Behcet's disease: reproductive function and pregnancy
https://doi.org/10.14412/1996-7012-2018-2-103-106
Abstract
The problem of fertility and pregnancy outcomes in rheumatic diseases (RDs) is discussed by both rheumatologists and obstetricians. The present paper considers the problems of reproductive function and pregnancy outcomes in patients with Behcet's disease (BD).
The study of the circulating level of anti-MЯllerian hormone (AMH) opened a new page in the evaluation of ovarian function and fertility in different diseases, including RDs. The evaluation of AMH as a marker of ovarian reserve substantially simplified its estimate and the determination of the contribution of the disease itself to patients' infertility.
Examination of the obstetric histories of patients with BD demonstrated different pregnancy outcomes. Our studies of familial aggregation in BD showed that there were large families in certain ethnic groups, which allowed us to evaluate, on the basis of obstetric histories, both reproductive function and pregnancy outcomes, and not one pregnancy, but several pregnancies, which is important in the study of fertility.
Data on the impact of pregnancy on BD, and vice versa, are scarce and contradictory; described as both an exacerbation of BD during gestation and improvement of disease symptoms. There is evidence for an exacerbation of BD in the third trimester of pregnancy only in the women who had painful genital ulcers. At the same time, a number of works have not reveal the impact of either BD on the outcome of gestation or that of pregnancy on the course of BD.
It is concluded that there is a need for further investigations of fertility, pregnancy and its outcomes in BD.
About the Authors
Z. S. Alekberova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522
D. A. Bizhanova
Russian Children's Clinical Hospital, Ministry of Health of Russia
Russian Federation
117, Leninsky Prospect, Moscow 119571
Russian Federation
117, Leninsky Prospect, Moscow 119571
References
1. Visser JA, de Jong FH, Laven JS, et al. Anti-Mü llerian hormone: a new marker for ovarian function. Reproduction. 2006 Jan; 131(1):1-9.
2. Seifer DB, Baker VL, Leader B. Age-specific serum anti-Mü llerian hormone values for 17,120 women presenting to fertility centers within the United States. Fertil Steril. 2011 Feb;95(2):747-50. doi: 10.1016/j. fertnstert.2010.10.011. Epub 2010 Nov 13.
3. Khader A, Lloyd SM, McConnachie A. External validation of anti-Mü llerian hormone based prediction of live birth in assisted conception. J Ovarian Res. 2013 Jan 7;6(1):3. doi: 10.1186/1757-2215-6-3.
4. Dolleman M, Faddy MJ, van Disseldorp J, et al. The relationship between anti-Mü llerian hormone in women receiving fertility assessments and age at menopause in subfertile women: evidence from large population studies. J Clin Endocrinol Metab. 2013 May;98(5):1946-53. doi: 10.1210/jc.2012-4228. Epub 2013 Mar 18.
5. Loh JS, Maheshwari A. Anti-Mü llerian hormone – is it a crystal ball for predicting ovarian ageing? Hum Reprod. 2011 Nov; 26(11):2925-32. doi: 10.1093/humrep/der271. Epub 2011 Aug 16.
6. Шабанова СШ, Алекберова ЗС, Гузов ИИ и др. Овариальная функция у больных системной красной волчанкой. Научно-практическая ревматология. 2004;42(3):4-9. [Shabanova SSh, Alekberova ZS, Guzov II, et al. Ovarial function in patients with systemic lupus erythematosus. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2004;42(3):4-9. (In Russ.)]. doi: 10.14412/ 1995-4484-2004-1469
7. Brouwer J, Laven JS, Hazes JM, et al. Levels of serum anti-Mü llerian hormone, a marker for ovarian reserve, in women with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2013 Sep;65(9):1534-8. doi: 10.1002/acr.22013.
8. Henes M, Froeschlin J, Taran FA, et al. Ovarian reserve alterations in premenopausal women with chronic inflammatory rheumatic diseases: impact of rheumatoid arthritis, BehНet's disease and spondyloarthritis on anti-Mü llerian hormone levels. Rheumatology (Oxford). 2015 Sep;54(9):1709-12. doi: 10.1093/rheumatology/kev124. Epub 2015 May 8.
9. Henes M, Henes JC, Neunhoeffer E, et al. Fertility preservation methods in young women with systemic lupus erythematosus prior to cytotoxic therapy: experiences from the FertiPROTEKT network. Lupus. 2012 Aug; 21(9):953-8. doi: 10.1177/ 0961203312442753. Epub 2012 Mar 21.
10. Ma W, Zhan Z, Liang X, el al. Subclinical impairment of ovarian reserve in systemic lupus erythematosus patients with normal menstruation not using alkylating therapy. J Womens Health (Larchmt). 2013 Dec;22(12): 1023-7. doi: 10.1089/jwh.2013.4255.
11. Lawrenz B, Henes J, Henes M, et al. Impact of systemic lupus erythematosus on ovarian reserve in premenopausal women: evaluation by using anti-Mü llerian hormone. Lupus. 2011 Oct;20(11):1193-7. doi: 10.1177/ 0961203311409272. Epub 2011 Jul 18.
12. Yamakami LY, Serafini PC, de Araujo DB, et al. Ovarian reserve in women with primary antiphospholipid syndrome. Lupus. 2014 Aug;23(9):862-7. doi: 10.1177/0961203314529468. Epub 2014 Mar 25.
13. Кошелева НМ, Хузмиева СИ, Алекберова ЗС. Системная красная волчанка и беременность. II. Влияние системной красной волчанки на исходы беременности. Научно-практическая ревматология. 2006;44(2):52-9. [Kosheleva NM, Khuzmieva SI, Alekberova ZS. Systemic lupus erythematosus and pregnancy. II. Effect of systemic lupus erythematosus on pregnancy outcomes. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2006;44(2):52-9. (In Russ)].
14. Кошелева НМ, Матьянова ЕВ. Ревматоидный артрит и беременность. Научно-практическая ревматология. 2014;52(6): 589-99. [Kosheleva NM, Mat'yanova EV. Rheumatoid arthritis and pregnancy. Nauchno-prakticheskaya revmatologiya = Rheumatology Science and Practice. 2014;52(6):589-99. (In Russ.)]. doi: 10.14412/1995-4484-2014-589-599
15. Лила АМ, Трофимов ЕА, Лила ВА. Системная красная волчанка: особенности течения у беременных и варианты терапии. Современная ревматология. 2015; 9(3):43-7. [Lila AM, Trofimov EA, Lila VA. Systemic lupus erythematosus: Specific features of its course and therapy options. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2015;9(3):43-7. (In Russ.)]. doi: 10.14412/1996-7012-2015-3-43-47
16. Har H, Cha D, Kim D. A case of Behcet's syndrome associated with pregnancy. New Med.J. 1983;27:45-8
17. Ferrano G, Lo Meo C, Moscarelli G, et al. A case of pregnancy in patients suffering from the Behcet's syndrome. Acta Eur Fertil. 1984 Jan-Feb;15(1):67-70.
18. Hamza M, Ellench M, Zribi A. Behcet's disease and pregnancy. Ann Rheum Dis. 1988 Apr;47(4):350.
19. Marsal S, Falga C, Simejn P, et al. Behcet's disease and pregnancy relationship study. Br J Rheumatol. 1997 Feb;36(2):234-8.
20. Bang D, Sun Chun I, Yaam I. The influence of Pregnancy on Behcet's disease, Textbook and Atlas. Springer; 2001. P. 87-192
21. Uzun S, Alpsoy E, Durdu M, et al. The clinical course of BehНet's disease in pregnancy: a retrospective analysis and review of the literature. J Dermatol. 2003 Jul;30(7): 499-502.
22. Fam A, Siminovitch K, Carette S. Neonatal Behcet's syndrome in an infant of a mather with the disease. Ann Rheum Dis. 1981 Oct;40(5):509-12.
23. Jadaon J, Shushan A, Ezra Y, et al. BehНet's disease and pregnancy. Acta Obstet Gynecol Scand. 2005 Oct;84(10):939-44. 24. Noel N, Wechsler B, Nizard J, et al. BehНet's disease and pregnancy. Arthritis Rheum. 2013 Sep;65(9):2450-6. doi: 10.1002/ art.38052.
24. Komaba H, Takeda Y, Fukagawa M. Extensive deep vein thrombosis in a postpartum woman with BehНet's disease associated with nephrotic syndrome. Kidney Int. 2007 Jan;71(1):6.
25. Marshall SE. BehНet's disease. Best Pract Res Clin Rheumatol. 2004 Jun;18(3):291-311. 27. Lorenzo Emmi. Behcet's syndrome. Springer Verlag; 2014. P. 159-64.
Review
For citations:
Alekberova ZS, Bizhanova DA. Behcet's disease: reproductive function and pregnancy. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2018;12(2):103-106. (In Russ.) https://doi.org/10.14412/1996-7012-2018-2-103-106
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