EPIGENETICS IN HUMAN INFERTILITY: ALTERED MECHANISMS AND IMPLICATIONS FOR ASSISTED REPRODUCTIVE THERAPY – AN INTEGRATIVE REVIEWANISMS AND IMPLICATIONS FOR ASSISTED REPRODUCTIVE THERAPY – AN INTEGRATIVE REVIEW
Abstract
Infertility affects between 8% and 12% of couples, presenting as an idiopathic condition without a cause defined by conventional exams. Epigenetics emerges as a pillar for understanding these failures, regulating gene expression via chemical modifications, such as DNA methylation and changes in organizing proteins, which do not modify the sequence of the genetic code. This integrative review, based on the Whittemore and Knafl protocol, analyzed 25 studies published in the period from 2014 to 2026. The assessment of methodological quality, conducted by standardized instruments such as SANRA and Newcastle Ottawa, revealed a predominance of narrative reviews of 44% and studies with small samples, which imposes restrictions on the statistical strength of the proposed biomarkers. The results point out that molecular failures in the H19 and MEST genes are present in up to 50% of male cases without a cause, while alterations in the HOXA10 gene compromise the ability of the uterus to receive the embryo. However, the critical analysis of the authors indicates that the clinical magnitude and reproducibility of these results in populations are uncertain due to the lack of universal reference values. Although molecular mapping is promising for future precision medicine, these tests still have an experimental character and face barriers of high cost and low clinical applicability. It is concluded that, although molecular surveillance is fundamental for the safety of assisted reproduction techniques, the transition to the office must be cautious, prioritizing lifestyle interventions that can partially reverse unwanted marks before the start of therapies.
Author Biographies
Medical Student at the University of Gurupi (UNIRG), Brazil.
Medical Student at the University of Gurupi (UNIRG), Brazil.
Medical Student at the University of Gurupi (UNIRG), Brazil.
Medical Student at the University of Gurupi (UNIRG), Brazil.
Medical Student at the University of Gurupi (UNIRG), Brazil.
Discente de medicina pela Universidade de Gurupi (UNIRG).
Bachelor's Degree in Biochemical Pharmacy from Paulista University (UNIP). Medical Student at the University of Gurupi (UNIRG), Brazil.
Mestre em Ensino de Biologia pela Universidade de Brasília (UNB). Docente de Genética médica do curso de Medicina. Universidade de Gurupi (UNIRG).
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