Relationship between serum levels of vitamin D and the success rate of pregnancy in an in vitro fertilization cycle (IVF): A prospective cohort study

Document Type : Original Article

Authors

1 PhD student of Midwifery, Students Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

2 M.Sc. of Midwifery, Students Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

3 B.Sc. of Midwifery, Islamic Azad University, Tabriz Branch, Tabriz, Iran.

4 Professor, Department of Obstetrics and Gynecology, Women's Reproductive Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

5 Professor, Department of Midwifery, Social Determinants of Health Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction: Vitamin D deficiency in women may play a role in the pathogenesis of infertility and menstrual dysfunction. Due to the high percentage of insufficient vitamin D serum levels in women of reproductive age, recently the role of vitamin D in reproductive physiology has also been considered. The present study was performed with aim to determine the relationship between vitamin D serum level and pregnancy success rate in a cycle of in vitro fertilization (IVF).
Methods: In this prospective cohort study conducted in 2022, 116 reproductive-aged women diagnosed with both primary or secondary infertility in their first IVF cycle were studied. Based on the serum level of vitamin D in the blood sample measured by the Elisa method 7 days before embryo transfer, the participants were divided into two groups: deficiency or insufficient and sufficient and were evaluated at the gestational age of 7 weeks in terms of the presence of intrauterine gestational sac and the presence of heartbeat. Data collection tools included socio-demographic, infertility, and nutrition questionnaires, and checklists for recording test results and pregnancy outcomes. Data were analyzed by SPSS statistical software (version 24) and chi-square, independent t-test, and multivariate logistic regression. P<0.05 was considered statistically significant.
Results: The mean of vitamin D serum level in people with successful pregnancy and unsuccessful pregnancy was 60.3±26.8 and 66.5±37.4, respectively (p=0.361) and the frequency of pregnancy success in vitamin D sufficient and insufficient group was 23.3% and 13.6%, respectively (p=0.247). Based on multivariate logistic regression and adjusting for confounding variables, there was no statistically significant difference between the groups in terms of pregnancy success rate (odds ratio: 2.08; 95% (CI): 0.45 to 9.5; (p=0.346).
Conclusion: Although vitamin D serum level in infertile women with successful pregnancies was more than in women with unsuccessful pregnancies, however, this difference was not significant.

Keywords

References

  1. Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem?. The Journal of steroid biochemistry and molecular biology 2014; 144:138-45.
  2. Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects. Physiological reviews 2016; 96(1):365-408.
  3. Pilz S, März W, Cashman KD, Kiely ME, Whiting SJ, Holick MF, et al. Rationale and plan for vitamin D food fortification: a review and guidance paper. Frontiers in endocrinology 2018; 9:373.
  4. Garbedian K, Boggild M, Moody J, Liu KE. Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization. Canadian Medical Association Open Access Journal 2013; 1(2):E77-82.
  5. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of clinical endocrinology & metabolism 2011; 96(7):1911-30.
  6. Tabrizi R, Moosazadeh M, Akbari M, Dabbaghmanesh MH, Mohamadkhani M, Asemi Z, et al. High prevalence of vitamin D deficiency among Iranian population: a systematic review and meta-analysis. Iranian journal of medical sciences 2018; 43(2):125.
  7. Chu J, Gallos I, Tobias A, Tan B, Eapen A, Coomarasamy A. Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis. Human reproduction 2018; 33(1):65-80.
  8. Seremak-Mrozikiewicz A, Drews K, Mrozikiewicz PM, Bartkowiak-Wieczorek J, Marcinkowska M, Wawrzyniak A, et al. Correlation of vitamin D receptor gene (VDR) polymorphism with osteoporotic changes in Polish postmenopausal women. Neuro Endocrinol Lett 2009; 30(4):540-6.
  9. Kumari KR, Hadalagi NM. Role of sunshine vitamin" D" sufficiency in male and female infertility. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2015; 4(2):305-12.
  10. Weisman Y, Harell A, Edelstein S, David M, Spirer Z, Golander AL. 1 α, 25-Dihydroxyvitamin D3, and 24, 25-dihydroxyvitamin D3 in vitro synthesis by human decidua and placenta. Nature 1979; 281(5729):317-9.
  11. Rajaei S, Mirahmadian M, Jeddi-Tehrani M, Tavakoli M, Zonoobi M, Dabbagh A, et al. Effect of 1, 25 (OH) 2 vitamin D3 on cytokine production by endometrial cells of women with repeated implantation failure. Gynecological Endocrinology 2012; 28(11):906-11.
  12. Kalani N. Different dimensions of infertility phenomenon in the life of Iranian women: a systematic review. Iran J Obstet Gynecol Infertil 2023; Articles in Press.
  13. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clinical biochemistry 2018; 62:2-10.
  14. Moghadam AD, Delpisheh A, Sayehmiri K. The trend of infertility in Iran, an original review and meta-analysis. Nursing Practice Today 2014; 1(1):46-52.
  15. Brugo-Olmedo S, Chillik C, Kopelman S. Definition and causes of infertility. Reproductive biomedicine online 2001; 2(1):173-85.
  16. Abdullah UH, Lalani S, Syed F, Arif S, Rehman R. Association of Vitamin D with outcome after intra cytoplasmic sperm injection. The Journal of Maternal-Fetal & Neonatal Medicine 2017; 30(1):117-20.
  17. Asadi M, Matin N, Frootan M, Mohamadpour J, Qorbani M, Tanha FD. Vitamin D improves endometrial thickness in PCOS women who need intrauterine insemination: a randomized double-blind placebo-controlled trial. Archives of gynecology and obstetrics 2014; 289:865-70.
  18. Arabian S, Raoofi Z. Effect of serum vitamin D level on endometrial thickness and parameters of follicle growth in infertile women undergoing induction of ovulation. Journal of Obstetrics and Gynaecology 2018; 38(6):833-5.
  19. Cozzolino M, Busnelli A, Pellegrini L, Riviello E, Vitagliano A. How vitamin D level influences in vitro fertilization outcomes: results of a systematic review and meta-analysis. Fertility and Sterility 2020; 114(5):1014-25.
  20. Rudick B, Ingles S, Chung K, Stanczyk F, Paulson R, Bendikson K. Characterizing the influence of vitamin D levels on IVF outcomes. Human reproduction 2012; 27(11):3321-7.
  21. Neysanian G, Taebi M, Rezaeian A, Nasr-Esfahani MH, Jahangirifar M. The effects of serum and follicular fluid vitamin D levels on assisted reproductive techniques: a prospective cohort study. International Journal of Fertility & Sterility 2021; 15(4):280.
  22. Deeks JJ, Hopewell S, Moher D, Higgins JP, Moons KG, Chandler J, et al. Doug Altman's legacy to Cochrane and evidence synthesis. Cochrane Database of Systematic Reviews 2018; 9.
  23. Zhao J, Huang X, Xu B, Yan Y, Zhang Q, Li Y. Whether vitamin D was associated with clinical outcome after IVF/ICSI: a systematic review and meta-analysis. Reproductive Biology and Endocrinology 2018; 16:1-7.
  24. Muyayalo KP, Song S, Zhai H, Liu H, Huang DH, Zhou H, et al. Low vitamin D levels in follicular fluid, but not in serum, are associated with adverse outcomes in assisted reproduction. Archives of Gynecology and Obstetrics 2022; 305(2):505-17
  25. Liu X, Zhang W, Xu Y, Chu Y, Wang X, Li Q, et al. Effect of vitamin D status on normal fertilization rate following in vitro fertilization. Reproductive Biology and Endocrinology 2019; 17(1):1-10.
  26. Franasiak JM, Molinaro TA, Dubell EK, Scott KL, Ruiz AR, Forman EJ, et al. Vitamin D levels do not affect IVF outcomes following the transfer of euploid blastocysts. American journal of obstetrics and gynecology 2015; 212(3):315-e1.
  27. Firouzabadi RD, Rahmani E, Rahsepar M, Firouzabadi MM. Value of follicular fluid vitamin D in predicting the pregnancy rate in an IVF program. Archives of gynecology and obstetrics 2014; 289:201-6.
  28. Ozkan S, Jindal S, Greenseid K, Shu J, Zeitlian G, Hickmon C, et al. Replete vitamin D stores predict reproductive success following in vitro fertilization. Fertility and sterility 2010; 94(4):1314-9.
  29. Shahine LK, Lamb JD, Lathi RB, Milki AA, Langen E, Westphal LM. Poor prognosis with in vitro fertilization in Indian women compared to Caucasian women despite similar embryo quality. PloS one 2009; 4(10):e7599.
  30. Homayouni-Meymandi M, Sotoodehnejadnematalahi F, Nasr-Esfahani MH. Relationship between serum vitamin D in male, sperm function and clinical outcomes in infertile men candidate for ICSI: a cohort study. International Journal of Fertility & Sterility 2022; 16(2):115-21.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 26, Issue 3
May 2023
Pages 33-42

Files

Share

How to cite

Statistics