維他命D缺乏會流產VD

2014.09.16

 維他命D缺乏會流產VD

維他命D其實是垂手可得的，單純曬陽光就可以得到維他命D，但在多囊性卵巢症候群的病人會有維他命D的缺乏，至於缺乏會導致：
1、肥胖。
2、卵巢裡面的生理環境不論是黃體素的生成，或者SHVG性荷爾蒙結合球蛋白的缺少。
3、AMH的上升。
因此服用維他命D可以改善不利於生育的情況，最近有很多報告的支持，維他命D缺乏會導致胚胎著床後流產，因為維他命D和子宮內膜也有一定的角色，如果妳有要生育、有多囊卵巢、如果妳肥胖，建議服用維他命D。
維他命D可增加試管嬰兒成功率嗎？會！VD
 
有一份美國南加州大學研究針對99個借卵生子不孕症患者的試管嬰兒療程，這個研究是有非常有名的南加州大學所做出來的，他們發現這99人中，有53％為高加索人、20％為亞洲人、16％為西班牙裔人、7％為非裔美國人，也就是說，各種種族都有。
 
這99位借卵不孕症患者，去抽血驗血中維他命D的濃度，再對比試管嬰兒成功率：如果維他命D缺乏，則只有37％的試管嬰兒懷孕率；反觀如果維他命D正常，則有高達78％的試管嬰兒懷孕率。
 
我們知道借卵這個族群的試管嬰兒懷孕率只有37%太低了，讓人無法˙接受，也因此我們建議，在進入任何試管嬰兒療程的病人都應該要：
1.抽血檢查血中維他命D濃度。
2.或直接補充維他命D。
 
現在市面上的維他命D 1顆400單位，理論上ㄧ天可以吃到5顆，當然，曬太陽也可得到維他命D3，但是抽血去維他命D的血中濃度太貴了，要將近1600元；所以與其去抽血驗維他命D的血中濃度，不如直接補充維他命D 。曬太陽
 
 
Fertil Steril. 2014 Feb;101(2):447-52. doi: 10.1016/j.fertnstert.2013.10.008. Epub 2013 Nov 5.
Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.
Rudick BJ1, Ingles SA2, Chung K3, Stanczyk FZ3, Paulson RJ3, Bendikson KA3.
Author information
 
Abstract
OBJECTIVE:
To elucidate the role of vitamin D in reproduction by examining the relationship between recipient vitamin D levels and pregnancy rates in donor-recipient IVF cycles.
DESIGN:
Retrospective cohort study.
SETTING:
Academic tertiary care center.
PATIENT(S):
Ninety-nine recipients of egg donation at University of Southern California Fertility.
INTERVENTION(S):
Serum was collected from egg donor recipients before ET and was tested for vitamin D levels [25(OH)D].
MAIN OUTCOME MEASURE(S):
Clinical pregnancy as defined by sonographic presence of a heartbeat at 7-8 weeks of gestation.
RESULT(S):
In a diverse population of 99 recipients (53% Caucasian, 20% Asian, 16% Hispanic, 7% African American), 
adjusted clinical pregnancy rates were lower among vitamin D-deficient recipients than among vitamin D-replete recipients (37% vs. 78%).
 Live-birth rates were 31% among vitamin D-deficient recipients, compared with 59% among vitamin D-replete recipients.
 There were no differences in adjusted clinical pregnancy and live-birth rates among recipients who were vitamin D deficient [25(OH)D<20 ng/mL] vs. among those who were vitamin D insufficient [20 ng/mL ≤ 25(OH)D<30 ng/mL].
CONCLUSION(S):
Nonreplete vitamin D status [25(OH)D<30 ng/mL] was associated with lower pregnancy rates in recipients of egg donation. Since the oocyte donor-recipient model is able to separate the impact of vitamin D on oocyte vs. endometrium, these data suggest that the effects of vitamin D may be mediated through the endometrium.