Anti-Müllerian hormone and ovarian dysfunction

Broekmans, Frank J.; Visser, Jenny A.; Laven, Joop S.E.; Broer, Simone L.; Themmen, Axel P. N.; Fauser, Bart C.J.M.

doi:10.1016/j.tem.2008.08.002

Cited by 196 publications

(137 citation statements)

References 89 publications

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“…Recent studies have shown that AMH is the serum marker that best reflects the gradual reduced reproductive capacity with increasing age. [14][15][16] Our results imply that AMH shows significant promise to serve as such a marker in thalassemia women with iron overload and seems a better marker than AFC, which in many cases is lower despite a normal AMH. Thalassemia women had a considerably lower ovarian volume compared with reported normal controls (1.25 Ϯ 1.2 cm 3 vs 6-6.6 cm 3 ), 17 also representing impaired ovarian reserve, probably a result of a halt in follicle maturation because of lack of gonadotropin stimulation.…”

Section: Resultsmentioning

confidence: 65%

Reproductive capacity in iron overloaded women with thalassemia major

Singer¹,

Vichinsky²,

Gildengorin³

et al. 2011

Blood

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The pathophysiology of iron-induced compromisedfertilityinwomenwiththalassemia major (TM) was evaluated in 26 adult TM females. Low gonadotropin secretion resulted in reduced ovarian antral follicle count and ovarian volume, but levels of anti-mü llerian hormone (AMH), a sensitive marker for ovarian reserve independent of gonadotropin effect, were mostly normal. AMH correlated with nontransferrin-bound iron (NTBI), suggesting a role of labile iron in the pathogenesis of decreased reproductive capacity, possibly occurring in parallel to cardiac iron toxicity, as cardiac iron was associated with the presence of amenorrhea and with NTBI levels. AMH emerges as an important biomarker for assessment of reproductive capacity in TM, demonstrating that fertility is preserved in the majority of those younger than 30 to 35 years. AMH can be useful in future studies aiming at improved chelation for fertility preservation, whereas NTBI and labile plasma iron may be valuable for monitoring iron effect on the reproductive system. (Blood. 2011;118(10):2878-2881) IntroductionDespite progress in chelation regimens, the deleterious effect of excess iron to the reproductive system of women with thalassemia major (TM) is still common. 1,2 Iron toxicity to the anterior pituitary results in declining synthesis of lutenizing hormone (LH) and follicle-stimulating hormone (FSH). 3 The effect of low gonadotropin secretion on the ovarian oocyte maturation has not been explored, and a possible direct effect of iron, in particular that of non-transferrin-bound iron (NTBI) and its redox active form, labile plasma iron (LPI), on the ovaries is unknown. Some have suggested iron-induced ovarian dysfunction 1 ; but with reports of successful ovulation-induction and pregnancies, it has been proposed that ovarian function is preserved even in women with amenorrhea. 2 Ovarian antral follicle pool can predict fertility capacity, and reproductive aging is directly related to the decline in this pool. Low ovarian reserve is associated with low chances for spontaneous pregnancy and poor response to hormonal stimulation. [4][5][6] Antral follicle count (AFC), visualized by ultrasound, and antimüllerian hormone (AMH), which corresponds with AFC, can accurately assess ovarian follicle pool and are used for ovarian reserve testing, identifying women at risk for early ovarian failure. 7,8 The usefulness of ovarian reserve testing for the care of thalassemia females has not been evaluated. Reproductive capacity in TM women cannot be well predicted by means of age, menstrual status, or transfusion and chelation parameters. 1,9 Yet, as overall survival continues to improve, 10,11 attainment of reproductive capacity is crucial for many patients, a concern often brought up to the hematologist.We evaluated the effect of iron burden on hypogonadism and ovarian reserve in TM women, to better understand the pathophysiology of reduced fertility and evaluate the predictive ability of ovarian reserve testing in this unique patient-population. MethodsThalassemia women (Ն...

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Section: Resultsmentioning

confidence: 65%

Reproductive capacity in iron overloaded women with thalassemia major

Singer¹,

Vichinsky²,

Gildengorin³

et al. 2011

Blood

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“…A high prevalence of polycystic ovary syndrome (PCOS) has been reported in female athletes (19,20) serum samples were analysed for antimullerian hormone (AMH) to differentiate hypothalamic amenorrhoea from PCOS and premature ovarian failure: AMH is elevated in PCOS bot does not vary over the menstrual cycle (21). Analysis was conducted using generation II ELISA kit (Beckman Coulter, High Wycombe, UK)).…”

Section: Menstrual Functionmentioning

confidence: 99%

Bone Geometry According to Menstrual Function in Female Endurance Athletes

et al. 2013

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“…Thus, AMH has been recommended as a diagnostic marker for PCOS in recent years [4]. Pigny et al [24] suggested AMH to be a good marker for the diagnosis of PCOS.…”

Section: Introductionmentioning

confidence: 99%

Different diagnostic power of anti-Mullerian hormone in evaluating women with polycystic ovaries with and without hyperandrogenism

Li¹,

Ma²,

Chen³

et al. 2012

J Assist Reprod Genet

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Purpose The aim of this study is to compare the secretory profiles and diagnostic power of anti-Mullerian hormone (AMH) for the PCOS patient with and without hyperandrogenism. Methods One hundred and thirty-one PCOS patients with oligomenorrhea or amenorrhea were recruited into the study. Sixty-two and sixty-nine patients had and did not have hyperandrogenism (HA+) hyperandrogenism (HA−), respectively. Sera were collected for determining the levels of AMH, basal sexual hormones, glucose and lipid metabolic indicators. Results The AMH serum levels of PCOS patients were significantly higher than the control group, with the highest AMH serum level in the HA+ group. The cut-off value for predicting PCOS patients of all types was 3.92 ng/mL, with a sensitivity of 65 %, and specificity of 62 %. The cut-off value for predicting PCOS patients in the HA+ group was 4.23 ng/mL, with a sensitivity of 82 %, and specificity of 64 %. The cut-off value for predicting PCOS patients in the HA− group was 3.76 ng/mL, with a sensitivity of 64 %, and specificity of 62 %. In the HA+ group, AMH was negatively associated with FSH and positively associated with LH. In the HA− group, AMH was negatively associated with HDL and positively associated with BMI, fasting glucose and LDL.Conclusions AMH is only suitable for predicting the PCOS patients with hyperandrogenism. The diagnostic power of AMH is limited when used to predict patients without hyperandrogenism. It reflects the differences in pathophysiology and severity of disrupted folliculogenesis between the two subtypes.

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Anti-Müllerian hormone and ovarian dysfunction

Cited by 196 publications

References 89 publications

Reproductive capacity in iron overloaded women with thalassemia major

Reproductive capacity in iron overloaded women with thalassemia major

Bone Geometry According to Menstrual Function in Female Endurance Athletes

Different diagnostic power of anti-Mullerian hormone in evaluating women with polycystic ovaries with and without hyperandrogenism

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