Ovarian reserve in women with primary antiphospholipid syndrome

Author(s)

Yamakami, L. Y. S. ^[1] ; Serafini, P. C. ^[1] ; de Araujo, D. B. ^{[2, 3]} ; Bonfa, E. ^[2] ; Leon, E. P. ^[2] ; Baracat, E. C. ^[1] ; Silva, C. A. ^{[4, 2]}

Affiliation

^[1] Hosp Serv Publ Estadual Sao Paulo, Dept Gynecol, Sao Paulo - Brazil

^[2] Hosp Serv Publ Estadual Sao Paulo, Div Rheumatol, Sao Paulo - Brazil

^[3] Hosp Serv Publ Estadual Sao Paulo, Dept Rheumatol, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Fac Med, Pediat Rheumatol Unit, Sao Paulo - Brazil

• Document type: Journal article
• Source: Lupus; v. 23, n. 9, p. 862-867, AUG 2014.
• Web of Science Citations: 16

Abstract

Objective: The objective of this paper is to evaluate ovarian reserve in primary antiphospholipid syndrome (PAPS) women and the association between ovarian reserve tests and clinical and laboratorial parameters, and anti-corpus luteum antibody (anti-CoL). Methods: We screened 85 female patients between 18 to 40 years old with APS. Of these, 67 patients were excluded because of association with other autoimmune diseases (n = 42), contraindication or unwillingness to stop hormonal contraceptive (n = 21), current pregnancy or breastfeeding (n = 3) and previous ovarian surgery (n = 1). Therefore, a cross-sectional study was conducted in 18 PAPS patients and 24 healthy women. They were evaluated at early follicular phase with measurement of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Mullerian hormone (AMH) and sonographic antral follicle count (AFC). Serum measurement of anti-CoL was determined by immunoblot analysis. All analyses were performed after at least six months from the last intake of hormonal contraceptive and resumption of menstruation. Results: The mean age was comparable in PAPS and controls (33.0 +/- 5.0 vs. 30.4 +/- 7.0 years; p = 0.19). Regarding ovarian reserve tests, the frequencies of low AFC (<= 10) (56% vs. 22%, p = 0.04) and very low AFC (<= 5) (37% vs. 9%, p = 0.04) were significantly higher in PAPS patients than controls. Trends of higher frequencies of reduced (< 1.0 ng/ml), low (< 0.5 ng/ml) and negligible (< 0.2 ng/ml) AMH levels were found in PAPS patients (p = 0.08, p = 0.07 and p = 0.07, respectively). FSH, LH and estradiol were similar in patients and controls. There was no association between low ovarian reserve and specific types of antiphospholipid antibodies. Anti-CoL was solely observed in PAPS patients (11% vs. 0%; p = 0.177) and was not related to ovarian reserve tests. Conclusion: Women suffering from PAPS possessed reduced ovarian reserve, with prevalence greater than 50%. (AU)

• FAPESP's process: 11/12471-2 - Ovarian reserve, antibody anti-corpus luteum and lower genital tract infection in adult women with systemic lupus erythematosus, Behçet's syndrome and Takayasu's arteritis
• Grantee: Clovis Artur Almeida da Silva
• Support Opportunities: Regular Research Grants