Abstract: PO2595
Menstrual Irregularities and Subfertility in Women with Glomerular Disease
Session Information
- Women's Health and Kidney Diseases
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Women’s Health and Kidney Diseases
- 2000 Women’s Health and Kidney Diseases
Authors
- Reynolds, Monica Lona, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Poulton, Caroline J., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Blazek, Lauren N., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Hogan, Susan L., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Falk, Ronald J., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Derebail, Vimal K., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Background
Women with CKD are known to have high rates of irregular menses and subfertility (an extended period of unwanted non-conception). Those with glomerular disease may be at particularly high risk due to exposure to immunosuppression, such as cyclophosphamide, that may lower fertility.
Methods
A women’s health survey was distributed to women ages 18-65 in the Glomerular Disease Collaborative Network, a longitudinal research registry in the southeastern United States. Descriptive statistics were employed to assess responses.
Results
The survery was completed by 192 women (response rate 16%) with median age 48 (34-57 interquartile range(IQR)) and BMI 28 (24-35 IQR). The most common diseases were IgA nephropathy/vasculitis (22%), Lupus nephritis (20%), ANCA vasculitis (18%) and FSGS (16%). At the time of the survey, 17% had a kidney transplant or required dialysis. Table 1 describes self-reported menstrual cycle length and permanent cessation of menses by age group. Of those over age 45, 41% reported permanent cessation of menses had occurred at ≤ 44 years old. Cyclophosphamide use was reported by 63 of 192 (33%), and their fertility preservation methods included leuprolide (6, 10%) and oocyte cryopreservation (1, < 2%). One in four women (50/192, 26%) reported a history of attempting to conceive for > 6 months without success. To aid conception, 26% (13/50) reported use of a medication (e.g. clomiphene) and 16% (8/50) underwent intrauterine insemination, in vitro fertilization, or received egg/sperm donation.
Conclusion
Women with glomerular disease and/or vasculitis had high rates of irregular menstruation and early menopause which may contribute to subfertility. Our data is limited as we do not know GFR, nor the timing or amount of cyclophosphamide prescribed. Response bias from women with a positive history may have also played a role. Future efforts should elucidate reproductive endocrinology utilization and success in this population.
Menstrual Cycle Length and Cessation Of Menses By Age Group
| Age group | 18-25 | 26-35 | 36-45 | 46-55 | 56-65 |
| N | 10 | 40 | 32 | 51 | 59 |
| Menstrual cycle lasting 24-35 days (%) | 30 | 68 | 69 | 26 | 0 |
| Abnormal menstrual cycle (lasting < 24 days, > 35 days, or too irregular to say) (%) | 70 | 28 | 19 | 12 | 2 |
| Permanent cessation of menses (%) | 0 | 5 | 13 | 61 | 98 |
| Cessation of menses occurring ≤ 44 years old (% (N respondents)) | N/A | N/A | N/A | 61 (19/31) | 30 (17/57) |
N/A: not applicable
Funding
- NIDDK Support