缺乏Vit D可能導致IVF較易流產

Hum Reprod. 2017 Nov 15:1-16. doi: 10.1093/humrep/dex326. [Epub ahead of print]

Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis.

Chu J1,2, Gallos I1,2, Tobias A1,3, Tan B4,5, Eapen A1,2, Coomarasamy A1,2.

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Abstract

STUDY QUESTION:

Is serum vitamin D associated with live birth rates in women undergoing ART?

SUMMARY ANSWER:

Women undergoing ART who are replete in vitamin D have a higher live birth rate than women who are vitamin D deficient or insufficient.

WHAT IS KNOWN ALREADY:

Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation as well as obstetric complications such as pre-eclampsia and fetal growth restriction. However, the effect of vitamin D on conception and early pregnancy outcomes in couples undergoing ART is poorly understood.

STUDY DESIGN, SIZE, DURATION:

A systematic review and meta-analysis of 11 published cohort studies (including 2700 women) investigating the association between vitamin D and ART outcomes.

PARTICIPANTS/MATERIALS, SETTINGS, METHODS:

Literature searches were conducted to retrieve studies which reported on the association between vitamin D and ART outcomes. Databases searched included MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CINAHL. Eleven studies matched the inclusion criteria.

MAIN RESULTS AND THE ROLE OF CHANCE:

Live birth was reported in seven of the included studies (including 2026 patients). Live birth was found to be more likely in women replete in vitamin D when compared to women with deficient or insufficient vitamin D status (OR 1.33 [1.08-1.65]). Five studies (including 1700 patients) found that women replete in vitamin D were more likely to achieve a positive pregnancy test than women deficient or insufficient in vitamin D (OR 1.34 ([1.04-1.73]). All 11 of the included studies (including 2700 patients) reported clinical pregnancy as an outcome. Clinical pregnancy was found to be more likely in women replete in vitamin D (OR 1.46 [1.05-2.02]). Six studies (including 1635 patients) reported miscarriage by vitamin D concentrations. There was no association found between miscarriage and vitamin D concentrations (OR 1.12 [0.81-1.54]. The included studies scored well on the Newcastle-Ottawa quality assessment scale.