The Relation of Serum and Follicular Fluid Vitamin D Levels and the Oocyte Maturation, Embryo Grade and Pregnancy Rate in In Vitro Fertilization/Intracytoplasmic Injection Cycles

Abstract

The clinical pregnancy rate in In Vitro Fertilization and intracytoplasmic sperm injection (ICSI) remains low in spite of many evolutions in assisted reproduction. The ovulatory infertility is the main causes of female infertility related to oocyte problems. Maternal age, oocyte competence with its follicular fluid affect oocyte quality and pregnancy rate. So many studies were done for the follicular fluid and its content to study the effect of its environment and their relation to pregnancy success. The aim of the study is found a relation between vitamin D blood level and the oocyte maturation, embryo grade and pregnancy rate in In Vitro Fertilization/Intracytoplasmic injection cycles Materials and Methods A prospective observational study which was connected at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies. Infertile women (75) who admitted to in vitro fertilization programs in the institute for the In Vitro Fertilization/Intracytoplasmic injection. Controlled ovarian stimulation was done to each patient and at the day of ova pick up, follicular fluid aspiration was done and Vitamin D analysis by Eliza was done. Level of Vitamin D was assessed to each patient. Results: Follicular fluid matching to successfully mature good quality oocyte to achieve pregnancy. In this study the common causes of infertility are: ovarian 13(21%), unexplained 12(19.4%), PCOS 10(16.1%), male factor 10(16.1%), tubal factor 10(16.1%), and mixed 7(11.3%). Serum level of vitamin D was divided into three groups: Group (1) or normal group (≥30 ng/ml), group (2) or insufficient group (21-29.9 ng/ml) and group (3) or deficient group (≤ 20.9 ng/ml) is found among 28 (43.5%),15(25.8%) 19(30.6%), of patients respectively. According to the serum level of vitamin D in three groups, the mean number of oocyte MII or embryo grades number was not significantly different .Positive chemical pregnancy is not significantly more among those with sufficient group (1) as compared with deficient group (3) . The vitamin D in follicular fluid level demonstrated a not significant positive correlation between its level and retrieved MI ,MII oocyte number. The results demonstrate a non-significant positive correlation between follicular fluid vitamin D level and grade (I) embryo. There is no significant difference between pregnancy rate and follicular fluid of vitamin D. Conclusion: There is a non-significant correlation between oocyte maturity, embryo grade and chemical pregnancy rate with both serum and follicular vitamin D level.