How vitamin D level influences in vitro fertilization outcomes: results of a systematic review and meta-analysis
Serum vitamin D levels do not seem to be associated with reproductive outcomes in patients undergoing in vitro fertilization.
Published
VOLUME 114, ISSUE 5, P1014-1025
Authors:
Mauro Cozzolino, M.D., Andrea Busnelli, M.D., Livia Pellegrini, Ph.D., Emma Riviello, M.D., Amerigo Vitagliano, M.D.
Abstract:
Objective
To investigate the impact of serum vitamin D level on in vitro fertilization (IVF) outcomes.
Design
Systematic review and meta-analysis.
Setting
Not applicable.
Patients
Infertile women undergoing conventional IVF or intracytoplasmic sperm injection (ICSI).
Interventions
Systematic search of PubMed, MEDLINE, EMBASE, Global Health, The Cochrane Library, Health Technology Assessment Database, and Web of Science from inception until July 2019 with cross-checking of references from relevant articles in English. Vitamin D levels were categorized into three groups: deficient (<20 ng/mL), insufficient (20−30 ng/mL), and replete (>30 ng/mL). Before starting the data extraction, we registered the review protocol in PROSPERO (CRD42019134258).
Main Outcome Measures
We consider clinical pregnancy rate (CPR), live birth rate (LBR), and/or ongoing pregnancy rate (OPR) as primary outcomes. Likewise, the miscarriage rate was considered as a secondary outcome.
Results
Primary analysis showed that women with a replete level of vitamin D had higher CPR and LBR/OPR compared to those with a deficient of insufficient level of vitamin D. However, sensitivity analysis led to non-significant differences between the comparators for CPR (odds ratio 0.71, 95% confidence interval 0.47−1.08, I2 = 61%) and OPR/LBR (odds ratio 0.78, 95% confidence interval 0.56−1.08], I2 = 61%). Also, for miscarriage a statistically different rate was not reached.
Conclusion
Serum vitamin D levels do not influence IVF outcomes in terms of CPR, LBR/OPR, and miscarriage rate. Future large cohort studies are warranted to determine whether the threshold of vitamin D affects reproductive outcomes. Currently, there is a lack of consensus between the appropriate vitamin D threshold to predict reproductive outcomes compared to the one established for bone health.
PROSPERO Number
CRD42019134258.
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