Journal
GYNECOLOGICAL ENDOCRINOLOGY
Volume 28, Issue 8, Pages 624-627Publisher
INFORMA HEALTHCARE
DOI: 10.3109/09513590.2011.650752
Keywords
Antimullerian hormone; cyclophosphamide; primary ovarian insufficiency; systemic lupus erythematosus
Funding
- Pilot and Collaborative Grant Program, Michigan Institute for Clinical and Health Research (MICHR) [UL1RR024986]
- National Institutes of Health [K12HD001438]
- Elizabeth Caroline Crosby Research Fund
- National Center for Research Resources [UL1RR024986]
- Herbert and Carol and Amster Lupus Research Fund
- Michael and Marcia Klein Lupus Research Fund
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Background: We measured antimullerian hormone (AMH), a marker of ovarian reserve, in women with lupus treated with cyclophosphamide (CYC) (group I), CYC plus gonadotropin-releasing hormone agonist (GnRH-a) (group II) or neither (group III). We hypothesized that AMH would be diminished in women exposed to CYC versus women receiving adjunctive GnRH-a treatment or no CYC exposure. Methods: Forty-eight premenopausal lupus patients were retrospectively divided into three treatment groups: CYC alone (group I, n = 11), CYC + GnRH-a (group II, n = 10) and neither (group III, n = 27). Serum AMH levels between groups were compared using a nonparametric test (Wilcoxon rank-sum). Multiple linear regression adjusting for age was performed. Results: AMH (ng/mL) levels at the last collection were significantly lower in group I versus group III (mean +/- SD: 0.18 +/- 0.20 group I vs 1.33 +/- 1.59 group III; p = 0.015), and versus group II (mean +/- SD: 0.86 +/- 1.06; p = 0.018). When centered on age 30 years, average AMH levels for group I, group II and group III were 0.20, 0.44 and 1.00, respectively. When adjusted for age, AMH between all groups was significantly different (p < 0.0001). Conclusion: Posttreatment AMH levels were significantly higher among patients receiving CYC + GnRH-a compared to CYC alone, suggesting that GnRH-a coadministration mitigates CYC-induced ovarian injury.
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