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Is Fertility Affected in Women of Childbearing Age with Multiple Sclerosis or Neuromyelitis Optica Spectrum Disorder?
Journal of Molecular Neuroscience ( IF 2.8 ) Pub Date : 2020-08-01 , DOI: 10.1007/s12031-020-01576-x
Niyousha Sadeghpour 1 , Omid Mirmosayyeb 1, 2, 3 , Geir Bjørklund 4 , Vahid Shaygannejad 2, 5
Affiliation  

Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disease of the central nervous system (CNS), which is more prevalent among women of childbearing age. Neuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune disease of the CNS with similar prevalence features to MS and has recently been considered a different entity from MS. Measuring ovarian reserve is one way of evaluating fertility. Anti-Müllerian hormone (AMH) is a peptide hormone produced by ovarian granulosa cells of early follicles and is considered to be a marker for ovarian reserve. With MS and NMOSD predominance in young women, the present study aimed to address the possibility of these diseases affecting fertility by measuring AMH levels in MS and NMOSD patients and comparing it with healthy controls. The present study included 23 relapsing-remitting MS (RRMS) patients, 23 seronegative NMOSD patients, and 23 healthy age-matched controls between 18 and 45 years of age. Serum samples of the three groups were collected, and the AMH levels were measured with AMH Gen II Enzyme-Linked Immunosorbent Assay, Beckman Coulter kit. In the present study, the AMH levels did not differ significantly between the groups (p = 0.996). The mean AMH in the RRMS group was 3.59 ± 0.55 ng/ml compared with the mean of 3.60 ± 0.50 ng/ml in healthy controls. The mean AMH levels in the NMOSD group were 3.66 ± 0.61 ng/ml. Lower levels of AMH were found to be negatively associated with annualized relapse rate (in both groups of patients) and MS severity score. However, the difference was not significant. In NMOSD patients, the serum levels of AMH were negatively associated with disease duration (r = − 0.42, p = 0.023). There had been a significant negative correlation between mean AMH serum levels with Expanded Disability Status Scale (EDSS) at the time of diagnosis and at the time of study in the NMOSD group (r = − 0.402, p = 0.03 and r = − 0.457, p = 0.014, respectively). There was not a significant difference in mean serum AMH levels between RRMS and NMOSD patients compared with that of healthy controls. Further studies with larger sample sizes should be conducted, which take more variables affecting fertility in women with either RRMS or NMOSD into account to put an end to the controversial issue of fertility in this area.



中文翻译:

患有多发性硬化症或视神经脊髓炎谱系障碍的育龄妇女的生育能力会受到影响吗?

多发性硬化症(MS)是一种慢性免疫介导的中枢神经系统(CNS)脱髓鞘疾病,在育龄妇女中更为普遍。视神经脊髓炎谱系障碍 (NMOSD) 是一种严重的 CNS 自身免疫性疾病,具有与 MS 相似的流行特征,最近被认为与 MS 不同。测量卵巢储备是评估生育能力的一种方法。抗苗勒管激素(AMH)是一种由早期卵泡的卵巢颗粒细胞产生的肽激素,被认为是卵巢储备的标志物。由于 MS 和 NMOSD 在年轻女性中占主导地位,本研究旨在通过测量 MS 和 NMOSD 患者的 AMH 水平并将其与健康对照组进行比较来解决这些疾病影响生育能力的可能性。本研究包括 23 名复发缓解型 MS (RRMS) 患者、23 名血清阴性 NMOSD 患者和 23 名年龄在 18 至 45 岁之间的健康年龄匹配对照。采集三组血清标本,采用AMH Gen II酶联免疫吸附试验、Beckman Coulter试剂盒测定AMH水平。在本研究中,各组之间的 AMH 水平没有显着差异(p  = 0.996)。RRMS 组的平均 AMH 为 3.59 ± 0.55 ng/ml,而健康对照组的平均值为 3.60 ± 0.50 ng/ml。NMOSD 组的平均 AMH 水平为 3.66 ± 0.61 ng/ml。发现较低水平的 AMH 与年复发率(两组患者)和 MS 严重程度评分呈负相关。然而,差异并不显着。在 NMOSD 患者中,AMH 的血清水平与病程呈负相关(r  = - 0.42,p  = 0.023)。在 NMOSD 组诊断时和研究时,平均 AMH 血清水平与扩展残疾状态量表 (EDSS) 呈显着负相关(r  = - 0.402,p  = 0.03 和r = - 0.457,p  = 0.014,分别)。与健康对照组相比,RRMS 和 NMOSD 患者的平均血清 AMH 水平没有显着差异。应进行更大样本量的进一步研究,将影响 RRMS 或 NMOSD 女性生育能力的更多变量考虑在内,以结束该领域有争议的生育问题。

更新日期:2020-08-01
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