Assessment of ovarian reserve by biomarkers in female patients with primary APS, SLE-associated APS and SLE

Abstract

Abstract Objectives To evaluate the ovarian reserve (OR) in women with systemic lupus erythematosus (SLE)-antiphospholipid syndrome (APS), and to determine the association between OR and clinical and laboratory parameters.Methods We compared the antral follicle count (AFC) and blood parameters of patients who were diagnosed with APS or SLE but had not yet been treated. We compared the presence of anticardiolipin antibody, and concentrations of anti-Müllerian hormone (AMH), inhibin B (INHB), follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), testosterone (T), and estradiol (E2) among patients with primary APS(PAPS), SLE-associated APS, and SLE who were treated at Jinhua Central Hospital between 2017 and 2020. We also conducted correlations and logistic regression analyses to identify the risk factors of OR failure in women with APS.Results Serum AMH levels were positively correlated with AFC and INHB levels in APS patients, and low AMH and high LH were independent risk factor for OR decline in APS patients. The receiver operating characteristic (ROC) curve also showed a high accuracy for AMH in the prediction of OR failure. Compared to healthy subjects (HS), patients with PAPS, SLE-APS, and SLE exhibited lower serum AMH, AFC, INHB, and E2 levels and higher FSH and LH levels (P < 0.05). Of all the patients, those with SLE-APS manifested the lowest serum AMH, AFC, INHB, and E2 levels and the highest FSH and LH levels (P < 0.05).Conclusions APS and SLE patients showed lower indications of OR, including AFC, AMH and LH, compared to HS. SLE-APS patients also appeared to have a lower OR than either SLE or PAPS patients. We noted that the low E2 levels in APS and SLE patients on day 3 of the menstrual cycle were not able to inhibit FSH release.