5-methyltetrahydrofolate: A mandatory support for T677T MTHFR SNP women suffering from premature ovarian insufficiency, endometriosis and/or multiple ART failures

A patients, age 39 in 2019, suffering hypermenorrhea, secondary dysmenorrhea and endometriosis with pelvic adhesions, Normal physical examination with an AMH value of 0.877 ng/L . At this time the couple had been trying to conceive for over 2 years while taking nature made prenatal vitamins and the wife was given 9 rounds of clomid treatments (6–50 mg, 3- 100 mg). She was advised to take DHEA and then started IUI and IVF with no success. On August, 2020, it was elected to check the couple for MTHFR mutation. The woman was found to be homozygous for T677T MTHFR mutation and her spouse homozygous for the C1298C MTHFR mutation but with a subnormal sperm. The patient and her spouse were both advised to discontinue any vitamins containing folic acid and start vitamins with a daily dose of 1,000 mcg of 5-MTHF (folate) with chelated zinc and a vitamin B complex. On December, 2020 spontaneous conception occurred. On July 27, 2021, a healthy 48.26 cm (19 inches), 3 kg (6 pounds 9 ounces) girl was delivered by c-section. Keywords: MTHFR 677TT SNP; endometriosis; ART failures; premature ovarian insufficiency; 5MTHF.