title: Decreased ovarian reserve in HIV-infected women.
abstract: OBJECTIVE
  To evaluate HIV directly or indirectly related altered ovarian function, using serum anti-Müllerian hormone (AMH) levels in HIV-infected women as compared with seronegative women.
  
  
  METHODS
  We conducted a matched cohort study from January 2008 to December 2013 in a tertiary university centre. Two hundred and one HIV-infected women requesting assisted reproductive technology and 603 age and cause of infertility-matched HIV seronegative women were enrolled in this study.
  
  
  METHODS
  All data were prospectively collected using a semistructured questionnaire. Serum AMH levels in HIV-infected women and matched controls were compared. To find out the contributing factors to increased serum AMH levels in HIV-infected women, a backward multiple linear regression was performed.
  
  
  RESULTS
  Serum AMH levels were significantly lower in HIV-infected group as compared with seronegative controls (3.0 ± 2.8 vs 3.7 ± 3.5 ng/ml; respectively, P = 0.001). Looking for factors associated with altered AMH among HIV-infected women, an association has been shown between tubal disease and a further decrease in serum AMH levels (2.4 ± 2.4 vs 3.4 ± 3.0 ng/ml; respectively, P = 0.011). Among HIV-infected women, after multivariate linear regression analysis, we showed that increased age, BMI and viral load were associated with decreased serum AMH levels whereas in striking contrast an increase in CD4⁺ cell count was associated with an increase of serum AMH levels.
  
  
  CONCLUSIONS
  Serum AMH levels were lower in the HIV-infected group than in the control group. Age, BMI, CD4⁺ cell count and viral load were the independent contributors affecting serum AMH levels among HIV-infected women.
authors.affiliation: aDepartment of Gynecology, Obstetrics II and Reproductive Medicine, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin bDepartment 'Development, Reproduction and Cancer', Institut Cochin, INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité cInstitut Cochin, Université Paris Descartes, Sorbonne Paris Cité CNRS (UMR 8104) dDepartment of Histology, Embryology, and Biology of Reproduction, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin eUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Universitaire (GHU) Ouest, Centre Hospitalier Universitaire (CHU) Cochin, Infectiologie, Paris, France. *Diane de Villardi and Pietro Santulli contributed equally to this work.
authors.forename: Pietro
authors.initials: P
authors.lastname: Santulli
authors.forename: Diane
authors.initials: D
authors.lastname: de Villardi
authors.forename: Vanessa
authors.initials: V
authors.lastname: Gayet
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Lafay Pillet
authors.forename: Louis
authors.initials: L
authors.lastname: Marcellin
authors.forename: Valerie
authors.initials: V
authors.lastname: Blanchet
authors.forename: Julia
authors.initials: J
authors.lastname: Gonnot
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Dulioust
authors.forename: Odile
authors.initials: O
authors.lastname: Launay
authors.forename: Charles
authors.initials: C
authors.lastname: Chapron
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000473:pathology*; D006801:Humans; D065851:Ovarian Reserve; D011446:Prospective Studies
chemical_list: D054304:Anti-Mullerian Hormone