title: Role of vitamin D in ovarian physiology and its implication in reproduction: a systematic review.
abstract: OBJECTIVE
  To report an update on the role of vitamin D (VD) in ovarian physiology with a focus on genes involved in steroidogenesis, follicular development, and ovarian reserve, as well as ovulatory dysfunction associated with polycystic ovary syndrome (PCOS), and ovarian response to assisted reproductive technology (ART).
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Human, animal, and cell culture models.
  
  
  METHODS
  Pubmed literature search.
  
  
  METHODS
  Granulosa cell function, serum antimüllerian hormone (AMH), AMH and its receptor gene expression, soluble receptor for advanced glycation end-products (sRAGE), PCOS parameters, and ART outcome.
  
  
  RESULTS
  In human granulosa cells, VD alters AMH signaling, FSH sensitivity, and progesterone production and release, indicating a possible physiologic role for VD in ovarian follicular development and luteinization. In the serum, 25-hydroxyvitamin D (25OH-D) is positively correlated with AMH, and appropriate VD supplementation in VD-depleted women can suppress the seasonal changes that occur in serum AMH. In VD-deficient women with PCOS, VD supplementation lowers the abnormally elevated serum AMH levels, possibly indicating a mechanism by which VD improves folliculogenesis. The antiinflammatory sRAGE serum levels significantly increase in women with PCOS after VD replacement. Although follicular fluid 25OH-D correlates with IVF outcomes, there is a lack of data pertaining to the impact of VD supplementation on pregnancy rates following IVF.
  
  
  CONCLUSIONS
  This review underscores the need for understanding the mechanistic actions of VD in ovarian physiology and the critical need for randomized trials to elucidate the impact of VD supplementation on controlled ovarian hyperstimulation/IVF outcome and ovulatory dysfunction associated with PCOS.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Irani
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont College of Medicine, Burlington, Vermont. Electronic address: zom00@hotmail.com.
authors.forename: Zaher
authors.initials: Z
authors.lastname: Merhi
mesh_terms: D000818:Animals; D019587:Dietary Supplements; D005260:Female; D005298:Fertility; D006801:Humans; D007247:Infertility, Female / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D006080:Ovarian Follicle / Q000378:metabolism; D010053:Ovary / Q000378:metabolism* / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted; D015398:Signal Transduction; D016896:Treatment Outcome; D014807:Vitamin D / Q000378:metabolism* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology
chemical_list: D014807:Vitamin D
keywords: AMH; IVF; PCOS; Vitamin D; folliculogenesis; ovarian reserve; steroidogenesis