Role of IGF1, VEGF, Vit. D3 and Vit. B12 in high AMH level in Iraqi Infertile women as criteria to prepare them for IVF

High Anti-mullerian hormone (AMH) level is a view of PCOS which is a common metabolic dysfunction and heterogeneous endocrine disorder in women of reproductive age. Although women with high level of serum AMH usually characterized by increase LH/FSH ratio and increase number of oocytes retrieved during IVF, they are often of very poor quality, leading to lower aspect of fertilization cleavage and poor implantation rate and then high ratio of miscarriage rate. The aims of this study was to asses and compare serum vitamin D3 and hormonal profile in infertile women with normal AMH value and high AMH value, and use these data as criteria for treatment and IVF. Study samples taken from 70 infertile female patients and selected high AMH level patients and also performed ultra sound scan and found polycystic ovaries distributed on the periphery of the ovarian cortex (PCOS pattern ovaries), furthermore we collected 20 controls from normal AMH infertile women. The total number of infertile women equal to 90 women with history of infertility (more than one year) and high AMH level. Seventy women of high AMH level estimation of D3, B12, IGF1 and VEGF1. Twenty women of normal AMH level estimation of D3, B12, IGF1 and VEGF1. Vitamin D3 replacement significantly decreases serum level of VEGF correlating with decrease IGF1 level in serum of women with highly level of AMH. This is a novel molecular explanation for the beneficial effects of Vit D3 supplementation. It is also suggest the need to investigate and evaluate the potential role of vitamin D3 in reducing the level of AMH in serum and reducing severity of OHSS in vitamin D3 deficient women with high AMH serum level.