Advertisement

Archives of Gynecology and Obstetrics

, Volume 295, Issue 1, pp 233–238 | Cite as

Ovarian reserve in women with a previous history of severe pre-eclampsia

  • Priya BhideEmail author
  • Åse Vårtun
  • Berit Aune
  • Kari Flo
  • Purusotam Basnet
  • Ganesh Acharya
Gynecologic Endocrinology and Reproductive Medicine

Abstract

Purpose

Severe pre-eclampsia affects maternal health with long-term consequences. It is postulated that during the process of implantation and cell differentiation, embryos resulting from the fertilization of ageing oocytes produce malfunctioning trophoectoderm leading to placental dysfunction. Therefore, severe pre-eclampsia may be associated with a decreased ovarian reserve. The objective of this study was to compare serum markers of ovarian reserve and function between women who had severe pre-eclampsia and those who had normal pregnancies.

Methods

Twenty women who had severe pre-eclampsia (PE) and 20 who had uncomplicated pregnancies (controls) matched for age and body mass index were included in the study. Fasting blood samples were taken during the follicular phase (day 5) of the menstrual cycle 6 months to 5 years after the delivery. Serum was separated and frozen at −70 °C until analyzed for anti-Mϋllerian hormone (AMH), total and free testosterone (TT), free-androgen index (FAI), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) hormone to evaluate ovarian reserve and function, and the results were compared between two groups.

Results

The median AMH was 0.91 ng/mL in PE group compared to 0.72 ng/mL in controls (p = 0.995). No significant differences were found between the two groups in the levels of LH (5.65 vs. 5.4 IU/L, respectively, p = 0.897) and FSH (4.95 vs. 5.1 IU/L, respectively, p = 0.523). However, total and free-TT levels as well as FAI were significantly lower in the PE group compared to controls (p = 0.017, p = 0.006, and p = 0.011, respectively).

Conclusions

Ovarian reserve and function are not altered significantly in women with a previous history of pre-eclampsia compared with women who had an uncomplicated pregnancy.

Keywords

Ovarian reserve Severe pre-eclampsia 

Notes

Acknowledgments

This study was partly funded by the Regional Health Authority of Northern Norway.

Compliance with ethical standards

Conflict of interest

P. Bhide declares that she has no conflict of interest. A. Vartun declares that she has no conflict of interest. B. Aune declares that she has no conflict of interest. K. Flo declares that she has no conflict of interest. P. Basnet declares that he has no conflict of interest. G. Acharya declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Roberts CL, Ford JB, Algert CS, Antonsen S, Chalmers J, Cnattingius S, Gokhale M et al (2011) Population-based trends in pregnancy hypertension and pre-eclampsia: an international comparative study. BMJ Open 1:e000101CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Duley L (2009) The global impact of pre-eclampsia and eclampsia. Semi Perinatol 33:130–137CrossRefGoogle Scholar
  3. 3.
    Green A, Loughna P, Broughton Pipkin F (2012) New-onset hypertension in pregnancy: a review of the long-term maternal effects. Obstet Gynaecol 14:99–105CrossRefGoogle Scholar
  4. 4.
    Rylander R (2015) Pre-eclampsia during pregnancy and cardiovascular disease later in life: the case for a risk group. Arch Gynecol Obstet 292(3):519–521CrossRefPubMedGoogle Scholar
  5. 5.
    Smith RA, Kenny LC (2006) Current thoughts on the pathogenesis of pre-eclampsia. Obstet Gynaecol 8:7–13CrossRefGoogle Scholar
  6. 6.
    Pijnenborg R, Vercruysse L, Hanssens M (2006) The uterine spiral arteries in human pregnancy: facts and controversies. Placenta 27(9–10):939–958CrossRefPubMedGoogle Scholar
  7. 7.
    Fisher SJ (2015) Why is placentation abnormal in preeclampsia? Am J Obstet Gynecol 213(4 Suppl):S115–S122CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Woldringh GH, Frunt MH, Kremer JA, Spaanderman ME (2006) Decreased ovarian reserve relates to pre-eclampsia in IVF/ICSI pregnancies. Hum Reprod 21(11):2948–2954CrossRefPubMedGoogle Scholar
  9. 9.
    Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, Zeeman GG, Brown MA (2014) The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens 4(2):97–104PubMedGoogle Scholar
  10. 10.
    Shea JL, Wongt PY, Chen Y (2014) Free testosterone: clinical utility and important analytical aspects of measurement. Adv Clin Chem 63:59–84CrossRefPubMedGoogle Scholar
  11. 11.
    Pallasmaa N, Ekblad U, Gissler M, Alanen A (2015) The impact of maternal obesity, age, pre-eclampsia and insulin dependent diabetes on severe maternal morbidity by mode of delivery—a register-based cohort study. Arch Gynecol Obstet 291(2):311–318CrossRefPubMedGoogle Scholar
  12. 12.
    van Disseldorp J, Eijkemans R, Fauser B, Broekmans F (2010) Hypertensive pregnancy complications in poor and normal responders after in vitro fertilization. Fertil Steril 93(2):652–657CrossRefPubMedGoogle Scholar
  13. 13.
    Levron Y, Dviri M, Segol I, Yerushalmi GM, Hourvitz A, Orvieto R, Mazaki-Tovi S, Yinon Y (2014) The ‘immunologic theory’ of preeclampsia revisited: a lesson from donor oocyte gestations. Am J Obstet Gynecol 211(4):383.e1–5CrossRefPubMedGoogle Scholar
  14. 14.
    Yarde F, Maas AH, Franx A, Eijkemans MJ, Drost JT, van Rijn BB, van Eyck J, van der Schouw YT, Broekmans FJ (2014) Serum AMH levels in women with a history of preeclampsia suggest a role for vascular factors in ovarian aging. J Clin Endocrinol Metab 99(2):579–586CrossRefPubMedGoogle Scholar
  15. 15.
    Tokmak A, Güney G, Aksoy RT, Guzel AI, Topcu HO, Keçecioğlu TS, Uygur D (2015) May maternal anti-mullerian hormone levels predict adverse maternal and perinatal outcomes in preeclampsia? J Matern Fetal Neonatal Med 28(12):1451–1456CrossRefPubMedGoogle Scholar
  16. 16.
    Tuuri A, Tiitinen A, Hiilesmaa V, Hämäläinen E, Turpeinen U, Tikkanen MJ, Kaaja R (2010) Hormonal and metabolic characteristics of premenopausal women with a history of preeclamptic pregnancy. Acta Obstet Gynecol Scand 89(10):1331–1337CrossRefPubMedGoogle Scholar
  17. 17.
    Laivuori H, Kaaja R, Rutanen EM, Viinikka L, Ylikorkala O (1998) Evidence of high circulating testosterone in women with prior preeclampsia. J Clin Endocrinol Metab 83(2):344–347PubMedGoogle Scholar
  18. 18.
    Chinnathambi V, More AS, Hankins GD, Yallampalli C, Sathishkumar K (2014) Gestational exposure to elevated testosterone levels induces hypertension via heightened vascular angiotensin II type 1 receptor signaling in rats. Biol Reprod 91(1):6CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Carlsen SM, Romundstad P, Jacobsen G (2005) Early second-trimester maternal hyperandrogenemia and subsequent preeclampsia: a prospective study. Acta Obstet Gynecol Scand 84(2):117–121CrossRefPubMedGoogle Scholar
  20. 20.
    Troisi R, Potischman N, Roberts JM, Ness R, Crombleholme W, Lykins D, Siiteri P, Hoover RN (2003) Maternal serum oestrogen and androgen concentrations in preeclamptic and uncomplicated pregnancies. Int J Epidemiol 32(3):455–460CrossRefPubMedGoogle Scholar
  21. 21.
    Wallis AB, Saftlas AF, Hsia J, Atrash HK (2008) Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987–2004. Am J Hypertens 21:521–526CrossRefPubMedGoogle Scholar
  22. 22.
    Dahlstrom BL, Engh ME, Bukholm G, Oian P (2006) Changes in the prevalence of pre-eclampsia in Akershus County and the rest of Norway during the past 35 years. Acta Obstet Gynecol Scand 85:916–921CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Priya Bhide
    • 1
    Email author
  • Åse Vårtun
    • 2
  • Berit Aune
    • 2
    • 3
  • Kari Flo
    • 2
    • 3
  • Purusotam Basnet
    • 2
    • 3
  • Ganesh Acharya
    • 2
    • 3
  1. 1.Homerton Fertility CentreHomerton University Hospital NHS Foundation TrustLondonUK
  2. 2.Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health SciencesUniversity of TromsøTromsøNorway
  3. 3.Department of Obstetrics and GynecologyUniversity Hospital of North NorwayTromsøNorway

Personalised recommendations