P-690 RESEarch on ovarian reseRVE among Neurologic patients: the RESERVEN study

Abstract

Abstract Study question Could Multiple Sclerosis (MS) reduce the levels of main ovarian reserve markers, measured through automated systems? Summary answer There is no statistically significant difference in ovarian reserve markers between women affected by Multiple Sclerosis and healthy controls. What is known already Few studies evaluated the issue of ovarian reserve in women affected by MS, so far. The majority of them observed no differences in ovarian reserve markers between women affected by MS and healthy controls. However, interestingly, women with MS in case of a more active disease were observed to have lower levels of ovarian reserve markers. In fact, evidence suggests that an inflammatory status may reduce the ovarian reserve, where autoimmune-related diseases are considered a possible cause of Premature Ovarian Insufficiency (POI). Study design, size, duration This is a single-center multidisciplinary prospective case-control (44 cases and 72 controls) study performed from September 2019 to September 2022. Participants/materials, setting, methods Cases were reproductive-age women affected by MS recruited at our MS unit, controls were age- and body mass index (BMI) - matched healthy women recruited at our assisted reproductive technology (ART) unit. During the early follicular phase, a transvaginal ultrasound was performed with sonoAVC software (GE medical systems) for 3D antral follicle count and a blood sample taken for hormonal assays (Anti-Müllerian hormone levels was measured using the Roche Elecsys AMH Plus). Main results and the role of chance There are no differences in age (p = 0.11), BMI (p = 0.96) as per protocol. Moreover, differences in FSH (p = 0.14), LH (p = 0.13), estradiol (p = 0.92), and AMH (p = 0.99) levels were not statistically significant. The 3D antral follicle count showed a statistically significant difference (p = 0.03), but following a re-evaluation of pictures in post-processing, removing the small antral follicles (2-4 mm) the difference was not statistically significant (p = 0.14). Limitations, reasons for caution We could not assess women before they started on medication for MS. Therefore, we could not exclude that medication have an impact in these results, also because the sample is small and patients were not treated with the same drug. Moreover, all patients were in disease remission at enrollment. Wider implications of the findings This is the first study to evaluate ovarian reserve markers with automated systems. Our results confirmed the ones previously published. However, the interesting data on 3D antral follicle count increased in MS women should be confirmed and studied in order to evaluate if follicular dynamics are altered in Multiple Sclerosis. Trial registration number Not applicable