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Hum Reprod. 2018 Jan 1;33(1):65-80. doi: 10.1093/humrep/dex326.

Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis.

Author information

1
Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK.
2
Birmingham Women's and Children's NHS Foundation Trust, Mindelsohn Way, Birmingham B15 2TG, UK.
3
Spanish Council for Scientific Research, Institute of Environmental Assessment and Water Research, Barcelona, Spain.
4
Heartlands Hospital, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK.
5
Reproductive Health, Warwick University, Coventry CV4 7AL, UK.

Abstract

STUDY QUESTION:

Is serum vitamin D associated with live birth rates in women undergoing ART?

SUMMARY ANSWER:

Women undergoing ART who are replete in vitamin D have a higher live birth rate than women who are vitamin D deficient or insufficient.

WHAT IS KNOWN ALREADY:

Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation as well as obstetric complications such as pre-eclampsia and fetal growth restriction. However, the effect of vitamin D on conception and early pregnancy outcomes in couples undergoing ART is poorly understood.

STUDY DESIGN, SIZE, DURATION:

A systematic review and meta-analysis of 11 published cohort studies (including 2700 women) investigating the association between vitamin D and ART outcomes.

PARTICIPANTS/MATERIALS, SETTINGS, METHODS:

Literature searches were conducted to retrieve studies which reported on the association between vitamin D and ART outcomes. Databases searched included MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CINAHL. Eleven studies matched the inclusion criteria.

MAIN RESULTS AND THE ROLE OF CHANCE:

Live birth was reported in seven of the included studies (including 2026 patients). Live birth was found to be more likely in women replete in vitamin D when compared to women with deficient or insufficient vitamin D status (OR 1.33 [1.08-1.65]). Five studies (including 1700 patients) found that women replete in vitamin D were more likely to achieve a positive pregnancy test than women deficient or insufficient in vitamin D (OR 1.34 ([1.04-1.73]). All 11 of the included studies (including 2700 patients) reported clinical pregnancy as an outcome. Clinical pregnancy was found to be more likely in women replete in vitamin D (OR 1.46 [1.05-2.02]). Six studies (including 1635 patients) reported miscarriage by vitamin D concentrations. There was no association found between miscarriage and vitamin D concentrations (OR 1.12 [0.81-1.54]. The included studies scored well on the Newcastle-Ottawa quality assessment scale.

LIMITATIONS REASONS FOR CAUTION:

Although strict inclusion criteria were used in the conduct of the systematic review, the included studies are heterogeneous in population characteristics and fertility treatment protocols.

WIDER IMPLICATIONS OF THE FINDINGS:

The findings of this systematic review show that there is an association between vitamin D status and reproductive treatment outcomes achieved in women undergoing ART. Our results show that vitamin D deficiency and insufficiency could be important conditions to treat in women considering ARTs. A randomized controlled trial to investigate the benefits of vitamin D deficiency treatment should be considered to test this hypothesis.

STUDY FUNDING/COMPETING INTERESTS:

No external funding was either sought or obtained for this study. The authors have no competing interests to declare.

REGISTRATION NUMBER:

N/A.

KEYWORDS:

Vitamin D; assisted reproductive treatments; endometrial receptivity; implantation; in vitro fertilization

PMID:
29149263
DOI:
10.1093/humrep/dex326
[Indexed for MEDLINE]

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