İntrauterin inseminasyon uygulanan hastalarda serum vitamin D seviyesinin gebelik ile ilişkisi

Amaç: İntrauterin inseminasyon, nedeni açıklanamayan infertil hastalarda ilk basamak tedavi yaklaşımıdır. Çalışmamızın amacı, intrauterin inseminasyon tedavisi uygulanan kadınların gebelik sonuçlarının, serum D vitamini seviyesi ile ilişkisini belirlemektir. Gereç ve yöntem: İntrauterin inseminasyon uygulanan 135 hastaya ait 212 ovulasyon indüksiyonu siklusuna ait veriler değerlendirilmiştir. Çalışmaya dahil edilen tüm hastalara gonadotropinler ile ovulasyon indüksiyonunu takiben intrauterin inseninasyon yapılmıştır. Hastanın ovulasyon indüksiyonu öncesi FSH, LH, estradiol, prolaktin, anti-müllerian hormon (AMH), TSH ve 25(OH) D vitamin seviyesi, overyan yanıtı ve gebelik sonucu incelenmiştir. Serum D vitamini seviyesine göre hastalar Grup A (≥20 ng/mL) ve Grup B (<20 ng/mL) olarak değerlendirilmiştir. Bulgular: Hastaların yaş ortalaması 29,71 ± 4,18 idi. Hastaların ortalama infertilite süresi 4,31± 2,55 yıldı. Toplam 212 siklus çalışmaya dahil edilmiştir. 212 siklusun ovulasyon indüksiyonunda siklus başına kullanılan ortalama gonadotropin dozu 832,0±463,8 IU, ortalama indüksiyon süresi 11,49±3,45 gündü. Grup A (vitamin D ≥20 ng/mL) ile Grup B (vitamin D <20 ng/mL) arasında yaş, infertilite süresi, vücut kitle indeksi, AMH değeri, bazal antral folikül sayısı, indüksiyon süresi, kullanılan total gonadotropin dozu, endometriyal kalınlık ölçülerinde istatistiksel olarak anlamlı fark tespit edilmedi (p<0,05). Grup A’da gebelik oranı %18,3 (n=11), Grup B’de ise %16,4 (n=25) olarak bulundu (p=0,742). D vitamini seviyesi ile vücut kitle indeksi, infertilite süresi, antral folikül sayısı, anti müllerian hormon, indüksiyon süresi, ve gelişen folikül sayısı arasında istatistiksel olarak anlamlı korelasyon tespit edilmedi. ROC eğrisi analizi, serum D vitamin seviyesinin gebelik prediksiyonunda faydalı olmadığını göstermiştir (AUC=0,478 p=0,684) Sonuç: Ovulasyon indüksiyonunu takiben yapılan intrauterin inseminasyon sikluslarında serum D vitamini seviyesi gebelik sonucu üzerinde etkili değildir.

Anahtar Kelimeler:

İnfertilite, intrauterin inseminasyon, vitamin D, gebelik

The relationship between serum vitamin D levels and pregnancy in patients undergoing intrauterine insemination

Purpose: This study aims to determine the relationship between pregnancy outcome of intrauterine insemination cycles with serum vitamin D levels. Materials and methods: Data from 212 ovulation induction cycles of 135 patients undergoing IUI after ovulation induction with gonadotropins were analyzed. Serum FSH, LH, estradiol, prolactin, anti-müllerian hormone (AMH), TSH, and vitamin 25(OH) D levels, ovarian response, and pregnancy results were analyzed. Patients were evaluated as Group A (20 ng / mL) and Group B (<20 ng / mL) according to serum vitamin D level. Results: The mean age of the patients was 29.71 ± 4.18. The mean duration of infertility was 4.31 ± 2.55 years. A total of 212 cycles were included in the study. The average gonadotropin dose used per cycle was 832.0 ± 463.8 IU. No statistically significant difference was detected between Group A (vitamin D ≥20 ng/mL) and Group B (vitamin D <20 ng/mL) regarding age, duration of infertility, BMI, AMH, antral follicle count, induction time, total gonadotropin dose, endometrial thickness (p <0.05). The pregnancy rate in Group A was 18.3% (n = 11), and 16.4% (n = 25) in Group B (p = 0.742). No correlation was found between vitamin D and BMI, duration of infertility, antral follicle number, AMH, induction time, and the number of follicles. ROC curve analysis showed that vitamin D levels are not predictive for pregnancy (AUC=0.478 p=0.684) Conclusion: Serum vitamin D levels do not affect the pregnancy rates after IUI cycles following the ovulation induction.

Keywords:

Infertility, intrauterine insemination, vitamin D, pregnancy,

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