血清25羟基维生素D水平与冻融胚胎移植早期妊娠结局的关系

Association of the serum 25-hydroxy vitamin D level with the early pregnancy outcomes of frozen-thawed embryo transfer

目的:探讨血清25羟基维生素D[25(OH)D]水平与冻融胚胎移植早期妊娠结局的关系。方法:选取2020年4月至2021年12月于中部战区总医院生殖医学科进行冻融胚胎移植(FET)治疗并测定血清25(OH)D水平的患者共119例。根据血清25(OH)D水平,分为维生素D缺乏组(59例):25(OH)D<45.0 nmol/L;不足组(47例):25(OH)D为(45.0~75.0 nmol/L);正常组(13例):25(OH)D≥75.0 nmol/L(且<375.0 nmol/L)。比较各组患者间基本资料、临床妊娠率、胚胎种植率、不良妊娠率是否有差异,再行二元Logistic回归分析探索影响妊娠结局的相关因素。结果:3组间年龄(≤42岁)、体质量指数(BMI)、移植日子宫内膜厚度(≥7 mm)、移植胚胎数、移植优质胚胎数、临床妊娠率、种植率及不良妊娠率等差异均无统计学意义(P>0.05)。二元Logistic回归分析显示血清25(OH)D水平与FET早期临床妊娠相关(OR:1.064,P=0.040);移植优胚数与FET早期临床妊娠相关(OR:0.495,P=0.004);而年龄(≤42岁)、移植日子宫内膜厚度(≥7 mm)、BMI、移植胚胎个数、转化日E2、P水平均与FET早期临床妊娠无显著相关性(P>0.05)。结论:血清25(OH)D水平与FET治疗早期妊娠结局呈正相关,高水平血清25(OH)D可改善FET早期临床妊娠结局,可作为预测FET成功率的良好指标。

Objective:To explore the association of the 25-hydroxy vitamin D(25(OH)D)level in the serum with the early pregnancy outcome of frozen-thawed embryo transfer(FET).Methods:We selected 119 infertile women that underwent FET and detection of serum 25(OH)D in the Department of Reproductive Medicine of the General Hospital of Central Theater Command from April 2020 to December 2021.According the level of serum 25(OH)D,we divided the patients into three groups:25(OH)D<45.0 nmol/L(n=59),25(OH)D 45.0-75.0 nmol/L(n=47),and 25(OH)D≥75.0 nmol/L but<375.0 nmol/L(n=13),compared the basic information and the rates of clinical pregnancy,embryo implantation and adverse pregnancy among the three groups,and investigated the factors affecting the early pregnancy outcome using binary logistic regression analysis.Results:No statistically significant differences were observed among the three groups in the age(≤42 yr),body mass index(BMI),endometrial thickness at the transplantation day(≥7 mm),numbers of embryos transferred and high-quality embryos transferred,or rates of clinical pregnancy,embryo implantation and adverse pregnancy(P>0.05).Binary logistic regression analysis showed that the rate of early clinical pregnancy was significantly correlated with the level of serum 25(OH)D(OR:1064,P=0.040)and the number of high-quality embryos transferred(OR:0.495,P=0.004),but not with the age(≤42 yr),BMI,endometrial thickness at the transplantation day(≥7 mm),number of embryos transferred,or the levels of E2 and progesterone at the transplantation day(P>0.05).Conclusion:The level of serum 25(OH)D is positively correlated with the early pregnancy outcome of FET.A high serum 25(OH)D level can improve the outcome and can be used as a good indicator to predict the success rate of FET.