血清与卵泡液25-羟维生素D水平与体外受精-胚胎移植妊娠结局的相关性研究  

Relationship between serum and follicular fluid 25-hydroxyvitamin D levels and pregnancy outcome after in vitro fertilization and embryo transfer

作　　者：何湘娇 赵静[1] 张琼[1] 侯昭娟 谢诗[1] 郝洁[1] 黄曦 何爱桦 傅婧 李艳萍[1] He Xiangjiao;Zhao Jing;Zhang Qiong;Hou Zhaojuan;Xie Shi;Hao Jie;Huang Xi;He Aihua;Fu Jing;Li Yanping(Department of Reproductive Medicine,Xiangya Hospital,Central South University,Clinical Research Center for Women’s Reproductive Health in Hunan Province,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院生殖中心湖南省女性生殖健康临床研究中心,长沙410008 [2]湖南省人民医院(湖南师范大学第一附属医院)妇产科

出　　处：《中华生殖与避孕杂志》2020年第4期271-278,共8页Chinese Journal of Reproduction and Contraception

摘　　要：目的研究血清和卵泡液中25-羟维生素D[25(OH)D]水平与体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)妊娠结局的关系。方法2017年8月至2018年6月期间前瞻性队列研究在中南大学湘雅医院生殖中心因输卵管因素接受IVF/ICSI-ET治疗的201例不孕症患者的临床资料。血清和卵泡液25(OH)D水平的cut-off值采用最小化P值的方法确定。分析血清与卵泡液25(OH)D水平相关性;分组比较血清或卵泡液的25(OH)D水平与年龄、体质量指数(BMI)、既往IVF史、人绒毛膜促性腺激素(hCG)注射日子宫内膜厚度、促性腺激素(Gn)、孕酮、雌二醇、获卵数、MII卵数、正常受精率、第3日(D3)优质胚胎率及与胚胎着床率、临床妊娠率及早期流产率间有无关联。将妊娠结局的影响因素进行二分类logistic回归分析。结果①血清25(OH)D水平为16.4(13.1,20.2)μg/L,卵泡液25(OH)D水平为15.3(11.6,20.3)μg/L,两者比较呈显著直线相关(r=0.78,P<0.001)。②血清25(OH)D低水平组的临床妊娠率(33.87%)、胚胎着床率(25.44%)低于高水平组(52.52%,P=0.014;40.24%,P=0.006);卵泡液25(OH)D低水平组的临床妊娠率(39.39%)、胚胎着床率(30.22%)低于高水平组(53.92%,P=0.039;40.98%,P=0.032),卵泡液低水平组的早期流产率(17.95%)明显高于高水平组(7.27%,P=0.002),差异有统计学意义。③二分类logistic回归分析显示血清和卵泡液25(OH)D水平与临床妊娠结局相关(P=0.016;P=0.020)。结论血清25(OH)D水平高于卵泡液25(OH)D水平,呈显著直线相关性;血清和卵泡液25(OH)D水平与IVF/ICSI-ET妊娠结局相关。Objective To investigate the relationship between 25-hydroxy vitamin D[25(OH)D)]in blood and follicular fluid and pregnancy outcome after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET).Methods A prospective cohort study of 201 infertility patients who were treated with IVF/ICSI-ET due to fallopian tube factors in Department of Reproductive Medicine,Xiangya Hospital,Central South University was performed.The cut-off values of 25(OH)D levels in serum and follicular fluid were determined by the method of minimizing P value.The correlations was studied between serum or follicular fluid levels of 25(OH)D and age,body mass index(BMI),past IVF history,endometrial thickness on human chorionic gonadotropin(hCG)injection day,gonadotropin(Gn),progesterone,estradiol,number of retrieved oocytes,and MII oocytes,normal fertilization rate,day 3 high-quality embryo rate,embryo implantation rate,clinical pregnancy rate and early abortion rate.Binary logistic regression analysis of influencing factors of pregnancy outcome was done.Results 1)The serum 25(OH)D level was 16.4(13.1,20.2)μg/L and the follicular fluid 25(OH)D was 15.3(11.6,20.3)μg/L.There was a significant linear correlation between the two groups(r=0.78,P<0.001).2)The clinical pregnancy rate(33.87%)and the embryo implantation rate(25.44%)in the low level group of 25(OH)D in serum were lower than those in the high level group(52.52%,P=0.014;40.24%,P=0.006).The clinical pregnancy rate(39.39%)and the embryo implantation rate(30.22%)in the low level group of 25(OH)D in follicular fluid were lower than those in the high level group(53.92%,P=0.039;40.98%,P=0.032).The early abortion rate in the low level group of 25(OH)D in follicular fluid(17.95%)was higher than that in the high level group(7.27%,P=0.002).3)The results of two classification logistic regression analysis showed that the levels of 25(OH)D in serum and follicular fluid were related to clinical pregnancy outcome(P=0.016,P=0.020).Conclusion There was a significant linear corr

关 键 词：受精 体外 胚胎移植 25-羟维生素D 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]