Replete vitamin D stores predict reproductive success following in vitro fertilization

Abstract

Objective: To determine whether 25OH-D levels in the follicular fluid (FF) of infertile women undergoing IVF demonstrate a relationship with IVF cycle parameters and outcome, hypothesizing that levels of 25OH-D in body fluids are reflective of vitamin repletion status.

Design: Prospective cohort study.

Setting: Academic tertiary care center.

Patient(s): Eighty-four infertile women undergoing IVF.

Intervention(s): Follicular fluid from follicles>or=14 mm; serum (n = 10) and FF levels of 25OH-D.

Main outcome measure(s): Clinical pregnancy (CP), defined as evidence of intrauterine gestation sac on ultrasound, following IVF; IVF cycle parameters.

Result(s): Serum and FF levels of 25OH-D were highly correlated (r=0.94). In a predominantly Caucasian population (66%), significantly lower FF 25OH-D levels were noted in Black versus non-Black patients. Significant inverse correlations were seen between FF 25OH-D levels and body mass index (r=-0.25). Significantly higher CP and implantation rates were observed across tertiles of FF25OH-D; patients achieving CP following IVF (n=26) exhibited significantly higher FF levels of 25OH-D. Multivariable logistic regression analysis confirmed FF 25OH-D levels as an independent predictor to success of an IVF cycle; adjusting for age, body mass index, ethnicity, and number of embryos transferred, each ng/mL increase in FF 25OH-D increased the likelihood for achieving CP by 6%.

Conclusion(s): Our findings that women with higher vitamin D level in their serum and FF are significantly more likely to achieve CP following IVF-embryo transfer are novel. A potential for benefit of vitamin D supplementation on treatment success in infertile patients undergoing IVF is suggested and merits further investigation.

Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Follicular fluid 25-OH Vitamin D reliably reflects serum levels

Figure 2

Population prevalence (%) of Vitamin D status

Figure 3

Significantly higher follicular fluid 25OH Vitamin D levels are noted in IVF cycles achieving clinical pregnancy

Figure 4

Increasing implantation and clinical pregnancy rates are observed across FF 25OHD tertiles.