Study: Vitamin D status and results of in-vitro fertilization
Study: Vitamin D status and results of in-vitro fertilization
Reference
Rudick Bj, Ingles Sa, Chung K, Stanczyk FZ, Paulson RJ, Bendikson Ka. Influence of vitamin D level on the results of in-vitro fertilization in donor-recipient cycles. fertilize sterile. 2014; 101 (2): 447-452.
Design
retrospective cohort study
participant
A diverse population of 99 recipients of an egg donation at the Fertility Center of the University of Southern California in Los Angeles (53 % Caucasians, 20 % Asian, 16 % Hispano -American and 7 % African Americans). Each recipient was assigned to a unique egg donor. Possible disruptive factors such as the age of the donor and receiver, the recipient's body mass index, the breed, the number of embryos transferred and the quality of the embryo were taken into account and statistical adjustments were made.
Study intervention
Vitamin D level in serum [25 (OH) D] were assessed at the beginning of the course and categorized on the basis of conventionally accepted reference areas for vitamin deficiency (30 ng/ml).
primary result dimensions
The primary benchmark was the clinical pregnancy, which was defined by the sonographic presence of cardiac activity in the 7th to 8th week of pregnancy. The living birth rate was a secondary measure of results.
most important knowledge
of the 99 study participants were saturated 35 %, 38 % insufficient and 26 % had a lack of vitamin D. The adapted clinical pregnancy rates were 78 % for recipients with vitamin D oversaturation and 37 % for recipients with vitamin D deficiency ( p = 0.004). The live birth rate was 31 % for recipients with a vitamin D deficiency, compared to 59 % for recipients with vitamin D oversaturation. There were no statistically significant differences in the adapted clinical pregnancy and living birth rates between recipients who were missing vitamin D compared to recipients that had sufficient vitamin D.
effects on practice
In this study, a vitamin D deficiency was associated with a 50 percent reduction in pregnancy and live birth rates in recipients of donated egg cells compared to patients with sufficient vitamin D mirrors. Vitamin D is a preliminary stage of a fat-soluble secosteroid hormone, 1,25 (OH2) vitamin D, with pleiiotropic effects on a variety of intracellular regulatory reactions, including those of the reproduction system. 1 VITAMIN D has been shown to have immune-modulating and inflammatory effects. Earlier studies have shown that a vitamin D deficiency with insulin resistance, hyperandrogenism, polycystic ovarian syndrome and pregnancy complications such as preeclampsia, sterility and recurring miscarriage are connected. In vitro fertilization carried out and show that women with a high vitamin D level have higher pregnancy rates than women with vitamin D deficiency.
Since earlier studies have shown no connection between the vitamin D status and the quality of embryos or egg cells, the authors tested their hypothesis using egg donors that the effect of vitamin D is conveyed between the embryo and the uterine mucosa via the uterine slime. The results of the study show that vitamin D status is more related to the function of the endometrium in connection with the implantation and not with the quality of the egg cells. This is supported by evidence that the active form of vitamin D, calcitriol, binds to the vitamin D receptor in the endometrium in order to delegate to genes (e.g. the Hox-gen 10a) that are necessary for the implantation and placentation of the embryo. Cytokines such as the colony stimulating factor 2, interleukin (IL) -1, IL-6 and the tumor necrosis factor lowers that are involved in the early loss of pregnancy.
In this study, a vitamin D deficiency was associated with a 50 percent reduction in pregnancy and living birth rates in recipients of donated egg cells compared to patients with sufficient vitamin D mirrors.
While this study adds the growing data that vitamin D may play a role in fertility, further studies are required to demonstrate the effects of vitamin D therapy and saturation on the pregnancy rates. Doctors who offer preceding advice and treat sterile women should assess the vitamin D levels and treat deficits with a vitamin D supplement, and not only for general benefits for health and reducing the risk of chronic diseases, but also to improve fertility, pregnancy health and live birth rates.
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