Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.
Andrology. 2020 Sep;8(5):1277-1286. doi: 10.1111/andr.12818. Epub 2020 Jun 3.
Vitamin D insufficiency/deficiency is highly prevalent in China, but its effect on sperm quality and outcomes of assisted reproductive technology (ART) in men from infertile couples is not clear. This study aimed to explore the association of serum 25-hydroxyvitamin D (25OHD) levels and semen parameters, as well as ART outcomes for men from infertile couples.
This study recruited 1308 men from infertile couples who attended the Reproductive Medicine Center of Peking University Third Hospital for first time from February to August 2019 (NCT03804294). Reproductive hormones levels, semen parameters, and clinical outcomes of ART were compared between vitamin D-deficient group (serum 25OHD ≤ 10 ng/mL), insufficient group (serum 25OHD 10-20 ng/mL), and sufficient group (serum 25OHD ≥ 20 ng/mL).
We found 27.7% of participants were vitamin D sufficient, suggesting high prevalence of vitamin D insufficiency/deficiency in China. Reproductive hormone levels were similar between the three groups. The total number of morphologically normal spermatozoa was significantly different between the three groups in all participants, impaired semen quality subgroup, and normozoospermia subgroup (P < .05) with the adjustment of confounders (age, BMI, alcohol consumption, cigarette smoking, and physical exercise). The percentage of normal sperm morphology significantly increased with elevated serum 25OHD levels in all participants and the participants with impaired semen quality (P < .05), and the total sperm count showed significant difference in participants with impaired semen quality (P = .026). For routine in vitro fertilization and intracytoplasmic sperm injection cycles, there were no differences in fertilization rate, top-quality embryo rate, biochemical pregnancy rate, and clinical pregnancy rate between serum 25OHD < 20 ng/mL and serum 25OHD ≥ 20 ng/mL groups.
Males of infertile couples with higher serum 25OHD levels exhibit better results in sperm morphology, and serum 25OHD levels may contribute to total sperm number in participants with impaired semen quality, but show no effects on the ART outcomes.
维生素 D 不足/缺乏在中国非常普遍，但它对不孕夫妇中男性的精子质量和辅助生殖技术（ART）结果的影响尚不清楚。本研究旨在探讨血清 25-羟维生素 D（25OHD）水平与精液参数以及不孕夫妇中男性 ART 结果之间的关系。
本研究纳入了 2019 年 2 月至 8 月期间首次到北京大学第三医院生殖医学中心就诊的 1308 名不孕夫妇中的男性（NCT03804294）。比较了维生素 D 缺乏组（血清 25OHD≤10ng/ml）、不足组（血清 25OHD10-20ng/ml）和充足组（血清 25OHD≥20ng/ml）的生殖激素水平、精液参数和 ART 临床结局。
我们发现 27.7%的参与者维生素 D 充足，表明中国维生素 D 不足/缺乏的发生率很高。三组的生殖激素水平相似。在所有参与者、精液质量受损亚组和正常精子亚组中，形态正常精子总数存在显著差异（P<.05），且调整了混杂因素（年龄、BMI、饮酒、吸烟和体育锻炼）后仍有显著差异。在所有参与者和精液质量受损者中，随着血清 25OHD 水平的升高，正常精子形态的比例显著增加（P<.05），而在精液质量受损者中，总精子计数也有显著差异（P=.026）。对于常规体外受精和胞浆内精子注射周期，血清 25OHD<20ng/ml 组和血清 25OHD≥20ng/ml 组之间的受精率、优质胚胎率、生化妊娠率和临床妊娠率均无差异。
血清 25OHD 水平较高的不孕夫妇男性的精子形态结果更好，血清 25OHD 水平可能与精液质量受损者的总精子数有关，但对 ART 结果无影响。
