Müllerian-inhibiting substance in follicular fluid and serum: a comparison of patients with tubal factor infertility, polycystic ovary syndrome, and endometriosis

Fallat, Mary E.; Siow, Yong; Marra, Maureen; Cook, Christine L.; Carrillo, Alberto J.

doi:10.1016/s0015-0282(97)81417-3

Cited by 170 publications

(117 citation statements)

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“…AMH has been shown to be two-to three-fold higher in serum from women with PCOS than in women with normal ovaries (Fallat et al 1997). This was initially thought to be due to the increase in the number of small Anti-Mü llerian hormone and PCOS antral follicles; however, in 2007, we demonstrated that AMH production was on average 75 times higher per granulosa cell from anovPCOs than from cells from normal ovaries (Fig.…”

Section: Amh and Pcosmentioning

confidence: 65%

“…It may be possible that it is not FSH per se that is affecting AMH levels, but it is the FSH-stimulated OE 2 production, and this effect may take a little longer to become evident. In support of this, a number of groups have shown a negative correlation between OE 2 and serum AMH concentrations in women with PCOS (Fallat et al 1997, La Marca et al 2004a; however, OE 2 production by the follicle is the end point of many processes and factors, and again these results are difficult to interpret. It seems that there is a fine balance between AMH production and follicle sensitivity to FSH, which will need to be examined further.…”

Section: Anti-mü Llerian Hormone and Pcosmentioning

confidence: 98%

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

Pellatt¹,

Rice²,

Mason³

2010

Reproduction

186

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: 65%

Section: Anti-mü Llerian Hormone and Pcosmentioning

confidence: 98%

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

Pellatt¹,

Rice²,

Mason³

2010

Reproduction

186

112

View full text Add to dashboard Cite

show abstract

“…Similar data have been found in several studies like that of Tian et al in 2014 (7.4 versus 3.5). [14][15][16][17] This means that even in our black African population, the AMH is significantly higher in PCOS women compared to non-PCOS women. This is due to the numerous follicles whose maturation is blocked in the ovaries of PCOS patients, but also to the deregulation of the expression of the AMH and of its specific receptor in the presence of LH, responsible of hyperstimulation of AMH production in the presence of LH, and no negative feedback of its receptor supposed to regulate this effect.…”

Section: Discussionmentioning

confidence: 79%

Correlation between the anti-Müllerian hormone and endovaginal ultrasound in the predictivity of polycystic ovary syndrome at Chracerh

Ndoua¹,

Ngah

Koh

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Polycystic ovary syndrome (PCOS) is a heterogeneous syndrome posing diagnostic problems in current practice, because of the cumbersomeness associated with the application of the criteria that define it; giving rise to over or under diagnosis of it. Anti-Müllerian hormone (AMH) is an effective alternative in this case, being a stable, reproducible and non-operator dependent marker to diagnose PCOS due to the link that binds it to the multiple pre-antral follicles in the ovaries of PCOS patients. The aim of this study was to determine the threshold value of AMH required to define PCOS in our African population, by revealing the correlation with antral follicles count (AFC) on endovaginal ultrasound.Methods: We carried out a comparative cross-sectional study, with retrospective data collection in 23 infertile patients diagnosed with PCOS according to the Rotterdam 2003 criteria, and 23 non-PCOS infertile controls having performed the AMH test using the Immunotech technique at CHRACERH. Endovaginal ultrasound (U/S) was performed using a 7.5 mega Hertz (MHz) transvaginal transducer by different qualified operators (radiologists, gynecologists). The comparison of the two independent groups (PCOS and non-PCOS) was performed by the Student t-test; correlations between AMH, age, AFC and ovarian volume obtained by the Pearson test; and the diagnostic power of AMH test in PCOS was evaluated by receiver operating characteristic curves (ROC).Results: AMH was approximately twice as high in PCOS compared to controls (6.09 versus 3.80, P <0.001) and was inversely correlated with age (r = -0.301; P ˂0.05); significantly correlated antral follicle count (R = 0.85, P <0.0001) and ovarian volume (r = 0.625, P <0.0001). ROC analysis revealed that the AMH test was very informative for the diagnosis of PCOS with an area under the curve (AUC) at 0.90 (0.81-0.99; 95% CI); and the threshold value given by the farthest point of the diagonal representing the nil contribution test was 4.40 ng/L, and predicted PCOS with a sensitivity of 96% and a specificity of 70%.Conclusions: AMH is a predictive marker for PCOS. It is highly correlated with AFC and ovarian volume and appears to decrease with age. It offers good diagnostic performance in PCOS, with a threshold value of 4.40 ng/L for a sensitivity of 96% and specificity of 70%.

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“…Results in Tables-(1 and 2) illustrated non-significant increase in AMH levels in GB and GC comparing to GA . Earlier data showed that in women with PCOS, serum and follicular AMH levels are higher than in healthy controls [18,19]. Subsequent data confirmed this finding and indicated that the elevated levels of AMH were related to increased number of follicles with a diameter of 2-5mm in women with PCOS [20].…”

Section: Resultsmentioning

confidence: 87%

Effect of Anti Mullerian Hormone (AMH) on Hyperthyroidism with and without polycystic ovarian syndrome (PCOS) in female patients

M.A Al-Qaisi,

M.J Al-Shammaa

2021

Iraqi Journal of Science

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AbstractsEffect Anti-Mullerian Hormone (AMH) on thyroid levels in patients with and without polycystic ovarian syndrome PCOS was studied, The results showed an increase in AMH ,T3 ,T4 with increase of age while TSH , BMI decreased with increase of age comparing to control in hyperthyroidism with PCOS patients. Otherwise an increase in AMH, TSH, BMI, T3 and T4 with increase of Age compared to healthy group in hyperthyroidism without PCOS. Effect of ovarian hormones (AMH) on inventory levels of thyroid and perturbations in terms of increases and its impact obesity as well as fertility in women was declared in this research. Serum Anti-Müllerian Hormone (AMH) was assessed using enzyme linked immunosorbent kit [Elisa] while Thyroid stimulating hormone (TSH), Triiodothyronine (T3), Thyroxin (T4) were determined by VIDAS kit method(enzyme linked fluorescent assay). Keywords ISSN: 0067-2904Al-Qaisi and Al-Shammaa Journal of Science, 2017, Vol. 58, No.4A, pp: 1808-1814 1809 IntroductionAnti-Mullerian hormone (AMH) is a dimeric glycoprotein belonging to the transforming growth factor-beta (TGF-β) super family, which acts on tissue growth and differentiation. It is composed of two 55KDa N-terminal and two 12.5KDa C-terminal homodimers, non-covalently linked by disulfide bridges [1]. Recent study have shown that the AMH C-terminal homodimer is much less active than the noncovalent complex, but almost all activity can be restored by associating with the N-terminal pro-region, which reforms a complex with the mature C-terminal homodimer. This finding raises the possibility that the AMH noncovalent complex is the active form of protein. It was reported that the cleaved AMH noncovalent complex binds to AMHRll and stimulates intracellular signaling, whereas full-length AMH shows only minimal activity [2]. In females, AMH is produced by the granulosa cells of small growing follicles from the 36 th week of gestation onwards until menopause when levels become undetectable. Potential clinical applications of low end anti-mullerian hormone (AMH) have been published in premature ovarian insufficiency, ovarian tumors, menopause and many more. AMH serum concentrations in females are thought to reflect the size of the ovarian follicle pool [3]. In general AMH production rate is considered to reflect the amount of growing follicles in ovaries and the reservoir of ovarian function in females [4]. Circulating AMH concentration predicts responsiveness to in vitro fertilization [5] decreases with aging [6]. AMH levels appear to remain constant throughout the menstrual cycle and thus can be reliably measured at any time unlike FSH, LH, estrodiol and other hormone markers that must be measured in the early follicular phase. The VIDAS T4 assay aids in assessing thyroid function, which is characterized by increase in patients with hyperthyroidism [7]. Hyperthyroidism is a condition caused by unregulated production of thyroid hormones. Thyrotoxicosis is a serious sequela of hyperthyroidism that corresponds to an overt tissue exposure to excess ...

show abstract

Müllerian-inhibiting substance in follicular fluid and serum: a comparison of patients with tubal factor infertility, polycystic ovary syndrome, and endometriosis

Cited by 170 publications

References 5 publications

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

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

Correlation between the anti-Müllerian hormone and endovaginal ultrasound in the predictivity of polycystic ovary syndrome at Chracerh

Effect of Anti Mullerian Hormone (AMH) on Hyperthyroidism with and without polycystic ovarian syndrome (PCOS) in female patients

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