Vitamin D and IVF Outcomes

The Role of Vitamin D Levels on IVF Outcomes in Donor-recipient
Fertility and Sterility
Volume 95, Issue 4, Supplement , Page S8, 15 March 2011.
B. Rudick, S.A. Ingles, F. Stanczyk, K. Chung, R. Paulson, K. Bendikson

Objective(s):
Vitamin D has been shown to play a role in reproductive capacity with a recent focus on its role in the endometrium. Multiple investigators have demonstrated higher pregnancy rates after IVF in vitamin D replete women. The goal of our study was to further elucidate the role of vitamin D in reproduction by validating these findings in donor-recipient cycles.

Design:
Retrospective analysis of donor-recipient IVF cycles performed at USC Fertility.

Materials and Method(S):
Recipients of egg donation from 2006 to 2009 were identified and their medical records were reviewed. Serum collected and frozen at the time of down-regulation during their first donor egg cycle was tested for Vitamin D levels (25OH-D). Vitamin D deficiency and insufficiency was defined as 25OHD < 20 ng/mL, 20-30 ng/ml, respectively. Patients were considered Vitamin D replete with levels >30 ng/mL.

Result(s):
In a diverse population of 64 recipients (56% Caucasian, 20% Asian, 13% Hispanic, 8% African American), 28% of the recipients were vitamin D deficient, 41% were vitamin D insufficient, and only 31% were vitamin D replete. Pregnancy rates were lower among those patients who were vitamin D deficient and insufficient (39% and 38% respectively), compared with those who were vitamin D replete (70%, P=0.02). The mean vitamin D level among those recipients who became pregnant was 28.5 ng/ml versus 23.4 ng/ml in those who did not become pregnant (P=0.04, figure 1). Serum 25OHD levels varied by ethnicity (P=0.04), being highest in Caucasians (mean, 27.3 ng/ml) and lowest in African Americans (mean, 15.6 ng/ml. Clinical pregnancy rates also varied by ethnicity being highest in Caucasian and Hispanic recipients (61% and 50% respectively) and lowest in African Americans and Asians (20% and 31% respectively).

Conclusion(s):
Vitamin D deficiency and insufficiency are associated with lower pregnancy rates in recipients of egg donation, suggesting that optimal preconception vitamin D levels are greater than 30 ng/ml. Since the oocyte donor-recipient model is able to separate the impact of oocyte and endometrium, the lower pregnancy rates observed in vitamin D deficient and insufficient recipients suggest that the effect of Vitamin D may be mediated through the endometrium.

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