Ovarian reserve markers and vitamin d level in women with diminished ovarian reserve

Background: Deficiency in serum vitamin D level is a common problem worldwide. Reduction in ovarian reserve even in young women is much alarming now a days. The mechanism by which vitamin D may affect reproductive physiology is little known; a direct effect of vitamin D in ovarian steroidogenesis and ovarian follicular development has been suggested. Several studies have identified an association between ovarian reserve and serum vitamin D level. Objective of the study was to evaluate association of ovarian reserve markers (AMH, AFC) and serum vitamin D in women with diminished ovarian reserve.
Materials and methods: In this case control study, the study population(156) were infertile women of reproductive age (20-34 years), who were diagnosed as diminished ovarian reserve (DOR) , as case (78) and patients with normal ovarian reserve (NOR) of same age group as control (78) , attending Reproductive Endocrinology and Infertility Department, Bangabandhu Sheikh Mujib Medical University. Baseline TVS was done on D2-5 and antral follicle count (AFC) was documented. Patients were advised for serum AMH and serum vitamin D level measurements at the same day. Then association between AMH, AFC and serum vitamin D was analyzed.
Result: Vitamin D deficiency is defined as level ≤ 20 ng/ml. The mean serum AMH was 1.42±1.49 in vitamin D level 20 ng/ml and 3.14±2.45 in vitamin D level >20 ng/ml. The mean AFC was 8.00±3.25 in vitamin D level 20 ng/ml and 10.84±4.03 in vitamin D level >20 ng/ml. The mean vitamin D level was significantly lower in DOR women. There were positive significant correlation (r=0.433; p=0.001) between vitamin D level and serum AMH and positive significant correlation (r=0.419; p=0.001) between vitamin D level and AFC too.
Conclusion: Vitamin D deficiency is found to be associated with diminished ovarian reserve group and shows significant positive correlation with serum AMH and AFC.