How are Homocystein and fertility related?

Homocysteine is a sulfur-containing amino acid; elevated blood levels (hyperhomocysteinemia) have been linked to fertility issues in both women and men. In women, high homocysteine may impair ovulation, embryo implantation, and early pregnancy maintenance, possibly through oxidative stress and vascular damage. Observational studies associate hyperhomocysteinemia with recurrent miscarriage and preeclampsia. In men, elevated homocysteine correlates with reduced sperm quality (motility, morphology) and increased DNA fragmentation. However, the evidence is largely observational and mechanistic; randomized controlled trials proving that lowering homocysteine improves fertility outcomes are lacking. Genetic variants such as MTHFR C677T can affect homocysteine metabolism, but the clinical utility of genetic testing for fertility remains debated. Supplementation with folate, vitamin B6, and B12 can lower homocysteine, but a clear fertility benefit is not established. MyBody-X does not directly measure homocysteine; its genetic analysis may only indicate predispositions. Caution: normal homocysteine does not rule out fertility problems. Overall evidence is mixed.