Department of Growth and Reproduction, International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Division of Bone and Mineral Research, Harvard School of Dental Medicine/Harvard Medical School, Harvard University, Boston, Massachusetts.
J Clin Endocrinol Metab. 2018 Mar 1;103(3):870-881. doi: 10.1210/jc.2017-01656.
Results of animal models and cross-sectional cohort studies have suggested a beneficial role for vitamin D in male reproduction.
Determine the effect of vitamin D and calcium supplementation on semen quality in infertile men with serum 25-hydroxyvitamin-D (25OHD) levels ≤50 nmol/L.
A single-center, triple-blinded, randomized clinical trial.
A total of 1427 infertile men were screened to include 330; 1002 men did not meet inclusion criteria and 95 did not wish to participate.
The active group received cholecalciferol 300,000 IU initially, then 1400 IU cholecalciferol and 500 mg of calcium daily for 150 days; the other group received placebo.
Serum concentrations of 25OHD and 1,25-dihydroxyvitamin D3 were significantly higher in men in the treatment group compared with the placebo group. Vitamin D supplementation was not associated with changes in semen parameters, although spontaneous pregnancies tended to be higher in couples in which the man was in the treatment group [7.3% vs 2.4%, Δ5.0% (-0.6%; 10.5%)]. Vitamin D treatment in a subgroup of oligozoospermic men increased the chance for a live birth compared with placebo [35.6% vs 18.3%, Δ17.3% (1.6%; 32.9%)]. Moreover, serum inhibin B levels were higher in men deficient in vitamin D who were randomly assigned to receive high-dose vitamin D [193 pg/mL vs 143 pg/mL, Δ49 pg/mL (8; 91 pg/mL)]; however, the increase in sperm concentration was not significantly higher than in the placebo group (P = 0.07).
High-dose vitamin D supplementation did not improve semen quality in vitamin D-insufficient infertile men. The positive impact of vitamin D supplementation on live birth rate and serum inhibin B in oligozoospermic and vitamin D-deficient men may be of clinical importance and warrant verification by others.
动物模型和横断面队列研究的结果表明，维生素 D 对男性生殖具有有益作用。
确定维生素 D 和钙补充剂对血清 25-羟维生素 D（25OHD）水平≤50nmol/L 的不育男性精液质量的影响。
一项单中心、三盲、随机临床试验。
共筛选了 1427 名不育男性，其中包括 330 名；1002 名男性不符合纳入标准，95 名男性不愿参与。
活性组最初接受胆钙化醇 300000IU，然后每天接受胆钙化醇 1400IU 和钙 500mg150 天；另一组接受安慰剂。
与安慰剂组相比，治疗组男性血清 25OHD 和 1,25-二羟维生素 D3 浓度显著升高。维生素 D 补充与精液参数的变化无关，尽管治疗组男性夫妇的自发妊娠率往往更高[7.3%比 2.4%，差异为 5.0%（-0.6%；10.5%）]。在少精子症男性亚组中，维生素 D 治疗与安慰剂相比增加了活产的机会[35.6%比 18.3%，差异为 17.3%（1.6%；32.9%）]。此外，随机分配接受高剂量维生素 D 的维生素 D 缺乏男性的血清抑制素 B 水平较高[193pg/mL 比 143pg/mL，差异为 49pg/mL（8；91pg/mL）]；然而，与安慰剂组相比，精子浓度的增加并不显著更高（P=0.07）。
高剂量维生素 D 补充并未改善维生素 D 不足的不育男性的精液质量。维生素 D 补充对少精子症和维生素 D 缺乏男性的活产率和血清抑制素 B 的积极影响可能具有临床重要性，值得其他人进一步验证。
