Vitamin D in Follicular Fluid Correlates With the Euploid Status of Blastocysts in a Vitamin D Deficient Population

Abstract

ContextThe widespread distribution of the Vitamin D (VitD) receptor in reproductive tissues suggests an important role for VitD in human reproduction. The assessment of patient´s VitD is based on the 25-hydroxyvitamin D (25(OH)D) metabolite measurement. However, most of the circulating 25(OH)D is bound to either VitD-binding protein (VDBP) (88%) or albumin (12%) and less than 1% circulates free.ObjectiveTo determine a possible correlation between VitD levels in serum (S) and follicular fluid (FF) and blastocyst ploidy status in patients undergoing infertility treatment.MethodsA prospective observational study was performed including couples planned for preimplantation genetic testing for aneuploidies (PGT-A) from ART Fertility Clinics. Patients were classified according to their 25(OH)D-Serum levels: VitD deficient group <20 ng/ml and insufficient/replete ≥20 ng/ml defined as VitD non-deficient group.ResultsSerum samples and 226 FF from individual follicles were collected for 25(OH)D, bioavailable 25(OH)D, free 25(OH)D, and % free 25(OH)D measurement. 25(OH)D-Serum in VitD deficient and non-deficient were 13.2±4.0 ng/ml vs 32.3±9.2 ng/ml; p<0.001. FF from 40 and 74 biopsied blastocysts was analysed of which 52.5 and 60.8% were euploid (p = 0.428), respectively. In VitD deficient patients, mean 25(OH)D-FF, bioavailable 25(OH)D-FF, and free 25(OH)D-FF were higher in euploid vs aneuploid blastocysts (18.3±6.3 ng/ml vs 13.9±4.8 ng/ml; p = 0.040; 1.5±0.5 ng/ml vs 1.1±0.4 ng/ml; p = 0.015; 0.005±0.002 ng/ml vs 0.003±0.001 ng/ml; p = 0.023, respectively), whilst no differences were found in VitD non-deficient patients (37.9±12.3 ng/ml vs 40.6±13.7 ng/ml; p = 0.380; 3.1±1.1 ng/ml vs 3.3±1.2 ng/ml; p = 0.323; 0.01±0.003 ng/ml vs 0.01±0.004 ng/ml; p = 0.319, respectively).ConclusionVitD non-deficient patients have a significantly higher probability of obtaining a euploid blastocyst compared to VitD deficient patients (OR:33.36, p = 0.002).

The level of vitamin D in follicular fluid and ovarian reserve in an in vitro fertilization program: A pilot study

“…12 Similarly, Anifandis et al demonstrated that FF vitamin D levels were negatively correlated to the quality of embryos and clinical pregnancy rate. 11 On the contrary, in other studies, women with higher FF vitamin D levels were more likely to be pregnant after ART, 14,34,35 have better embryo quality, 34,36 or no significant differences were observed between FF vitamin D levels and pregnancy rate. 13 These discrepancies might have resulted from the fact that the ovarian reserve status was never considered in previous studies.…”

Follicular GH and IGF1 Levels Are Associated With Oocyte Cohort Quality: A Pilot Study

“…However, we did not find any evidence of such a relationship. Although the possible association with oocyte morphology has not previously been assessed, other IVF parameters have been evaluated in the literature; there was no difference in the number of oocytes collected ( 55 , 56 ) or in the oocyte maturation rate as a function of the follicular 25OHD level ( 56 ). Conversely, some researchers have observed a negative correlation between the follicular 25OHD level and the fertilisation rate ( 57 ).…”

Free 25(Oh)d3 Levels in Follicular Ovarian Fluid Top Quality Embryo is Higher Than Non- Top Quality Embryo in Normoresponders Group

“…Intrafollicular vitamin D levels are positively correlated with oocyte maturity, fertilization rate, and topquality embryos. uid correlated with serum levels of vitamin D. [15] This is thought to be related to the pleiotropic effect of vitamin D, which is related to the vitamin D response element (VDRE) gene, which gives a different phenotype in each cell.…”

“…In a study by Liu et al, a cut-off value of 25(OH)D3 serum of > 14.1 ng/mL can predict a normal fertilization rate, pregnancy rate, and live birth rate. [15] The cut off value of follicular free 25(OH)D3, which can be used as a predictor of top quality embryo (TQE), is > 0.00175 ng/mL (95% CI 0.605 (0.528-0.678), p = 0.0146, sensitivity 34.88%, speci city 85.06%). The relationship between the cut off value of follicle-free 25(OH)D3 levels > 0.00175 ng/mL between the TQE and non-TQE groups differed statistically signi cantly (p = 0.002, OR (95% CI) 3.05(1.46-6) ,38)).…”

“…However, a study conducted by Ciepiela et al showed different results; the TQE group had lower follicular 25(OH)D3 levels than the non-TQE group[4]. Rudick et al revealed that race had an effect on the relationship between vitamin D status and post-IVF pregnancy rates [15]. The results of this study were in line with those of Zainab M.Alawad and Arnanz et al due to the same sample (Asian racial group), while in the study of Ciepiela et al the study subjects were the Hispanic race group.…”