Correlation between 25 hydroxyvitamin D in serum and follicular fluid and pregnancy outcome of in vitro fertilization and embryo transfer

doi:10.3877/cma.j.issn.1674-0785.2020.06.002

Abstract

Abstract:

Objective

To investigate the relationship between 25 hydroxyvitamin D [25(OH)D] in serum and follicular fluid and the pregnancy outcome of in vitro fertilization and embryo transfer (IVF-ET).

Methods

From July 2017 to July 2018, 67 infertile patients who received IVF-ET for the first time at the Reproductive Center of the First Hospital of Shanxi Medical University were divided into a pregnant group and non-pregnant group according to the pregnancy outcome. The general data, laboratory data, and 25(OH)D in serum and follicular fluid were compared between the two groups. The t-test or rank test was used to compare the differences between the two groups, and the variables with statistical significance were further analyzed by logistic regression. The correlation between serum 25(OH) D levels and follicular fluid 25(OH) D levels was evaluated by Pearson correlation analysis, and the correlation between serum 25(OH) D level and triglyceride, thyroid stimulating hormone (TSH), and fertilization rate was evaluated by Spearman correlation analysis.

Results

The average level of 25(OH)D in serum in all patients was 26.27 μg/L. The levels of TSH [2.34 (1.80-3.20) mIU/ml vs 2.93 (2.28-4.53) mIU/ml] and triglyceride [0.93 (0.73-1.22) mmol/L vs 1.14(0.87-1.56) mmol/L] and the initial dose of gonadotropins [225.0 (150.0-300.0) IU/L vs 262.5 (225.0-300.0) IU/L] in the pregnant group were significantly lower than those in the non-pregnant group (Z=-2.237, -2.138, and -2.107; P=0.020, 0.032, and 0.035, respectively). The fertilization rate [85.7 (78.3-94.4)% vs 76.3 (63.5-92.5)%] and 25(OH)D in serum and follicular fluid [serum: (37.08±13.39) mmol/L vs (28.90±12.53) mmol/L; follicular fluid: (31.18±13.10) mmol/L vs (21.92±9.24) mmol/L] in the pregnant group were significantly higher than those in the non-pregnant group (Z=-2.178, P=0.029; t=2.579 and 3.282, P=0.012 and 0.020, respectively). There was a positive correlation between 25(OH)D in serum and 25(OH)D in follicular fluid in IVF-ET patients (r=0.836, P<0.01). 25(OH)D in serum had a negative correlation with triglyceride (r=-0.286, P=0.019), no correlation with TSH (r=-0.007, P=0.958), and a positive correlation with fertilization rate (r=-0.43, P<0.01). The results of logistic regression analysis showed that serum 25(OH)D, follicular fluid 25(OH)D, triglyceride, TSH, initial gonadotropins dose, and fertilization rate had no significant effect on the pregnancy outcome of IVF-ET patients after excluding confounding factors (P>0.05). The regression analysis after the combination of serum and follicular fluid 25(OH)D showed that it had no significant effect on the pregnancy outcome of IVF-ET patients after excluding confounding factors (OR=1.001, P=0.058).

Conclusion

There is a general lack of vitamin D in infertility patients, but there is no significant correlation between vitamin D and clinical pregnancy outcome of IVF-ET.

Key words: 25 hydroxyvitamin D, In vitro fertilization and embryo transfer, Pregnancy outcome

Hongqin Lu, Yujie He. Correlation between 25 hydroxyvitamin D in serum and follicular fluid and pregnancy outcome of in vitro fertilization and embryo transfer[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(06): 407-412.

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References 22

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组别	例数	年龄（岁，±s）	不孕年限［年，M（Q_R）］	体质量指数[kg/m²，M（Q_R）]	收缩压[mmHg，M（Q_R）]	舒张压（mmHg，±s）
妊娠组	31	29.77±3.89	4（3~5）	22.03（20.79~24.51）	112（108~121）	77.48±7.47
未妊娠组	36	31.61±4.60	4（2.25~5.75）	23.88（21.40~27.91）	117（113~126）	79.31±8.20
统计值	?	t=-1.749	Z=-0.401	Z=-1.472	Z=-1.290	t=-0.945
P值	?	0.085	0.688	0.141	0.197	0.348
组别	例数	游离三碘甲状原氨酸［pmol/L，M（Q_R）］	游离甲状腺素（pmol/L，±s）	促甲状腺素［mIU/ml，M（Q_R）］	甲状腺过氧化物酶抗体［IU/ml，M（Q_R）］	甲状腺球蛋白抗体［IU/ml，M（Q_R）］
妊娠组	31	4.72（4.31~5.19）	15.78±2.30	2.34（1.80~3.20）	15.36（13.12~23.29）	13.58（8.24~20.13）
未妊娠组	36	5.16（4.60~5.53）	15.26±2.54	2.93（2.28~4.53）	15.87（10.45~23.39）	14.27（9.04~20.09）
统计值	?	Z=-1.836	t=0.867	Z=-2.237	Z=-0.233	Z=-0.478
P值	?	0.066	0.389	0.020	0.816	0.633
组别	例数	天门冬氨酸氨基转移酶［U/L，M（Q_R）］	丙氨酸氨基转移酶［U/L，M（Q_R）］	血清肌酐（μmol/L，±s）	血尿素氮（μmol/L，±s）	血清钙［mmol/L，M（Q_R）］
妊娠组	31	19.0（17.0~24.9）	16.0（11.0~22.0）	52.07±8.08	3.74±0.84	2.34（2.32~2.38）
未妊娠组	36	20.0（17.3~28.5）	19.0（15.0~25.3）	49.57±8.13	3.91±1.11	2.36（2.32~2.43）
统计值	?	Z=-0.839	Z=-1.878	t=1.247	t=-0.686	Z=-0.895
P值	?	0.402	0.060	0.217	0.495	0.371

组别	例数	年龄（岁，±s）	不孕年限［年，M（Q_R）］	体质量指数[kg/m²，M（Q_R）]	收缩压[mmHg，M（Q_R）]	舒张压（mmHg，±s）
妊娠组	31	29.77±3.89	4（3~5）	22.03（20.79~24.51）	112（108~121）	77.48±7.47
未妊娠组	36	31.61±4.60	4（2.25~5.75）	23.88（21.40~27.91）	117（113~126）	79.31±8.20
统计值	?	t=-1.749	Z=-0.401	Z=-1.472	Z=-1.290	t=-0.945
P值	?	0.085	0.688	0.141	0.197	0.348
组别	例数	游离三碘甲状原氨酸［pmol/L，M（Q_R）］	游离甲状腺素（pmol/L，±s）	促甲状腺素［mIU/ml，M（Q_R）］	甲状腺过氧化物酶抗体［IU/ml，M（Q_R）］	甲状腺球蛋白抗体［IU/ml，M（Q_R）］
妊娠组	31	4.72（4.31~5.19）	15.78±2.30	2.34（1.80~3.20）	15.36（13.12~23.29）	13.58（8.24~20.13）
未妊娠组	36	5.16（4.60~5.53）	15.26±2.54	2.93（2.28~4.53）	15.87（10.45~23.39）	14.27（9.04~20.09）
统计值	?	Z=-1.836	t=0.867	Z=-2.237	Z=-0.233	Z=-0.478
P值	?	0.066	0.389	0.020	0.816	0.633
组别	例数	天门冬氨酸氨基转移酶［U/L，M（Q_R）］	丙氨酸氨基转移酶［U/L，M（Q_R）］	血清肌酐（μmol/L，±s）	血尿素氮（μmol/L，±s）	血清钙［mmol/L，M（Q_R）］
妊娠组	31	19.0（17.0~24.9）	16.0（11.0~22.0）	52.07±8.08	3.74±0.84	2.34（2.32~2.38）
未妊娠组	36	20.0（17.3~28.5）	19.0（15.0~25.3）	49.57±8.13	3.91±1.11	2.36（2.32~2.43）
统计值	?	Z=-0.839	Z=-1.878	t=1.247	t=-0.686	Z=-0.895
P值	?	0.402	0.060	0.217	0.495	0.371

组别	例数	雌二醇［pmol/L，M（Q_R）］	促卵泡生成素（mIU/ml，±s）	黄体生成素［mIU/ml，M（Q_R）］	孕酮［ng/L，M（Q_R）］	催乳泌素［μg/L，M（Q_R）］	孕酮［ng/L，M（Q_R）］
妊娠组	31	38.9（30.4~58.0）	6.59±2.66	2.90（2.30~4.20）	0.44（0.32~0.68）	13.50（11.23~23.20）	15.73（6.88~25.98）
未妊娠组	36	32.7（25.8~46.4）	7.06±2.54	2.75（1.93~4.05）	0.35（0.23~0.53）	13.00（10.82~16.88）	16.42（9.18~24.90）
统计值	?	Z=-1.535	t=-0.740	Z=-0.812	Z=-1.548	Z=-1.075	Z=-0.302
P值	?	0.125	0.462	0.417	0.122	0.282	0.763
组别	例数	三酰甘油［mmol/L，M（Q_R）］	总胆固醇（mmol/L，±s）	高密度脂蛋白胆固醇［mmol/L，M（Q_R）］	低密度脂蛋白胆固醇［mmol/L，M（Q_R）］	空腹血糖（mmol/L，±s）	空腹胰岛素［U/L，M（Q_R）］
妊娠组	31	0.93（0.73~1.22）	4.48±1.02	1.45（1.34~1.74）	2.57（1.60~3.09）	5.37±0.36	11.24（9.76~21.16）
未妊娠组	36	1.14（0.87~1.56）	4.10±1.08	1.38（1.09~1.77）	1.94（0.87~2.61）	5.30±0.40	13.47（11.57~18.55）
统计值	?	Z=-2.138	t=1.443	Z=-0.704	Z=-1.918	t=0.818	Z=-1.710
P值	?	0.032	0.154	0.481	0.055	0.416	0.087

组别	例数	雌二醇［pmol/L，M（Q_R）］	促卵泡生成素（mIU/ml，±s）	黄体生成素［mIU/ml，M（Q_R）］	孕酮［ng/L，M（Q_R）］	催乳泌素［μg/L，M（Q_R）］	孕酮［ng/L，M（Q_R）］
妊娠组	31	38.9（30.4~58.0）	6.59±2.66	2.90（2.30~4.20）	0.44（0.32~0.68）	13.50（11.23~23.20）	15.73（6.88~25.98）
未妊娠组	36	32.7（25.8~46.4）	7.06±2.54	2.75（1.93~4.05）	0.35（0.23~0.53）	13.00（10.82~16.88）	16.42（9.18~24.90）
统计值	?	Z=-1.535	t=-0.740	Z=-0.812	Z=-1.548	Z=-1.075	Z=-0.302
P值	?	0.125	0.462	0.417	0.122	0.282	0.763
组别	例数	三酰甘油［mmol/L，M（Q_R）］	总胆固醇（mmol/L，±s）	高密度脂蛋白胆固醇［mmol/L，M（Q_R）］	低密度脂蛋白胆固醇［mmol/L，M（Q_R）］	空腹血糖（mmol/L，±s）	空腹胰岛素［U/L，M（Q_R）］
妊娠组	31	0.93（0.73~1.22）	4.48±1.02	1.45（1.34~1.74）	2.57（1.60~3.09）	5.37±0.36	11.24（9.76~21.16）
未妊娠组	36	1.14（0.87~1.56）	4.10±1.08	1.38（1.09~1.77）	1.94（0.87~2.61）	5.30±0.40	13.47（11.57~18.55）
统计值	?	Z=-2.138	t=1.443	Z=-0.704	Z=-1.918	t=0.818	Z=-1.710
P值	?	0.032	0.154	0.481	0.055	0.416	0.087

组别	例数	降调节剂量［mg，M（Q_R）］	窦卵泡数［个，M（Q_R）］	Gn起始剂量［IU/L，M（Q_R）］	Gn起始时间［d，M（Q_R）］	Gn使用天数［d，M（Q_R）］	Gn剂量（IU/L，±s）	HCG日雌二醇水平［pmol/L，M（Q_R）］	HCG日卵泡数［个，±s］
妊娠组	31	1.7（1.6~1.7）	13（11~18）	225.0（150.0~300.0）	3（3~4）	12（11~13）	2960.89±892.16	3000.00（2331.50~3000.00）	18.61±7.36
未妊娠组	36	1.7（1.6~1.7）	13（10~15）	262.5（225.0~300.0）	3（3~4）	12（11~13）	3400.70±1085.40	2915.15（2103.40~3000.00）	17.97±6.59
统计值	?	Z=-0.290	Z=-1.203	Z=-2.107	Z=-0.501	Z=-0.169	t=-1.793	Z=-0.452	t=0.376
P值	?	0.772	0.229	0.035	0.616	0.866	0.078	0.651	0.708
组别	例数	获卵数［个，±s］	卵裂率［%，M（Q_R）］	受精率［%，M（Q_R）］	2PN［个，±s］	胚胎数［个，±s］	优胚数［个，M（Q_R）］	优胚率（%，±s）	移植日内膜厚度［mm，M（Q_R）］
妊娠组	31	17.87±7.10	93.0（87.5~100.0）	85.7（78.3~94.4）	10.45±4.88	14.43±5.53	6（3~8）	38.11±19.70	10（9~11）
未妊娠组	36	17.86±7.01	92.0（81.4~95.5）	76.3（63.5~92.5）	9.31±5.18	13.56±5.57	4（2~7）	32.84±19.98	10（9~11）
统计值	?	t=0.006	Z=-1.111	Z=-2.178	t=0.902	t=0.640	Z=-1.100	t=1.076	Z=-0.038
P值	?	0.995	0.266	0.029	0.370	0.525	0.286	0286	0.970

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