In a nutshell
This study looked at adding vitamin D for women with polycystic ovarian syndrome (PCOS) who were overweight and being treated with clomiphene citrate (Clomid). It found that vitamin D increased ovulation and pregnancy rates for these patients.
Polycystic ovarian syndrome (PCOS) is a common condition of women of reproductive age. PCOS involves infrequent ovulation and hormonal changes and is linked to obesity. Over 90% of women whose infertility is caused by a lack of ovulation have PCOS.
Vitamin D deficiency is common, with 20-48% of adults having low vitamin D. However it is more common in women with PCOS. Vitamin D has many roles in the body, including allowing calcium to be absorbed from food. The ovaries are sensitive to calcium, and the mineral may play a role in how a follicle is selected. The follicle is where the egg develops prior to ovulation.
Clomiphene citrate is a treatment for infertility which causes the body to release more estrogen than it otherwise would. This can promote ovulation. It is unclear whether vitamin D can improve ovulation rates during treatment with clomiphene citrate.
Methods & findings
This study included 186 women with PCOS and infertility. The patients had body mass indexes (a measurement of weight in relation to height) between 25 and 30 kg/m2, which indicates being overweight. All of the women were treated with clomiphene citrate and a calcium supplement. Half of the women were randomly assigned to also take a high-dose vitamin D supplement (10000 UI twice weekly), and the other half took a placebo (inactive pill). Calcium and vitamin D or placebo were started one month before the first clomiphene citrate cycle. The patients were followed for three cycles.
Within the first three treatment cycles, significantly more patients in the vitamin D group ovulated (92.5% vs. 78.5%). Also, the dominant follicle was significantly larger for women in the vitamin D group (18.07 vs. 16.79 mm), which may indicate better development of the egg.
More patients taking vitamin D had a positive pregnancy test (61.3% vs. 49.5%) and a pregnancy visible on ultrasound (50.5% vs. 39.8%). Among pregnant patients, fewer of those taking vitamin D had a miscarriage during the study (29.8% vs. 45.9%).
The bottom line
This study found that adding vitamin D to clomiphene citrate treatment increased ovulation and pregnancy rates in patients with PCOS.
The fine print
This study did not test vitamin D levels before treatment due to ethical considerations, so it was not able to show that patients had low vitamin D before treatment. Also, this study had a small number of patients.
Published By :
May 03, 2020