T1DM: abnormality in ovarian markers common in reproductive-age women

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Takeaway

  • In women with type 1 diabetes mellitus (T1DM) in their 30s, more than one-third had elevated anti-Müllerian hormone (AMH) consistent with presence of PCOS.
  • Abnormality in ovarian markers is common in this patient category and is not associated with irregular menses.
  • Elevated AMH could explain reduced fecundity in women with T1DM apart from irregular menses.

Why this matters

  • Women are at increased risk for infertility as they age, with risk more prominent in those with T1DM.
  • Very few studies have examined if ovarian markers influence infertility in this patient category.

Study design

  • Secondary analysis of 379 reproductive-age women (median age, 35 years) with T1DM.
  • Funding: NIH.

Key results

  • Irregular menses history was reported by 21% women, whereas 35% reported elevated AMH (≥26.70 pmol/L).
  • 12.2% and 2.7% women reported testosterone levels >1.74 and ≥3.05 nmol/L, respectively.
  • Younger age, lower insulin dosages (P=.0027) and higher testosterone concentrations were associated with higher AMH concentration.
  • No association was observed between AMH or testosterone concentrations and irregular menses.
  • Only age was associated with presence of at least 2 reproductive abnormalities with older age corresponding to lower odds (OR, 0.87; 95% CI, 0.80-0.94).

Limitations

  • Difficulty with fertility and actual thyroid hormone levels not assessed.