The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in non-obese subfertile women with and without polycystic ovary syndrome

Nardo, Luciano G.; Yates, Allen P.; Roberts, Stephen A.; Pemberton, P.; Laing, Ian

doi:10.1093/humrep/dep225

Cited by 166 publications

(109 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although similar stimulation protocols are used in IVF, the ovarian response to exogenous FSH varies widely ranging from poor to hyper-responsive. Many parameters, such as age and diminished ovarian reserve (Klingman & Rosenwaks 2001) and serum AMH levels (Nardo et al 2009), have been used as a marker to predict the ovarian response. However, determining the dose of FSH to attain optimum response is one of the ongoing challenges in the field of infertility management in IVF clinics.…”

Section: Association Of Fshr Gene Polymorphisms With Ovarian Responsementioning

confidence: 99%

Mutations and polymorphisms in FSH receptor: functional implications in human reproduction

Desai¹,

Roy²,

Mahale³

2013

Reproduction

114

View full text Add to dashboard Cite

FSH brings about its physiological actions by activating a specific receptor located on target cells. Normal functioning of the FSH receptor (FSHR) is crucial for follicular development and estradiol production in females and for the regulation of Sertoli cell function and spermatogenesis in males. In the last two decades, the number of inactivating and activating mutations, single nucleotide polymorphisms, and spliced variants of FSHR gene has been identified in selected infertile cases. Information on genotype-phenotype correlation and in vitro functional characterization of the mutants has helped in understanding the possible genetic cause for female infertility in affected individuals. The information is also being used to dissect various extracellular and intracellular events involved in hormone-receptor interaction by studying the differences in the properties of the mutant receptor when compared with WT receptor. Studies on polymorphisms in the FSHR gene have shown variability in clinical outcome among women treated with FSH. These observations are being explored to develop molecular markers to predict the optimum dose of FSH required for controlled ovarian hyperstimulation. Pharmacogenetics is an emerging field in this area that aims at designing individual treatment protocols for reproductive abnormalities based on FSHR gene polymorphisms. The present review discusses the current knowledge of various genetic alterations in FSHR and their impact on receptor function in the female reproductive system. Reproduction (2013) 146 R235-R248

show abstract

Section: Association Of Fshr Gene Polymorphisms With Ovarian Responsementioning

confidence: 99%

Mutations and polymorphisms in FSH receptor: functional implications in human reproduction

Desai¹,

Roy²,

Mahale³

2013

Reproduction

114

View full text Add to dashboard Cite

show abstract

“…In patients diagnosed with 'PCOS', AMH is significantly elevated in serum (17,18) as well as in the follicular fluid (19). In addition, AMH seems to be related to body mass index (BMI) (20), fasting insulin levels (21), and DHEAS (22).…”

Section: Introductionmentioning

confidence: 99%

Anti-Müllerian hormone confirms the novel classification of female functional androgenization including polycystic ovary syndrome

Wetzka

Textor²,

Ochsner³

et al. 2011

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Functional androgenization (FA) can be divided into five groups corresponding to the predominant organ pathology as recently shown by our group: functional cutaneous androgenization (FCA, skin) and FA syndrome (FAS) I (ovary, lean individual), II (adrenal gland), III (ovary, fat tissue, pancreas, and hyperinsulinemia), and IV (residual FA dysfunctions). Group-specific clusters are based on primary variables such as LH, testosterone, DHEAS, sex hormone-binding globulin (SHBG), body mass index (BMI), glucose, insulin, and enlarged polyfollicular ovaries. Because anti-Mü llerian hormone (AMH) positively correlates with the antral follicle count, its relevance as an additional primary variable for classifying FA was investigated. Design: In this study, 178 patients with FA were consecutively enrolled and classified into the five FA groups as described earlier and 30 women with regular menstrual cycles served as control. Methods: Primary variables and serum AMH were analyzed in the early follicular phase. Results: FA patients showed significantly elevated AMH levels (11.1G6.7 ng/ml) versus control (3.0G2.0 ng/ml; P!.0001). AMH was significantly increased in groups FAS I (15.6G5.8 ng/ml) and FAS III (11.6G6.6 ng/ml) compared with groups FCA (7.0G3.8 ng/ml), FAS II (5.05G3.0 ng/ml), and FAS IV (6.9G4.6 ng/ml) and correlated positively (P!.0001) with LH (rZ0.538) and testosterone (rZ0.368). In regression and multivariate analyses, AMH was not dependent on SHBG, DHEAS, BMI, glucose, or insulin. In receiver operating characteristic analysis, 9.21 ng/ml AMH showed 90% specificity with 71.2% sensitivity for the diagnosis of the two ovarian FA groups, FAS I and III. Conclusion: AMH confirms the novel stratification system and constitutes a useful primary variable in the algorithm of FA classification.

show abstract

“…AMH levels appear to be related to the severity of PCOS, as represented by elevated luteinizing hormone (LH), testosterone or insulin levels or an increased follicle number and/or ovarian volume as established on ultrasound [8][9][10][11]. Moreover, AMH is higher in amenorrheic compared with oligomenorrheic women with PCOS, indicating higher AMH levels reflect more impaired disruption in folliculogenesis and granulosa cell function in the ovary [8].…”

mentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in non-obese subfertile women with and without polycystic ovary syndrome

Cited by 166 publications

References 40 publications

Mutations and polymorphisms in FSH receptor: functional implications in human reproduction

Mutations and polymorphisms in FSH receptor: functional implications in human reproduction

Anti-Müllerian hormone confirms the novel classification of female functional androgenization including polycystic ovary syndrome

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

Contact Info

Product

Resources

About