Impact of Folates in the Care of the Male Infertility

NCT01407432 | Completed Phase 3

• 1 other identifier: P 100108
• Study Type: interventional
• Target: 162
• Locations: 1 country
• Sites: 1

Brief Summary

Unexplained male infertility is increasing, and, nowadays, the investigators only can propose palliative treatment, as In VITRO Fertilization (IVF). The folate metabolism is a key for the maintenance of genome integrity. A dysfunction in this pathway can be responsible of spermatogenesis defects, and further, of infertility. Few assays have shown that folate treatment can improve sperm parameters and fertility, till 30% in some of theses studies. The purpose of the investigators study is to demonstrate the impact of folates treatment on improvement of sperm parameters and on the rate of success of in VITRO fertilization procedures.

Conditions

Male Infertility

Keywords

Male infertility; folic acid; in VITRO fertilization; sperm parameters; MTHFR genotype

Outcome Measures

Primary Outcomes (1)

• The rates of pregnancy in IVF +/- ICSI and spontaneous pregnancy according to the arm of treatment

  Estimate the efficiency of the treatment by folic acid at infertile men on the improvement of improvement of the pregnancy rates in IVF +/- ICSI and spontaneous pregnancy before IVF +/- ICSI

  3 months

Secondary Outcomes (4)

• The rate of improvement of the sperm parameters with acid folic treatment

  3 months

• The rate of improvement of the nuclear quality of gametes with acid folic treatment

  3 months

• The rate of pregnancy of couple with infertile men treated by folic acid according to the methylene-tetrahydrofolate reductase (MTHFR) genotype

  3 months

• The difference between the methylene-tetrahydrofolate reductase (MTHFR) genotype of the patients on sperm parameters according to the arm of treatment

  3 months

Study Arms (2)

Folic acid

EXPERIMENTAL

tablets of 5 mg of folic acid

Drug: Folic acid

Placebo

PLACEBO COMPARATOR

Tablets of placebo of folic acid

Drug: placebo of folic acid

Interventions

Folic acid DRUG

Taking of folic acid 15 mg per day by hanging oral route during 3 at 4 months

Folic acid

placebo of folic acid DRUG

Taking of placebo of folic acid by hanging oral route during 3 at 4 months

Placebo

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Couple whose man is from 18 to 60 years old
• Couple whose man presents an infertility indicating a care in VITRO fertilization with or without intracytoplasmic sperm injection (IVF +/- ICSI)
• Couple whose spouse is from 18 to 38 years old
• Couple whose spouse do not present particular factors of infertility
• Couple Taken care in IVF +/- ICSI
• Couple with social insurance
• members of the couple having signed the consent

You may not qualify if:

• Etiology of not genetic known male infertility : infertility of neoplastic origine, infertility of definitive obstructive origin
• Presence of a factor of feminine infertility : A definitive infertility tubal, Turned out ovarian incapacity (FSH \> 9 and/or CFA \<= 8)
• Male infertility requiring the appeal to some sperm testicular or in some frozen sperm- Men or women attend of HIV or hepatitis B or C
• Epileptic men
• Men under anti-folic treatment
• Men presenting a big sensibility to the folic acid or to one of the constituents of the drug
• Couple of which one of the partners refuses to participate in the study

Sponsors & Collaborators

• Assistance Publique - Hôpitaux de Paris: lead

Study Sites (1)

Service of gynaecology-obstetrics and medicine of the reproduction, Tenon Hospital - APHP

Paris, 75020, France

Location

Related Publications (30)

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  PMID: 8405528 BACKGROUND

• Bezold G, Lange M, Peter RU. Homozygous methylenetetrahydrofolate reductase C677T mutation and male infertility. N Engl J Med. 2001 Apr 12;344(15):1172-3. doi: 10.1056/NEJM200104123441517. No abstract available.

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• Blount BC, Mack MM, Wehr CM, MacGregor JT, Hiatt RA, Wang G, Wickramasinghe SN, Everson RB, Ames BN. Folate deficiency causes uracil misincorporation into human DNA and chromosome breakage: implications for cancer and neuronal damage. Proc Natl Acad Sci U S A. 1997 Apr 1;94(7):3290-5. doi: 10.1073/pnas.94.7.3290.

  PMID: 9096386 BACKGROUND

• Boxmeer JC, Smit M, Weber RF, Lindemans J, Romijn JC, Eijkemans MJ, Macklon NS, Steegers-Theunissen RP. Seminal plasma cobalamin significantly correlates with sperm concentration in men undergoing IVF or ICSI procedures. J Androl. 2007 Jul-Aug;28(4):521-7. doi: 10.2164/jandrol.106.001982. Epub 2007 Feb 7.

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• Boxmeer JC, Macklon NS, Lindemans J, Beckers NG, Eijkemans MJ, Laven JS, Steegers EA, Steegers-Theunissen RP. IVF outcomes are associated with biomarkers of the homocysteine pathway in monofollicular fluid. Hum Reprod. 2009 May;24(5):1059-66. doi: 10.1093/humrep/dep009. Epub 2009 Feb 15.

  PMID: 19221098 BACKGROUND

• Boxmeer JC, Smit M, Utomo E, Romijn JC, Eijkemans MJ, Lindemans J, Laven JS, Macklon NS, Steegers EA, Steegers-Theunissen RP. Low folate in seminal plasma is associated with increased sperm DNA damage. Fertil Steril. 2009 Aug;92(2):548-56. doi: 10.1016/j.fertnstert.2008.06.010. Epub 2008 Aug 22.

  PMID: 18722602 BACKGROUND

• Chen J, Ma J, Stampfer MJ, Palomeque C, Selhub J, Hunter DJ. Linkage disequilibrium between the 677C>T and 1298A>C polymorphisms in human methylenetetrahydrofolate reductase gene and their contributions to risk of colorectal cancer. Pharmacogenetics. 2002 Jun;12(4):339-42. doi: 10.1097/00008571-200206000-00011.

  PMID: 12042673 BACKGROUND

• Choi SW, Mason JB. Folate and colorectal carcinogenesis: is DNA repair the missing link? Am J Gastroenterol. 1998 Nov;93(11):2013-6. doi: 10.1111/j.1572-0241.1998.02013.x. No abstract available.

  PMID: 9820367 BACKGROUND

• Doerksen T, Benoit G, Trasler JM. Deoxyribonucleic acid hypomethylation of male germ cells by mitotic and meiotic exposure to 5-azacytidine is associated with altered testicular histology. Endocrinology. 2000 Sep;141(9):3235-44. doi: 10.1210/endo.141.9.7661.

  PMID: 10965894 BACKGROUND

• Ebisch IM, van Heerde WL, Thomas CM, van der Put N, Wong WY, Steegers-Theunissen RP. C677T methylenetetrahydrofolate reductase polymorphism interferes with the effects of folic acid and zinc sulfate on sperm concentration. Fertil Steril. 2003 Nov;80(5):1190-4. doi: 10.1016/s0015-0282(03)02157-5.

  PMID: 14607573 BACKGROUND

• Eskenazi B, Kidd SA, Marks AR, Sloter E, Block G, Wyrobek AJ. Antioxidant intake is associated with semen quality in healthy men. Hum Reprod. 2005 Apr;20(4):1006-12. doi: 10.1093/humrep/deh725. Epub 2005 Jan 21.

  PMID: 15665024 BACKGROUND

• Goyette P, Sumner JS, Milos R, Duncan AM, Rosenblatt DS, Matthews RG, Rozen R. Human methylenetetrahydrofolate reductase: isolation of cDNA mapping and mutation identification. Nat Genet. 1994 Aug;7(4):551. No abstract available.

  PMID: 7951330 BACKGROUND

• Heijmans BT, Gussekloo J, Kluft C, Droog S, Lagaay AM, Knook DL, Westendorp RG, Slagboom EP. Mortality risk in men is associated with a common mutation in the methylene-tetrahydrofolate reductase gene (MTHFR). Eur J Hum Genet. 1999 Feb-Mar;7(2):197-204. doi: 10.1038/sj.ejhg.5200283.

  PMID: 10196703 BACKGROUND

• Kelly TL, Li E, Trasler JM. 5-aza-2'-deoxycytidine induces alterations in murine spermatogenesis and pregnancy outcome. J Androl. 2003 Nov-Dec;24(6):822-30. doi: 10.1002/j.1939-4640.2003.tb03133.x.

  PMID: 14581508 BACKGROUND

• Kelly TL, Neaga OR, Schwahn BC, Rozen R, Trasler JM. Infertility in 5,10-methylenetetrahydrofolate reductase (MTHFR)-deficient male mice is partially alleviated by lifetime dietary betaine supplementation. Biol Reprod. 2005 Mar;72(3):667-77. doi: 10.1095/biolreprod.104.035238. Epub 2004 Nov 17.

  PMID: 15548731 BACKGROUND

• Kim YI, Pogribny IP, Basnakian AG, Miller JW, Selhub J, James SJ, Mason JB. Folate deficiency in rats induces DNA strand breaks and hypomethylation within the p53 tumor suppressor gene. Am J Clin Nutr. 1997 Jan;65(1):46-52. doi: 10.1093/ajcn/65.1.46.

  PMID: 8988912 BACKGROUND

• Koury MJ, Horne DW, Brown ZA, Pietenpol JA, Blount BC, Ames BN, Hard R, Koury ST. Apoptosis of late-stage erythroblasts in megaloblastic anemia: association with DNA damage and macrocyte production. Blood. 1997 Jun 15;89(12):4617-23.

  PMID: 9192787 BACKGROUND

• Kundu TK, Rao MR. CpG islands in chromatin organization and gene expression. J Biochem. 1999 Feb;125(2):217-22. doi: 10.1093/oxfordjournals.jbchem.a022276.

  PMID: 9990116 BACKGROUND

• Lengauer C, Kinzler KW, Vogelstein B. DNA methylation and genetic instability in colorectal cancer cells. Proc Natl Acad Sci U S A. 1997 Mar 18;94(6):2545-50. doi: 10.1073/pnas.94.6.2545.

  PMID: 9122232 BACKGROUND

• Ma J, Stampfer MJ, Giovannucci E, Artigas C, Hunter DJ, Fuchs C, Willett WC, Selhub J, Hennekens CH, Rozen R. Methylenetetrahydrofolate reductase polymorphism, dietary interactions, and risk of colorectal cancer. Cancer Res. 1997 Mar 15;57(6):1098-102.

  PMID: 9067278 BACKGROUND

• Matsushita S, Muramatsu T, Arai H, Matsui T, Higuchi S. The frequency of the methylenetetrahydrofolate reductase-gene mutation varies with age in the normal population. Am J Hum Genet. 1997 Dec;61(6):1459-60. doi: 10.1086/301640. No abstract available.

  PMID: 9399898 BACKGROUND

• Oliva A, Dotta A, Multigner L. Pentoxifylline and antioxidants improve sperm quality in male patients with varicocele. Fertil Steril. 2009 Apr;91(4 Suppl):1536-9. doi: 10.1016/j.fertnstert.2008.09.024. Epub 2008 Nov 5.

  PMID: 18990381 BACKGROUND

• Ravel C, Chantot-Bastaraud S, Chalmey C, Barreiro L, Aknin-Seifer I, Pfeffer J, Berthaut I, Mathieu EE, Mandelbaum J, Siffroi JP, McElreavey K, Bashamboo A. Lack of association between genetic polymorphisms in enzymes associated with folate metabolism and unexplained reduced sperm counts. PLoS One. 2009 Aug 6;4(8):e6540. doi: 10.1371/journal.pone.0006540.

  PMID: 19657388 BACKGROUND

• Rosenberg N, Murata M, Ikeda Y, Opare-Sem O, Zivelin A, Geffen E, Seligsohn U. The frequent 5,10-methylenetetrahydrofolate reductase C677T polymorphism is associated with a common haplotype in whites, Japanese, and Africans. Am J Hum Genet. 2002 Mar;70(3):758-62. doi: 10.1086/338932. Epub 2002 Jan 4.

  PMID: 11781870 BACKGROUND

• Rozen R, Fraser FC, Shaw G. Decreased proportion of female newborn infants homozygous for the 677 C-->T mutation in methylenetetrahydrofolate reductase. Am J Med Genet. 1999 Mar 12;83(2):142-3. doi: 10.1002/(sici)1096-8628(19990312)83:23.0.co;2-y. No abstract available.

  PMID: 10190487 BACKGROUND

• Skjelbred CF, Svendsen M, Haugan V, Eek AK, Clausen KO, Svendsen MV, Hansteen IL. Influence of DNA repair gene polymorphisms of hOGG1, XRCC1, XRCC3, ERCC2 and the folate metabolism gene MTHFR on chromosomal aberration frequencies. Mutat Res. 2006 Dec 1;602(1-2):151-62. doi: 10.1016/j.mrfmmm.2006.08.009. Epub 2006 Sep 25.

  PMID: 16997330 BACKGROUND

• Stegmann K, Ziegler A, Ngo ET, Kohlschmidt N, Schroter B, Ermert A, Koch MC. Linkage disequilibrium of MTHFR genotypes 677C/T-1298A/C in the German population and association studies in probands with neural tube defects(NTD). Am J Med Genet. 1999 Nov 5;87(1):23-9.

  PMID: 10528242 BACKGROUND

• Szymanski W, Kazdepka-Zieminska A. [Effect of homocysteine concentration in follicular fluid on a degree of oocyte maturity]. Ginekol Pol. 2003 Oct;74(10):1392-6. Polish.

  PMID: 14669450 BACKGROUND

• Wong WY, Merkus HM, Thomas CM, Menkveld R, Zielhuis GA, Steegers-Theunissen RP. Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial. Fertil Steril. 2002 Mar;77(3):491-8. doi: 10.1016/s0015-0282(01)03229-0.

  PMID: 11872201 BACKGROUND

• de Ligny W, Smits RM, Mackenzie-Proctor R, Jordan V, Fleischer K, de Bruin JP, Showell MG. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2022 May 4;5(5):CD007411. doi: 10.1002/14651858.CD007411.pub5.

  PMID: 35506389 DERIVED

MeSH Terms

Conditions

Infertility, Male

Interventions

Folic Acid

Condition Hierarchy (Ancestors)

Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Infertility; Male Urogenital Diseases

Intervention Hierarchy (Ancestors)

Pterins; Pteridines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds

Study Officials

• Emmanuelle MATHIEU - D'ARGENT, MD

  TENON Hospital - APHP

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 28, 2011
• First Posted: August 2, 2011
• Study Start: November 1, 2011
• Primary Completion: April 1, 2016
• Study Completion: April 1, 2016
• Last Updated: June 9, 2016

Record last verified: 2016-05

Locations

FR (1)