Abstract
PurposeThis study investigated the relationship between the vitamin D [25(OH)D] level in individual follicles and oocyte developmental competence.MethodsA prospective cohort study in a private infertility center. Infertile women (N = 198) scheduled for intracytoplasmic sperm injection (ICSI) and a single embryo transfer (SET) provided serum samples and 322 follicular fluid (FF) specimens, each from a single follicle on the day of oocyte retrieval.ResultsFFs corresponding to successfully fertilized oocytes (following ICSI) contained significantly lower 25(OH)D level compared with those that were not fertilized (28.4 vs. 34.0 ng/ml, P = 0.001). Top quality embryos on the third day after fertilization, when compared to other available embryos, developed from oocytes collected from follicles containing significantly lower 25(OH)D levels (24.56 vs. 29.59 ng/ml, P = 0.007). Positive hCG, clinical pregnancy, and live birth rates were achieved from embryos derived from oocytes that grew in FF with significantly lower 25(OH)D levels than in follicles not associated with subsequent pregnancy. The concentration of 25(OH)D in FF in women with negative hCG was 32.23 ± 20.21 ng/ml, positive hCG 23.62 ± 6.09 ng/ml, clinical pregnancy 23.13 ± 6.09 ng/ml, and live birth 23.45 ± 6.11 ng/ml (P < 0.001). Women with serum 25(OH)D < 20 ng/ml had not only a higher fertilization rate (71 vs. 61.6%, P = 0.026) and a higher clinical pregnancy rate (48.2 vs. 25%, P = 0.001), but also higher miscarriage rate (14.5 vs. 3.8%, P = 0.013) compared with those with levels ≥ 20 ng/ml.ConclusionThis study reveals that the level of 25(OH)D in FF correlates negatively with the oocytes’ ability to undergo fertilization and subsequent preimplantation embryo development. Oocytes matured in FF with low 25(OH)D concentration are more likely to produce top quality embryos and are associated with higher pregnancy and delivery rates. On the other hand, low serum vitamin D concentration is associated with higher miscarriage rates.
Highlights
Recognized actions of vitamin D include calcium and phosphorus homeostasis, as well as the support of bone mineralization, while its deficiency leads to an increased risk of osteoporosis, bone fractures, and muscle weakness [1]
All methods were performed in accordance with the relevant guidelines and regulations of European Society of Human Reproduction and Embryology (ESHRE), The American Society for Reproductive Medicine (ASRM) and The Polish Society of Reproductive Medicine and Embryology (PSRME)
We investigated the association between vitamin D serum level and IVF clinical outcomes, such as chemical pregnancy rate, clinical pregnancy rate, and live birth rate
Summary
Recognized actions of vitamin D include calcium and phosphorus homeostasis, as well as the support of bone mineralization, while its deficiency leads to an increased risk of osteoporosis, bone fractures, and muscle weakness [1]. There is growing evidence that 25-hydroxyvitamin D [25(OH)D] exerts many other important actions, especially on human reproductive functions [2]. Vitamin D receptors (VDR) have been identified in the female reproductive tissues including. J Assist Reprod Genet (2018) 35:1265–1276 human ovarian, endometrial and fallopian tube epithelial cells, placenta, and decidual cells [8]. Vitamin D via its receptor can modulate ovarian steroidogenesis [9]. Data from clinical reports suggest that lower vitamin D level is associated with gestational diabetes and preeclampsia [10, 11]
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