Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec;44(12):3087-3092.
doi: 10.1007/s00296-024-05724-z. Epub 2024 Sep 25.

Ovarian reserve alteration in premenopausal women with systemic sclerosis

A C Pecher  1 , J C Henes  2   3 , A Demin  4 , E M Staufenberg  5 , M Henes  5
Affiliations

Ovarian reserve alteration in premenopausal women with systemic sclerosis

A C Pecher et al. Rheumatol Int. 2024 Dec.

Abstract

Anti-Muellerian hormone (AMH) is produced by the granulosa cells of ovarian follicles. It serves as a sensitive laboratory parameter for assessing ovarian reserve. A reduced ovarian reserve has been observed in patients with various autoimmune diseases. To compare serum levels of AMH as a surrogate parameter for ovarian reserve in female patients with systemic sclerosis compared to healthy controls and thereby assess fertility. In this single centre study from the University Hospital Tuebingen, Germany, we used serum samples to determine concentrations of AMH via an electrochemiluminescence immunoassay. We analysed 30 premenopausal female patients with systemic sclerosis and 30 age-matched healthy controls from 18 to 40 years. Patients who had received cyclophosphamide were excluded from this study. AMH levels were significantly reduced in patients with systemic sclerosis (955 ng/l versus 1.940 ng/L, p < 0.01). Interestingly, in contrast to healthy controls, we observed no significant correlation between age and AMH levels in patients. For women diagnosed with systemic sclerosis, especially at a younger age, regular assessment of AMH levels should be considered to improve guidance with regard to optimal pregnancy timepoint, fertility preservation and treatment options.

Keywords: Anti-Muellerian hormone; Autoimmune diseases; Fertility; Systemic sclerosis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interests: Ann-Christin Pecher received honoraria by Novartis, UCB, Boehringer Ingelheim. Joerg Henes received grant support for SSc studies by Miltenyi and NEOVI and honoraria for lectures by ABBVIE, Astra-Zeneca, BMS, GSK, Novartis, UCB, Boehringer Ingelheim; Pfizer, Johnson & Johnson; SOBI. All other authors stated no conflict of interest. Ethical standards: The study was approved by the local ethics committee of the Eberhard-Karls-University Tuebingen (IRB 454/2023BO2) and all participants gave their written informed consent.

Figures

Fig. 1
Fig. 1
Serum levels of Anti-Muellerian hormone (AMH) in 30 patients with systemic sclerosis (SSc) and 30 age-matched healthy controls (HC). A AMH levels were significantly lower in patients with SSc compared to HC (0.955 ng/l versus 1.940 ng/L, p < 0.01). B AMH concentration showed an inverse correlation between age at the timepoint of AMH measurement in HC (R2 = 0.282, p < 0.01) but not in SSc (R2 = 0.038, p = 0.34)
Fig. 2
Fig. 2
A/B Serum levels of Anti-Muellerian hormone (AMH) in patients with systemic sclerosis receiving different therapies (myophenolate mofetil [MMF], glucocorticoids [GC] as high as prednisone ≤ 5mg per day, azathioprine [AZA], and methotrexate [MTX]) compared to healthy controls (HC)) (2A). In addition patients with or without bosentan showed a significant difference (2B)
See this image and copyright information in PMC

References

    1. Nelson SM, Shaw M, Ewing BJ, McLean K, Vechery A, Briggs SF (2024) Antimullerian hormone levels are associated with time to pregnancy in a prospective cohort study of 3,150 women. Fertil Steril. 10.1016/j.fertnstert.2024.06.024 - PubMed
    1. Volovsky M, Seifer DB (2024) Current status of ovarian and endometrial biomarkers in predicting ART outcomes. J Clin Med 13:13. 10.3390/jcm13133739 - PMC - PubMed
    1. Galdo FD, Lescoat A, Conaghan PG, Ananyeva LP, Balbir-Gurman A, Bertoldo E, Boyadzhieva V, Castellví I, Colic J, Denton CP, Distler O, Aoufy KE, Emmel J, Farrington S, Gabrielli A, Galetti I, Hoffmann-Vold AM, Kowal-Bielecka O, Cerinic MM, Müller-Ladner U, Ostojic P, Rednic S, Santiago T, Suliman YA, Tarasova A, Vonk M, Allanore Y (2023) OP0234 2023 update of eular recommendations for the treatment of systemic sclerosis. Ann Rheum Dis 82(Suppl 1):154–155. 10.1136/annrheumdis-2023-eular.1383 - PubMed
    1. Wetzels JF (2004) Cyclophosphamide-induced gonadal toxicity: a treatment dilemma in patients with lupus nephritis? Neth J Med 62(10):347–352 - PubMed
    1. Leiper A, Houwing M, Davies EG, Rao K, Burns S, Morris E, Laven J, van der Kooi AL, van den Heuvel EM, Nussey S (2020) Anti-Mullerian hormone and Inhibin B after stem cell transplant in childhood: a comparison of myeloablative, reduced intensity and treosulfan-based chemotherapy regimens. Bone Marrow Transplant 55(10):1985–1995. 10.1038/s41409-020-0866-9 - PubMed

Publication types