Reduced ovarian reserve in patients with Takayasu arteritis

To assess ovarian reserve markers in patients with Takayasu arteritis (TA).

Twenty patients with TA and 24 healthy controls were evaluated for ovarian reserve by follicle-stimulating hormone, luteinizing hormone, and estradiol, and antral follicle count (AFC). Anti-Müllerian hormone (AMH) was measured by ELISA using 2 different kits. Demographical data, menstrual abnormalities, disease variables, and treatment were also analyzed.

The median current age was similar in patients with TA and controls (31.2 ± 6.1 vs 30.4 ± 6.9 yrs, p = 0.69). The frequencies of decreased levels of AMH in patients with TA were identical using both kits and higher when compared to controls (50% vs 17%, p = 0.02; 50% vs 19%, p = 0.048). A positive correlation was observed between the 2 kits in patients with TA (r = +0.93, p < 0.0001) and in healthy controls (r = +0.93, p < 0.0001). The apparent lower AFC (11 vs 16, p = 0.13) and the higher frequency of low AFC (41% vs 22%, p = 0.29) in TA compared to controls did not reach statistical significance. Other hormones were similar in both groups (p > 0.05). Further evaluation of patients with TA with low AMH levels (< 1.0 ng/ml) versus normal AMH levels (> 1.0 ng/ml) revealed that the frequency of current disease activity (p = 1.0) and the median of erythrocyte sedimentation rate (p = 0.6), C-reactive protein (p = 0.4), prednisone cumulative dose (p = 0.8), and methotrexate cumulative dose (p = 0.8) were comparable in both groups. Cyclophosphamide use was reported in only 1 patient with reduced ovarian reserve, whereas none of the remaining patients received gonadotoxic drugs.

To the best of our knowledge, our present study was the first to suggest that patients with TA may have diminished ovarian reserve.