Free 25(Oh)d3 Levels in Follicular Ovarian Fluid Top Quality Embryo is Higher Than Non- Top Quality Embryo in Normoresponders Group

Abstract Introduction: Vitamin D and calcium in follicular fluid play essential roles in modulating steroidogenesis, folliculogenesis, and oocyte quality determination. Both collaborate to produce high-quality embryos (TQE) during in vitro fertilization. This study aimed to compare free 25(OH)D3 and calcium levels in follicular fluid between TQE and non-TQE groups (non-TQE). Methods This cross-sectional study included women who underwent IVF (In Vitro Fertilization) procedures at tertiary hospitals in Bandung, Indonesia. Ovarian follicular fluid was collected during the ovum pick-up procedure. Examination of 25(OH)D3 levels, vitamin D-binding protein and calcium in the follicles was performed using an enzyme-linked immunosorbent assay (ELISA). Free 25(OH)D3 levels were calculated using a method of Vermeulen formula. Results A total of 173 samples, consisting of 86 subjects in the TQE group and 87 subjects in the non-TQE group, met the study criteria. There was a significant difference in free 25(OH)D3 follicular fluid levels between the TQE and non-TQE groups (p = 0,017), there was no significant difference in calcium levels between the two groups (p = 0,805). This study also revealed that there was a significant association between free 25(OH)D3 follicular fluid level and embryo quality (OR 3.05, 95% CI, 1.46–6.38; p value = 0.002), but there was no significant association between follicular fluid calcium and embryo quality (p = 0.144 and OR, 1.74 (95% CI 0.82–3.68)). Conclusion These circumstances allow free 25(OH)D3 and calcium in the follicular fluid to act independently in the processes of steroidogenesis, folliculogenesis, and fertilization.