The relationship between serum anti-Müllerian hormone levels and the follicular arrest for women with polycystic ovary syndrome

Abstract

(2015) The relationship between serum anti-Müllerian hormone levels and the follicular arrest for women with polycystic ovary syndrome, Systems Biology in Reproductive Medicine, 61:2, 103-109, DOI: 10.3109/19396368.2014.973123 To link to this article: https://doi.org/10. 3109/19396368.2014 AbstractThe aim of this study was to ascertain whether higher levels of serum anti-Mü llerian hormone (AMH) are associated with the ovarian follicular arrest in women with polycystic ovary syndrome (PCOS). This prospective study compared AMH levels between serum and dominant follicular fluid (FF) in ovulatory polycystic ovary (PCO) women and anovulatory (menstrual cycle !60 days.) PCOS women. All 102 women provided a baseline hormone profile and underwent controlled ovarian hyperstimulation (COH). The anovulatory PCO women had a similar body mass index (BMI), antral follicle count (AFC), and baseline serum AMH levels as the ovulatory PCO women except that their median luteinizing hormone (LH; 10.0 mIU/ml), testosterone (T) (0.61 ng/l), and androstenedione (A) (3.47 ng/l) levels were significantly higher than ovulatory PCO women (4.9 mIU/m; 0.43 ng/l and 2.09 ng/l, respectively). The ovarian response to gonadotropin stimulation during COH including serum AMH on the day of HCG administration and dominant FF AMH at 36 hours after HCG administration, total follicle stimulating hormone (FSH) dose administrated, peak E 2 , (estrogen) levels and number of occytes retrieved were all similar between women with anovulatory and ovulatory PCO. Using multiple regression analysis it was found that an important independent determinant affecting AMH was AFC, as opposed to LH and T. Logistic regression analysis showed that the two most important factors affecting ovulation were serum LH and T, whereas serum AMH and AFC were not selected for inclusion in the model. The reduction in AMH during COH occurs as a consequence of dominant follicles with a corresponding reduction in small antral follicle number. Elevated serum AMH levels in PCO women seem to be related only to follicular excess and not follicular arrest.

Mechanism of elevated LH/FSH ratio in lean PCOS revisited: a path analysis

“…This study revealed a significant positive correlation between AMH levels and the LH/FSH ratio in lean women with PCOS (Table 3 ). Several previous studies have reported similar findings, demonstrating a positive correlation between AMH and LH levels in women with PCOS 46 – 48 . In women with PCOS, there is an increased production of AMH from ovarian granulosa cells compared to controls.…”

Efficacy of predictive models for polycystic ovary syndrome using serum levels of two antimüllerian hormone isoforms (proAMH and AMHN,C)

“…Ultrasound was used to confirm the presence or absence of PCO in a subset of women, but data on ovarian morphology and antral follicle counts were not collected as experimental variables. Increases in per-follicle output have been observed in women with PCOS (11,41) and this, in combination with increased numbers of antral follicles, is the likely explanation for the increased total AMH levels in serum. Incorporating antral follicle counts into future multivariate predictive models may enable AMH output per follicle to be estimated (Serum [Total AMH]/Antral follicle count) and assessed as a predictive variable.…”

An update on polycystic ovary syndrome: A review of the current state of knowledge in diagnosis, genetic etiology, and emerging treatment options

“…The minute follicles resemble cyst-like structures on transvaginal ultrasonography. [38][39][40][41][42] Initially, as authorized in the Rotterdam criteria, the cut-off value for identifying a polycystic morphology was a value of 12 or more Follicle Number Per Ovary (FNPO), measuring between the size of 2-9 mm or, an ovary with a volume of 10 cm 3 on a transvaginal scan. 26 The FNPO value, a key parameter, was later updated in conformity with the technological advancements that enabled more magnified imaging.…”