Abstract
BackgroundThe importance of vitamin D in general health as well as in human reproductive success has been an area of focus. A better understanding of vitamin D metabolism, particularly vitamin D binding protein, is important when elucidating this relationship.MethodsThis case control trial seeks to characterize vitamin D metabolism in infertile patients undergoing natural cycle IVF as compared to normally cycling premenopausal women with proven fertility matched for age and body mass index (BMI). A total of 68 subjects were examined; 39 were infertile premenopausal women and 29 were regularly cycling fertile controls. Their 25-hydroxy vitamin D (25OHD), vitamin D binding protein (DBP), and albumin were measured and free and bioavailable 25OHD calculated. Between group comparisons were conducted with an unpaired t-test. A stepwise regression using age, BMI, 25OHD, estradiol & albumin in the model were used to determine predictors of DBP.ResultsAge, BMI, and total 25OHD did not differ between the two groups. However, vitamin D binding protein, free and bioavailable vitamin D were significantly different in the infertile patients as compared to the regularly cycling fertile controls (p < 0.01). Stepwise Regression using age, BMI, 25OHD, estradiol & albumin in the model showed that only albumin was a predictor of DBP (β-coefficient − 0.310; p = 0.01).ConclusionThe implications of lower vitamin D binding protein associated with infertility is not clear from this pilot study, and requires further study.
Highlights
The importance of vitamin D in general health as well as in human reproductive success has been an area of focus
The distribution of vitamin D status indicates that the majority of women had 25-hydroxy vitamin D (25OHD) concentrations within normal range (Table 1)
Total serum 25OHD did not differ between the two groups with levels of 30.3 ± 9.8 ng/mL in the infertile group and 28.9 ± 8.7 ng/ mL in the fertile controls (p = 0.57) (Table 2)
Summary
The importance of vitamin D in general health as well as in human reproductive success has been an area of focus. The 25-hydroxy vitamin D (25OHD) deficiency epidemic in the United States has prompted exploration into its relationship with many areas of human health and disease. It has subsequently been linked to many chronic diseases of the cardiovascular and metabolic systems [1,2,3] and recent work has evaluated its impact on human reproduction and obstetrical outcomes [4,5,6]. Given the potential for 25OHD to impact even early pregnancy, 25OHD status in patients undergoing infertility treatment has been of interest. Investigation into this area using total 25OHD has resulted in conflicting findings. Another study charaterizing 25OHD status in patients undergoing euploid embryo transfer found no correlation between 25OHD status and pregnancy outcomes [7]
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