 

PT. SIMEX PHARMACEUTICAL INDONESIA asone of the pharmaceutical companies in Indonesia presents HY-FOLIC® products as supplementcontaining biologically active form of Folate (5-MTHF). HY-FOLIC® as active folate is not formingunmetabolized folic acid (UMFA) which is elevated in patients with folic acid.HY-FOLIC® has better absorption than folic acid; has sufficient dosage for therapyin pregnancy and infertility; and practical to be consumed. HY-FOLIC® has FDA, EFSAapproval and HALAL certificate.

 

Sumber:

MaRgolis R., MyRskyla M. 2011. AGlobal Perspective on Happiness and Fertility. Popul Dev Rev. 2011; 37 (1):29-56.

Servy EJ., Fournols LJ., et.al.2018. MTHFR isoform carriers. 5-MTHF (5-methyl tetrahydrofolate) vs folic acid:a key to pregnancy outcome: a case series. Journal of Assisted Reproduction andGenetics.

Clement A., Menezo Y., et.al.2019. 5-Methyltetrahydrofolate reduces blood homocysteine level significantlyin C677T methyltetrahydrofolate reductase single-nucleotide polymorphismcarriers consulting for infertility. Elsevier: Journal of Gynecology Obstetricsand Human Reproduction 49 (2020) 101622

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