Background/Purpose: Recent publications showed a negative influence of systemic lupus erythematosus and antiphospholipid antibody syndrome on female ovarian reserve (OR). Other authors did not find a significant impact of Crohn’s disease or early rheumatoid arthritis (RA) on anti-Muellerian hormone (AMH) levels. This study aimed to investigate the potential effect of Behcet’s disease (BD), RA and spondyloarthritis (SpA) on OR, as reflected by serum AMH levels.

Methods: Serum samples of 33 RA, 32 SpA and 30 BD patients without previous cytotoxic – especially cyclophosphamide – treatment were analyzed and compared to age matched, healthy controls. AMH was quantified using a standard ELISA with standard value 1-8µg/l; values < 1µg/l defined as reduced, < 0.4µg/l as severely reduced fertility. All patients gave written informed consent and filled out a questionnaire on menstrual irregularities, lifestyle, pregnancy outcomes and contraception. For statistical analysis SPSS 19.0 was used and p<0.05 considered statistically significant.

Results: The median age was 26, 28.5 and 33 years and the disease duration was 6, 5.9 and 7 years for RA, SpA and BD patients, respectively. Compared to healthy controls the patients had significant reduced AMH levels with a median value for RA of 1.83 (control. 2.44; p=0.009), SpA 1.46 (control: 2.3; p=0.013) and for BD of 1.08 (control; 1.93; p=0.007). The mean number of children was 0.4 for RA, 0.5 for SpA and 1.0 for BD patients. The HLAB51 status and origin in BD patients were not associated with significant reduced AMH levels.

Conclusion: This is the first study to show the reduced OR in patients with RA, SpA and BD. Together with the findings in SLE we conclude a negative influence of chronic rheumatic diseases on OR.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ovarian-reserve-alterations-in-premenopausal-women-with-rheumatoid-arthritis-behcets-disease-and-spondyloarthritis-impact-on-anti-muellerian-hormone-levels/