Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Key Laboratory of Remodelling-Related Research Centre for Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
Department of Obstetrics and Gynaecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, China.
Reprod Biomed Online. 2024 Aug;49(2):103909. doi: 10.1016/j.rbmo.2024.103909. Epub 2024 Feb 23.
Does vitamin D affect the pregnancy rate of patients with polycystic ovary syndrome (PCOS) receiving ovulation-induction therapy?
The retrospective study included 200 patients with PCOS and 200 healthy women. The prospective study included 160 patients with PCOS receiving vitamin D or placebo supplementation. Pregnancy rates were assessed after a maximum of three cycles of ovulation induction. Serum concentrations of 25-hydroxycalciferol [25-(OH)D3], LH, FSH, progesterone, oestradiol, testosterone and fasting insulin; LH/FSH ratio; and body mass index were evaluated.
In the retrospective study, patients with PCOS had lower 25-(OH)D3 concentrations than healthy women, pregnant patients with PCOS had higher 25-(OH)D3 concentrations than non-pregnant patients with PCOS (both P = 0.000), and the pregnancy rate was lower in the vitamin-D-deficient group compared with the non-vitamin-D-deficient group (P = 0.022). In the prospective study, compared with placebo supplementation, vitamin D supplementation increased the serum concentration of 25-(OH)D3 (P = 0.000), and reduced the LH/FSH ratio, and concentrations of LH and testosterone significantly (all P ≤ 0.049). After the intervention, it was found that the LH/FSH ratio, and concentrations of LH and testosterone were significantly lower in both groups compared with pre-intervention (P = 0.000). After ovulation induction, the pregnancy rate was higher in patients in the vitamin D supplementation group compared with the placebo supplementation group (P = 0.049).
Vitamin D deficiency is common in patients with PCOS, and vitamin-D-deficient patients with PCOS have lower pregnancy rates after ovulation induction compared with non-vitamin-D-deficient patients with PCOS. Vitamin D supplementation can improve the pregnancy rate and mitigate basic hormone disorders. Therefore, monitoring vitamin D supplementation and checking vitamin D concentrations before and during interventions are essential for patients with PCOS.
维生素 D 会影响多囊卵巢综合征（PCOS）患者接受促排卵治疗的妊娠率吗？
回顾性研究纳入 200 例 PCOS 患者和 200 例健康女性。前瞻性研究纳入 160 例接受维生素 D 或安慰剂补充的 PCOS 患者。在最多三个周期的促排卵后评估妊娠率。评估血清 25-羟维生素 D3 [25-(OH)D3]、LH、FSH、孕酮、雌二醇、睾酮和空腹胰岛素浓度；LH/FSH 比值；以及体重指数。
在回顾性研究中，PCOS 患者的 25-(OH)D3 浓度低于健康女性，妊娠的 PCOS 患者的 25-(OH)D3 浓度高于未妊娠的 PCOS 患者（均 P = 0.000），维生素 D 缺乏组的妊娠率低于非维生素 D 缺乏组（P = 0.022）。在前瞻性研究中，与安慰剂补充相比，维生素 D 补充增加了血清 25-(OH)D3 浓度（P = 0.000），并显著降低了 LH/FSH 比值以及 LH 和睾酮浓度（均 P ≤ 0.049）。干预后，两组患者的 LH/FSH 比值以及 LH 和睾酮浓度均较干预前显著降低（P = 0.000）。促排卵后，维生素 D 补充组患者的妊娠率高于安慰剂补充组（P = 0.049）。
维生素 D 缺乏在 PCOS 患者中很常见，与非维生素 D 缺乏的 PCOS 患者相比，维生素 D 缺乏的 PCOS 患者在接受促排卵后妊娠率较低。维生素 D 补充可提高妊娠率并减轻基础激素紊乱。因此，对于 PCOS 患者，监测维生素 D 补充情况并检查干预前后的维生素 D 浓度至关重要。
