血清维生素D与体外受精-胚胎移植治疗结局的相关性

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摘要目的：探讨维生素D缺乏是否影响体外受精-胚胎移植（IVF）的治疗结果及血清维生素D水平是否能有效预测IVF妊娠结局。方法：选取2016年2月至6月在温州医科大学附属第一医院生殖中心行IVF/单精子卵胞浆内注射长方案治疗的不孕患者，共321例，其中307例患者完成IVF治疗。根据IVF治疗前一月经周期第2～第5天血清总25(OH)D水平（基础VD）分：＜50 nmol/L，即维生素D缺乏组（173例）；≥50 nmol/L，即对照组（134例）；将有新鲜胚胎移植的196例（维生素缺乏组107例和对照组89例）分妊娠组（107例）和未妊娠组（89例）。比较各组的基础VD水平、促排卵及妊娠结果。结果：维生素D缺乏组基础VD水平显著低于对照组，分别为（38.2±7.8）nmol/L和（63.8±11.1）nmol/L（P＜0.01）。维生素D缺乏组年龄显著低于对照组（P＜0.01）。2组体质量指数、基础卵泡刺激素值、雌二醇峰值、获卵数、受精率、优质胚胎率、种植率及临床妊娠率等差异均无统计学意义（P＞0.05）。妊娠组和未妊娠组的基础VD水平差异均无统计学意义（P＞0.05）。妊娠组的卵子成熟率、受精率及优质胚胎率均显著高于未妊娠组（P＜0.01）。结论：血清基础VD水平和不孕妇女的IVF治疗结局没有相关性，不能作为预测IVF成功率的良好指标。

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	陈雅
	黄学锋
	杨海燕
	王佩玉

关键词 ：维生素D, 胚胎移植, 妊娠, 长方案

Abstract：Objective: To investigate the effect of vitamin D deficiency on the in vitro fertilization (IVF) outcomes and validate the predictive value of serum vitamin D levels on pregnancy outcomes following IVF. Methods: This prospective study randomly chose 321 cases undergoing IVF with long protocols from January to June 2016, in which 307 patients finished ovarian sitimulation cycles. The patients were allocated to one of the two groups according to their serum 25-OH vitamin D (basal VD) concentrations on menstrual cycle 2 to 5 days before IVF. VD deficiency Group (n=173) with less than 50 nmol/L, the control (n=134) with more than or equal to 50 nmol/L. In 196 cycles undergoing fresh embryos transfer, they were divided into pregnant group (n=107) and non-pregnant group (n=89). The levels of 25-OH vitamin D and the results of ovarian stimulation and clinical outcomes were compared in groups. Results: Basal serum 25-OH VD constration was significantly lower in VD deficiency group than that in control (38.2±7.8 nmol/L vs 63.8±11.1 nmol/L, respectively, P<0.01). Expect for age, there were no statistical differences of body mass index (BMI), basal follicle stimulation hormone levels, the peak values of estradiol number of oocytes, the rates of fertilization, good-quality embryos, implantation and clinical pregnancy in two groups (P>0.05). Concentration of plasma 25-OHVD in pregnant women was similar to that of non-pregnant women (P>0.05). Compared with non-pregnant patients, the rates of ovum maturation, fertilization and good-quality embryos were significantly higher in pregnant patients (P<0.01). Conclusion: The results obtained suggest that basal serum levels of vitamin D are not correlated with clinical outcomes of infertile women after IVF, and currently, the concentration of vitamin D could not be a valuable predictor of IVF success ratio.

Key words： vitamin D embryo transfer pregnant long protocol

收稿日期: 2016-08-05

作者简介: 陈雅（1979-），女，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I6/445

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