By TAP Integrative

Success rates of assisted reproductive treatments (ART), including in vitro fertilization (IVF), have improved over time because of enhanced abilities to select and transfer the embryo with the highest pregnancy potential. Still, overall success rates were only 36% as of 2016. Researchers suggest that an additional way to improve success rates will be to improve the likelihood of implantation in the uterus. Vitamin D receptors are expressed in the endometrium, and it has been proposed that vitamin D may regulate initial embryo implantation. In this context, researchers have begun to investigate the importance of vitamin D in patients undergoing ART. 

Researchers in the United Kingdom conducted a systematic review and meta-analysis to summarize the available evidence related to vitamin D status and reproductive outcomes of ART. The study included cohort studies of women undergoing any form of ART who had their vitamin D status checked. The primary outcome was live birth rates according to vitamin D status.  

 The review included 11 studies and 2700 women. All studies scored well on the Newcastle-Ottowa quality assessment scale, indicating a low risk of bias. All studies were observational cohort studies, all assayed 25(OH) vitamin D, and all used the Endocrine Society classification of vitamin D status (<50 nmol/l deficient; 50-75 nmol/l insufficient; >75 nmol/l replete).  

 The overall prevalence of vitamin D deficiency in the meta-analysis of 11 studies was 35%; insufficiency was 45%; and sufficiency was 26%. Live birth was reported in 7 studies and found to be 33% more likely in women replete in vitamin D when compared to women with insufficient or deficient vitamin D status (OR = 1.33; 95% CI, 1.08-1.65). Women replete in vitamin D were also more likely to achieve a positive pregnancy test (OR = 1.34; 95% CI, 1.04-1.73, based on 5 studies) and clinical pregnancy (OR = 1.45; 95% CI, 1.05-2.20, based on 11 studies). There was no association between vitamin D status and miscarriage.   

The results of this review and meta-analysis demonstrate that women with sufficient vitamin D status have a greater chance of ART success. The authors suggest that treatment of vitamin D deficiency should be considered in women undergoing ART and that the benefits should be evaluated in randomized controlled trials.   

Reference  

Chu, J., Gallos, I., Tobias, A., Tan, B., Eapen, A., & Coomarasamy, A. (2017). Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis. Hum Reprod, 1-16. 


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