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 Fer tilization/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.