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IVF 4X more successful for white women with lots of vitamin D – Oct 2012

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IVF 4X more successful for white women with lots of vitamin D – Oct 2012

Characterizing the influence of vitamin D levels on IVF outcomes
Oxford Journals Medicine Human Reproduction Volume 27, Issue 11Pp. 3321-3327.
B. Rudick1,*, S. Ingles2,†, K. Chung3, F. Stanczyk3, R. Paulson3 and K. Bendikson3,†
1 Center for Women's Reproductive Health, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Columbia University, 1790 Broadway 2nd Floor, New York, NY 10019, USA
2 Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
3 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, 2020 Zonal Avenue, Room 534, Los Angeles, CA 90033, USA
?*Correspondence address. E-mail: briana.rudick at gmail.com
Received August 29, 2011; Revision received June 13, 2012; Accepted June 21, 2012.

BACKGROUND Vitamin D plays a role in reproductive capacity. Recently, several investigators have demonstrated higher IVF pregnancy rates in vitamin D replete women. The objective of this study was to validate these findings and to further elucidate the role of vitamin D in reproduction among a diverse group of women.

METHODS This was a retrospective cohort study in an academic tertiary care center of 188 infertile women undergoing IVF. Serum levels of vitamin D (25OH-D) were measured in previously frozen serum samples. The main outcome measure was clinical pregnancy, defined as sonographic presence of a heartbeat following IVF.

RESULTS The relationship between vitamin D status and pregnancy rates differed by race (P < 0.01). Among non-Hispanic whites, pregnancy rates declined with progressively lower levels of vitamin D, while in Asians, the reverse was true. Adjusting for age and number and quality of embryos transferred among non-Hispanic whites, the odds of pregnancy were four times higher in vitamin D replete versus deficient patients. Live birth rates mirrored pregnancy rates. Vitamin D status was not associated with ovarian stimulation parameters or with markers of embryo quality.

CONCLUSIONS Vitamin D deficiency is associated with lower pregnancy rates in non-Hispanic whites, but not in Asians, possibly due to their lower IVF success rates. Vitamin D deficiency was not correlated with ovarian stimulation parameters or with markers of embryo quality, suggesting its effect may be mediated through the endometrium.

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Another study found In vitro fertilization 2X less successful if low vitamin D – Nov 2013

Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.
Fertil Steril. 2013 Nov 5. pii: S0015-0282(13)03154-3. doi: 10.1016/j.fertnstert.2013.10.008.
Rudick BJ, Ingles SA, Chung K, Stanczyk FZ, Paulson RJ, Bendikson KA.
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Center for Women's Reproductive Health, Columbia University, New York, New York. Electronic address: briana.rudick at gmail.com.

OBJECTIVE: To elucidate the role of vitamin D in reproduction by examining the relationship between recipient vitamin D levels and pregnancy rates in donor-recipient IVF cycles.

DESIGN: Retrospective cohort study.
SETTING: Academic tertiary care center.

PATIENT(S): Ninety-nine recipients of egg donation at University of Southern California Fertility.

INTERVENTION(S): Serum was collected from egg donor recipients before ET and was tested for vitamin D levels [25(OH)D].

MAIN OUTCOME MEASURE(S): Clinical pregnancy as defined by sonographic presence of a heartbeat at 7-8 weeks of gestation.

RESULT(S): In a diverse population of 99 recipients (53% Caucasian, 20% Asian, 16% Hispanic, 7% African American), adjusted clinical pregnancy rates were lower among vitamin D-deficient recipients than among vitamin D-replete recipients (37% vs. 78%).
Live-birth rates were 31% among vitamin D-deficient recipients, compared with 59% among vitamin D-replete recipients. There were no differences in adjusted clinical pregnancy and live-birth rates among recipients who were vitamin D deficient [25(OH)D<20 ng/mL] vs. among those who were vitamin D insufficient [20 ng/mL ≤ 25(OH)D<30 ng/mL].

CONCLUSION(S): Nonreplete vitamin D status [25(OH)D<30 ng/mL] was associated with lower pregnancy rates in recipients of egg donation. Since the oocyte donor-recipient model is able to separate the impact of vitamin D on oocyte vs. endometrium, these data suggest that the effects of vitamin D may be mediated through the endometrium.

Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
PMID: 24210230

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Should We Be Monitoring Vitamin D Levels In Our Infertile Patients? comment on the study

Clinical pregnancy 1.5 X more likely after IVF when vitamin D level > 30 ng - June 2013

Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization.
CMAJ Open. 2013 Jun 28;1(2):E77-82. doi: 10.9778/cmajo.20120032. eCollection 2013.
Garbedian K1, Boggild M2, Moody J3, Liu KE1.
1Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ont.
2Faculty of Medicine, University of Toronto, Toronto, Ont.
3Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont.

Recent studies suggest that vitamin D may play a role in human reproduction. Our goal was to investigate whether vitamin D levels are predictive of implantation and clinical pregnancy rates in infertile women following in vitro fertilization (IVF).

We prospectively evaluated vitamin D status, as determined by serum 25-hydroxy-vitamin D (25OHD) levels, in a cohort of 173 women undergoing IVF at Mount Sinai Hospital, Toronto, Ontario. Serum 25(OH)D samples were collected within 1 week before oocyte retrieval. We classified patients as having sufficient (≥ 75 nmol/L) or insufficient (or deficient; hereafter referred to as "insufficient"; < 75 nmol/L) serum levels of 25(OH)D. We compared patient demographics and IVF cycle parameters between groups. The primary outcome measure was clinical pregnancy (intrauterine sac visible on ultrasound performed 4-5 weeks after embryo transfer).

Of the included women, 54.9% had insufficient 25(OH)D levels and 45.1% had sufficient levels.
Women with sufficient levels had significantly higher rates of clinical pregnancy per IVF cycle started (52.5%) compared with women with insufficient levels (34.7%; p < 0.001).
Implantation rates were also higher in the sufficient 25(OH)D group, but the results were not statistically significant. Multivariable logistic regression analysis (adjusted for age, body mass index and day 5 v. day 3 embryo transfer) showed that serum 25(OH)D level may be a predictor of clinical pregnancy (adjusted odds ratio 1.01, 95% confidence interval 1.00-1.03).

Our findings suggest that women with sufficient levels of vitamin D are significantly more likely to achieve clinical pregnancy following IVF. Vitamin D supplementation could provide an easy and cost-effective way of improving pregnancy rates; this merits further investigation.

TRIAL REGISTRATION: ClinicalTrials.gov, no. NCT01348594.

PMID: 25077107

Vitamin D levels NOT associated with IVF success - Sept 2014 (disagrees with all previous studies)

Impact of circulating levels of total and bioavailable serum vitamin D on pregnancy rate in egg donation recipients
Alberta Fabris, M.D.a, Alberto Pacheco, Ph.D.a, María Cruz, Ph.D.a, Jose Manuel Puente, M.D.a, Human Fatemi, M.D.b, Juan A. Garcia-Velasco, M.D., Ph.D.a, ,
a IVI-Madrid, Rey Juan Carlos University, Madrid, Spain
b Nova IVI Fertility, Abu Dhabi, United Arab Emirates
Received 15 June 2014, Revised 12 August 2014, Accepted 26 August 2014, Available online 23 September 2014

Objective: To investigate the correlation between total and bioavailable serum 25-OH vitamin D and the pregnancy rate in recipients of donated oocytes.
Design: Retrospective study.
Setting: University-affiliated private IVF center.
Patient(s): A total of 267 patients who were referred to our clinic for oocyte donation from June 2013 to December 2013.
Intervention(s): Serum analysis of vitamin D and bioavailable vitamin D and reproductive outcomes.
Main Outcome Measure(s): Pregnancy and implantation rate.

Result(s):Among all patients, 15.3% (n = 41) were vitamin D replete (vitamin D >30 ng/mL), 50.2% (n = 134) had vitamin D deficiency (20–30 ng/mL), and 34.4% (n = 92) had insufficient vitamin D (<20 ng/mL). Implantation rates were similar among patients with normal, insufficient, or deficient total serum 25-OH vitamin D levels (61%, 63.4%, and 65.2%, respectively).
Pregnancy rates did not differ among the three groups (70%, 69.9%, and 73.9%).
Ongoing pregnancy rates were also comparable among the three groups (55.9%, 52.7%, and 60.7%).
The predictive value of total vitamin D regarding pregnancy rate was analyzed by the receiver operating characteristic curve, and the area under the curve (AUC) was 0.468.
The AUC for bioavailable 25-OH vitamin D was 0.499, showing that the analysis of the AUC for vitamin D or bioavailable vitamin D was not informative.

Conclusion(s): Vitamin D insufficiency and deficiency are frequent conditions in our southern European infertile population. In contrast to previous studies, patients who are not vitamin D replete do not have a decreased chance of becoming pregnant with egg donation.
Bioavailable 25-OH vitamin D, which is a better marker of the status than total 25-OH vitamin D, does not correlate with pregnancy rate in recipients of donated oocytes.
Thus, at this stage, there is insufficient evidence to recommend vitamin D screening in patients undergoing egg donation.

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Attached files

ID Name Comment Uploaded Size Downloads
4220 Characterizing the influence of vitamin D levels on IVF outcomes.pdf PDF admin 02 Aug, 2014 13:05 161.18 Kb 1207
2663 CMAJ.pdf PDF 2013 admin 29 Jun, 2013 13:05 252.82 Kb 787
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