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In Vitro Fertilization (D5 SET ICSI) 40 percent more successful if high vitamin D – Sept 2014

Two studies on this page

Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ICSI

Medicine & Health Human Reproduction Volume 29, Issue 9Pp. 2032-2040.
Nikolaos P. Polyzos1,*, Ellen Anckaert2, Luis Guzman2,3, Johan Schiettecatte2, Lisbet Van Landuyt1, Michel Camus1, Johan Smitz2 and Herman Tournaye1
1Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
2Laboratory of Hormonology and Tumormarkers, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
3Grupo PRANOR, Lima, Perú
↵*Correspondence address. Tel: +32-2-477-66-60; Fax: +32-2-477-66-49; E-mail: n.polyzos at gmail.com; nikolaos.polyzos at uzbrussel.be
Received January 7, 2014. Revision received April 13, 2014. Accepted May 12, 2014.

STUDY QUESTION What is the influence of vitamin D deficiency on pregnancy rates among women undergoing IVF/ICSI and Day 5 (blastocyst stage) single embryo transfer (SET)?

SUMMARY ANSWER Vitamin D deficiency results in significantly lower pregnancy rates in women undergoing single blastocyst transfer.

WHAT IS KNOWN ALREADY Preliminary experiments have identified the presence of vitamin D receptors in the female reproductive system. However, results regarding the effect of vitamin D deficiency on clinical outcomes are conflicting. None of the previous studies adopted a SET strategy.

STUDY DESIGN, SIZE, DURATION Serum vitamin D concentration was measured retrospectively in patients who underwent SET on Day 5. Overall 368 consecutive infertile women treated within a period of 15 months were included in the study.

PARTICIPANTS/MATERIALS, SETTING, METHODS All patients underwent ovarian stimulation for IVF/ICSI and Day 5 SET. Serum samples were obtained 7 days prior to embryo transfer and stored frozen at −20°C. Samples were collectively analyzed for their 25-OH vitamin D content.
Vitamin D deficiency was defined as serum 25-OH vitamin D levels <20 ng/ml in accordance with the Institute of Medicine and the Endocrine Society clinical practice guidelines.

MAIN RESULTS AND THE ROLE OF CHANCE Clinical pregnancy rates were significantly lower in women with vitamin D deficiency compared with those with higher vitamin D values (41 versus 54%, P = 0.015). Logistic regression analysis was performed to identify whether vitamin D deficiency is independently associated with clinical pregnancy rates after controlling for 16 potential confounding factors.
According to our results vitamin D deficiency was independently associated with lower clinical pregnancy rates, odds ratios [ORs (95% confidence interval (CI) 0.61 (0.39–0.95)] for vitamin D deficiency (deficient versus non-deficient women), P = 0.030.
Finally, even when restricting our analysis to women undergoing elective SET (274 patients), vitamin D deficiency was again independently associated with pregnancy rates [OR (95% CI) 0.56 (0.33–0.93), P = 0.024].

LIMITATIONS, REASONS FOR CAUTION Our results refer only to patients undergoing Day 5 SET. Although vitamin D deficiency appears to compromise pregnancy rates in this population, no guidance can be provided regarding a potential relationship between vitamin D deficiency and ovarian reserve or response to ovarian stimulation.

WIDER IMPLICATIONS OF THE FINDINGS Vitamin D deficiency impairs pregnancy rates in women undergoing single blastocyst transfer. Future prospective confirmatory studies are needed to validate our results and examine the exact underlying mechanism by which vitamin D levels may impair pregnancy rates in infertile women undergoing IVF/ICSI.


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Comment by VitaminDWiki

It appears to be 40% improvement if > 20 ng vs < 20 ng (54% vs 41%)
Suspect far better success if > 40 ng – perhaps 70%

IVF 2X better if > 20 ng than < 20 ng, Best if > 30 ng Aug 2014

Vitamin D Deficiency and Infertility: Insights From in vitro Fertilization Cycles.
J Clin Endocrinol Metab. 2014 Aug 14:jc20141802. [Epub ahead of print]
Paffoni A1, Ferrari S, Vigano P, Pagliardini L, Papaleo E, Candiani M, Tirelli A, Fedele L, Somigliana E.
1Fondazione IRCCS Ca' Granda (A.P., S.F., A.T., L.F., E.S.), Ospedale Maggiore Policlinico, Milan, Italy; Obstetrics and Gynecology Unit (P.V., L.P., E.P.), San Raffaele Scientific Institute, Milan, Italy; Università Vita-Salute (M.C.), San Raffaele Scientific Institute, Milan, Italy; University of Milan (L.F.).

Context: Vitamin D deficiency has been proven to affect fertility in mammals, but data in human is less convincing. In particular, data on in vitro fertilization (IVF), an attractive model to draw information on this topic, are sparse and conflicting. Objective: To investigate IVF outcome in women with deficient 25-hydroxy-vitamin D [25(OH)D] serum levels (<20 ng/mL).

Design: Prospective cross-sectional study. Setting: Infertility unit of an academic setting. Patients: The main inclusion criteria were as follows: (1) indication to IVF, (2) age 18-42 years, (3) BMI 18-25 kg/m2, (4) adequate ovarian reserve according to Bologna criteria. Eligible women provided a serum sample for 25(OH)D measurement at the time of cycle preparation. Subjects were subsequently excluded if the cycle was cancelled or if the attempt was excessively delayed. Intervention: Quantitative detection of serum 25(OH)D.

Main Outcome Measure: Clinical pregnancy rate.

Results: The number of recruited women with serum 25(OH)D <20 ng/mL and ≥20 ng/mL was 154 and 181, respectively. The clinical pregnancy rates were 20% (30/154) and 31% (56/181), respectively (P = 0.02); the adjusted odds ratio for clinical pregnancy in women with vitamin D ≥20 ng/mL was 2.15 (95% CI: 1.23-3.77). Subgroup analyses showed that the group of women with the highest serum levels (>30 ng/mL) had the highest chances of pregnancy.

Conclusions: Vitamin D is an emerging factor influencing female fertility and IVF outcome. Additional studies are pressingly needed to confirm a causal relationship and to investigate the potential therapeutic benefits of vitamin D supplementation.
PMID: 25121462

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