Page 112 - Fertility in Women with Rheumatoid Arthritis Vruchtbaarheid van vrouwen met reumatoïde artritis

Chapter 7
Hormone measurements
Serum AMH levels during follow-up were compared to AMH levels in healthy controls ( gure 2). The mean age in controls was 30.6 ± 7.4 years, with a range of 18.0 – 46.8 years. The age range for patients at the follow-up visit was 31.6 – 53.5 years. Corrected for age, AMH levels in women with RA at the follow-up visit were signi cantly lower than those in controls (p<0.001).
Figure 2 – First and last available serum anti-Müllerian hormone (AMH) levels (ug/L) in women with rheumatoid arthritis who participated in the Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) study and were visited again after 6.4 – 13.7 years. The lines represent the 10th, 50th and 90th percentiles of AMH values in healthy controls (Lie Fong 2012)26
Looking at the age speci c percentiles, 50 subjects (39%; 95%CI 31–48%) had a serum AMH level below the 10th percentile, compared to 20 patients (16%; 95%CI 9.3–22%) at the rst available assessment ( gure 2). At the follow-up assessment, 3 RA patients were older than 51 years, and as such, their age exceeded the age range of the nomogram (maximum age 51 years).
In patients not using oral contraceptives (n=100), the percentage of women with AMH levels below the 10th percentile was 36% (95%CI: 27–45%). In women not using any steroid sex hormones (n=61), this was 33% (95%CI 21–47%).
In Table 3 the age-speci c AMH percentiles are shown for all subjects at the rst and last measurement, grouped by disease characteristics. At the last assessment, higher percentages of patients with AMH levels below the 10th percentile were seen
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