Vitamin D and assisted reproductive treatment outcome: a prospective cohort study.


Journal

Reproductive health
ISSN: 1742-4755
Titre abrégé: Reprod Health
Pays: England
ID NLM: 101224380

Informations de publication

Date de publication:
15 Jul 2019
Historique:
received: 24 09 2018
accepted: 30 06 2019
entrez: 17 7 2019
pubmed: 17 7 2019
medline: 28 12 2019
Statut: epublish

Résumé

Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation leading to obstetric complications such as pre-eclampsia and fetal growth restriction. However, the effect of vitamin D on reproductive treatment outcomes in couples undergoing assisted reproductive treatment is poorly understood. This study investigates the association between vitamin D and reproductive treatment outcomes in women undergoing assisted reproductive treatments? A prospective cohort study conducted at a large tertiary teaching hospital, United Kingdom. Five hundred women undergoing assisted reproductive treatment were recruited between September 2013 and September 2015. All participants had their serum vitamin D measured and their reproductive treatment outcomes collated. Women were categorised in to three groups: vitamin D replete (> 75 nmol/L), insufficient (50-75 nmol/L) and deficient (< 50 nmol/L) according to Endocrine Society guidance. The primary outcome was live birth. Secondary outcomes included biochemical pregnancy, clinical pregnancy and pregnancy loss rates. Vitamin D deficiency was found in 53.2% (266/500) of participants and vitamin D insufficiency was found in 30.8% (154/500) of participants. Only 16% (80/500) of women were vitamin D replete. The live birth rates for vitamin D deficient, insufficient and replete women were 23.2% (57/246), 27.0% (38/141) and 37.7% (29/77) respectively (p = 0.04). The respective live birth rates for vitamin D deficient, insufficient and replete women were 24.3, 27.1, 34.4% after adjustment for key prognostic factors (p = 0.25). Vitamin D deficiency and insufficiency are common in women undergoing assisted reproductive treatments. The crude live birth rate achieved in women undergoing assisted reproductive treatments are associated with serum vitamin D, although statistical significance is lost when adjusting for important prognostic variables. Vitamin D deficiency could be an important condition to treat in women considering fertility treatment. A research trial to investigate the benefits of vitamin D deficiency treatment would test this hypothesis. Clinicaltrials.gov - NCT02187146 .

Sections du résumé

BACKGROUND BACKGROUND
Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation leading to obstetric complications such as pre-eclampsia and fetal growth restriction. However, the effect of vitamin D on reproductive treatment outcomes in couples undergoing assisted reproductive treatment is poorly understood. This study investigates the association between vitamin D and reproductive treatment outcomes in women undergoing assisted reproductive treatments?
METHODS METHODS
A prospective cohort study conducted at a large tertiary teaching hospital, United Kingdom. Five hundred women undergoing assisted reproductive treatment were recruited between September 2013 and September 2015. All participants had their serum vitamin D measured and their reproductive treatment outcomes collated. Women were categorised in to three groups: vitamin D replete (> 75 nmol/L), insufficient (50-75 nmol/L) and deficient (< 50 nmol/L) according to Endocrine Society guidance. The primary outcome was live birth. Secondary outcomes included biochemical pregnancy, clinical pregnancy and pregnancy loss rates.
RESULTS RESULTS
Vitamin D deficiency was found in 53.2% (266/500) of participants and vitamin D insufficiency was found in 30.8% (154/500) of participants. Only 16% (80/500) of women were vitamin D replete. The live birth rates for vitamin D deficient, insufficient and replete women were 23.2% (57/246), 27.0% (38/141) and 37.7% (29/77) respectively (p = 0.04). The respective live birth rates for vitamin D deficient, insufficient and replete women were 24.3, 27.1, 34.4% after adjustment for key prognostic factors (p = 0.25).
CONCLUSIONS CONCLUSIONS
Vitamin D deficiency and insufficiency are common in women undergoing assisted reproductive treatments. The crude live birth rate achieved in women undergoing assisted reproductive treatments are associated with serum vitamin D, although statistical significance is lost when adjusting for important prognostic variables. Vitamin D deficiency could be an important condition to treat in women considering fertility treatment. A research trial to investigate the benefits of vitamin D deficiency treatment would test this hypothesis.
TRIAL REGISTRATION BACKGROUND
Clinicaltrials.gov - NCT02187146 .

Identifiants

pubmed: 31307482
doi: 10.1186/s12978-019-0769-7
pii: 10.1186/s12978-019-0769-7
pmc: PMC6631833
doi:

Substances chimiques

Vitamins 0
Vitamin D 1406-16-2

Banques de données

ClinicalTrials.gov
['NCT02187146']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106

Subventions

Organisme : Department of Health
ID : HCS SCL-2014-05-001
Pays : United Kingdom
Organisme : Birmingham Women's and Children's NHS Foundation Trust
ID : Springboard Fellowship

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Auteurs

Justin Chu (J)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK.
Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

Ioannis Gallos (I)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK. i.d.gallos@bham.ac.uk.
Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK. i.d.gallos@bham.ac.uk.
Birmingham Women's Foundation NHS Trust, Edgbaston, B15 2TG, UK. i.d.gallos@bham.ac.uk.

Aurelio Tobias (A)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK.
Spanish Council for Scientific Research, Institute of Environmental Assessment and Water Research, Barcelona, Spain.

Lynne Robinson (L)

Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

Jackson Kirkman-Brown (J)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK.
Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

Rima Dhillon-Smith (R)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK.
Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

Hoda Harb (H)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK.
Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

Abey Eapen (A)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK.
Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

Madhurima Rajkhowa (M)

Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

Arri Coomarasamy (A)

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, B15 2TT, UK.
Birmingham Women's and Children's National Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.

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