Homocysteine in pregnancy planning

What is homocysteine and how does it affect the body?

Homocysteine is an amino acid formed during the breakdown of methionine, which enters the human body through protein foods (meat, fish, eggs, milk). Normally, this substance is produced in small amounts and is purified by folic acid (vitamin B9), but only if it has been converted into its active form, 5MTHF. This transformation is possible thanks to the enzymes MTRR, MTHFR, and MTR. However, when the activity of these enzymes is impaired, the metabolism of methionine becomes less efficient, leading to an accumulation of homocysteine in the body. Elevated levels of this amino acid can pose a serious threat to pregnancy.

Effects of hyperhomocysteinemia on pregnancy

Hyperhomocysteinemia, caused by high levels of homocysteine in the blood, affects 10 to 15% of women of childbearing age and can lead to a number of complications:

1. Fetal malformations:
   • Anencephaly, which results in fetal death;
   • Failure of the cerebrospinal canal, leading to severe neurological problems in the child.
2. Thrombosis of blood vessels:
   • Widespread vascular pathology in the second half of pregnancy;
   • Preeclampsia;
   • Gestational diabetes.
3. Risks for the mother and fetus:
   • Autoimmune processes;
   • Antiphospholipid syndrome, which worsens the course of pregnancy;
   • Free penetration of homocysteine through the placenta with a risk to the health of the fetus.

Why measure homocysteine levels when planning a pregnancy?

The level of homocysteine is an important health indicator when planning a pregnancy. Its study is recommended for women to minimize the risk of complications.

In addition, it may be prescribed:

• tests for folate and vitamin B12 levels;
• genetic tests to detect mutations in the MTHFR enzymes.

Homocysteine norms:

• In urine: no substance;
• In blood: up to 12 µmol/l in women (up to 10 µmol/l during pregnancy). Levels above 15 µmol/l are considered high.

What to do in case of hyperhomocysteinemia?

If the homocysteine level exceeds the norm, it is necessary to conduct further research. The attending physician interprets the results taking into account age, health status, the presence of chronic diseases, diet, and lifestyle.

The main correction methods:

• Intake of folic acid and B vitamins (B6, B12);
• Individual choice of doses and duration of treatment under the supervision of a specialist.

Homocysteine and IVF (in vitro fertilization)

The measurement of homocysteine is an important step in preparing for IVF, especially for women over 35 or those with blood coagulation disorders. High levels of homocysteine can negatively affect embryo implantation.

Specialist recommendations: with the results of the analysis, it is advisable to consult a reproductive specialist or obstetrician-gynecologist, who will develop an individual plan for correcting hyperhomocysteinemia. This will increase the chances of successful conception and the birth of a healthy child.