Comparison of Blood Homocysteine Levels in Women with Unexplained Infertility and Women with Normal fertility

Background: Subfertility affects approximately 15% of couples globally, with unexplained infertility being a common diagnosis. Homocysteine, a sulfur-containing amino acid, has been implicated in reproductive health, but its association with unexplained infertility remains unclear. Aim: This observational case–control study aimed to compare homocysteine levels among women with unexplained infertility and those with normal fertility. Methods: Fifty women with unexplained infertility and fifty controls matched for age and BMI were recruited. Homocysteine levels were measured using venous blood samples collected after overnight fasting. Statistical analysis included independent t-tests, ROC (receiver operating characteristic) curve analysis, and odds ratio calculations. Results: Women with unexplained infertility had significantly higher mean homocysteine levels compared to controls (15.05 ± 2.4 vs. 9.2 ± 2.3 μmol/L, p < 0.001). The ROC analysis showed a cutoff value of 12.3 μmol/L, with a sensitivity of 92.0% and a specificity of 99.9%. The odds ratio for unexplained infertility with homocysteine levels >12.3 μmol/L was 180.16 (p < 0.001). Discussion: The findings are consistent with previous studies, suggesting elevated homocysteine levels as a potential biomarker for unexplained infertility. The high discriminatory power of homocysteine levels indicates its potential diagnostic utility in identifying women at risk for unexplained infertility. Conclusion: Determination of homocysteine levels may be helpful in diagnosing unexplained infertility, providing a cost-effective biomarker to guide treatment strategies and optimize resource utilization in fertility care. Further research could explore interventions that target homocysteine levels to improve fertility outcomes in affected women.