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The Role of Vitamin D in Reproductive Health—A Trojan Horse or the Golden Fleece?

机译:维生素D在生殖健康中的作用-木马还是金羊毛?

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摘要

In the last decade, vitamin D was in the spotlight in many fields of research. Despite numerous publications, its influence on reproductive health remains ambiguous. This paper presents an up-to-date review of current knowledge concerning the role of cholecalciferol in human reproduction. It covers various infertility issues, such as polycystic ovary syndrome, endometriosis, myoma-induced infertility, male infertility, premature ovary failure and in vitro fertilization techniques. Vitamin D deficiency, defined as serum concentration of 25-hydroxycalciferol of less than 50 nmol/L, is commonly noted more frequently than only in fertility clinic patients. It is a global trend that is observed in all age groups. The results of original publications dated up to 2015 have been summarized and discussed in a critical manner. Most experts agree that vitamin D supplementation is a necessity, particularly in women suffering from obesity, insulin resistance or small ovarian reserve, as well as in men with oligo- and asthenozoospermia if serum concentration should fall below 50 nmol/L (normal range up to 125 nmol/L). High concentration of vitamin D and its metabolites in decidua during the 1st trimester suggests its important role in the implantation process and a local immunological embryo-protection. On the other hand, evidence-based research did not prove a significant difference so far in ovulation stimulation or embryo development depending on vitamin D level. In one of the publications, it was also found that vitamin D binding protein (VDBP) has a molecular similarity to anti-sperm antibodies, and another one concluded that both low (<50 nmol/L) and high (>125 nmol/L) concentration of vitamin D are associated with decreased number and quality of spermatozoa in semen. Vitamin D is definitely not a Trojan Horse in reproductive health, since there were no adverse effects reported for vitamin D intake of up to 10,000 IU/day, but to proclaim it the Golden Fleece, more evidence is needed.
机译:在过去的十年中,维生素D在许多研究领域备受关注。尽管有许多出版物,但它对生殖健康的影响仍然不明确。本文介绍了有关胆钙化固醇在人类生殖中的作用的最新知识的最新综述。它涵盖了各种不育问题,例如多囊卵巢综合征,子宫内膜异位症,肌瘤诱发的不育症,男性不育症,卵巢早衰和体外受精技术。维生素D缺乏症定义为25-羟基钙化固醇的血清浓度低于50 nmol / L,通常比仅在生育诊所的患者中更为常见。这是一个全球趋势,在所有年龄组中都可以观察到。截止到2015年,原始出版物的结果已经进行了总结和讨论。大多数专家都认为必须补充维生素D,特别是对于患有肥胖症,胰岛素抵抗或卵巢储备不足的女性,以及如果血清浓度应降至50 nmol / L以下,则患有少精症和弱精子症的男性(正常范围为125 nmol / L)。早孕期蜕膜中维生素D及其代谢产物的浓度很高,表明其在着床过程和局部免疫胚胎保护中起着重要作用。另一方面,迄今为止,基于证据的研究尚未证明排卵刺激或胚胎发育取决于维生素D水平的显着差异。在其中一本出版物中,还发现维生素D结合蛋白(VDBP)与抗精子抗体具有分子相似性,另一本出版物的结论是低(<50 nmol / L)和高(> 125 nmol / L)维生素D的浓度与精液中精子的数量和质量下降有关。维生素D在生殖健康方面绝对不是特洛伊木马,因为据报道维生素D摄入量不超过10,000 IU /天没有不利影响,但要称其为金羊毛,还需要更多的证据。

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