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维生素 D 补充对受精结局的影响:5 项随机对照试验的试验序贯荟萃分析。

Effect of Vitamin D Supplementation on Fertilization Outcomes: A Trial Sequential Meta-Analysis of 5 Randomized Controlled Trials.

机构信息

Reproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.

Department of Reproductive Medicine, The First People's Hospital of Yunnan Province, Kunming, China.

出版信息

Front Endocrinol (Lausanne). 2022 Mar 17;13:852428. doi: 10.3389/fendo.2022.852428. eCollection 2022.

Abstract

Despite numerous studies indicating an imperative role of vitamin D for reproduction, the importance of vitamin D supplementation on fertilization (IVF) outcomes remains controversial. We therefore performed this meta-analysis to investigate the IVF outcomes of vitamin D supplementation in infertile women with vitamin D deficiency. We systematically searched PubMed, Embase and the Cochrane library for identifying all relevant studies published before August 2021. Pregnancy rate was defined as the primary outcome while good quality embryo, fertilization rate, ongoing pregnancy, and miscarriage were secondary outcomes. We used Review Manager 5.3 (RevMan) to conduct meta-analysis and examined the robustness of the primary outcome by trial sequential analysis. Five studies were included in the final analysis and it suggested that vitamin D supplementation was associated with improved chemical pregnancy rate (risk ratio [RR] = 1.53, 95% confidence interval [CI] = 1.06 to 2.20, p = 0.02) but not benefited in improving clinical pregnancy rate (RR = 1.34, 95% CI = 0.81 to 2.24, p = 0.25) and all secondary outcomes. Trial sequential analysis suggested further studies are needed to confirm this conclusion. We concluded that vitamin D supplementation should be prescribed to improve chemical pregnancy in infertile women with vitamin D deficiency and more studies are required to further confirm this finding.

摘要

尽管有大量研究表明维生素 D 对生殖至关重要,但维生素 D 补充剂对体外受精 (IVF) 结局的重要性仍存在争议。因此,我们进行了这项荟萃分析,以调查维生素 D 缺乏的不孕女性补充维生素 D 对 IVF 结局的影响。我们系统地检索了 PubMed、Embase 和 Cochrane 图书馆,以确定截至 2021 年 8 月之前发表的所有相关研究。妊娠率定义为主要结局,而优质胚胎、受精率、持续妊娠和流产为次要结局。我们使用 Review Manager 5.3 (RevMan) 进行荟萃分析,并通过试验序贯分析检查主要结局的稳健性。最终有 5 项研究纳入了分析,结果表明维生素 D 补充与提高化学妊娠率相关(风险比 [RR] = 1.53,95%置信区间 [CI] = 1.06 至 2.20,p = 0.02),但对改善临床妊娠率没有益处(RR = 1.34,95% CI = 0.81 至 2.24,p = 0.25)和所有次要结局。试验序贯分析表明,需要进一步的研究来证实这一结论。我们得出结论,维生素 D 补充剂应该开给维生素 D 缺乏的不孕女性,以提高化学妊娠率,需要进一步的研究来进一步证实这一发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f58c/8969598/ce2eedbcb5e8/fendo-13-852428-g001.jpg

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