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Low vitamin D levels in follicular fluid, but not in serum, are associated with adverse outcomes in assisted reproduction

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
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Abstract

Purpose

To assess the relationship between serum/follicular fluid (FF) vitamin D (VD) status and assisted reproductive technology (ART) treatment outcomes among infertile patients.

Methods

A prospective cohort study, including 132 infertile patients scheduled for their first ART treatment cycle, was carried out in a Reproductive Medical Center. Serum and FF samples were collected to assess 25-hydroxy VD [25(OH)D] levels. Low VD level was defined as 25(OH)D concentration of less than 30 ng/mL.

Results

Most infertile patients had low VD levels in serum (88%) and FF (90%). We observed a moderately positive correlation between VD levels in serum and FF (r = 0.34, p < 0.0001). Compared to the group of patients with low VD levels in the FF, those with sufficient VD levels had a significantly higher number of retrieved oocytes (p = 0.03), normal fertilization (p = 0.01), and high-quality embryos (p = 0.001). Moreover, patients with sufficient VD levels in the FF also had significantly higher implantation rates than those with low VD levels (76.92% vs. 46.58%, respectively, p = 0.01) and clinical pregnancy rates (92.31% vs. 61.54%, respectively, p = 0.04).

Conclusion

These data collectively revealed that low VD levels in serum and FF were common among infertile patients. VD levels in FF, but not in serum, were associated with embryo quality, normal fertilization, implantation rates, and clinical pregnancy rates. Further studies are mandatory to determine the molecular mechanism and VD’s potential therapeutic benefits in infertile patients.

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Availability of data and material

All datasets generated for this study are included in the article.

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Funding

This work was supported by a research grant from the Integrated Innovative Team for Major Human Diseases Program of Tongji Medical College of Huazhong University of Science and Technology (no. 5001519002).

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  1. Kahindo P. Muyayalo, Su Song and Hui Zhai have contributed equally to this work.

Authors and Affiliations

  1. Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, People’s Republic of China

    Kahindo P. Muyayalo, Hong Liu, Dong-Hui Huang, Hui Zhou & Ai-Hua Liao

  2. Department of Obstetrics and Gynecology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo

    Kahindo P. Muyayalo

  3. Wuhan Tongji Reproductive Medical Hospital, Wuhan, People’s Republic of China

    Su Song & Yang-Jiao Chen

  4. School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China

    Hui Zhai

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Contributions

KM, SS, HZ, and AL conceived the study, collected the data, and wrote the manuscript. HL, DH, HZ and YC performed the literature search, collected and analyzed the data. AL administered the project, including designing, supervising, revising and final approval. All authors participated in the research significantly and critically appraised, revised and approved the manuscript.

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Correspondence to Ai-Hua Liao.

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We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, and there is no professional or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled, "Low vitamin D levels in follicular fluid, but not in serum, are associated with adverse outcomes in assisted reproduction.

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The study protocol was approved by the Ethical Committee of Tongji Medical College of Huazhong University of Science and Technology. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Muyayalo, K.P., Song, S., Zhai, H. et al. Low vitamin D levels in follicular fluid, but not in serum, are associated with adverse outcomes in assisted reproduction. Arch Gynecol Obstet 305, 505–517 (2022). https://doi.org/10.1007/s00404-021-06174-9

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