Evidence check: Homocystein in the context of Fruchtbarkeit

Homocysteine is an amino acid that, when elevated, is associated with increased risk of cardiovascular disease, neural tube defects, and possibly fertility issues. In the context of fertility, elevated homocysteine has been linked to recurrent pregnancy loss, poor egg quality, and sperm abnormalities. However, the evidence is not strong enough to recommend routine homocysteine testing for all infertility patients. Some studies show that lowering homocysteine with B vitamins (folate, B12, B6) may improve outcomes, but randomized trials are limited. Genetic variants in MTHFR (e.g., C677T) can affect homocysteine metabolism, but their clinical utility for fertility is debated. Consumer DNA tests often include MTHFR, but the results should be interpreted cautiously. Overall, homocysteine is a plausible but not proven biomarker for fertility; lifestyle and dietary interventions to optimize B vitamin status are generally safe and may help.