Reproductive function of women with rheumatoid arthritis: the effect of the disease and methotrexate therapy on the serum level of anti-Mhllerian hormone
- Autores: Perminova S.G1, Vlasova G.A1, Kosheleva N.M2
-
Afiliações:
- V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia
- V.A. Nasonova Research Institute of Rheumatology
- Edição: Nº 4 (2020)
- Páginas: 104-110
- Seção: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/248891
- DOI: https://doi.org/10.18565/aig.2020.4.104-110
- ID: 248891
Citar
Texto integral
Acesso aberto
Acesso está concedido
Acesso é pago ou somente para assinantes
Resumo
Aim. To investigate ovarian reserve using anti-Mullerian hormone (AMH) as a marker of ovarian reserve in patients with rheumatoid arthritis (RA) and infertility, who received or did not receive methotrexate (MTX) therapy. Materials and methods. The observational study comprised 72 patients with infertility. Of them, patients with RA (n=32) constituted the study group, and patients without RA (n=40) made up the control group. Patients with RA were stratified into subgroups based on whether or not they received MTX. The level of AMH was evaluated concerning RA duration and activity, as well as the age at initiation of MTX therapy, dosage, and treatment duration. Results. There was a statistically significant decrease in the level of AMH in RA patients compared with patients with infertility only, and MTX therapy was associated with a reduction in ovarian reserve. No statistically significant differences in the levels of AMH were found regarding RA duration and activity, as well as the total dose and duration of MTX therapy. Conclusions. Patients with RA have lower serum AMH levels. MTX therapy is associated with a more significant decrease in AMH levels. The age at initiation of MTX therapy is negatively correlated with the AMH level.
Texto integral
Sobre autores
S. Perminova
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia
Email: perisvet@list.ru
Associate Professor, Dr.Med.Sci., Leading Researcher at the 1st Department of Gynecology 117997 Russia, Moscow, Ac. Oparina str. 4
G. Vlasova
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia
Email: galinavlasova089@gmail.com
Ph.D. Student at the 1st Department of Gynecology 117997 Russia, Moscow, Ac. Oparina str. 4
N. Kosheleva
V.A. Nasonova Research Institute of Rheumatology
Email: nadkosheleva@yandex.ru
Ph.D., Senior Researcher at the Laboratory of Vascular Rheumatology 115522 Russia, Moscow, Kashirskoye Shosse 34A
Bibliografia
- Насонов Е.Л., ред. Ревматология. Российские клинические рекомендации. М.: «ГЭОТАР-Медиа», 2017. 456 с
- Jawaheer D., Zhu J.L., Nohr E.A., et al. Time to pregnancy among women with rheumatoid arthritis. Arthritis Rheum. 2011; 63(6): 1517-21. doi: 10.1002/ art.30327.
- Clowse M., Chakravarty E., Costenbader K. H., Chambers C., Michaud, K. Effects of infertility, pregnancy loss and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res. (Hoboken). 2012; 64(5): 668-74. doi: 10.1002/acr.21593.
- Brouwer J., Hazes J.M., Laven J.S., Dolhain R.J. Fertility in women with rheumatoid arthritis: influence of disease activity and medication. Ann. Rheum. Dis. 2015; 74(10):1836-41. doi: 10.1136/annrheumdis-2014-205383.
- Brouwer J., Fleurbaaij R., Hazes J.M., Dolhain, R.J., Laven J. S. Subfertility in rheumatoid arthritis is often unexplained or caused by anovulation. Arthritis Care Res (Hoboken). 2017; 69(8): 1142-9. doi: 10.1002/ acr.23124.
- Andreoli L., Bertsias G.K., Agmon-Levin N., Brown S., Cervera R., Costedoat-Chalumeau N., et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann. Rheum. Dis. 2017; 76(3): 76-85. doi: 10.1136/annrheum-dis-2016-209770.
- Van Sinderen M., Menkhorst E., Winship A., Cum an C., Dimitri a dis E. Preimplantation human blastocyst-endometrial interactions: the role of inflammatory mediators. Am J Reprod Immunol 2013; 69(5): 427-40. doi: 10.1111/ aji.12038.
- Ince-Askan H., Dolhain R.J. Pregnancy and rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2015; 29(4-5): 580-96. doi: 10.1016/j.berh.2015.07.001.
- Micu M.C., Micu R., Ostensen M. Luteinized unruptured follicle syndrome increased by inactive disease and selective cyclooxygenase 2 inhibitors in women with inflammatory arthropathies. Arthritis Care Res. 2011; 63(9):1334-8. doi: 10.1002/acr.20510.
- Mendonca L.L., Khamashta M.A., Nelson-Piercy C., Hunt B.J., Hughes G.R. Non-steroidal anti- inflammatory drugs as a possible cause for reversible infertility. Rheumatology. 2000; 39(8): 880-2.
- Saketos M., Sharma N., Santoro N.F. Suppression of the hypothalamic-pituitary-ovarian axis in normal women by glucocorticoids. Biol Reprod. 1993; 49(6): 1270-6.
- McLaren J.F., Burney R.O., Milki A.A., Westphal L.M., Dahan M.H., Lathi R.B. Effect of methotrexate exposure on subsequent fertility in women undergoing controlled ovarian stimulation. Fertil Steril. 2009; 92: 515-9. doi: 10.1016/j. fertnstert.2008.07.009
- Brouwer J., Laven, J.S., Hazes J.M., Schipper I., Dolhain R.J. Levels of serum anti-Mullerian hormone, a marker for ovarian reserve, in women with rheumatoid arthritis. Arthritis Care Res. (Hoboken) 2013; 65(9): 1534-8. doi: 10.1002/ acr.22013.
- Hill M.J., et al. Ovarian reserve and subsequent assisted reproduction outcomes after methotrexate therapy for ectopic pregnancy or pregnancy of unknown location. Fertil. Steril. 2014; 101(2): 413-9. doi: 10.1016/j.fertnstert.2013.10.027.
- Henes M, et al. Ovarian reserve alterations in premenopausal women with chronic inflammatory rheumatic diseases: impact of rheumatoid arthritis, Behcet’s disease and spondyloarthritis on antiMullerian hormone levels. Rheumatology (Oxford) 2015; 54(9): 1709-12. doi: 10.1093/rheumatology/ kev124.
- Sowers M, et al. Anti-Mullerian hormone and inhibin B variability during normal menstrual cycles. Fertil. Steril. 2010; 94(4): 1482-6. doi: 10.1016/j. fertnstert.2009.07.1674.
- Manger K., Wildt L., Kalden J.R., Manger B. Prevention of gonadal toxicity and preservation of gonadal function and fertility in young women with systemic lupus erythematosus treated by cyclophosphamide: the PREGO-Study. Autoimmunity reviews. 2006; 5(4):269-272.
Arquivos suplementares
