Istanbul IVF-Center, Istanbul, Turkey.
Vocational School of Health Services, Beykent University, Istanbul, Turkey.
Taiwan J Obstet Gynecol. 2022 Jul;61(4):620-625. doi: 10.1016/j.tjog.2022.03.041.
To determine the possible relationship between follicular fluid 25-hydroxyvitamin D [25(OH)D] levels and fertility outcome of women who underwent IVF/ICSI with the diagnosis of lean polycystic ovary syndrome.
Thirty patients who were diagnosed with PCOS according to the Rotterdam criteria and decided on IVF/ICSI were included in the study. Thirty patients who were scheduled for IVF/ICSI for reasons other than PCOS and matched in terms of age and BMI were taken as the control group (non-PCOS). According to BMI values, patients in both PCOS and non-PCOS groups were lean. Women in both groups were aged 21-35 years with a normal BMI (18.5-24.9 kg/m2) and first IVF/ICSI attempt. Both groups of patients were followed up using the antagonist protocol. Vit D levels were measured in serum and follicular fluid (FF) samples taken on the day of oocyte collection. The correlation between FF vit D levels, the number of total oocytes, MII oocytes and 2 PN zygotes, HOMA-IR, hormonal and demographic parameters, clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate were evaluated.
At the time of oocyte retrieval women with PCOS had similar serum Vitamin D compared to non-PCOS women (21.8 (12.6-24.8) ng/ml vs 22.3 (11.5-25.1) ng/ml, p < 0.54). In FF, assessed on the day of oocyte retrieval, the concentration of Vitamin D was similar in women with PCOS when compared to non-PCOS women (11.2 (9.2-14.4) ng/ml vs 13.3 (11.1-17.4) ng/ml, p < 0.06). For both groups, Vitamin D levels were lower in FF compared to serum vit D. A positive correlation was found between serum and FF Vitamin D concentrations in the full cohort. A positive and significant correlation was found between FF-vit D levels and the number of total oocyte (r = 0.344, p < 0.04) and MII oocyte (r = 0.404, p < 0.02) in the PCOS group. The number of total oocyte, MII oocyte and 2 PN zygotes of the PCOS group were significantly higher than the non-PCOS group. Positive pregnancy test rate, clinical pregnancy and live birth rates were similar in both groups. The miscarriage rates in the non-PCOS group were significantly higher than in the PCOS group. A positive and significant correlation was also found between FF vit D levels and positive pregnancy test (r = 0.566, p < 0.03) and CPR (r = 0.605, p < 0.02) in PCOS group. There was no correlation between FF-vit D levels and live birth and miscarriage rates in neither the PCOS nor the non-PCOS group.
Both serum and FF 25-hydroxyvitamin D level of women with PCOS at the time of oocyte retrieval are similar to non-PCOS controls. While FF 25-hydroxyvitamin D levels correlate with total and MII oocyte counts, positive pregnancy test and CPR, it does not correlate with miscarriage and live birth rates.
确定接受体外受精/卵胞浆内单精子注射（IVF/ICSI）的诊断为瘦多囊卵巢综合征（PCOS）的女性的卵泡液 25-羟维生素 D [25(OH)D]水平与生育结局之间可能存在的关系。
纳入了 30 名根据鹿特丹标准诊断为 PCOS 并决定进行 IVF/ICSI 的患者。选择了 30 名因非 PCOS 原因而计划进行 IVF/ICSI 且年龄和 BMI 匹配的患者作为对照组（非 PCOS）。根据 BMI 值，PCOS 和非 PCOS 组的患者均为瘦体型。两组患者的年龄均为 21-35 岁，BMI 正常（18.5-24.9 kg/m2），并首次进行 IVF/ICSI。两组患者均采用拮抗剂方案进行随访。在取卵日抽取血清和卵泡液（FF）样本测量 Vit D 水平。评估 FF vit D 水平与总卵母细胞数、MII 卵母细胞数和 2PN 受精卵数、HOMA-IR、激素和人口统计学参数、临床妊娠率（CPR）、活产率（LBR）和流产率之间的相关性。
在取卵时，PCOS 患者的血清维生素 D 水平与非 PCOS 患者相似（21.8（12.6-24.8）ng/ml 与 22.3（11.5-25.1）ng/ml，p < 0.54）。在 FF 中，在取卵日评估时，PCOS 患者的 Vit D 浓度与非 PCOS 患者相似（11.2（9.2-14.4）ng/ml 与 13.3（11.1-17.4）ng/ml，p < 0.06）。对于两组，FF 中的 Vit D 水平均低于血清 vit D。在整个队列中发现血清和 FF 维生素 D 浓度之间存在正相关。在 PCOS 组中，FF-vit D 水平与总卵母细胞数（r = 0.344，p < 0.04）和 MII 卵母细胞数（r = 0.404，p < 0.02）呈正相关。PCOS 组的总卵母细胞数、MII 卵母细胞数和 2PN 受精卵数明显高于非 PCOS 组。两组的阳性妊娠试验率、临床妊娠率和活产率相似。非 PCOS 组的流产率明显高于 PCOS 组。在 PCOS 组中，FF vit D 水平与阳性妊娠试验（r = 0.566，p < 0.03）和 CPR（r = 0.605，p < 0.02）之间也存在正相关。在 PCOS 组和非 PCOS 组中，FF-vit D 水平与活产率和流产率均无相关性。
取卵时 PCOS 患者的血清和 FF 25-羟维生素 D 水平与非 PCOS 对照组相似。虽然 FF 25-羟维生素 D 水平与总卵母细胞数和 MII 卵母细胞数、阳性妊娠试验和 CPR 相关，但与流产率和活产率无关。
