Changes in Anti-Müllerian Hormone (AMH) throughout the Life Span: A Population-Based Study of 1027 Healthy Males from Birth (Cord Blood) to the Age of 69 Years

Aksglæde, Lise; Sørensen, Kaspar; Boas, Malene; Mouritsen, Annette; Hagen, Casper P; Jensen, Rikke Beck; Petersen, Jørgen Holm; Linneberg, Allan; Andersson, Anna‐Maria; Main, Katharina M.; Skakkebæk, Niels E.; Juul, Anders

doi:10.1210/jc.2010-1207

Cited by 225 publications

(228 citation statements)

References 41 publications

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“…A second interpretation is that the gonadal endocrine system of sperm retrieval positive and negative iNOA men may be representative of different stages of testicular development/maturation. The blood level of AMH is high from the neonatal to the pubertal stage in males, with a subsequent decrease to 3-4% of the infant levels throughout the adulthood 35 . In this context, AMH production is under the control of FSH up to the pubertal stage 36 without being subject to control by androgens 37 ; in contrast, AMH level is drastically reduced by T during the adult life 16 .…”

Section: Discussionmentioning

confidence: 98%

Anti-Mullerian hormone-to-testosterone ratio is predictive of positive sperm retrieval in men with idiopathic non-obstructive azoospermia

Alfano¹,

Ventimiglia²,

Locatelli³

et al. 2018

European Urology Supplements

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The lack of clinically-reliable biomarkers makes impossible to predict sperm retrieval outcomes at testicular sperm extraction (TESE) in men with non-obstructive azoospermia (NOA), resulting in up to 50% of unnecessary surgical interventions. Clinical data, hormonal profile and histological classification of testis parenchyma from 47 white-Caucasian idiopathic NOA (iNOA) men submitted to microdissection TESE (microTESE) were analyzed. Logistic regression analyses tested potential clinical predictors of positive sperm retrieval. The predictive accuracy of all variables was evaluated using the receiver operating characteristic-derived area under the curve, and the clinical net benefit estimated by a decision-curve analysis (DCA). Overall, 23 (49%) and 24 (51%) patients were classified as positive and negative sperm retrievals at microTESE. While circulating hormones associated to a condition of primary hypogonadism did not predict sperm retrieval, levels of anti-Mullerian hormone (AMH) and the ratio AMH-to-total Testosterone (AMH/tT) achieved independent predictor status for sperm retrieval at microTESE, with a predictive accuracy of 93% and 95%. Using cutoff values of <4.62 ng/ml for AMH and <1.02 for AMH/tT, positive sperm retrieval was predicted in all individuals, with 19 men out of 47 potentially spared from surgery. DCA findings demonstrated clinical net benefit using AMH and AMH/tT for patient selection at microTESE.The relevance of male infertility has progressively grown in Western societies, with significant medical, psychological, and socio-economic implications. Seven out of 100 men are infertile, with up to 40% of infertile conditions still of unexplained or idiopathic origin [1][2][3] . Azoospermia affects about 1% among all men and 10-15% of infertile men 4,5 . With no sperm found at multiple semen analyses, non-obstructive azoospermia (NOA) is the most severe form of infertility 1,5 . Despite genetic causes have been associated with male infertility 3,6,7 , genetic defects are found only in 17-20% of NOA individuals [7][8][9][10] . Except for a portion of patients with central endocrine disorders, the remaining 80% of NOA men having negative results on genetic testing are classified as idiopathic NOA (iNOA) 11 .In patients with clinical evidence of NOA, testicular sperm extraction (TESE) is the technique of choice, which rationally has to be planned as a part of in vitro fertilization programs; in this context, microdissection TESE (microTESE) has been advocated as the gold-standard technique to improve sperm yield with minimal

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Section: Discussionmentioning

confidence: 98%

Anti-Mullerian hormone-to-testosterone ratio is predictive of positive sperm retrieval in men with idiopathic non-obstructive azoospermia

Alfano¹,

Ventimiglia²,

Locatelli³

et al. 2018

European Urology Supplements

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“…71 In boys, AMH concentrations fall as Sertoli cells differentiate and testos terone production increases. 72 In male individuals, INSL3 is secreted by Leydig cells during fetal and immediate postnatal life. 8,73 Testicular INSL3 secretion declines during childhood before increasing at the time of puberty and peaking during adulthood.…”

Section: Puberty and Reproductionmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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“…The thick lines illustrate the mean levels, and the thin lines the 95% CI. The illustration is based on the following references: Josso et al (1993), Lee et al (1996), Schwindt et al (1997), Rajpert-De Meyts et al (1999), Rey et al (1999), Guibourdenche et al (2003), Oppelt et al (2005), Aksglaede et al (2010), Hagen et al (2010), Grinspon et al (2011) and Chong et al (2013). See also Tran et al (1987), Munsterberg & Lovell-Badge (1991), Hirobe et al (1992), Taketo et al (1993) and Al-Attar et al (1997) for information on mice and rats.…”

Section: Two Forms Of Amh Exist In the Circulationmentioning

confidence: 99%

Anti-Müllerian hormone is a gonadal cytokine with two circulating forms and cryptic actions

McLennan¹,

Pankhurst²

2015

Journal of Endocrinology

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Anti-Mü llerian hormone (AMH) is a multi-faceted gonadal cytokine. It is present in all vertebrates with its original function in phylogeny being as a regulator of germ cells in both sexes, and as a prime inducer of the male phenotype. Its ancient functions appear to be broadly conserved in mammals, but with this being obscured by its overt role in triggering the regression of the Mü llerian ducts in male embryos. Sertoli and ovarian follicular cells primarily release AMH as a prohormone (proAMH), which forms a stable complex (AMH N,C ) after cleavage by subtilisin/kexin-type proprotein convertases or serine proteinases. Circulating AMH is a mixture of proAMH and AMH N,C , suggesting that proAMH is activated within the gonads and putatively by its endocrine target-cells. The gonadal expression of the cleavage enzymes is subject to complex regulation, and the preliminary data suggest that this influences the relative proportions of proAMH and AMH N,C in the circulation. AMH shares an intracellular pathway with the bone morphogenetic protein (BMP) and growth differentiation factor (GDF) ligands. AMH is male specific during the initial stage of development, and theoretically should produce male biases throughout the body by adding a male-specific amplification of BMP/GDF signalling. Consistent with this, some of the male biases in neuron number and the non-sexual behaviours of mice are dependent on AMH. After puberty, circulating levels of AMH are similar in men and women. Putatively, the function of AMH in adulthood maybe to add a gonadal influence to BMP/GDF-regulated homeostasis.

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Changes in Anti-Müllerian Hormone (AMH) throughout the Life Span: A Population-Based Study of 1027 Healthy Males from Birth (Cord Blood) to the Age of 69 Years

Cited by 225 publications

References 41 publications

Anti-Mullerian hormone-to-testosterone ratio is predictive of positive sperm retrieval in men with idiopathic non-obstructive azoospermia

Anti-Mullerian hormone-to-testosterone ratio is predictive of positive sperm retrieval in men with idiopathic non-obstructive azoospermia

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

Anti-Müllerian hormone is a gonadal cytokine with two circulating forms and cryptic actions

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