Comparative Study Between the Use of Folic Acid and L-Methylfolate in Patients with MTHFR Gene Mutation

In 2021, Ahmed Essmat published the results of his scientific study titled "Comparative Study Between the Use of Regular Folic Acid and L-Methylfolate in Patients with MTHFR Gene Mutation and Recurrent Miscarriages" in the Open Journal of Obstetrics and Gynecology, by Scientific Research Publishing. The aim of the study was to compare the effectiveness of supplementation with folic acid and L-methylfolate in women with the MTHFR gene mutation who had a history of recurrent miscarriages.

Study Objective

The study was based on the analysis of results from 100 patients, and the author referenced 16 sources to support his findings. The scope of the work focuses on assessing the benefits that the use of L-methylfolate, the active form of folate, may bring compared to traditional folic acid in this group of patients.

MTHFR Gene Mutation and Folic Acid Metabolism

The MTHFR gene mutation leads to problems with folic acid metabolism, resulting in lower levels of biologically active folate in the body. This, in turn, causes an increase in homocysteine levels, which can lead to circulation disorders between the mother and fetus, increasing the risk of recurrent miscarriages.

Homocysteine is known as a risk factor for many pregnancy complications, such as preterm labor (PTL), preeclampsia (PE), and premature rupture of membranes (PROM). Folic acid supplementation is commonly used to prevent neural tube defects in the developing fetus; however, in women with the MTHFR mutation, traditional folic acid may be insufficient.

Study Methodology

In Essmat's study, the women were divided into two groups:

• The first group received regular folic acid at a dose of 5 mg daily from the time of a positive pregnancy test until the end of the first trimester.
• The second group took L-methylfolate at a dose of 1000 mcg daily for the same period.

Both groups were monitored for the occurrence of pregnancy complications and the number of miscarriages. The researchers also evaluated how long the pregnancies were carried to term in both groups and whether the patients experienced complications such as PE, PROM, and PTL.

Study Results

The study results clearly showed that supplementation with L-methylfolate yielded significantly better outcomes than the use of traditional folic acid:

• In the group of patients who took L-methylfolate, 60% carried the pregnancy to term, while in the folic acid group, this percentage was only 22%.
• Preterm labor (PTL) occurred in only 8% of women taking L-methylfolate, compared to 24% in the folic acid group.
• Preeclampsia (PE) occurred in 6% of women in the L-methylfolate group, while in the folic acid group, it occurred in 14%.

First-trimester miscarriages were also rarer in the L-methylfolate group (16% vs. 54% in the folic acid group).

Conclusions

The study confirmed that L-methylfolate significantly reduces the risk of miscarriages and pregnancy complications, making it more effective in treating women with the MTHFR gene mutation.

Essmat recommends that doctors consider introducing L-methylfolate supplementation as a routine treatment for women with a positive MTHFR gene mutation.

Source

Essmat, A. (2021). Comparative Study between the Use of Regular Folic Acid Supplement versus the Use of L-Methyl Folate in Patients with Methyl Tetrahydrofolate Reductase (MTHFR) Gene Mutation with Recurrent Pregnancy Loss. Open Journal of Obstetrics and Gynecology, 11, 1104-1111. https://doi.org/10.4236/ojog.2021.119103.