Vitamin D (VD) 血清濃度高低與試管懷孕率無明顯差異 

補充Vit D 是否提升懷孕率仍具爭議

Original ArticleVolume 122, Issue 5p866-874November 2024

Vitamin D levels in couples undergoing in vitro fertilization treatment: lack of association with embryo quality or pregnancy rates

Objective

To investigate the potential impact of vitamin D (VD) serum levels on couples going through in vitro fertilization treatment in terms of embryo quality and pregnancy rates.

Patient(s)

A total of 267 couples underwent intracytoplasmic sperm injections between January 2017 and March 2019.

Intervention(s)

The couples were categorized into four groups on the basis of 25-hydroxy VD (25OHD) levels measured at the beginning of the stimulation protocol: group 1 with 25OHD levels ≥30 ng/mL for both women and men; group 2 with 25OHD levels <30 ng/mL for both; group 3 women with 25OHD levels <30 ng/mL and men with 25OHD levels ≥30 ng/mL; and group 4 with women with 25OHD level ≥30 ng/mL and men with 25OHD level <30 ng/mL.

Main Outcome Measure(s)

We consider the quantity and quality of embryos during the cleavage as well as blastocyst stages as primary outcomes. Correspondingly, the clinical pregnancy rate (CPR) was regarded as a secondary outcome.

Result(s)

Our findings revealed no significant correlations between the studied VD groups and the evaluated outcomes. This includes the quantity and quality of embryos during the cleavage and blastocyst stages, as well as the CPR. Primary analysis revealed a small but statistically significant difference in the duration of controlled ovarian stimulation between group 1 and group 2 (95% confidence interval, 0.07–3.04) and between group 1 and group 3 (95% confidence interval, 0.05–3.23).

Conclusion(s)

The present study found no correlation between the studied VD levels and the quantity as well as quality of cleavage or blastocyst stage embryos, nor did it show any impact on CPRs. Further well-designed, prospective studies are warranted to determine whether and how vitamin D affects reproductive outcome

捐卵冷凍或新鮮卵子或胚胎植入後懷孕率無明顯差異

Trends and outcomes of fresh and frozen donor oocyte cycles in the United States

Cover Image - Fertility and Sterility, Volume 122, Issue 5

Objective

To examine trends, characteristics, and outcomes of donor oocyte embryo transfer cycles by original oocyte and resultant embryo state and determine whether oocyte state (fresh or frozen) is differentially associated with clinical pregnancy, live birth, and term, healthy birthweight neonates among singleton live births.

Patient(s)

Patients undergoing donor oocyte embryo transfer cycles in the United States reporting to the National Assisted Reproductive Technology Surveillance System from 2013 to 2020.

Annual numbers and proportions of total donor oocyte embryo transfer cycles stratified by oocyte and embryo state and single embryo transfer cycles resulting in the live birth of term (≥37 weeks gestation), healthy birthweight (≥2,500 g) singletons during 2013–2020. Rates of live birth and term, healthy birthweight neonates among singleton live births for 2018–2020 are also reported. Relative risks examine associations between donor oocyte state and live birth and term, healthy birthweight neonates among singleton live births resulting from donor oocyte embryo transfer cycles.

Result(s)

From 2013 to 2020, there were 135,085 donor oocyte embryo transfer cycles, of which the proportions increased for frozen embryos (42.3%–76.6%), fresh embryos using frozen donor oocytes (19.9%–68.3%) and single embryo transfers (36.4%–85.5%). During 2018–2020, there were 48,679 donor oocyte embryo transfer cycles. Rates of live birth were lower with frozen compared with fresh donor oocytes for both fresh (46.2%, 55.9%; adjusted relative risk [aRR], 0.83; 95% confidence interval [CI], 0.79–0.87) and frozen (41.3%, 45.8%; aRR, 0.94; 95% CI, 0.91–0.98) embryo transfer cycles. Among singleton live births, rates of delivering a term, healthy birth weight neonate were similar for frozen compared with fresh donor oocyte transfer cycles among fresh (77.3%, 77.2%; aRR, 1.01; 95% CI, 0.98–1.03) and frozen (75.6%, 75.1%; aRR, 1.02; 95% CI, 0.99–1.04) embryos.

Conclusion(s)

In this national study of donor oocyte embryo transfer cycles, frozen embryo transfers, fresh embryo transfers using frozen oocytes, and single embryo transfers increased. Although frozen compared with fresh oocytes were associated with a slightly reduced rate of live birth, rates of term, healthy birthweight neonates among singleton live births were comparable between donor oocyte states.