Vitamin D improves in-vitro fertilization outcomes in infertile women with polycystic ovary syndrome and insulin resistance.

IF 4.7 4区 医学 0 MEDICINE, GENERAL & INTERNAL
Minerva medica Pub Date : 2019-06-01 Epub Date: 2019-01-04 DOI:10.23736/S0026-4806.18.05946-3
Juan Zhao, Shan Liu, Yidan Wang, Peng Wang, Danni Qu, Minghui Liu, Wei Ma, Yuan Li
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引用次数: 21

Abstract

Background: The aim of f this study is to investigate the effect of vitamin D supplementation upon the outcome of in-vitro fertilization (IVF) in infertile women with polycystic ovarian syndrome (PCOS) and insulin resistance (IR).

Methods: Three hundred and five infertile patients with PCOS and insulin resistance undergoing IVF were included in this study. All participants underwent oral glucose tolerance test (OGTT). Insulin resistance was calculated by homeostasis model assessment. Vitamin D status was measured by assessing circulating levels of 25OH-VD in serum samples by radioimmunoassay.

Results: All the patients were then divided into four groups according to their relative levels of serum 25OH-VD (levels of 25OH-VD≥20 ng/mL were defined as being normal) and whether treatment had been administered prior to COH: Group I (deficiency group without treatment [25OH-VD<20 ng/mL]); Group II (normal group [25OH-VD≥20 ng/mL]), Group III (normal group after treatment), Group IV (deficiency group after treatment). In total, 305 women were included in this study. Implantation rates across the four groups were 8.5% (9/106) in Group I, 49% (24/49) in Group II, 49.1% (55/112) in Group III and 14.3 (18/126) in Group IV, respectively. Clinical pregnancy rates were 19.3% (11/57), 65.2 (15/23), 66.7% (38/57) and 23.5% (16/68) in the four groups, respectively. Both the implantation rate and clinical pregnancy rate in groups in which serum 25OH-VD was normal (Groups II and III) were significantly higher (P<0.05) than the other two groups. Serum levels of 25OH-VD were highly correlated with clinical pregnancy and implantation rates (P<0.01).There also were significant differences among the four groups in terms of fertilization rate (80±16%, 93±10%, 90±12%, and 79±23%), two pronucleus (2PN) fertilization rate (59±21%, 72±14%, 76±17% and 66±24%) and cleavage rate (76±20%, 91±10%, 89±24% and 76±25%). Particularly marked differences were observed in the number of high-quality embryos (20±16%, 63±25%, 55±22%, and 32±19%) and the available embryos which could be transferred (2.5±1.8, 5.8±2.8, 5.2±2.4, and 3.6±1.9) (all P<0.01). Much higher rates of implantation and clinical pregnancy were observed among the 25OH-VD deficient patients who had received vitamin D supplements and 25OH-VD levels returned to normal compared to patients in which 25OH-VD levels did not return to normal. Group III, which had normal 25OH-VD levels following Vitamin D supplementation produced the same number of high-quality embryos as Group II which had normal 25OH-VD levels (Group III versus Group II; 7.6±4.1 vs. 10.6±5.2, 55±22% vs. 63±25%; P<0.05).

Conclusions: Our data indicate that vitamin D supplementation can help return serum vitamin D levels in infertile women with PCOS and IR to normal levels leading to an improvement in the quality of embryos and a significantly higher clinical pregnancy rate. Maintaining a normal serum vitamin D level in PCOS women is very important in achieving a successful clinical pregnancy following in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

维生素D改善患有多囊卵巢综合征和胰岛素抵抗的不孕妇女的体外受精结果。
背景:本研究的目的是探讨补充维生素D对患有多囊卵巢综合征(PCOS)和胰岛素抵抗(IR)的不孕妇女体外受精(IVF)结果的影响。方法:对305例经体外受精治疗的多囊卵巢综合征合并胰岛素抵抗的不孕症患者进行研究。所有参与者均进行口服葡萄糖耐量试验(OGTT)。通过稳态模型评估计算胰岛素抵抗。通过放射免疫分析法评估血清样本中25OH-VD的循环水平来测量维生素D状态。结果:根据患者血清25OH-VD的相对水平(25OH-VD≥20 ng/mL为正常)及COH前是否接受过治疗分为4组:ⅰ组(缺乏症组,未接受治疗[25OH-VD])我们的数据表明,补充维生素D有助于使患有多囊卵巢综合征和IR的不孕妇女的血清维生素D水平恢复到正常水平,从而改善胚胎质量,显著提高临床妊娠率。PCOS患者维持正常的血清维生素D水平对于体外受精(IVF)或胞浆内单精子注射(ICSI)后成功临床妊娠非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Minerva medica
Minerva medica 医学-医学:内科
CiteScore
6.40
自引率
6.40%
发文量
358
审稿时长
>12 weeks
期刊介绍: Minerva Medica publishes scientific papers on internal medicine. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics.
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