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J Ovarian Res. 2018 Jul 24;11(1):62. doi: 10.1186/s13048-018-0435-7.

Is the ovarian reserve influenced by vitamin D deficiency and the dress code in an infertile Iranian population?

Author information

Avicenna Research Institute, ACECR, Tehran, Iran.
Bahman Hospital Infertility Center, North Iran Zamin St, Shahrak Gharb, Tehran, Iran.
Givar Infertility Center, Tehran, Iran.
Department of Epidemiology and Reproductive Health, Reproductive Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Sarem Infertility Center, Sarem Women's Hospital, Shahrak Ekbatan, Tehran, Iran.
Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical science, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, Iran.
IVF department, IVI RMA Middle-East Fertility Clinic, Abu Dhabi, UAE.
IVF department, IVI RMA Middle-East Fertility Clinic, Abu Dhabi, UAE.
Women's university hospital Tuebingen, Tuebingen, Germany.



In the recent years, vitamin D has become a topical subject and a focus of research not only in reproductive medicine but across many medical disciplines. In reproductive medicine, studies have identified an association between vitamin D status in women and ovarian reserve. In humans, exposure of the skin to sunlight is the main important source of vitamin D. A dress code of wearing concealing clothing is a risk factor for vitamin D deficiency. The objective of this prospective observational study was to evaluate the correlation between vitamin D deficiency and ovarian reserve in a population of infertile women in Iran. As part of the basic fertility assessment of study participants, blood tests were taken to measure vitamin D concentration and transvaginal ultrasound scans were performed on day 2-5 of the cycle to determine antral follicle count (AFC). All study participants were assessed by a reproductive medicine specialist and consultant dermatologist to classify their skin types according to the Fitzpatrick classification. In addition, the dress code of each study participant was recorded noting the percentage of exposed skin not covered by concealing clothing.


189 infertility patients were included in this study. The mean concentration of vitamin D in this study population was 15.46 ng/ml, indicating severe vitamin D deficiency. A statistically significant negative correlation between age and vitamin D (p = 0.008) and age and AFC (p = 0.001) was identified. This study revealed a highly significant correlation between vitamin D concentrations and AFC (p < 0.001).


A concealing dress code is an independent risk factor for vitamin D deficiency due to a lack of skin exposure to sunlight. Our study suggests that the so caused severe vitamin D deficiency may play a crucial role in reduced ovarian reserve in the herein described group of an infertile female Iranian population.


Dress code; Ovarian reserve; Skin-type; Vitamin D deficiency

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