title: Iron overload is associated with low anti-müllerian hormone in women with transfusion-dependent β-thalassaemia.
abstract: OBJECTIVE
  To investigate anti-müllerian hormone (AMH) as a best test of ovarian reserve in women with transfusion-dependent β-thalassaemia, and the relationship between AMH and iron overload.
  
  
  METHODS
  A case-control study in a tertiary medical centre.
  
  
  METHODS
  Twenty-nine women with transfusion-dependent β-thalassaemia and 29 healthy controls of a similar age were recruited.
  
  
  METHODS
  Blood sampling, questionnaires and medical record reviews were used.
  
  
  METHODS
  The history of iron overload-related morbidities, haematological phenotypes, serum levels of AMH and ferritin, and hormonal profiles were analysed.
  
  
  RESULTS
  The serum levels of AMH, luteinising hormone, and estradiol were lower in women with transfusion-dependent β-thalassaemia than in age-matched normal controls. In women with transfusion-dependent β-thalassaemia, the serum AMH level was significantly inversely related to the ferritin level, but not related to the presence of hypogonadotrophic hypogonadism, diabetes and haematological phenotypes. The serum ferritin level was positively associated with advanced age and the presence of hypogonadotrophic hypogonadism in the study participants. However, the inverse relationship between AMH and ferritin still exists after further adjustment for advanced age in women with transfusion-dependent β-thalassaemia.
  
  
  CONCLUSIONS
  The present study indicates that the serum AMH levels in women with transfusion-dependent β-thalassaemia are lower when compared with normal healthy women of a similar age, and are significantly negatively correlated with their serum ferritin levels. This implies that ovarian function might be impaired by the chronic iron overload status in women with transfusion-dependent β-thalassaemia.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: H-H
authors.initials: HH
authors.lastname: Chang
authors.forename: M-J
authors.initials: MJ
authors.lastname: Chen
authors.forename: M-Y
authors.initials: MY
authors.lastname: Lu
authors.forename: J P S
authors.initials: JP
authors.lastname: Chern
authors.forename: C-Y
authors.initials: CY
authors.lastname: Lu
authors.forename: Y-L
authors.initials: YL
authors.lastname: Yang
authors.forename: S-T
authors.initials: ST
authors.lastname: Jou
authors.forename: D-T
authors.initials: DT
authors.lastname: Lin
authors.forename: Y-S
authors.initials: YS
authors.lastname: Yang
authors.forename: K-H
authors.initials: KH
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood* / Q000172:deficiency; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005293:Ferritins / Q000097:blood; D006785:Hospitals, University; D006801:Humans; D019190:Iron Overload / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D017086:beta-Thalassemia / Q000097:blood* / Q000628:therapy*
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone; D005293:Ferritins