A recently published case series study has evaluated the effect of 5-MTHF glucosamine salt (Quatrefolic®) in couples with recurrent miscarriages, lasting for at least 4 years.
5-MTHF glucosamine salt (Quatrefolic®) has been supplemented in a B vitamin complex and chelated zinc (Impryl®, Parthenogen, Switzerland or Tretrafolic®, Nurilia, France) at the dosage of 800 µg/day, according to the 5-MTHF glucosamine salt requirements in healthy women.

The study conclusion highlights that the conventional use of large doses of folic acid (5 mg/day) has become obsolete. A physiological dose of 5-MTHF glucosamine salt (800 μg) bypasses the MTHFR block and is suggested to be an effective treatment for couple fertility problems.

In the trial, the selected population shows a strong link between an impaired folate cycle, due to the presence of polymorphism of the enzyme methylentetrahydrofolate reductase (MTHFR), and consequently the capacity to achieve conception and carry a pregnancy to term.
The women distribution of the C677T was: Wild Type 38%, Heterozygous 45% and Homozygous 17%, very close to what is generally observed in Europe. Most of the women had been previously treated unsuccessfully with high doses of folic acid (5 mg/day).

There is now strong evidence indicating that MTHFR isoforms are detrimental for fertility in women and men; in all couples of the study, at least one of the partners was a carrier of one of the two main MTHFR isoforms.

Of 33 couples, 13 spontaneous pregnancies were observed at the end of the treatment and other 13 pregnancies were obtained after assisted reproductive technology (ART), with the overall ongoing pregnancy rate of 86.7%.

The supplementation with 5-MTHF (Quatrefolic®) instead of folic acid appears to be an effective treatment for patients carrying the above mutations, where the physiological dose of 5-MTHF glucosamine salt (800 μg) bypasses the MTHFR block.

On the contrary, excess of folic acid intake leads to the UMFA (Un-Metabolized Folic Acid) syndrome in this peculiar population; UMFA syndrome may increase the cancer risks and cause immune dysfunction.
UMFA generated by high doses of folic acid may induce a pseudo MTHFR syndrome via a mechanism of substrate inhibition, inducing a reversal of the cycle and a resulting increase in homocysteine (Hcy).

The study highlights the benefits of Quatrefolic®- the active folate form immediately bioavailable without metabolization of MTHFR enzyme – and the importance of scientific communication lead by Gnosis in these years.
Finished formulations with Quatrefolic® are in the limelight of new clinical studies, providing even more evidence of the real advantages respect to the folic acid, in term of efficacy and safety.