血清中25(OH)D水平对隐匿型原发性卵巢功能不全患者妊娠结局的影响

Effect of serum level of 25-OH vitamin D on the pregnancy outcome of women with occult primary ovarian insufficiency

目的研究血清中25(OH)D水平对隐匿型原发性卵巢功能不全(occult primary ovarian insufficiency,oPOI)患者妊娠结局的影响。方法回顾性分析2018年9月至2022年12月在广东省妇幼保健院生殖中心行辅助生殖治疗的218例患者的临床资料。将符合纳入标准的对照组和oPOI组患者按孕产妇的年龄节点分为≤35岁和>35岁,比较各组的25(OH)D浓度及妊娠结局的差异,随后对oPOI患者进行维生素D补充,追踪助孕结局。结果在≤35岁患者中,oPOI组的25(OH)D水平及妊娠率显著低于对照组(41.62±11.90 vs 63.04±16.26,42.37±4.62 vs 53.33±1.97,P<0.05),在>35岁患者中,25(OH)D水平及妊娠率均无显著性差异。在≤35岁oPOI患者中,25(OH)D干预组的血清25(OH)D浓度和优质胚胎率显著高于25(OH)D未干预组,差异具有统计学意义(42.13±12.91 vs 78.26±23.91,55.74±25.16 vs 80.39±29.05,P<0.05),但两组间的获卵数、受精率、临床妊娠率和着床率均没有显著差异;在>35岁的oPOI患者中,25(OH)D干预组与未干预组的血清25(OH)D浓度、获卵数、受精率、优质胚胎率、临床妊娠率和着床率均未见显著差异。结论≤35岁的女性不孕患者中,oPOI患者的维生素D水平低于其他因素不孕的患者,给予维生素D补充后可改善oPOI患者25(OH)D水平及优质胚胎率,但未改变oPOI患者的妊娠结局。

Objective This study aims to investigate the effect of serum 25(OH)D levels on pregnancy outcomes in women with occult primary ovarian insufficiency(oPOI).Methods Retrospective analysis of clinical data of 218 patients who underwent assisted reproductive therapy at the Reproductive Medicine Center,Guangdong Women and Children Hospital from September 2018 to December 2022.The oPOI group and the control group with normal ovarian function should be consulted due to fallopian tube factors were divided into≤35 years old and>35 years old based on the age of elderly pregnant women,and the differences in serum 25(OH)D concentrations among all groups were compared.Subsequently,the oPOI patients were supplemented with vitamin D to track the pregnancy outcomes.Results In the≤35 years old group,the 25(OH)D level and pregnancy rate in the oPOI group were significantly lower than those in the control group(41.62±11.90 vs 63.04±16.26,42.37±4.62 vs 53.33±1.97,P<0.05).In the>35 years old group,there were no significant differences in serum 25(OH)D levels and pregnancy rates.In oPOI patients≤35 years old,the serum 25(OH)D concentration and high-quality embryo rate after vitamin D supplementation was higher than that in the non-supplementation group(42.13±12.91 vs 78.26±23.91,55.74±25.16 vs 80.39±29.05,P<0.05),and there was no significant difference in number of eggs obtained,fertilization rate,clinical pregnancy rate and implantation rate.In oPOI patients>35 years old,there were no significant differences in serum 25(OH)D concentration,number of eggs,fertilization rate,high-quality embryo rate,clinical pregnancy rate and implantation rate between unsupplemented and supplemented vitamin D groups.Conclusion In female infertility patients≤35 years old,vitamin D levels in oPOI patients were lower than in patients with other infertility factors,and vitamin D supplementation improved 25(OH)D levels and highquality embryo rate in oPOI patients but did not change pregnancy outcomes.