OBJECTIVE
To study the efficacy of assisted reproductive technology (ART) programs in patients with familial Mediterranean fever (FMF).
MATERIAL AND METHODS
Retrospective case-control study: 42 patients with FMF and 17 patients without FMF. Data collected from the register of the Centerof Medical Genetics (CMG), Yerevan, Armenia, for 1998-2018. ART cycles were performed after controlled ovarian stimulation (COS). Twenty patients (47.6%) received colchicine regularly, 22 (52.4%) did not take colchicine or received it irregularly.
RESULTS
Average age of patients with FMF (the 1st group) was 22-41 (30.0±5.3) years, without FMF (the 2nd group) — 24-45 (33.9±5.3) years, duration of infertility was 5.9±1.2 years and 5.3±1.8 years, BMI (kg/m2) was 28.7±2.3 and 29.7±2.3, respectively. The value of the follicle-stimulating hormone (FSH) (mIU/ml) and estradiol (E2) (pg/ml) was 6.5±1.8 and 176.8±16.7 in the 1st group, 7.1±3.3 and 144.0±16.7 in the 2nd group, the number of antral follicles was 8.0±2.0 and 8.1±1.8, respectively. 46 cycles performed in the 1st group and 35 cycles performed in the 2nd group. Clinical pregnancy rate per embryo transfer: 23/44 (52.3%) versus 17/32 (53.1%) (0.749) and the Take-home baby rate index: 13/44 (30.0%) versus 12/32 (37.5%) (p=0.679) were comparable. The Live-birth rate per pregnancy: 13/23 (56.5%) versus 12/17 (70.6%) (p=0.012) and the Live birth rate per patient: 13/42 (31.0%) versus 12/17 (70.6%) (p=0.045) in the 1st group was lower. Statistically significant differences in early (30.4% versus 17.6%, respectively) and late miscarriages (4.3% versus 0.0%), ectopic pregnancy (EP) (8.7% versus 5.9%), preterm labor (PL) <37 weeks (30.8% versus 15.4%) was not detected. Perinatal outcomes were comparable: low Apgar scores (<7) at the 1st minute (23.1% versus 30.8%; p=0.631) and the 5th minute (7.7% versus 7.7%; p=0.432), congenital malformations (0.0% versus 5.9%; p=0.239). The outcomes of 11 pregnancies were assessed in 20 FMF patients regularly taking colchicine and 12 pregnancies in 22 without colchicine. With the regular intake of colchicine, the Live birth rate per pregnancy was 8/11 (72.7%) versus 5/12 (41.7%), respectively (p=0.045). Maintaining control over attacks and the chances of a favorable pregnancy outcome were 1.7 times higher in patients receiving colchicine (OR=1.7; 95% CI 1.0-3.9).
CONCLUSIONS
FMF patients receiving colchicine have a comparable response to controlled ovarian stimulation. Colchicine therapy has a beneficial effect on the clinical course of the disease and pregnancy outcomes.
