Factors associated with decreased ovarian reserve in Crohn's disease: A systematic review and meta‐analysis

Abstract

AbstractIntroductionIt is still unclear whether Crohn's disease (CD) might be associated with diminished ovarian reserve (OvR) and factors influencing anti‐Mullerian hormone (AMH) levels in CD are poorly known.Material and MethodsWe conducted a comprehensive literature search of multiple electronic databases from inception to June 2022 to identify all studies reporting AMH levels or factors associated with diminished OvR in patients with CD.ResultsOf the 48 studies identified in our search, eight (including 418 patients with CD) were finally included. The mean difference (95% confidence interval [CI]) in the AMH level between pooled CD patients and controls was −0.56 (−1.14 to 0.03) (p = 0.06). A history of CD‐related surgery was not associated with a lower OvR (odds ratio, OR [95% CI] 1.34, [0.66–2.7]; p = 0.4). While disease activity and perianal disease seems associated with a low OvR, disease location (L2 vs. L1, OR [95% CI] = 95% CI [0.47–7.4]; p = 0.4) and L3 vs. L1 (OR [95% CI] = 1.44 [0.67–3.12]; p = 0.3), CD medication, and disease behavior were not.ConclusionsOur systematic review and meta‐analysis did not identify a significantly low OvR in patients with CD. Contrary to CD‐related surgery risk factor, active disease was associated lower AMH levels.