Creatine Metabolism in Female Reproduction, Pregnancy and Newborn Health

Creatine metabolism is an important component of cellular energy homeostasis. Via the creatine kinase circuit, creatine derived from our diet or synthesized endogenously provides spatial and temporal maintenance of intracellular adenosine triphosphate (ATP) production; this is particularly important for cells with high or fluctuating energy demands. The use of this circuit by tissues within the female reproductive system, as well as the placenta and the developing fetus during pregnancy is apparent throughout the literature, with some studies linking perturbations in creatine metabolism to reduced fertility and poor pregnancy outcomes. Maternal dietary creatine supplementation during pregnancy as a safeguard against hypoxia-induced perinatal injury, particularly that of the brain, has also been widely studied in pre-clinical in vitro and small animal models. However, there is still no consensus on whether creatine is essential for successful reproduction. This review consolidates the available literature on creatine metabolism in female reproduction, pregnancy and the early neonatal period. Creatine metabolism is discussed in relation to cellular bioenergetics and de novo synthesis, as well as the potential to use dietary creatine in a reproductive setting. We highlight the apparent knowledge gaps and the research road forward to understand, and then utilize, creatine to improve reproductive health and perinatal outcomes.

Automated summary

Creatine metabolism plays a crucial role in maintaining cellular energy homeostasis, particularly in tissues with high or fluctuating energy demands. Studies have linked perturbations in creatine metabolism to reduced fertility and poor pregnancy outcomes. While maternal dietary creatine supplementation has shown potential benefits in protecting against perinatal injury, there is still a lack of consensus on its essentiality for successful reproduction. Further research is needed to better understand and utilize creatine to improve reproductive health and perinatal outcomes.