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TalkingNutrition

Providing perspectives on recent research into vitamins and nutritionals

pregnant-womans

Want to be Pregnant? Remember Vitamins are Important

By Michael McBurney

When people think about vitamins and dietary supplementation, the tendency is to think about prolonging life for older adults - reducing risk of cancer and cardiovascular disease later in life. Vitamins are also important to conceive and carry a baby to full term.

Approximately one out of four couples have fertility problems. Vitamin insufficiency is associated with impairments in sperm production and sperm competitiveness.  During pregnancy, increased biomarkers of oxidative stress are associated with acute pregnancy complications and spontaneous abortion. So researchers wondered if vitamin status might affect conception.

A new study finds women with high serum vitamin D concentrations (> 75 nmol/L) undergoing in vitro fertilization (IVF) have significantly higher chances of becoming pregnant . Paffoni and colleagues investigated IVF rates among healthy women (18-42y) with normal body weight (BMI 18-25). The women who had been referred to an infertility unit had serum 25(OH)D3 concentrations measured and correlated with fertilization rates.  Women with the highest vitamin D levels (group mean = 73) had pregnancy rates 1.85 times higher than those below 50 nmol/L ( group mean = 35). The authors write, “Overall, we believe that it can be concluded that vitamin D insufficiency negatively affects clinical pregnancy in women undergoing IVF.”

The association reported for vitamin D and fertility is observational. It does not confirm cause and effect. The finds are very relevant to couples wanting to have children. 99% of US women do not consume the Estimated Average Requirement (EAR) for vitamin D from their diet.

Other vitamins affect fertility as well. Vitamin E was discovered for its role in fertilization and pregnancy. Vitamin C is needed to regenerate vitamin E. 99% and 47% of US women do not consume recommended amounts of vitamin E and C, respectively, from their diet. Multivitamin-mineral supplementation decreases serum lipid peroxidation levels and increases serum vitamin A and C concentrations in women undergoing IVF.  

After an egg has been fertilized, vitamin inadequacies can impact pregnancy outcomes. Pregnant women with low serum 25(OH)D3 concentrations are at increased risk of bacterial vaginosis, lower birthweight infants, and gestational diabetes. Gernand and colleagues reported lower mean birth weight was lower for women with vitamin D levels below 30 nmol/L vs > 50 nmol/L.

The scientific literature is rich with in vitro and animal studies demonstrating a cause and effect role of vitamins D, C and E on fertility and pregnancy.  Emerging evidence is linking suboptimal vitamin status with in vitro fertilization rates and pregnancy outcomes. Want to have a baby? Remember vitamins are essential for life.

Main Citation

Paffoni A, Ferrari S, Vigano P, Pagliardini L, Papaleo E, Candiani M, Tirelli A, Fedele L, Somigliana E. Vitamin D deficiency and infertility: Insights from in vitro fertilization cycles. 2014 J Clin Endocrinol Med doi: 10.1210/jc.2014.1802

Other Citations

Menezo Y, Evenson D, Cohen M, Dale B. Effect of antioxidants on sperm genetic damage.2014 Adv Exp Med Biol 791:173-89. doi: 10.1007/978-1-4614-7783-9_11

Ruder EH, Hartman TJ, Blumberg J, Goldman MB. Oxidative stress and antioxidants: exposure and impact on female fertility. 2008 Hum Reprod Update 14(4):345-57. doi: 10.1093/humupd/dmn011

Aghajafari F, Nagulesapillai, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. 2012 Br Med J doi: 10.1136/bmj.f1169

Gernand AD, Simhan HN, Baca KM, Bodnar LM. Maternal serum 25-hydroxyvitamin D and fetal growth in multicenter US study. 2013 FASEB J 27:848.19

Niki E, Traber MG. A history of vitamin E. Annals of nutrition & metabolism 2012;61(3):207-12. doi: 10.1159/000343106

Bailey RL, Fulgoni VL, Keast DR, Dwyer JT. Examination of vitamin intakes among US adults by dietary supplement use. 2012 J Acad Nutr Diet 112:657-663. doi: 10.1016/j.jand.2012.01.026

Ozkaya MO, Naziroglu M. Multivitamin and mineral supplementation modulates oxidative stress and antioxidant vitamin levels in serum and follicular fluid of women undergoing in vitro fertilization. 2010 Fertil Steril 94:2465-2466. doi: 10.1016/j.fertnstert.2010.01.066


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ppsagehen@yahoo.com
Chirp August 16, 2014 4:07 AM
A few thoughts: Vitamin D status is influenced by many things…sunlight exposure (and all of the things that influence whether or not one chooses to go in the sun), supplements, tanning, season, dietary intake but also perhaps most importantly age, obesity, smoking and perhaps inflammation. Which of these influence both status AND IVF rates? Without getting too much into detail their approach to selecting confounders was less than ideal and did not consider all the possible confounders that I would be concerned by…no mention of smoking for example or inclusion of age or season in the final model.

In their methods they mentioned analyzing by two groups (cutoff of 20ng) but in the results they break it into 3 groups, suggesting that there was some post-hoc analysis (fishing…?)
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