Dubai: Fertility rates in the Middle East are becoming increasingly impacted by widespread vitamin D deficiency combined with rising obesity rates, which stem from regional-specific lifestyle factors. There is now an increased requirement to develop educational public health strategies for couples, in order to raise awareness about the impact of these issues on female fertility.
Vitamin D deficiency is considered to be one of the primary causes contributing towards a reduced likelihood of impregnation and an increased risk of pregnancy complications. Lack of the vitamin can also contribute towards a decreased reserve of eggs in women, by influencing AMH (Antimullerian Hormone) levels, which can affect egg quality and pregnancy rates. There are different factors in the Middle East which contribute to the low sun exposure which leads to low vitamin D levels in women of reproductive age. A high prevalence of vitamin D deficiency is extensive scientific evidence confirming the significance of sunlight exposure in vitamin D synthesis. Other than clothing, vitamin D deficiency has also been associated with insufficient dietary intake of vitamin D, environmental conditions, and key population characteristics, as well as increased time spent on indoor activities, such as computers and television.
Specific proposals aiming to counteract these factors include vitamin D fortification of milk, dairy products and other foods and beverages, use of multivitamin tablets and encouraging a more active outdoor lifestyle.
Another key factor contributing towards an increased risk of infertility is an elevated body mass index (BMI) (>30 kg/m2), which can cause hormone abnormalities and ovulation dysfunction. Menstrual irregularities, anovulation, and low conception rates in particular have all been associated with obesity through its effect on the hypothalamic pituitary ovarian axis.
Experts suggest that obese women undergoing IVF treatment are significantly more likely to respond inadequately to controlled ovarian hyper stimulation (COH) and to fail in achieving pregnancy compared with non-obese women. Increased BMI is also associated with a greater need for fertility hormones such as gonadotropins, lower pregnancy rates), fewer eggs, and higher miscarriage rates amongst women undergoing assisted reproductive technique (ART).
-The author is reproductive endocrinologist and fertility specialist at Fakih IVF
