Circulating vitamin D correlates with serum antimüllerian hormone levels in women older than 40

AMH stands for AntiMullerian Hormone. It is also called MIS (Mullerian Inhibiting Substance).  Since AMH is produced directly by the ovarian follicles, AMH levels correlate with the number of residual eggs in the ovary.  It has been documented that women with lower AMH have lower antral follicular counts and produce a lower number of oocytes compared to women with higher levels.

In this study the authors  demostrated that 25OH-D was positively correlated with serum AMH levels in late-reproductive-aged (age ≥40 years) women.

The authors conclude:

There is some evidence suggesting that vitamin D deficiency might be involved in the pathogenesis of insulin resistance and the metabolic syndrome in polycystic ovarian syndrome (PCOS). In women with PCOS, low 25OH-D levels are associated with obesity and metabolic and endocrine disturbances  and vitamin D supplementation might improve menstrual frequency and metabolic disturbances in those women.   Because vitamin D induces the AMH gene  and because we found here that vitamin D and AMH are positively correlated, it is possible that vitamin D contributes to AMH actions by increasing AMH production by granulosa cells. These speculations warrant further investigation. ( Source : Fertility And Sterility)

At a minimum patients undergoing fertility treatments should be tested for vitamin D levels and Supplemented if  found deficient.

Women with Vitamin D deficiency have lower implantation at IVF: study

Physicians from the Albert Einstein school of medicine in New York measured follicular fluid levels of Vitamin D  in women who underwent follicular fluid aspiration for IVF.

One of their finding was that the follicular fluid Vitamin D level correlated with serum level: women who were Vitamin D deficient also had lower levels of Vitam D in their ovaries.

In addition the study found that although the number of eggs and embryos was the same . the women who were deficient in Vitamin D had much lower implantation rates.

Comments from the authors below:

Improved COH parameters, in the context of higher vitamin D levels, are suggestive of facilitatory implications of FF 25OH-D on ovarian steroidogenesis, albeit insignificantly so; these observations are hence in keeping with published literature.However, in the absence of any significant relationship with ovarian response, our observations may identify endometrial receptivity as the potential target for beneficial influences of higher circulating vitamin D levels.

The author continue....

The observed prevalence of vitamin D insufficiency in an otherwise healthy population is concerning, especially in the context of accruing data on beneficial influences of replete vitamin D stores on multiple physiological processes and the emerging roles of vitamin D insufficiency in a spectrum of diseases. Given our findings, assessment of vitamin D status might be considered as a part of routine infertility workup since appropriate supplementation of those deemed depleted of vitamin D might translate to improved fertility outcome and improved overall health. These latter conjectures merit further assessment by appropriately designed longitudinal studies.

My conclusion is adequatte vitami D supplementation is an essential  in women deficient in Vitamin D who are undergoing IVF.