Ovarian Reserve in Reproductive-Aged Women with Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Abstract

Prospective registration of the protocol for a systematic review and meta-analysis examining whether reproductive-aged women (18-45 years) with chronic kidney disease have lower serum anti-Mullerian hormone (AMH) concentrations than age-comparable women without kidney disease. The review comprises four separate syntheses, which are not combined into a single pooled estimate: (1) non-dialysis CKD versus controls without CKD (primary analysis); (2) dialysis versus controls; (3a) post-transplant versus controls; (3b) post- versus pre-transplant measurements within the same individuals (paired). Primary outcome: serum AMH. Secondary outcomes: antral follicle count, basal FSH, estradiol, prevalence of menstrual disturbance. Effect measure: standardized mean difference, random-effects model with Hartung-Knapp-Sidik-Jonkman adjustment. Risk of bias: Newcastle-Ottawa Scale adapted for cross-sectional studies. Certainty of evidence: GRADE. Databases searched: PubMed/MEDLINE, Embase, Scopus, and Web of Science, from inception, with no language, date, or study-design restriction. Registered prospectively before screening commenced. PROSPERO registration was not possible at the time of registration because its submission form offered no active review category appropriate to an exposure review.