Anti-Mullerian hormone is increased in follicular fluid from unstimulated ovaries in women with polycystic ovary syndrome

Das, Mausumi; Gillott, David J.; Sarıdoğan, Ertan; Djahanbakhch, O.

doi:10.1093/humrep/den185

Cited by 92 publications

(68 citation statements)

References 27 publications

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“…3). Similarly, concentrations of AMH were found to be five times higher in follicular fluid from unstimulated follicles from women with anovulatory PCOS compared to women who were ovulatory (Das et al 2008). In a further study, the serum concentration of AMH correlated with the severity of symptoms, with again the ovulatory group having lower concentrations than those who were equally hyperandrogenic but anovulatory (Piouka et al 2009).…”

Section: Amh and Pcosmentioning

confidence: 81%

Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high?

Pellatt¹,

Rice²,

Mason³

2010

Reproduction

190

112

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Anti-Mü llerian hormone (AMH) was initially thought to be produced solely by the foetal male during sexual differentiation to promote regression of the Mü llerian ducts. Over the last decade, however, a new and interesting role has emerged for AMH in the ovary. In human ovaries, AMH is produced by granulosa cells from 36 weeks of gestation until menopause, with the highest expression being in small antral follicles. AMH production gradually declines as follicles grow; once follicles reach a size at which they are dominant, it has largely disappeared. Its removal from these larger follicles appears to be an important requirement for dominant follicle selection and progression to ovulation as AMH has an inhibitory role in the ovary, reducing both primordial follicle initiation and follicle sensitivity to FSH by inhibition of aromatase. It is for this reason that AMH is a focus of interest in polycystic ovary syndrome (PCOS). Serum levels are doubled, and granulosa cell production is greatly increased. Interestingly, there appear to be two groups of women with PCOS who can be distinguished by their AMH level: one group consists of those who have high levels which do not reduce with treatment and who respond less well to induction of ovulation, and a second group consists of those in whom the level is less elevated and reduces on treatment and who seem to respond rather better. Understanding the reason for the raised AMH in PCOS may give clues as to the mechanism of anovulation. To conclude, AMH appears to have a major inhibitory role during folliculogenesis, which may contribute to anovulation in PCOS.

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Section: Amh and Pcosmentioning

confidence: 81%

Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high?

Pellatt¹,

Rice²,

Mason³

2010

Reproduction

190

112

View full text Add to dashboard Cite

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“…However, the recent studies observed that the increase in AMH concentrations was more due to the increase in production of AMH by each follicle. Indeed, concentrations of AMH were found to be five times higher in follicular fluid from unstimulated follicles in women with PCOS than normoovulatory controls [7].…”

mentioning

confidence: 93%

Correlation of serum Anti-Müllerian hormone concentrations on day 3 of the in vitro fertilization stimulation cycle with assisted reproduction outcome in polycystic ovary syndrome patients

Wei

Gong

2012

J Assist Reprod Genet

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Purpose To investigate whether serum Anti-Müllerian hormone (AMH) on day 3 could predict controlled ovarian stimulation and reproductive outcomes in women with polycystic ovary syndrome. Methods A total of 164 PCOS patients undergoing their first IVF treatment cycle were prospectively included. Serum AMH levels on cycle day 3 was measured. The controlled ovarian stimulation and clinical outcomes for the study population were divided according to the <25th, 25 to 75th, or >75th percentile of serum day-3 AMH. Results Estradiol levels on hCG day and the number of retrieved oocytes significantly increased with increasing serum AMH levels, while total consumption of gonadotropin dose showed a significant decrease (P<0.05). Fertilization rate and the number of good quality embryos were comparable among the low, average and high groups (P>0.05). Embryo implantation rates in the high AMH group was significantly inferior to those with low and average AMH concentration (27 versus 48.8 and 50%, P<0.01). Clinical pregnancy rates was lower in the high AMH group than that of the low and average group (45.9 versus 65 and 66.7%, P00.09), but this difference was only close to statistical significance. In addition, ordinal regression analysis indicated that LH level was the only independent predictor of embryo implantation rates (P00.017). Conclusions In PCOS women, AMH levels on day 3 of the IVF stimulation cycle positively predict ovarian response to gonadotrophins. However, the women with high AMH levels had a significantly decreased IR, which may be due to remarkably increased LH concentrations.Keywords Anti-Müllerian hormone . Assisted reproduction . Polycystic ovary syndrome . Serum AMH Anti-Müllerian hormone (AMH), also known as Müllerian inhibiting substance (MIS), is producted specifically by granulose cells of early developing pre-antral and small antral follicles in the ovary, and declines with advancing age. AMH has therefore been proposed as a novel clinical marker of ovarian reserve [1]. Another major reason for the interest in AMH is the fact that serum AMH levels are increased significantly in women with polycystic ovary syndrome (PCOS) when compared with normoovulatory women [2,3].PCOS is the most frequent cause of anovulatory infertility and hyperandrogenism in young women [4]. Women with this syndrome are characterized by an excessive number of small antral follicles (2-3 fold that of normal ovaries) [5]. As an exclusively granulosa cell product, it was initially proposed that the rise in serum AMH in PCOS was a consequence of the increased small antral follicle number in these ovaries [6]. The Capsule In PCOS women, high AMH levels on day 3 of the IVF stimulation cycle predict high ovarian response to gonadotrophins, but low embryo implantation rates.

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“…This phenomenon might be the result of an intrinsic abnormality in the ovarian follicles of patients with PCOS, which could contribute to disordered folliculogenesis [20].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms

Şahmay

Aydın

Öncül

et al. 2013

J Assist Reprod Genet

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Purpose We assessed the utility of using anti-Müllerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems. Methods A total of 606 females were admitted to a university hospital with menstrual irregularities or symptoms of hyperandrogenism were enrolled in this cross-sectional study. Fasting blood samples were collected. Pelvic and/or abdominal ultrasonography and clinical examination were performed. Patients were evaluated for the presence of PCOS according to conventional diagnostic criteria. The diagnostic performance of using serum AMH levels alone and in various combinations with the clinical features of PCOM, OA, and HA were investigated. Results For the diagnosis of PCOS, the combination of OA and/or HA with AMH showed 83 % sensitivity and 100 % specificity according to the Rotterdam criteria; 83 % sensitivity and 89 % specificity according to the National Institutes of Health (NIH) criteria; and 82 % sensitivity and 93.5 % specificity according to the Androgen Excess Society (AES) criteria. Conclusions The serum AMH level is a useful diagnostic marker for PCOS and is correlated with conventional diagnostic criteria. The combination of AMH level with OA and/ or HA markedly increased the clinical scope for PCOS diagnosis and can be introduced as a possible objective criterion for the diagnosis of this disease.

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Anti-Mullerian hormone is increased in follicular fluid from unstimulated ovaries in women with polycystic ovary syndrome

Cited by 92 publications

References 27 publications

Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high?

Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high?

Correlation of serum Anti-Müllerian hormone concentrations on day 3 of the in vitro fertilization stimulation cycle with assisted reproduction outcome in polycystic ovary syndrome patients

Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms

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