Vitamin D is an essential nutrient that is often overlooked by those who are attempting to conceive. Vitamin D has the unique distinction of being a fat-soluble vitamin and a hormone. The liver metabolizes and stores Vitamin D, and too much in your system can be toxic. For my clients, I always recommend a food-first approach to get vital nutrients. However, Vitamin D is hard to obtain through diet alone. Sources of vitamin D include fatty fish and fortified dairy products. However, in order to get adequate levels via food, a massive and unrealistic amount needs to be consumed. It is often nicknamed “the sunshine supplement” since our primary source of vitamin D is the sun. As a result, depending on your region, many people are vitamin D deficient in the winter. Vitamin D deficiency (VDD) is an ongoing public health issue.
Besides helping with calcium absorption, bone health, and muscle development, Vitamin D has countless benefits for conditions including
High blood pressure
Type 2 diabetes
Cancer prevention
Immune protection (protects against bacterial and viral infections)
Depression
Inflammatory conditions
Regarding fertility, studies indicate that Vitamin D increases pregnancy outcomes and prevents miscarriage. Optimal Vitamin D levels also can increase success rates for fertility treatments such as IVF.
During my client consultations, I spend considerable time discussing nutrition, particularly vitamin D supplementation. Below are my top recommendations and critical facts regarding vitamin D.
Get Vitamin D Levels Checked
Fertility centers routinely check vitamin D as part of their preconception panel. If levels were critically low, the fertility doctor would often prescribe a booster dose and re-check levels after the last dose was taken. Prenatal and multivitamins may contain Vitamin D, but it might be an inadequate dose. Once you know your levels, it is easier to figure out how much Vitamin D you should take. You can get tested at your doctor's office or using an at-home Vitamin D test.
Vitamin D Formulation and Absorption
Make sure you take the correct form of Vitamin D, which should be Vitamin D3. Vitamin D2 can also be used, but it is slightly less active and, as a result, less effective. For maximum absorption, it should be either in a liquid or soft gel form and taken with food. Types of food that help with Vitamin D absorption are dairy and healthy fats. Healthy fats include polyunsaturated fats (omega-3, three fatty acids) and monounsaturated fats. Below are examples of foods from these categories:
Salmon
Avocado
Whole eggs
Walnuts
Extra virgin olive oil
Full-fat dairy: whole milk and yogurt
In addition, taking vitamin K2 with vitamin D further enhances absorption.
Adequate Levels of Vitamin D for Fertility
Optimal levels for fertility are different than for the general adult population. Studies indicate that a level between 30 and 50 ng/mL in women boosted pregnancy chances and prevented miscarriages. It is important to follow your healthcare provider's recommendation regarding dosing. It is equally vital to find the right provider that addresses fertility versus one that addresses vitamin D deficiency in the general population.
Vitamin D and Ovarian Reserve
Anti-Mullerian hormone (AMH) is a routine test performed in fertility centers that is one of many factors providers use to determine ovarian reserve testing. Optimal levels of AMH indicate a good amount of follicles (that contain eggs) are available for fertilization. Studies suggest that women who have low Vitamin D may have falsely low AMH. As a matter of fact, women who get treated for their Vitamin D deficiency might see a rise in their AMH levels once the deficiency is addressed.
Over the Counter (OTC) Supplementation
Nutrient stores can take up to two to six months to reach adequate levels in your body, depending on the dose and form of supplementation. It is essential that women take Vitamin D in the preconception stage, as it may play a role in preventing miscarriage. Fifteen percent of pregnancies end in miscarriage, and oftentimes, the cause may be unknown.
Additional Modifications for Pregnancy Promotion
Besides taking adequate supplements, eating nutrient-dense foods, balancing glucose and insulin levels, incorporating key exercises, and getting adequate sleep can promote fertility. Lifestyle modification is crucial but challenging for many.
Visit our forum section for helpful tips on nutrition, sleep, exercise, and, more importantly, how to start and maintain fertility-promoting habits.
Please view our list of recommended fertility tools, including at-home vitamin D testing and supplements.
Sources
Barber TM, Cheaib, S, Coussa A, Hasan H. Preconception vitamin d level and in vitro fertilization: pregnancy outcome. Endocrine Practice. 2023 April 29 (4): 235-239.
Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J Pharmacology Pharmacotherapy. 2012 Apr;3(2):118-26. doi: 10.4103/0976-500X.95506. PMID: 22629085; PMCID: PMC3356951.
Tamblyn JA, Pilarski NSP, Markland AD, Marson EJ, Devall A, Hewison M, Morris RK, Coomarasamy A. Vitamin D and miscarriage: a systematic review and meta-analysis. Fertility and Sterility. 2022 Jul;118(1):111-122. doi: 10.1016/j.fertnstert.2022.04.017. Epub 2022 May 28. PMID: 35637024.
Várbíró S, Takács I, Tűű L, Nas K, Sziva RE, Hetthéssy JR, Török M. Effects of vitamin D on fertility, pregnancy and polycystic ovary syndrome-a review. Nutrients. 2022 Apr 15;14(8):1649. doi: 10.3390/nu14081649. PMID: 35458211; PMCID: PMC9029121.
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