Abstract
Objective
To assess the correlation between the levels of vitamin D in follicular fluid and
serum, and to determine whether the level of 25-hydroxyvitamin D (25OH-D) in follicular
fluid of infertile women undergoing assisted reproductive technology (ART) is associated
with the outcome.
Study design
Eighty-two infertile women undergoing ART at an academic tertiary care centre were
recruited for a prospective cohort study. Levels of 25OH-D in follicular fluid and
serum were measured. Standardized regimens for pituitary downregulation and controlled
ovarian hyperstimulation were employed. Patient and cycle parameters, and clinical
pregnancy (defined as evidence of intra-uterine gestation sac plus heart rate on ultrasound)
were determined.
Results
A significant correlation was found between the levels of vitamin D in follicular
fluid and serum (r = 0.767, p = 0.001). The overall rates of chemical, clinical and ongoing pregnancy were 35.5% (n = 29), 29.3% (n = 24) and 23.2% (n = 19), respectively. No significant difference was found in these pregnancy rates between
the tertiles of 25OH-D level in follicular fluid (p = 0.959, 0.995 and 0.604, respectively). The median serum level of vitamin D was 8.13
(range 5.37–13.62) ng/ml in the clinically pregnant group and 8.29 (range 5.93–21.23) ng/ml in the non-pregnant group (p = 0.235). Interestingly, the median level of vitamin D in follicular fluid was 9.19
(range 5.25–19.51) ng/ml in the clinically pregnant group and 10.34 (range 5.89–29.69) ng/ml in the non-pregnant group (p = 0.433). The fertilization rate decreased significantly and the implantation rate increased
(not significantly) with increasing tertiles of 25OH-D level in follicular fluid.
Conclusions
The level of 25OH-D in follicular fluid is reflective of body stores of vitamin D.
Most subjects in this study were deficient in vitamin D, but this study found that
vitamin D deficiency does not play a pivotal role in the outcome of ART.
Keywords
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References
- Vitamin D deficiency.N Engl J Med. 2007; 357: 266-281
- Vitamin D in health and disease.Clin J Am Soc Nephrol. 2008; 3: 1535-1541
- Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications.in: Favus M.J. Primer on the metabolic bone diseases and disorders of mineral metabolism. 6th ed. American Society for Bone and Mineral Research, Washington, DC2006: 129-137
- Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis.Am J Clin Nutr. 2004; 79: 362-371
- Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis.JAMA. 2006; 296: 2832-2838
- Calcium plus vitamin D and the risk of colorectal cancer.N Engl J Med. 2006; 354: 2287-2288
- Vitamin D and disease prevention with special reference to cardiovascular disease.Prog Biophys Mol Biol. 2006; 92: 39-48
- Effect of vitamin D deficiency on fertility and reproductive capacity in the female rat.J Nutr. 1980; 110: 1573-1580
- Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads.Endocrinology. 2000; 141: 1317-1324
- Mice lacking the vitamin D receptor exhibit impaired bone formation, uterine hypoplasia and growth retardation after weaning.Nat Genet. 1997; 16: 391-396
- Regulation of human placental lactogen expression by 1,25-dihydroxyvitamin D3.Endocrinology. 1994; 135: 2651-2656
- Endocrine regulation of HOX genes.Endocr Rev. 2006; 27: 331-355
- Vitamin D is necessary for reproductive functions of the male rat.J Nutr. 1989; 119: 741-744
- Reproductive defects are corrected in vitamin D-deficient female rats fed a high calcium, phosphorus and lactose diet.J Nutr. 2002; 132: 2270-2273
- Normalization of serum calcium restores fertility in vitamin D-deficient male rats.J Nutr. 1992; 122: 1338-1344
- Replete vitamin D stores predict reproductive success following in vitro fertilization.Fertil Steril. 2010; 94: 1314-1319
- Vitamin D deficiency in Iran: a multi-center study among different urban areas.Iran J Publ Health. 2008; 1: 72-78
- Prognostic value of follicular fluid 25-OH vitamin D and glucose levels in the IVF outcome.Reprod Biol Endocrinol. 2010; 8: 91
- The role of vitamin D levels on IVF outcomes in donor–recipient cycles.Fertil Steril. 2011; 95: S8
- Prevalence and significance of low 25-hydroxyvitamin D concentrations in healthy subjects in Delhi.Am J Clin Nutr. 2000; 72: 472-475
- Vitamin D deficiency and causative factors in the population of Tehran.BMC Public Health. 2004; 4: 38
- Vitamin D status in mothers and their newborns in Iran.BMC Preg Childbirth. 2007; 7: 1
- Calciotropic hormones, insulin resistance, and the polycystic ovary syndrome.Fertil Steril. 2010; 93: 1208-1214
- Glucose intolerance is associated with altered calcium homeostasis: a possible link between increased serum calcium concentration and cardiovascular disease mortality.Metabolism. 1997; 46: 1171-1177
- 25-Hydroxyvitamin D-alphahydroxylase in normal and malignant colon tissue.Lancet. 2001; 357: 1673-1674
Article info
Publication history
Published online: July 29, 2011
Accepted:
July 11,
2011
Received in revised form:
May 9,
2011
Received:
December 19,
2010
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
