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Vitamin D and TSH: Do Their Level Impact on IVF Outcomes?

Ricardo Negreiros,Luis Negreiros, Victor Rosado, Leonardo Cavalcanti,Bernardo Rosado, Breno Machado,Bianca Bianco, Viviane Assunção

Journal of the Endocrine Society(2021)

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摘要
Abstract Abstract: There is a positive correlation between serum 25 (OH) Vit D concentrations below 30 ng/ml and the incidence of preterm delivery, while higher levels can bring benefits to pregnancy. Although studies agree that TSH levels affect fertility, in euthyroid women (0.530 ng/mL (Group 1, n=204; Group 2, n=55). Primary endpoint was clinical pregnancy (the presence of the gestational sac and fetal heartbeat by ultrasound) and secondary outcomes were miscarriage and gestacional age (preterm or full-term pregnancy). The rate of clinical pregnancy in group 1 was significantly higher in patients with 25 (OH) Vit D <30 ng/ml (51.9%) than 25 (OH) Vit D >30 ng/ml (42.2%) according to the chi-square test and Fisher’s exact test (p<0.05 all). There was no significant difference in group 2 (p=0.35), with percentages of 49% and 40% in the respective subgroups. Moreover, no statistical difference between the abortion rates was seen in 25 (OH) Vit D subgroups in groups 1 (p=0.71) and 2 (p=0.52). When gestational age rates were measured, the percentage of full-term pregnancies was lower in patients with 25 (OH) Vit D <30 ng/ml (Group 1=62.6%; Group 2=57.9%), compared to those with 25 (OH) Vit D >30 ng/ml (Group 1=77.6%; Group 2=78.9%), however, only the subgroups in the TSH category between 0.5-2.49 mUI/L showed a statistically significant difference (p<0,05). The Spearman test identified a weak positive correlation between 25 (OH) Vit D and gestational age (ρ=0.218; p<0.05). The findings indicate lower frequency of clinical pregnancy in patients with TSH between 0.5-2.49 mIU/L and 25 (OH) Vit D >30 ng/ml. In addition, variations in 25 (OH) Vit D, in both TSH groups, do not suggest interference in miscarriage rates. Furthermore, higher serum concentrations of 25 (OH) Vit D seem to be involved with an increase in the prevalence of full-term births, an important finding to guide the procedures for IVF.
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