The Effect of Vitamin D Metabolic Status and Endometrial Immune Patterns on the Outcomes of ART Programs

The objective of this study was to assess the possibility of predicting the outcomes of in vitro fertilization (IVF) and IVF/ICSI (intracytoplasmic injection [transfer] of sperm into eggs), protocols based on the serum vitamin D content and endometrial expression of vitamin D receptor (VDR), CD4+T cells, and CD8+T cells. Methods and Results: The results of IVF and IVF/ICSI programs were analyzed in 147 patients of older reproductive age (36-44 years of age) with tubal-peritoneal factor of infertility. Depending on the outcomes of ART programs, 2 groups were formed. Group 1 included 37 women with the onset of pregnancy; Group 2 included 110 women with negative outcomes of ART programs. The level of 25(OH)D in the blood serum and follicular fluid (FF) was assessed. The sampling of the material (blood and FF) was carried out on the day of ovarian puncture, the 25(OH)D content – at least three days after the last administration of the drug. Anti-Müllerian hormone (AMH) was determined using AMH reagent (AMH Gen II ELISA) and the Beckman Coulter Access® 2 Immunoassay System (Beckman Coulter, Inc. USA). Morphological examination of the endometrium was performed after biopsy sampling by pipelle biopsy on Day 7 after confirmed ovulation in the cycle preceding ART. The endometrial expression of VDR, CD4+Tcells, and CD8+Tcells was evaluated in 68 women of the sample: 18 – with pregnancy, 50 – with negative outcomes in ART programs. Vitamin D deficiency (