Abstract
Recurrent implantation failure (RIF) is a challenging situation for infertility specialists, and its treatment is introduced as a difficult case in the field of assisted reproductive technology (ART). Vitamin D (VD) is one of the supplements that have been suggested to improve the implantation process. In the present study, the effect of VD on the expression and protein levels of VD receptor (VDR), progesterone receptor (PR), prolactin (PRL), insulin-like growth factor binding protein-1 (IGFBP-1), and homeobox protein A10 (HOXA10) in the endometrial cells of unknown RIF women with and without VD deficiency were assessed by qRT-PCR and immunohistochemistry. Twelve women with unknown RIF and VD deficiency (≤ 20 ng/ml) and twelve women with unknown RIF without VD deficiency (≥ 30 ng/ml) from 2021 to 2022 were identified. Endometrial specimens were collected in the mid-luteal stage before treatment or pregnancy. In the group with VD deficiency, oral medication of VD 50,000 units was prescribed for 2 to 3 months and their serum levels of VD were re-measured, then an endometrial biopsy at the same stage of the menstrual cycle was performed. The expression and protein levels of VDR, PR, PRL, IGFBP1, and HOXA10 in RIF patients with VD deficiency were lower than the RIF patients without VD deficiency (P value < 0.05). Our findings suggest that VD can play a key role in the pregnancy process, especially during embryo implantation and decidualization of the endometrial cells.
IRCT registration number: IRCT20220528055006N1, Registration date: 2022-10-15, Registration timing: retrospective







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The data that support the findings of this study are available at the IVF centers.
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Acknowledgements
This article has been extracted from the thesis written by Mrs. Zahra kuroshli in the School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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The present article is financially supported by “Research Department of the School of Medicine Shahid Beheshti University of Medical Sciences” (Grant No 30767).
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Z.K contributed to the study design, performed the experiments, data acquisition, and analysis, as well as drafting of the manuscript. Z.S.M contributed to the study concept and design, interpretation of data, designed the assessments and analyses, and preparation of the draft of the manuscript. M.A.A contributed to the study concept and design, interpretation of data, and editing and final approval of the manuscript. All authors reviewed and commented on the manuscript and approved the final manuscript.
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Kuroshli, Z., Novin, M.G., Nazarian, H. et al. The Efficacy of Vitamin D Supplement in the Expression and Protein Levels of Endometrial Decidualization Factors in Women with Recurrent Implantation Failure. Reprod. Sci. 31, 675–686 (2024). https://doi.org/10.1007/s43032-023-01349-y
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DOI: https://doi.org/10.1007/s43032-023-01349-y