189 THE EFFECT OF VITAMIN D SUPPLEMENTATION ON ANTI-MULLERIAN HORMONE LEVELS IN REPRODUCTIVE-AGE WOMEN

Abstract

Vitamin D deficiency has been correlated with the infertility and lower clinical pregnancy following IVF. Anti-Mullerian hormone (AMH) plays a key role during follicle development; it has been recognised as a predictor of regular ovulation and probably IVF success. Considering the critical need for experimental human study to investigate the impact of vitamin D supplementation on ovulatory function, the aim of this study was to demonstrate the effectiveness of the vitamin D supplementation on AMH serum levels among reproductive-age women with vitamin D deficiency. 195 reproductive women (18–35 year-old) with confirmed vitamin D deficiency [serum 25(OH)D <75 nmol L^–1] and without diagnosed polycystic ovary syndrome (PCOS) were enrolled to this controlled clinical trial. Participants were randomly assigned to a control group (n = 96) or an intervention group (n = 99). Women in the intervention group used 2000 IU day^–1 vitamin D drops for 15 weeks. 19 participants were missed during the follow-up; finally the numbers of women in the intervention and control groups were 91 and 85, respectively. At the beginning of the study and after the intervention, 25-hydroxyvitamin D and AMH serum levels were quantified using enzyme immunoassay (EIA; Immunodiagnostic Systems, Boldon, UK) and ELISA (Beckman-Coulter Inc., Fullerton, CA, USA) methods respectively. The post-intervention AMH measurement was performed after 2–5 weeks in the same day-of-cycle on which basal AMH measurement was done. Paired t-test, independent t-test, and Pearson correlation were used as appropriate and a P-value of less than 0.05 was considered significant. Significantly low AMH levels were seen in the vitamin D deficient women of this study (14.46 ± 11.92 pmol L^–1 in control group and 14.09 ± 11.52 pmol L^–1 in intervention group). After the intake of vitamin D supplementation in intervention group, AMH levels were increased to 24.89 ± 12.47 pmol L^–1, which were significantly different from the 15.43 ± 13.03 pmol L^–1 in control group (P < 0.001). Correlation coefficients for AMH with pre-intervention and post-intervention vitamin D were r = 0.489 and r = 0.599 respectively (P < 0.001). Treatment of vitamin D deficiency increases AMH to the optimum levels. Vitamin D deficient women had low levels of AMH. These findings support other studies which found a correlation of poor IVF outcomes with low vitamin D levels. Vitamin D supplementation could be useful in the improvement of controlled ovarian hyper-stimulation/IVF outcomes in case of vitamin D deficiency.