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Research

Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization

Kimberley Garbedian, Miranda Boggild, Joel Moody and Kimberly E. Liu
June 28, 2013 1 (2) E77-E82; DOI: https://doi.org/10.9778/cmajo.20120032
Kimberley Garbedian
1Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ont.
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Miranda Boggild
2Faculty of Medicine, University of Toronto, Toronto, Ont.
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Joel Moody
3Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ont.
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Kimberly E. Liu
4Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ont.
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    Table 1: Characteristics of 173 women undergoing in vitro fertilization, by vitamin D status
    CharacteristicVitamin D status, mean (± SD)*
    Insufficient or deficient
    n = 95
    Sufficient
    n = 78
    p value†
    25-Hydroxy-vitamin D, nmol/L54.5 ± 14.095.5 ± 17.8< 0.001
    Age, yr34.6 ± 4.034.4 ± 3.90.8
    Ethnic background, no. (%)0.3
    White56 (58.9)58 (74.4)
    Black3 (3.2)1 (1.3)
    Other36 (37.9)19 (24.4)
    Body mass index24.8 ± 4.723.3 ± 3.80.02
    Gravidity0.8 ± 1.10.9 ± 1.30.6
    Parity0.2 ± 0.50.3 ± 0.60.5
    Duration of infertility, mo20.7 ± 15.117.5 ± 12.30.1
    Follicle-stimulating hormone, baseline, IU/L6.4 ± 1.96.8 ± 2.30.9
    Antral follicle count, baseline, no. of follicles15.9 ± 8.417.7 ± 10.30.2
    Previous IVF cycles, no.0.7 ± 1.00.6 ± 1.00.4
    Season in which IVF cycle was performed, no. (%) of patients0.8
    Spring50 (52.6)41 (52.6)
    Summer31 (32.6)28 (35.9)
    Fall14 (14.7)9 (11.5)

    Note: IVF = in vitro fertilization, SD = standard deviation.
*Unless otherwise stated.
†χ2 (categorical) and Student t or Mann–Whitney U (continuous) test; statistically significant, p < 0.05.

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      Table 2: In vitro fertilization cycle parameters for 173 women, by vitamin D status
      CharacteristicVitamin D status, no. (%) or mean ± SDp value*
      Insufficient or deficient
      n = 95
      Sufficient
      n = 78
      IVF protocol, no. (%)0.08
      Long29 (30.5)34 (43.6)
      Antagonist64 (67.4)40 (51.3)
      Flare2 (2.1)4 (5.1)
      Day of hCG injection12.1 ± 1.311.9 ± 1.40.4
      Gonadotropin dose, IU2602.8 ± 1287.32547.1 ± 1330.30.8
      Follicle diameter > 14 mm, no.11.9 ± 6.511.7 ± 5.80.8
      Estradiol level on the day of hCG administration, pmol/L8556.7 ± 6187.39776.15 ± 5902.60.2
      Endometrial thickness on the day of hCG administration, cm1.0 ± 1.61.0 ± 0.20.5
      Oocytes retrieved, no.12.6 ± 7.412.7 ± 6.60.9
      Intracytoplasmic sperm injection, no. (%)74 (77.9)63 (80.8)0.4
      Embryos transferred, no.1.8 ± 1.01.8 ± 0.90.9
      Day of embryo transfer, no. (%)
      Day 331 (32.6)19 (24.4)0.2
      Day 556 (58.9)56 (71.8)0.054.00
      Implantation rate, %25.634.50.6
      Clinical pregnancy rate, per cycle start, %34.752.5< 0.001
      Clinical pregnancy rate, per embryo transfer, %37.954.7< 0.001

      Note: hCG = human chorionic gonadotropin, SD = standard deviation.
*χ2 (categorical) and Students t or Mann–Whitney U (continuous) test; statistically significant, p < 0.05.
†Follicle-stimulating hormone or human menopausal gonadotropin, depending on protocol.

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        Table 3: Predictors of clinical pregnancy among 173 women undergoing in vitro fertilization
        VariableCrude OR (95% CI)p valueAdjusted OR (95% CI)*p value†
        Age, yr0.96 (0.89–1.04)0.30.98 (0.90–1.07)0.7
        Body mass index0.92 (0.86–1.00)0.050.94 (0.87–1.01)0.1
        Day 5 embryos transferred (v. day 3)1.50 (0.81–2.90)0.21.28 (0.61–2.77)0.5
        25-Hydroxy-vitamin D, mmol/L1.02 (1.00–1.03)0.21.01 (1.00–1.03)0.05

        Note: CI = confidence interval, OR = odds ratio.
*Analyses adjusted for age, BMI, number of day 5 embryos transferred and 25 OH-D level.
†Statistically significant, p < 0.05.

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        CMAJ Open: 1 (2)
        Vol. 1, Issue 2
        16 May 2013
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        Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization
        Kimberley Garbedian, Miranda Boggild, Joel Moody, Kimberly E. Liu
        May 2013, 1 (2) E77-E82; DOI: 10.9778/cmajo.20120032

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        Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization
        Kimberley Garbedian, Miranda Boggild, Joel Moody, Kimberly E. Liu
        May 2013, 1 (2) E77-E82; DOI: 10.9778/cmajo.20120032
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