Ovarian reserve in an Egyptian cohort with end-stage kidney disease on hemodialysis and after successful kidney transplantation: a prospective study
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Women with chronic kidney disease commonly have menstrual irregularities and fertility abnormalities. Antimüllerian hormone (AMH) and antral follicle count (AFC) are well-recognized indicators of ovarian reserve.
To assess AMH level and total AFC in women who are on hemodialysis and after successful kidney transplantation (KTx).
Sixty women with end-stage kidney disease (ESKD) on regular hemodialysis were included in this study with 20 patients of them were going to have renal transplant. Fifty age-matched healthy females were enrolled as control. Serum AMH level was measured in all participants once and in transplant patients four times (before surgery, and at 1, 6, and 12 months after surgery). AFC was evaluated once in all subjects and in transplant patients twice (before and 1 year after surgery).
ESKD patients had significantly lower AMH concentration and AFC than healthy controls (1.8 ± 1.2 vs. 3.5 ± 1.7 ng/ml, p < 0.001) and (12 ± 4.6 vs. 17.4 ± 4.3, p < 0.001), respectively. In the subgroup transplant patients, AMH level decreased significantly from (1.7 ± 1.3 ng/ml) before Ktx to (1.5 ± 1.2 ng/ml, p = 0.001) at 1 month, (1.1 ± 0.9 ng/ml, p < 0.001) at 6 months, (0.9 ± 0.8 ng/ml, p < 0.001) at 1 year after Ktx. Also, total AFC declined in transplant females from (11.1 ± 4.5) before KTx to (6.6 ± 3.4) after KTx (p < 0.001).
Women with ESKD who are on hemodialysis have lower ovarian reserve than healthy females. Moreover, renal transplantation was associated with reduction in AMH level and AFC.
KeywordsAntimüllerian hormone Antral follicle count Chronic kidney disease
This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
Compliance with ethical standards
Conflict of interest
The authors have declared that no conflict of interest exists.
The local ethical committee of the Internal Medicine department, School of Medicine, Cairo University, approved this work.
Research involving human and animal participants
All procedures performed in this study 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 was obtained from all individual participants included in the study.
- 1.Pietrzak B, Wielgos M, Kamiński P, Jabiry-Zieniewicz Z, Bobrowska K (2006) Menstrual cycle and sex hormone profile in kidney-transplanted women. Neuro Endocrinol Lett 27:198–202Google Scholar
- 8.Younis JS (2012) Ovarian aging and implications for fertility female health. Minerva Endocrinol 37:41–57Google Scholar
- 11.Kalaiselvi VS, Saikumar P, Prabhu K, Prashanth Krishna G (2012) The anti mullerian hormone-a novel marker for assessing the ovarian reserve in women with regular menstrual cycles. J Clin Diagn Res 6:1636–1639Google Scholar
- 16.Lima ML, Martins WP, Coelho Neto MA, Nastri CO, Ferriani RA, Navarro PA(2015)The assessment of ovarian reserve by antral follicle count in ovaries with endometrioma. Ultrasound Obstet Gynecol 46: 239–242Google Scholar