Plasma Homocysteine and Haematological Changes in Infertile Women in Lagos, Nigeria

Abstract

Hyperhomocysteinemia has been described as a risk factor for infertility and adverse pregnancy outcomes such as recurrent/early pregnancy loss, pre-eclampsia and intrauterine growth restriction. Although Nigeria has a high prevalence of infertility, the contribution of homocysteine to female infertility is yet to be studied. This study aim to find possible relationship between elevated plasma homocysteine level and infertility. This descriptive cross-sectional study was carried out among eligible infertile and fertile women seeking care at the Lagos University Teaching Hospital. The subjects were 100 infertile women randomly selected from the fertility clinic, and the controls were 50 fertile women that have given birth in the last one year. Fasting plasma levels of homocysteine were estimated using enzyme immunoassay technique, while anticoagulated whole blood sample was used to evaluate haematological parameters (Hb, WBC, MCV, MCH, MCHC, RDW %), using the HMX haematology autoanalyser by Beckman Coulter. Statistical analysis was performed using the Chi-square and simple logistic regression model for associations and Student t-test for mean differences. Statistical significance was set at p-value <0.05. Among infertile women, 34.0% (n=34) complained of primary infertility while 66.0% (n=66) had secondary infertility. Mean plasma homocysteine level of subjects and controls were 9.50 ± 1.88μmol/L and 9.44 ± 1.85μmol/L respectively. In the control group, the 95th percentile for homocysteine level was 12.0μmol/L. Differences in mean plasma homocysteine levels between the subjects and controls were not statistically significant (p=0.952).Mean values of haematological parameters did not vary significantly in both groups except for a marginal increase in WBC count of infertile women. Hyperhomocysteinemia may not be a major factor in female infertility in our environment.

Key words: Plasma homocysteine, Female infertility, Haematological parameters