Although MTHFR polymorphisms and/or hyperhomocysteinemia are strongly associated with cardiovascular risk and adverse pregnancy outcomes, studies have shown that lowering Hcy levels by increasing folic acid intake is not necessarily effective in reducing the risk of adverse outcomes, or may even yield opposite results, suggesting that other factors may interfere with folate metabolism pathway and influence its downstream effects (25–28). Here, MTHFR is linked to hyperhomocysteinemia.