Male Fertility · Male Endocrine and Genetic Factors

Vitamin D and Male Fertility: An Updated Review

Cito G, Cocci A, Micelli E, Gabutti A, Russo GI, Coccia ME, Franco G, Serni S, Carini M, Natali A

Published April 2020 The world journal of men's health, 38(2), 164-177
DOI 10.5534/wjmh.190057 PMID 31190482 PMC PMC7076312

RRM Academy Synopsis

Many studies link higher vitamin D to better sperm motility

A review of 36 studies found many linking higher vitamin D to better sperm motility. The 2020 systematic review covered human and animal research through December 2018. Results on testosterone, sperm count and pregnancy were mixed. The studies differed widely in design.

Key Findings

  • Many studies found a positive association between vitamin D levels and sperm motility, and several linked vitamin D deficiency to lower motility.
  • Results on sperm count were controversial. Most studies found no association between vitamin D and sperm shape (morphology), and only four found a positive one.
  • Most observational studies found no relationship between vitamin D and total or free testosterone. Supplementation studies gave variable results depending on how long men took it.
  • In a randomized trial of infertile men, sperm count and concentration matched placebo at day 150. Among men with low sperm counts (oligozoospermia), vitamin D raised the chance of a live birth.
  • One study found higher pregnancy and delivery rates in couples with normal vitamin D levels during timed intercourse cycles. A trend toward more miscarriage with low vitamin D was not statistically significant.

Interpretation

This systematic review searched four databases, screened 101 records and included 36 studies. Most human semen studies were observational, so they describe links between vitamin D and sperm quality. Only two studies gave men vitamin D and measured semen. Many hormone and mechanism findings come from animals. The authors report wide differences in study design, populations, methods and vitamin D cutoffs. They also name confounders such as age, body mass index and other illness. They call for a defined range of vitamin D levels tied to healthy fertility parameters.

RRM Context

Restorative reproductive medicine evaluates both partners, and the semen analysis is where the male half of that evaluation starts. A low motility result calls for a search for its cause. The review lists vitamin D status as one candidate with an unsettled role.

Abstract

To date, the key role of vitamin D in male reproductive system has been suggested, since the expression of vitamin D receptors and metabolizing enzymes was demonstrated in the testis and spermatozoa. Nevertheless, a general consensus about the role of vitamin D in male fertility is still debated. The aim of this review is to provide an updated systematic revision of the current available literature, discussing the experimental and clinical evidence on the role of vitamin D in the regulation of testis hormone production, seminal parameters and male fertility. The consequences of vitamin D deficiency on serum levels of testicular hormones have been analysed by several observational and interventional studies, with controversial results. Equally, the experimental researches not were able to state a certain relationship between vitamin D status and testis hormone production. Possible bias, including age, body mass index, and baseline vitamin D status justified the differences among studies. As well as concerning the effect of vitamin D on semen parameters, most of the studies agreed in the possibility that vitamin D might have a positive effect on human male fertility potential, particularly through better sperm motility. Regarding pregnancy outcomes, normal level of vitamin D seems to be related to better pregnancies. However, all the previous studies displayed a wide heterogeneity in study design, population, methodology, and cut off values used for the evaluation of vitamin D status. Future studies are needed to better clarify the exact role of vitamin D on hormonal and seminal panel in both fertile and infertile men.

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Male Fertility › Male Endocrine and Genetic Factors › Testicular Function
Gianmartin Cito, Andrea Cocci, Elisabetta Micelli, Alejandro Gabutti, Giorgio Ivan Russo, Maria Elisabetta Coccia, Giorgio Franco, Sergio Serni, Marco Carini, Alessandro Natali
G Cito, A Cocci, E Micelli, A Gabutti, G Russo, M Coccia, G Franco, S Serni, M Carini, A Natali
PMID 31190482 31190482 DOI 10.5534/wjmh.190057 10.5534/wjmh.190057 Cito et al. 2020, Cito 2020