Dressler N, Chandra A, Aguirre Dávila L, Spineli L M, Schippert C, von Versen-Höynck F
Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
Center for Reproductive Medicine Bad Münder, Hannoversche Straße 24, 31848, Bad Münder, Germany.
Arch Gynecol Obstet. 2016 Apr;293(4):907-14. doi: 10.1007/s00404-015-3950-4. Epub 2015 Nov 16.
Animal and human studies suggest that vitamin D regulates functions of the reproductive system. Vitamin D deficiency is prevalent in women of reproductive age. Vitamin D status has been associated with in vitro fertilisation outcome, features of polycystic ovarian syndrome (PCOS) and endometriosis. The aims of our study were to investigate the prevalence of vitamin D deficiency of infertile women living in central Germany, to identify risk factors for vitamin D deficiency and to specify seasonal variations of vitamin D status.
This was a retrospective cohort study at an academic tertiary care centre (N = 113) and an Outpatient Centre for Reproductive Medicine (N = 193) of women presenting for infertility treatment. The statistical evaluation was descriptive and explorative. Possible risk factors associated with an increased risk for vitamin D deficiency were assessed using multiple logistic regression models. Variables with p value less than 0.05 were further assessed in a multivariable logistic regression model.
Overall, 98.2 % of patients at centre 1 and 81.3 % of women with impaired fertility at centre 2 had deficient or insufficient vitamin D levels. Overweight BMI and limited exposure to sun (winter, spring and autumn trimester) were associated with an increased risk of vitamin D deficiency. Vitamin D levels did not vary according to age or infertility associated disorders (e.g. endometriosis, PCOS).
The rate of vitamin D deficiency among women with impaired fertility is alarming. Prospective studies are pressingly needed to confirm a causal relationship and to investigate the potential therapeutic benefits of vitamin D supplementation in this population.
动物和人体研究表明,维生素D可调节生殖系统功能。维生素D缺乏在育龄女性中普遍存在。维生素D状态与体外受精结局、多囊卵巢综合征(PCOS)及子宫内膜异位症特征相关。我们研究的目的是调查居住在德国中部的不孕女性维生素D缺乏的患病率,确定维生素D缺乏的风险因素,并明确维生素D状态的季节性变化。
这是一项在一家学术三级护理中心(N = 113)和一家生殖医学门诊中心(N = 193)对前来接受不孕治疗的女性进行的回顾性队列研究。统计评估为描述性和探索性的。使用多元逻辑回归模型评估与维生素D缺乏风险增加相关的可能风险因素。p值小于0.05的变量在多变量逻辑回归模型中进一步评估。
总体而言,中心1的98.2%患者和中心2生育能力受损的女性中有81.3%维生素D水平不足或缺乏。超重的体重指数和有限的日照(冬季、春季和秋季孕期)与维生素D缺乏风险增加相关。维生素D水平不因年龄或不孕相关疾病(如子宫内膜异位症、PCOS)而有所不同。
生育能力受损女性中维生素D缺乏率令人担忧。迫切需要进行前瞻性研究以证实因果关系,并调查补充维生素D对该人群的潜在治疗益处。