Can Vitamin D Supplemental Therapy improve the Disturbed Follicular Fluid Milieu and affect the Outcome of ICSI? | ||
| SVU-International Journal of Medical Sciences | ||
| Volume 6, Issue 2, July 2023, Pages 827-840 PDF (367.17 K) | ||
| Document Type: Original research articles | ||
| DOI: 10.21608/svuijm.2023.247331.1733 | ||
| Authors | ||
| Ahmed M.E. Ossman* 1; Mohamed H. Fouda2; Mona K. Omar1 | ||
| 1Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Tanta, Egypt. | ||
| 2Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt. | ||
| 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 (P<0.001) decreased after VD-ST. Number of retrieved oocytes (P=0.036) and embryos showing >95% 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 | ||
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