Vitamin D and endometriosis: Is there a correlation with disease severity?

Article information

Clin Exp Reprod Med. 2020;47(3):235-236

Publication date (electronic) : 2020 August 25

doi : https://doi.org/10.5653/cerm.2019.03342.r1

Jong Chul Baek¹, Jae Yoon Jo², Seon Mi Lee², In Ae Cho², Jeong Kyu Shin^2,3,4, Soon Ae Lee^2,3,4, Jong Hak Lee^2,3,4, Min-Chul Cho^4,5, Won Jun Choi^,2,3,4

¹Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Changwon, Korea

²Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea

³Department of Obstetrics and Gynecology, Gyeongsang National University College of Medicine, Jinju, Korea

⁴Institute of Health Sciences, Gyeongsang National University, Jinju, Korea

⁵Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea

Corresponding author: Won Jun Choi Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, 79 Gangnam-ro, Jinju 52727, Korea Tel: +82-55-750-8147 Fax: +82-55-759-1118 E-mail: choiwj@gnu.ac.kr

Received 2020 April 6; Revised 2020 April 8; Accepted 2020 April 9.

Thank you for your kind comments. Our research started with an interest in how vitamin D, which is involved in the immune response, affects the pathogenesis of endometriosis. Numerous research reports indicate that endometriosis can occur due to abnormal immune response activity, involving various pathological mechanisms [1,2]. In accordance with your comments, the authors sought to clarify the role of vitamin D as a biomarker for the diagnosis of endometriosis through this study. We also wanted to find evidence regarding whether vitamin D could be used as a treatment for endometriosis.

In our present study, we did not observe any link between endometriosis and vitamin D or vitamin D-binding protein. A reason for this finding may be that there were few cases and the results therefore could not reach statistical significance. In ongoing follow-up studies, the number of cases has been increased to augment the statistical power of the research.

As you said, the revised American Society for Reproductive Medicine (rASRM) classification has the advantages of being easy to use and being the most widely used system, but it has the disadvantage of not reflecting severity, certain locations (such as cul-de-sac lesions), or deep-infiltration lesions [3]. We agree that the Enzian classification is an alternative that addresses the disadvantages of the rASRM classification [4]. In order to apply the Enzian classification, however, the total number of patients would need to be increased. In addition, patient classification requires effort to describe findings in a purely morphological manner.

In accordance with your opinions, follow-up studies are planned with the goals of obtaining meaningful results regarding the role of vitamin D in the pathogenesis of endometriosis and exploring the role of vitamin D as a therapeutic agent.