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Assessment of ovarian reserve in patients with type 1 diabetes: a systematic review and meta-analysis

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Abstract

Purpose

Current knowledge about the ovarian reserve in patients with type 1 diabetes is inconsistent and based on studies with small sample size. This meta-analysis aimed to produce a comprehensive evaluation on the ovarian reserve of type 1 diabetes female patients and to analyze the associated factors with the ovarian reserve.

Methods

Systematic searches were conducted for studies published from the inception to December 2021. Original human observational studies either with case-control, cross-sectional, or longitudinal design evaluating ovarian reserve markers between type 1 diabetes patients and healthy controls were included. Levels of anti-müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2) were extracted.

Results

It was indicated that women with type 1 diabetes were associated with decreased levels of AMH compared with healthy controls (weighted mean difference [WMD] −0.70 ng/ml, 95% confidence intervals [CI] −1.05 to −0.34 ng/ml, P = 0.0001). Subgroup analyses stratified by age showed that adult patients with type 1 diabetes were associated with decreased levels of AMH (WMD −0.70 ng/ml, 95% CI −1.06 to −0.34 ng/ml, P = 0.0001) and FSH (WMD −1.07 IU/L, 95% CI −1.75 to −0.39 IU/L, P = 0.002) compared with healthy controls. Meta-regression analysis showed no significant correlation between AMH, FSH, and clinical factors, while level of E2 was negatively correlated with daily insulin doses and glycosylated hemoglobin A1c (HbA1c) values.

Conclusion

According to this meta-analysis, type 1 diabetes might be associated with decreased AMH levels. Further studies using different markers and fertility outcomes focus on the ovarian reserve of women with type 1 diabetes are urgently needed.

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Acknowledgements

The authors would like to thank all the doctors, nurses, and technicians for their practical work during the study at Department of Endocrinology and Metabolism, Peking University People’s Hospital.

Author contributions

X.C. and L.J. conceived and designed the review. W.Y., C.L., F.L., X.Z. identified reports and extracted data. X.C. and X.H. provided statistical advice and contributed to data interpretation. W.Y. drafted the paper. M.Z. helped revised the paper. All authors read and approved the final paper.

Funding

This study was supported by National Natural Science Foundation of China (No. 81903711, 81970698, 81970708) and Beijing Natural Science Foundation (No. 7202216).

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Author notes

  1. These authors contributed equally: Xiaoling Cai, Linong Ji

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Peking University People’s Hospital, Beijing, China

    Wenjia Yang, Chu Lin, Fang Lv, Xingyun Zhu, Xueyao Han, Xiaoling Cai & Linong Ji

  2. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China

    Mengqian Zhang

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  1. Wenjia Yang
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Yang, W., Lin, C., Zhang, M. et al. Assessment of ovarian reserve in patients with type 1 diabetes: a systematic review and meta-analysis. Endocrine 77, 205–212 (2022). https://doi.org/10.1007/s12020-022-03091-y

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