Serum Vitamin D Levels in Fertile and Infertile Women with Polycystic Ovary Syndrome

Abstract

Introduction In polycystic ovary syndrome, serum vitamin D levels are known to correlate with metabolic conditions such as diabetes mellitus, metabolic syndrome and cardiovascular disease. However, there are not enough studies showing such a relationship with female fertility. We aimed to compare serum vitamin D levels in fertile and infertile women with polycystic ovary syndrome to evaluate whether vitamin D may play a role in the pathogenesis of fertility problems in women with polycystic ovary syndrome. Materials and Methods 274 infertile and 111 fertile women with polycystic ovary syndrome were included in this retrospective study. Infertile and fertile groups were matched by age, body mass index and homeostasis model assessment of insulin resistance. Anthropometric, clinical and laboratory characteristics of the women were recorded. Serum 25(OH)D3 levels were used to assess serum vitamin D levels. Results No significant differences were detected between groups in terms of anthropometric, clinical and laboratory features except for serum 25(OH)D3 levels and the incidence of vitamin D deficiency. Vitamin D levels were significantly lower and vitamin D deficiency was more common in the infertile group compared to the fertile group. When the groups were stratified into obese/non-obese or insulin resistance positive/negative, infertile obese and infertile insulin resistance-positive women had the lowest serum 25(OH)D3 levels. Conclusion Serum vitamin D levels are lower in infertile women with polycystic ovary syndrome compared to fertile women. When insulin resistance or obesity was present, vitamin D levels were reduced further. Thus, in polycystic ovary syndrome, lower vitamin D levels may play a role in the pathogenesis of fertility problems.

A systematic review and meta-analysis of the association between vitamin D and ovarian reserve

“…Participants' mean age ranged from 17.8 to 42.5 years old and BMI from 20.7 to 35.7 kg/m 2 . The enrolled studies were published between 2009 and 2020 of which 9 were from Turkey 24 – 32 , 5 from United States 12 , 15 , 33 – 35 , 3 from Iran 36 – 38 , 3 from Poland 39 – 41 , 2 from South-Korea 14 , 42 , 2 from Saudi Arabia 43 , 44 , 2 from China 45 , 46 , 2 from India 47 , 48 . Others were from Spain 49 , Belgium 7 , Slovakia 50 , Egypt 51 , Bosnia and Herzegovina 52 , Australia 53 , Japan 54 , and Canada 55 .…”

“…Others were from Spain 49 , Belgium 7 , Slovakia 50 , Egypt 51 , Bosnia and Herzegovina 52 , Australia 53 , Japan 54 , and Canada 55 . Moreover, 21 studies were cross-sectional in design 7 , 14 , 24 – 29 , 33 , 36 , 37 , 39 , 40 , 42 , 43 , 46 , 47 , 49 , 51 , 52 , 54 , 9 case–control 30 – 32 , 38 , 41 , 44 , 45 , 48 , 50 and 6 cohorts 12 , 15 , 34 , 35 , 53 , 55 . Seventeen studies mentioned the season of sample collection 7 , 14 , 15 , 27 , 32 – 35 , 37 , 38 , 40 – 42 , 52 – 55 .…”

“…Moreover, 21 studies were cross-sectional in design 7 , 14 , 24 – 29 , 33 , 36 , 37 , 39 , 40 , 42 , 43 , 46 , 47 , 49 , 51 , 52 , 54 , 9 case–control 30 – 32 , 38 , 41 , 44 , 45 , 48 , 50 and 6 cohorts 12 , 15 , 34 , 35 , 53 , 55 . Seventeen studies mentioned the season of sample collection 7 , 14 , 15 , 27 , 32 – 35 , 37 , 38 , 40 – 42 , 52 – 55 . Twenty-five studies selected serum vitamin D < 20 ng/ml as deficient, eight studies serum vitamin D < 10 ng/ml, and the others did not mention the cut-off values.…”

“…Twenty-five studies selected serum vitamin D < 20 ng/ml as deficient, eight studies serum vitamin D < 10 ng/ml, and the others did not mention the cut-off values. Based on the NOS, 23 studies were ranked as high quality 7 , 12 , 15 , 24 , 27 – 29 , 32 – 35 , 37 , 42 – 46 , 48 – 50 , 53 – 55 and 13 moderate 14 , 25 , 26 , 30 , 31 , 36 , 38 – 41 , 47 , 51 , 52 , respectively. Table 1 provides the primary information of enrolled studies and Fig.…”

“…Twenty studies 7 , 14 , 28 , 32 , 34 , 37 , 40 – 42 , 45 , 46 , 51 , 53 , 54 with 3406 subjects evaluated the correlation between AMH and 25(OH)D. There was no significant correlation between AMH and 25(OH)D (Fisher’s Z: − 0.03; 95% CI − 0.11 to 0.04; P = 0.355) with considerable heterogeneity (I 2 = 73.3%, P < 0.001) (Fig. 7 ).…”