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Objective-To investigate the relationship between antimullerian hormone (AMH) and steroidogenesis in follicles of normoandrogenic ovulatory women undergoing FSH therapy for IVF-ET. Design-Prospective cohort.Setting-Institutional/private practice.Patients-26 normoandrogenic ovulatory women. All women received GnRH analog and ovarian stimulation for IVF-ET.Interventions-Follicle fluid was aspirated at oocyte retrieval from the first follicle of each ovary.Main Outcome Measures-Follicle fluid was assayed for AMH, E 2 , P, androstenedione, T, dihydrotestosterone, insulin and FSH.Results-Intrafollicular AMH levels positively and negatively correlated with E 2 and FSH concentrations in follicles, respectively, causing a positive relationship between follicle fluid AMH levels and E2/FSH ratios as a measure of follicle sensitivity to FSH. A positive relationship also existed in follicles between AMH levels and E 2 /androgen ratios as a marker of aromatase activity. Conclusions-AMH

Maternal phenylketonuria, PKU, has a detrimental effect on embryogenesis. Infant pathology is independent of fetal genotype, but is directly correlated with excessive phenylalaninaemia throughout pregnancy. Although normal children have been delivered by affected mothers who either had benign hyperphenylalaninaemia or in whom strict diet has apparently maintained maternal phenylalaninaemia in the low normal range from before conception, more abnormal than normal births have been reported. In addition, attempts at dietary management are often unsuccessful; most reported cases documented various severe pathological consequences of maternal PKU. Currently available methods provide viable alternative treatment. In vitro fertilization using the parental gametes, followed by implantation of the pre-embryo in a surrogate mother, would avoid a metabolic environment impairing normal development, and therefore should be recommended as alternative therapy for potential mothers with PKU.

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