Evidence check: COMT in the context of Fruchtbarkeit

COMT (catechol-O-methyltransferase) is an enzyme involved in the breakdown of catecholamines (dopamine, adrenaline) and estrogens. The common Val158Met variant (rs4680) alters enzyme activity: the Val variant is high-activity, the Met variant low-activity. In the context of fertility, COMT is primarily linked to estrogen metabolism. Some studies suggest an association between the Met variant and increased risk of endometriosis or PCOS, which can indirectly affect fertility. However, effect sizes are small and findings are inconsistent. There is no strong clinical evidence that COMT testing alone can predict general fertility or treatment outcomes. Most data come from mechanistic or observational studies. Direct-to-consumer DNA tests often list COMT as a 'fertility marker,' but clinical validity is limited. A comprehensive evaluation by a reproductive specialist—including hormone levels, cycle regularity, and lifestyle—is essential. Caution is warranted: COMT is just one small piece in a complex puzzle.