Assisted Reproduction – 5 studies concluded vitamin D repletion helps – Review March 2015

Vitamin D and assisted reproduction: should vitamin D be routinely screened and repleted prior to ART? A systematic review.

J Assist Reprod Genet. 2015 Mar;32(3):323-35. doi: 10.1007/s10815-014-0407-9. Epub 2014 Dec 30.
Pacis MM1, Fortin CN, Zarek SM, Mumford SL, Segars JH.
1Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA.

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PURPOSE:
To review the current literature regarding the role of vitamin D status in pregnancy outcomes in women undergoing assisted reproductive technology (ART) and to assess cost-effectiveness of routine vitamin D deficiency screening and repletion prior to initiation of ART.

METHODS:
A systematic literature review was conducted using PubMed. Relevant study outcomes were compared among the selected studies. A cost-benefit analysis was performed using a decision tree mathematical model with sensitivity analyses from the perspective of direct societal cost. Published data were used to estimate probabilities and costs in 2014 US dollars.

RESULTS:
Thirty-four articles were retrieved, of which eight met inclusion criteria. One study demonstrated a negative relationship between vitamin D status and ART outcomes, while two studies showed no association. The remaining five studies concluded that ART outcomes improved after vitamin D repletion.

CONCLUSION:
The majority of reviewed studies reported a decrement in ART outcomes in patients with vitamin D deficiency. Cost-benefit analyses suggested that screening and supplementing vitamin D prior to ART might be cost effective, but further evidence is needed. Given the absence of Level I evidence regarding vitamin D status and ART outcomes, full endorsement of routine vitamin D screening and supplementation prior to ART is premature.

PMID: 25547950

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