THE ROLE OF VITAMIN D IN REPRODUCTIVE HEALTH AND INFERTILITY: A REVIEW OF THE LITERATURE
Abstract
Vitamin D is increasingly recognized as a pleiotropic steroid hormone influencing numerous physiological systems, including reproductive function. Over the past decade, evidence has demonstrated a strong link between vitamin D deficiency and impaired ovarian function, suboptimal endometrial receptivity, reduced sperm quality, and adverse outcomes in assisted reproductive technologies (ART). This comprehensive review synthesizes clinical and mechanistic evidence on the role of vitamin D in female and male infertility, emphasizing ovulation, polycystic ovary syndrome (PCOS), endometrial function, ART outcomes, and male reproductive parameters. Systematic analysis of studies published from 2010 to 2025, including randomized controlled trials, cohort studies, and meta-analyses, shows that sufficient serum 25-hydroxyvitamin D [25(OH)D] levels are associated with improved reproductive parameters, including higher ovulation rates, enhanced implantation, clinical pregnancy, live birth rates, and better sperm quality and motility. Supplementation studies suggest potential benefits in correcting vitamin D deficiency in women with PCOS, women undergoing ART, and men with impaired sperm parameters, although heterogeneity in dosing regimens, baseline populations, and outcome measures limits definitive clinical recommendations. Mechanistic evidence indicates that vitamin D regulates steroidogenesis, endometrial immunomodulation, insulin sensitivity, placental angiogenesis, and spermatogenesis, which may underlie its clinical effects. While current findings support routine assessment and correction of vitamin D deficiency, optimal serum targets, timing, and supplementation protocols require further investigation. Large-scale randomized trials are necessary to establish standardized clinical guidelines and confirm long-term reproductive benefits in both sexes.
References
Irani, M., Nejatbakhsh, R., Hajian, S., & Alizadeh, Z. (2020). Vitamin D deficiency in women with infertility and its association with ovarian reserve markers. Clinical Endocrinology, 93(1), 123–131.
Lerchbaum, E., & Obermayer-Pietsch, B. (2012). Vitamin D and fertility: A systematic review. European Journal of Endocrinology, 166(5), 765–778.
Pal, L., & Santoro, N. (2014). Role of vitamin D in reproductive health: Clinical and mechanistic insights. Fertility and Sterility, 101(2), 290–296.
Wu, Y., Zhang, C., Bao, W., & Xiong, Z. (2015). Serum vitamin D levels and IVF outcomes in women undergoing assisted reproduction. Human Reproduction, 30(3), 533–540.
Irani, M., et al. (2023). Vitamin D supplementation in women with PCOS undergoing ART: A systematic review and meta-analysis. Frontiers in Endocrinology, 14, 115632.
Chiu, K. H., Lee, S., & Wu, C. (2014). Vitamin D status and male reproductive function: An overview. Asian Journal of Andrology, 16(5), 729–734.
Blomberg Jensen, M., & Juul, A. (2020). Vitamin D and male reproduction: Clinical and mechanistic evidence. Hormone Molecular Biology and Clinical Investigation, 42(2), 83–94.
Chu, J., et al. (2014). Vitamin D and semen quality in men attending infertility clinics. Fertility and Sterility, 101(5), 1280–1286.
Lerchbaum, E., & Obermayer-Pietsch, B. (2022). The effect of vitamin D on ovarian reserve markers and reproductive hormones: A meta-analysis. Endocrine Connections, 11(3), e210490.
Irani, M., & Merhi, Z. (2014). Role of vitamin D in ovarian follicular development and endometrial function. Reproductive Sciences, 21(12), 1451–1459.
Pérez-López, F. R., et al. (2011). Vitamin D and assisted reproduction: A review of current evidence. Maturitas, 70(3), 315–324.
Lerchbaum, E., et al. (2016). Vitamin D and in vitro fertilization outcomes: A systematic review and meta-analysis. Reproductive Biomedicine Online, 32(6), 625–635.
Chu, J., et al. (2015). Vitamin D supplementation and semen quality in infertile men: A randomized trial. Asian Journal of Andrology, 17(3), 503–509.
Liu, X., et al. (2014). Vitamin D and endometrial receptivity in women undergoing IVF. Fertility and Sterility, 102(4), 1160–1166.
Pal, L., et al. (2016). Vitamin D status and reproductive outcomes in women with PCOS. Clinical Endocrinology, 84(2), 216–223.
Lerchbaum, E., et al. (2019). Effects of vitamin D on reproductive hormones and menstrual cyclicity. European Journal of Endocrinology, 180(6), 367–377.
Chu, J., et al. (2020). Vitamin D, sperm DNA integrity, and ART outcomes: Clinical evidence. Human Reproduction, 35(9), 2152–2161.
Blomberg Jensen, M., et al. (2018). Vitamin D signaling in testicular tissue: Molecular insights and clinical relevance. Molecular and Cellular Endocrinology, 462, 40–50.
Irani, M., et al. (2022). Vitamin D and polycystic ovary syndrome: Mechanistic pathways and clinical applications. Frontiers in Endocrinology, 13, 883502.
Pérez-López, F. R., et al. (2020). Vitamin D in reproductive health: Current perspectives. Gynecological Endocrinology, 36(3), 175–181.
Copyright (c) 2026 Marta Piotrowska, Paweł Jan Babiński, Magdalena Wiśniewska, Zuzanna Karolina Jędrzejczak, Andrzej Józef Horabik, Małgorzata Dmochowska, Julia Hertmanowska, Krzysztof Chmura, Adrianna Alicja Piekarska, Gabriela Kryger
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