Multiple sclerosis and fecundity: a study of anti-mullerian hormone level in Egyptian patients

Abstract

Background: Multiple sclerosis (MS) is a neurological disease that affects people aged 20–40 years on average. It classically affects young females of reproductive age. The prevalence of MS for females to males has increased markedly in recent years (from 2.3 to 3.5:1). Females with MS seem to use infertility treatments more frequently and fecundity could be affected years before making an MS diagnosis. The anti-Müllerian hormone (AMH) level is the strongest marker of ovarian reserve. Although recent studies suggest that patients with MS have lower ovarian reserve, there is no definite data to conclude that females with MS suffer from impaired fertility. This study aimed to investigate fertility and fecundity among female patients with MS by assessing AMH level. This study included 100 patients with MS and 60 healthy controls (HC). Both groups were assessed for AMH levels, activities of daily living (ADL) were assessed using the Kurtzke Expanded Disability Status Scale (EDSS) and the reproductive history of both groups was assessed via a self-administered questionnaire. Results: AMH levels among the HCs (0.34–2 ng/ml with a mean of 1.03 ± 0.41 ng/ml) were significantly higher than in patients with MS (0.15–2 ng/ml with a mean of 0.68 ± 0.31 ng/ml). The use of disease-modifying therapies (DMT) was the only predictor of below normal AMH among patients, but there was no significant correlation with age, duration of disease or type of DMT. Conclusions: Levels of AMH were significantly lower in MS patients than in healthy controls.