Male vitamin D status and male factor infertility

Objective: To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility. Design: Secondary analysis of a randomized, controlled trial. Setting: 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 <= 40% 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 2,000 111 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. (C) 2021 by American Society for Reproductive Medicine.