Anti-Müllerian Hormone Determination Research Articles

Effect of a GnRH Antagonist on Anti-Müllerian Hormone and Follicular Population in Anestrous Bitches.

The objective of this study was to describe the effect of the third-generation GnRH antagonist, acyline, on ovarian follicular population and serum anti-Müllerian hormone (AMH) concentrations in female dogs. Four late anestrous bitches were administered 330 μg/kg SC acyline every 10 days for 60 days and followed up for 45 days. Blood samples were drawn on days -1, 15, 30, 45, 60, 75, 90 and 105 for AMH determination. Then, the females were ovariectomized and the excised ovaries were gross and histologically evaluated. The total ovarian follicles were counted. None of the female dogs presented estrus during treatment. Only one bitch presented an ovulatory estrus 20 days after treatment. The total number of ovarian follicles in these bitches was 96,200.10 ± 26,125.12, with 84.13%, 11.36%, 7.8% and 0.01% corresponding to primordial, primary, secondary and antral structures, respectively. Pretreatment AMH concentrations were 0.62 ± 0.17 ng/mL. This hormone varied throughout the study period (p < 0.01), diminishing to nadir values during treatment to then rapidly recover after its effect (0.2 ± 0.05 vs. 0.67 ± 0.22 ng/mL; p < 0.01). Acyline rapidly and reversibly prevented the initiation of cycling without affecting follicle count but diminishing serum AMH concentrations.

Effects of postpartum diseases on antral follicle count and serum concentration of Anti-Müllerian hormone in dairy cows

The antral follicle count (AFC) and Anti-Müllerian hormone (AMH) concentration are validated markers for ovarian reserve in cattle, but their use as fertility markers is controverse. Here we assessed the effects of postpartum diseases on AFC and AMH concentration, as well as the influence of parity and breed on these parameters. Cows (n = 513, mostly Holstein Friesian and Brown Swiss, parity 3.0 ± 1.8) underwent a single ultrasonography examination 28–56 days after parturition and categorized as having low (n ≤ 15 follicles), intermediate (n = 16–24 follicles), or high (n ≥ 25 follicles) AFC based on objective video analysis of recorded sequences. Blood samples for AMH determination were collected at the time of examination and animals divided into low (< 0.05 ng/ml) and high AMH (≥ 0.05 ng/ml) group, respectively. No effects of postpartum diseases or breed on either AFC or AMH groups could be observed. There was a strong interaction between parity and AFC, primiparous cows having less follicles (13.6 ± 6.2 vs. 17.1 ± 7.0, P < 0.001) than pluriparous cows. The AFC did not affect reproductive parameters or productivity of the cows. In comparison, pluriparous cows with high AMH concentration had shorter calving to first service (86.0 ± 37.6 vs. 97.1 ± 46.7 days, P < 0.05) and calving to conception (123.8 ± 51.9 vs. 135.8 ± 54.4 days, P < 0.05) intervals, but lower milk yield (8440.3 ± 2292.9 vs. 8927.9 ± 2192.5 kg, P < 0.05) compared to cows with low AMH. In conclusion, no effect of postpartum diseases on AFC or AMH concentration of dairy cows could be observed. However, an interaction between parity and AFC, as well as associations of AMH with fertility and productivity in pluriparous cows, were demonstrated.

O-135 Application of AMH determination in preoperative evaluation of micro-TESE in NOA patients

Abstract Study question To investigate the value of anti-Müllerian hormone(AMH) determination for estimating the sperm retrieval rate(SRR) of microdissection testicular sperm extraction(micro-TESE) in non-obstructive azoospermia(NOA) patients. Summary answer NOA with low AMH would have more opportunity to present heterogeneous seminiferous tubules when micro-TESE was performed and had higher SRR, especially in idiopathic cases. What is known already For infertile patients with NOA, micro-TESE is considered to have higher SRR than traditional surgery methods. However, serum inhibin B, follicle-stimulating hormone (FSH) and various clinical parameters are not reliable predictors for the presence of focal spermatogenesis and SRR. In male, AMH is a glycoprotein secreted by Sertoli cells and facilitate the regression of Müllerian structures in the developing foetus. It is still controversial that whether AMH level has value to predict the SRR of micro-TESE. Study design, size, duration This was a retrospective case-control study. From September 2014 to May 2022, 502 NOA patients treated with micro-TESE were divided into different groups according to their surgery outcome and seminiferous tubules appearance. Age, testis volume, serum AMH, FSH and testosterone level were compared between the different groups. The differences of SRR and AMH level in NOA patients with different etiologies were also compared. Participants/materials, setting, methods Micro-TESE was performed at x10 to x20 magnification. An attempt was made to identify seminiferous tubules that were larger and more opaque than others. The procedure was terminated when sperm were retrieved. If all tubules were seen to have an identical appearance, at least three samples (upper, middle, and lower) were extracted. Venous blood samples were drawn from each patient (7–10 AM) after an overnight fast. FSH and AMH were measured by electrochemiluminescence immunoassay. Main results and the role of chance Testicular sperms were successfully retrieved in 270 cases (SRR=53.8%). There were no statistical differences in age, testicular volume, FSH and testosterone levels between the patients who succeeded and failed to obtain sperm (all P&amp;gt;0. 05). The patients who obtained sperms had lower serum AMH level than those without sperm [0.81(0.16, 3.26)μg/L vs.1.37(0.21, 4.84)μg/L, P&amp;lt;0.05]. Patients with orchitis or AZFc deletion, cryptorchidism, KS, idiopathic azoospermia would have different AMH level [0.15(0.01, 0.41)μg/L, 5.71(3.57, 8.26)μg/L, 2.29(1.36, 3.81)μg/L, 0.15(0.05, 0.39)μg/L, 2.46(0.75, 5.49)μg/L, P&amp;lt;0.05]. Idiopathic azoospermia patients who obtained sperms had higher age but lower testosterone and AMH level than those without sperm [(35.2±8.9) years vs. (32.5±5.5) years, P&amp;lt;0.05, (3.1±1.4)μg/L vs. (3.7±2.1)μg/L, P&amp;lt;0.05; 1.63(0.35, 3.84)μg/L vs.3.00(1.20, 6.68)μg/L, P&amp;lt;0.05], there were no statistical differences in testicular volume and FSH level between the two groups (P&amp;gt;0.05). Receiver operating characteristic (ROC) curve showed that cut-off of serum AMH for successful sperm retrieval of idiopathic azoospermia patients was determined to be 2.96, with a sensitivity of 0.710 and specificity of 0.523, area under the curve (AUC) was 0.649. In the cases presenting heterogeneous seminiferous tubules during micro-TESE had lower AMH level and higher SRR than those presenting homogeneous seminiferous tubules [0.55(0.12, 2.05)μg/L vs.2.99(0.76, 6.11)μg/L, 75.9%(236/311)vs. 17.8%(34/191), all P&amp;lt;0.05]. Limitations, reasons for caution Pathology analysis should be involved in the following study. Randomized controlled trial comparing micro-TESE and traditional TESE would demonstrate that whether idiopathic azoospermia patients with higher serum AMH level would have less benefit by microsurgery than patients with lower AMH level. Wider implications of the findings Recently, in our pathologic research, NOA patients with extremely lower serum AMH level were observed to have more opportunity to present severe hyalinization in their seminiferous tubules. Tubules with severe hyalinization have less Sertoli cells and seem very thin. Therefore, tubules with spermatogenesis would be easy to identify during micro-TESE. Trial registration number not applicable

Anti-Müllerian hormone as a diagnostic tool to identify queens with ovarian remnant syndrome.

ObjectivesOvarian remnant syndrome (ORS) is suspected when heat signs occur in spayed individuals, but further diagnostic procedures are necessary to exclude other possible oestrogen sources, such as the adrenal gland or exogenous supplementation. Anti-Müllerian hormone (AMH), secreted by granulosa cells or Sertoli cells, serves to differentiate sexually intact from gonadectomised animals and has been described in dogs as a tool for diagnosing ORS. The aim of this study was to evaluate if AMH determination can be used to diagnose ORS in cats.MethodsAMH was measured with a chemiluminescence immunoassay in serum samples of 15 sexually intact, 9 spayed and 16 cats with a history of heat signs after spaying. Abdominal ultrasound (n = 13), vaginal smears (n = 7), progesterone measurement (n = 5) and laparotomy (n = 14) were used to determine the presence of ovarian tissue. After surgery, a histological examination of the obtained tissue was performed in the cats with suspected ORS.ResultsIn 15 cats with ORS the AMH serum concentrations were significantly higher than in spayed cats (n = 10; P = 0.025) and significantly lower than in sexually intact cats (n = 15; P = 0.001). Among the cats with ORS, the highest AMH serum concentrations were measured in the queens with cystic ovarian alterations and in one cat from which a whole ovary was obtained. The cat with the lowest AMH serum concentration had a simultaneous high progesterone serum concentration. Cats with ORS did not show any heat signs after surgical removal of the ovarian tissue.Conclusions and relevanceA single determination of AMH in blood serum is a useful diagnostic tool for the diagnosis of ORS in cats, regardless of the hormonal activity of the remnant ovarian tissue.

The role of anti-Müllerian Hormone (AMH) in girls and adolescents.

Anti-mullerian hormone (AMH) is produced by the granular cells of primary, preantral and antral follicles. The circulating levels of AMH in adult women reflect the number of remaining primordial follicles. AMH determination plays an increasingly important role in diagnostics in endocrinology and gynecology in adult women. Although the determination of AMH levels is used in pediatric practice, still little is known about its role in various pubertal disorders in girls. This article presents the clinical use of AMH in girls and adolescents.

Antral follicle count and anti-Müllerian hormone to classify low-prognosis women under the POSEIDON criteria: a classification agreement study of over 9000 patients.

What is the agreement between antral follicle count (AFC) and anti-Müllerian hormone (AMH) levels when used to patient classification according to the Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria? Our study indicates a strong agreement between the AFC and the AMH levels in classifying POSEIDON patients; thus, either can be used for this purpose, although one in four women will have discordant values when both biomarkers are used. According to the POSEIDON criteria, both AFC and AMH may be used to classify low-prognosis patients. Proposed AFC and AMH thresholds of 5 and 1.2 ng/ml, respectively, have their basis in published literature; however, no study has yet determined the reproducibility of patient classification in comparing one biomarker with the other, nor have their thresholds ever been validated within this patient population. A population-based cohort study involving 9484 consecutive patients treated in three fertility clinics in Brazil, Turkey and Vietnam between 2015 and 2017. Participants were infertile women between 22 and 46 years old in their first in vitro fertilization/intracytoplasmic sperm injection cycle of standard ovarian stimulation with exogenous gonadotropins whose baseline ovarian reserves had been assessed by both AFC and AMH. Details of pre- and post-treatment findings were input into a coded research file. Two indicators of interest were created to classify patients according to the POSEIDON criteria based upon AFC and AMH values. Patients who did not fit any of the four POSEIDON groups were classified as non-POSEIDON. AFC was determined in the early follicular phase using two-dimensional (2D) transvaginal ultrasonography, whereas AMH values were based on the modified Beckman Coulter generation II enzyme-linked immunosorbent assay. Agreement rates were computed between AFC and AMH to classify patients using Cohen's kappa statistics. Logistic regression analyzes were carried out to examine the association between ovarian markers and low (<4) and suboptimal (4-9) oocyte yield. The degree of agreement in classifying patients according to POSEIDON groups was strong overall (kappa = 0.802; 95% CI: 0.792-0.811). A total of 73.8% of individuals were classified under the same group using both biomarkers. The disagreement rates were ∼26% and did not diverge when AFC or AMH was used as the primary biomarker criterion. Significant regression equations were found between ovarian markers and oocyte yield (P < 0.0001). For low oocyte yield, the optimal AFC and AMH cutoff values were 5 and 1.27 ng/ml with sensitivities of 0.61 and 0.66, specificities of 0.81 and 0.72, and AUC receiver operating characteristics of 0.791 and 0.751, respectively. For suboptimal oocyte yield respective AFC and AMH cutoffs were 12 and 2.97 ng/ml with sensitivities of 0.74 and 0.69, specificities of 0.76 and 0.66 and AUCs of 0.81 and 0.80. Our study relied on 2D transvaginal sonography to quantify the AFC and manual Gen II assay for AMH determination and classification of patients. AMH data must be interpreted in an assay-specific manner. Treatment protocols varied across centers potentially affecting patient classification. Three of four patients will be classified the same using either AFC or AMH values. Both biomarkers provide acceptable and equivalent accuracy in predicting oocyte yield further supporting their use and proposed thresholds in daily clinical practice for patient classification according to the POSEIDON criteria. However, the sensitivity of POSEIDON thresholds in predicting low oocyte yield is low. Clinicians should adopt the biomarker that may best reflect their clinical setting. Unrestricted investigator-sponsored study grant (MS200059_0013) from Merck KGaA, Darmstadt, Germany. The funder had no role in study design, data collection, analysis, decision to publish or manuscript preparation. S.C.E. declares receipt of unrestricted research grants from Merck and lecture fees from Merck and Med.E.A. H.Y. declares receipt of payment for lectures from Merck and Ferring. L.N.V. receives speaker fees and conferences from Merck, Merck Sharp and Dohme (MSD) and Ferring and research grants from MSD and Ferring. T.M.H. received speaker fees and conferences from Merck, MSD and Ferring. The remaining authors have nothing to disclose. not applicable.

Anti-Müllerian hormone in dogs and cats reproduction.

The anti-Müllerian hormone (AMH) is a glycoprotein secreted by Sertoli cells in males and granulosa cells in females. It has first been determined in blood serum of dogs and cats by Place et al. in 2011 with the use of a human-based ELISA test. Meanwhile, different immunoassays have been validated for AMH determination in animals and a variety of studies have demonstrated the clinical significance of AMH. This review summarizes the current knowledge about AMH in dogs and cats and describes future opportunities for its diagnostic use.

Anti-Müllerian hormone and ovarian aging in mares.

Anti-Müllerian hormone (AMH) is used as a marker of follicle population numbers and potential fertility in several species including horses but limited data exist across the lifespan. No one has decreased ovarian reserve experimentally to investigate whether a corresponding, quantitative decrease in AMH results. Concentrations of AMH across the lifespan were compiled from 1101 equine females sampled from birth to >33 years of age. Young and old mares (averaging 6 and 19 years) were hemi-ovariectomized and circulating AMH was assessed before and daily thereafter for 15 days. The remaining ovary was removed later and blood was drawn again before and after this second surgery for AMH determination. Polynomial regression analysis and analysis of mares grouped by 5-year intervals of age demonstrated AMH concentrations to be higher in mares aged 5-10 and 10-15 years than 0-5 years of age and lower in mares after 20 years of age. There was high variability in AMH concentrations among neonatal fillies, some of which had concentrations typical of males. Hemi-ovariectomy was followed by a decrease of AMH, almost exactly halving concentrations in intact mares. Concentrations of AMH had returned to intact levels in old mares before complete ovariectomy, as if exhibiting ovarian compensatory hypertrophy, but recovery of AMH was not evident in young mares. AMH may reflect ovarian senescence in mares after 20 years of age but is too variable to do so in the first two decades of life. The ovarian endocrine response to hemi-ovariectomy in mares appears to change with age.

Anti-Müllerian hormone profiling in prepubertal horses and its relationship with gonadal function

Anti-Müllerian hormone (AMH) has gained increasing interest as a biomarker for assessment of gonadal activity. The ability to predict the ovarian follicular reserve of prepubertal female horses (fillies) or to identify stallions with testicular pathologies already during their prepubertal life has not been analyzed so far. Both would help to select fertile horses and reduce costs associated with keeping animals. The objectives of the present study were to (1) assess AMH, LH, FSH, progesterone (females) and testosterone (males) dynamics in prepubertal horses from birth onwards and (2) determine whether AMH concentrations detected in plasma of prepubertal female and male horses are correlated with postpubertal gonadal development. Warmblood foals (n = 30, 14 females, 10 normal males and 6 males with abnormal testicular development) born between February and May of two consecutive years (n = 28 in the first year and n = 2 the next year), were included in the study. Information on gestational length, parity of the dam and placental weight was collected for all foals. Blood samples for hormone analysis were collected from birth onwards every four weeks up to the age of one year. At two years, blood samples were collected on the day when antral follicle count (AFC) and total testicular volume (TTV) were assessed. AMH was detectable in the plasma of all animals from birth onwards and its concentration was significantly higher (P < .001) in males than in females, regardless of testicular development. In males, AMH and testosterone concentration were similar for all animals during the first year of life, regardless of testicular development. At two years, AMH concentration was higher (P < .05) in males with abnormal testicular development than in those with normal testes. In females, AMH concentration at two years was correlated with AMH concentration at birth (P < .05) and with AFC (P < .001). At birth, LH concentration was lower (P < .05) in stallions with abnormal testes (0.3 ± 0.2 ng/ml) than in controls (0.6 ± 0.2 ng/ml). A high negative correlation between AMH concentration and gestation length was observed in males during the first eight weeks of life (P < .01, r = −0.64 to −0.71). Elevated progesterone concentrations over 1 ng/ml were observed in several females starting with 20 weeks of age. This was paralleled by an increase in AMH concentration and was preceded by FSH and LH increases. In conclusion, AMH determination can be reliably used from two years onwards to identify stallions with abnormal testicular development, but it is inconclusive before puberty. In female horses, determination of AMH concentration at a prepubertal age allows for prediction of AMH and AFC after puberty. We suggest that premature luteinisation occurs before the onset of puberty in female horses and that LH secretion in the perinatal period is involved in testicular development and descent in the horse.

Influence of body mass index in anti-Müllerian hormone levels in 951 non-polycystic ovarian syndrome women followed at a reproductive medicine unit.

Anti-Müllerian hormone (AMH) is a useful marker of ovarian reserve. Obesity/overweight are increasing and may affect the reproductive health. Previous studies regarding the effect of body mass index (BMI) on AMH levels are discordant. Our main goal was to evaluate the influence of BMI on AMH levels in women without polycystic ovarian syndrome. Revision of medical records of 951 women who performed AMH determinations as part of their fertility workup, between 2011 and 2016. Median AMH concentration was 1.75 [interquartile range (IQR) 2] ng/mL (12.9 pmol/mL) and median age at AMH determination was 35 (IQR 6) years. These women evidenced a median BMI of 23 (IQR 5) kg/m2. Caucasian women were more represented [889(89.3%)]. Smoking habits (present/past) were present in 359(36.1%), and 147(14.8%) harboured a history of ovarian surgery. On univariable analysis AMH was not correlated with BMI (r = 0.048/p = 0.135); the only factors influencing AMH were age (p < 0.001), ethnicity (p = 0.004), and previous ovarian surgery (p < 0.001). On multivariable analysis, age was the only variable significantly associated with AMH, evidencing a reduction of 6.2% for each additional year (p < 0.0001). Furthermore, we verified a trend suggesting an AMH reduction of 22% (p = 0.08) in black patients comparing with the caucasian ones, when controlling for the other variables. We report one of the largest series evaluating the influence of BMI on AMH levels and, consequently, on ovarian reserve. BMI does not seem to affect AMH levels. The reported concerns on infertility in overweight and obese women may be related to follicular development/oocyte maturation or endometrial disorders, rather than decreased ovarian reserve.

140 Endocrine Profiling in Prepubertal Stallions with Abnormal Testicular Development

The use of anti-Müllerian hormone (AMH) as a biomarker for assessment of male gonadal activity has become increasingly widespread. Aberrant AMH concentration successfully detects cryptorchids or pathologic testes in postpubertal stallions, but the ability to use AMH to identify stallions with testicular pathologies during their prepubertal life has not been analysed so far. The objectives of this work were to (1) assess AMH, testosterone, LH, and FSH dynamics in male horses with or without testicular pathologies during the first year of life; and (2) find a reliable diagnostic approach that would enable the identification of animals that will develop abnormal testes at an early stage. Warmblood colts (n = 16) born from February to May on the same stud farm were used. Blood samples for hormone determinations were collected from birth onwards every 4 weeks until the age of 1 year. At 2 years, testicular development was assessed, total testicular volume calculated. and a blood sample collected. Concentrations of AMH, testosterone, LH, and FSH were determined in all samples; AMH (AL-115, Ansh Laboratories, Webster, TX, USA) and testosterone (DE1559, Demeditec, Kiel-Wellsee, Germany) concentrations were determined by ELISA, whereas LH and FSH concentrations were determined by radioimmunoassay. Statistical analysis (SPSS Statistics 24; IBM/SPSS, Armonk, NY, USA) was performed by ANOVA using a general linear model for repeated measures. In 2 stallions, unilateral cryptorchism, and in other 4 stallions, subnormal total testicular volume (&lt;mean minus SD) were diagnosed at 2 years. Concentrations of AMH, testosterone, and FSH changed over time (P &lt; 0.001) but were similar (P &gt; 0.05) within the first year of life irrespective of testicular morphology and location. Concentration of LH at birth was lower (P = 0.05) in stallions with abnormal testes (0.3 ± 0.2 ng mL−1) than in controls (0.6 ± 0.2 ng mL−1), but did not differ thereafter. At 2 years of age, AMH concentration was higher (P &lt; 0.01) in stallions with abnormal testes (39.7 ± 12.7 ng mL−1) than in controls (8.0 ± 0.2 ng mL−1), but no group differences with regard to LH, FSH, and testosterone existed. There was a low but significant negative correlation between AMH and FSH (P &lt; 0.001, r = –0.24), as well as between AMH and LH (P &lt; 0.05, r = –0.15). Also, testosterone concentration was positively correlated with FSH (P &lt; 0.05, r = 0.18) and LH (P &lt; 0.05, r = 0.16) concentrations. In conclusion, AMH determination can be reliably used from 2 years onwards to identify stallions with abnormal testicular development, but it is inconclusive before puberty. We concluded that LH secretion in the perinatal period is involved in testicular development and descent in the horse.

Effectiveness of ovarian age as the background risk for aneuploidy screening in an unselected pregnant population

The aim of this study was to assess the performance of first-trimester combined screening when replacing the chronological maternal age by Anti-Müllerian hormone (AMH) and antral follicle count (AFC)-derived ovarian ages, as the background risk in trisomy risk estimation. A total of 639 pregnant women who completed first-trimester combined screening together with AMH and AFC determination were included. Trisomy risks were estimated based on three distinct ‘maternal ages’ as a-priori risk (chronological age, AMH- and AFC-derived ovarian age). The screening performance was assessed using three different approaches: received operator curve; detection rate and false positive rates for a fixed 1/250 threshold; and detection rates for a fixed 3% false positive rate. A non-significant trend was shown for AMH-derived age for both an increased area under the curve (0.986 versus 0.979) and an increased detection rate (from 83% to 100%) for a 1/250 risk threshold. For a 3% false-positive rate, a non-significant trend for increased detection with the use of both AMH- and AFC-derived ovarian ages was observed (from 67% to 83%). These results indicate that, although ovarian derived ages seem to potentially reflect a more precise background risk for fetal trisomies, the improvement in screening performance is only residual.

Plasma anti-Müllerian hormone as a predictive endocrine marker to select Bos taurus (Holstein) and Bos indicus (Nelore) calves for in vitro embryo production

This study evaluated the association between plasma anti-Müllerian hormone (AMH) concentrations and in vitro embryo production in Bos indicus (Nelore; experiment 1) and Bos taurus (Holstein; experiment 2) calves superstimulated or not with 140 mg of porcine follicle-stimulating hormone (pFSH; 4 decreasing doses twice daily). Oocytes were recovered from calves aged 2 to 4 mo after receiving gonadotropin stimulation (Nelore, n = 15; Holstein, n = 12) or not (Nelore, n = 15; Holstein, n = 12). Cycling heifers formed a positive control group (n = 15 for Nelore [aged 18–24 mo], n = 10 for Holstein [aged 14–16 mo]). All the calves underwent laparoscopic ovum pickup, and cycling heifers underwent a regular transvaginal ultrasound-guided ovum pickup for oocyte recovery. Immediately before oocyte retrieval, blood samples were taken for subsequent AMH determination (ng/mL). Regardless of the genetic group, calves that received pFSH (3.6 ± 1.1 in Nelore and 4.6 ± 1.2 in Holstein) or did not receive pFSH (3.2 ± 1.0 in Nelore and 2.5 ± 0.8 in Holstein) had greater plasma AMH concentrations (P = 0.01 in Nelore and P = 0.003 in Holstein) than cycling heifers (1.1 ± 0.2 in Nelore and 0.6 ± 0.07 in Holstein). AMH concentrations in calves with or without pFSH were similar in both genetic groups (3.6 ± 1.1 vs 3.2 ± 1.0 in Nelore; 4.6 ± 1.2 vs 2.5 ± 0.8 in Holstein). In calves, positive correlations were observed between plasma AMH concentrations and the numbers of follicles >2 mm (r = 0.86, P < 0.0001 in Nelore; r = 0.78, P < 0.0001 in Holstein), cumulus-oocyte complexes (COCs) retrieved (r = 0.91, P < 0.0001 in Nelore; r = 0.82, P < 0.0001 in Holstein), COCs cultured (r = 0.71, P < 0.0001 in Nelore; r = 0.79, P < 0.0001 in Holstein), and blastocysts produced (r = 0.62, P = 0.0003 in Nelore; r = 0.58, P = 0.009 in Holstein), and these results were independent of pFSH treatment. In conclusion, calves had greater plasma AMH concentrations than cycling heifers. In addition, treatment with pFSH did not influence AMH concentrations in calves, regardless of the genetic group. More importantly, plasma AMH concentrations were positively correlated with the antral follicle population and the number of COCs retrieved, COCs cultured, and blastocysts produced in B indicus and B taurus calves. Therefore, AMH is a promising tool for selecting oocyte donor calves to maximize results during in vitro embryo production.

An assessment of anti-Müllerian hormone in predicting mating outcomes in female hamsters that have undergone natural and chemically-accelerated reproductive aging

In mammals, female fertility declines with age due in part to a progressive loss of ovarian follicles. The rate of follicle decline varies among individuals making it difficult to predict the age of onset of reproductive senescence. Serum anti-Müllerian hormone (AMH) concentrations correlate with the numbers of ovarian follicles, and therefore, AMH could be a useful predictor of female fertility. In women and some production animals, AMH is used to identify which individuals will respond best to ovarian stimulation for assisted reproductive technologies. However, few studies have evaluated AMH’s predictive value in unassisted reproduction, and they have yielded conflicting results. To assess the predictive value of AMH in the context of reproductive aging, we prospectively measured serum AMH in 9-month-old Siberian hamsters shortly before breeding them. Female Siberian hamsters experience substantial declines in fertility and fecundity by 9months of age. We also measured serum AMH in 5-month-old females treated with 4-vinylcyclohexene diepoxide (VCD), which selectively destroys ovarian follicles and functionally accelerates ovarian aging. Vehicle-treated 5-month-old females served as controls. AMH concentrations were significantly reduced in VCD-treated females yet many females with low AMH reproduced successfully. On average, both young and old hamsters that littered had higher AMH concentrations than females that did not. However, some females with relatively high AMH concentrations failed to litter, whereas several with low AMH succeeded. Our results suggest that mean AMH concentration can predict mating outcomes on a population or group level, but on an individual basis, a single AMH determination is less informative.

Time to be pragmatic. AMH vs FSH blood determination. Trying to find the simplest and most comfortable method for our patients

Historically ovarian reserve has been analyzed by using different and complicated tests. The clinical aplications of antimüllerian hormone(AMH) have increased over the last decades due to different studies. The aim of this study is to know if AMH blood determination is as efficient as FSH to predict the ovarian response and to know if it is able to predict the risk of ovarian hyperstimulation syndrome(OHSS).

Antimüllerian hormone as predictor of reproductive outcome in subfertile women with elevated basal follicle-stimulating hormone levels: a follow-up study

To investigate the role of serum antimüllerian hormone (AMH) as a predictor of live birth and reproductive stage in subfertile women with elevated basal FSH levels. A prospective observational cohort study conducted between February 2005 and June 2009. Tertiary fertility center. Subfertile women with [1] a regular menstrual cycle (mean cycle length 25-35 days); [2] basal FSH concentrations ≥12.3 IU/L; and [3] younger than 40 years (n = 96). None. Live birth and reproductive stage according to the Stages of Reproductive Aging Workshop. A cumulative live birth rate of 63.5% was observed during a median follow-up of 3.3 years (n = 85). The AMH level was significantly associated with live birth. There was evidence of a nonlinear prediction pattern, with an increase in chances of live birth until an AMH level of 1 μg/L. Other ovarian reserve tests and chronological age appeared of limited value in predicting live birth. In addition, AMH was significantly associated with the timing of reproductive stages (n = 68) (i.e., the occurrence of menopausal transition or menopause during follow-up). The present findings suggest applicability of AMH determination as a marker for actual fertility in subfertile women with elevated basal FSH levels.

Anti-Müllerian Hormone: A Valuable Addition to the Toolbox of the Pediatric Endocrinologist

Anti-Müllerian hormone (AMH), secreted by immature Sertoli cells, provokes the regression of male fetal Müllerian ducts. FSH stimulates AMH production; during puberty, AMH is downregulated by intratesticular testosterone and meiotic germ cells. In boys, AMH determination is useful in the clinical setting. Serum AMH, which is low in infants with congenital central hypogonadism, increases with FSH treatment. AMH is also low in patients with primary hypogonadism, for instance in Down syndrome, from early postnatal life and in Klinefelter syndrome from midpuberty. In boys with nonpalpable gonads, AMH determination, without the need for a stimulation test, is useful to distinguish between bilaterally abdominal gonads and anorchism. In patients with disorders of sex development (DSD), serum AMH determination helps as a first line test to orientate the etiologic diagnosis: low AMH is indicative of dysgenetic DSD whereas normal AMH is suggestive of androgen synthesis or action defects. Finally, in patients with persistent Müllerian duct syndrome (PMDS), undetectable serum AMH drives the genetic search to mutations in the AMH gene, whereas normal or high AMH is indicative of an end organ defect due to AMH receptor gene defects.

Anti-Müllerian hormone plasma concentration in prepubertal ewe lambs as a predictor of their fertility at a young age

BackgroundIn mammals, the ovarian follicular reserve is highly variable between individuals and impacts strongly on ovarian function and fertility. Nowadays, the best endocrine marker of this reserve in human, mouse and cattle is the anti-Müllerian hormone (AMH). The objectives of this work were to determine whether AMH could be detected in the plasma of prepubertal ewe lambs and to assess its relationship with their fertility at a young age.ResultsPlasma was taken from 76 Rasa Aragonesa ewe lambs at 3.6 months of age for AMH determination. Simultaneously, 600 IU equine chorionic gonadotropin (eCG) was administered and the number of ovulations recorded 6 days later. AMH was detected in 93% of the lambs, and the concentrations were about 3–4-fold higher in ovulating than in non-ovulating lambs (P < 0.004). Ewes aged around 10 months were mated, giving an overall fertility of 29%, and those failing to conceive were mated again 4 months later. Fertility at first mating was significantly correlated with plasma AMH concentration at 3.6 months (Spearman’s ρ = 0.34; P < 0.01). To use plasma AMH concentration as a screening test, a value of 97 pg/mL was determined as the optimum cutoff value to predict fertility at first mating (sensitivity = 68.2%; specificity = 72.2%). Fertility at first mating was 34.8 percentage points higher in ewe lambs with an AMH ≥ 97 pg/mL than in those with lower AMH concentrations (50% vs. 15%; P < 0.001).ConclusionsPlasma AMH concentration might be a reliable marker of the ovarian status of prepubertal ewe lambs, reflecting their ability to respond to eCG stimulation. A single AMH measurement performed on ewe lambs early in age could be useful to select for replacement ewes with a higher predicted fertility at first mating.

Anti-Müllerian Hormone and Sertoli Cell Function in Paediatric Male Hypogonadism

In the prepubertal male, Sertoli cells are the most active testicular cell population. Without stimulation tests, prepubertal hypogonadism can only be evidenced if Sertoli cell function is assessed. Anti-müllerian hormone (AMH) is a distinctive marker of the prepubertal Sertoli cell. Serum AMH is high from fetal life until puberty. In postnatal life, AMH testicular production is stimulated by FSH and potently inhibited by androgens. In anorchid patients, AMH is undetectable. In prepubertal males with fetal- or childhood-onset primary or central hypogonadism affecting the whole gonad, serum AMH is low. Conversely, when hypogonadism only affects Leydig cells (i.e., LH/human chorionic gonadotrophin receptor or steroidogenic enzyme defects), serum AMH is normal/high. AMH is also normal/high in patients with androgen insensitivity. In patients of pubertal age with central hypogonadism, AMH is low for Tanner stage – reflecting lack of FSH stimulus, – but high for age – reflecting lack of testosterone inhibitory effect. FSH treatment results in serum AMH rise, whereas human chorionic gonadotrophin treatment increases testosterone levels which inhibit AMH production. In conclusion, AMH determination is helpful in assessing gonadal function, without need for stimulation tests, and orientates the aetiological diagnosis of paediatric male hypogonadism. Furthermore, serum AMH is an excellent marker of FSH and androgen action in the testis.

Basal and stimulation day 5 anti-Müllerian hormone serum concentrations as predictors of ovarian response and pregnancy in assisted reproductive technology cycles stimulated with gonadotropin-releasing hormone agonist–gonadotropin treatment

Anti-Müllerian hormone (AMH) has been recently proposed as a marker for ovarian ageing and poor ovarian response to controlled ovarian hyperstimulation in assisted reproduction cycles. The present study was undertaken to investigate the usefulness of baseline cycle day 3 AMH levels and AMH serum concentrations obtained on the fifth day of gonadotropin therapy in predicting ovarian response and pregnancy in women undergoing ovarian stimulation with FSH under pituitary desensitization for assisted reproduction. A total of 80 women undergoing their first cycle of IVF/intracytoplasmic sperm injection (ICSI) treatment were studied. Twenty consecutive cycles which were cancelled because of a poor follicular response were initially selected. As a control group, 60 women were randomly selected from our assisted reproduction programme matching by race, age, body mass index, basal FSH and indication for IVF/ICSI to those in the cancelled group. For each cancelled patient, three IVF/ICSI women who met the matching criteria were included. Basal and day 5 AMH serum concentrations were significantly lower in the cancelled than in the control group. Receiver-operating characteristic (ROC) analysis showed that the capacity of day 5 AMH in predicting the likelihood of cancellation in an assisted reproduction treatment programme was significantly higher than that for basal AMH measurement. However, the predictive capacity of day 5 AMH was not better than that provided by day 5 estradiol. In addition, neither basal nor day 5 AMH or estradiol measurements were useful in the prediction of pregnancy after assisted reproductive treatment. AMH concentrations obtained early in the follicular phase during ovarian stimulation under pituitary suppression for assisted reproduction are better predictors of ovarian response than basal AMH measurements. However, AMH is not useful in the prediction of pregnancy. Definite clinical applicability of AMH determination as a marker of IVF outcome remains to be established.