Department of Obstetrics and Gynecology, Virginia Commonwealth University Health, Richmond, Virginia.
Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
Fertil Steril. 2021 Oct;116(4):973-979. doi: 10.1016/j.fertnstert.2021.06.035. Epub 2021 Jul 18.
To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility.
Secondary analysis of a randomized, controlled trial.
Nine fertility centers in the United States.
PATIENT(S): Men (n = 154) with sperm concentration between 5 and 15 million/mL, motility ≤40%, or normal morphology ≤4% were eligible. Female partners were ovulatory, ≤40 years old, and had documented tubal patency.
INTERVENTION(S): Men provided semen and blood at baseline for semen analysis and 25-hydroxyvitamin D (25(OH)D) levels. They were randomly assigned to receive a vitamin formulation including vitamin D 2,000 IU daily or placebo for up to 6 months. Couples attempted to conceive naturally during the first 3 months and with clomiphene citrate with intrauterine insemination of the female partner in months 4 through 6.
MAIN OUTCOME MEASURE(S): Primary: sperm concentration, motility, morphology, and DNA fragmentation at baseline. Secondary: cumulative pregnancy, miscarriage, and live birth rates.
RESULT(S): Semen parameters and sperm DNA fragmentation were not statistically significantly different between men with vitamin D deficiency and men with 25(OH)D levels ≥20 ng/mL. In addition, clinical pregnancy and live birth rates were similar. Male 25(OH)D level <20 ng/mL was associated with a higher rate of pregnancy loss (adjusted odds ratio 9.0; 95% confidence interval 1.3 to 61.3).
CONCLUSION(S): Vitamin D deficiency in the male partner did not significantly impact semen parameters or treatment outcomes. Further study is warranted to better characterize the rate of miscarriage in couples with male vitamin D deficiency.
确定男性伴侣维生素 D 水平与轻度男性因素不育夫妇生育结局的关系。
随机对照试验的二次分析。
美国的 9 家生育中心。
符合条件的男性（n = 154）的精子浓度在 5 到 1500 万/ml 之间，活力≤40%，或正常形态≤4%。女性伴侣排卵正常，≤40 岁，且输卵管通畅有记录。
男性在基线时提供精液和血液进行精液分析和 25-羟维生素 D（25（OH）D）水平检测。他们被随机分配接受含有维生素 D 2000IU 的维生素配方或安慰剂治疗，最长 6 个月。夫妇在前 3 个月尝试自然受孕，在第 4 个月至第 6 个月期间使用克罗米酚和宫腔内人工授精使女性伴侣受孕。
基线时的精子浓度、活力、形态和 DNA 碎片化。次要指标：累积妊娠、流产和活产率。
维生素 D 缺乏症男性与 25（OH）D 水平≥20ng/ml 的男性的精液参数和精子 DNA 碎片化无统计学差异。此外，临床妊娠和活产率相似。男性 25（OH）D 水平<20ng/ml 与较高的妊娠丢失率相关（调整后的优势比 9.0；95%置信区间 1.3 至 61.3）。
男性伴侣维生素 D 缺乏并未显著影响精液参数或治疗结局。需要进一步研究以更好地描述男性维生素 D 缺乏症夫妇流产率。
