Early Follicular Anti-Mullerian Hormone and Antral Follicle Count as an Indicator of Ovarian Reserve: A First Pilot Study in the Nepalese Population

Abstract

Background: Anti-Mullerian Hormone (AMH) is produced by the granulosa cells of primary, preantral and greater antral follicles, and plays an imperative role in human folliculogenesis. It is a measure of ovarian function, useful in assessing conditions such as polycystic ovary syndrome and premature ovarian failure. The objective of this study was to evaluate the correlation between chronological age with levels of antral follicle count (AFC), and AMH. Methods: Anti-Mullerian Hormone (AMH) is produced by the granulosa cells of primary, preantral and greater antral follicles, and plays an imperative role in human folliculogenesis. It is a measure of ovarian function, useful in assessing conditions such as polycystic ovary syndrome and premature ovarian failure. The objective of this study was to evaluate the correlation between chronological age with levels of antral follicle count (AFC), and AMH. Results: The correlations between AFC, AMH, and age were statistically significant. The lowest value of AMH and AFC were 0.09 ng/ml and 1 respectively. The highest values of AMH and AFC were 15.90 ng/ml and 14 respectively. The study revealed consistent levels of AMH up to 25 years of age, whereas decline in the levels post 25 years. Conclusion: AFC is being used as a marker of ovarian reserve; AMH levels have a positive correlation with AFC and can be measured on any day of the cycle. Anti-Mullerian hormone is believed to be of paramount importance in its role as an endocrine marker for assessment of decline of the ovarian pool in healthy women; thus, it has a potential ability to predict future reproductive lifespan.