PT - JOURNAL ARTICLE AU - Brouwer, Jenny AU - Dolhain, Radboud J E M AU - Hazes, Johanna M W AU - Erler, Nicole S AU - Visser, Jenny A AU - Laven, Joop S E TI - Decline of ovarian function in patients with rheumatoid arthritis: serum anti-Müllerian hormone levels in a longitudinal cohort AID - 10.1136/rmdopen-2020-001307 DP - 2020 Oct 01 TA - RMD Open PG - e001307 VI - 6 IP - 3 4099 - http://rmdopen.bmj.com/content/6/3/e001307.short 4100 - http://rmdopen.bmj.com/content/6/3/e001307.full SO - RMD Open2020 Oct 01; 6 AB - Objective Rheumatoid arthritis (RA) often affects women in their fertile age, and is known to compromise female fertility. Serum anti-Müllerian hormone (AMH) levels are a proxy for the total number of primordial follicles, and a reliable predictor of the age at menopause. Our objective was to study the longitudinal intra-individual decline of serum AMH levels in female RA patients.Methods Female RA patients from a nationwide prospective cohort (2002–2008) were re-assessed in 2015–2016. Serum AMH levels were measured using the picoAMH assay and compared with healthy controls. A linear mixed model (LMM) was built to assess the effect of RA-related clinical factors on the decline of AMH levels.Results A group of 128 women were re-assessed at an age of 42.6±4.4 years, with a median disease duration of 15.8 (IQR 12.7–21.5) years. The time between first and last AMH assessments was 10.7±1.8 (range 6.4–13.7) years. Participants represented a more fertile selection of the original cohort. At follow-up, 39% of patients had AMH levels below the 10th percentile of controls (95% CI 31% to 48%), compared with 16% (95% CI 9.3% to 22%) at baseline. The LMM showed a significant decline of AMH with increasing age, but no significant effect of RA-related factors on AMH.Conclusion AMH levels in RA patients showed a more pronounced decline over time than expected, supporting the idea that in chronic inflammatory conditions, reproductive function is compromised, resulting in a faster decline of ovarian function over time and probably an earlier age at menopause.