Impact of vitamin D on human embryo implantation—a prospective cohort study in women undergoing fresh embryo transfer

Neither free nor total 25-hydroxyvitamin D serum concentrations in women undergoing embryo transfer after first ovarian hyperstimulation is associated with successful embryo implantation.

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VOLUME 115, ISSUE 3, P655-664, MARCH 01, 2021


Sufen Cai, M.D., Jian Li, Ph.D., Suimin Zeng, M.S., Liang Hu, M.D., Ph.D., Yangqin Peng, M.D., Sha Tang, M.D., Shufei Zeng, M.D., Chang Chu, M.D., Fei Gong, M.D., Ge Lin, M.D., Ph.D., Berthold Hocher, M.D., Ph.D.



To measure free and total 25-hydroxyvitamin D [25(OH)D] immediately before embryo transfer and analyze its association with early pregnancy outcome parameters such as biochemical pregnancy, implantation rate, and clinical pregnancy rates in women undergoing fresh embryo transfer after their first ovarian hyperstimulation.


Prospective cohort study.


Academically affiliated private fertility center.


A total of 2,569 women undergoing fresh embryo transfer after ovarian hyperstimulation.



Main Outcome Measure(s)

The study end points were biochemical pregnancy rate, implantation rate, clinical pregnancy rate, ectopic pregnancy rate, early miscarriages, and ongoing pregnancy rate. Free and total 25(OH)D concentrations were measured 1 day before embryo transfer.


Total 25(OH)D correlated with free 25(OH)D. Total and free 25(OH)D serum concentrations were similar in those patients reaching and not reaching the study outcomes (biochemical pregnancy rate, implantation rate, clinical pregnancy rate, ectopic pregnancy rate, early miscarriages, and ongoing pregnancy rate). There was likewise no statistical difference when analyzing the frequency of all study outcomes in quintiles of either total or free 25(OH)D. In addition, the study population was divided into three groups according to the total vitamin D status based on clinical practice guideline. All outcomes were similar in women with adequate, insufficient, and deficient total 25(OH)D. Multiple linear regression analysis considering confounding likewise indicated no association of free or total vitamin D with any of the study outcomes.


Neither free nor total 25(OH)D concentration at embryo transfer was associated with successful embryo implantation in women undergoing fresh transfer after ovarian hyperstimulation.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.