More fertility associated with higher vitamin D - Dec 2023

Fertil Steril . 2023 Dec 23:S0015-0282(23)02094-0. doi: 10.1016/j.fertnstert.2023.12.023. Online ahead of print.

Association between Serum 25-hydroxyvitamin D and Antimüllerian Hormone in a Cohort of African-American Women

Anita Subramanian 1, Quaker E Harmon 2, Lia A Bernardi 3, Mercedes R Carnethon 4, Erica E Marsh 5, Donna D Baird 2, Anne Marie Z Jukic 2
Affiliations expand
PMID: 38145700 DOI: 10.1016/j.fertnstert.2023.12.023
Abstract
Objective: To examine the association between serum 25-hydroxyvitamin D [25(OH)D] and ovarian reserve as measured by antimüllerian hormone (AMH).

Design: Cross-sectional study.

Setting: Detroit, Michigan area.

Subjects: Data were obtained from a prospective cohort of self-identified Black/African-American women aged 23-35 years at the time of enrollment (N=1593), had no prior diagnosis of polycystic ovary syndrome (PCOS), were not currently pregnant, and were not missing AMH or 25(OH)D measures.

Exposure: Serum 25(OH)D.

Main outcome measure: Serum AMH was the main outcome. Linear regression was used to examine the associations between categorical 25(OH)D (<12 ng/mL, 12-<20, 20-<30, ≥30) and continuous natural log-transformed AMH. Associations between 25(OH)D and high (upper 10th percentile: >7.8 ng/mL) or low AMH (<0.7 ng/mL) were estimated with logistic regression. Models were adjusted for age, age-squared, BMI, hormonal contraceptive use, smoking, and exercise.

Results: The 25(OH)D levels were low; 70% of participants were below 20 ng/mL. In fully-adjusted models, compared to 25(OH)D levels <12 ng/mL, those with 25(OH)D levels of 12-<20, 20-<30 and ≥30 ng/mL had an AMH level that was 7% (95% CI: -4, 20) , 7% (95% CI: -6, 22), or 11% higher (95% CI: -7, 34), respectively. Moreover, these groups had a lower odds of having low AMH (OR[95% CI): 0.63 (0.40, 0.99), 0.60 (0.34, 1.07), 0.76 (0.35, 1.65), respectively, and the highest category of 25(OH)D had a higher odds of having high AMH, (OR [[95% CI]: 1.42 [0.74, 2.72]). Exclusion of participants with either irregular cycles or very high AMH (>25 ng/mL), did not alter the associations.

Conclusion: Taken together, these results indicate that higher levels of 25(OH)D are associated with a slightly higher AMH, a lower odds of low AMH, and a higher odds of high AMH. This evidence is weak, however, since only a small percentage of participants had high 25(OH)D. Future studies should examine populations with a wide distribution of 25(OH)D levels (both high and low), with a clinical trial design, or with longitudinal measures of both 25(OH)D and AMH.