Ovarian reserve decreases in women with Crohn's disease: clinical characteristics and risk factors-a case control study

Abstract

Abstract Background:Crohn’s disease(CD), often occurring in women of child-bearing age, can decline the fertility rate. However, whether it reduces ovarian reserve has been rarely reported. This study aimed to evaluate the ovarian reserve in women with CD from the perspective of anti-müllerian hormone(AMH), and explore the factors that can decrease ovarian reserve. Methods: A case-control retrospective study was designed. We analyzed the AMH levels in a total of 135 CD women and 878 healthy controls. Then using the technique of propensity score matching, the subjected were grouped in a ratio of 1:3, according to age, body mass index and smoking status. Finally, 121 patients were included into the CD group, and 324 into control group, with similar basic characteristics. Serum AMH levels were measured by chemiluminescence.Results: The AMH level in the CD group was significantly lower than that in the control group (2.17±2.23ug/L vs 3.95±2.01ug/L, 95%CI[1.34-2.21], P<0.001). In both groups, the AMH levels decreased as age increased, but without between-group difference in the decreasing rate (P=0.639). Multivariate analysis showed that age>30 years (OR,2.905;95%CI[1.053-8.531], P=0.017), disease activity (OR,4.314; 95%CI[1.561-12.910], P=0.002) and thalidomide use (OR,12.628; 95%CI[4.351 -42.820], P<0.001) were independent risk factors associated with decreased ovarian reserve (AMH＜1.1ug/L). Conclusion: Ovarian reserve is lower in CD women than in healthy women. Age, CD activity and medication of thalidomide are risk factors that an aggravate the decline of ovarian reserve.