E-ISSN: 1309-0380
Assessment of ovarian reserve and Doppler characteristics in patients with multiple sclerosis using immunomodulating drugs
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Original Investigation
VOLUME: 10 ISSUE: 4
P: 213-219
December 2009

Assessment of ovarian reserve and Doppler characteristics in patients with multiple sclerosis using immunomodulating drugs

J Turk Ger Gynecol Assoc 2009;10(4):213-219
Aylin Pelin Çil 1
Alev Leventoglu 2
Murat Sönmezer 3
Rabia Soylukoç 4
Kutluk Oktay 5
1. Etlik Obstetrics And Gynecology Training And Research Hospital, Ankara, Turkey
2. Ufuk University School Of Medicine, Department Of Neurology, Ankara, Turkey
3. Department Of Obstetrics And Gynecology, Ankara University School Of Medicine, Ankara, Turkey
4. Kirikkale University School Of Medicine, Department Of Neurology, Kirikkale, Turkey
5. New York Medical College, Department Of Obstetrics And Gynecology, Valhalla, Ny, And Institute For Fertility Preservation, Center For Human Reproduction, New York, Usa
No information available.
No information available
Received Date: 27.09.2009
Accepted Date: 03.10.2009
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ABSTRACT

Objective:

There is limited data about fertility in multiple sclerosis (MS) patients using immunomodulating drugs and no data exists regarding the ovarian reserve of these patients. Therefore, we aimed to evaluate,the ovarian reserve and doppler characteristics of MS patients using immunomodulating drugs.

Material and Methods:

MS patients using immunomodulating drugs (interferon (IFN) β and glatiramer acetate) and age-matched healthy controls were included in the study. Subjects were examined in the early follicular phase of the menstrual cycle with transvaginal ultrasound to evaluate ovarian volume, antral follicle count (AFC) and ovarian stromal artery Doppler. On the same day, blood was taken for determining serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels. A subgroup analysis was also carried out between MS patients using only IFN β and controls to compare the same parameters.

Results:

Mean ovarian volume and total AFC were lower in MS patients using immunomodulating drugs than in the controls. FSH and E2 levels did not show any differences between the groups, but LH levels were significantly higher in MS patients. All the Doppler parameters of the ovarian stromal artery were higher in MS patients but not significantly. In the subgroup analysis, the same significant differences were found for ovarian volume, AFC and LH levels. In addition, MS patients showed significantly higher mean pulsatility index measurement than the controls.

Conclusion:

The findings of this study demonstrated diminished ovarian volume and follicular reserve in MS patients using immunomodulating drugs compared to age matched healthy controls. However, further studies are required to elucidate whether compromised ovarian reserve in MS patients is due to drugs or the disease itself.

Keywords:
Multiple Sclerosis, immunomodulating therapy, interferon-beta, ovarian reserve, Doppler