Follicular fluid 25-hydroxyvitamin D levels determine fertility outcome in patients with polycystic ovary syndrome.

OBJECTIVE

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.