Does vitamin D supplementation improve ovarian reserve in women with diminished ovarian reserve and vitamin D deficiency: a before-and-after intervention study

Shahintaj Aramesh, Touran Alifarja, Ramin Jannesar, Parvin Ghaffari, Raziyeh Vanda, Fatemeh Bazarganipour, Shahintaj Aramesh, Touran Alifarja, Ramin Jannesar, Parvin Ghaffari, Raziyeh Vanda, Fatemeh Bazarganipour

Abstract

Objective: Evaluation of vitamin D supplementation on ovarian reserve in women with diminished ovarian reserve and vitamin D deficiency.

Methods: The study is a before-and-after intervention study that was performed on women with diminished ovarian reserve referred to Shahid Mofteh Clinic in Yasuj, Iran. Eligible women were prescribed vitamin D tablets at a dose of 50,000 units weekly for up to 3 months. Serum levels of vitamin D and AMH were evaluated at the end of 3 months. Significance level was also considered P ≤ 0.05.

Results: Our results have been showed there was a statistically significant difference in vitamin D levels of participants before [12.1(6.5)] and after [26(9.15)] the intervention (P < 0.001). Moreover, there was a statistically significant difference in serum AMH levels of participants before [0.50(0.44)] and after [0.79(0.15)] the intervention (P=0.02 ).

Conclusion: In conclusion, the results of the current study support a possible favorable effect of vitamin D on increase AMH expression by acting on the AMH gene promoter. Therefore, it is possible that vitamin D increases AMH levels without changing the antral follicle count/ovarian reserve.

Keywords: Ovarian reserve; Vitamin D.

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Sharara FI, Scott JRT, Seifer DB. The detection of diminished ovarian reserve in infertile women. Am J Obstet Gynecol. 1998;179(3):804–812. doi: 10.1016/S0002-9378(98)70087-0.
    1. Practice Committee of the American Society for Reproductive Medicine Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2012;98(6):1407–1415. doi: 10.1016/j.fertnstert.2012.09.036.
    1. Ferraretti AP, Gianaroli L. The Bologna criteria for the definition of poor ovarian responders: is there a need for revision? Hum Reprod. 2014;29(9):1842–1845. doi: 10.1093/humrep/deu139.
    1. Sills ES, Alper MM, Walsh AP. Ovarian reserve screening in infertility: practical applications and theoretical directions for research. Eur J Obstet Gynecol Reprod Biol. 2009;146(1):30–36. doi: 10.1016/j.ejogrb.2009.05.008.
    1. Visser JA, de Jong FH, Laven JS, Themmen AP. Anti-Mullerian hormone: a new marker for ovarian function. Reproduction. 2005;131:1–9. doi: 10.1530/rep.1.00529.
    1. Pellatt L, Rice S, Dilaver N, Heshri A, Galea R, Brincat M, Brown K, Simpson ER, Mason HD. Anti-Mullerian hormone reduces follicle sensitivity to follicle-stimulating hormone in human granulosa cells. Fertil Steril. 2011;96:1246–1251. e1241. doi: 10.1016/j.fertnstert.2011.08.015.
    1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–281. doi: 10.1056/NEJMra070553.
    1. Malloy PJ, Peng L, Wang J, Feldman D. Interaction of the vitamin D receptor with a vitamin D response element in the Müllerian-inhibiting substance (MIS) promoter: regulation of MIS expression by calcitriol in prostate cancer cells. Endocrinology. 2009;150(4):1580–1587. doi: 10.1210/en.2008-1555.
    1. Kinuta K, Tanaka H, Moriwake T, Aya K, Kato S, Seino Y. Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads. Endocrinology. 2000;141:1317–1324. doi: 10.1210/endo.141.4.7403.
    1. Chu J, Gallos I, Tobias A, Tan B, Eapen A, Coomarasamy A. Vitamin D and assisted reproductive treatment outcome: a systematic review and meta-analysis. Hum Reprod. 2018;33:65–80. doi: 10.1093/humrep/dex326.
    1. Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, Colao A. Low vitamin D status and obesity: role of nutritionist. Rev Endocr Metab Disord. 2017;18:215–225. doi: 10.1007/s11154-017-9410-7.
    1. Moridi I, Chen A, Tal O, Tal R. The association between vitamin D and anti-Müllerian hormone: a systematic review and meta-analysis. Nutrients. 2020;12:1567. doi: 10.3390/nu12061567.
    1. Ersoy E, Ersoy AO, Yildirim G, Buyukkagnici U, Tokmak A, Yilmaz N. Vitamin D levels in patients with premature ovarian failure. Ginekol Pol. 2016;87(1):32–36. doi: 10.17772/gp/57839.
    1. Malloy PJ, Peng L, Wang J, Feldman D. Interaction of the vitamin D receptor with a vitamin D response element in the Mullerian-inhibiting substance (MIS) promoter: regulation of MIS expression by calcitriol in prostate cancer cells. Endocrinology. 2009;150:1580–1587. doi: 10.1210/en.2008-1555.
    1. 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. 2014;99:E1137–E1145. doi: 10.1210/jc.2013-4161.
    1. Irani M, Merhi Z. Role of vitamin D in ovarian physiology and its implication in reproduction: a systematic review. Fertil Steril. 2014;102:460–468. doi: 10.1016/j.fertnstert.2014.04.046.
    1. Naderi Z, Kashanian M, Chenari L, Sheikhansari N. Evaluating the effects of administration of 25-hydroxyvitamin D supplement on serum anti-mullerian hormone (AMH) levels in infertile women. Gynecol Endocrinol. 2018;34:409–412. doi: 10.1080/09513590.2017.1410785.
    1. Tal R, Seifer DB. Potential mechanisms for racial and ethnic differences in antimullerian hormone and ovarian reserve. Int J Endocrinol. 2013;2013:818912. doi: 10.1155/2013/818912.
    1. Chang EM, Kim YS, Won HJ, Yoon TK, Lee WS. Association between sex steroids, ovarian reserve, and vitamin D levels in healthy nonobese women. J Clin Endocrinol Metab. 2014;99:2526–2532. doi: 10.1210/jc.2013-3873.
    1. Xu Z, Wang Q, Zhu L, Ma L, Ye X, Li C, Lan Y, Huang Y, Liu J, Zhou J. Correlation of serum vitamin d levels with ovarian reserve markers in patients with primary ovarian insufficiency. Int J Clin Exp Med. 2019;12:4147–4153.
    1. Bakeer E, Radwan R, El Mandoury A, El Rahman AA, Gad M, El Maksoud SA. Anti-müllerian hormone as a diagnostic marker in Egyptian infertile polycystic ovary syndrome females: correlations with vitamin D, total testosterone, dyslipidemia and anthropometric parameters. J Med Biochem. 2018;37:448–455. doi: 10.1515/jomb-2017-0068.
    1. Szafarowska M, Dziech E, Kaleta B, Kniotek M, Rogowski A, Segiet-Swiecicka A, Jerzak M. Anti-Mullerian hormone level is associated with vitamin D receptor polymorphisms in women with polycystic ovary syndrome. J Assist Reprod Genet. 2019;36:1281–1289. doi: 10.1007/s10815-019-01472-3.
    1. Arslan E, Gorkem U, Togrul C. Is there a relationship between vitamin D deficiency status and PCOS in infertile women? Geburtshilfe Frauenheilkd. 2019;79:723–730. doi: 10.1055/a-0871-6831.
    1. Lata I, Tiwari S, Gupta A, Yadav S, Yadav S. To study the vitamin D levels in infertile females and correlation of vitamin D deficiency with AMH levels in comparison to fertile females. J Hum Reprod Sci. 2017;10:86–90. doi: 10.4103/jhrs.JHRS_105_16.
    1. Bednarska-Czerwinska A, Olszak-Wasik K, Olejek A, Czerwinski M, Tukiendorf AA. Vitamin D and anti-Mullerian hormone levels in infertility treatment: the change-point problem. Nutrients. 2019;11:1053. doi: 10.3390/nu11051053.
    1. Dastorani M, Aghadavod E, Mirhosseini N, Foroozanfard F, Zadeh Modarres S, Amiri Siavashani M, Asemi Z. The effects of vitamin D supplementation on metabolic profiles and gene expression of insulin and lipid metabolism in infertile polycystic ovary syndrome candidates for in vitro fertilization. Reprod Biol Endocrinol. 2018;16:94. doi: 10.1186/s12958-018-0413-3.
    1. Dennis NA, Houghton LA, Pankhurst MW, Harper MJ, McLennan IS. Acute supplementation with high dose vitamin D3 increases serum anti-müllerian hormone in young women. Nutrients. 2017;9:719. doi: 10.3390/nu9070719.
    1. Garg D, Tal R. The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reprod BioMed Online. 2016;33:15–28. doi: 10.1016/j.rbmo.2016.04.007.
    1. Tal R, Seifer DB, Khanimov M, Malter HE, Grazi RV, Leader B. Characterization of women with elevated antimullerian hormone levels (AMH): correlation of AMH with polycystic ovarian syndrome phenotypes and assisted reproductive technology outcomes. Am J Obstet Gynecol. 2014;211:59.e1–59.e8. doi: 10.1016/j.ajog.2014.02.026.
    1. Lagowska K, Bajerska J, Jamka M. The role of vitamin D Oral supplementation in insulin resistance in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Nutrients. 2018;10:1637. doi: 10.3390/nu10111637.
    1. Zhang H, Huang Z, Xiao L, Jiang X, Chen D, Wei Y. Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss. Int J Gynaecol Obstet. 2017;138:242–249. doi: 10.1002/ijgo.12209.
    1. Pearce K, Gleeson K, Tremellen K. Serum anti-Mullerian hormone production is not correlated with seasonal fluctuations of vitamin D status in ovulatory or PCOS women. Hum Reprod. 2015;30:2171–2177. doi: 10.1093/humrep/dev167.
    1. Hollis BW. Editorial: the determination of circulating 25-hydroxyvitamin D: no easy task. J Clin Endocrinol Metab. 2004;89:3149–3151. doi: 10.1210/jc.2004-0682.
    1. Barrea L, Muscogiuri G, Laudisio D, Pugliese G, de Alteriis G, Colao A, Savastano S. Influence of the Mediterranean diet on 25- Hydroxyvitamin D levels in adults. Nutrients. 2020;12:1439. doi: 10.3390/nu12051439.

Source: PubMed

3
Abonneren