不明原因不孕症诱导排卵患者维生素D水平与妊娠结局的关系

Iman Abu Gleda, S. S. Hassan, M.R.C.O.G. Abdel-Hafeez, Ahmed Hamed
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摘要

目的:评估不明原因不孕妇女血清维生素D水平与促排卵妊娠结局的关系。方法:对不明原因不孕妇女进行队列研究。结果:孕妇维生素D水平明显高于非孕妇。在调整了其他变量的影响后,维生素D水平与化学妊娠之间没有统计学上的显著关系。另一方面,继发性不孕是化学妊娠的独立预测因子。结果表明,维生素D水平具有有限的预测价值,ROC曲线下面积(AUC)为0.621。最佳临界值为>32.5 ng/mL,灵敏度为28%,特异性为95%。血清维生素D与LH水平呈弱负相关。最后,在调整了其他变量的影响后,充足的维生素D和继发性不孕是化学妊娠的独立预测因子。血清维生素D充足的妇女化学妊娠试验阳性率明显高于血清维生素D缺乏/不足的妇女。结论:不明原因不孕引排卵妇女血清维生素D水平与妊娠结局无统计学意义。此外,我们的研究结果表明,维生素D水平对不明原因不孕妇女诱导排卵的预测价值有限,最佳临界值>32.5 ng/mL。在调整了其他变量的影响后,充足的维生素D是化学妊娠的独立预测因子。
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The Relation between Vitamin D Level and Pregnancy Outcome in Women with Unexplained Infertility Undergoing Induction of Ovulation
Objective: assess the association between serum level of Vitamin D and pregnancy outcome in women with unexplained infertility undergoing an induction of ovulation. Methods: cohort study including women with unexplained infertility .Results: the vitamin D level was significantly higher in pregnant women than non pregnant. After adjustment for the effect of other variables, there was no statistically significant relation between vitamin D level and chemical pregnancy. On the other hand, secondary infertility was an independent predictor of chemical pregnancy. Our results showed that vitamin D level has limited predictive value with an area under the ROC curve (AUC) of 0.621. The best cutoff is a value of >32.5 ng/mL, which has a sensitivity of 28% and specificity of 95%. There is weak negative correlation between serum vitamin D and LH level. Lastly, after adjustment for the effect of other variables, adequate vitamin D and secondary infertility were an independent predictors of chemical pregnancy. There was significantly high rate of positive chemical pregnancy test among women had sufficient serum vitamin D when compared to those had deficient/ insufficient serum vitamin D.Conclusion: There was no statistically significant relation between vitamin D level and pregnancy outcome in women with unexplained infertility undergoing induction of ovulation. Moreover, our results showed that vitamin D level has limited predictive value in women with unexplained infertility undergoing induction of ovulation, the best cutoff value was >32.5 ng/mL. After adjustment for the effect of other variables, adequate vitamin D was an independent predictors of chemical pregnancy.
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