The role of serum vitamin D in patients with normal ovarian reserve undergoing the first IVF/ICSI cycle

Abstract

BackgroundThe debate over the impact of vitamin D in assisted reproduction continues. The purpose of our study was to assess embryo quality and pregnancy outcomes among groups with different levels of vitamin D after the first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle in patients with normal ovarian reserve (NOR).MethodsPatients in this retrospective cohort study were divided into three groups: severe vitamin D deficiency group (25OH-D < 10 ng/ml), vitamin D deficiency group (10 ng/ml ≤ 25OH-D < 20 ng/ml), and non-vitamin D deficiency group (25OH-D ≥ 20 ng/ml). The primary outcome was clinical pregnancy, while the secondary outcomes were mature oocytes, oocyte fertilization, available cleavage embryos, available blastocysts, biochemical pregnancy, early abortion, and embryo implantation. A modified Poisson regression model and multiple linear regression analysis were conducted for the multivariate analysis.Results264 NOR patients undergoing the first IVF/ICSI cycles were included. For the primary outcome, there was no significant difference in clinical pregnancy between the severe vitamin D deficiency group and the other two groups (vitamin D deficiency group: adjusted RR = 1.026; 0.780 - 1.350; P = 0.854; non-vitamin D deficiency group: adjusted RR = 1.092; 0.743 - 1.605; P = 0.652). For all secondary outcomes, no significant differences were observed among the severe vitamin D deficiency, vitamin D deficiency, and non-vitamin D deficiency groups (P > 0.05). Exploratory subgroup analyses concerning the season of embryo transfer, phase of embryo transferred, and endometrial thickness, as well as the sensitivity analysis using logistic regression models for the primary outcome, revealed comparable clinical pregnancy rates among the groups (P > 0.05). Subgroup analysis concerning ovarian stimulation protocol indicated that in the subgroup of gonadotrophin-releasing hormone (GnRH) antagonist protocol, the clinical pregnancy rate of the non-vitamin D deficiency group was significantly higher than that of the other two groups (P < 0.05).ConclusionSerum vitamin D level was not associated with embryo quality and pregnancy outcomes for patients with NOR. Further studies with greater sample sizes and a longer follow-up period are needed to elucidate the relationships between vitamin D levels and IVF outcomes.

Effects of Preconceptional Vitamin D Levels on IVF Outcomes in Infertile Patients with Polycystic Ovary Syndrome: A Retrospective Cohort Study

“…On the other hand, ROC analysis indicated that the vitamin D cut-off value for a patient to have a miscarriage was 26.06 ng/mL. However, the result does not indicate su cient signi cance to state that that value can be used as a cutoff value (0.172), and the miscarriage rates did not differ with vitamin D levels (0.122), which was also indicated in previous studies (24,25,44). Furthermore, two extensive meta-analyses conducted in 2022 and 2023, comprising 3711 women and 2352 women, respectively, undergoing in vitro fertilization (IVF), indicated that the level of vitamin D plays a pivotal role in attaining a successful pregnancy.…”

“…(22)(23)(24). Furthermore, another study in 2023 about the effect of vitamin D status on in vitro fertilization (IVF) also stated that vitamin D does have any signi cant effect on the any IVF outcome, including clinical pregnancy rates (25). Additionally, A 2019 study on the effect of vitamin D supplementation on IVF revealed a cut-off vitamin D value of 14.1 ng/mL, despite not having any obvious effect on clinical pregnancy rates (26).…”

“…Effects of vitamin D on endometrial thickness has been a debatable topic for a long time. Some studies suggested that vitamin D has no considerable impact on EMT (25). However, there were studies concluding that a better state of vitamin D has a positive effect on EMT (31,32).…”