Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, North Karegar Street, Tehran 1411713135, Iran.
Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):132-7. doi: 10.1016/j.ejogrb.2011.07.006. Epub 2011 Aug 10.
To assess the correlation between the levels of vitamin D in follicular fluid and serum, and to determine whether the level of 25-hydroxyvitamin D (25OH-D) in follicular fluid of infertile women undergoing assisted reproductive technology (ART) is associated with the outcome.
Eighty-two infertile women undergoing ART at an academic tertiary care centre were recruited for a prospective cohort study. Levels of 25OH-D in follicular fluid and serum were measured. Standardized regimens for pituitary downregulation and controlled ovarian hyperstimulation were employed. Patient and cycle parameters, and clinical pregnancy (defined as evidence of intra-uterine gestation sac plus heart rate on ultrasound) were determined.
A significant correlation was found between the levels of vitamin D in follicular fluid and serum (r=0.767, p=0.001). The overall rates of chemical, clinical and ongoing pregnancy were 35.5% (n=29), 29.3% (n=24) and 23.2% (n=19), respectively. No significant difference was found in these pregnancy rates between the tertiles of 25OH-D level in follicular fluid (p=0.959, 0.995 and 0.604, respectively). The median serum level of vitamin D was 8.13 (range 5.37-13.62)ng/ml in the clinically pregnant group and 8.29 (range 5.93-21.23)ng/ml in the non-pregnant group (p=0.235). Interestingly, the median level of vitamin D in follicular fluid was 9.19 (range 5.25-19.51)ng/ml in the clinically pregnant group and 10.34 (range 5.89-29.69)ng/ml in the non-pregnant group (p=0.433). The fertilization rate decreased significantly and the implantation rate increased (not significantly) with increasing tertiles of 25OH-D level in follicular fluid.
The level of 25OH-D in follicular fluid is reflective of body stores of vitamin D. Most subjects in this study were deficient in vitamin D, but this study found that vitamin D deficiency does not play a pivotal role in the outcome of ART.
评估卵泡液和血清中维生素 D 水平之间的相关性，并确定接受辅助生殖技术 (ART) 的不孕妇女卵泡液中 25-羟维生素 D (25OH-D) 的水平是否与结局相关。
本前瞻性队列研究招募了在一家学术性三级保健中心接受 ART 的 82 名不孕妇女。测量卵泡液和血清中 25OH-D 的水平。采用垂体下调和控制性卵巢过度刺激的标准化方案。确定患者和周期参数以及临床妊娠（定义为超声显示宫内妊娠囊加胎心率）。
发现卵泡液和血清中维生素 D 水平之间存在显著相关性（r=0.767，p=0.001）。化学妊娠、临床妊娠和持续妊娠的总发生率分别为 35.5%（n=29）、29.3%（n=24）和 23.2%（n=19）。卵泡液中 25OH-D 水平的三分位数之间这些妊娠率无显著差异（p=0.959、0.995 和 0.604）。临床妊娠组血清维生素 D 中位数为 8.13（范围 5.37-13.62）ng/ml，未妊娠组为 8.29（范围 5.93-21.23）ng/ml（p=0.235）。有趣的是，临床妊娠组卵泡液中维生素 D 的中位数为 9.19（范围 5.25-19.51）ng/ml，未妊娠组为 10.34（范围 5.89-29.69）ng/ml（p=0.433）。随着卵泡液中 25OH-D 水平三分位数的增加，受精率显著下降，而着床率略有增加。
卵泡液中 25OH-D 的水平反映了体内维生素 D 的储存量。本研究中的大多数受试者都存在维生素 D 缺乏，但这项研究发现，维生素 D 缺乏在 ART 结局中并没有起到关键作用。
