Can Vitamin D Supplemental Therapy improve the Disturbed Follicular Fluid Milieu and affect the Outcome of ICSI?

Abstract

Background: Vitamin D (VD) receptor is widely distributed in reproductive systems thus hypovitaminosis D can impair the response to ovarian stimulation. Objectives: Determination of the effect of VD supplemental therapy (VD-ST) on the ovarian follicular fluid (FF) milieu in infertile women undergoing intracytoplasmic sperm injection (ICSI). Patients and Methods: 103 infertile women were evaluated clinically and gave blood samples for estimation of serum and FF levels of 25-hydroxy vitamin D (25-OH-VD), and FF levels of tumor necrosis factor-α (TNF-α) and total antioxidant capacity and underwent a cycle of ICSI using the antagonist protocol before and after receiving 3-month VD-ST. The study outcome is the impact of VD-ST on the clinical pregnancy rate. Results: Serum (P=0.0004) and FF (P=0.040) levels of 25-OH-VD were significantly increased, while FF levels of TNF-α were significantly (P95% fragmentation (P=0.019) rates were significantly increased with doubling of number of high-grade embryos and clinical pregnancy rate. These changes were correlated positively with increased in serum and FF levels of 25OH-VD and decrease of TNF-α level. Statistical analyses defined the higher increase in serum and FF levels of 25OH-VD as the important predictors for the number of oocytes and clinical pregnancy, while the higher decrease in FF levels of TNF-α was the important predictor for the rate of high-grade embryos. Conclusion: VD-ST may play an important role for success of ICSI through increasing serum and FF levels of VD and decreasing FF levels of TNF-α.

Keywords

• follicular fluid icsi vitamin d supplemental therapy tumor necrosis factor-α total antioxidant capacity