Objective To investigate the impact of vitamin D(VD)deficiency on clinical indicators and pregnancy outcomes of patients with polycystic ovary syndrome(PCOS).Methods A total of 358 PCOS patients who underwent conventional in vitro fertilization embryo transfer(IVF-ET)or intracytoplasmic sperm injection(ICSI)assisted pregnancy at the Department of Reproductive Medicine,the Affiliated Luoyang Central Hospital of Zhengzhou University from January 2019 to December 2021 were selected as the research subjects.They were divided into the VD deficient PCOS group and the VD sufficient PCOS group based on their VD levels.The general clinical data such as age and infertility years of patients were collected through electronic medical records.Before entering the IVF/ICSI cycle,the patient's height and body mass were measured,and the body mass index(BMI)was calculated;fasting venous blood of the patients was extracted,and the levels of serum 25-hydroxyvitamin D[25-(OH)D],blood glucose,insulin,triglycerides,total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),and low density lipoprotein cholesterol(LDL-C)were detected by electrochemiluminescence,and the homeostasis model assessment-insulin resistance index(HOMA-IR)was calculated.On the 2nd to 3rd day of menstruation,2-3 mL of fasting venous blood was extracted,and the levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),prolactin(PRL),testosterone(T),progesterone(P),and anti-Müllerian hormone(AMH)were measured by using an electrochemiluminescence instrument.The dosage of gonadotropin(Gn),days of Gn use,and levels of LH,E2,and P on trigger day.The number of retrieved oocytes,number of transferred embryos,the rate of oocyte-obtained,mid-division(MⅡ)oocyte rate,rate of two pronucleus embryo(2PN)rate,2PN cleavage rate,rate of high-quality embryos,and endometrial thickness on the day of transfer were recorded;and the biochemical pregnancy rate,clinical pregnancy rate,and miscarriage rate were calculated.The influencing factors of vitamin D in PCOS patients were analyzed by logistic linear regression,and the influencing factors of clinical pregnancy in PCOS patients were analyzed by multivariate analysis of logistic regression.Results The levels of E2,LDL-C,and fasting blood glucose of patients in the VD deficiency PCOS group were significantly higher than those in the VD sufficient PCOS group,while the AMH level was significantly lower than that in the VD sufficient PCOS group(P＜0.05);there was no statistically significant difference in age,infertility years,BMI,FSH,LH,PRL,T,triglycerides,TC,HDL-C,fasting insulin,and HOMA-IR of patients between the two groups(P＞0.05).There was no statistically significant difference in terms of GN dosage,days of GN use,LH level on trigger day,E2 level on trigger day,P level on trigger day,average number of retrieved oocytes,number of transferred embryos,the rate of oocyte-obtained,MⅡ oocyte rate,2PN fertilization rate,2PN cleavage rate,high-quality embryo rate,endometrium thickness on transfer day,biochemical pregnancy rate,clinical pregnancy rate,and miscarriage rate of patients between the two groups(P＞0.05).After removing confounding factors such as age and body mass,the results of logistic linear regression analysis showed that the 25-(OH)D levels were positively correlated with AMH,cholesterol,and FSH(P＜0.05);and negatively correlated with triglycerides,HDL-C,LDL-C,and fasting blood glucose in PCOS patients(P＜0.05);there was no correlation between 25-(OH)D levels and fasting insulin,HOMA-IR,LH and E2 levels(P＞0.05).The results of multivariate logistic regression analysis showed that BMI,25(OH)D levels,triglycerides,HOMA-IR,number of high-quality embryos,endometrial thickness,and P level on trigger day were correlated with clinical pregnancy in PCOS patients(P＜0.05);however,there was no correlation between age,AMH,high HDL-C,LDL-C and clinical pregnancy(P＞0.05).Conclusion VD deficiency can affect glycolipid metabolism and pregnancy outcomes in PCOS patients.
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