Serum anti-Müllerian hormone levels in reproductive-age women with relapsing-remitting multiple sclerosis

Background: Fertility might be reduced in women with multiple sclerosis (MS), although only few studies exist and the underlying reasons are not well understood. Similar to other autoimmune diseases, a decreased ovarian reserve may contribute to impaired fertility in women with MS. Anti-Müllerian hormone (AMH) is an established marker of the ovarian reserve and an objective indicator of ovarian function, which is independent of the hypothalamus-pituitary-gonadal axis function.

Objective: The purpose of this study was to determine AMH levels in females with relapsing-remitting MS (RRMS) in combination with other reproduction and lifestyle factors.

Methods: A total of 76 reproductive-age females with RRMS and 58 healthy controls were included in this case control study. An enzymatically amplified two-site immunoassay was used to measure serum AMH level.

Results: Mean AMH level was significantly decreased in females with RRMS (p<0.04), and a higher proportion of females with RRMS showed very low AMH values (<0.4 ng/ml) compared to healthy controls (p<0.05). The majority of these women were currently without any disease modifying treatment.

Conclusions: Our data contribute to our understanding of impaired fertility in women with MS. The unexpected finding that the majority of MS subjects with very low AMH levels were currently without medication requires further evaluation.