Embriyo Transferi Yapılan Kadınlarda D Vitamini Destek Programının Doğurganlık Sonuçları Üzerindeki Rolü
Abstract
Amaç: Bu çalışma embriyo transferi yapılan kadınlara verilen D vitamini desteğinin, gebelik sonuçları üzerindeki etkisini belirlemeyi amaçlamaktadır.
Gereç ve Yöntemler: Bu çalışma ön test-son test düzeninde deneysel olarak yürütülmüştür. Çalışmanın örneklemi 58’i girişim, 60’ı kontrol grubunda olmak üzere toplam 118 kadından oluşmaktadır. Girişim grubundaki kadınlara infertilite tedavisinin başlangıcında D vitamini destek programı uygulanırken, kontrol grubundaki kadınlara D vitamini destek programı uygulanmamıştır. Çalışmanın sonunda, girişim ve kontrol grubundaki kadınların gebelik ve klinik gebelik oranları ve kanda 25(OH)D düzeyleri incelenmiştir.
Bulgular: Girişim grubundaki kadınların tedavi başlangıcındaki D vitamini düzeyi (12,47±6,03 ng/mL), beta-hCG günü bakılan D vitamin düzeyinden (32,34±9,62 ng/mL) istatistiksel olarak anlamlı düzeyde daha düşüktür (p=0,000). Kontrol grubundaki kadınların beta-hCG günü bakılan D vitamini düzeyi (14,30±7,03 ng/mL), girişim grubundaki kadınlardan (32,34±9,62 ng/mL) istatistiksel olarak anlamlı derecede daha düşüktür (p=0,000). Girişim ve kontrol grubundaki kadınların gebelik oranlarında istatistiksel olarak anlamlı bir fark bulunmazken, klinik gebelik oranlarında istatistiksel olarak anlamlı bir fark bulunmuştur (p=0,066, p=0,014 sırasıyla).
Sonuç: Bu çalışma, infertilite tedavisi gören ve D vitamini düzeyi eksik ya da yetersiz olan kadınlara yönelik D vitamini destek programının, kadınların D vitamini düzeylerini ve embriyo transferi sonrası klinik gebelik oranlarını artırabileceğini göstermiştir.
Ethical Statement
Ethics approval was obtained from the Turkish Ministry of Health, Turkish Pharmaceuticals, and the Medical Devices Agency Clinical Studies Ethical Board. The study authors reviewed written consent forms with the participants, who were allowed to read the consent forms independently and ask questions before signing them.
Supporting Institution
This study was supported by the Akdeniz University Scientific Research Project Management Unit (Project No: TSA-2015-409).
Project Number
Project No: TSA-2015-409
References
- 1. Down J, Stafford D. The Vitamin D cure revised edition. Canada: John Wiley & Sons; 2012.
- 2. Lauretani F, Maggio M, Ruggiero C, Ceda GP, Ferrucci L. Vitamin D in health of seniors. In: Watson RR, editors. Handbook of Vitamin D in human health. Netherlands: Wageningen Academic Publishers; 2013.
- 3. Grzechocinska B, Dabrowski FA, Cyganek A, Wielgos M. The role of vitamin D in impaired fertility treatment. Neuro Endocrinol Lett 2013; 34(8):756-62.
- 4. De-Regil LM, Palacios C, Lombardo LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2016; 1(1):CD008873.
- 5. Ferrero S, Gillott DJ, Anserini P, Remorgida V, Price KM, Ragni N, Grudzinskas JG. Vitamin D binding protein in endometriosis. Soc Gynecol Investig 2005; 12(4):272-77.
- 6. Somigliana E, Panina-Bordignon P, Murone S, Di Lucia P, Vercellini P, Vigano P. Vitamin D reserve is higher in women with endometriosis. Hum Reprod 2007; 22(8):2273-78.
- 7. Harris HR, Chavarro JE, Malspeis S, Willett WC, Missmer SA. Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study. Am J Epidemiol 2013; 177(5):420-30.
- 8. Pagliardini L, Vigano' P, Molgora M, Persico P, Salonia A, Vailati SH, Paffoni A, Somigliana E, Papaleo E, Candiani M. High prevalence of vitamin D deficiency in infertile women referring for assisted reproduction. Nutrients 2015; 7(12):9972-84.
- 9. Sur D, Chakravorty R. The relationship between Vitamin D, insülin resistance and infertility in PCOS women. Gynecol Obstet 2015; 5(5):1-4.
- 10. Wehr E, Pieber TR, Obermayer-Pietsch B. Effect of vitamin D3 treatment on glucose metabolism and menstrual frequency in polycystic ovary syndrome women: a pilot study. J Endocrinol Invest 2011; 34:757-63.
- 11. Thomson RL, Spedding S, Buckley JD. Vitamin D in the etiology and management of polycystic ovary syndrome. Clin Endocrinol 2012; 77(3):343-50.
- 12. Asadi M, Matin N, Frootan M, Mohamadpour J, Qorbani M, Tanha FD. Vitamin D improves endometrial thickness in PCOS women who need intrauterine insemination: a randomized double-blind placebo. Arch Gynecol Obstet 2014; 289(4):865-70.
- 13. Baird DD, Hill MC, Schectman JM, Hollis BW. Vitamin D and the risk of uterine fibroids. Epidemiology 2013; 24:447-53.
- 14. Paffoni A, Somigliana E, Vigano' P, Benaglia L, Cardellicchio L, Pagliardini L, Papaleo E, Candiani M, Fedele L. Vitamin D status in women with uterine leiomyomas. J Clin Endocrinol Metab 2013; 98(8):E1374-E78.
- 15. Sabry M, Halder SK, Allah AS, Roshdy E, Rajaratnam V, Al-Hendy A. Serum vitamin D3 level inversely correlates with uterine fibroid volume in different ethnic groups: a cross-sectional observational study. Int J Womens Health 2013; 5:93-100.
- 16. Özkaya F, Demirel A. Vitamin D deficiency in infertile patients. Arch Esp Urol 2018; 71(10):850-5.
- 17. Triggianese P, Watad A, Cedola F, Perricone C, Amital H, Giambini I, Perricone R, Shoenfeld Y, De Carolis C. Vitamin D deficiency in an Italian cohort of infertile women. Am J Reprod Immunol 2017; 78(4):1-6.
- 18. Li L, Schriock E, Dougall K, Givens C. Prevalence and risk factors of vitamin D deficiency in women with infertility. Fertil Steril 2012; 97(3): S26.
- 19. Vanni VS, Vigano' P, Somigliana E, Papaleo E, Paffoni A, Pagliardini L, Candiani M. Vitamin D and assisted reproduction technologies: current concepts. Reprod Biol Endocrinol 2014; 12: 47.
- 20. Boz İ, Teskereci G, Özekinci M. High prevalence of vitamin D deficiency in Turkish women undergoing in vitro fertilization: A descriptive study. Health Care Women Int 2019; 29:1-12.
- 21. Rudick B, Ingles S, Chung K, Stanczyk F, Paulson R, Bendikson K. Characterizing the influence of vitamin D levels on IVF outcomes. Hum Reprod 2012; 27(11):3321-27.
- 22. Garbedian K, Boggild M, Moody J, Liu KE. Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization. CMAJ Open 2013; 28(1):77-82.
- 23. Paffoni A, Ferrari S, Viganò P, Pagliardini L, Papaleo E, Candiani M, Tirelli A, Fedele L, Somigliana E. Vitamin D deficiency and infertility: Insights from in vitro fertilization cycles. J Clin Endocrinol Metab 2014; 99(11):E2372-E76.
- 24. Polyzos NP, Anckaert E, Guzman L, Schiettecatte J, Van Landuyt L, Camus M, Smitz J, Tournaye H. Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ ICSI. Hum Reprod 2014; 29(9):2032-40.
- 25. Aflatoonian A, Arabjahvani F, Eftekhar M, Sayadi M. Effect of vitamin D insufficiency treatment on fertility outcomes in frozen-thawed embryo transfer cycles: a randomized clinical trial. Iran J Reprod Med 2014; 12(9):595-600.
- 26. Fabris A, Pacheco A, Cruz M, Puente JM, Fatemi H, Garcia-Velasco JA. Impact of circulating levels of total and bioavailable serum vitamin D on pregnancy rate in egg donation recipients. Fertil Steril 2014; 102(6):1608-12.
- 27. Franasiak JM, Molinaro TA, Dubell EK, Scott KL, Ruiz AR, Forman EJ, Werner MD, Hong KH, Scott RT Jr. Vitamin D levels do not affect IVF outcomes following the transfer of euploid blastocysts. Am J Obstet Gynecol 2015; 212(3):315.e1-6.
- 28. Fatemi F, Mohammadzadeh A, Sadeghi MR, Akhondi MM, Mohammadmoradi S, Kamali K, Lackpour N, Jouhari S, Zafadoust S, Mokhtar S, Giahi L. Role of vitamin E and D3 supplementation in Intra-Cytoplasmic Sperm Injection outcomes of women with polycystic ovarian syndrome: a double-blinded randomized placebo-controlled trial. Clin Nutr ESPEN 2017; 18:23-30.
- 29. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011; 96(7):1911-30.
- 30. Naderi Z, Kashanian M, Chenari L, Sheikhansari N. Evaluating the effects of administration of 25-hydroxyvitamin D supplement on serum antimullerian hormone (AMH) levels in infertile women. Gynecol Endocrinol 2018; 34(5):409-12.
- 31. Lerchbaum E, Obermayer-Pietsch B. Vitamin D, and fertility: a systematic review. Eur J Endocrinol 2012; 166(5):765-78.
Abstract
Objective: This study aimed to determine the effect of vitamin D supplementation given to women undergoing embryo transfer on pregnancy outcomes.
Materials and Methods: This study was conducted experimentally in a pre-test-post-test design. The sample of the study consisted of a total of 118 women, with 58 in the intervention group and 60 in the control group. While the vitamin D supplementation program was administered to women in the intervention group at the beginning of infertility treatment, women in the control group did not receive a vitamin D supplementation program. At the end of the study, pregnancy and clinical pregnancy rates of women in the intervention and control groups, as well as their serum 25(OH) D levels, were examined.
Results: The vitamin D level of women in the intervention group at the beginning of treatment (12.47±6.03 ng/mL) was statistically significantly lower than the vitamin D level on the day of beta-hCG (32.34±9.62 ng/mL) (p=0.000). The mean vitamin D level of the women in the control group (14.30±7.03 ng/mL) on the day of beta-hCG was statistically significantly lower than that of the women in the intervention group (32.34±9.62 ng/mL) (p=0.000). While there was no statistically significant difference in the pregnancy rates of women in the intervention and control groups, a statistically significant difference was found in the clinical pregnancy rates (respectively, p=0.066 and p=0.014).
Conclusion: This study demonstrated that vitamin D supplementation program for women undergoing infertility treatment with deficient or insufficient vitamin D levels may increase vitamin D levels and clinical pregnancy rate after embryo transfer.
Project Number
Project No: TSA-2015-409
References
- 1. Down J, Stafford D. The Vitamin D cure revised edition. Canada: John Wiley & Sons; 2012.
- 2. Lauretani F, Maggio M, Ruggiero C, Ceda GP, Ferrucci L. Vitamin D in health of seniors. In: Watson RR, editors. Handbook of Vitamin D in human health. Netherlands: Wageningen Academic Publishers; 2013.
- 3. Grzechocinska B, Dabrowski FA, Cyganek A, Wielgos M. The role of vitamin D in impaired fertility treatment. Neuro Endocrinol Lett 2013; 34(8):756-62.
- 4. De-Regil LM, Palacios C, Lombardo LK, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2016; 1(1):CD008873.
- 5. Ferrero S, Gillott DJ, Anserini P, Remorgida V, Price KM, Ragni N, Grudzinskas JG. Vitamin D binding protein in endometriosis. Soc Gynecol Investig 2005; 12(4):272-77.
- 6. Somigliana E, Panina-Bordignon P, Murone S, Di Lucia P, Vercellini P, Vigano P. Vitamin D reserve is higher in women with endometriosis. Hum Reprod 2007; 22(8):2273-78.
- 7. Harris HR, Chavarro JE, Malspeis S, Willett WC, Missmer SA. Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study. Am J Epidemiol 2013; 177(5):420-30.
- 8. Pagliardini L, Vigano' P, Molgora M, Persico P, Salonia A, Vailati SH, Paffoni A, Somigliana E, Papaleo E, Candiani M. High prevalence of vitamin D deficiency in infertile women referring for assisted reproduction. Nutrients 2015; 7(12):9972-84.
- 9. Sur D, Chakravorty R. The relationship between Vitamin D, insülin resistance and infertility in PCOS women. Gynecol Obstet 2015; 5(5):1-4.
- 10. Wehr E, Pieber TR, Obermayer-Pietsch B. Effect of vitamin D3 treatment on glucose metabolism and menstrual frequency in polycystic ovary syndrome women: a pilot study. J Endocrinol Invest 2011; 34:757-63.
- 11. Thomson RL, Spedding S, Buckley JD. Vitamin D in the etiology and management of polycystic ovary syndrome. Clin Endocrinol 2012; 77(3):343-50.
- 12. Asadi M, Matin N, Frootan M, Mohamadpour J, Qorbani M, Tanha FD. Vitamin D improves endometrial thickness in PCOS women who need intrauterine insemination: a randomized double-blind placebo. Arch Gynecol Obstet 2014; 289(4):865-70.
- 13. Baird DD, Hill MC, Schectman JM, Hollis BW. Vitamin D and the risk of uterine fibroids. Epidemiology 2013; 24:447-53.
- 14. Paffoni A, Somigliana E, Vigano' P, Benaglia L, Cardellicchio L, Pagliardini L, Papaleo E, Candiani M, Fedele L. Vitamin D status in women with uterine leiomyomas. J Clin Endocrinol Metab 2013; 98(8):E1374-E78.
- 15. Sabry M, Halder SK, Allah AS, Roshdy E, Rajaratnam V, Al-Hendy A. Serum vitamin D3 level inversely correlates with uterine fibroid volume in different ethnic groups: a cross-sectional observational study. Int J Womens Health 2013; 5:93-100.
- 16. Özkaya F, Demirel A. Vitamin D deficiency in infertile patients. Arch Esp Urol 2018; 71(10):850-5.
- 17. Triggianese P, Watad A, Cedola F, Perricone C, Amital H, Giambini I, Perricone R, Shoenfeld Y, De Carolis C. Vitamin D deficiency in an Italian cohort of infertile women. Am J Reprod Immunol 2017; 78(4):1-6.
- 18. Li L, Schriock E, Dougall K, Givens C. Prevalence and risk factors of vitamin D deficiency in women with infertility. Fertil Steril 2012; 97(3): S26.
- 19. Vanni VS, Vigano' P, Somigliana E, Papaleo E, Paffoni A, Pagliardini L, Candiani M. Vitamin D and assisted reproduction technologies: current concepts. Reprod Biol Endocrinol 2014; 12: 47.
- 20. Boz İ, Teskereci G, Özekinci M. High prevalence of vitamin D deficiency in Turkish women undergoing in vitro fertilization: A descriptive study. Health Care Women Int 2019; 29:1-12.
- 21. Rudick B, Ingles S, Chung K, Stanczyk F, Paulson R, Bendikson K. Characterizing the influence of vitamin D levels on IVF outcomes. Hum Reprod 2012; 27(11):3321-27.
- 22. Garbedian K, Boggild M, Moody J, Liu KE. Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization. CMAJ Open 2013; 28(1):77-82.
- 23. Paffoni A, Ferrari S, Viganò P, Pagliardini L, Papaleo E, Candiani M, Tirelli A, Fedele L, Somigliana E. Vitamin D deficiency and infertility: Insights from in vitro fertilization cycles. J Clin Endocrinol Metab 2014; 99(11):E2372-E76.
- 24. Polyzos NP, Anckaert E, Guzman L, Schiettecatte J, Van Landuyt L, Camus M, Smitz J, Tournaye H. Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ ICSI. Hum Reprod 2014; 29(9):2032-40.
- 25. Aflatoonian A, Arabjahvani F, Eftekhar M, Sayadi M. Effect of vitamin D insufficiency treatment on fertility outcomes in frozen-thawed embryo transfer cycles: a randomized clinical trial. Iran J Reprod Med 2014; 12(9):595-600.
- 26. Fabris A, Pacheco A, Cruz M, Puente JM, Fatemi H, Garcia-Velasco JA. Impact of circulating levels of total and bioavailable serum vitamin D on pregnancy rate in egg donation recipients. Fertil Steril 2014; 102(6):1608-12.
- 27. Franasiak JM, Molinaro TA, Dubell EK, Scott KL, Ruiz AR, Forman EJ, Werner MD, Hong KH, Scott RT Jr. Vitamin D levels do not affect IVF outcomes following the transfer of euploid blastocysts. Am J Obstet Gynecol 2015; 212(3):315.e1-6.
- 28. Fatemi F, Mohammadzadeh A, Sadeghi MR, Akhondi MM, Mohammadmoradi S, Kamali K, Lackpour N, Jouhari S, Zafadoust S, Mokhtar S, Giahi L. Role of vitamin E and D3 supplementation in Intra-Cytoplasmic Sperm Injection outcomes of women with polycystic ovarian syndrome: a double-blinded randomized placebo-controlled trial. Clin Nutr ESPEN 2017; 18:23-30.
- 29. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011; 96(7):1911-30.
- 30. Naderi Z, Kashanian M, Chenari L, Sheikhansari N. Evaluating the effects of administration of 25-hydroxyvitamin D supplement on serum antimullerian hormone (AMH) levels in infertile women. Gynecol Endocrinol 2018; 34(5):409-12.
- 31. Lerchbaum E, Obermayer-Pietsch B. Vitamin D, and fertility: a systematic review. Eur J Endocrinol 2012; 166(5):765-78.
Details
| Primary Language | English |
|---|---|
| Subjects | Reproduction |
| Journal Section | Research Article |
| Authors | |
| Project Number | Project No: TSA-2015-409 |
| Early Pub Date | May 22, 2025 |
| Publication Date | May 28, 2025 |
| Submission Date | November 14, 2023 |
| Acceptance Date | December 9, 2024 |
| Published in Issue | Year 2025 Volume: 11 Issue: 2 |
