title: Study of anti-Müllerian hormone and its relation to the subsequent probability of pregnancy in 112 patients with systemic lupus erythematosus, exposed or not to cyclophosphamide.
abstract: BACKGROUND
  Cyclophosphamide is used for renal and major extrarenal involvement in systemic lupus erythematosus (SLE) and is associated with a risk of premature ovarian failure. There are no data available about the relation between anti-Müllerian hormone (AMH) serum levels and the probability of subsequent pregnancy in SLE patients.
  
  
  OBJECTIVE
  We analyzed AMH levels and the probability of pregnancy in SLE women exposed to cyclophosphamide.
  
  
  METHODS
  We conducted a matched cohort study in referral centers for SLE.
  
  
  METHODS
  Fifty-six cyclophosphamide-exposed SLE women younger than 40 years of age and 56 control SLE women matched for age within 6 months participated in the study.
  
  
  METHODS
  AMH was measured in samples from the PLUS study (ClinicalTrials.gov no. NCT00413361). All patients were interviewed in May 2012 regarding their obstetric status.
  
  
  RESULTS
  The mean age ± SD of the 112 patients was 31.6 ± 5.8 years. The mean AMH level was low (1.21 ± 1.01 ng/mL) and was significantly lower in patients exposed to cyclophosphamide (P = .03) and in patients older than 30 years (P = .02). During a median follow-up (interval between sampling and the interview) period of 4.2 (range, 2.5-4.8) years, 38 patients sought to become pregnant, and 32 (84.2%) succeeded. In the univariate analysis, the risk of failure was associated with cumulative cyclophosphamide dose (P = .007) and older age (P = .02), but not with AMH.
  
  
  CONCLUSIONS
  We confirmed that AMH levels are low in SLE patients and decrease significantly with age and cyclophosphamide exposure. Nonetheless, the risk of failure to conceive was low and was predicted by cyclophosphamide exposure and age, but not by AMH levels.
authors.affiliation: University Pierre and Marie Curie (UPMC), Université Paris 6, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Morel
authors.forename: Anne
authors.initials: A
authors.lastname: Bachelot
authors.forename: Zeina
authors.initials: Z
authors.lastname: Chakhtoura
authors.forename: Pascale
authors.initials: P
authors.lastname: Ghillani-Dalbin
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
authors.forename: Lionel
authors.initials: L
authors.lastname: Galicier
authors.forename: Olivier
authors.initials: O
authors.lastname: Aumaitre
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
authors.forename: Jacques
authors.initials: J
authors.lastname: Pourrat
authors.forename: Du
authors.initials: D
authors.lastname: Boutin
authors.forename: Karim
authors.initials: K
authors.lastname: Sacre
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: Kahn
authors.forename: Pierre
authors.initials: P
authors.lastname: Duhaut
authors.forename: Dominique
authors.initials: D
authors.lastname: Farge
authors.forename: Camille
authors.initials: C
authors.lastname: Francès
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Guettrot-Imbert
authors.forename: Jean-Robert
authors.initials: JR
authors.lastname: Harlé
authors.forename: Olivier
authors.initials: O
authors.lastname: Lambotte
authors.forename: Véronique
authors.initials: V
authors.lastname: Le Guern
authors.forename: Damien
authors.initials: D
authors.lastname: Sène
authors.forename: Salim
authors.initials: S
authors.lastname: Trad
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Vidal
authors.forename: Francoise
authors.initials: F
authors.lastname: Sarrot-Reynauld
authors.forename: Anne
authors.initials: A
authors.lastname: Gompel
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Tanguy
authors.forename: Philippe
authors.initials: P
authors.lastname: Touraine
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Lacorte
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costedoat-Chalumeau
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000188:drug therapy; D011247:Pregnancy; D017697:Premenopause / Q000097:blood
chemical_list: D007166:Immunosuppressive Agents; D054304:Anti-Mullerian Hormone; D003520:Cyclophosphamide