Vitamin D and assisted reproductive treatment outcomes: is there a link?

  • Chu J & al.
  • Reprod Health
  • 15 Jul 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Vitamin D deficiency and insufficiency were highly prevalent among women undergoing assisted reproductive treatment (ART).
  • Crude live birth rates achieved in women undergoing ART were associated with vitamin D levels, although statistical significance was lost after adjusting for prognostic variables.

Why this matters

  • Infertility affects 1 in 7 couples in the UK.
  • Vitamin D deficiency could be an important condition to treat in women considering fertility treatment which can potentially improve the chances of ART success.

Study design

  • This prospective cohort study included 500 women who underwent ART and were categorised into 3 groups: vitamin D replete (>75 nmol/L), insufficient (50-75 nmol/L) and deficient (
  • Primary outcome: live birth.
  • Secondary outcomes: biochemical pregnancy, clinical pregnancy and miscarriage rates.

Key results

  • Overall, 53.2% of women were vitamin D deficient, 30.8% vitamin D insufficient and 16% vitamin D replete.
  • Live birth rate in the vitamin D deficient, insufficient and replete groups were 23.2% (95% CI, 18.0-28.4%), 27.0% (95% CI, 19.6-34.3%) and 37.7% (95% CI, 26.9-48.5%), respectively (P=.04).
  • After adjustment for key prognostic factors, the respective live birth rates for vitamin D deficient, insufficient and replete women were 24.3% (95% CI, 18.7-29.9%), 27.1% (95% CI, 19.9-34.2%) and 34.4% (95% CI, 23.9-44.9%), respectively.
  • Biochemical pregnancy rates were as follows:
    • deficient group: 32.5% (95% CI, 26.7-38.4%),
    • insufficient group: 39.0% (95% CI, 30.9-47.1%), and
    • replete group: 48.1% (95% CI, 36.9 to 59.2%).
  • Clinical pregnancy rates were as follows:
    • deficient group: 26.0% (95% CI, 20.6-31.4%),
    • insufficient group: 31.9% (95% CI, 24.2-39.6%), and
    • replete group: 41.6% (95% CI, 30.5-52.6).
  • Clinical miscarriage rates were as follows:
    • deficient group: 10.9% (95% CI, 3.3-18.6%),
    • insufficient group: 15.6% (95% CI 5.0-26.1%), and
    • replete group: 9.4% (95% CI, 0.1-19.5%).

Limitations

  • Observational design.