P-45: Predictive Value of Follicular Fluid VitaminD on Assisted Reproductive TechniqueOutcome

Background: Vitamin D, a steroid hormone, has critical roles in human health. The available data thus identify vitamin D as an important substance in processes involved in reproductive success and thereby suggest pathophysiological mechanisms for reproductive compromise in the setting of vitamin D deficiency. Realizing the prevalence of vitamin D insufficiency in our country, we hypothesized that deficiant vitamin D stores will translate to decreased reproductive success following ART. This study aimed to determine whether 25OH-D levels in the follicular fluid of infertile women undergoing ART demonstrate a relationship with stimulation cycle parameters and outcome. Materials and Methods: A prospective cohort study was undertaken at Infertility department of Shariati Hospital affiliated to Tehran University of Medical Sciences. Eightytwo infertile women undergoing assisted reproductive technique were enrolled between 2009 and 2010. The study protocol was in accordance with the guidelines of Declaration of Helsinki, approved by institutional review board of the Tehran University of Medical Sciences. All patients underwent ART cycles with standardized regimens for COH after long protocol pituitary down regulation. Serum samples of Vitamin D (25OH-D), calcium, phosphorus, alkaline phosphatase, parathormone were collected. Transvaginal ultrasound guided oocyte retrieval was performed 36 hours following the hCG injection. Follicular fluid was collected from follicles ≥14mm; following oocyte isolation, follicular fluid for each patient was pooled, centrifuged and the supernatant was stored until assayed for Vitamin D (25OH-D). Fertilization was assessed 24 hours after insemination. Fresh embryotransfer was performed on day 3 after insemination. The luteal phase was supported by intramuscular and vaginalprogesterone. ART cycle parameters were determined. Positive serum hCG tested 14 days after embryo transfer was considered as evidence of implantation. Clinical pregnancy was defined as intrauterine gestational sac visible on transvaginal ultrasound. Results: Baseline characteristics and ovarian stimulation parameters of the under study patients were similar. Based on previously defined serum criteria, serum and follicular 25OHD level >30ng/mL was defined to reflect ’’replete’’ vitamin D status; level between 20-30 ng/mL was taken to reflect vitamin D insufficiency, whereas 25OH-D level