Skip to main content
Log in

Serum vitamin D status and in vitro fertilization outcomes: a systematic review and meta-analysis

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To assess the correlation between serum 25-hydroxy vitamin D [25(OH)D] status and outcomes of in vitro fertilization (IVF) in infertile women through review systematically.

Methods

We used Embase, Pubmed, and Cochrane database to identify all studies that assessed the correlation between serum vitamin D levels and IVF outcomes in infertile women up until 30 June 2015, with the restricted language of English. We included studies that compared IVF outcomes between infertile women vitamin D <20 ng/ml and vitamin D ≥20 ng/ml. The results were summarized using Stata 12.0 software. For studies reported dichotomous outcomes (clinical pregnancy rate and live birth rate), we pooled the relative risks ratios (RRs) and 95 % confidence intervals (CIs) in a random effects model.

Results

Our search resulted in the retrieval and screening of 134 studies. Of those, five studies were included in our meta-analysis. The risk for lower clinical pregnancy rate was not significantly increased in the deficient group (RR 0.88, 95 % CI 0.69–1.11). Lower vitamin D status was associated with lower live birth rate (RR 0.76, 95 % CI 0.61–0.93).

Conclusion

There is no significant correlation between deficient serum vitamin D level and lower clinical pregnancy rate in infertile woman undergoing in vitro fertilization. On the other hand, deficient vitamin D level was related to lower live birth rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281

    Article  CAS  PubMed  Google Scholar 

  2. Holick MF (2009) Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 19:73–78

    Article  PubMed  PubMed Central  Google Scholar 

  3. Pilz S, Dobnig H, Winklhofer-Roob B et al (2008) Low serum levels of 25-hydroxyvitamin D predict fatal cancer in patients referred to coronary angiography. Cancer Epidemiol Biomark Prev 17:1228–1233

    Article  CAS  Google Scholar 

  4. Pilz S, Marz W, Wellnitz B et al (2008) Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J Clin Endocrinol Metab 93:3927–3935

    Article  CAS  PubMed  Google Scholar 

  5. Mannion CA, Gray-Donald K, Koski KG et al (2006) Association of low intake of milk and vitamin D during pregnancy with decreased birth weight. CMAJ 174(9):1273–1277

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lewis S, Lucas RM, Halliday J et al (2010) Vitamin D deficiency and pregnancy: from preconception to birth. Mol Nutr Food Res 54:1092–1102

    CAS  PubMed  Google Scholar 

  7. Lucas RM, Ponsonby AL, Pasco JA et al (2008) Future health implications of prenatal and early-life vitamin D status. Nutr Rev 66(12):710–720

    Article  PubMed  Google Scholar 

  8. Perez-Lopez FR (2007) Vitamin D: the secosteroid hormone and human reproduction. Gynecol Endocrinol 23(1):13–24

    Article  CAS  PubMed  Google Scholar 

  9. Kinuta K, Tanaka H, Moriwake T et al (2000) Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads. Endocrinology 141(4):1317–1324

    CAS  PubMed  Google Scholar 

  10. Hurley WL, Doane RM (1989) Recent developments in the roles of vitamins and minerals in reproduction. J Dairy Sci 72(3):784–804

    Article  CAS  PubMed  Google Scholar 

  11. Vigano P, Lattuada D, Mangioni S et al (2006) Cycling and early pregnant endometrium as a site of regulated expression of the vitamin D system. J Mol Endocrinol 36(3):415–424

    Article  CAS  PubMed  Google Scholar 

  12. Wojtusik J, Johnson PA (2012) Vitamin D regulates anti-mullerian hormone expression in granulosa cells of the hen. Biol Reprod 86:91

    Article  PubMed  Google Scholar 

  13. Dokoh S, Donaldson CA, Marion SL et al (1983) The ovary: a target organ for 1,25-dihydroxy vitamin D3. Endocrinology 112:200–206

    Article  CAS  PubMed  Google Scholar 

  14. Thonneau P, Marchand S, Tallec A et al (1991) Incidence and main causes of infertility in a resident population (1,850,000) of three French regions (1988–1989). Hum Reprod 6:811–816

    CAS  PubMed  Google Scholar 

  15. Ozkan S, Jindal S, Greenseid K et al (2010) Replete vitamin D stores predict reproductive success following in vitro fertilization. Fertil Steril 94:1314–1319

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Rudick B, Ingles S, Chung K et al (2012) Characterizing the influence of vitamin D levels on IVF outcomes. Hum Reprod 0:1–7

    Google Scholar 

  17. Benyamini Y, Gozlan M, Kokia E (2005) Variability in the difficulties experienced by women undergoing infertility treatments. Fertil Steril 83:275–283

    Article  PubMed  Google Scholar 

  18. Wells GA, Shea B, O’Connell D et al (2015) The Newcastle–Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analysis. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 15 Mar 2015

  19. Garbedian K, Boggild M, Moody J et al (2013) Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization. CMAJ Open 1:E77–E82

    Article  PubMed  PubMed Central  Google Scholar 

  20. Firouzabadi RD, Rahmani E, Rahsepar M et al (2014) Value of follicular fluid vitamin D in predicting the pregnancy rate in an IVF program. Arch Gynecol Obstet 289:201–206

    Article  CAS  PubMed  Google Scholar 

  21. Rudick BJ, Ingles SA, Chung K et al (2014) Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles. Fertil Steril 101:447–452

    Article  CAS  PubMed  Google Scholar 

  22. Polyzos NP, Anckaert E, Guzman L et al (2014) Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ICSI. Hum Reprod 29:2032–2040

    Article  CAS  PubMed  Google Scholar 

  23. Franasiak JM, Molinaro TA, Dubell EK, et al. (2015) Vitamin D levels do not affect IVF outcomes following the transfer of euploid blastocysts. Am J Obstet Gynecol 212:315.e1–315.e6

    Article  CAS  Google Scholar 

  24. Rosen CJ, Abrams SA, Aloia JF et al (2012) IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 97:1146–1152

    Article  CAS  PubMed  Google Scholar 

  25. Vanni VS, Vigano’ P, Somigliana E et al (2014) Vitamin D and assisted reproduction technologies: current concepts. Reprod Biol Endocrinol 12:47

    Article  PubMed  PubMed Central  Google Scholar 

  26. Aghajafari F, Nagulesapillai T, Ronksley PE et al (2013) Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 346:f1169

    Article  PubMed  Google Scholar 

  27. Parikh G, Varadinova M, Suwandhi P et al (2010) Vitamin D regulates steroidogenesis and insulin-like growth factor binding protein-1 (IGFBP-1) production in human ovarian cells. Horm Metab Res 42:754–757

    Article  CAS  PubMed  Google Scholar 

  28. Zarnani AH, Shahbazi M, Salek-Moghaddam A et al (2010) Vitamin D3 receptor is expressed in the endometrium of cycling mice throughout the estrous cycle. Fertil Steril 93:2738–2743

    Article  CAS  PubMed  Google Scholar 

  29. Avila E, Díaz L, Halhali A et al (2004) Regulation of 25-hydroxy vitamin D3 1alpha-hydroxylase 1,25-dihydroxy vitamin D3 24-hydroxylase and vitamin D receptor gene expression by 8-bromo cyclic AMP in cultured human syncytiotrophoblast cells. J Steroid Biochem Mol Biol 89–90:115–119

    Article  PubMed  Google Scholar 

  30. Henry HL (2011) Regulation of vitamin D metabolism. Best Pract Res Clin Endocrinol Metab 25:531–541

    Article  CAS  PubMed  Google Scholar 

  31. Hewison M, Burke F, Evans KN et al (2007) Extra-renal 25-hydroxy vitamin D3-1alpha-hydroxylase in human health and disease. J Steroid Biochem Mol Biol 103:316–321

    Article  CAS  PubMed  Google Scholar 

  32. Stephanou A, Ross R, Handwerger S (1994) Regulation of human placental lactogen expression by 1,25-dihydroxy vitamin D3. Endocrinology 135:2651–2656

    CAS  PubMed  Google Scholar 

  33. Barrera D, Avila E, Hernández G, Halhali A et al (2008) Calcitriol affects hCG gene transcription in cultured human syncytiotrophoblasts. Reprod Biol Endocrinol 6:3

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kinuta K, Tanaka H, Moriwake T et al (2000) Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads. Endocrinology 141:1317–1324

    CAS  PubMed  Google Scholar 

  35. Yoshizawa T, Handa Y, Uematsu Y et al (1997) Mice lacking the vitamin D receptor exhibit impaired bone formation uterine hypoplasia and growth retardation after weaning. Nat Genet 16:391–396

    Article  CAS  PubMed  Google Scholar 

  36. Du H, Daftary GS, Lalwani SI et al (2005) Direct regulation of HOXA10 by 1,25-(OH)2D3 in human myelomonocytic cells and human endometrial stromal cells. Mol Endocrinol 19:2222–2233

    Article  CAS  PubMed  Google Scholar 

  37. Bagot CN, Troy PJ, Taylor HS (2000) Alteration of maternal Hoxa10 expression by in vivo gene transfection affects implantation. Gene Ther 7:1378–1384

    Article  CAS  PubMed  Google Scholar 

  38. Bodnar LM, Catov JM, Simhan HN et al (2007) Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab 92:3517–3522

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Ott J, Wattar L, Kurz C et al (2012) Parameters for calcium metabolism in women with polycystic ovary syndrome who undergo clomiphene citrate stimulation: a prospective cohort study. Eur J Endocrinol 166:897–902

    Article  CAS  PubMed  Google Scholar 

  40. Wehr E, Pieber TR, Obermayer-Pietsch B (2011) Effect of vitamin D3 treatment on glucose metabolism and menstrual frequency in PCOS women: a pilot study. J Endocrinol Invest 34:757–763

    CAS  PubMed  Google Scholar 

  41. Asadi M, Matin N, Frootan M et al (2013) Vitamin D improves endometrial thickness in PCOS women who need intrauterine insemination: a randomized double blind placebo-controlled trial. Arch Gynecol Obstet 289:865–870

    Article  PubMed  Google Scholar 

  42. Lasco A, Catalano A, Benvenga S (2012) Improvement of primary dysmenorrhea caused by a single oral dose of vitamin D: results of a randomized double blind, placebo-controlled study. Arch Intern Med 172:367–369

    Article  Google Scholar 

  43. Wise LA, Ruiz-Narváez EA, Haddad SA et al (2014) Polymorphisms in vitamin D-related genes and risk of uterine leiomyomata. Fertil Steril 102:503–510

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Rojansky N, Benshushan A, Meirsdorf S et al (2000) Seasonal variability in fertilization and embryo quality rates in women undergoing IVF. Fertil Steril 74:476–481

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yong Xu.

Ethics declarations

Conflict of interest

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, and there is no professional or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled, “Serum vitamin D status and In Vitro Fertilization Outcomes: A Systematic Review and Meta-analysis.”

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lv, S.S., Wang, J.Y., Wang, X.Q. et al. Serum vitamin D status and in vitro fertilization outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet 293, 1339–1345 (2016). https://doi.org/10.1007/s00404-016-4058-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-016-4058-1

Keywords

Navigation