PMID- 31777809
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231019
IS  - 2578-5745 (Electronic)
IS  - 2578-5745 (Linking)
VI  - 1
IP  - 5
DP  - 2019 Jul
TI  - Reduced Ovarian Function in Female Rheumatoid Arthritis Patients Trying to 
      Conceive.
PG  - 327-335
LID - 10.1002/acr2.11043 [doi]
AB  - OBJECTIVE: Subfertility, a time to pregnancy (TTP) longer than 12 months, is 
      present in 40% of female patients with rheumatoid arthritis (RA) who are actively 
      trying to conceive. Because patients with RA appear to reach menopause at a 
      younger age, diminished ovarian function may explain the reduced fertility. Serum 
      anti-Mullerian hormone (AMH) levels are the best proxy to measure ovarian 
      function. Our objectives were to study AMH levels in female patients with RA and 
      determine the association of preconception serum AMH levels with TTP. METHODS: A 
      post hoc analysis was performed before conception in patients of the 
      Pregnancy-Induced Amelioration of Rheumatoid Arthritis (PARA) cohort. Serum AMH 
      levels were compared with those in an existing cohort of healthy controls using 
      analysis of covariance. Associations between AMH and TTP were studied using the 
      Cox proportional hazard analysis. RESULTS: Preconception serum was available in 
      209 women of the PARA cohort (aged 32.1 +/- 3.9 years), of whom 45% were subfertile 
      in the current episode. The median AMH level was 2.5 mug/l (interquartile range: 
      1.5-4.6). AMH levels were significantly lower compared with those in healthy 
      controls (P < 0.001), with 17% of patients having levels below the age-specific 
      10th percentile. A multivariable analysis showed a negative association of AMH 
      with the presence of anticitrullinated protein antibodies (ACPAs) (P = 0.009). 
      AMH levels showed no significant association with TTP (P = 0.26). CONCLUSION: 
      Women with RA have lower AMH levels than healthy controls, and AMH levels were 
      lower in ACPA-positive patients. However, because preconception AMH levels were 
      not associated with TTP, the reduced AMH levels do not explain the reduced 
      fertility in patients with RA.
CI  - (c) 2019 The Authors. ACR Open Rheumatology published by Wiley Periodicals Inc on 
      behalf of American College of Rheumatology.
FAU - Brouwer, Jenny
AU  - Brouwer J
AUID- ORCID: 0000-0003-0174-2201
AD  - Erasmus University Medical Center Rotterdam Rotterdam The Netherlands.
FAU - Dolhain, Radboud J E M
AU  - Dolhain RJEM
AD  - Erasmus University Medical Center Rotterdam Rotterdam The Netherlands.
FAU - Hazes, Johanna M W
AU  - Hazes JMW
AD  - Erasmus University Medical Center Rotterdam Rotterdam The Netherlands.
FAU - Visser, Jenny A
AU  - Visser JA
AD  - Erasmus University Medical Center Rotterdam Rotterdam The Netherlands.
FAU - Laven, Joop S E
AU  - Laven JSE
AD  - Erasmus University Medical Center Rotterdam Rotterdam The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20190704
PL  - United States
TA  - ACR Open Rheumatol
JT  - ACR open rheumatology
JID - 101740025
PMC - PMC6857972
OTO - NOTNLM
OT  - anti-Mullerian hormone
OT  - fertility
OT  - rheumatoid arthritis
OT  - women's health
EDAT- 2019/11/30 06:00
MHDA- 2019/11/30 06:01
PMCR- 2019/07/04
CRDT- 2019/11/29 06:00
PHST- 2019/11/29 06:00 [entrez]
PHST- 2019/11/30 06:00 [pubmed]
PHST- 2019/11/30 06:01 [medline]
PHST- 2019/07/04 00:00 [pmc-release]
AID - ACR211043 [pii]
AID - 10.1002/acr2.11043 [doi]
PST - epublish
SO  - ACR Open Rheumatol. 2019 Jul 4;1(5):327-335. doi: 10.1002/acr2.11043. eCollection 
      2019 Jul.