Franasiak, Jason M.; Lara, Evelin; Pellicer, Antonio


  • Vitamin D status is associated with a wide range of disease states and its receptor is located throughout the reproductive tract.
  • Reproductive outcomes in assisted reproduction have been associated with vitamin D status; however, determining if its role is primarily in folliculogenesis or in embryonic implantation has been challenging, suggesting vitamin D’s role may be more sophisticated that originally proposed.
  • The method of determining vitamin D status in clinical and research settings has not been standardized and is an area that requires clarification moving forward.

Purpose of review: Vitamin D deficiency has been associated with a wide range of human disease states and the global epidemic, particularly in reproductive aged women, has led to a focus on this complex hormones role in human reproduction. Indeed vitamin D receptors are found throughout the reproductive tract in the ovary, endometrium, and the placenta. It has roles both in calcium-dependent and independent pathways. However, agreement upon the most appropriate way to assess vitamin D status and ultimately its activity at various sites has proven challenging.

Recent findings: Investigators have studied vitamin D’s role in assisted reproduction and found successful outcomes are correlated with vitamin D replete status. However, subsequent studies have found mixed results when parsing its role in folliculogenesis and oogenesis versus its impact on embryonic implantation in the endometrium. Correlation was shown in a donor oocyte model which suggests endometrial involvement; however, in a euploid blastocyst transfer model with attention to embryo and endometrial synchrony this was not seen. It may be that the major impact is proximal to blastocyst formation at the site of folliculogenesis as has been shown in a primate model. Taken together, these studies suggest that vitamin D’s role may be more sophisticated when it comes to reproductive success. Further, it has become clear that the nonstandard method of determining vitamin D status in the clinical and research settings requires clarification to ensure more comparable data in future studies.

Summary: Vitamin D has clear roles in human health and disease, and its impact on human reproduction seems promising but requires clarification. With new techniques for assessing its status in patients and its impact at end organs as well as evolving theories regarding its potential to influence folliculogenesis, endometrial receptivity, and ovarian aging, we will soon gain additional clarity and hope to be able to impact reproductive success in a positive way.