School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Bentley WA 6845, Australia; PIVET Medical Centre, Leederville, Perth WA 6007, Australia.
PIVET Medical Centre, Leederville, Perth WA 6007, Australia.
Reprod Biomed Online. 2020 Dec;41(6):1101-1111. doi: 10.1016/j.rbmo.2020.08.014. Epub 2020 Aug 21.
To determine the relationship between vitamin D (VitD) status and embryological, clinical pregnancy and live birth outcomes in women undergoing IVF.
Cross-sectional, observational study conducted at a university-affiliated private IVF clinic. A total of 287 women underwent 287 IVF cycles and received a fresh embryo transfer. Patients had their serum 25-hydroxyvitamin D2/D3 (VitD) determined on the day of oocyte retrieval, which was analysed in relation to blastocyst development rate, clinical pregnancy and live birth outcomes.
In stepwise, multivariable logistic regression models, increases in blastocyst development rate, number and quality, along with embryo cryopreservation and utilization rates were associated with women with a sufficient VitD status (≥20 ng/ml). For a single increase in the number of blastocysts generated per cycle or embryos cryopreserved per cycle, the likelihood for the patient to be VitD sufficient was increased by 32% (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.10-1.58, P = 0.002 and OR 1.33, 95% CI 1.10-1.60, P = 0.004, respectively). Clinical pregnancy (40.7% versus 30.8%, P = 0.086) and live birth rates (32.9% versus 25.8%, P = 0.195) in the sufficient VitD group versus the insufficient group were not significantly different and VitD sufficiency was not significantly associated with these outcomes.
A strong relationship was observed between blastocyst development and VitD sufficiency. However, there was no association between VitD and clinical pregnancy or live birth outcomes. Further larger studies are needed to investigate whether the observed effect on blastocyst development may have downstream implications on subsequent clinical pregnancy or live birth rates, and on a potential mechanism where sufficient VitD concentrations are linked to improved IVF outcomes.
确定维生素 D(VitD)状态与接受体外受精的女性胚胎发生、临床妊娠和活产结局之间的关系。
在一所大学附属的私立 IVF 诊所进行的横断面、观察性研究。共有 287 名女性接受了 287 个 IVF 周期,并进行了新鲜胚胎移植。患者在取卵当天测定血清 25-羟维生素 D2/D3(VitD),分析其与囊胚发育率、临床妊娠和活产结局的关系。
在逐步、多变量逻辑回归模型中,囊胚发育率、数量和质量的增加,以及胚胎冷冻保存和利用率与 VitD 状态充足(≥20ng/ml)的女性相关。对于每个周期生成的囊胚数量或每个周期冷冻保存的胚胎数量的单一增加,患者 VitD 充足的可能性增加 32%(优势比[OR]1.32,95%置信区间[CI]1.10-1.58,P=0.002 和 OR 1.33,95%CI 1.10-1.60,P=0.004)。充足 VitD 组与不足组的临床妊娠率(40.7%对 30.8%,P=0.086)和活产率(32.9%对 25.8%,P=0.195)无显著差异,VitD 充足与这些结局无显著相关性。
观察到囊胚发育与 VitD 充足之间存在很强的关系。然而,VitD 与临床妊娠或活产结局之间没有关联。需要进一步进行更大规模的研究,以调查观察到的对囊胚发育的影响是否对随后的临床妊娠或活产率有影响,以及 VitD 浓度充足与改善 IVF 结局之间是否存在潜在机制。