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Fertility and Ovarian Reserve among Women with Rheumatoid Arthritis

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Eudy AM1, McDaniel G1, Hurd WW1, Clowse MEB1. J Rheumatol. 2018 Nov 15. pii: jrheum.180176. doi: 10.3899/jrheum.180176. [Epub ahead of print]

Abstract

Author information 1 From the Division of Rheumatology and Immunology, Department of Medicine, Duke University Medical Center; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA. Pfizer Inc. provided the funding for this project through its ASPIRE award program for investigator-initiated studies. It had no say on the design or conduct of the research, and did not alter the manuscript. M.E. Clowse is a consultant for UCB regarding issues surrounding the use of certolizumab for RA in pregnancy. This work does not involve issues of infertility or AMH. A.M. Eudy, PhD, Postdoctoral Associate, Division of Rheumatology and Immunology, Duke University Medical Center; G. McDaniel, PA-C, Clinical Research Coordinator, Division of Rheumatology and Immunology, Duke University Medical Center; W.W. Hurd, MD, MSc, MPH, Professor and Director, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Duke University Medical Center; M.E. Clowse, MD, MPH, Associate Professor of Medicine, Division of Rheumatology and Immunology, Duke University Medical Center. Address correspondence to A.M. Eudy, Duke University Medical Center, Division of Rheumatology and Immunology, DUMC 3490, Durham, North Carolina 27710, USA. E-mail: amanda.eudy@duke.edu. Accepted for publication August 10, 2018.

Abstract

OBJECTIVE: We sought to identify causes for infertility in women with and without rheumatoid arthritis (RA).

METHODS: Women with RA were matched to healthy controls. Differences in anti-M├╝llerian hormone (AMH) and anovulation were analyzed.

RESULTS: Women with RA had lower AMH (╬▓ -1.05, 95% CI -2.09 to -0.005), but no difference was observed when AMH was log-transformed. No difference in anovulation was observed. Infertility prevalence was similar between groups, primarily attributable to polycystic ovary syndrome in healthy controls but largely unexplained in women with RA.

CONCLUSION: AMH was lower in women with RA, but reasons for infertility among women with RA remain unknown.