维生素D对PCOS伴不孕女性促排卵效果的回顾性研究
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河北医科大学第四医院

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河北省医学科学研究课题计划(项目编号:20170706)


Effect of vitamin D supplementation on ovulation induction in infertile women with PCOS
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    摘要:

    目的 回顾性分析维生素D对25(OH)D缺乏的PCOS伴不孕女性促排卵效果的影响。方法 选择2019年1月至2019年12月来我院生殖中心就诊的25(OH)D缺乏的PCOS伴不孕女性并给予维生素D治疗后其血清25(OH)D达正常水平[25(OH)D≥30ng/mL]72例作为观察组(A组),选取同期就诊的25(OH)D缺乏的PCOS伴不孕女性未给予维生素D治疗59例作为对照组(B组)。2组给予枸橼酸氯克罗米芬(CC)/CC+尿促性素方案促排卵治疗,收集2组一般资料及周期排卵率、周期生化妊娠率、周期临床妊娠率、周期OHSS发生率。结果 2组年龄、体重指数(BMI)、不孕年限、基础激素水平[雌二醇、孕酮、卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮]、基础子宫内膜厚度相比,无显著差异(P>0.05)。A组周期排卵率(χ2=4.28,P=0.039)及周期临床妊娠率(χ2=5.17,P=0.023)显著高于B组,而2组周期生化妊娠率、周期卵巢过度刺激综合征(OHSS)发生率无显著差异(P>0.05)。对周期排卵、周期临床妊娠进行多因素Logistic回归分析显示:血清25(OH)D达正常水平是周期排卵的唯一预测因子(β=3.197,OR=0.041,95%CI:0.003-0.629,P= 0.022)。血清25(OH)D达正常水平(β=0.042,OR=0.563,95%CI:0.420-0.755,P= 0.000)、基础睾酮(β=-1.293,OR=1.370,95%CI:1.012-1.854,P= 0.042)是周期临床妊娠独立预测因子。结论 对25(OH)D缺乏的PCOS伴不孕女性补充维生素D,使其血清25(OH)D达正常水平,可提高治疗周期排卵率及临床妊娠率;血清25(OH)D正常水平是周期排卵的唯一预测因子,血清25(OH)D正常水平及血清睾酮水平是促排卵周期临床妊娠的预测因子。

    Abstract:

    Abstract Objective: to analyze the effect of vitamin D supplementation on ovulation induction in infertile women with PCOS and 25(OH)D deficiency. Methods: a total of 72 PCOS infertile women with 25(OH)D deficiency in our reproductive center from January 2019 to December 2019 after vitamin D treatment were selected as observation group (group A), and 59 infertile PCOS women without vitamin D treatment were selected as control group (group B). The two groups were treated with clomiphene citrate (CC) / CC + urotropin. The general data, cycle ovulation rate, biochemical pregnancy rate, clinical pregnancy rate and OHSS incidence rate in two groups were collected. Results: there were no significant differences in age, body mass index (BMI), infertility years, basal hormone levels [estradiol, progesterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone)] and basal endometrial thickness between the two groups (P > 0.05). The ovulation rate (χ 2 = 4.28, P = 0.039) and clinical pregnancy rate (χ 2 = 5.17, P = 0.023) in group A were significantly higher than those in group B, but there was no significant difference in biochemical pregnancy rate and OHSS incidence between the two groups (P > 0.05). Multivariate logistic regression analysis showed that serum 25(OH)D level was the only predictor of ovulation (β = 3.197, or = 0.041, 95% CI: 0.003-0.629, P = 0.022). Serum 25(OH)D (β = 0.042, or = 0.563, 95% CI: 0.420-0.755, P = 0.000), basal testosterone (β = - 1.293, or = 1.370, 95% CI: 1.012-1.854, P = 0.042) were independent predictors of clinical pregnancy. Conclusion: vitamin D supplementation can improve the ovulation rate and clinical pregnancy rate of PCOS women with infertility and 25(OH)D deficiency. Serum 25(OH)D level is the only predictor of ovulation cycle, and serum 25(OH)D level and testosterone are predictive factors of clinical pregnancy in ovulation induction cycle.

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贾新转.维生素D对PCOS伴不孕女性促排卵效果的回顾性研究[J].福建医科大学学报自然版,2021,55(6):28-30

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  • 收稿日期:2021-09-13
  • 最后修改日期:2021-12-20
  • 录用日期:2021-12-28
  • 在线发布日期: 2022-03-07
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