基于前瞻性队列研究:维生素D水平对卵巢储备功能正常人群卵泡期长方案促排卵助孕治疗妊娠结局的影响OA
Based on prospective cohort study:Effect of vitamin D level on pregnancy outcomes of assisted reproductive technology with follicular-phase GnRH agonist long protocol in women with normal ovarian reserve function
目的 探讨维生素D水平对卵巢储备功能正常人群行卵泡期长方案促排卵后常规体外受精-胚胎移植(IVF-ET)周期妊娠结局的影响.方法 选取2022年6月至2024年1月在保定市妇幼保健院生殖医学科采用卵泡期长方案促排卵、行常规IVF-ET助孕的380例卵巢储备功能正常的不孕症患者为研究对象.助孕周期前采用化学发光免疫分析法检测血清25羟基维生素D[25(OH)D]水平,并根据检测水平分为维生素D缺乏组[血清25(OH)D＜20.0 ng/ml(50.0 nmol/L),n=135]、维生素D不足组[血清25(OH)D 20.0～29.9 ng/ml(50.0～74.9 nmol/L),n=184]和维生素D充足组[血清25(OH)D≥30.0 ng/ml(75.0 nmol/L),n=61].比较各组间促排卵、胚胎移植相关指标及妊娠结局.结果 3组间年龄、不孕年限、体质量指数(BMI)等一般情况比较均无显著性差异(P＞0.05);3组间促性腺激素(Gn)天数、Gn总量、扳机日黄体生成素(LH)、雌二醇(E2)及孕酮(P)水平、获卵数、扳机日子宫内膜厚度、移植胚胎数比较均无显著性差异(P＞0.05).维生素D充足组的胚胎着床率显著高于维生素D缺乏组、不足组(41.79％vs.33.33％、27.16％,P＜0.001),而3组间人绒毛膜促性腺激素(HCG)阳性率、临床妊娠率、流产率、活产率及新生儿出生体重及出生身长比较均无显著性差异(P＞0.05).结论 卵巢储备功能正常人群应用卵泡期长方案促排卵常规IVF-ET助孕时,维生素D水平显著影响胚胎着床率,但对临床妊娠率及活产率无显著影响.
Objectives:To investigate the effect of vitamin D level on pregnancy outcomes of in vitro fertilization-embryo transfer(IVF-ET)with follicular-phase gonadotropin-releasing hormone(GnRH)agonist long protocol in women with normal ovarian reserve function. Methods:A total of 380 infertile patients(380 cycles)with normal ovarian reserve function were selected from the Department of Reproductive Medicine of Baoding Maternal & Child Health Hospital who underwent conventional IVF-ET cycles with controlled ovarian stimulation of follicular phase GnRH agonist long protocol from June 2022 to January 2024.Chemiluminescence immunoassay was employed to detect serum 25(OH)D levels before the treatment.According to 25(OH)D levels,they were divided into three groups:vitamin D deficiency group[serum 25(OH)D level＜20.0 ng/ml(50.0 nmol/L),n=135],vitamin D insufficiency group[serum 25(OH)D level 20.0-29.9 ng/ml(50.0-74.9 nmol/L),n=184],and vitamin D sufficiency group[serum 25(OH)D level ≥30.0 ng/ml(75.0 nmol/L),n=61].Ovulation induction related indicators and pregnancy outcomes were compared across the groups. Results:There were no significant differences in basic characteristics such as age,duration of infertility,and body mass index(BMI)among the three groups(P＞0.05).There were no significant differences in total duration of gonadotropin(Gn)use,total dose of Gn use,serum levels of luteinizing hormone(LH),estradiol(E2)and progesterone(P)on human chorionic gonadotropin(HCG)day,number of retrieved oocytes,endometrial thickness on trigger day,and number of transferred embryos among the three groups(P＞0.05).The embryo implantation rate in the vitamin D sufficiency group was significantly higher than those of the other two groups(41.79％vs.33.33％,27.16％,P＜0.001).H owever,there were no significant differences in HCG-positive rate,clinical pregnancy rate,miscarriage rate,live birth rate,and weight and length of newborns among the three groups(P＞0.05). Conclusions:The serum vitamin D levels in infertile women with normal ovarian reserve function have a significant impact on the implantation rate of conventional IVF-ET cycles with follicular-phase GnRH agonist long protocol,while have no significant effect on clinical pregnancy rate and live birth rate in the cycles.
宋影莹;梁辉;王娜;韩晶;陈英;赵媛媛
保定市妇幼保健院(保定市妇儿医院)生殖医学科,保定 071000保定市妇幼保健院(保定市妇儿医院)生殖医学科,保定 071000保定市妇幼保健院(保定市妇儿医院)生殖医学科,保定 071000保定市妇幼保健院(保定市妇儿医院)生殖医学科,保定 071000保定市妇幼保健院(保定市妇儿医院)生殖医学科,保定 071000保定市妇幼保健院(保定市妇儿医院)生殖医学科,保定 071000
医药卫生
维生素D卵巢储备功能卵泡期长方案体外受精-胚胎移植
Vitamin DOvarian reserve functionFollicular-phase GnRH agonist long protocolIn vitro fertilization-embryo transfer
《生殖医学杂志》 2026 (5)
645-650,6
保定市科技计划项目(2241ZF085)
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