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- W2892380009 abstract "Fecundity is the capacity to produce offspring. Identifying dietary factors that influence human fecundity is of major clinical and public health significance. This review focuses on the evidence from epidemiologic literature for the relationships between key nutritional factors and female reproductive potential. According to existing data, women trying to achieve pregnancy are encouraged to increase consumption of whole grains, omega-3 fatty acids, fish, and soy and to reduce consumption of trans fats and red meat. In addition, a daily multivitamin that contains folic acid before and during pregnancy may not only prevent birth defects, but also improve the chance of achieving and maintaining a pregnancy. In contrast, there is limited evidence supporting an association between vitamin D and human fecundity outcomes despite promising evidence from nonhuman studies. Questions for future research included the roles of other types of fat (especially omega-6 and monounsaturated fats) and protein (especially white meat and seafood) on female fertility; particular attention should also be paid to exposure to environmental contaminants in foods. Although much work remains, this review accrued best available evidence to provide practical dietary recommendations for women trying to conceive. Fecundity is the capacity to produce offspring. Identifying dietary factors that influence human fecundity is of major clinical and public health significance. This review focuses on the evidence from epidemiologic literature for the relationships between key nutritional factors and female reproductive potential. According to existing data, women trying to achieve pregnancy are encouraged to increase consumption of whole grains, omega-3 fatty acids, fish, and soy and to reduce consumption of trans fats and red meat. In addition, a daily multivitamin that contains folic acid before and during pregnancy may not only prevent birth defects, but also improve the chance of achieving and maintaining a pregnancy. In contrast, there is limited evidence supporting an association between vitamin D and human fecundity outcomes despite promising evidence from nonhuman studies. Questions for future research included the roles of other types of fat (especially omega-6 and monounsaturated fats) and protein (especially white meat and seafood) on female fertility; particular attention should also be paid to exposure to environmental contaminants in foods. Although much work remains, this review accrued best available evidence to provide practical dietary recommendations for women trying to conceive. Discuss: You can discuss this article with its authors and other readers at https://www.fertstertdialog.com/users/16110-fertility-and-sterility/posts/33449-26262 Discuss: You can discuss this article with its authors and other readers at https://www.fertstertdialog.com/users/16110-fertility-and-sterility/posts/33449-26262 It is estimated that infertility affects 15.5% of reproductive-age women in the United States (1Thoma M.E. McLain A.C. Louis J.F. King R.B. Trumble A.C. Sundaram R. et al.Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach.Fertil Steril. 2013; 99: 1324-13231.e1Abstract Full Text Full Text PDF PubMed Scopus (161) Google Scholar), and 30% of pregnancies are lost after implantation (2Wilcox A.J. Weinberg C.R. O'Connor J.F. Baird D.D. Schlatterer J.P. Canfield R.E. et al.Incidence of early loss of pregnancy.N Engl J Med. 1988; 319: 189-194Crossref PubMed Google Scholar). Although assisted reproductive technologies (ART) become a common treatment choice, because of the financial and emotional challenges associated with ART, emerging scientific efforts focus on the identification of modifiable factors, such as diet and lifestyles, that may affect fertility. Dietary factors have been implicated in the pathology of multiple disorders (3Willett W.C. Diet and health: what should we eat?.Science. 1994; 264: 532-537Crossref PubMed Google Scholar, 4Willett W.C. Stampfer M.J. Current evidence on healthy eating.Annu Rev Public Health. 2013; 34: 77-95Crossref PubMed Scopus (76) Google Scholar, 5Ley S.H. Hamdy O. Mohan V. Hu F.B. Prevention and management of type 2 diabetes: dietary components and nutritional strategies.Lancet. 2014; 383: 1999-2007Abstract Full Text Full Text PDF PubMed Scopus (237) Google Scholar, 6Schulze M.B. Hu F.B. Primary prevention of diabetes: what can be done and how much can be prevented?.Annu Rev Public Health. 2005; 26: 445-467Crossref PubMed Scopus (187) Google Scholar), and the idea that dietary changes may boost fertility appears to be promising. Human fecundity is difficult to assess directly. Therefore, most researchers rely on proxy measures, such as assessment of time to pregnancy (a shorter time indicating a higher fecundity) and whether a pregnancy, pregnancy loss, or live birth occurs among pregnancy planners or women undergoing ART. Other commonly used fecundity proxies include medically determined causes of infertility, reproductive hormonal profiles and menstrual irregularities (to assess ovulatory function), and ovarian antral follicle counts as well as serum levels of antimüllerian hormone (to assess ovarian reserve). In this review, we summarize the evidence from human studies relating diet to these markers of fecundity for the purpose of providing a tool to counsel patients trying to achieve pregnancy. Folate, involved in the synthesis of DNA (7Ebisch I.M. Thomas C.M. Peters W.H. Braat D.D. Steegers-Theunissen R.P. The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility.Hum Reprod Update. 2007; 13: 163-174Crossref PubMed Scopus (200) Google Scholar), is crucial in gametogenesis, fertilization, and pregnancy (8Jaroudi S. SenGupta S. DNA repair in mammalian embryos.Mutat Res. 2007; 635: 53-77Crossref PubMed Scopus (0) Google Scholar, 9Kiefer J.C. Epigenetics in development.Dev Dyn. 2007; 236: 1144-1156Crossref PubMed Scopus (0) Google Scholar). Therefore, folate (natural form of vitamin B9) or folic acid (synthetic form of vitamin B9) may play an important role in human reproduction. Since the early 1990, the U.S. Public Health Service and Centers for Disease Control and Prevention have recommended that all women of childbearing age take a daily supplement containing 0.4–0.8 mg folic acid to prevent neural tube defects (10Houk VN, Oakley GP, Erickson JD, Mulinare J, James LM. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects 1992.Google Scholar). In the mid-1990s, controversy over the safety of folic acid supplementation arose when three studies reported increased spontaneous abortion (SAB) rates among folic acid users (11Czeizel A.E. Dudas I. Metneki J. Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Final report.Arch Gynecol Obstet. 1994; 255: 131-139Crossref PubMed Scopus (0) Google Scholar, 12Windham G.C. Shaw G.M. Todoroff K. Swan S.H. Miscarriage and use of multi-vitamins or folic acid.Am J Med Genet. 2000; 90: 261-262Crossref PubMed Scopus (33) Google Scholar, 13Hook E.B. Czeizel A.E. Can terathanasia explain the protective effect of folic-acid supplementation on birth defects?.Lancet. 1997; 350: 513-515Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar). The validity of these findings was later challenged on methodologic grounds (14Wald N. Hackshaw A. Folic acid and prevention of neural-tube defects.Lancet. 1997; 350: 665Abstract Full Text Full Text PDF PubMed Google Scholar, 15Wald N.J. Hackshaw A.K. Folic acid and miscarriage: an unjustified link.Am J Med Genet. 2001; 98: 204Crossref PubMed Scopus (10) Google Scholar), and in the most recent Cochrane review (16Balogun O.O. da Silva Lopes K. Ota E. Takemoto Y. Rumbold A. Takegata M. et al.Vitamin supplementation for preventing miscarriage.Cochrane Database Syst Rev. 2016; : CD004073PubMed Google Scholar), on the basis of three randomized trials (11Czeizel A.E. Dudas I. Metneki J. Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Final report.Arch Gynecol Obstet. 1994; 255: 131-139Crossref PubMed Scopus (0) Google Scholar, 17MRC Vitamin Study Research GroupPrevention of neural tube defects: results of the Medical Research Council Vitamin Study.Lancet. 1991; 338: 131-137Abstract PubMed Scopus (2947) Google Scholar, 18Central Technical Co-ordinating Unit and ICMRCentral Technical Co-ordinating UnitMulticentric study of efficacy of periconceptional folic acid containing vitamin supplementation in prevention of open neural tube defects from India.Indian J Med Res. 2000; 112: 206-211PubMed Google Scholar), daily folic acid (0.8 mg in one study and 4 mg in two studies) plus multivitamin supplementation before and during pregnancy did not increase SAB rates among users versus nonusers. Similarly, a large population-based study in China found no increased risk for SAB among daily consumers of folic acid (19Gindler J. Li Z. Berry R.J. Zheng J. Correa A. Sun X. et al.Folic acid supplements during pregnancy and risk of miscarriage.Lancet. 2001; 358: 796-800Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar), and a Brazilian multicenter trial reported no difference in SAB rates between high and low folic acid supplementation groups (0.4 vs. 4 mg/d) (20Vila-Nova C. Wehby G.L. Queiros F.C. Chakraborty H. Felix T.M. Goco N. et al.Periconceptional use of folic acid and risk of miscarriage—findings of the Oral Cleft Prevention Program in Brazil.J Perinat Med. 2013; 41: 461-466Crossref PubMed Scopus (6) Google Scholar). Interestingly, recent data from observational studies, including a large prospective cohort of healthy women in the Nurse's Healthy Study II (NHS-II), suggested a reduced SAB risk among women using folic acid before or during early pregnancy, particularly at intake levels well above those recommended for the prevention of neural tube defects (21Gaskins A.J. Rich-Edwards J.W. Hauser R. Williams P.L. Gillman M.W. Ginsburg E.S. et al.Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth.Obstet Gynecol. 2014; 124: 23-31Crossref PubMed Scopus (26) Google Scholar, 22Hasan R. Olshan A.F. Herring A.H. Savitz D.A. Siega-Riz A.M. Hartmann K.E. Self-reported vitamin supplementation in early pregnancy and risk of miscarriage.Am J Epidemiol. 2009; 169: 1312-1318Crossref PubMed Scopus (12) Google Scholar, 23Byrne J. Periconceptional folic acid prevents miscarriage in Irish families with neural tube defects.Ir J Med Sci. 2011; 180: 59-62Crossref PubMed Scopus (5) Google Scholar). The associations between folic supplementation and infertility have also been examined in three prospective cohort studies, which in general suggested a protective effect. Specifically, among women from the NHS-II study, multivitamin users had approximately one-third lower risk of developing ovulatory infertility compared to nonusers, and folic acids appeared to explain most of this association (24Chavarro J.E. Rich-Edwards J.W. Rosner B.A. Willett W.C. Use of multivitamins, intake of B vitamins, and risk of ovulatory infertility.Fertil Steril. 2008; 89: 668-676Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar). Similarly, folate intake was related to a lower frequency of sporadic anovulation in a prospective cohort of young healthy women (the Biocycle study) (25Gaskins A.J. Mumford S.L. Chavarro J.E. Zhang C. Pollack A.Z. Wactawski-Wende J. et al.The impact of dietary folate intake on reproductive function in premenopausal women: a prospective cohort study.PLoS One. 2012; 7: e46276Crossref PubMed Scopus (0) Google Scholar) and to a shorter time to pregnancy among pregnancy planners in a large Danish cohort (26Cueto H.T. Riis A.H. Hatch E.E. Wise L.A. Rothman K.J. Sorensen H.T. et al.Folic acid supplementation and fecundability: a Danish prospective cohort study.Eur J Clin Nutr. 2016; 70: 66-71Crossref PubMed Scopus (1) Google Scholar). Studies among subfertile women generally suggest a favorable effect of folate supplementation on ART outcomes. In a small randomized controlled trial (RCT) of subfertile women, women who took a daily multivitamin (containing 0.4 mg folic acid) had 16% higher probability of pregnancy than women in the placebo group (27Westphal L.M. Polan M.L. Trant A.S. Double-blind, placebo-controlled study of Fertilityblend: a nutritional supplement for improving fertility in women.Clin Exp Obstet Gynecol. 2006; 33: 205-208PubMed Google Scholar). In addition, in two studies, the MTHFR 677T allele mutation (leading to lower MTHFR enzyme activity and lower serum folate levels) was associated with poor ovarian response, fewer retrieved oocytes (28Thaler C.J. Budiman H. Ruebsamen H. Nagel D. Lohse P. Effects of the common 677C>T mutation of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene on ovarian responsiveness to recombinant follicle-stimulating hormone.Am J Reprod Immunol. 2006; 55: 251-258Crossref PubMed Scopus (0) Google Scholar), and lower granulosa-cell E2 production than the wild-type allele (29Hecht S. Pavlik R. Lohse P. Noss U. Friese K. Thaler C.J. Common 677C>T mutation of the 5,10-methylenetetrahydrofolate reductase gene affects follicular estradiol synthesis.Fertil Steril. 2009; 91: 56-61Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar). Furthermore, in a prospective ART cohort in Boston (EARTH study), women consuming >0.8 mg/d folate compared with those consuming <0.4 mg/d, before conception, had a higher probability of live birth (30Gaskins A.J. Afeiche M.C. Wright D.L. Toth T.L. Williams P.L. Gillman M.W. et al.Dietary folate and reproductive success among women undergoing assisted reproduction.Obstet Gynecol. 2014; 124: 801-809Crossref PubMed Scopus (61) Google Scholar). In this same study, higher serum levels of folate and vitamin B12 measured during the stimulation phase of the cycle were associated with a higher probability of live birth (31Gaskins A.J. Chiu Y.H. Williams P.L. Ford J.B. Toth T.L. Hauser R. et al.Association between serum folate and vitamin B-12 and outcomes of assisted reproductive technologies.Am J Clin Nutr. 2015; 102: 943-950Crossref PubMed Scopus (0) Google Scholar). Nonetheless, the results from three European cohort studies of folate and ART outcomes did not show similar benefits (32Haggarty P. McCallum H. McBain H. Andrews K. Duthie S. McNeill G. et al.Effect of B vitamins and genetics on success of in-vitro fertilisation: prospective cohort study.Lancet. 2006; 367: 1513-1519Abstract Full Text Full Text PDF PubMed Scopus (103) Google Scholar, 33Murto T. Kallak T.K. Hoas A. Altmae S. Salumets A. Nilsson T.K. et al.Folic acid supplementation and methylenetetrahydrofolate reductase (MTHFR) gene variations in relation to in vitro fertilization pregnancy outcome.Acta Obstet Gynecol Scand. 2014; 94: 65-71Crossref PubMed Scopus (5) Google Scholar, 34Murto T. Skoog Svanberg A. Yngve A. Nilsson T.K. Altmae S. Wanggren K. et al.Folic acid supplementation and IVF pregnancy outcome in women with unexplained infertility.Reprod Biomed Online. 2014; 28: 766-772Abstract Full Text Full Text PDF PubMed Google Scholar). The latter results, however, should be interpreted with caution considering they excluded women who failed before embryo transfer. If folates affect early ART outcomes, as suggested by some studies (30Gaskins A.J. Afeiche M.C. Wright D.L. Toth T.L. Williams P.L. Gillman M.W. et al.Dietary folate and reproductive success among women undergoing assisted reproduction.Obstet Gynecol. 2014; 124: 801-809Crossref PubMed Scopus (61) Google Scholar, 35Szymanski W. Kazdepka-Zieminska A. [Effect of homocysteine concentration in follicular fluid on a degree of oocyte maturity].Ginekol Pol. 2003; 74 (Polish): 1392-1396PubMed Google Scholar, 36Ebisch I.M. Peters W.H. Thomas C.M. Wetzels A.M. Peer P.G. Steegers-Theunissen R.P. Homocysteine, glutathione and related thiols affect fertility parameters in the (sub)fertile couple.Hum Reprod. 2006; 21: 1725-1733Crossref PubMed Scopus (0) Google Scholar, 37Boxmeer J.C. Macklon N.S. Lindemans J. Beckers N.G. Eijkemans M.J. Laven J.S. et al.IVF outcomes are associated with biomarkers of the homocysteine pathway in monofollicular fluid.Hum Reprod. 2009; 24: 1059-1066Crossref PubMed Scopus (43) Google Scholar), then excluding these women could bias the results toward the null. Overall, current evidence generally supports folic acid supplementation before and during pregnancy, because it appears that folate is not associated with higher risks of SAB but may instead improve a woman's chance of achieving and maintaining a pregnancy. Benefits seem to appear at intakes above those recommended for the prevention of neural tube defects, but trials testing these doses in relation to fertility are lacking. Accruing literature suggests that vitamin D may modulate reproductive processes. Vitamin D receptors are widely distributed across the reproductive system, including ovaries, uterus, and endometrium (38Lerchbaum E. Obermayer-Pietsch B. Vitamin D and fertility: a systematic review.Eur J Endocrinol. 2012; 166: 765-778Crossref PubMed Scopus (124) Google Scholar). Animal studies have shown that female rodents fed a vitamin D deficient diets, as well as knockouts for vitamin D receptors and 1α-hydroxylase (enzyme responsible for converting circulating 25-hydroxy vitamin D3 [25(OH]D) to its biologically active form) have reduced fertility (39Kwiecinksi G.G. Petrie G.I. DeLuca H.F. 1,25-Dihydroxyvitamin D3 restores fertility of vitamin D–deficient female rats.Am J Physiol. 1989; 256: E483-E487PubMed Google Scholar, 40Johnson L.E. DeLuca H.F. Vitamin D receptor null mutant mice fed high levels of calcium are fertile.J Nutr. 2001; 131: 1787-1791Crossref PubMed Scopus (119) Google Scholar, 41Kovacs C.S. Woodland M.L. Fudge N.J. Friel J.K. The vitamin D receptor is not required for fetal mineral homeostasis or for the regulation of placental calcium transfer in mice.Am J Physiol Endocrinol Metab. 2005; 289: E133-E144Crossref PubMed Scopus (0) Google Scholar, 42Panda D.K. Miao D. Tremblay M.L. Sirois J. Farookhi R. Hendy G.N. et al.Targeted ablation of the 25-hydroxyvitamin D 1alpha-hydroxylase enzyme: evidence for skeletal, reproductive, and immune dysfunction.Proc Natl Acad Sci U S A. 2001; 98: 7498-7503Crossref PubMed Scopus (416) Google Scholar, 43Yoshizawa T. Handa Y. Uematsu Y. Takeda S. Sekine K. Yoshihara Y. et al.Mice lacking the vitamin D receptor exhibit impaired bone formation, uterine hypoplasia and growth retardation after weaning.Nat Genet. 1997; 16: 391-396Crossref PubMed Scopus (811) Google Scholar). Furthermore, vitamin D stimulates ovarian steroidogenesis, promotes follicular maturation, and regulates HOXA10 expression (involved in successful implantation) (44Irani M. Merhi Z. Role of vitamin D in ovarian physiology and its implication in reproduction: a systematic review.Fertil Steril. 2014; 102: 460-468 e3Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar, 45Anagnostis P. Karras S. Goulis D.G. Vitamin D in human reproduction: a narrative review.Int J Clin Pract. 2013; 67: 225-235Crossref PubMed Scopus (34) Google Scholar), and its deficiency may be involved in the pathogenesis of polycystic ovary syndrome (PCOS). Despite a promising role of vitamin D in reproduction in nonhuman animal studies, studies evaluating the relation between vitamin D and fecundity in healthy human populations generally show no strong associations. Among women participating in the NHS-II study, vitamin D intake was unrelated to anovulatory infertility (46Chavarro J.E. Rich-Edwards J.W. Rosner B. Willett W.C. A prospective study of dairy foods intake and anovulatory infertility.Hum Reprod. 2007; 22: 1340-1347Crossref PubMed Scopus (50) Google Scholar). Similarly, vitamin D concentrations were not associated with either the overall probability of conception (among healthy Danish women) (47Moller U.K. Streym S. Heickendorff L. Mosekilde L. Rejnmark L. Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women.Eur J Clin Nutr. 2012; 66: 862-868Crossref PubMed Scopus (0) Google Scholar) or conception in less than 1 year (among Italian women undergoing routine aneuploidy screening) (48Somigliana E. Paffoni A. Lattuada D. Colciaghi B. Filippi F. la Vecchia I. et al.Serum levels of 25-hydroxyvitamin D and time to natural pregnancy.Gynecol Obstet Invest. 2016; 81: 468-471Crossref PubMed Scopus (4) Google Scholar). Furthermore, a meta-analysis (49Zhang H. Huang Z. Xiao L. Jiang X. Chen D. Wei Y. Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss.Int J Gynaecol Obstet. 2017; 138: 242-249Crossref PubMed Scopus (2) Google Scholar) of 10,630 pregnant women from five cohort studies (50Flood-Nichols S.K. Tinnemore D. Huang R.R. Napolitano P.G. Ippolito D.L. Vitamin D deficiency in early pregnancy.PLoS One. 2015; 10: e0123763Crossref PubMed Scopus (22) Google Scholar, 51Schneuer F.J. Roberts C.L. Guilbert C. Simpson J.M. Algert C.S. Khambalia A.Z. et al.Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population.Am J Clin Nutr. 2014; 99: 287-295Crossref PubMed Scopus (0) Google Scholar, 52Zhou J. Su L. Liu M. Liu Y. Cao X. Wang Z. et al.Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China.Eur J Clin Nutr. 2014; 68: 925-930Crossref PubMed Scopus (0) Google Scholar, 53Andersen L.B. Jorgensen J.S. Jensen T.K. Dalgard C. Barington T. Nielsen J. et al.Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort.Am J Clin Nutr. 2015; 102: 633-638Crossref PubMed Scopus (0) Google Scholar, 54Aydogmus S. Kelekci S. Aydogmus H. Eris S. Desdicioglu R. Yilmaz B. et al.High prevalence of vitamin D deficiency among pregnant women in a Turkish population and impact on perinatal outcomes.J Matern Fetal Neonatal Med. 2015; 28: 1828-1832Crossref PubMed Scopus (7) Google Scholar) revealed no association between low 25(OH)D levels and SAB risks, although extremely low levels (<20 ng/mL) were associated with increased early SAB risk in a subgroup analysis of two studies (50Flood-Nichols S.K. Tinnemore D. Huang R.R. Napolitano P.G. Ippolito D.L. Vitamin D deficiency in early pregnancy.PLoS One. 2015; 10: e0123763Crossref PubMed Scopus (22) Google Scholar, 53Andersen L.B. Jorgensen J.S. Jensen T.K. Dalgard C. Barington T. Nielsen J. et al.Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort.Am J Clin Nutr. 2015; 102: 633-638Crossref PubMed Scopus (0) Google Scholar). Results concerning a possible role of vitamin D on ART outcomes are inconsistent. In a recent meta-analysis of 11 cohort studies (five prospective [55Anifandis G.M. Dafopoulos K. Messini C.I. Chalvatzas N. Liakos N. Pournaras S. et al.Prognostic value of follicular fluid 25-OH vitamin D and glucose levels in the IVF outcome.Reprod Biol Endocrinol. 2010; 8: 91Crossref PubMed Scopus (70) Google Scholar, 56Firouzabadi R.D. Rahmani E. Rahsepar M. Firouzabadi M.M. Value of follicular fluid vitamin D in predicting the pregnancy rate in an IVF program.Arch Gynecol Obstet. 2014; 289: 201-206Crossref PubMed Scopus (44) Google Scholar, 57Garbedian K. Boggild M. Moody J. Liu K.E. Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization.CMAJ Open. 2013; 1: E77-E82Crossref PubMed Google Scholar, 58Ozkan S. Jindal S. Greenseid K. Shu J. Zeitlian G. Hickmon C. et al.Replete vitamin D stores predict reproductive success following in vitro fertilization.Fertil Steril. 2010; 94: 1314-1319Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar, 59Paffoni A. Ferrari S. Vigano P. Pagliardini L. Papaleo E. Candiani M. et al.Vitamin D deficiency and infertility: insights from in vitro fertilization cycles.J Clin Endocrinol Metab. 2014; 99: E2372-E2376Crossref PubMed Scopus (0) Google Scholar] and six retrospective [60Fabris A. Pacheco A. Cruz M. Puente J.M. Fatemi H. Garcia-Velasco J.A. Impact of circulating levels of total and bioavailable serum vitamin D on pregnancy rate in egg donation recipients.Fertil Steril. 2014; 102: 1608-1612Abstract Full Text Full Text PDF PubMed Google Scholar, 61Franasiak J.M. Molinaro T.A. Dubell E.K. Scott K.L. Ruiz A.R. Forman E.J. et al.Vitamin D levels do not affect IVF outcomes following the transfer of euploid blastocysts.Am J Obstet Gynecol. 2015; 212 (e1–6): 315Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar, 62Fru K. Segal T. Cox J. Mumford S. Sharara F. Segars J. Replete vitamin D levels are associated with higher pregnancy rates and increased number of live births in autologous IVF cycles.Fertil Steril. 2014; 102: e277Abstract Full Text Full Text PDF Google Scholar, 63Polyzos N.P. Anckaert E. Guzman L. Schiettecatte J. Van Landuyt L. Camus M. et al.Vitamin D deficiency and pregnancy rates in women undergoing single embryo, blastocyst stage, transfer (SET) for IVF/ICSI.Hum Reprod. 2014; 29: 2032-2040Crossref PubMed Google Scholar, 64Rudick B. Ingles S. Chung K. Stanczyk F. Paulson R. Bendikson K. Characterizing the influence of vitamin D levels on IVF outcomes.Hum Reprod. 2012; 27: 3321-3327Crossref PubMed Scopus (71) Google Scholar, 65Rudick B.J. Ingles S.A. Chung K. Stanczyk F.Z. Paulson R.J. Bendikson K.A. Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.Fertil Steril. 2014; 101: 447-452Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar]) of women undergoing ART (66Chu J. Gallos I. Tobias A. Tan B. Eapen A. Coomarasamy A. Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis.Hum Reprod. 2018; 33: 65-80Crossref PubMed Scopus (2) Google Scholar), Chu et al. found that women replete in vitamin D, compared with women with either deficient or insufficient vitamin D levels, had higher probability of clinical pregnancy and live birth. No association of vitamin D with probability of miscarriage was noted (66Chu J. Gallos I. Tobias A. Tan B. Eapen A. Coomarasamy A. Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis.Hum Reprod. 2018; 33: 65-80Crossref PubMed Scopus (2) Google Scholar). Similarly, a post hoc analysis of an RCT in PCOS patients found that serum 25(OH)D <30 versus >30 ng/mL was associated with lower live birth rates (67Pal L. Zhang H. Williams J. Santoro N.F. Diamond M.P. Schlaff W.D. et al.Vitamin D status relates to reproductive outcome in women with polycystic ovary syndrome: secondary analysis of a multicenter randomized controlled trial.J Clin Endocrinol Metab. 2016; 101: 3027-3035Crossref PubMed Google Scholar). In contrast, three small observational studies, not included in this meta-analysis, found no association between serum or follicular fluid vitamin D concentrations and ART outcomes (68Abadia L. Gaskins A.J. Chiu Y.H. Williams P.L. Keller M. Wright D.L. et al.Serum 25-hydroxyvitamin D concentrations and treatment outcomes of women undergoing assisted reproduction.Am J Clin Nutr. 2016; 104: 729-735Crossref PubMed Scopus (9) Google Scholar, 69Aleyasin A. Hosseini M.A. Mahdavi A. Safdarian L. Fallahi P. Mohajeri M.R. et al.Predictive value of the level of vitamin D in follicular fluid on the outcome of assisted reproductive technology.Eur J Obstet Gynecol Reprod Biol. 2011; 159: 132-137Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar, 70Neville G. Martyn F. Kilbane M. O'Riordan M. Wingfield M. McKenna M. et al.Vitamin D status and fertility outcomes during winter among couples undergoing in vitro fertilization/intracytoplasmic sperm injection.Int J Gynaecol Obstet. 2016; 135: 172-176Crossref PubMed Google Scholar). Furthermore, findings from two small RCTs did not support the administration of vitamin D to improve pregnancy outcomes (71Aflatoonian A. Arabjahvani F. Eftekhar M. Sayadi M. Effect of vitamin D insufficiency treatment on fertility outcomes in frozen-thawed embryo transfer cycles: a randomized clinical trial.Iran J Reprod Med. 2014; 12: 595-600PubMed Google Scholar, 72Asadi M. Matin N. Frootan M. Mohamadpour J. Qorbani M. Tanha F.D. Vitamin D improves endometrial thickness in PCOS women who need intrauterine insemination: a randomized double-blind placebo-controlled trial.Arch Gynecol Obstet. 2014; 289: 865-870Crossref PubMed Scopus (21) Google Scholar). Neither weekly supplementation of 50,000 IU vitamin D for 6–8 weeks to deficient women (71Aflatoonian A. Arabjahvani F. Eftekhar M. Sayadi M. Effect of vitamin D insufficiency treatment on fertility outcomes in frozen-thawed embryo transfer cycles: a randomized clinical trial.Iran J Reprod Med. 2014; 12: 595-600PubMed Google Scholar) nor administration of megadose vitamin D (300,000 IU) to women with PCOS improved reproductive outcomes (72Asadi M. Matin N. Frootan M. Mohamadpour J. Qorbani M. Tanha F.D. Vitamin D improves endometrial thickness in PCOS women who need intrauterine insemination: a randomized double-blind placebo-controlled trial.Arch Gynecol Obstet. 2014; 289: 865-870Crossref PubMed Scopus (21) Google Scholar). In the latter, a significant increase in endometrial thickness was noted but did not translate to a significantly higher probability of pregnancy (72Asadi M. Matin N. Frootan M. Mohamadpour J. Qorbani M. Tanha F.D. Vitamin D improves endometrial thickness in PCOS women who need intrauterine insemination: a randomized double-blind placebo-controlled trial.Arch Gynecol Obstet. 2014; 289: 865-870Crossref Pu" @default.
- W2892380009 created "2018-09-27" @default.
- W2892380009 creator A5006815708 @default.
- W2892380009 creator A5055368875 @default.
- W2892380009 creator A5075236631 @default.
- W2892380009 date "2018-09-01" @default.
- W2892380009 modified "2023-10-17" @default.
- W2892380009 title "Diet and female fertility: doctor, what should I eat?" @default.
- W2892380009 cites W1605309780 @default.
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