The modern strategies of clinical management of vitamin D deficiency in practices of the obstetrician gynecologist




vitamin D, reproductive system, PCOS, endometriosis, uterine fibroid, preeclampsia, infertility


Low vitamin D concentrations were presented in a significant proportion of the population. Many diseases in people, both middle and old, were directly associated with vitamin D deficiency. The effect of vitamin D levels on reproductive function in both men and women has been proven. Low vitamin D concentrations have been associated with a wide range of adverse maternal and offspring health outcomes in observational epidemiological studies.

Complications of pregnancy with a low level of vitamin D are pre-eclampsia, gestational diabetes and premature birth. It is proved that the appointment of vitamin D to women during pregnancy reduces the proportion of cesarean section in delivery. Numerous authors prove the role of vitamin D in the pathogenetic chain of the polycystic ovary syndrome. It was found that during the menopause due to the violation of steroidogenesis there is a loss of bone mass due to vitamin D deficiency. In addition, a decrease in the level of vitamin D is associated with the occurrence of uterine fibroids.

However, despite a dearth of interventional evidence supporting supplementation/treatment of vitamin D in randomised controlled trial settings, it is generally accepted that supplementation/treatment is not harmful and may have some significant short- and long-term health benefits. In this regard, timely correction of vitamin D deficiency becomes very important in solving reproductive problems. This review focuses on the problem of correcting the level of vitamin D in different population groups. Treatment of vitamin D deficient women and vitamin D supplementation is safe and is recommended for all women who are pregnant or breastfeeding.

Author Biographies

О. В. Булавенко, Vinnytsia National Pirogov Memorial Medical University

MD, professor, head of Obstetrics and Gynecology Department No. 2

Т. Ф. Татарчук, SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”

MD, professor, corresponding member of the NAMS of Ukraine, deputy director for research work, сhief of the Endocrine Gynecology Department

Д. Г. Коньков, Vinnytsia National Pirogov Memorial Medical University

MD, associate professor at the Obstetrics and Gynecology Department No. 1

О. В. Фурман, Vinnytsia National Pirogov Memorial Medical University

PhD, associate professor at the Obstetrics and Gynecology Department No. 2


  1. Aghajafari, F., Nagulesapillai, T., Ronksley, P.E., et al. “Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies.” BMJ 346 (2013): f1169.
  2. Aquila, S., Guido, C., Middea, E., et al. “Human male gamete endocrinology: 1alpha, 25-dihydroxyvitamin D3 (1,25(OH)2D3) regulates different aspects of human sperm biology and metabolism.” Reprod Biol Endocrinol 7 (2009): 140.
  3. Anagnostis, P., Karras, S., Goulis, D.G. “Vitamin D in human reproduction: a narrative review.” Int J Clin Pract 67.3 (2013): 225–35.
  4. Andersen, L.B., et al. “Insufficiency of vitamin D is associated with an increased risk in the first trimester of pregnancy miscarriage in the Odense Child Cohort.” Am J Clin Nutr (2015). PII: ajcn103655.
  5. Baker, A.M., Haeri, S., Camargo, C.A. Jr, et al. “A nested case-control study of midgestation vitamin D deficiency and risk of severe preeclampsia.” J Clin Endocrinol Metab 95 (2010): 5105–9.
  6. Baker, A.M., et al. “First trimester maternal vitamin D status and risk of gestational diabetes (GDM): A nested case-control study.” Diabetes Metab Res Rev 28.2 (2012): 164–8.
  7. Bikle, D. “Nonclassic actions of vitamin D.” J Clin Endocrinol Metab 94 (2009): 26–34.
  8. Bodnar, L.M., Catov, J.M., Simhan, H.N., et al. “Maternal vitamin D deficiency increases the risk of preeclampsia.” J Clin Endocrinol Metab 92 (2007): 3517–22.
  9. Bodnar, L.M., Catov, J.M., Zmuda, J.M., et al. “Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational age births in white women.” J Nutr 140 (2010): 999–1006.
  10. Bodnar, L.M., Krohn, M.A., Simhan, H.N. “Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy.” J Nutr 139 (2009): 1157–61.
  11. Bowyer, L., Catling-Paull, C., Diamond, T., et al. “Vitamin D, PTH and calcium levels in pregnant women and their neonates.” Clin Endocrinol (Oxf) 70 (2009): 372–7.
  12. Buggio, L., Roncella, E., Somigliana, E., Vercellini, P. “Vitamin D and benign gynaecological diseases: A critical analysis of the current evidence.” Gynecol Endocrinol 16 (2015): 1–5.
  13. Compston, J.E., Vedi, S., Ledger, J.E., et al. “Vitamin D status and bone histomorphometry in gross obesity.” Amer J Clinical Nutr 34 (1981): 2359–63.
  14. Cosman, F., de Beur, S.J., de Beur, M.S. “Clinician’s guide to prevention and treatment of osteoporosis.” Osteoporos Int 26 (2015): 2045–7.
  15. Dicken, C.L., et al. “Peripubertal vitamin D(3) deficiency delays puberty and disrupts the estrous cycle in adult female mice.” Biol Reprod 87.2 (2012): 51.
  16. European Food Safety Authority (EFSA). “EFSA Scientific Opinion on the Tolerable Upper Intake Level of vitamin D EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA).” EFSA Journal 10.7 (2012): 2813.
  17. Hahn, S., Haselhorst, U., Tan, S., et al. “Low serum 25-hydroxy vitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome.” Exp Clin Endocrinol Diab 114 (2006): 577–83.
  18. Hewison, M. “Vitamin D and the immune system: new perspectives on an old theme.” Endocrinol Metab Clin North Am 39.2 (2010): 365–79.
  19. Harris, H.R., Chavarro, J.E., Malspeis, S., et al. “Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study.” Am J Epidemiol 1775 (2013): 420–30.
  20. Heaney, R.P., Davies, K.M., Chen, T.C., et al. “Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol.” Am J Clin Nutr 77 (2003): 204–10.
  21. Hensel, K.J., Randis, T.M., Gelber, S.E., Ratner, A.J. “Pregnancy-specific association of vitamin D deficiency and bacterial vaginosis.” Am J Obstet Gynecol 204.41 (2011): e1–9.
  22. Holick, M.F., Binkley, N.C., Bischoff-Ferrari, H.A., et al. “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.” J Clin Endocrinol Metab 96.7 (2011): 1911–30.
  23. Hollis, B.W., Johnson, D., Hulsey, T.C., et al. “Vitamin D supplementation during pregnancy: Double-blind, randomized clinical trial of safety and effectiveness.” J Bone Miner Res 26 (2011): 2341–57.
  24. Garg, G., Kachhawa, G., Ramot, R., et al. “Effect of vitamin D supplementation on insulin kinetics and cardiovascular risk factors in polycystic ovarian syndrome: a pilot study.” Endocr Connect 4 (2015): 108–16.
  25. Gromova, O.A., et al. “Roles of vitamin D in the prevention and treatment of female infertility.” Gynecology 18 (2016): 3.
  26. Jia, X.Z., et al. “Effect of vitamin D on clinical and biochemical parameters in polycystic ovary syndrome women: A meta-analysis.” J Obstet Gynaecol Res 41.11 (2015): 1791–802.
  27. Kinuta, K., Tanaka, H., Moriwake, T., et al. “Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads.” Endocrinol 141 (2000): 1317–24.
  28. Lasco, A., Catalano, A., Benvenga, S. “Improvement of primary dysmenorrheal caused by a single oral dose of vitamin D: results of a randomized, double-blind, placebo-controlled study.” Arch Intern Med 172.4 (2012): 366–7.
  29. Leffelaar, E.R., Vrijkotte, T.G., van Eijsden, M. “Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort.” Br J Nutr 104 (2010): 108–17.
  30. Lemire, J.M., Adams, J.S., Sakai, R., Jordan, S.C. “1Alpha,25-dihydroxyvitamin D3 suppresses proliferation and immunoglobulin production by normal human peripheral blood mononuclear cells.” J Clin Invest 74 (1984): 657–61.
  31. Lerchbaum, E., Obermayer-Pietsch, B. “Vitamin D and fertility: a systematic review.” Eur J Endocrinol 166.5 (2012): 765–78.
  32. Lv, S.S., et al. “Serum vitamin D status and in vitro fertilization outcomes: a systematic review and meta-analysis.” Arch Gynecol Obstet 293.6 (2016): 1339–45.
  33. Maltseva, E.V., Vasilyeva, E.N., et al. “Provision with vitamin D and correction of its deficit during pregnancy.” Department of Obstetrics and Gynecology No. 1 of Kazan State Medical Academy. Practical medicine 05.09.2017.
  34. Mathieu, C., Gysemans, C. “Vitamin D and diabetes.” Av Diabetol 22.3 (2006): 187–93.
  35. Merewood, A., Mehta, S.D., Chen, T.C., et al. “Association between vitamin D deficiency and primary cesarean section.” J Clin Endocrinol Metab 94 (2009): 940–5.
  36. Merhi, Z., Doswell, A., Krebs, K., Cipolla, M. “Vitamin D alters genes involved in follicular development and steroidogenesis in human cumulus granulosa cells.” J Clin Endocrinol Metab 99.6 (2014): E1137–45.
  37. Ozkan, S., et al. “Replete vitamin D stores predict reproductive success following in vitro fertilization.” Fertil Steril 94.4 (2010): 1314–9.
  38. Pittas, A.G., Lau, J., Hu, F.B., Dawson-Hughes, B. “The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis.” J Clin Endocrinol Metab 92 (2007): 2017–29.
  39. Provvedini, D.M., Tsoukas, C.D., Deftos, L.J., Manolagas, S.C. “1,25-Dihydroxyvitamin D3 receptors in human leukocytes.” Science 221 (1983): 1181–3.
  40. Robinson, C.J., Alanis, M.C., Wagner, C.L., et al. “Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia.” Am J Obstet Gynecol 203.366 (2010): e1–6.
  41. Robinson, C.J., Wagner, C.L., Hollis, B.W., et al. “Maternal vitamin D and fetal growth in early-onset severe preeclampsia.” Am J Obstet Gynecol 204.556 (2011): e1–4.
  42. Rudick, B.J., Ingles, S.A., Chung, K., et al. “Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.” Fertil Steril 101.2 (2014): 447–52.
  43. Shahrokhi, S.Z., et al. “Role of vitamin D in female reproduction.” Clin Chim Acta 455 (2016): 33–8.
  44. McDonnell, S., Baggerly, K.A., Baggerly, C.A., et al. “Maternal 25(OH)D concentrations ≥40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center.” A GrassrootsHealth Paper. PLOS ONE (2017).
  45. Thomson, R.L., Spedding, S., Buckley, J.D. “Vitamin D in the aetiology and management of polycystic ovary syndrome.” Clin Endocrinol (Oxf) 77 (2012): 343–50.
  46. Wortsman, J., Matsuoka, L.Y., Chen, T.C., et al. “Decreased bioavailability of vitamin D in obesity.” Amer J Clin Nutr 72 (2000): 690–3.
  47. Tatarchuk, T.F., Bulavenko, O.V., Kapshuk, I.M., Tarnopolska, V.O. “Vitamin D deficiency in the genesis of reproductive health disorders.” Ukrainian Medical Journal 5 (2015): 57–60.



How to Cite

Булавенко, О. В., Татарчук, Т. Ф., Коньков, Д. Г., & Фурман, О. В. (2018). The modern strategies of clinical management of vitamin D deficiency in practices of the obstetrician gynecologist. REPRODUCTIVE ENDOCRINOLOGY, (39), 38–44.