Department of Obstetrics and Gynecology, Acıbadem University Atakent Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Health Sciences University Kanuni Sultan Suleyman Suam, Istanbul, Turkey.
Ginekol Pol. 2021;92(8):550-555. doi: 10.5603/GP.a2020.0170. Epub 2021 Apr 12.
Crohn's disease (CD) is a repeating bowel disease characterized by remission and exacerbation periods. The disease mostly affects adults of reproductive age. Women with desires to conceive are concerned about the effects of CD on their fertility. To demonstrate the relationship between ovarian reserve and CD anti-Müllerian hormone (AMH) levels, antral follicle count (AFC) and ovarian volüme were evaluated.
The prospective case-controlled study was conducted at a tertiary referral center in Istanbul between March-August 2019. Ovarian functions were evaluated in 50 patients with CD and in 95 healthy women. Serum gonadotropin and AMH levels were determined. AFCs and ovarian volumes were calculated for all subjects.
AMH levels were significantly lower in CD patients (2.1 ± 0.8) compared to the control group (3.3 ± 0.9) (p = 0.001). Serum AMH levels were significantly lower in patients with active CD (2.1 ± 0.6) than the CD patients in remission (2.6 ± 0.8) (p = 0.002). Ovarian volumes and AFC values were significantly lower in both ovaries in CD patients compared to the controls (p < 0.05).
AMH levels, ovarian volume and AFC counts, and thus ovarian reserve was shown to be decreased in CD patients of reproductive age compared to healthy control subjects. Because possible effects of inflammatory damage may be seen in newly diagnosed female CD patients who desire to have a child, we believe that CD patients should be comprehensively assessed for ovarian reserve.
克罗恩病(CD)是一种反复发作的肠道疾病,其特征为缓解期和加重期。该疾病主要影响育龄期成年人。有生育需求的女性担心 CD 对其生育能力的影响。为了证明卵巢储备与 CD 抗苗勒管激素(AMH)水平、窦卵泡计数(AFC)和卵巢体积之间的关系,评估了这些指标。
这项前瞻性病例对照研究于 2019 年 3 月至 8 月在伊斯坦布尔的一家三级转诊中心进行。对 50 例 CD 患者和 95 名健康女性进行了卵巢功能评估。测定了血清促性腺激素和 AMH 水平。对所有受试者计算 AFCs 和卵巢体积。
与对照组(3.3 ± 0.9)相比,CD 患者的 AMH 水平明显更低(2.1 ± 0.8)(p = 0.001)。活动期 CD 患者(2.1 ± 0.6)的血清 AMH 水平明显低于缓解期 CD 患者(2.6 ± 0.8)(p = 0.002)。与对照组相比,CD 患者双侧卵巢的卵巢体积和 AFC 值均显著降低(p < 0.05)。
与健康对照组相比,生育期 CD 患者的 AMH 水平、卵巢体积和 AFC 计数(即卵巢储备)降低。由于新诊断的有生育需求的女性 CD 患者可能会出现炎症损伤的影响,我们认为 CD 患者应全面评估卵巢储备。