Abstract

BackgroundHypovitaminosis D has been linked with poor semen parameters and endocrinological factors in male infertility. This study aimed to analyze the association of serum vitamin D levels and reproductive hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (TT) with the semen parameters in a cohort of infertile men.MethodologyIn this study, 224 infertile men (aged 18-45 years) were recruited after applying inclusion and exclusion criteria. Semen analysis was performed as per the 2010 World Health Organization (WHO) criteria. The patients were divided into two groups on the basis of semen parameters: normozoospermic men and men with one or more altered semen parameters as per the WHO 2010 guidelines for all the analysis. Vitamin D and hormone levels were evaluated by quantitative competitive immunoassay by chemiluminescent microparticle immunoassay technology with flexible assay protocols (Architect, Abbott Diagnostics, Lake Forest, IL, USA). The patients were further divided into three groups on the basis of vitamin D levels: Sufficient (>20 ng/mL), insufficient (12-20 ng/mL), and deficient (<12 ng/mL). These groups were compared for different semen and hormonal parameters.ResultsOut of the 224 infertile men included, 124 were normozoospermic while 100 patients had one or more altered semen parameters. The median age of the participants was 30 years (minimum = 18 years, maximum = 45 years). The serum vitamin D and TT levels were significantly lower (p < 0.0001) and FSH (p = 0.001) and LH levels (p < 0.0001) were significantly higher in those with one or more altered semen parameters compared to the normozoospermic men. The sperm concentration, total motility, linear progressive motility, percentage normal morphology, and serum TT levels were significantly lower in the patients with serum vitamin D levels of <12 ng/mL in both the normozoospermic men and those with one or more altered semen parameters compared to patients with higher vitamin D levels. Semen parameters such as sperm concentration, total motility, linear progressive motility, and morphology were positively correlated with the levels of serum vitamin D and TT.ConclusionsVitamin D deficiency was examined in a large proportion of infertile men. Serum vitamin D and TT levels were positively associated with semen parameters evident from lower levels of vitamin D and TT in men with altered semen parameters compared to normozoospermic men. However, further comprehensive studies with larger sample sizes should be conducted to further validate the role of vitamin D in male infertility by checking the effect of vitamin D supplementation on semen parameters.

Highlights

  • Vitamin D deficiency has become a global health problem

  • The serum vitamin D and TT levels were significantly lower (p < 0.0001) and follicle-stimulating hormone (FSH) (p = 0.001) and luteinizing hormone (LH) levels (p < 0.0001) were significantly higher in those with one or more altered semen parameters compared to the normozoospermic men

  • The sperm concentration, total motility, linear progressive motility, percentage normal morphology, and serum TT levels were significantly lower in the patients with serum vitamin D levels of

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Summary

Introduction

Vitamin D deficiency has become a global health problem. Several factors such as modern lifestyles (tendency to remain indoors frequently), food habits, and milk allergies have resulted in the increased prevalence of vitamin D deficiency making it a global public health concern [1]. Vitamin D3 is a key player in several important physiological and biochemical processes; it is primarily considered to be the regulator of calcium and phosphorus equilibrium and is implicated in bone health [2]. It is involved in several other important processes such as fat metabolism [3], thyroid function [4], innate immunity [5], cardiovascular function [6], central nervous system [7], and the reproductive system [8]. This study aimed to analyze the association of serum vitamin D levels and reproductive hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (TT) with the semen parameters in a cohort of infertile men

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