title: Ovarian reserve alterations in premenopausal women with chronic inflammatory rheumatic diseases: impact of rheumatoid arthritis, Behçet's disease and spondyloarthritis on anti-Müllerian hormone levels.
abstract: OBJECTIVE
  Recent publications have shown a negative influence of SLE on female ovarian reserve. Other authors have not found a significant impact of Crohn's disease or early RA on anti-Müllerian hormone (AMH) levels. This study aimed to investigate the potential effect of Behçet's disease (BD), RA and SpA on ovarian reserve as reflected by serum AMH levels.
  
  
  METHODS
  Serum samples from 33 RA, 32 SpA and 30 BD patients without previous cytotoxic treatment were analysed and compared with age-matched, healthy controls. AMH was quantified using a standard ELISA with a standard value of 1-8 ng/ml; values <1 ng/ml defined a reduced ovarian reserve.
  
  
  RESULTS
  Median age was 26, 28.5 and 33 years and median disease duration was 6, 5.9 and 7 years for RA, SpA and BD patients, respectively. Compared with healthy controls, patients had significantly reduced AMH levels, with a median value for RA of 1.8 ng/ml (control 2.4 ng/ml; P = 0.009), for SpA of 1.5 ng/ml (control 2.3 ng/ml; P = 0.013) and for BD of 1.1 ng/ml (control 1.9 ng/ml; P = 0.007). HLA-B27 had a negative influence on ovarian reserve in SpA patients, whereas other serological parameters did not in the other diseases.
  
  
  CONCLUSIONS
  This is the first study to show a reduced ovarian reserve in patients with RA, SpA or BD. Together with our findings in SLE, we conclude a negative influence of chronic rheumatic diseases on ovarian reserve.
authors.affiliation: Department of Gynaecology and Obstetrics.
authors.forename: Melanie
authors.initials: M
authors.lastname: Henes
authors.affiliation: Department of Gynaecology and Obstetrics.
authors.forename: Julia
authors.initials: J
authors.lastname: Froeschlin
authors.affiliation: Department of Gynaecology and Obstetrics.
authors.forename: Florin A
authors.initials: FA
authors.lastname: Taran
authors.affiliation: Department of Gynaecology and Obstetrics.
authors.forename: Sara
authors.initials: S
authors.lastname: Brucker
authors.affiliation: Department of Gynaecology and Obstetrics.
authors.forename: Kristin K
authors.initials: KK
authors.lastname: Rall
authors.affiliation: Department of Internal Medicine II (Oncology, Haematology, Immunology, Rheumatology, Pulmonology), University Hospital Tuebingen, Tuebingen, Germany and.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Xenitidis
authors.affiliation: Department of Internal Medicine II (Oncology, Haematology, Immunology, Rheumatology, Pulmonology), University Hospital Tuebingen, Tuebingen, Germany and.
authors.forename: Annette
authors.initials: A
authors.lastname: Igney-Oertel
authors.affiliation: Fakih Infertility Centre, Private Hospital, Abu Dhabi, United Arab Emirates.
authors.forename: Barbara
authors.initials: B
authors.lastname: Lawrenz
authors.affiliation: Department of Internal Medicine II (Oncology, Haematology, Immunology, Rheumatology, Pulmonology), University Hospital Tuebingen, Tuebingen, Germany and joerg.henes@med.uni-tuebingen.de.
authors.forename: Joerg C
authors.initials: JC
authors.lastname: Henes
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D001528:Behcet Syndrome / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D016022:Case-Control Studies; D005193:Family Planning Services; D005260:Female; D015796:HLA-B27 Antigen / Q000097:blood; D059949:HLA-B51 Antigen / Q000097:blood; D006801:Humans; D065851:Ovarian Reserve / Q000502:physiology*; D010053:Ovary / Q000503:physiopathology; D017697:Premenopause / Q000502:physiology*; D012217:Rheumatoid Factor / Q000097:blood; D025241:Spondylarthritis / Q000097:blood* / Q000150:complications / Q000503:physiopathology
chemical_list: D015796:HLA-B27 Antigen; D059949:HLA-B51 Antigen; D054304:Anti-Mullerian Hormone; D012217:Rheumatoid Factor
keywords: AMH; Behçet’s disease; fertility; ovarian reserve; rheumatoid arthritis; spondyloarthritis