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      Deficiencia de vitamina D y patologías ginecológicas de la mujer en edad reproductiva Translated title: Vitamin D deficiency and gynecological pathologies in women of reproductive age

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          Abstract

          RESUMEN La vitamina D está actualmente en el ámbito de la investigación en muchos campos de la medicina. Es conocido que tiene funciones fundamentales en el metabolismo del calcio y modelado óseo. La deficiencia de vitamina definida como la concentración de 25-hidroxicalciferol < 20 ng/mL es observada con frecuencia en pacientes con patologías ginecológicas. En las últimas dos décadas existe evidencia sobre la asociación de concentraciones séricas bajas de vitamina D con trastornos como diabetes mellitus y síndrome metabólico. Cada vez hay más informes que plantean el impacto del metabolismo de esta vitamina en el desarrollo de trastornos del sistema reproductor femenino. El receptor de vitamina D y la 1α-hidroxilasa están presentes en los órganos reproductivos, lo que sugiere que la vitamina D puede tener algún efecto en la modulación de las funciones celulares. Se ha comunicado los efectos perjudiciales de la deficiencia en pacientes con diagnóstico de síndrome de ovarios poliquísticos, endometriosis y leiomiomatosis. La suplementación de vitamina D debería agregarse a los esquemas de tratamiento de la mayoría de las patologías ginecológicas en pacientes con deficiencia, tanto por la mejora de la insulinorresistencia (como en las pacientes con síndrome de ovarios poliquísticos) como por los resultados del tratamiento de la infertilidad. El objetivo de esta revisión fue establecer los efectos de la deficiencia de vitamina D en patologías de la mujer en edad reproductiva.

          Translated abstract

          ABSTRACT Vitamin D is currently under investigation in many fields of medicine. It is known to have fundamental functions in calcium metabolism and bone modeling. Vitamin D deficiency defined as 25-hydroxychalciferol concentration < 20 ng/mL and is frequently observed in patients with gynecological pathologies. In the last two decades there is evidence on the association of low serum vitamin D concentrations with disorders such as diabetes mellitus and metabolic syndrome. There are increasing reports of the impact of vitamin D metabolism on the development of disorders of the female reproductive system. Vitamin D receptor and 1α-hydroxylase are present in the reproductive organs, suggesting that vitamin D may have some effect in modulating cellular functions. The detrimental effects of deficiency have been shown in patients diagnosed with polycystic ovarian syndrome, endometriosis, and leiomyomatosis. Vitamin D supplementation should be added to the treatment schemes of most gynecologic pathologies in patients with deficiency, both for the improvement of insulin resistance (as in patients with polycystic ovarian syndrome) and for the outcomes of infertility treatment. The aim of this review was to establish effects of vitamin D deficiency on pathologies in women of reproductive age.

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          Most cited references48

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          Replete vitamin D stores predict reproductive success following in vitro fertilization.

          To determine whether 25OH-D levels in the follicular fluid (FF) of infertile women undergoing IVF demonstrate a relationship with IVF cycle parameters and outcome, hypothesizing that levels of 25OH-D in body fluids are reflective of vitamin repletion status. Prospective cohort study. Academic tertiary care center. Eighty-four infertile women undergoing IVF. Follicular fluid from follicles>or=14 mm; serum (n = 10) and FF levels of 25OH-D. Clinical pregnancy (CP), defined as evidence of intrauterine gestation sac on ultrasound, following IVF; IVF cycle parameters. Serum and FF levels of 25OH-D were highly correlated (r=0.94). In a predominantly Caucasian population (66%), significantly lower FF 25OH-D levels were noted in Black versus non-Black patients. Significant inverse correlations were seen between FF 25OH-D levels and body mass index (r=-0.25). Significantly higher CP and implantation rates were observed across tertiles of FF25OH-D; patients achieving CP following IVF (n=26) exhibited significantly higher FF levels of 25OH-D. Multivariable logistic regression analysis confirmed FF 25OH-D levels as an independent predictor to success of an IVF cycle; adjusting for age, body mass index, ethnicity, and number of embryos transferred, each ng/mL increase in FF 25OH-D increased the likelihood for achieving CP by 6%. Our findings that women with higher vitamin D level in their serum and FF are significantly more likely to achieve CP following IVF-embryo transfer are novel. A potential for benefit of vitamin D supplementation on treatment success in infertile patients undergoing IVF is suggested and merits further investigation. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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            The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review.

            Metabolic disturbances, in particular, insulin resistance (IR) and dyslipidemia, are common in women suffering from polycystic ovary syndrome (PCOS). Evidence is accumulating that vitamin D status may contribute to the development of metabolic disturbances in PCOS.
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              Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.

              To elucidate the role of vitamin D in reproduction by examining the relationship between recipient vitamin D levels and pregnancy rates in donor-recipient IVF cycles. Retrospective cohort study. Academic tertiary care center. Ninety-nine recipients of egg donation at University of Southern California Fertility. Serum was collected from egg donor recipients before ET and was tested for vitamin D levels [25(OH)D]. Clinical pregnancy as defined by sonographic presence of a heartbeat at 7-8 weeks of gestation. In a diverse population of 99 recipients (53% Caucasian, 20% Asian, 16% Hispanic, 7% African American), adjusted clinical pregnancy rates were lower among vitamin D-deficient recipients than among vitamin D-replete recipients (37% vs. 78%). Live-birth rates were 31% among vitamin D-deficient recipients, compared with 59% among vitamin D-replete recipients. There were no differences in adjusted clinical pregnancy and live-birth rates among recipients who were vitamin D deficient [25(OH)D<20 ng/mL] vs. among those who were vitamin D insufficient [20 ng/mL ≤ 25(OH)D<30 ng/mL]. Nonreplete vitamin D status [25(OH)D<30 ng/mL] was associated with lower pregnancy rates in recipients of egg donation. Since the oocyte donor-recipient model is able to separate the impact of vitamin D on oocyte vs. endometrium, these data suggest that the effects of vitamin D may be mediated through the endometrium. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                rgo
                Revista Peruana de Ginecología y Obstetricia
                Rev. peru. ginecol. obstet.
                Sociedad Peruana de Obstetricia y Ginecología (Lima, , Peru )
                2304-5132
                January 2022
                : 68
                : 1
                : 00010
                Affiliations
                [1] Maracaibo orgnameUniversidad del Zulia orgdiv1Facultad de Medicina Venezuela
                [2] Maracaibo Zulia orgnameHospital Central Dr. Urquinaona orgdiv1Servicio de Obstetricia y Ginecología Venezuela
                Article
                S2304-51322022000100010 S2304-5132(22)06800100010
                10.31403/rpgo.v68i2387
                99283b1e-b632-4a80-a6b8-940ba7234c0f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 01 December 2021
                : 25 October 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 0
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                SciELO Peru

                Categories
                Artículos Especiales

                Polycystic ovary syndrome,Fertilización in vitro,Endometriosis,Leiomiomatosis uterina,Síndrome de ovarios poliquísticos,Vitamina D,In vitro fertilization,Uterine leiomyomatosis,Vitamin D

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