Chapter 43 - Role in Reproductive Biology and Reproductive Dysfunction in Women

Abstract

Pleotropic effects of vitamin D are increasingly being recognized, and beneficial roles for vitamin D are emerging against a spectrum of disorders involving a variety of physiological processes. Accruing data suggests critical roles for vitamin D signaling for human reproductive physiology. This chapter provides an overview of the existing literature on relevance of vitamin D for female reproductive physiology and pathology. While amidst a burgeoning pandemic of vitamin D deficiency on one hand, beneficial roles for vitamin D are emerging in a spectrum of pathological processes ranging from autoimmunity, cardiovascular disease, and diabetes to carcinogenesis. Limited data identify the active hormonal form of vitamin D, 1,25 dihydroxyvitamin D (1,25(OH)2D), as necessary for multiple processes involved in reproductive physiology; vitamin D signaling seems to be relevant for both male and female reproductive function, as well as important for procreative successes. Emerging data suggest transgenerational implications of maternal vitamin D status with impact on the progeny's skeleton and metabolic milieu. Vitamin D inadequacy (low serum levels of the prohormone 25 hydroxyvitamin D [25(OH)D]) is emerging as a modifiable risk for common population morbidities, and aggressive repletion strategies may offer a cost-effective, safe, and easily accessible option with potential for improving reproductive health. Despite the tantalizing suggestions of existing evidence, high-quality intervention trials are critically needed before any cause and effect relationship to the spectrum of the recognized associations can be established; until then, the promise of vitamin D for reproductive physiology largely remains conjectural.