Chapter 1
Before you know it
“This . . . hormone also regulates the expression of a large number of genes in reproductive tissues implicating a role for vitamin D in female reproduction.” ~Grundmann and von Versen-Höynk, 2011
Because of its steroid structure and function, vitamin D plays an important role in priming cells for other hormones to do their action.” ~Kaushal and Magon, 2013
“Vitamin D deficiency during pregnancy is of epidemic proportions, present in ~20%–85% of women, depending on country of residence and other factors.” ~Shin et al., 2010
“Pregnancy loss is one of the most common obstetric complications, affecting over 30% of conceptions. Most of these occur early in gestation, are due to problems with implantation and may not be clinically apparent. “~Silver, 2007
“There is evidence that vitamin D regulates key target genes associated with implantation, trophoblast [recently fertilized egg] invasion and implantation tolerance.” ~Grundmann and von Versen-Höynk, 2011
So much happens in the life of the fetus before mom has an inkling that she has become host to a new little creature, actually an alien, one who has never been on this earth before now. Well, this is not exactly true. True, it is a little alien, but it was already here, hidden in your genes and in the genes of the other person who somehow became involved. And, of course, hidden in the genes of your parents and of his parents, and of their parents, and of their parents, and so on. The combinations are endless, and a new and unique individual will soon arrive on planet earth in the form of a baby.
Did you know that vitamin D made this all possible? Of course you didn’t—you are very busy, occupied with the frivolous things of life. But the truth is, vitamin D is involved not only in the creation of sperm of superior quality, and involved in helping them swim swiftly toward their objective (Lerchbaum and Obermayer-Pietsch, 2012), it is also involved in allowing the fertilized cell to begin the task of developing an interface between it and you (Gundmann and von Versne-Höynic, 2011). This alien will need stuff, so of course a placenta and an umbilical cord will be most necessary—an alien hasta eat, you know! And you are on the menu. Some little alien is counting on you.
And being an alien, this new little creature is “foreign” to you. Foreign cells and tissues are generally met with an overwhelming immune reaction, one that recognizes them as undesirable and targets them for destruction. But not now. Your immune system will be “told” not to react, and the alien inside will be allowed to exist and to thrive. This is, in part, under direction of vitamin D, and when supplies are low (think very low) your pregnancy may end at its very beginning, the result of an immune system not all that into alien possession (Shin et al., 2010; Grayson and Hewison, 2011). And another future person is lost forever, destroyed by an immune system that should have been appropriately restrained. But we are getting a little ahead in our story. Rejection is not an issue at this point in time. It is implantation that I am a little worried about (more in a few moments). There are a few crucial events that need to occur or there will be no little alien.
Fertilization of the egg, more formally called the ovum, takes place in the fallopian tube, a passageway leading from ovary to uterus. It is a 3day journey from fallopian tube to uterus (Lyons et al., 2006). This journey is an assisted journey, assisted by a lining of oscillating hair-like structures that reside on the inner surface of the fallopian tube and gently move the now rapidly dividing egg (blastocyst) forward, in the direction of the uterus (Lyons et al., 2006). Muscular contractions of the fallopian tube also play an important role in moving the fertilized egg toward its goal (Lyons et al., 2006). Apparently, vitamin D plays a role in this journey, but even in those who are deficient, this seems to still go as planned—there must be enough vitamin D around somewhere to pull this off. Although things are headed in the right direction, the pregnancy has not yet begun.
Implantation is next on the agenda. Boy I hope this goes well! Implantation (permanent attachment to the inner lining of the uterus) is a complex series of events involving hormonal signaling between the fertilized egg and the anticipating uterus. And the vitamin D hormone is crucially involved (Shin et al., 2010; Grayson and Hewison, 2011; Gundmann and von Versne-Höynic, 2011). Women with low vitamin D levels have lower rates of implantation success (think infertility) (Shin et al., 2010; Grayson and Hewison, 2011). Even those who undergo what is called artificial or in vitro fertilization may fail to become pregnant if vitamin D levels are low (Grayson and Hewison, 2011; Lerchbaum and Obermayer-Pietsch, 2012). However, we do know that pregnancy can occur even in the vitamin D deficient woman, but this is a set-up for compromised fetal development should correction not occur.
Once implantation transpires, vitamin D will be needed in everincreasing amounts for normal development to take place and for the fulfillment of other important needs that arise during gestation (Dror and Allen, 2010).
So before you know it, a pregnancy has begun. Your pregnancy! And the outcome of this pregnancy is not at all certain. There are many dangers ahead. One danger is a mother who is ill-informed or inattentive to the needs of the one who is developing deep inside, and developing at an incredible rate. You are going to get bigger and just might explode.