الفهرس 
Vitamin DOnly 14 pages are availabe for public view
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Abstract
Infertility is a disease, defined by the failure to achieve a successful pregnancy after 12 months or more of appropriate, timed unprotected intercourse or therapeutic donor insemination. Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women over age 35 years.
The causes of female infertility are different and include genetic and anatomic abnormalities as well as endocrine and autoimmune disorders (ADs).
Once infertility has been ascertained, regardless of which definition one uses, the (diagnosis) of unexplained female infertility is made when tubal patency and normal ovulatory function are established in the presence of A normal semen analysis.
Vitamin D is a steroid hormone well known for its role in calcium homeostasis and bone mineralization. It is mainly produced in the skin after sunlight exposure. Diet and dietary supplements constitute alternative sources of vitamin D for humans. There are two distinct forms of vitamin D, that of D2 or ergocalciferol and D3 or cholecalciferol. Cholecalciferol is formed in the human skin from 7-dehydrocholesterol (7-DHC), a cholesterol precursor, in the presence of ultraviolet B radiation (UVB). UVB converts 7-DHC to previtamin D3, which is rapidly isomerized to vitamin D3.Ergocalciferol derives from several nutritional sources including green plants, mushrooms, fish fat and cod liver oil. Another source of vitamin D is commercially available vitamin D supplements.
Vitamin D plays a key role in calcium and phosphorus metabolism. Its main actions include intestinal calcium absorption and renal calcium reabsorption, as well as a direct effect on chondrocyte and osteoblast differentiation and subsequent bone formation.
Maintenance of sufficient vitamin D concentrations is essential for musculoskeletal health. Vitamin D deficiency has long been associated with a defect in bone mineralization, resulting in rickets or osteomalacia, increased bone turnover and high risk for falls and fractures. Apart from its relationship with bone disease, vitamin D deficiency has been associated with increased risk of cancer, autoimmune diseases, CVD and increased prevalence of CVD risk factors, as well as all-cause mortality in the general population.
Accumulating evidence from animal and human studies suggests that vitamin D is also involved in many functions of the reproductive system in both genders. This observation is further enhanced by the fact that vitamin D status has been associated, in women, with IVF outcome, features of PCOS and endometriosis, as well as, in men, with semen quality and sperm count, motility and morphology. These observations provide new aspects in the complex pathogenesis of infertility.
The aim of our study is to elucidate if there is a relationship between vitamin D and unexplained infertility and if it more prevalent in them.
The study is a case-control study had been conducted at Ain Shams maternity hospital and at Ain Shams immunology laboratories, enrolled 216 women into two groups. Each group contain 108 women, the case group with unexplained infertility women and the control group with fertile women.
After taking consent of cases a detailed general, family, past, obstetric and menstrual history. Also general, abdominal and local gynaecological examination had done. Also, laboratory investigations as FSH, LH,CBC, PT, aPTT, TSH, 1 hour Postprandial, ALT, AST, serum testosterone and semen analysis for men had been checked to determine any cause OF infertility or chronic disease to exclude these cases.
The vitamin D had been checked by ELISA by (Stat Fax 2100, USA) and calcium by (Au 480) (Beckman coulter, USA). Reference ranges were 8.4-10.2mg/dL for serum calcium and 25 (OH)D status was graded as deficiency if (<20 ng/mL).
The results of this study was revealed that vitamin D deficiency isn’t significant in women with unexplained infertility than control fertile women (82.1% versus 73.4% p-value =0.190) and also calcium isn’t significantly decreased in cases group than control group (mean: 8.12+/-1.32 versus 8.43+/-1.28 p-value 0.082) and there are no significancy with skin colour or exposure to Sun or albumin or phophate.