“…Two studies specifically described the effect of thalidomide on ovarian reserve function and were analyzed as a subgroup. The ovarian reserve function was significantly lower in reproduction-age IBD women taking Fréour [22] * * * * * * -* Good (7) Şenateş [8] * * * * * * -* Good (7) Henes [10] * * * * * * -* Good (7) Rekawek [23] * * * * * * --Good (6) Peng [18] * * * * * * * * Good (8) Kadirogullari [19] * * * * * * * * Good (8) Zhao [20] * * * * * * -* Good (7) thalidomide than in healthy women (Fig. 4A) without any obvious publication bias (Fig.…”
Purpose:
We conducted a systematic review and meta-analysis to examine the role of inflammatory bowel disease (IBD) in ovarian reserve functions.
Methods:
The PECO strategy was employed. Women of reproductive age (Population) and with IBD (Exposure) were compared with healthy women of reproductive age (Comparison) to evaluate the ovarian reserve function (Outcome). Two reviewers searched three databases as well as relevant gray literature. After following the PRISMA 2020 guidelines, RevMan 5.0 software and Newcastle–Ottawa Scale (NOS) scoring were used to analyze and summarize the data included in the studies. The protocol was registered on PROSPERO (CRD42021267804).
Results:
The search yielded 367 studies, out of which 13 were selected for full-text evaluation, and finally, seven studies were included in our research. An analysis of ovarian reserve function in IBD women of reproductive age and healthy women revealed that the ovarian reserve function was lower in IBD women of reproductive age than in healthy women (P < .01, I
2 = 81%); the ovarian reserve function was significantly lower in women with IBD in remission than in healthy women (P < .01, I
2 = 0%), and ovarian reserve function was lower in IBD women of reproductive age taking thalidomide than in healthy women (P < .01, I
2 = 18%).
Conclusion:
IBD could reduce ovarian reserve function in women of reproductive age, and patients should plan for conception as soon as possible under permissible conditions.
“…Two studies specifically described the effect of thalidomide on ovarian reserve function and were analyzed as a subgroup. The ovarian reserve function was significantly lower in reproduction-age IBD women taking Fréour [22] * * * * * * -* Good (7) Şenateş [8] * * * * * * -* Good (7) Henes [10] * * * * * * -* Good (7) Rekawek [23] * * * * * * --Good (6) Peng [18] * * * * * * * * Good (8) Kadirogullari [19] * * * * * * * * Good (8) Zhao [20] * * * * * * -* Good (7) thalidomide than in healthy women (Fig. 4A) without any obvious publication bias (Fig.…”
Purpose:
We conducted a systematic review and meta-analysis to examine the role of inflammatory bowel disease (IBD) in ovarian reserve functions.
Methods:
The PECO strategy was employed. Women of reproductive age (Population) and with IBD (Exposure) were compared with healthy women of reproductive age (Comparison) to evaluate the ovarian reserve function (Outcome). Two reviewers searched three databases as well as relevant gray literature. After following the PRISMA 2020 guidelines, RevMan 5.0 software and Newcastle–Ottawa Scale (NOS) scoring were used to analyze and summarize the data included in the studies. The protocol was registered on PROSPERO (CRD42021267804).
Results:
The search yielded 367 studies, out of which 13 were selected for full-text evaluation, and finally, seven studies were included in our research. An analysis of ovarian reserve function in IBD women of reproductive age and healthy women revealed that the ovarian reserve function was lower in IBD women of reproductive age than in healthy women (P < .01, I
2 = 81%); the ovarian reserve function was significantly lower in women with IBD in remission than in healthy women (P < .01, I
2 = 0%), and ovarian reserve function was lower in IBD women of reproductive age taking thalidomide than in healthy women (P < .01, I
2 = 18%).
Conclusion:
IBD could reduce ovarian reserve function in women of reproductive age, and patients should plan for conception as soon as possible under permissible conditions.
“…10 , 11 , 12 , 13 , 14 , 15 , 16 Nine articles finally meet the eligibility criteria for inclusion. 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 There was almost perfect agreement between the two reviewers in judging eligibility of the citations (kappa statistic = 0.854). Two articles were moderate quality 17 , 21 judged by NOS score system while the rest studies were high quality.…”
Section: Resultsmentioning
confidence: 93%
“…Two articles were moderate quality 17 , 21 judged by NOS score system while the rest studies were high quality. 18 , 19 , 20 , 22 , 23 , 24 , 25 Figure 1 Flow diagram of the assessment of studies identified in the systematic review. …”
Section: Resultsmentioning
confidence: 99%
“…Another 3 articles performed subgroup analyses of IBD patients’ AMH disease stage. 17 , 18 , 25 Four studies made the diagnosis of IBD based on clinical, radiological, endoscopic, and histological features, 17 , 18 , 22 , 25 three studies made the diagnosis based on medical records 19 , 23 , 24 and another 2 studies made the diagnosis based on register data. 20 , 21 Most of the articles selected the control group from the same population and matched with clinical factors such as age and disease duration.…”
“… 4 – 7 This is supported by data demonstrating similar levels of serum anti-Mullerian hormone (AMH) in women with IBD compared with the general population, indicating no reduction in ovarian reserve. 11 , 12 However, AMH levels are significantly lower during active disease and inversely correlate with the Crohn’s Disease Activity Index, 13 supporting the observation that fertility rates are reduced in active disease. 9 , 14 A nationwide Korean study found a 21% reduced live birth rate in women with moderate-to-severe IBD activity, while birth rates in women with quiescent or mildly active IBD were comparable with women without IBD.…”
Inflammatory bowel disease (IBD) frequently affects women of childbearing age and can have implications in pregnancy. Most women with IBD have comparable fertility with women in the general population. Fertility is reduced in women with active disease or previous ileal-pouch–anal anastomosis (IPAA) surgery and is temporarily reduced in men taking sulfasalazine. Women with IBD have an increased risk of preterm delivery, low birth weight, small-for-gestational-age infants and Cesarean section (CS) delivery, however, no increased risk of congenital abnormalities. These adverse outcomes are particularly prevalent for women with active IBD compared with those with quiescent disease. Conception should occur during disease remission to optimize maternal and fetal outcomes and reduce the risk of disease exacerbations during pregnancy. Pre-conception counseling is therefore pertinent to provide patient education, medication review for risk of teratogenicity and objective disease assessment. Most medications are safe during pregnancy and breastfeeding, with the exception of methotrexate, ciclosporin, allopurinol and tofacitinib. Delivery modality should be guided by obstetric factors in most cases; however, CS is recommended for women with active perianal disease and can be considered for women with inactive perianal disease or IPAA. In conclusion, most women with IBD have uncomplicated pregnancies. Active IBD is the predominant predictor of poor outcomes and disease exacerbations; therefore, maintenance of disease remission during and before pregnancy is crucial.
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