Clinical Value Of Transvaginal Three-dimensional Ultrasound Combined With Anti-müllerian Hormone In Assessment Of Ovarian Reserve Function In SLE

Objective: Toassess ovarian reserve function in patients with systemic lupus erythematosus(SLE)and to determine the autoimmune effect of SLE on female fertility potential by using vaginal three-dimensional ultrasound combined with anti-mullerian hormone(AMH).Methods: A total of 60 patients were included in this study,including 30 in the SLE group(study group)and 30 in the control group.Menstruation of the two groups was recorded.The number of sinus follicles(AFC),ovarian volume(OV),peak systolic blood flow velocity(PSV),systolic/diastolic velocity ratio(S/D),pulsation index(PI)and resistance index(RI)were measured by three-dimensional vaginal ultrasound.At the same time,venous blood was collected for the detection of anti-mullerin hormone(AMH),follicle stimulating hormone(FSH)and other serological indexes.The imparity of the above ultrasonic measurements and serum AMH values between the two groups were analyzed,and the relevance between various ultrasonic indicators and the relevance between ultrasonic indicators and AMH was also analyzed.Results: The abnormality of menstruation in study group was higher than that in healthy control group,and the difference was statistically significant(P<0.05).AMH,AFC,PSV and OV in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in S/D,PI,RI and FSH between the two groups(P>0.05).In the study group,AFC,PSV,OV showed certain correlation with AMH(P<0.05).AFC,OV and PSV were all positively correlated with AMH(r=0.535,0.444,0.369,P<0.05).AFC was positively correlated with AMH(r=0.535,P<0.05),AFC was positively correlated with OV(r=0.426,P=0.019),AFC,OV had no correlation with PSV(r=0.193,0.154,P=0.306,0.417),PI,RI,S/D had no correlation with AMH(r=-0.066、-0.333、-0.219,P=0.729、0.073、0.246).Conclusion:⑴ Decline in ovarian reserve function in patients with SLE is associated with the disease itself.⑵ AFC and AMH are sensitive,useful and practical indexes for evaluating ovarian reserve in SLE patients;Serum AMH levels and AFC can be used in monitoring ovarian reserve and in early detection of reproductive decline of SLE patients.⑶ Three-dimensional ultrasound can intuitively and accurately provide ovarian morphological information that cannot be obtained by biochemical indicators.It has high sensitivity and accuracy in detecting AFC and OV.Combined with serum AMH level,it can systematically and comprehensively evaluate ovarian reserve function.