Volume 110, Issue 4, Pages 761–766.e1

Authors:

Alice J. Shapiro, M.D., Sarah K. Darmon, Ph.D., David H. Barad, M.D., Norbert Gleicher, M.D., Vitaly A. Kushnir, M.D.

Abstract:

Objective

To determine whether a relationship exists between vitamin D (25OH-D) levels and ovarian reserve parameters (antimüllerian hormone [AMH] and FSH levels) in a large cohort of infertile women with a high prevalence of diminished ovarian reserve.

Design

Retrospective cohort study.

Setting

Academically affiliated private fertility center.

Patient(s)

A total of 457 infertile women 21–50 years of age who had baseline hormone measurements.

Intervention(s)

None.

Main Outcome Measure(s)

Statistical analyses to determine whether a relationship exists between AMH, FSH, and serum 25OH-D levels.

Result(s)

As defined by 25OH-D <20.0 ng/mL, 74/457 patients (16.2%) had vitamin D deficiency. AMH and FSH levels did not vary between women with vitamin D deficiency and those with normal levels (0.8 ± 3.0 vs. 0.5 ± 1.6 ng/mL [P=.18] and 9.4 ± 7.2 vs. 9.2 ± 9.5 mIU/mL [P=.54], respectively). Multivariate linear regression analysis of log-transformed AMH and FSH with 25OH-D levels adjusted for age, body mass index, and seasonal variation confirmed lack of association. Receiver operating characteristic (ROC) analysis to determine if 25OH-D levels are predictive of AMH showed areas under the ROC curves (AUCs) for women <38 years of age to be 0.501, 0.554, and 0.511 for AMH threshold values of 0.5 ng/mL, 1.0 ng/mL, and 5.0 ng/mL, respectively. For women ≥38 years respective AUC values were 0.549, 0.545, and 0.557 ng/mL.

Conclusion(s)

Vitamin D levels were not associated with ovarian reserve in a large group of infertile women with a high prevalence of diminished ovarian reserve. Previously reported vitamin D–associated outcomes in infertility patients may, therefore, be mediated by factors other than ovarian reserve.

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