Abstract
BackgroundVitamin D deficiency in women diagnosed with polycystic ovary syndrome (PCOS) remarkably decreases the chance of pregnancy, which might be related to its impact on metabolic abnormalities in these patients. It is hypothesized that vitamin D supplementation influences metabolic profile of these patients and indirectly might affect fertility and the outcomes. Therefore, this study was conducted to determine the effects of vitamin D supplementation on the levels of anti-Müllerian hormone (AMH), metabolic profiles, and gene expression of insulin and lipid metabolism in infertile women with PCOS who were candidate for in vitro fertilization (IVF).MethodsThis study was a randomized, double-blinded, placebo-controlled trial conducted among 40 infertile women, aged 18–40 years, diagnosed with PCOS and was candidate for IVF. Participants were randomly assigned into two intervention groups for receiving either 50,000 IU vitamin D or placebo (n = 20 each group) every other week for 8 weeks. Gene expression for insulin and lipid metabolism was conducted using peripheral blood mononuclear cells (PBMCs) of women with PCOS, via RT-PCR method.ResultsVitamin D supplementation led to a significant reduction in serum AMH (− 0.7 ± 1.2 vs. − 0.1 ± 0.5 ng/mL, P = 0.02), insulin levels (− 1.4 ± 1.6 vs. -0.3 ± 0.9 μIU/mL, P = 0.007), homeostatic model of assessment for insulin resistance (− 0.3 ± 0.3 vs. -0.1 ± 0.2, P = 0.008), and a significant increase in quantitative insulin sensitivity check index (+ 0.009 ± 0.01 vs. + 0.001 ± 0.004, P = 0.04), compared with the placebo. Moreover, following vitamin D supplementation there was a significant decrease in serum total- (− 5.1 ± 12.6 vs. + 2.9 ± 10.9 mg/dL, P = 0.03) and LDL-cholesterol levels (− 4.5 ± 10.3 vs. + 2.5 ± 10.6 mg/dL, P = 0.04) compared with the placebo.ConclusionOverall, the findings of this trial supported that 50,000 IU vitamin D supplementation every other week for 8 weeks had beneficial effects on insulin metabolism, and lipid profile of infertile women with PCOS who are candidate for IVF. These benefits might not be evident upon having sufficient vitamin D levels.Trial registrationThis study was retrospectively registered in the Iranian website (www.irct.ir) for clinical trials registration (http://www.irct.ir: IRCT20170513033941N27).
Highlights
Vitamin D deficiency in women diagnosed with polycystic ovary syndrome (PCOS) remarkably decreases the chance of pregnancy, which might be related to its impact on metabolic abnormalities in these patients
After 8-week intervention, vitamin D supplementation led to a significant reduction in serum anti-Müllerian hormone (AMH) (− 0.7 ± 1.2 vs. -0.1 ± 0.5 ng/mL, P = 0.02) and insulin levels (− 1.4 ± 1.6 vs. -0.3 ± 0.9 μIU/mL, P = 0.007), homeostasis model of assessment-insulin resistance (HOMA-IR) (− 0.3 ± 0.3 vs. -0.1 ± 0.2, P = 0.008), as well as a significant increase in quantitative insulin sensitivity check index (QUICKI) (+ 0.009 ± 0.01 vs. + 0.001 ± 0.004, P = 0.04) compared with placebo (Table 3)
real-time PCR (RT-PCR) quantitative tests showed a significant upregulation of gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (P = 0.01), GLUT1 (P = 0.009) and low-density lipoprotein receptor (LDLR) (P = 0.03) in peripheral blood mononuclear cells (PBMCs) of infertile women diagnosed with PCOS who were candidate for in vitro fertilization (IVF) following vitamin D supplementation rather than placebo (Fig. 2). The results of this trial demonstrated the beneficial effects of 50,000 IU vitamin D supplementation every other week for 8 weeks on improving insulin metabolism and some of the markers of lipid profile among infertile women diagnosed with PCOS who were candidate for IVF
Summary
Vitamin D deficiency in women diagnosed with polycystic ovary syndrome (PCOS) remarkably decreases the chance of pregnancy, which might be related to its impact on metabolic abnormalities in these patients. This study was conducted to determine the effects of vitamin D supplementation on the levels of anti-Müllerian hormone (AMH), metabolic profiles, and gene expression of insulin and lipid metabolism in infertile women with PCOS who were candidate for in vitro fertilization (IVF). Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women affecting 4% to 12% of women in reproductive age [1]. It is a multifactorial syndrome presented with obesity, insulin resistance, dyslipidemia and other metabolic abnormalities. The independent role of insulin resistance in in vitro fertilization (IVF) outcomes is less defined in the literature [7]
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