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Maternal folate metabolism and the survival of a trisomic DS embryo For what instead concerns the possibility that a trisomic DS embryo will survive up to the birth, a complex maternal-embryonic interaction involving folate metabolism was proposed (Martnez-Fras et al., 2006): Particularly, since many genes involved in folate metabolism map to chromosome 21, including RFC1 , CBS , and others, it was hypothesized that embryos with full trisomy 21 might have a different folate demand than normal embryos, and that maternal folate intake during pregnancy, maternal genotype for genes of the folate metabolic pathway, as well as genotype and expression levels of folate pathway genes mapping to chromosome 21 in the DS embryo, could interact to determine death in utero or survival up to the birth (Martnez-Fras et al., 2006) (Figure 2)

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The titration schedule follows the same pattern, but the clinical context differs

It does not cause big changes in other pituitary hormones