Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, People's Republic of China.
Department of Obstetrics and Gynecology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
Arch Gynecol Obstet. 2022 Feb;305(2):505-517. doi: 10.1007/s00404-021-06174-9. Epub 2021 Aug 8.
To assess the relationship between serum/follicular fluid (FF) vitamin D (VD) status and assisted reproductive technology (ART) treatment outcomes among infertile patients.
A prospective cohort study, including 132 infertile patients scheduled for their first ART treatment cycle, was carried out in a Reproductive Medical Center. Serum and FF samples were collected to assess 25-hydroxy VD [25(OH)D] levels. Low VD level was defined as 25(OH)D concentration of less than 30 ng/mL.
Most infertile patients had low VD levels in serum (88%) and FF (90%). We observed a moderately positive correlation between VD levels in serum and FF (r = 0.34, p < 0.0001). Compared to the group of patients with low VD levels in the FF, those with sufficient VD levels had a significantly higher number of retrieved oocytes (p = 0.03), normal fertilization (p = 0.01), and high-quality embryos (p = 0.001). Moreover, patients with sufficient VD levels in the FF also had significantly higher implantation rates than those with low VD levels (76.92% vs. 46.58%, respectively, p = 0.01) and clinical pregnancy rates (92.31% vs. 61.54%, respectively, p = 0.04).
These data collectively revealed that low VD levels in serum and FF were common among infertile patients. VD levels in FF, but not in serum, were associated with embryo quality, normal fertilization, implantation rates, and clinical pregnancy rates. Further studies are mandatory to determine the molecular mechanism and VD's potential therapeutic benefits in infertile patients.
评估血清/卵泡液（FF）维生素 D（VD）状态与不孕患者辅助生殖技术（ART）治疗结局之间的关系。
进行了一项前瞻性队列研究，纳入了 132 名计划进行首次 ART 治疗周期的不孕患者，研究地点在生殖医学中心。采集血清和 FF 样本以评估 25-羟维生素 D [25（OH）D] 水平。低 VD 水平定义为 25（OH）D 浓度低于 30ng/ml。
大多数不孕患者的血清（88%）和 FF（90%）中 VD 水平较低。我们观察到血清和 FF 中的 VD 水平之间存在中度正相关（r=0.34，p<0.0001）。与 FF 中 VD 水平较低的患者相比，VD 水平充足的患者的获卵数（p=0.03）、正常受精（p=0.01）和优质胚胎（p=0.001）显著更高。此外，FF 中 VD 水平充足的患者的胚胎着床率（76.92% vs. 46.58%，分别，p=0.01）和临床妊娠率（92.31% vs. 61.54%，分别，p=0.04）也显著更高。
这些数据表明，不孕患者的血清和 FF 中普遍存在低 VD 水平。FF 中的 VD 水平，而不是血清中的 VD 水平，与胚胎质量、正常受精、胚胎着床率和临床妊娠率有关。需要进一步的研究来确定 VD 在不孕患者中的分子机制和潜在治疗益处。
