IVF 50 percent more likely to result in pregnancy if high vitamin D – meta-analysis Nov 2017


Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis - Nov 2017

Hum Reprod. 2017 Nov 15:1-16. doi: 10.1093/humrep/dex326. [Epub ahead of print]
Chu J1,2, Gallos I1,2, Tobias A1,3, Tan B4,5, Eapen A1,2, Coomarasamy A1,2.


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!More Live Births if > 30 ng of vitamin D
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More Pregnancies if > 30 ng of vitamin D
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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.

LIMITATIONS REASONS FOR CAUTION:
Although strict inclusion criteria were used in the conduct of the systematic review, the included studies are heterogeneous in population characteristics and fertility treatment protocols.

WIDER IMPLICATIONS OF THE FINDINGS:
The findings of this systematic review show that there is an association between vitamin D status and reproductive treatment outcomes achieved in women undergoing ART. Our results show that vitamin D deficiency and insufficiency could be important conditions to treat in women considering ARTs. A randomized controlled trial to investigate the benefits of vitamin D deficiency treatment should be considered to test this hypothesis.

PMID: 29149263 DOI: 10.1093/humrep/dex326


Live birth 26% more likely after IVF if good level of vitamin D - Meta-analysis Feb 2018

Reprod Biol Endocrinol. 2018 Feb 9;16(1):13. doi: 10.1186/s12958-018-0324-3.
Whether vitamin D was associated with clinical outcome after IVF/ICSI: a systematic review and meta-analysis.
Zhao J1, Huang X1, Xu B1, Yan Y1, Zhang Q1, Li Y2.
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BACKGROUND:
There exist contradictive views on whether the vitamin D has association with clinical outcome of in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI). The present meta-analysis aim to establish whether vitamin D was associated with clinical outcomes of IVF/ICSI.

METHODS:
MEDLINE, Google Scholar and the Cochrane Library from database inception to March 2017 were searched. Clinical studies, which evaluated the association of vitamin D level and the clinical outcomes after IVF/ICSI, were included. The Main Outcome Measures were clinical pregnancy, ongoing pregnancy, and live birth.

RESULTS:
In the analysis of clinical pregnancy, 9 cohort studies were included. Of which, 2 studies and 3 studies were identified in analyzing ongoing pregnancy and live birth, respectively. Meta-analysis showed trends toward lower clinical pregnancy [RR 0.91, (95% CI 0.77-1.07)] and higher ongoing pregnancy [RR 1.06, (95% CI 0.95-1.19)] for women with deficient level of vitamin D. The probability of live birth for women with deficient level of vitamin D was significantly lower than cases with sufficient level of vitamin D [RR 0.74, (95% CI 0.58-0.90)].

CONCLUSIONS: Deficient vitamin D was associated with decreased probability of live birth after IVF/ICSI. So vitamin D should be supplied to women with deficient level vitamin D.

PMID: 29426322 DOI: 10.1186/s12958-018-0324-3

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