Study On The Relationship Between Vitamin D Levels And Pregnancy Rates Of In Vitor Fertilization And Embryo Tranfer

ObjectiveTo explore the relationship between IVF/ICSI outcomes and serum vitamin D(VD,VitD)level through the detection of infertile women's VD levels.To confirm whether vitamin D deficiency will reduce the clinical pregnancy rate among women undergoing IVF/ICSI.Materials and Methods(1)Retrospective analysis in the 618 patients with normal ovarian function for the first time undergoing IVF/ICSI.The data wered analysised from Reproductive Center of The Third Affiliated Hospital of Zhengzhou University between December 2015 and January 2017 that included patients with IVF/ICSI.(2)In the standard:(1)meet the line IVF,ICSI indications,fresh cycle have two Day 3 embryo transfer;(2)age ? 35 years;(3)body mass index(BMI)18-25 kg / m2;(4)ovarian reserve function is normal:(AFC)> 6,Basic Follicle Stimulating Hormone(bFSH)<10 IU / L,Basic Estradial(bE2)<50 ng / L.(3)Exclusion criteria: Elimination of malignant tumors(history),hypertension,diabetes,multiple sclerosis,endocrine and metabolic diseases requiring long-term drug therapy,liver or kidney disease,hyperprolactinemia,Polycystic ovarian syndrome Syndrome,PCOS),oral compound vitamin preparations or vitamin D mixture.(4)Serum 25-hydroxy vitamin D levels were measured by chemiluminescence.Univariate analysis was used to women were divided into two groups: obtained clinical pregnancy group and without obtained clinical pregancy group.To confirm whether vitamin D deficiency will reduce the clinical pregnancy rate among women undergoing IVF/ICSI.In the logistic regression model,the results of univariate analysis as independent variables,clinical pregnancy was set as the dependent variable,Logistic regression analysis was used to analyze the correlation of pregnancy.(4)Based on serum 25(OH)D levels of the subjects were divided into group A: Serum 25(OH)D <25nmol / L;Group B: serum 25(OH)D 25 ~ 50 nmol / L;Group C: Serum 25(OH)D> 50 nmol / L,three groups were compared between the number of eggs,the total number of mature eggs,high-quality embryos,fertilized ovum total number of available embryos,biochemical pregnancy,clinical pregnancy whether the differences.(5)The data were analyzed by SPSS 21.0 statistical software,P <0.05 was statistically significant.Results(1)In the 618 subjects,167 cases of severe vitamin D deficiency accounted for 27% of the total number of subjects;173 cases of vitamin D deficiency,accounting for 28% of the number of survey;vitamin D deficiency of 275,accounting for the survey The number of 44.5%;vitamin D normal 3 people,accounting for 0.5% of the number of survey;did not find the presence of vitamin D over the situation.The serum 25-(OH)D was 36.04 ± 5.388 nmol / L,which was lower than that of the foreign scholars.According to the adult VD standard,only three female VD levels in the normal range,accounting for 0.5%,more than 95.5% of patients with varying degrees of VD deficiency or deficiency.(2)The average age of the 618 patients was 28.81±3.55 years,387women(62.6%)in the pregnancy group and 231women(37.4%)in the non-pregnancy group.Univariate analysis showed that the age of the pregnant group was lower than that of the non-pregnant group [(28.59±3.49)vs.(29.28±3.64)years],and the endometrial thickness of the pregnant group was greater than that of the non-pregnant group [(11.63±2.09)vs.10.52±2.54)mm],The quality of the transplanted embryos was higher than that of the non-pregnant group [high quality embryos 205(52.9)vs 99(42.9)],non-quality embryos [182(47.1)vs.132(57.1)],Vitamin D deficiency in the non-pregnant group [187(48.3)vs 156(67.5)],and vitamin D was not deficient [200(51.7)vs.75(32.5)](P <0.05).Clinical pregnancy was set as the dependent variable,with independent variables being age,endometrial thickness,quality of the embryo transferred,serum 25(OH)D levels.The results show that Endometrial thickness(OR = 1.251,95% CI: 1.013-1.545,p = 0.037),has been transferred embryo quality(OR = 1.903,95% CI: 1.123-3.226,p = 0.017),serum 25(OH)D(OR = 0.995,95% CI: 0.991-0.998,p = 0.004)were statistically significant.(3)There were 167 cases of group A(vitamin D <25mol / L),173 cases of group B(vitamin D 25 ~ 50 mol / L),and 278 cases of group C(vitamin D> 50 mol / L).There were no significant differences in age,BMI,infertility,total number of sinus follicles,E2,LH and FSH in the three groups(P> 0.05).Three groups of biochemical pregnancy rate,clinical pregnancy rate,the difference was statistically significant(P <0.05).There were no significant differences in total of Gn,Gn days,total number of mature eggs,number of high quality embryos,total number of fertilized eggs,number of available embryosendometrial thickness on the day of hCG,and serum progesterone levels on the day of hCG administration.Conclusions 1.Deficiency or inadequate of serum vitamin D levels in women with IVF / ICSI infertility.2.In IVF / ICSI patients,vitamin D deficiency are independent factors of clinical pregnancy.3.Compared with 25(OH)D> 50 nmol / L,the clinical pregnancy rate of IVF / ICSI was significantly lower in patients with serum 25(OH)D 25(OH)D <25mol / L.4.There was no significant correlation between serum 25(OH)D level and egg number,number of mature eggs,number of available embryos and embryo quality.