Abadia Laura, Gaskins Audrey J, Chiu Yu-Han, Williams Paige L, Keller Myra, Wright Diane L, Souter Irene, Hauser Russ, Chavarro Jorge E
Departments of Nutrition.
Departments of Nutrition, Epidemiology.
Am J Clin Nutr. 2016 Sep;104(3):729-35. doi: 10.3945/ajcn.115.126359. Epub 2016 Jul 27.
Vitamin D deficiency impairs fertility in animal models, but the role of vitamin D in human fertility or treatment of infertility is less clear.
We examined the association between circulating 25-hydroxyvitamin D [25(OH)D] concentrations and the outcome in women undergoing assisted reproduction technologies (ARTs).
We randomly selected 100 women undergoing infertility treatment with ART enrolled in an ongoing prospective cohort study who underwent 168 treatment cycles. Serum 25(OH)D concentrations were measured in samples collected from women between days 3 and 9 of gonadotropin treatment. Generalized linear mixed models were used to evaluate the association of 25(OH)D concentrations with ART outcomes while adjusting for potential confounders and accounting for repeated treatment cycles per woman.
Median (range) serum 25(OH)D concentrations were 86.5 (33.5-155.5) nmol/L. Ninety-one percent of participants consumed multivitamins. Serum 25(OH)D concentrations were positively related to fertilization rate. The adjusted fertilization rate for women in increasing quartiles of serum 25(OH)D were 0.62 (95% CI: 0.51, 0.72), 0.53 (95% CI: 0.43, 0.63), 0.67 (95% CI: 0.56, 0.76), and 0.73 (95% CI: 0.63, 0.80), respectively (P-trend = 0.03). This association persisted when analyses were restricted to women with serum 25(OH)D between 50 and 125 nmol/L when models were further adjusted for season of blood draw and when analyses were restricted to the first treatment cycle. However, 25(OH)D concentrations were unrelated to probability of pregnancy (P-trend = 0.83) or live birth after ART (P-trend = 0.47).
Vitamin D may be associated with higher fertilization rates, but this apparent benefit does not translate into higher probability of pregnancy or live birth. This trial was registered at www.clinicaltrials.gov as NCT00011713.
维生素D缺乏会损害动物模型的生育能力，但维生素D在人类生育或不孕症治疗中的作用尚不清楚。
我们研究了循环25-羟基维生素D[25(OH)D]浓度与接受辅助生殖技术（ART）的女性结局之间的关联。
我们从一项正在进行的前瞻性队列研究中随机选择了100名接受ART不孕症治疗的女性，她们经历了168个治疗周期。在促性腺激素治疗第3至9天采集的女性样本中测量血清25(OH)D浓度。使用广义线性混合模型评估25(OH)D浓度与ART结局的关联，同时调整潜在混杂因素并考虑每位女性的重复治疗周期。
血清25(OH)D浓度中位数（范围）为86.5（33.5 - 155.5）nmol/L。91%的参与者服用多种维生素。血清25(OH)D浓度与受精率呈正相关。血清25(OH)D四分位数增加的女性调整后的受精率分别为0.62（95%CI：0.51，0.72）、0.53（95%CI：0.43，0.63）、0.67（95%CI：0.56，0.76）和0.73（95%CI：0.63，0.80）（P趋势 = 0.03）。当分析仅限于血清25(OH)D在50至125 nmol/L之间的女性时，当模型进一步调整采血季节时，以及当分析仅限于第一个治疗周期时，这种关联仍然存在。然而，25(OH)D浓度与妊娠概率（P趋势 = 0.83）或ART后的活产概率（P趋势 = 0.47）无关。
维生素D可能与较高的受精率相关，但这种明显的益处并未转化为更高的妊娠概率或活产概率。该试验在www.clinicaltrials.gov上注册为NCT00011713。
