Assessment of ovarian reserve as an indicator of fertility and health consequences in patients with chronic kidney disease stages 3–4

Abstract

The aim of the study was to evaluate whether ovarian reserve depends on chronic kidney disease. Twenty-four patients, 23–45 years with chronic kidney disease (CKD) stages 3–4 were included in the study. All the patients underwent transvaginal ultrasounds to assess antral follicle count (AFC) and ovarian volume. The serum samples were obtained on days 3–5 of the menstrual cycle from all participants for anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), and estradiol (E2) levels. On the base of the study, it was concluded that the most sensitive parameters of ovarian reserve are AMH and AFC. AMH levels and number of antral follicles in both ovaries were statistically significantly lower in the group of patients with CKD than in control ones. But there were no significant differences in the ovarian volumes (right and left ovary), FSH and E2 levels between study and control groups. Ovarian reserve is not dependent on the duration of CKD and hormonal parameters of ovarian reserve like FSH and estradiol (E2) are not dependent on the presence or absence of proteinuria in patients with CKD, but the most sensitive parameter – AMH is significantly lower in patients with CKD and proteinuria.

摘要

本项研究的目的是评估卵巢储备功能是否依赖于慢性肾脏病。本研究共纳入24例23-45岁的慢性肾脏病（chronic kidney disease, CKD）3-4期的患者。所有患者均行阴道超声检查以评估窦卵泡计数（antral follicle count, AFC）和卵巢体积。在所有参与者月经周期的第3-5天获取血清样本进行抗苗勒氏管激素（anti-Mullerian hormone, AMH）、卵泡刺激素（follicle stimulating hormone, FSH）和雌二醇（E2）水平检测。在此研究基础上得出结论, 反映卵巢储备功能最敏感的参数为AMH和AFC。CKD组患者的AMH水平及双侧卵巢窦卵泡数均明显低于对照组, 差异有统计学意义。但卵巢体积（左右卵巢）, FSH和E2水平在实验组与对照组之间无显著差异。而且卵巢储备功能不依赖于CKD的持续时间, 反映卵巢储备功能的激素参数FSH和E2水平不依赖于CKD患者的蛋白尿存在与否, 但最敏感的参数——AMH水平在存在蛋白尿的CKD患者中显著降低。

Keywords:

• Ovarian reserve
• chronic kidney disease
• AMH

Disclosure statement

No potential conflict of interest was reported by the authors.