Thyroid autoimmunity and vitamin D: Effects on in vitro fertilization/intracytoplasmic sperm injection laboratory outcomes.

This prospective cohort study aimed to determine the effects of thyroid autoimmunity, serum/follicular fluid vitamin D levels, and vitamin D receptor expression in granulosa cells on laboratory outcomes of in vitro fertilization/intracytoplasmic sperm injection. The study included 206 women with or without thyroid autoimmunity undergoing in vitro fertilization/intracytoplasmic sperm injection ovarian stimulation cycles. The primary outcomes in thyroid autoimmunity and non-thyroid autoimmunity patients with high or low follicular fluid vitamin D levels (high vitamin D level, ≥20 ng/mL; low vitamin D level, <20 ng/mL) were the number of oocytes retrieved and quality of embryos. The secondary outcomes were the association between serum and follicular fluid vitamin D levels and vitamin D receptor expression in granulosa cells. Our study revealed that thyroid autoimmunity was associated with fewer good-quality embryos but not oocytes (p = 0.010). The vitamin D level in the follicular fluid was significantly correlated with that in the serum (p < 0.001, r > 0.5). The study populations in the thyroid autoimmunity and non-thyroid autoimmunity groups were divided into two subgroups based on high/low serum/follicular fluid vitamin D levels. There was no significant difference in the number of retrieved oocytes and good-quality embryos between the subgroups with high or low vitamin D levels (p > 0.05), and the incidence of thyroid autoimmunity was comparable between the subgroups (p > 0.05). Linear regression analysis indicated that thyroid autoimmunity had a negative effect on the number of healthy embryos (p = 0.038). Reverse transcription-polymerase chain reaction results indicated that vitamin D receptor expression in granulosa cells was positively correlated with follicular vitamin D levels in the thyroid autoimmunity (p = 0.0002) and non-thyroid autoimmunity (p < 0.0001) groups. The current findings suggest that thyroid autoimmunity may have a more detrimental effect on in vitro fertilization/intracytoplasmic sperm injection laboratory outcomes than vitamin D.

Status of nucleolar channel systems in uterine secretions accurately reflects their prevalence-a marker for the window of implantation-in simultaneously obtained endometrial biopsies.

OBJECTIVE: To assess whether nucleolar channel systems (NCSs) can be detected in exfoliated endometrial epithelial cells (EECs) of uterine secretions and whether such noninvasively determined NCS status is associated with significant NCS prevalence in simultaneously obtained endometrial biopsies. DESIGN: Prospective study (December 2015-February 2017). SETTING: University-affiliated and private fertility clinics. PATIENT(S): Luteal-phase patients of reproductive age requiring endometrial biopsy for medical indications. INTERVENTION(S): Uterine secretion aspiration before endometrial biopsy. Cells in uterine secretions were spun onto slides and fixed. NCSs were identified and quantified in cells and paraffin-embedded tissue sections by indirect immunofluorescence. MAIN OUTCOME MEASURE(S): Comparison of NCS status of uterine secretions with NCS prevalence in biopsies. Based on NCS detection, uterine secretions were assigned a status of NCS-positive (n = 15) or NCS-negative (n = 7). NCS prevalence in biopsies was expressed as a percentage of NCSs per EECs. RESULT(S): NCSs can be detected in exfoliated EECs of uterine secretions. Median NCS prevalence in endometrial biopsies from patients with NCS-positive secretions was 41.9% (interquartile range [IQR], 21.1-53.9) versus 2.0% (IQR, 0-6.9) when secretions were NCS-negative. The NCS status of secretions identified a significant difference in NCS prevalence of simultaneously obtained biopsies. CONCLUSION(S): NCS status of secretions accurately reflects NCS prevalence of biopsies, a marker for the implantation window. As secretion aspiration is compatible with same-day ET, our study provides proof of principle for a minimally invasive approach to determine endometrial receptivity for timing frozen ET.