Main Article Content
Uterine leiomyoma, Infertility, Serum vitamin D3
Background: In women of reproductive age, uterine fibroid, a benign tumour of the uterine smooth muscle, is a common cause of menorrhagia and dysmenorrhea. Fibroid etiopathogenesis involves numerous factors. The aetiology of fibroids is influenced by hormonal variables, although other causes are still unknown. According to some theories, uterine fibroids form as a result of an inappropriate response to tissue repair that alters the formation of extracellular matrix. Vitamin D may be able to prevent this abnormal response by controlling it.
Objective: The study was conducted to determine the frequency of leiomyoma in patients presenting with infertility and to compare the mean serum vitamin D3 levels in females with and without leiomyoma.
Study design: A cross-sectional study
Place and Duration: This study was conducted in Jinnah Hospital, Lahore from July 2021 to January 2022
Methodology: Using a non-probability, consecutive sampling method 101 cases of 18 to 40 years presenting with infertility were included in the study. These patients were then divided into two groups on the bases of ultrasound findings. The group I included the patients with uterine fibrosis and group II included those without uterine fibrosis. Later, 5 ml of blood was drawn from each patient under an aseptic measure and was sent to the lab for measurement of serum vitamin-D3 levels. All the collected data was entered and analyzed into SPSS version 25
Results: The findings of this study revealed that the mean BMI was 27.99±5.95 kg/m2, mean serum vitamin-D3 levels was 31.67±4.179 ng/ml and mean age was calculated as 30.65±3.48 years. It was observed that 24.8 %( n=25) were in the age group of 18-28 years. There were 56.44% (n=57) females from rural areas, and the Frequency of uterine leiomyoma was 15.8 % (n=16). The t-test of association revealed that patients with uterine leiomyoma had lesser mean Vit D3 levels compared to the patients without uterine leiomyoma with a significant p-value <0.05
Conclusion: We found that the frequency of uterine leiomyoma was 15.8 % (n=16). Both groups were compared for mean serum vitamin-D3 levels. P=0.000. It is concluded from the study results that the mean percentage of serum vitamin D3 level was significantly lower in uterine leiomyoma patients.
2. Sohn GS, Cho SH, Kim YM, Cho CH, Kim MR, Lee SR. Obstet Gynecol Sci 2018;61(2):192–201.
3. McWilliams MM, Chennathukuzhi VM. Recent Advances in Uterine Fibroid Etiology. Semin Reprod Med 2017;35(2):181–9.
4. Mas A, Tarazona M, Carrasco JD, Estaca G, Cristóbal I, Monleón J. Updated approaches for management of uterine fibroids. Int J Womens Health 2017;9:607–17.
5. Woźniak A, Woźniak S. Ultrasonography of uterine leiomyomas. Prz Menopauzalny 2017;16(4):113–7.
6. Jadoon SA, Ahmed A, Alam MA. Vitamin-D deficiency in Pakistan: tip of iceberg. J Ayub Med Coll Abbottabad 2018;30(1):78–80..
7. Izhar R, Husain S, Tahir S, Husain S. Incidence of intrauterine abnormalities in Pakistani women with unexplained infertility diagnosed via saline infusion sonography. Journal of ultrasonography. 2018;18(74):186.
8. Paffoni A, Somigliana E, Vigano P, Benaglia L, Cardellicchio L, Pagliardini L, et al. Vitamin D Status in Women with Uterine Leiomyomas. J Clin Endocrinol Metab 2013;98(8):E1374-8.
9. Singh V, Barik A, Imam N. Vitamin D3 Level in Women with Uterine Fibroid: An Observational Study in Eastern Indian Population. J Obstet Gynaecol India 2019;69(2):161-5.
10. Khyade RL. A study of menstrual disturbance in cases of fibroid uterus. Int J Reprod Contracept Obstet Gynecol. 2017;6:2494–2497.
11. Schwartz SM, Marshall LM, Baird DD. Epidemiologic contributions to understanding the etiology of uterine leiomyomata. Environ Health Perspect. 2000;108(suppl 5):821–827.
12. Makariou S, Liberopoulos EN, Elisaf M, et al. Novel roles of vitamin D in disease: what is new in 2011? Eur J Intern Med. 2011;22:355–362.
13. Shahani Z, Shaikh AR, Gemnani VK, Abro K, Aizuddin AN, Manaf MR, Shahani MP. Neonatal Morbidity Patterns and Admission Outcomes: A Cross Sectional Study at a Tertiary Care Hospital in Pakistan. Journal of Pharmaceutical Research International. 2022 Jan 10:72-6.
14. Talreja W, Jhatial IA, Panhwar M, Siyal MA, Shahani MP, Khoso AA, Aijaz K. FREQUENCY OF HEPATOTROPHS (A, B & C VIRUSES) IN HEPATIC ENCEPHALOPATHY AND THEIR OUTCOME IN CHILDREN.
15. Ciavattini A, Carpini GD, Serri M, Vignini A, Sabbatinelli J, Tozzi A, Aggiusti A, Clemente N. Hypovitaminosis D and “small burden” uterine fibroids: Opportunity for a vitamin D supplementation. Medicine. 2016 Dec;95(52).
16. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911–30.
17. Ciarmela P, Ciavattini A, Giannubilo SR, et al. Management of leiomyomas in perimenopausal women. Maturitas 2014;78:168–73.
18. Baker TG. Radiosensitivity of mammalian oocytes with particular reference to the human female. Am J Obstet Gynecol. 1971 Jul 01;110(5):746-61.
19. Gupta A. Vitamin D deficiency in India: prevalence, causalities and interventions. Nutrients. 2014;6(2):729–775
20. Munusamy MM, Sheelaa WG, Lakshmi VP. Clinical presentation and prevalence of uterine fibroids: a 3-year study in 3-decade rural South Indian women. Int J Reprod Contracept Obstet Gynecol. 2017;6:5596–5601.