Monday, January 30, 2012

Vitamin D and fertility in men and women

Vitamin D and fertility in men and women
January 30, 2012 -- Dr John Cannell

Every year, billions are spent in fertility clinics; the result of which is often in vitro fertilization (IVF). About 5 years ago, I began receiving emails from a nurse practitioner in Indiana who works in a fertility clinic. Her experience was dramatic; 5,000 IU/day for both the man and woman frequently resulted in a healthy baby. However, her last email to me was quite sad, she was in danger of losing her job as her boss, a gynecologist, was losing money due to vitamin D. He ordered her to stop advocating it or lose her job.

Today, the Daily Mail and several other newspapers reviewed a lengthy article in The European Journal of Endocrinology that concluded, “Given the high prevalence of infertility as well as vitamin D insufficiency in otherwise healthy young women and men and the possible role of vitamin D in human reproduction, research might lead to new therapeutic approaches such as vitamin D supplementation in the treatment of female and male reproductive disorders.”

Critical to this carefully caged advice is the fact that men need help as frequently as the women do. “Population-based studies found that in 30-40% of infertile couples the underlying cause is the male factor. In this context it should be mentioned that the overall semen quality of men is decreasing, which might partly be explained by environmental factors. Indeed, as much as 20% of young men have sperm concentration below the WHO recommendation level and 40% present with sperm concentrations below a level that is considered optimal for fertility.” Pretty amazing, especially when you realize these men have normal testosterone levels but that vitamin D levels are steadily decreasing.

Elisabeth Lerchbaum and Barbara Obermayer-Pietsch Vitamin D and fertility-a systematic review. European Journal of Endocrinology January 30, 2012

The authors go onto say, “In northern countries, where a strong seasonal contrast in luminosity (sunshine intensity) exists, the conception rate is decreased during the dark winter months, whereas a peak in conception rate during summer leading to a maximum in birth rate in spring has been observed. Moreover, ovulation rates and endometrial receptivity seem to be reduced during long dark winters in northern countries.”

While no direct studies exist of vitamin D levels and fertility per se, the authors report, “In a study among 84 infertile women undergoing in vitro fertilization, women with higher levels of 25(OH)D in serum and follicular fluid were significantly more likely to achieve clinical pregnancy following in vitro fertilization . . .”

If you don’t want to work your way through the entire 42 page paper, read the excellent synopsis in the Daily Mail below.

Carey T. Sunny break may be alternative to in vitro fertilization: How the sunshine vitamin can help boost fertility. Daily Mail Online, January 30, 2012.

The takeaway message is the same as always, a message so common I should just start saying “ditto.” If you want to get pregnant, make sure you and your partner take 5,000 IU/day. If you don’t want to get pregnant, make sure you and your partner are on 5,000 IU/day plus a reliable method of birth control. I take no responsibility for surprise pregnancies.

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