N, 32, had fertility issues. She had been married for the past 4 years and was diagnosed as having polycystic ovarian syndrome (PCOS). She was obese with a BMI of 30. Her menses were irregular, occurring once every 2 to 3 months. The menstrual flow was heavy at times and could last for between 10 to 14 days. Her blood Vitamin D level was low (< 20ng/ml).
Vitamin D deficiency in PCOS
Studies have shown that PCOS is associated with vitamin D deficiency in 67–85% of cases. The more obese the patient, the lower the blood vitamin levels will be. The low vitamin D levels is thought to be due to the trapping of the vitamin in the fatty tissue.
In a local population, 54.5% of females were classified as having vitamin D deficiency, according to a study published in 2016. Thus, it is important to assess blood vitamin D level in the management of PCOS.
Vitamin D in Fertility and In Vitro Fertilisation
Animal experiments have demonstrated that vitamin D has a positive influence on the growth and development of both the egg and sperm as well as the process of fertilization. Similar results have been shown in human studies.
Vitamin D also improves the outcomes of in vitro fertilization (IVF) in healthy women as well as in those with PCOS.
In addition, vitamin D supplementation and optimal vitamin D levels reduce pregnancy- related complications and adverse events in PCOS patients.
What Is Vitamin D?
Vitamin D is an important micronutrient for our health. It helps keep our bones strong, supports the immune system, regulates blood sugar levels and improves our cognitive function and mood. It plays an important role in cardiovascular health as well as reproductive health.
Vitamin D2 and Vitamin D3
Vitamin D exists in two primary forms, D2 and D3. D2 or ergocalciferol, is found in mushrooms and yeasts. Once consumed, it is absorbed in the small intestine and transported to the liver and kidneys where it is converted into the active form of vitamin D (calcitriol).
D3, or cholecalciferol, is produced by the body when the skin is exposed to sunlight. It is also found in fatty fish such as salmon, egg yolks, and animal’s liver. It is metabolized in the liver and kidneys to calcitriol.
Ways to Get Vitamin D
Sunlight exposure and dietary sources are the best ways to get vitamin D.
Sunlight exposure: Spending about 10–15 minutes in the sun without sunscreen a few times a week can help the body produce adequate amounts of vitamin D.
Dietary sources: Vitamin D can be found in fatty fish, egg yolks, organ meats, and fortified foods like milk and cereal.
Vitamin D supplements are easily available in pharmacies if a patient has limited sun exposure or has difficulty absorbing vitamin D from food sources.
N was advised to reduce weight by diet and exercise. Besides being treated with medications, vitamin D supplementation was given. Her menstrual regularity improved. She conceived naturally after being on the treatment for 9 months.