Fabris Alberta, Pacheco Alberto, Cruz María, Puente Jose Manuel, Fatemi Human, Garcia-Velasco Juan A
IVI-Madrid, Rey Juan Carlos University, Madrid, Spain.
Nova IVI Fertility, Abu Dhabi, United Arab Emirates.
Fertil Steril. 2014 Dec;102(6):1608-12. doi: 10.1016/j.fertnstert.2014.08.030. Epub 2014 Sep 23.
To investigate the correlation between total and bioavailable serum 25-OH vitamin D and the pregnancy rate in recipients of donated oocytes.
Retrospective study.
University-affiliated private IVF center.
PATIENT(S): A total of 267 patients who were referred to our clinic for oocyte donation from June 2013 to December 2013.
INTERVENTION(S): Serum analysis of vitamin D and bioavailable vitamin D and reproductive outcomes.
MAIN OUTCOME MEASURE(S): Pregnancy and implantation rate.
RESULT(S): Among all patients, 15.3% (n = 41) were vitamin D replete (vitamin D >30 ng/mL), 50.2% (n = 134) had vitamin D deficiency (20-30 ng/mL), and 34.4% (n = 92) had insufficient vitamin D (<20 ng/mL). Implantation rates were similar among patients with normal, insufficient, or deficient total serum 25-OH vitamin D levels (61%, 63.4%, and 65.2%, respectively). Pregnancy rates did not differ among the three groups (70%, 69.9%, and 73.9%). Ongoing pregnancy rates were also comparable among the three groups (55.9%, 52.7%, and 60.7%). The predictive value of total vitamin D regarding pregnancy rate was analyzed by the receiver operating characteristic curve, and the area under the curve (AUC) was 0.468. The AUC for bioavailable 25-OH vitamin D was 0.499, showing that the analysis of the AUC for vitamin D or bioavailable vitamin D was not informative.
CONCLUSION(S): Vitamin D insufficiency and deficiency are frequent conditions in our southern European infertile population. In contrast to previous studies, patients who are not vitamin D replete do not have a decreased chance of becoming pregnant with egg donation. Bioavailable 25-OH vitamin D, which is a better marker of the status than total 25-OH vitamin D, does not correlate with pregnancy rate in recipients of donated oocytes. Thus, at this stage, there is insufficient evidence to recommend vitamin D screening in patients undergoing egg donation.
探讨血清总25-羟维生素D及生物活性25-羟维生素D水平与接受赠卵者妊娠率之间的相关性。
回顾性研究。
大学附属私立体外受精中心。
2013年6月至2013年12月期间转诊至我院接受赠卵的267例患者。
维生素D及生物活性维生素D的血清分析及生殖结局评估。
妊娠率及着床率。
所有患者中，15.3%（n = 41）维生素D充足（维生素D>30 ng/mL），50.2%（n = 134）维生素D缺乏（20 - 30 ng/mL），34.4%（n = 92）维生素D不足（<20 ng/mL）。血清总25-羟维生素D水平正常、不足或缺乏的患者着床率相似（分别为61%、63.4%和65.2%）。三组患者的妊娠率无差异（分别为70%、69.9%和73.9%）。三组的持续妊娠率也相当（分别为55.9%、52.7%和60.7%）。通过受试者工作特征曲线分析总维生素D对妊娠率的预测价值，曲线下面积（AUC）为0.468。生物活性25-羟维生素D的AUC为0.499，表明维生素D或生物活性维生素D的AUC分析无信息量。
维生素D不足和缺乏在我们南欧不孕人群中很常见。与以往研究不同的是，维生素D不充足的患者接受赠卵后怀孕几率并未降低。生物活性25-羟维生素D作为比总25-羟维生素D更好的状态标志物，与接受赠卵者的妊娠率无关。因此，现阶段尚无足够证据推荐对接受赠卵的患者进行维生素D筛查。
