血清维生素D水平与体外受精-胚胎移植长方案新鲜周期妊娠结局的相关性研究  

Correlation between serum vitamin D level and pregnancy outcome in fresh IVF cycles

作　　者：王馥新[1] 高靓[1] 石燕[2] 李红[1] WANG Fu-xin;GAO Liang;SHI Yan;LI Hong(Center for Reproduction and Genetics,Suzhou Municipal Hospital,Suzhou Affiliated Hospital of Nanjing Medical University,Suzhou215000;Department of Laboratory Medicine,Suzhou Affiliated Hospital of Nanjing Medical University,Suzhou215000)

机构地区：[1]南京医科大学附属苏州医院苏州市立医院本部生殖与遗传中心,苏州215000 [2]南京医科大学附属苏州医院苏州市立医院本部检验科,苏州215000

出　　处：《生殖医学杂志》2019年第2期117-122,共6页Journal of Reproductive Medicine

基　　金：南京医科大学科技发展基金项目(2016NJMU146)

摘　　要：目的探讨HCG日次日血清维生素D水平与输卵管因素行IVF-ET新鲜周期妊娠结局的相关性。方法选取2017年3月至2018年2月在苏州市立医院本部生殖与遗传中心因单纯输卵管因素第一次行IVF长方案助孕的新鲜周期移植患者(<35岁)147例。按HCG日次日血清维生素D水平分为维生素D缺乏组(<20ng/ml,43例)、维生素不足组(20～30ng/ml,68例)、维生素D充足组(≥30ng/ml,36例),比较组间一般情况及妊娠结局;按不同季节分组,比较组间一般情况及妊娠结局;并进一步按妊娠组及未妊娠组分组,比较两者血清维生素D水平及一般情况。结果研究对象中,维生素D充足者仅占24.48%,维生素D缺乏或不足状态较为普遍。按血清维生素D水平分组,组间患者一般资料、MII卵率、优质胚胎率、临床妊娠率、异位妊娠率均无统计学差异(P>0.05);早期流产率绝对值随维生素D水平增高而降低,但无统计学差异(P>0.05)。按季节分组,冬春季患者血清维生素D水平显著低于夏秋两季(P<0.05),但各组间临床妊娠率、流产率、异位妊娠率均无统计学差异(P>0.05)。按妊娠结局分组,妊娠组与非妊娠组血清维生素D水平无统计学差异[(24.05±7.59)ng/ml vs.(25.27±7.10)ng/ml,P>0.05]。结论 HCG日次日血清维生素D水平可能与因输卵管因素行IVF新鲜周期胚胎移植助孕患者的妊娠结局无相关性。Objective:To evaluate the correlation between serum vitamin D levels on the day after HCG injection and the pregnancy outcome in the fresh IVF cycles.Methods:The data of 147 fresh IVF cycles of the patients of less than 35 years old with pure tubal factors in the Department of Reproductive and Genetics Center of Suzhou Municipal Hospital from March 2017 to February 2018 were retrospectively analyzed.The patients were divided into three groups according to the serum vitamin D level:the vitamin D deficiency group(<20 ng/ml),the vitamin insufficiency group(20~30 ng/ml),the vitamin D sufficient group( >30 ng/ml).The general conditions and pregnancy outcomes were compared among the groups.Furthermore,the patients were subdivided to different groups according to season or whether pregnancy or not,and the general conditions,clinical outcomes and vitamin D levels among the groups were compared.Results:Among all the patients,the patients with vitamins D sufficient only accounted for 24.48%,and vitamin D deficiency status was common.There was no significant difference in general condition,MII oocyte rate,high quality embryo rate,clinical pregnancy rate and ectopic pregnancy rate among the groups with different serum vitamin D level(P >0.05).The early abortion rate was decreased with the increase of vitamin D level,but there was no statistical difference(P >0.05).Grouped by season,the serum vitamin D levels of patients in winter and spring were significantly lower than that in summer and autumn(P<0.05),but there was no significant difference in clinical pregnancy rate,abortion rate and ectopic pregnancy rate among the groups(P >0.05).The serum vitamin D levels were not significantly different between the pregnancy group and the non-pregnant group[(24.05±7.59)vs.(25.27±7.10)ng/ml,P >0.05].Conclusions:Serum vitamin D levels on the day after HCG injection are not related with the clinical outcome in fresh embryo transfer cycles in patients with fallopian tube factors.

关 键 词：维生素D 体外受精-胚胎移植 妊娠 

分 类 号：R711.6[医药卫生—妇产科学]