Journal of Developmental Medicine(Electronic Version)  2020, Vol. 8 Issue (2): 115-121 DOI: 10.3969/j.issn.2095-5340.2020.02.005 |
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| The effect of serum vitamin D on the clinical outcomes of patients with diminished ovarian reserve undergoing IVF-ET |
| Wang Xiang, Sun Ningxia, Wang Liang,et al
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| (Reproductive Medicine Center, Changzheng Hospital, Naval Military Medical University of the PLA, Shanghai 200003,China) |
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Abstract 【Abstract】 Objective To analyze the relationship of serum vitamin D level and the outcomes of patients with diminished ovarian reserve (DOR) undergoing in vitro fertilization-embryo transfer (IVF-ET), and to discuss the effect of vitamin D on follicular growth, embryo development and pregnancy outcomes in patientswith DOR. Methods From January 1, 2014 to December 31, 2017, among patients with DOR who received IVF-ET therapy in Reproductive Medicine Center, Changzheng Hospital, Naval Military Medical University of the PLA, 204 couples were included in the study, including 486 fresh cycles and 270 frozenthawedcycles. According to the level of serum 25(OH)D, the patients were divided into three groups: deficiency
group (<20 μg/L), insufficiency group (20-30 μg/L) and sufficiency group ( ≥ 30 μg/L). The observation indexes
were retrospectively analyzed: dose of gonadotropins (Gn), days of ovarian hyperstimulation, number of oocytes achieved, rate of D3 transferable embryos, rate of D3 embryos of good quality, clinical pregnancy rate, miscarriage rate and cumulative pregnancy rate. Nonparametric Kruskal Wallis test, Bonferroni correction and χ2 test were used for statistics. Results The dosage of Gn in vitamin D deficiency group, insufficiency group and sufficieny group were (1 353±811), (1 191±784) and (1 131±661) IU. The days of Gn treatment were (8.7±3.1), (8.0±3.2) and (7.8±2.4) d, respectively. The Gn dosage and Gn days of
deficiency group were higher than those of insufficiency group and sufficiency group (P<0.05), but there were no significant differences between insufficiency group and sufficiency group (P>0.05). There were no significant differences among the three groups in the number of oocytes obtained [(3.9±4.1), (3.4±3.0) and (3.1±2.4)], the rate of D3 transferable embryos [82.8%(313/378), 82.4%(416/505) and 82.9%(223/269)], the rate of D3 embryos of good quality [60.0%(204/340), 53.4%(242/453) and 52.7%(127/241)] (P>0.05). In fresh embryo transfer cycles, there was no tansfer in sufficiency group. The clinical pregnancy rate [71.4%(5/7) vs 66.7%(4/6)] and abortion rate [0.0% (0/5) vs 0.0% (0/4)] had no significant differences between the deficiency group and insufficiency group (P>0.05). In frozen-thawed embryo transfer cycles, the clinical pregnancy
rate [44.3% (35/79), 42.7% (50/117) and 35.7% (25/70)] and abortion rate [25.7% (9/35), 20.0% (10/50) and 16.0%
(4/25)] had no significant differences among the three groups (P>0.05). The cumulative pregnancy rates of the three
groups were 73.6% (39/53), 65.4% (53/81) and 60.5% (23/38) respectively (χ2 =1.844, P=0.398). Conclusion
Patients with vitamin D deficiency need more Gn dosage and longer Gn days to promote follicular development in
the IVF-ET treatment, but it does not affect embryo development and pregnancy outcomes.
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Received: 13 January 2020
Published: 22 April 2020
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