Endocrine Abstracts

Several studies suggest that vitamin D (VitD) has beneficial effects on male reproduction. Analysis of the correlation between VitD and sperm quality parameters demonstrated that it has a significant impact on sperm motility, partially suggesting a relationship between higher serum testosterone levels and VitD levels. In females, vitD deficiency is associated with adverse pregnancy outcomes and metabolic complications in PCOS. However, there is still no concrete evidence to support the use of VitD supplementation to improve the outcomes of patients with altered sperm parameters and hormonal disorders. Here we analyze reproductive hormonal function, fertility outcome, and sexual dysfunction in a rare disease, X-linked hypophosphatemic rickets (XLH), as an in vivo model for VitD resistance, in patients not on conventional therapy with calcitriol or phosphate salts. Nine patients with XLH were studied, 3 men and 6 women (mean age 36.89±12.10). We evaluated: BMI, HOMA index, 25OHVitD, 17-β-estradiol, testosterone, FSH, LH, number of pregnancies with live births. All patients responded to questionnaires to identify sexual dysfunctions: FDSF (Female Sexual Distress Scale) and FSFI (Female Sexual Function Index) for female sexual dysfunctions and IIEF-5 (International Index of Erectile Function-5), SIEDY (Structured Interview on Erectile Dysfunction) and PEDT (Premature Ejaculation Diagnostic Tool) for erectile dysfunction and premature ejaculation. We found that the male population was obese (I degree) and with an increased HOMA index. All patients had low VitD levels, normal gonadotropin levels and only one patient had low testosterone levels but was father of two daughters. In the female population, only 1 patient was obese (II degree) and with an increased HOMA index. All had low levels of VitD, normal levels of estrogens and gonadotropins. The questionnaires used showed no sexual dysfunction, except for premature ejaculation in one patient. Three females had one or more spontaneous pregnancies; two males were fathers of their children. No patient had to undertake assisted reproductive techniques. Studies claim that VitD can positively affect fertility by influencing hormone levels and metabolic markers. Here we show an apparently normal hormonal profile, fertility and sexual health in our patients with XLH. The limited number of our sample does not allow us to reach solid conclusions. Further data are needed to evaluate the real role of VitD in the reproductive process.