Vitamin D and assisted reproduction technologies: current concepts

Reprod Biol Endocrinol. 2014 May 31:12:47. doi: 10.1186/1477-7827-12-47.

Abstract

Accumulating evidence from animal and human studies suggests that vitamin D is involved in many functions of the human reproductive system in both genders, but no comprehensive analysis of the potential relationship between vitamin D status and Assisted Reproduction Technologies (ART) outcomes is currently available. On this basis, the purpose of this systematic review and meta-analysis was to perform an in-depth evaluation of clinical studies assessing whether vitamin D status of patients undergoing ART could be related to cycle outcome variables. This issue is of interest considering that vitamin D deficiency is easily amenable to correction and oral vitamin D supplementation is cheap and without significant side effects. Surprisingly, no studies are currently available assessing vitamin D status among male partners of couples undergoing ART, while seven studies on vitamin D status of women undergoing controlled ovarian hyperstimulation (COH) for ART were found and included in the review. Results show that vitamin D deficiency is highly prevalent among women undergoing COH, ranging from 21% to 31% across studies conducted in Western countries and reaching 75-99% in Iranian studies. Data on vitamin D deficiency (25-hydroxyvitamin D serum levels <20 ng/ml) in relation to ART outcomes could be extracted from three studies and included in the meta-analysis, yielding a common risk ratio (RR) of 0.89 (95% CI 0.53-1.49) and showing a lower but not statistically significant likelihood of clinical pregnancy for vitamin-D-deficient women compared with vitamin-D-sufficient patients. In conclusion, there is insufficient evidence to support the routine assessment of vitamin D status to predict the clinical pregnancy rate in couples undergoing ART. The partly conflicting results of the available studies, potentially explaining the lack of statistical significance for a negative influence of vitamin D deficiency on clinical pregnancy rate, are likely secondary to confounders and insufficient sample size, and further larger cohort and randomised controlled studies are required.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Dietary Supplements
  • Female
  • Humans
  • Infertility, Female / etiology*
  • Infertility, Female / prevention & control
  • Infertility, Female / therapy
  • Infertility, Male / etiology*
  • Infertility, Male / prevention & control
  • Male
  • Nutritional Status
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate
  • Prevalence
  • Reproducibility of Results
  • Reproductive Techniques, Assisted*
  • Semen Analysis
  • Vitamin D / therapeutic use
  • Vitamin D Deficiency / diet therapy
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / physiopathology*

Substances

  • Vitamin D