Replete vitamin D stores predict reproductive success following in vitro fertilization

Abstract

Objective-Hypothesizing that levels of 25OH-D in body fluids are reflective of vitamin repletion status, we aimed to determine if 25OH-D levels in the follicular fluid (FF) of infertile women undergoing in vitro fertilization (IVF) demonstrate a relationship with IVF cycle parameters and outcome. Design-Prospective Cohort study Setting-Academic tertiary care center Patients-84 infertile women undergoing IVFInterventions-FF from follicles ≥14mm; serum (n=10) and FF levels of 25OH-D Main outcome measures-Clinical pregnancy (CP) (defined as evidence of intrauterine gestation sac on ultrasound) following IVF; IVF cycle parameters.Results-Serum and FF levels of 25OH-D were highly correlated (r=0.94, p<0.001). In a predominantly Caucasian population (66%), significantly lower FF 25OH-D levels were noted in Black versus non-Black patients (p=0.001). Significant inverse correlations were seen between FF 25OH-D levels and BMI (r−0.25, p=0.035). Significantly higher CP and implantation rates were observed across tertiles of FF25OH-D (p=0.029 and p=0.041 respectively); patients achieving CP following IVF (n=26) exhibited significantly higher FF levels of 25OH-D (p=0.005). Multivariable logistic regression analysis confirmed FF 25OH-D levels as an independent predictor to success of an IVF cycle; adjusting for age, BMI, ethnicity and number of embryos transferred (ET) each ng/ml increase in FF 25OH-D increased the likelihood for achieving CP by 6% (p=0.030). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-Our findings that women with higher vitamin D level in their serum and FF are significantly more likely to achieve CP following IVF-ET are novel. A potential for benefit of vitamin D supplementation on treatment success in infertile patients undergoing IVF is suggested that merits further investigation. NIH Public Access

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review

“…The results of the regression revealed that vitamin D deficiency was independently associated with lower CP rates (OR 0.61, 95 % 0.39-0.95, p=0.030). Similar to the suggestions made by Ozkan et al [69], Polyzos et al postulate that this finding might be due to a deleterious effect on endometrial receptivity.…”

“…Only eight of the 34 articles retrieved from PubMed met criteria (Fig. 2) [66][67][68][69][70][71][72][73]. Reference lists of chosen studies and narrative reviews were cross-referenced to find additional studies.…”

“…A societal perspective was employed and only estimated direct costs were considered. Vitamin D deficiency was defined as <20 ng/mL in accordance with the Endocrine Society guidelines [7], and also consistent with the definition utilized by the majority the trials included in this review [67][68][69][70][71][72]. The study by Polyzos et al [73] was selected for utilization of clinical pregnancy and ongoing pregnancy rates for mathematical modeling secondary to reporting the largest cohort, recency of publication and attempting to control for embryo quality and quantity by including single blastocyst ART cycles only.…”

“…Ozkan et al [69] were the first to report a positive correlation between vitamin D levels and IVF outcomes. In their prospective cohort study, women achieving CP demonstrated significantly higher FF vitamin D levels compared to women who did not achieve CP (34.42 ng/mL±15.58 versus 25.62 ng/mL±10.53, p=0.013).…”

Donor egg IVF model to assess ecological implications for ART success

“…Importance of vitamin D for reproductive success is well described, albeit mostly in non-human animal models [22]; data in humans are sparse. In a cross sectional study of infertile women undergoing IVF, we had previously identified significantly higher levels of 25-hydroxyvitamin D (25OHD), a metabolite that reliably reflects the overall vitamin D status, in the follicular fluid of women achieving clinical pregnancy following IVF [23]. While this latter observation was recently corroborated by others [24], including in donor egg recipients [25], data relating vitamin D status to IVF outcome remain far from unequivocal [26].…”