Relação entre os níveis séricos do hormônio anti-Mulleriano, inibina B, estradiol e hormônio folículo estimulante no terceiro dia e o status folicular ovariano

Abstract

Relação entre os níveis séricos do hormônio anti-Mulleriano, inibina B, estradiol e hormônio folículo estimulante no terceiro dia e o status folicular ovariano antrais foi determinado pela ultra-sonografi a (dia basal) (folículo antral precoce; 3-10 mm). RESULTADOS: as médias do nível sérico de HAM, inhibina B, E 2 , P 4 e FSH (dia basal) foram 3,4±0,14 ng/mL, 89±4,8 pg/mL, 34±2,7 pg/mL, 0,22±0,23 ng/mL e 6,6±0,1 mUI/mL, respectivamente, e a média do número de folículos antrais precoces foi 17±0,39. O nível sérico do HAM foi negativamente correlacionado com a idade (r= -0,19, p<0,04) e positivamente correlacionado com o número de folículos antrais precoces (r=0,65, p<0,0001), mas isto não se aplicou aos níveis séricos de inibina B, E 2 e FSH. CONCLUSÕES: esse dado demonstra a associação do HAM com a quantidade de folículo antral, sendo aquele, portanto, um provável biomarcador do status folicular ovariano.Abstract PURPOSE: to examine the hypothesis that serum anti-Müllerian hormone (AMH) levels refl ect the ovarian follicular status. METHODS: Design: prospective study. Patients: we studied 101 IVF-ET candidates undergoing controlled ovarian hyperstimulation with GnRH agonist and FSH. After the achievement of pituitary suppression and before FSH administration (baseline), serum AMH, inhibin B, and FSH levels were measured. The number of antral follicles was determined by ultrasound at baseline (early antral follicles; 3-10 mm). RESULTS: at baseline, median serum levels of AMH, inhibin B, E 2 , P 4 and FSH were 3.42±0.14 ng/mL, 89±4.8 pg/mL, 34±2.7 pg/mL, 0.22±0.23 ng/mL and 6.6±0.1 mIU/mL, respectively, and the mean number of early antral follicles was 17±0.39. Serum levels of AMH were negatively correlated with age (r=-0.19, p<0.04), and positively correlated with number of antral follicles (r=0.65, p<0.0001), but this did not apply to serum levels of either inhibin B, E 2 or FSH. CONCLUSIONS: the data demonstrate an association between AMH and antral follicular counts. Therefore, AMH is probable a biomarker of ovarian follicular status.

Ovarian reserve evaluation: state of the art

“…Other studies, however, have not reproduced the results favorable to the use of inhibin-B as a marker of ovarian reserve [34][35][36], which remains a subject to be studied further. No studies have confirmed what was postulated more than one decade ago by Franchimont et al and Fowler et al, who proposed a possible association of inhibin-B concentrations with oocyte quality in AR cycles [37,38].…”

“…In other words, AMH is considered to be a marker that can estimate the quantity and activity of retrievable follicle units in early stages of maturation, thus being more reliable for the prediction of ovarian reserve [24,36,42,[48][49][50][51].…”

Revisiting Ovarian Reserve Evaluation with Focus on Infertility

“…In agreement with them, Seifer et al demonstrated the presence of higher estrogenic response and number of oocytes obtained after stimulation for ART when women had serum inhibin-B ≥ 45 pg/mL, while cancellations were three times more frequent among patients with lower levels (Seifer et al, 1997). Other studies, however, were unable to repeat favorable results on the use of inhibin-B as a marker of ovarian reserve (Corson et al, 1999;Scheffer et al, 2007). The systematic review of Broekmans et al was categorical in stating that the high rate of false positives in routine determination of basal inhibin-B should lead to unnecessary exclusion of patients from IVF programs.…”

“…In the last decade, anti-müllerian hormone (AMH) has been used as predictor ovarian follicular reserve, since it signals the size of the pool of growing follicles, which in turn would be correlated to the stock of primordial follicles. In other words, it is considered to be an accurate marker, able to estimate the amount and activity of recruitable follicles at early stages of maturation, being, thus, more reliable for prediction of ovarian reserve (van Rooij et al, 2002;Fanchin et al, 2003, Muttukrishna et al, 2005, Scheffer et al, 2007. Since AMH reduced variability in serum has been demonstrated along menstrual cycles, the marker has gained credibility and consistency when compared with FSH, inhibin-B and E2 (Fanchin et al, 2005;La Marca et al, 2006;Elgindy et al, 2008).…”

Follicular Atresia, Cell Proliferation, and Anti-Mullerian Hormone in Two Neotropical Primates (Aotus nancymae and Sapajus macrocephalus)

“…AMH is produced by granulosa cells from follicles recruited to dominance and is likely involved in the regulation of follicular steroidogenesis [ 66 ]. Furthermore, AMH can act as an indirect serum marker of ovarian reserve and is considered a potential biomarker of ovarian follicular status [ 67 , 68 , 69 , 70 ]. Thus, we suggest that AMH acts as a regulator in the maturation of preantral and antral follicles during the ovarian cycle of the species in this study.…”