Background: Crohn's disease (CD) mainly affects young adults of reproductive age. Few studies have been conducted on their ovarian reserve status, and factors associated with impaired ovarian reserve remains unknown. This study aimed to investigate potential risk factors associated with low ovarian reserve as reflected by serum anti-Mullerian hormone (AMH) in young women of reproductive age with CD.
Methods: This individual matched, case-control study was conducted in the First Affiliated Hospital of Sun Yat-sen University. Cases were 87 patients diagnosed with CD and controls were paired with no history of IBD, recruited in a 1:1 ratio, for age, height, weight and BMI index. Serum AMH levels were measured by ELISA.
Results: The serum AMH level was significantly lower in CD patients than health control group (2.47±2.08ng/ml vs 4.12±2.31ng/ml, p<0.001), which remained comparable with the age younger than 25 years (4.41±1.52ng/ml vs 3.49±2.10ng/ml, p=0.06), but decreased in CD patients after 25 years at any age stage (p<0.05). Patients with active disease (p<0.05), stricturing type (B2) (p<0.05), perianal disease (p<0.05), ileocolonic (L3) involved disease (p<0.05) and receiving thalidomide therapy (p<0.05) showed a significantly lower serum AMH level. Multivariable logistic regression analysis showed that age more than 25 years old (OR: 9.33, 95% CI 1.85–47.05, p<0.05), active disease (OR: 24.2, 95% CI 5.56–104.75, p<0.05) and thalidomide use (OR: 19.6, 95% CI 2.99–118.6, p<0.05) were independent risk factors were associated with low ovarian reserve in CD patients.
Conclusions: Age more than 25 years old, active disease and thalidomide use were independently associated with low ovarian reserve in young women of reproductive age with CD.