Effect Of Vitamin D Intervention On Outcomes Of Re-IVF Fresh Embryo Transplantation

ObjectiveTo investigate the correlation between serum 25?OH?D level and clinical indicators of in vitro fertilization?IVF?fresh embryo transplantation failure,and the effect of vitamin D intervention on the outcome of re-IVF fresh embryo transplantation.MethodsFrom December 2016 to January 2019,51 infertile patients who had failed to undergo IVF fresh embryo transplantation under the previous long program of Reproductive Medicine Center of General Hospital of Ningxia Medical University were selected to undergo IVF fresh embryo transplantation again.According to the level of serum 25?OH?D,the patients were divided into three groups:vitamin D insufficient group?group A?:20 ng/ml<25?OH?D<30 ng/ml in 4 cases,vitamin D deficiency group?group B?:10 ng/ml<25?OH?D<20 ng/ml in 35 cases,severe vitamin D deficiency group?group C?:25?OH?D<10 ng/ml in 12 cases,and the correlation between age,BMI,AMH,T3,T4,TSH and serum25?OH?D levels was compared among the three groups.The three groups were given intramuscular injection of vitamin D2 10 mg every 2 weeks for 3 times and Calcium carbonate D3 tablets 500 mg daily for 6 weeks,then re-entered the IVF cycle for fresh embryo transplantation.The correlation between clinical indicators and pregnancy outcomes of patients before and after vitamin D intervention was compared.Results1.There was no correlation between the age,BMI,AMH,T3,T4,TSH and serum25?OH?D levels in group A,B and C with previous failure of IVF fresh embryo transplantation?P>0.05?.2.There were no significant differences in the number of days of use of gonadotropin?Gn?,the dosage of Gn,the shape and thickness of endometrium on transplantation day,the serum estradiol?E₂?,progesterone?P?and the ratio of estradiol to progesterone?E₂/P?before and after vitamin D intervention in IVF fresh embryo transplanters?P>0.05?,but there were no significant differences in the ratio of estradiol to progesterone?E2/P?before and after vitamin D intervention?P>0.05?.The number of eggs retrieved?6.67+3.835;8.41+4.797?,the number of MII eggs?5.37+3.364;7.14+3.995?,and the number of 2PN?2.77+2.462;4.26+3.334?were significantly different?P<0.05?.3.The clinical pregnancy rates of group A,B and C after vitamin D supplementation were25.00%,21.86%and 41.67%,respectively,but there was no significant difference?P>0.05?.Conclusion 1.Serum vitamin D levels were generally deficient in IVF fresh embryo transplantation failure.2.Vitamin D may affect the outcome of re-IVF fresh embryo transplantation by affecting the ovarian function and egg quality of infertile patients.3.Patients with different serum vitamin D levels received the same dose of vitamin D supplementation treatment,the clinical pregnancy rate of severe vitamin D deficiency patients was the highest,so it is speculated that vitamin D intervention for patients with severe vitamin D deficiency may help to improve the clinical pregnancy rate of fresh embryo transplantation with re-IVF.