الفهرس 
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Abstract
Summary
Terine fibroidsare the most common benign pelvic tumors in women of reproductive age with an incidence ranging from 5.4% to 77%, which grow in the uterine muscle of premenopausal women. African American race, null parity, obesity, and a positive family history of fibroids are the risk factors for high rate of leiomyoma, they may be asymptomatic or can cause abnormal bleeding, pelvic pressure symptoms, infertility and growth or regress throughout the life. Leiomyoma affects millions of women and it is a leading cause of hysterectomy.
Functional effects of vitamin D include reduced cell proliferation, increased apoptosis, enhanced differentiation, and regulation of biological processes including angiogenesis, extracellular matrix production, and immune response. The pathogenesis of fibroids has been hypothesized to involve a positive feedback loop between extracellular matrix production and cell proliferation, and vitamin D might act to block the positive feedback.
Recently, vitamin D has been identified as a potential antitumor compound, inhibiting uterine fibroid cells and reducing fibroid lesions demonstrating the role of vitamin D as antitumoral agent. Recent evidence demonstrates a correlation between vitamin D serum deficiency and increased risk of uterine fibroids.
In this study, we aimed to evaluate the effect of vitamin-D supplementation on the size of Uterine fibroid in patients with vitamin-D deficiency.
This randomized controlled trial was conducted at tertiary care hospital at Beni-Suef university hospital from January 2022 till October 2022 andperformed on a total of 100 women in child bearing period diagnosed with uterine fibroid who had vitamin- D deficiency.
The current study revealed that there was no significant difference among both groups regarding demographic characteristics (age, BMI, parity, age at menarche, sun exposure) and clinical characteristics (Vitamin D level at the beginning of the study and size of the fibroid).
After Vitamin D supplementation for 6 months, the current study results revealed that the group who receive Vitamin D supplementation showed a sufficient level of Vitamin D while all studied patients in the control group showed Vitamin D deficiency with a significant difference between the mean and the mean difference of Vitamin D level at 6 months between the Vitamin D group and control group.
As regards the fibroid size after Vitamin D supplementation for 6 months, the current study results revealed that there is no significant difference in the size of the fibroid between Vitamin D group and control group over the first three months while the size of the fibroid was significantly lower in the Vitamin D group at the fourth, fifth month and sixth months.
Consequently, the size of the tumor decreased significantly over the six months in the group of Vitamin D supplementation with no significant improvement in the size of the fibroid over the 6 months in the control group.
We concluded that vitamin D supplement is a simple, safe and inexpensive modality for leiomyoma growth prevention and low-risk treatment for fibroids stabilization, preventing the progression to more severe and symptomatic conditions. Vitamin D supplementation seems to prevent fibroid growth.
We recommended that Serum vitamin D level should be done as routine investigation in women diagnosed with uterine fibroids and corrected in case of deficiency which may reduce the progression to an extensive disease, and thus the need of conventional surgical or medical therapy.