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维生素 D 与体外受精:系统评价。

Vitamin D and in vitro fertilization: a systematic review.

机构信息

Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, Cerqueira César, São Paulo, 05403-000, Brazil.

出版信息

J Assist Reprod Genet. 2023 Apr;40(4):735-743. doi: 10.1007/s10815-023-02767-2. Epub 2023 Mar 8.

Abstract

PURPOSE

Vitamin D (VD) action on calcium is well known, but its other properties, particularly in the human reproductive system, are not completely understood. This review aims at assessing the relationship between serum VD levels and IVF results.

METHODS

A systematic review was carried out using MEDLINE, EMBASE, LILACS, Google scholar, the CAPES journal portal, and the Cochrane Library, as well as the descriptors "vitamin D" and "fertilization in vitro." The review was conducted by two authors following the PRISMA recommendations between September 2021 and February 2022.

RESULTS

Eighteen articles were selected. Five of them showed a positive correlation between serum VD levels and IVF results, 12 lacked any association, and 1 exhibited a negative correlation. The 3 studies that assessed VD in the follicular fluid found a positive correlation between the serum and follicular levels. Non-Hispanic White patients seemed to suffer the consequence of vitamin D deficiency more than Asian patients. In one study alone in the VD-deficient group, there was a larger number of natural killer (NK) cells, B cells, a greater proportion of helper T cells/cytotoxic T cells (Th/Tc), and an association with a smaller number of mature oocytes.

CONCLUSION

The association between serum VD levels and the post-IVF pregnancy rate is uncertain. However, VD levels might be more relevant in the White than in the Asian ethnicity and in the number of aspiration follicles, and they could act in the immune system having an impact both on embryo implantation and on pregnancy.

摘要

目的

维生素 D(VD)对钙的作用是众所周知的,但它的其他特性,特别是在人类生殖系统中的作用,还不完全清楚。本综述旨在评估血清 VD 水平与体外受精(IVF)结果之间的关系。

方法

我们使用 MEDLINE、EMBASE、LILACS、Google 学术、巴西 CAPES 期刊门户和 Cochrane 图书馆,以及“维生素 D”和“体外受精”这两个主题词,对 2021 年 9 月至 2022 年 2 月期间的文献进行了系统性综述。由两名作者按照 PRISMA 建议进行综述。

结果

共选择了 18 篇文章。其中 5 篇文章显示血清 VD 水平与 IVF 结果呈正相关,12 篇文章缺乏任何关联,1 篇文章呈负相关。在评估卵泡液中 VD 的 3 项研究中,发现血清和卵泡液水平之间存在正相关。非西班牙裔白人患者似乎比亚洲患者更容易受到维生素 D 缺乏的影响。在一项单独的研究中,VD 缺乏组的自然杀伤(NK)细胞、B 细胞数量更多,辅助性 T 细胞/细胞毒性 T 细胞(Th/Tc)比例更高,与成熟卵母细胞数量减少有关。

结论

血清 VD 水平与 IVF 后妊娠率之间的关联尚不确定。然而,VD 水平在白种人群中可能比在亚洲人群中更为相关,与抽吸卵泡的数量相关,并且可能在免疫系统中发挥作用,对胚胎着床和妊娠都有影响。

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Vitamin D and in vitro fertilization: a systematic review.维生素 D 与体外受精:系统评价。
J Assist Reprod Genet. 2023 Apr;40(4):735-743. doi: 10.1007/s10815-023-02767-2. Epub 2023 Mar 8.
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Follicular flushing during oocyte retrieval in assisted reproductive techniques.在辅助生殖技术中取卵时卵泡冲血。
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Cochrane Database Syst Rev. 2005 Apr 18(2):CD003357. doi: 10.1002/14651858.CD003357.pub2.

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