Abstract
To analyze the ovarian reserve via measurement of follicular density and anti-Müllerian hormone (AMH) in endometriosis patients participating to a clinical program of cortical ovarian cryopreservation. Retrospective analysis of serum AMH levels and prospective investigation of ovarian follicle number. University Hospital. Two hundred and two women with endometriosis and 400 controls. Blood samples and ovarian biopsies. Correlation of serum AMH levels and the number of non-growing follicles in the biopsied cortical tissues in endometriosis and control subjects, including age, type of AMH kit, and the laboratory performing the analysis as covariates. AMH levels were shown to decrease with age in untreated endometriosis patients (P < 1.0 × 10-5) but they were significantly lower in endometriosis compared to controls only in patients over 36 years old (P = 2.7 × 10-4). The AMH decrease was faster in endometriosis compared to controls (beta = 0.27, P = 4.0 × 10-4). Primordial follicle number decreased with the reduction of AMH levels in both cases and controls (beta = 0.3; P = 0.04). AMH is a reliable marker of ovarian reserve in endometriosis patients, and it can predict follicular density in women undergoing ovarian tissue cryopreservation.
Highlights
Fertility preservation represents a significant clinical challenge for the biomedical community
The most used non-invasive tests are the ovarian antral follicle count (AFC), evaluated by ultrasound, and serum anti-Müllerian hormone (AMH) [8] both considered predictive in assisted reproductive treatment (ART) or for age of menopause [9, 10]
Even though a limited sample size was analyzed, we showed that AMH might be used as a marker of ovarian reserve in endometriosis cases
Summary
Fertility preservation represents a significant clinical challenge for the biomedical community. Available options for fertility preservation for adult women include the cryopreservation of oocytes, which, thanks to the development of vitrification protocols, allows the achievement of fertilization rates comparable to those with fresh gametes [3, 4]. This approach cannot be applied to young women who have not yet reached sexual and psychological maturity, to patients who need to start an immediate anticancer treatment, or to women with hormonesensitive malignancies. The most used non-invasive tests are the ovarian antral follicle count (AFC), evaluated by ultrasound, and serum anti-Müllerian hormone (AMH) [8] both considered predictive in assisted reproductive treatment (ART) or for age of menopause [9, 10]
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