RUOLO DI VITAMINE E MICRONUTRIENTI NELLA DIAGNOSI E CURA DELL¿INFERTILITÀ DI COPPIA
Tesi di Dottorato
Data di Pubblicazione:
2017
Citazione:
RUOLO DI VITAMINE E MICRONUTRIENTI NELLA DIAGNOSI E CURA DELL¿INFERTILITÀ DI COPPIA / A. Paffoni ; coordinatore: G. Zuccotti ; tutor: F. Parazzini. DIPARTIMENTO DI SCIENZE CLINICHE E DI COMUNITA', 2017 Apr 11. 29. ciclo, Anno Accademico 2016. [10.13130/paffoni-alessio_phd2017-04-11].
Abstract:
Introduction
Maternal nutritional status is considered by many Authors to be closely related to the reproductive success. The human reproductive process, from a probabilistic point of view, is ineffective and, in spite of the scientific research progressively adding elements to the understanding of reproductive failure, the mechanisms underlying the failure to conceive, the embryonic arrest and the occurrence of neonatal malformations remain largely unknown. In this area, nutrition and micronutrient status represent an important research target for two main aspects: 1) nutrition as a cause of reproductive failures 2) nutritional status as a key variable influencing the chance of success in assisted reproduction procedures.
Aim
This PhD project has been focused on the study of specific analytes in infertile couples, with particular reference to the probability of success in terms of pregnancy given particular conditions of deficiency / insufficiency.
Methods and results
The project was conducted at the “Infertility Unit” of the Fondazione IRCCS Ca 'Granda Ospedale Maggiore Policlinico of Milan in collaboration with the Department of Clinical Sciences and Community at the University of Milan, in order to assess the baseline status of specific micronutrients and place it in relation to the chances of getting pregnant using assisted reproductive technologies. Evaluated analytes (vitamin D, folate, homocysteine, vitamin B12, vitamin E, vitamin E, iron and ferritin) were selected based on their involvement in the reproductive process. Subjects were recruited from couples treated for infertility; in the study of serum levels in infertile compared to subfertile women, recruitment was performed among pregnant women during the first trimester prenatal screening (U.O. Obstetrics and Gynecology). Several outcomes were evaluated using case series disjointed or partially overlapping. In particular, the PhD work was divided into 5 main studies, the characteristics of which are summarized in the following scheme:
Study: 1
Analyte: Vitamin D
Main Outcome: Pregnancy Rate in in vitro fertilization cycles
Design: Prospective cross-sectional
Subjects: 480 women in infertile couples
Main results: Women with 25 (OH) D ≥ 20 ng / ml are more likely to have a pregnancy compared to those with 25 (OH) D insufficiency.
Adjusted OR = 2.15 (95% CI: 1.23-3.77) (p = 0 .007).
Study: 2
Analyte: Vitamin D
Main Outcome: Concordance of serum levels between partners
Design: Prospective cross-sectional
Subjects: 103 infertile couples
Main results: 71% of infertile couples showed concordance between a condition of sufficiency or insufficiency between partners. This frequency is higher than expected in case of random assortment between partners(p = 0.007).
Study: 3
Analyte: Vitamin D
Main outcome: Serum levels in fertile versus subfertile women
Design: Prospective case-control
Subjects: 73 cases and 73 controls
Main results: Vitamin D status does not affect the natural fertility. OR for subfertility (time to pregnancy> 12 months) in women with low vitamin D = 0.85 (95% CI: 0.44-1.62)
Study: 4
Analytes: Folate, Homocystein, Vitamin B12, Vitamin A, Vitamin E, Iron, Ferritin
Main outcome: Rate of insufficiency
Design: Prospective cross-sectional
Subjects: 269 women in infertile couples
Main results: Only a minority of women attending an Infertility Unit show pre-gestational values of intraerythrocytic folate (12%) and vitamin B12 (44%)
Study: 5
Analytes: Folate, Homocystein, Vitamin B12
Main outcome: Pregnancy Rate in in-vitro fertilization cycles
Design: Prospective cross-sectional
Subjects: 209 women in infertile couples
Main results: Women with serum and intraerythrocytic folate in the third tertile of concentra
Tipologia IRIS:
Tesi di dottorato
Keywords:
Nutrizione; Fertilità; Fecondazione in vitro
Elenco autori:
A. Paffoni
Link alla scheda completa:
Link al Full Text: