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Hosseinisadat, R., Saeed, L., Ghasemirad, A., Habibzadeh, V., & Safar Heidari, S. (2022). Assessment of the effect of serum and follicular fluid vitamin D and glucose on assisted reproductive technique outcome: A cross-sectional study. International Journal of Reproductive BioMedicine (IJRM), 20(3), 221-230. https://doi.org/10.18502/ijrm.v20i3.10714
https://doi.org/10.18502/ijrm.v20i3.10714
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authors
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Robabe Hosseinisadat
Robabe Hosseinisadat
Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Lida Saeed
Lida Saeed
Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Anis Ghasemirad
Anis Ghasemirad
Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Victoria Habibzadeh
Victoria Habibzadeh
Department of Obstetrics and Gynecology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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Sedigheh Safar Heidari
Sedigheh Safar Heidari
Afzalipour Infertility Center, Kerman University of Medical Sciences, Kerman, Iran.
Published Date
- Apr 21, 2022
Assessment of the effect of serum and follicular fluid vitamin D and glucose on assisted reproductive technique outcome: A cross-sectional study
Abstract
Background: Vitamin D and glucose play an important role in the female reproductive system.
Objective: The aim of this study was to assess the effect of serum and follicular fluid vitamin D on assisted reproductive technique (ART) outcomes.
Materials and Methods: 102 infertile women were enrolled in the study. All cases received the routine in vitro fertilization protocol. On the oocyte retrieval day, a sample of their peripheral blood and follicular fluid was obtained to determine the level of vitamin D and glucose. We also evaluated ART outcomes including oocytes, 2 pronucleus and embryo number, implantation, chemical and clinical pregnancy, and abortion rate. Finally, the effect of serum and follicular fluid vitamin D and glucose on the ART outcomes was assessed.
Results: There was no difference in the characteristics, serum vitamin D, follicular fluid vitamin D, fasting blood sugar (FBS), or follicular fluid glucose between the women with vs. without a positive clinical pregnancy. There was no significant difference between the ART outcomes based on vitamin D level. The mean follicular fluid glucose levels in women who were deficient, insufficient and sufficient in vitamin D were 65.20 ± 14.65, 63.47 ± 14.90 and 55.97 ± 15.64, respectively. Follicular fluid glucose was lower in women with sufficient vitamin D levels and this difference was statistically significant (p = 0.01). There was no relationship between the three follicular fluid vitamin D levels and ART outcomes. In women with normal FBS levels, the level of follicular fluid vitamin D was significantly lower than in the women with pre-diabetic FBS status (p < 0.001).
Conclusion: The present study showed that serum vitamin D level, follicular fluid vitamin D level, FBS, and follicular fluid sugar were not predictive parameters for ART outcomes.
Key words: Vitamin D, Glucose, Follicular fluid, Pregnancy, Assisted reproductive techniques.
References
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[3] Fung JL, Hartman TJ, Schleicher RL, Goldman MB. Association of vitamin D intake and serum levels with fertility: Results from the lifestyle and fertility study. Fertil Steril 2017; 108: 302–311.
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[6] Slominski AT, Brożyna AA, Zmijewski MA, Jóźwicki W, Jetten AM, Mason RS, et al. Vitamin D signaling and melanoma: Role of vitamin D and its receptors in melanoma progression and management. Lab Invest 2017; 97: 706–724.
[7] Eftekhar M, Mirhashemi ES, Molaei B, Pourmasumi S. Is there any association between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes? Arch Endocrinol Metab 2020; 64: 11–16.
[8] Akl Sh, El-Mekkawi Sh, El-Kotb AM, Mostafa A. Role of vitamin D supplementation therapy on ovulation and insulin resistance in women with PCOS: A randomized controlled trial. Evid Based Womens Health J 2019; 9: 329–336.
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[11] Aleyasin A, Agha Hosseini M, Mahdavi A, Safdarian L, Fallahi P, Mohajeri MR, et al. Predictive value of the level of vitamin D in follicular fluid on the outcome of assisted reproductive technology. Eur J Obstet Gynecol Reprod Biol 2011; 159: 132–137.
[12] Da Broi MG, Giorgi VSI, Wang F, Keefe DL, Albertini D, Navarro PA. Influence of follicular fluid and cumulus cells on oocyte quality: Clinical implications. J Assist Reprod Genet 2018; 35: 735–751.
[13] Nandi S, Girish Kumar V, Manjunatha BM, Ramesh HS, Gupta PSP. Follicular fluid concentrations of glucose, lactate and pyruvate in buffalo and sheep, and their effects on cultured oocytes, granulosa and cumulus cells. Theriogenology 2008; 69: 186–196.
[14] Anifandis GM, Dafopoulos K, Messini CI, Chalvatzas N, Liakos N, Pournaras S, et al. Prognostic value of follicular fluid 25-OH vitamin D and glucose levels in the IVF outcome. Reprod Biol Endocrinol 2010; 8: 91.
[15] Lee DM, Tajar A, Pye SR, Boonen S, Vanderschueren D, Bouillon R, et al. Association of hypogonadism with vitamin D status: The European male ageing study. Eur J Endocrinol 2012; 166: 77–85.
[16] van de Vijver A, Drakopoulos P, Van Landuyt L, Vaiarelli A, Blockeel C, Santos-Ribeiro S, et al. Vitamin D deficiency and pregnancy rates following frozen-thawed embryo transfer: A prospective cohort study. Hum Reprod 2016; 31: 1749–1754.
[17] Franasiak JM, Molinaro ThA, Dubell EK, Scott KL, Ruiz AR, Forman EJ, et al. Vitamin D levels do not affect IVF outcomes following the transfer of euploid blastocysts. Am J Obstet Gynecol 2015; 212: 315.
[18] 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: 1608–1612.
[19] Garbedian K, Boggild M, Moody J, Liu KE. Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization. CMAJ Open 2013; 1: E77–E82.
[20] 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: 3321–3327.
[21] Paffoni A, Ferrari S, Viganò P, Pagliardini L, Papaleo E, Candiani M, et al. Vitamin D deficiency and infertility: Insights from in vitro fertilization cycles. J Clin Endocrinol Metab 2014; 99: E2372–E2376.
[22] Polyzos NP, Anckaert E, Guzman L, Schiettecatte J, Van Landuyt L, Camus M, et al. Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ICSI. Hum Reprod 2014; 29: 2032–2040.
[23] Yoshizawa T, Handa Y, Uematsu Y, Takeda S, Sekine K, Yoshihara Y, et al. Mice lacking the vitamin D receptor exhibit impaired bone formation, uterine hypoplasia and growth retardation after weaning. Nat Genet 1997; 16: 391– 396.
[24] Liao EY, Zhang ZhL, Xia WB, Lin H, Cheng Q, Wang L, et al. Calcifediol (25-hydroxyvitamin D) improvement and calcium-phosphate metabolism of alendronate sodium/vitamin D(3) combination in Chinese women with postmenopausal osteoporosis: A post hoc efficacy analysis and safety reappraisal. BMC Musculoskelet Disord 2018; 19: 210.
[25] Harkness LS, Bonny AE. Calcium and vitamin D status in the adolescent: Key roles for bone, body weight, glucose tolerance, and estrogen biosynthesis. J Pediatr Adolesc Gynecol 2005; 18: 305–311.
[26] Al-Harbi AN, Khan KhM, Rahman A. Developmental vitamin D deficiency affects spatial learning in Wistar rats. J Nutr 2017; 147: 1795–1805.
[27] Belenchia AM, Johnson SA, Kieschnick AC, Rosenfeld CS, Peterson CA. Time course of vitamin D depletion and repletion in reproductive-age female C57BL/6 mice. Comp Med 2017; 67: 483–490.
[28] Grzesiak M, Burzawa G, Kurowska P, Blaszczyk K, Szlaga A, Blasiak A, et al. Altered vitamin D3 metabolism in the ovary and periovarian adipose tissue of rats with letrozoleinduced PCOS. Histochem Cell Biol 2021; 155: 101–116.
[29] Dupuis ML, Pagano MT, Pierdominici M, Ortona E. The role of vitamin D in autoimmune diseases: Could sex make the difference? Biol Sex Differ 2021; 12: 1–12.
[30] Tosti C, Biscione A, Morgante G, Bifulco G, Luisi S, Petraglia F. Hormonal therapy for endometriosis: From molecular research to bedside. Eur J Obstet Gynecol Reprod Biol 2017; 209: 61–66.
[31] Garbossa SG, Folli F. Vitamin D, sub-inflammation and insulin resistance: A window on a potential role for the interaction between bone and glucose metabolism. Rev Endocr Metab Disord 2017; 18: 243–258.
[32] Osati S, Homayounfar R, Hajifaraji M. Metabolic effects of vitamin D supplementation in vitamin D deficient patients: A double-blind clinical trial. Diabetes Metab Syndr 2016; 10: S7–S10.
[33] Kouhkan A, Khamseh ME, Moini A, Pirjani R, Arabipoor A, Zolfaghari Z, et al. Diagnostic accuracy of body mass index and fasting glucose for the prediction of gestational diabetes mellitus after assisted reproductive technology. Int J Fertil Steril 2019; 13: 32–37.
[34] Tashrifi F, Haghani Nasimi O, Abdollahi M, Moradi B. Fasting blood sugar, glucose challenge test and one-two hour glucose tolerance test in diagnosis of gestational diabetes in women without risk factor. Iran J Diabetes Obesity 2018; 10: 106–108.
[35] Zhang Ch, Yang Ch, Li N, Liu X, He J, Chen X, et al. Elevated insulin levels compromise endometrial decidualization in mice with decrease in uterine apoptosis in early-stage pregnancy. Arch Toxicol 2019; 93: 3601– 3615.
[36] Namvar Jahromi B, Dabbaghmanesh MH, Bakhshaie P, Parsanezhad ME, Anvar Z, Alborzi M, et al. Assessment of oxytocin level, glucose metabolism components and cutoff values for oxytocin and Anti-Mullerian hormone in infertile PCOS women. Taiwan J Obstet Gynecol 2018; 57: 555–559.
[2] Gaskins AJ, Chavarro JE. Diet and fertility: A review. Am J Obstet Gynecol 2018; 218: 379–389.
[3] Fung JL, Hartman TJ, Schleicher RL, Goldman MB. Association of vitamin D intake and serum levels with fertility: Results from the lifestyle and fertility study. Fertil Steril 2017; 108: 302–311.
[4] Bahadori MH, Sharami SH, Fakor F, Milani F, Pourmarzi D, Dalil-Heirati SF. Level of vitamin E in follicular fluid and serum and oocyte morphology and embryo quality in patients undergoing IVF treatment. J Family Reprod Health 2017; 11: 74–81.
[5] Fichera M, Török P, Tesarik J, Della Corte L, Rizzo G, Garzon S, et al. Vitamin D, reproductive disorders and assisted reproduction: Evidences and perspectives. Int J Food Sci Nutr 2020; 71: 276–285.
[6] Slominski AT, Brożyna AA, Zmijewski MA, Jóźwicki W, Jetten AM, Mason RS, et al. Vitamin D signaling and melanoma: Role of vitamin D and its receptors in melanoma progression and management. Lab Invest 2017; 97: 706–724.
[7] Eftekhar M, Mirhashemi ES, Molaei B, Pourmasumi S. Is there any association between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes? Arch Endocrinol Metab 2020; 64: 11–16.
[8] Akl Sh, El-Mekkawi Sh, El-Kotb AM, Mostafa A. Role of vitamin D supplementation therapy on ovulation and insulin resistance in women with PCOS: A randomized controlled trial. Evid Based Womens Health J 2019; 9: 329–336.
[9] Ozkan S, Jindal S, Greenseid K, Shu J, Zeitlian G, Hickmon Ch, et al. Replete vitamin D stores predict reproductive success following in vitro fertilization. Fertil Steril 2010; 94: 1314–1319.
[10] Dehghani Firouzabadi R, Rahmani E, Rahsepar M, Mahdavi Firouzabadi M. Value of follicular fluid vitamin D in predicting the pregnancy rate in an IVF program. Arch Gynecol Obstet 2014; 289: 201–206.
[11] Aleyasin A, Agha Hosseini M, Mahdavi A, Safdarian L, Fallahi P, Mohajeri MR, et al. Predictive value of the level of vitamin D in follicular fluid on the outcome of assisted reproductive technology. Eur J Obstet Gynecol Reprod Biol 2011; 159: 132–137.
[12] Da Broi MG, Giorgi VSI, Wang F, Keefe DL, Albertini D, Navarro PA. Influence of follicular fluid and cumulus cells on oocyte quality: Clinical implications. J Assist Reprod Genet 2018; 35: 735–751.
[13] Nandi S, Girish Kumar V, Manjunatha BM, Ramesh HS, Gupta PSP. Follicular fluid concentrations of glucose, lactate and pyruvate in buffalo and sheep, and their effects on cultured oocytes, granulosa and cumulus cells. Theriogenology 2008; 69: 186–196.
[14] Anifandis GM, Dafopoulos K, Messini CI, Chalvatzas N, Liakos N, Pournaras S, et al. Prognostic value of follicular fluid 25-OH vitamin D and glucose levels in the IVF outcome. Reprod Biol Endocrinol 2010; 8: 91.
[15] Lee DM, Tajar A, Pye SR, Boonen S, Vanderschueren D, Bouillon R, et al. Association of hypogonadism with vitamin D status: The European male ageing study. Eur J Endocrinol 2012; 166: 77–85.
[16] van de Vijver A, Drakopoulos P, Van Landuyt L, Vaiarelli A, Blockeel C, Santos-Ribeiro S, et al. Vitamin D deficiency and pregnancy rates following frozen-thawed embryo transfer: A prospective cohort study. Hum Reprod 2016; 31: 1749–1754.
[17] Franasiak JM, Molinaro ThA, Dubell EK, Scott KL, Ruiz AR, Forman EJ, et al. Vitamin D levels do not affect IVF outcomes following the transfer of euploid blastocysts. Am J Obstet Gynecol 2015; 212: 315.
[18] 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: 1608–1612.
[19] Garbedian K, Boggild M, Moody J, Liu KE. Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization. CMAJ Open 2013; 1: E77–E82.
[20] 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: 3321–3327.
[21] Paffoni A, Ferrari S, Viganò P, Pagliardini L, Papaleo E, Candiani M, et al. Vitamin D deficiency and infertility: Insights from in vitro fertilization cycles. J Clin Endocrinol Metab 2014; 99: E2372–E2376.
[22] Polyzos NP, Anckaert E, Guzman L, Schiettecatte J, Van Landuyt L, Camus M, et al. Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ICSI. Hum Reprod 2014; 29: 2032–2040.
[23] Yoshizawa T, Handa Y, Uematsu Y, Takeda S, Sekine K, Yoshihara Y, et al. Mice lacking the vitamin D receptor exhibit impaired bone formation, uterine hypoplasia and growth retardation after weaning. Nat Genet 1997; 16: 391– 396.
[24] Liao EY, Zhang ZhL, Xia WB, Lin H, Cheng Q, Wang L, et al. Calcifediol (25-hydroxyvitamin D) improvement and calcium-phosphate metabolism of alendronate sodium/vitamin D(3) combination in Chinese women with postmenopausal osteoporosis: A post hoc efficacy analysis and safety reappraisal. BMC Musculoskelet Disord 2018; 19: 210.
[25] Harkness LS, Bonny AE. Calcium and vitamin D status in the adolescent: Key roles for bone, body weight, glucose tolerance, and estrogen biosynthesis. J Pediatr Adolesc Gynecol 2005; 18: 305–311.
[26] Al-Harbi AN, Khan KhM, Rahman A. Developmental vitamin D deficiency affects spatial learning in Wistar rats. J Nutr 2017; 147: 1795–1805.
[27] Belenchia AM, Johnson SA, Kieschnick AC, Rosenfeld CS, Peterson CA. Time course of vitamin D depletion and repletion in reproductive-age female C57BL/6 mice. Comp Med 2017; 67: 483–490.
[28] Grzesiak M, Burzawa G, Kurowska P, Blaszczyk K, Szlaga A, Blasiak A, et al. Altered vitamin D3 metabolism in the ovary and periovarian adipose tissue of rats with letrozoleinduced PCOS. Histochem Cell Biol 2021; 155: 101–116.
[29] Dupuis ML, Pagano MT, Pierdominici M, Ortona E. The role of vitamin D in autoimmune diseases: Could sex make the difference? Biol Sex Differ 2021; 12: 1–12.
[30] Tosti C, Biscione A, Morgante G, Bifulco G, Luisi S, Petraglia F. Hormonal therapy for endometriosis: From molecular research to bedside. Eur J Obstet Gynecol Reprod Biol 2017; 209: 61–66.
[31] Garbossa SG, Folli F. Vitamin D, sub-inflammation and insulin resistance: A window on a potential role for the interaction between bone and glucose metabolism. Rev Endocr Metab Disord 2017; 18: 243–258.
[32] Osati S, Homayounfar R, Hajifaraji M. Metabolic effects of vitamin D supplementation in vitamin D deficient patients: A double-blind clinical trial. Diabetes Metab Syndr 2016; 10: S7–S10.
[33] Kouhkan A, Khamseh ME, Moini A, Pirjani R, Arabipoor A, Zolfaghari Z, et al. Diagnostic accuracy of body mass index and fasting glucose for the prediction of gestational diabetes mellitus after assisted reproductive technology. Int J Fertil Steril 2019; 13: 32–37.
[34] Tashrifi F, Haghani Nasimi O, Abdollahi M, Moradi B. Fasting blood sugar, glucose challenge test and one-two hour glucose tolerance test in diagnosis of gestational diabetes in women without risk factor. Iran J Diabetes Obesity 2018; 10: 106–108.
[35] Zhang Ch, Yang Ch, Li N, Liu X, He J, Chen X, et al. Elevated insulin levels compromise endometrial decidualization in mice with decrease in uterine apoptosis in early-stage pregnancy. Arch Toxicol 2019; 93: 3601– 3615.
[36] Namvar Jahromi B, Dabbaghmanesh MH, Bakhshaie P, Parsanezhad ME, Anvar Z, Alborzi M, et al. Assessment of oxytocin level, glucose metabolism components and cutoff values for oxytocin and Anti-Mullerian hormone in infertile PCOS women. Taiwan J Obstet Gynecol 2018; 57: 555–559.