CORRELATION BETWEEN PLASMA LEAD AND SERUM ANTI MULLERIAN HORMONE LEVELS IN WOMEN WITH PREMATURE OVARIAN FAILURE

Abstract

Background: Lead is a highly toxic metal to humans, with the injurious effects on the hemopoietic, nervous and reproductive system. Lead crosses the placenta during pregnancy and has been associated with intrauterine death, prematurity and low birth weight. Objective: To collate between plasma lead and serum antimullerian hormone levels in women with premature ovarian failure, by estimation of level of Anti Mullerian Hormone (AMH), Follicular Stimulating Hormone (FSH), Estradiol (E2) and plasma Lead level. Subjects and Method: This study was conducted in Al Azhar University Hospital outpatient clinics after approval of the research and ethical committee during the period from December 2015 to December 2018. Study groups were: Group 1 included 50 normal candidate women under 40 years old has regular menstrual cycles (21-35 days), fertile (at least one natural pregnancy carried to term), and serum FSH was less than 10 mlU/ml, Group 2 included 50 patients with premature ovarian failure who aged under 40 years with absence of spontaneous menstrual bleeding for more than 12 months, serum estradiol level was less than 25pg/ml, serum FSH level more than 40 mlU/ml. AMH, plasma lead level in patients with premature ovarian failure diagnosed and correlated with level of serum FSH with the normal control group. Results: There was a statistically significant positive correlation between plasma lead levels with FSH among the study group. On the other hand, there was no statistically significant correlation between plasma lead level and AMH level. Conclusion: The anti mullerian hormone showed a significant difference between the cases of premature ovarian insufficiency and the control group. Moreover, AMH was a good marker for ovarian reserve and ovarian response for gonadotropins simulation. Chronic exposures to heavy metals, especially lead, affected the ovarian function and impairment in folliculogenesis which increased the incidence of Premature Ovarian Failure (POF) especially in rural area due to the low socioeconomic status.