P171 Subfertility in young patients with Crohn′s disease. A case-control study.

Abstract

Abstract Background Inflammatory bowel disease (IBD) commonly affects women and men during the reproductive years.The effect of the disease burden on fertility in these patients is a common concern for them. ECCO guidelines establish that active disease is associated with decreased fertility in women but studies regarding this topic are of low quality and outdated. Aims to investigate the effect of CD on fertility, studying ovarian reserve in women as well as global Sertoli cell function in men, - To compare these results of CD patients with the healthy control group. (HC) - To assess the related factors to subfertility in women and males with CD. Methods This was a cross-sectional, prospective and case-control study, including CD patients, aged 18-40 years-old, and HC matched by gender and age (ratio 2:1). Morning baseline IB was measured in men using ELISA. Serum anti-Müllerian hormone (AMH) was measured by ECLIA. Sociodemographic and phenotypic features of CD patients and controls were collected.Subfertility was defined as IB < 89pg/mL, AMH <1.66 ug/L in 0-24 years old group; <1.18 ug/L in 25-29 years old group; <0.67 ug/L in 30-34 years old group; <0.77 ug/L in 35-39 years old group; and <0.01 ug/L in 40-44 years old group. AMH <2 ug/L in women under 40 was considered low. Results A total of 163 individuals were included: 83 men (58 CD, median 28 years old, RIQ 24-36; 25 HC, median 31 years old, RIQ 26-37) and 80 women (50 CD, median 26 years old, RIQ 21-36; 30 HC, median 28, RIQ 26-32). Sedentary lifestyle was more frequent in women with CD vs HC (46% vs 3,3%, p<0,001). 24% of women with CD and 8% of males had clinical activity (IHB >4). Low AMH (<2ug/L) in women older than 30 was more frequent in CD vs HC: 95% (18/19) vs 44% (4/9) p=0.001, with an OR of presenting AMH < 2 ug/L of 3.28 (IC 95%, 1.6-6.4) for women with CD >30 years old. The average AMH serum level was similar between women with CD and HC [1.83 (1.04-3.34) vs. 2.74 (1.05-4.12) g/L, p=0.4]. Abnormal AMH rate by age rank was not different between groups in global population (11/50, 22% EC vs. 7/30, 23% in CS, p=0.9,). IB levels were significantly lower in men with CD vs HC [169 (140-217) vs 232 ug/L (178-274) p=0.001]. IB <89 pg/mL was not detected in any control vs 6% (n=3) in CD. In multivariate analysis, only AMH was associated with lower levels of IB in CD men, no association with clinical activity or treatments in CD was found. Conclusion Women with CD and >30 years old have a higher risk than general population of presenting low AMH (<2).These data could be helpful at council of women with CD that desire to have progeny. IB concentration was lower in men with CD compared to HC.