Effects Of Vitamin D Supplementation Treatment On Sex Hormones,Glucose Metabolism And Ovulation Promotion In Patients With PCOS

Objective : The study was designed to assess the impact of vitamin D(VitD)supplementation therapy on sex hormones,glucose metabolism,endometrial thickness on the day of ovulation,ovulation and cycle pregnancy rate after ovulation induction in patients with polycystic ovary syndrome(PCOS),in order to provide new ideas for the selection of treatment modalities for PCOS.Methods:A total of 131 PCOS patients with VitD deficiency who attended the reproductive and gynecological departments of our hospital from September 2019 to September 2020 were selected and divided into VitD group and control group.The control group was given Diane-35 and the VitD group was given Diane-35 and VitD.Fasting blood samples were collected from patients pre-treatment and post-treatment on days 3-5 of menstruation.Observation indexes were collected:(1)serum 25(OH)D;(2)sex hormones:luteinizing hormone(LH),testosterone(T),follicle stimulating hormone(FSH),LH/ FSH;(3)glucose metabolism: fasting blood glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR).Excluding the patients without fertility requirements,according to the order of visited in the two groups,40 cases in the VitD group and the control group were selected to give clinical data on ovulation induction,1-3 ovulation induction cycles were observed,endometrial thickness on the day of ovulation was monitored,and the number of cycle ovulation rate and cycle pregnancy rate were recorded.The levels of 25(OH)D and other clinical data were compared between the pre-treatment and post-treatment and between the two groups,and the endometrial thickness on the day of ovulation,ovulation rate and cycle pregnancy rate rate were compared between the two groups.Results: 1.Comparison of 25(OH)D level and other clinical data pre-treatment between the VitD group and control group: comparison of age,BMI,25(OH)D,FPG,FINS,HOMA-IR,LH,FSH,LH/FSH and T pre-treatment between the two groups showed no statistically significant discrepancies(P>0.05),with comparability.2.Comparison the control group of 25(OH)D level and other clinical data pretreatment and post-treatment: FPG,LH,and LH/FSH were significantly lower posttreatment than pre-treatment,and the all discrepancies were statistically significant(P<0.05);BMI,FINS,HOMA-IR,FSH,T,and 25(OH)D did not change significantly pretreatment and post-treatment,and the all discrepancies were not statistically significant(P>0.05).3.Comparison the VitD group of 25(OH)D level and other clinical data pre-treatment and post-treatment: post-treatment 25(OH)D level was observably higher than pretreatment,and the discrepancy was statistically significant(P<0.05);The levels of FPG,FINS,HOMA-IR,LH,LH/FSH and T were observably lower post-treatment compared with those pre-treatment,and the discrepancies were all statistically significant(P<0.05);The changes of BMI and FSH levels did not significantly pre-treatment and post-treatment,and the discrepancies were not significant(P>0.05).4.Comparison of 25(OH)D level and other clinical data post-treatment between the VitD group and control group: 25(OH)D level was clearly higher in the VitD group versus to the control group,and the difference was significant(P < 0.05).In the VitD group,posttreatment FPG,FINS,HOMA-IR,LH and T levels were lower than that in the control group,and all discrepancies were statistically significant(P<0.05);BMI,FSH,LH/FSH levels were not observably changed,and the discrepancies were not statistically significant(P>0.05).5.Comparison between VitD and control groups in terms of ovulation promotion:comparison between the two groups in terms of endometrial thickness on the day of ovulation(8.16?1.36 mm vs 7.89?1.44 mm,P=0.407)and cycle pregnancy rate rate(15.15%vs 15.22%,P=0.990),the discrepancies were not statistically significant;In VitD group,the cycle ovulation rate was clearly superior to the control group(96.12% vs 88.46%,P=0.039),and the discrepancy was statistically significant.Conclusions:1.VitD supplementation improves FPG,FINS,HOMA-IR,LH,T levels in patients with PCOS with VitD deficiency and may be a new approach to the comprehensive treatment of PCOS.2.The use of VitD as a treatment for PCOS patients can improve ovulation in shortterm follow-up interventions;However,there were no observably impact on endometrial thickness and cycle pregnancy rate.