anti-Müllerian Hormone Values Research Articles

The Predictive Value of Anti-Mullerian Hormone on Pregnancy Rate After IVF

The Predictive Value of Anti-Mullerian Hormone on Pregnancy Rate After IVF

Is ovarian recovery after chemotherapy in young patients with early breast cancer influenced by controlled ovarian hyperstimulation for fertility preservation or tumor characteristics? Results of a prospective study in 126 patients.

Young individuals, aged <40 years, represent 7% of all patients with early breast cancer (EBC), most of whom receive chemotherapy. Preserving future fertility in these patients has become a major concern. This prospective study assessed ovarian function during and after chemotherapy according to patient and tumor characteristics and evaluated the outcome of controlled ovarian hyperstimulation (COH). Ovarian reserve was evaluated in terms of amenorrhea duration and by longitudinal serum anti-Müllerian hormone (AMH) level variations measured at study entry, during treatment and until 24 months thereafter. COH has been proposed for patients receiving adjuvant chemotherapy. We studied the association between clinical factors and ovarian function using Cox models and logistic regression. In this young population (age < 38 years, median=32), 85 of 90 evaluable patients (94%) experienced chemo-induced amenorrhea, including six persistent amenorrhea and one chemotherapy-induced definitive ovarian failure. Overall, 33% of patients still had undetectable AMH values 12 months after the end of chemotherapy, although most had recovered spontaneous and regular menstrual function. No specific factor was associated with clinical or biological late ovarian dysfunction, except for age and baseline AMH value. Overall, 58 patients underwent COH. The mean number of total retrieved oocytes and metaphase II oocytes were of 11.7 and 6.9, respectively. Thus, our study confirms the importance of fertility preservation in young patients with EBC. Our findings indicate that sequential chemotherapy is associated with a higher risk of persistent amenorrhea. There was no significant association between tumor characteristics, fertility preservation or recovery of ovarian reserve.

Reply: A single cut-off value of anti-Mullerian hormone should not be used for the diagnosis of PCOS in all reproductive-aged women.

Reply: A single cut-off value of anti-Mullerian hormone should not be used for the diagnosis of PCOS in all reproductive-aged women.

Relationship between the concentration of anti-Müllerian hormone and antral follicle count in pasture-managed Holstein cows in the high tropics.

We evaluated the relationship between plasma levels of anti-Müllerian hormone (AMH) and the number of antral follicles at the restart of the follicular wave in crossbred Holstein cows reared under extensive grazing systems over 2500 m above sea level. The study included 140 cows from 15 farms that were in average at the 75.3 ± 2.10 d post partum. Animals were synchronized according to the following regime: day 0 = intravaginal progesterone releasing device (IPD) + estradiol benzoate (EB); day 7: withdrawal of IPD + prostaglandin; and day 8: EB, for restart of the follicular wave on day 11. On this day 11, antral follicle counts (AFCs) were made by transrectal ultrasound, and a plasma sample was taken for the determination of AMH. The mean AMH plasma level was 0.06 ± 0.03 ng/ml and the mean AFC was 17.26 ± 0.38 follicles. A strong positive linear correlation was found between these two variables (r = 0.783, r = 0.613, P < 0.0001). Cows were categorized according to AMH concentration as high (>0.09 ng/ml), intermediate (0.09-0.05 ng/ml) or low (<0.05 ng/ml). Cows with high AMH presented a higher AFC (25.0 ± 2.21 follicles) than those with low AMH (14.08 ± 2.68 follicles; P < 0.001. Our results suggest that the cut-off value of AMH = 0.09 ng/ml may be useful for selecting donors in multiple ovulation embryo transfer programs involving cows with these characteristics. Our data further suggest that AMH plasma concentration correlates with AFC and can be used as an endocrine biomarker of the number of antral follicles present at a given moment of the estrous cycle in crossbred Holstein cows raised at altitudes above 2500 m.

Serum Anti-Müllerian Hormone: A Potential Semen Quality Biomarker in Stud Dogs?

Simple SummaryAssessing semen quality in dogs requires experience and specialized equipment. Therefore, this study investigates the potential value of measuring the blood concentration of Anti-Müllerian hormone (AMH), a hormone produced by Sertoli cells, to predict semen quality in dogs. Forty-five healthy dogs were included in this study and their age as well as different semen parameters were correlated to blood AMH concentration. Moderate negative associations were found between AMH and semen motility and morphology indicating that high serum AMH may be a potential biomarker for identifying which dogs would require further semen investigation. Future research is however needed to confirm these preliminary results.Anti-Müllerian hormone (AMH) has been suggested to be involved in spermatogenesis. The aim of this study was to investigate the relationship between blood serum AMH concentration and semen quality in dogs. Moreover, this study sought to find the optimal cut-off point value of serum AMH with the greatest sensitivity and specificity to predict semen quality. Forty-five clinically healthy dogs were included in the study and their age as well as the following semen parameters were determined and correlated to serum AMH concentration: total sperm output, normal morphology, plasma membrane integrity, total motility, progressive motility, and velocity parameters. Statistical analysis for correlations were performed using Spearman’s correlation coefficients. Moderate negative associations were found between serum AMH and semen total motility (r = −0.38, p = 0.01), progressive motility (r = −0.36, p = 0.01), and normal morphology (r = −0.36, p= 0.02). Based on these associations, an AMH concentration of 5.54 µg/L was found to be the optimal cut-off point value to obtain the greatest summation of sensitivity (86%) and specificity (63%) to predict semen quality. The serum AMH assay may therefore be a potential hormonal marker to predict which dogs would require further semen analysis. Future research is however needed to confirm these preliminary results.

Diagnostic and predictive accuracy of anti-mullerian hormone for ovarian function after chemotherapy in premenopausal women with early breast cancer

PurposeAccurate diagnosis and prediction of loss of ovarian function after chemotherapy for premenopausal women with early breast cancer (eBC) is important for future fertility and clinical decisions regarding the need for subsequent adjuvant ovarian suppression. We have investigated the value of anti-mullerian hormone (AMH) as serum biomarker for this.MethodsAMH was measured in serial blood samples from 206 premenopausal women aged 40–45 years with eBC, before and at intervals after chemotherapy. The diagnostic accuracy of AMH for loss of ovarian function at 30 months after chemotherapy and the predictive value for that of AMH measurement at 6 months were analysed.ResultsUndetectable AMH showed a high diagnostic accuracy for absent ovarian function at 30 months with AUROC 0.89 (96% CI 0.84–0.94, P < 0.0001). PPV of undetectable AMH at 6 months for a menopausal estradiol level at 30 months was 0.77. In multivariate analysis age, pre-treatment AMH and FSH, and taxane treatment were significant predictors, and combined with AMH at 6 months, gave AUROC of 0.90 (95% CI 0.86–0.94), with PPV 0.79 for loss of ovarian function at 30 months. Validation by random forest models with 30% data retained gave similar results.ConclusionsAMH is a reliable diagnostic test for lack of ovarian function after chemotherapy in women aged 40–45 with eBC. Early analysis of AMH after chemotherapy allows identification of women who will not recover ovarian function with good accuracy. These analyses will help inform treatment decisions regarding adjuvant endocrine therapy in women who were premenopausal before starting chemotherapy.

Is anti-Mullerian hormone a useful biomarker in the diagnosis of polycystic ovary syndrome in Chinese adolescents?

Objective (1) To investigate anti-Mullerian-hormone (AMH) in adolescents with polycystic ovary syndrome (PCOS) compared to age-matched girls without PCOS; (2) to determine whether AMH is a valuable marker for diagnosing PCOS and to explore the best cutoff value in adolescents; (3) using a multivariate predictive model for the diagnosis of PCOS. Methods Ninety girls (aged 10–20 years) recruited during two years for the PCOS-group (n = 45) or control-group (n = 45). PCOS diagnostic criteria according guidelines of the Endocrinology Expert Group, Obstetrics/Gynecology Branch of the Chinese Medical Association. Serum AMH and other sex hormones were measured. Logistic regression analysis to estimate the odds ratio of AMH and other variables for the diagnosis of PCOS. Receiver operator characteristics (ROC) curve analysis was performed to reveal the diagnostic potential. Results (A) AMH was significantly higher in PCOS patients than in controls (10.21 ± 5.85 ng/ml vs. 4.31 ± 2.84 ng/ml, p < .001). In PCOS-group, total testosterone (TT), free testosterone (FT) and biologically active testosterone (BioT) were significantly higher than in controls (p < .001). (B) Logistic regression suggests that AMH and TT are correlated with the diagnosis of PCOS (p < .05). (C) ROC curve analyses demonstrated that the optimal value of AMH for predicting PCOS was 6.32 ng/mL, with 69.8% sensitivity and 80.5% specificity. Furthermore, AMH combined with TT can provide 83.7% sensitivity and 80.5% specificity for diagnosing PCOS in adolescents. Conclusions AMH may be a useful biomarker for the diagnosis of PCOS in Chinese adolescent girls. A cutoff value of 6.32 ng/mL best discriminated between PCOS patients and controls. Besides AMH a multivariate predictive model should include TT.

Laparoscopic Ovarian Drilling in Polycystic Ovarian disease patients: is it hazardous?

Objective: to evaluate the outcomes of endoscopic ovarian drilling (LOD) on the Anti Mullerian hormone (AMH)plasma levels, potential changes of the stromal ovarianblood flow, and antral follicular count by three-dimensionalpower Doppler ultrasonography in an-ovulatory polycysticovarian disease (PCOD) and if this can explain the ovariandrilling mechanism of action.Methods: The prospective, comparative (case control) research was completed on fifty patients from Bab El-ShaareaUniversity Hospital (El Sayed Galal). They were selectedfrom infertility and family planning clinics. Women wereassigned into one of two equal groups (each 25 patients).The first included infertile women, resistant to clomiphenecitrate and scheduled for drilling. The second includedhealthy women from the family planning clinic, who wereseeking for contraception. The main outcomes were AMHlevels, Doppler indices and Antral follicular counts beforeand after drilling. The secondary outcome in the studygroup included occurrence of ovulation, chemical and clinical pregnancy rate within 6 months after drilling.Results: The mean initial AMH, doppler indices and antral follicular counts were singingly higher among studythan control group. AMH and AFC significantly reduced incases after than before drilling [2.8 to 3.9], [13.9 to 15.8].Ovarian FI, VI, and VFI significantly decreased after thanbefore drilling. In the study group, 20 (80%) had ovulation,and 13 (52%) got pregnant within 6 months of the operation.Regression analysis showed that initial AMH, initial AFC,initial VFI, post-LOD AMH, post-LOD AFC, post-LOD VI,post-LOD FI and post-LOD VFI were significant indicatorsof successful ovulation and successful pregnancy within 6months after drilling.Conclusion: Endoscopic ovarian drilling had a significantdecreasing effect on serum AMH, AFC, and Ovarian Doppler indices in PCOD patient not responding to clomiphenecitrate. The initial values of AMH, AFC and VFI; besidespost-drilling values of AMH, AFC, VI, FI, and VFI weresignificant indicators of ovulation after drilling.

Association Between AMH Levels and Fertility/Reproductive Outcomes Among Women Undergoing IVF: A Retrospective Study

Background:Anti-mullerian hormone (AMH) is a marker for predicting ovarian response to gonadotropin stimulation. It plays an important role in ovarian primordial follicle recruitment and dominant follicle selection. Therefore, the present study evaluated the AMH levels and their association with fertility/reproductive outcomes among women undergoing IVF.Methods:A retrospective study was conducted on 665 women in GarbhaGudi Institute of Reproductive Health and Research in India from October 2018 to 2019. Subjects were divided into ≥1.1 and ≤1.1 AMH level groups. Data on age, luteinizing hormone; LH (mIU/L), follicle-stimulating hormone values; FSH (mIU/ml), LH value, oocytes retrieved, and oocytes fertilization were collected. AMH category was considered as the primary explanatory variable. Independent sample t-test and chi-square tests were performed. The p<0.05 was considered statistically significant.Results:Couple’s age, FSH values (mIU/ml), number of large follicles, matured oocytes, fertilized oocytes, and cleaved embryos were statistically significant (p<0.001) among subjects with ≥1.1 AMH values. Percentage of women with successful embryo transfer was slightly higher among AMH category 1.1 (p=0.09). Fertilization rate (86.67±20.08 vs. 83.64±21.39, p=0.18) and clinical pregnancy rate (43.38% vs. 36.36%, p=0.19) were slightly higher among women with AMH level of ≥1.1 as compared to AMH of <1.1. Live birth rate was slightly higher among women with AMH level of 1.1 (25.85% vs. 22.22%, p=0.45). Also, the number of fertilized oocytes was associated with clinical pregnancy rate (aOR=1.20, 95%CI 1.09–1.33).Conclusion:Women with ≥1.10 serum AMH levels had more number of retrieved oocytes, good oocyte quality, increased embryo transfer, and fertilization rates.

Association between Thyroid Function and Ovarian Reserve in Infertile Women: A Cross-sectional Study

Introduction: Thyroid dysfunctions are among the most common diseases in women of reproductive age group. Thyroid hormone receptors are present on oocytes which indicate that thyroid hormones may influence ovarian functions. Serum AntiMüllerian Hormone (AMH) is secreted from growing granulosa cells of ovaries. Serum AMH concentrations are used to evaluate ovarian reserve in females. Aim: To find the association between ovarian reserve, measured by AMH concentration and thyroid functions in women with infertility. Materials and Methods: This cross-sectional study was conducted in Department of Biochemistry at Government Medical College, Badaun, Uttar Pradesh, India, from July 2021 to December 2021. The involved women with infertility in the age group of 20 to 40 years attending the infertility clinic. Participants were divided into two groups based on whether the serum AMH value was &lt;1 ng/mL (lower than low normal ovarian reserve) or ≥1 ng/mL (low normal to normal ovarian reserve). The blood samples were processed for Serum Thyroid Stimulating Hormone (TSH), free Triiodothyronine (fT3 ), free Thyroxine (fT4), Prolactin and AMH. The median values of TSH and fT4 levels were compared in the subgroups of patients defined by the level of serum AMH i.e., serum AMH value &lt;1 ng/mL, and serum AMH value ≥1 ng/mL. Chi-square test was used to establish the association between the categorical variables. Results: Based on serum AMH values, 22 (28%) females had below normal ovarian reserve i.e., serum AMH value &lt;1 ng/mL, and 56 (72%) females had low normal to normal ovarian reserve i.e., serum AMH value ≥1 ng/mL. The mean age of participants with AMH &lt;1 ng/mL was 33.23±4.28, which was significantly higher than those with AMH value ≥1 ng/mL (p-value=0.002). Serum TSH value was significantly higher in the subgroup of participants with AMH &lt;1 ng/mL, the value being 4.75 mIU/L and was lower (2.8 mIU/L) in the subgroup of participants with AMH ≥1 ng/mL (p-value=0.002). Conclusion: In conclusion, the present study found the highly significant difference in serum TSH values in the two groups based on whether the serum AMH value was &lt;1 ng/mL and ≥1 ng/mL suggesting that subclinical hypothyroidism has negative impact on the female fertility. Increasing age of the females was negatively correlated with the ovarian reserve.

Evaluation of Ovarian Reserve among Newly Diagnosed Hashimoto’s Thyroiditis Related Subclinical and Overt Hypothyroid Reproductive Women: A Cross-sectional Study

Introduction: Thyroid autoimmunity is amore common autoimmune disease among reproductive women. It is proposed that, thyroid peroxidase antibodies pass through the blood follicle barrier during follicular development which damages the growing follicles and oocytes. Previous studies have demonstrated the association between thyroid autoimmunity and ovarian failure. Serum Anti-Müllerian Hormone (AMH) levels are used as a marker of ovarian reserve in clinical practice. Aim: To evaluate ovarian reserve among newly diagnosed Hashimoto’s Thyroiditis (HT) related subclinical and overt hypothyroid women. Materials and Methods: A cross-sectional study was conducted at the Department of Biochemistry, Government Medical College Nalgonda, Telangana, India, from August 2020 to July 2021. The study included 180 subjects, 60 in each Overt Hypothyroid (OH group), Subclinical Hypothyroid (SCH group) and Euthyroid subjects (EU group). Socio-demographic details and other parameters age, Body Mass Index (BMI), AMH, Thyroid Stimulating Hormone (TSH), free T4 (fT4), Thyroid Peroxidase Antibodies (TPOAb), Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), Antral Follicular Count (AFC) were evaluated and compared in all the three groups. The above data were recorded and analysed using Statistical Package for Social Sciences (SPSS) version 20.0 and the Analysis of Variance (ANOVA) test, Chi-square test, and Spearman’s correlation test were performed for statistical analysis. Results: The median age, BMI, and total AFC were not statistically significant (p-value &gt;0.05). Serum TPOAb levels were significantly (p-value &lt;0.001) high in the OH group and SCH group when compared to the EU group. The AMH levels were significantly (p-value=0.015) high inthe EU group compared to the OH group, but there were no statistically significant differences among other groups. The AMH values were negatively correlated with age among all the three groups. There was no significant correlation between AMH and other parameters analysed among different groups. Conclusion: The AMH levels were significantly low in the OH group when compared to the EU group. There were no statistically significant differences among other groups. Age was found to be an independent factor for low AMH levels among all the three groups.

Fertility and Pregnancy Outcomes in Systemic Lupus Erythematosus Patients: A Study Using Antimullerian Hormone

Background: Systemic lupus Erthymatosus (SLE) affects predominantly women of reproductive age, and can lead to both negative effect on their fertility and adverse pregnancy outcomes. Antimullerian hormone (AMH) serum levels have been found to be a reliable marker of ovarian reserve. Objectives: This research aimed to assess ovarian reserve by measuring AMH level in premenopausal SLE patients and to study different factors that can have an effect on it, and also to evaluate pregnancy outcomes in SLE patients. Methods: The study was performed on 60 subjects divided into 2 groups; (I): 30 SLE female patients and (II): control group which includes 30 healthy female subjects. Full history taking and examination were carried out including assessment of disease activity by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) score and damage index by Systemic Lupus International Collaborating Clinics American College of Rheumatology Damage index (SLICC/ACR) on SLE patients, pregnancy questionnaire were used for taking history of the pregnancy outcomes. AMH levels were measured in both groups using AMH Gen II ELISA kits. Results: There was no statistically significant difference between both groups as regard to median AMH levels and there was no statistically significant correlation between AMH and disease duration, BMI, SLEDAI-2K activity score, damage index and the immunosuppressive drugs such as cyclophosphamide, mycophenolate mofetil and azathioprine. There was statistically significant difference between both groups as regards to occurrence of miscarriage (P&lt;0.0166) and hypertension in pregnancy (P&lt;0.04). Conclusion: From these results we can conclude that AMH values did not differ between SLE patients and healthy subjects, and the disease duration and/or activity did not affect its level. Moreover, the study reflected that immunosuppressive agents such as cyclophosphamide, azathioprine and mycophenolate mofetil did not affect the fertility in SLE patients. However, it was noted that adverse pregnancy outcomes were relatively more common in SLE patients, namely hypertension in pregnancy and miscarriages.

The relation of Anti-Mullerian Hormone with final Menstrual period and menopausal symptoms in the menopausal transition

Objective: To determine the role of anti- mullerian hormone (AMH), menstrual hormones and symptoms in predicting final menstrual period (FMP) in menopausal transition (MT). Material and Methods: Eighty-two women aged 37-50 years in MT with any degree of menopausal symptoms were included in this prospective study. At the beginning and at the end of two years; serum AMH and menstrual hormone (Follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol) levels were measured, Menopause Rating Scale (MRS) scores were recorded, then compared. The cut-off of initial AMH level to detect FMP was calculated. Results: Of the 82 patients that were followed for two years, thirty six were in early MT, forty-six were in late MT at the initial. At the end of two years, 15.8 % (13/82) of patients were found to have reached menopause. The rate of AMH decline in two years did not differ significantly between patients who had and did not go through menopause. According to ROC analysis, in patients with menopause the optimal threshold value of baseline AMH to predict FMP over the next 12 months was 0.085 ng/ml (area under curve :0.873, 95% CI: 0.726-0.948, p&lt;.001). There was a significant positive correlation between AMH change rate and MRS score change in two years (r=0.462, p&lt;0.001). A significant negative correlation was observed between baseline AMH levels and second year MRS scores (r=- 0.56, p&lt;0.001). Multivariate regression analysis showed no significant independent effect of age, BMI, baseline AMH level, FSH, estradiol, baseline MRS score on AMH change. Conclusion: In MT, serum AMH level and menopausal symptom scores can help predict FMP and assist in the appropriate management of the MT period to provide women with a long-term healthy life.

Anti-Müllerian hormone levels in the diagnosis of adolescent polycystic ovarian syndrome: a systematic review and meta-analysis.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that causes menstrual cycle irregularities and infertility. PCOS is diagnosed based on hyperandrogenism, polycystic ovarian morphology (PCOM), and an-/oligo-ovulation. Upregulation of anti-Müllerian hormone (AMH) in the serum of women with PCOS may be another suitable alternative diagnostic criterion for PCOM. However, previous meta-analyses have reported conflicting results due to the age-dependent decline in serum AMH levels. Therefore, we performed a meta-analysis to evaluate the threshold of AMH for the diagnosis of PCOS in adolescents and women in their early twenties. Fifteen trials were included in this meta-analysis. PCOS is diagnosed with either Rotterdam criteria, NIH, or AE-PCOS. AMH levels were significantly higher in adolescents with PCOS (weighted mean difference, 3.05; 95% confidence interval: 2.09-4.01) than in the control group. The cutoff values of AMH for the diagnosis of adolescent PCOS were 6.1, 6.26, 7.03, 7.11, 7.2, and 7.25 ng/mL in the studies that reported the usefulness of AMH levels. The summary receiver operating characteristic analysis of the diagnostic accuracy demonstrated that the specificity and sensitivity were 81% and 66.3%, respectively. Our meta-analysis demonstrates that AMH may be a useful diagnostic test for adolescent PCOS and, based on the previous studies included in the meta-analysis, its cutoff value was estimated to be 6-7 ng/mL.

An eight centre, retrospective, clinical practice data analysis of algorithm-based treatment with follitropin delta

Research questionCan efficacy and success rates of the first recombinant FSH expressed in a human cell line with an individualized dosing algorithm based on body weight and anti-Müllerian hormone (AMH) as shown in the ESTHER-1 trial be confirmed in routine clinical practice? DesignIn eight reproductive medicine centres in Germany, observational data of 360 women who underwent ovarian stimulation with follitropin delta were evaluated as part of the quality control from January 2018 to June 2019. The data were analysed retrospectively. ResultsMean age of patients was 33.5 (±3.8) years. Pretreatment AMH concentrations ranged from <0.5 ng/ml or 3.6 pmol/l (2.5%) to >5.6 ng/ml or 40 pmol/l (19.7%), with 79.7% of all AMH measurements above 2.0 ng/ml or 14.5 pmol/l. The mean number of oocytes obtained in n = 359 first follitropin delta cycles was 11.2 (±6.7) oocytes with 42.1% of patients having between eight and 14 oocytes retrieved at oocyte retrieval. The average clinical pregnancy rate in the first cycle with a fresh embryo transfer was 38.2% with a mean of 1.4 embryos per transfer. The cumulative pregnancy rate was 49.4% for the first stimulation cycle (including cryopreservation cycles generated from the first stimulation cycle). ConclusionThe goal of obtaining an adequate number of oocytes (8–14 oocytes) using the follitropin delta dosing algorithm was reached in 42.1% of patients despite a wide range of pretreatment AMH values, while achieving very good clinical pregnancy rates. Hence, algorithm-based ovarian stimulation with follitropin delta remains highly effective in clinical practice.

GONADOTROPIN, ANTI MULLERIAN HORMON DAN ESTRADIOL PADA SINDROM OVARIUM POLIKISTIK

PCOS (Polycystic Ovary Syndrome) is an endocrine disorder characterized by anovulation and hyperandrogenism. It was found that about ±10% of women of reproductive age cause infertility so that it becomes a burden for partners physically, psychologically and materially. Increasing age affects a woman's fertility and menstrual cycle. The menstrual cycle in women is influenced by hormones, depression, weight, and lifestyle. Gonadotropin Releasing Hormone (GnRH) is released by the hypothalamus through a secretory process every 90 – 120 minutes which then binds to gonadotropin cells and stimulates Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH). FSH, LH levels will increase after puberty, FSH, LH, Anti Mullerian Hormone (AMH) and estradiol are very important in folliculogenesis. However, the interactions between the four hormones are not yet fully understood. The purpose of this review was to determine the correlation between LH/FSH Ratio, AMH and Estradiol in women with Polycystic Ovarian Syndrome (PCOS). This understanding is expected to increase knowledge about the pathophysiology of PCOS. This study uses secondary data from the Pramita Surabaya Clinic laboratory which is examined for reproductive hormones. Data from 228 women aged &lt; 35 years with an average LH/FSH ratio (0.61), AMH (3.56 ng/dL), and estradiol (34.42 pg/mL) and 172 women aged 35 years with a mean ratio of LH/FSH (0.54), AMH (2.93 ng/dL), and estradiol (36.60 pg/mL). LH, FSH, AMH and Estradiol examinations were performed on the 2-4th day of menstruation. Bivariate correlation analysis was used to see the relationship between AMH and the LH/FSH ratio and AMH and estradiol. From the results, there was a positive correlation between the AMH value and the LH/FSH ratio and a positive correlation between AMH and Estradiol which showed that AMH had an effect on the secretion of LH, FSH and Estradiol. Keywords: infertility, LH/FSH, AMH, estradiol, SOPK

Lower Circulating Sertoli and Leydig Cell Hormone Levels During Puberty in Obese Boys: A Cross-sectional Study.

Alterations in semen characteristics and circulating Sertoli and Leydig cell hormones have been described in obese male adults. Whether hormonal alterations occur before adulthood has not been fully evaluated. We describe circulating Sertoli and Leydig cell hormone levels in overweight-obese (ow/ob) boys through childhood and adolescence in a cross-sectional study. Monocentric study in the Pediatric Endocrinology Unit of Angers University Hospital. Three hundred and fifty-one obese and overweight boys aged 5-19 years underwent physical examination, dual-energy X-ray absorptiometry for body composition, oral glucose tolerance test on insulin and glucose, and measurements of follicle-stimulating hormone, luteinizing hormone, anti-Müllerian hormone (AMH), inhibin B, testosterone, and estradiol. Hormonal levels were compared with normative data obtained from 652 healthy nonoverweight nonobese boys of similar age or Tanner stage. Median inhibin B and testosterone levels during puberty were significantly lower in ow/ob than in healthy boys (1) from age >12 years and thereafter for inhibin B, and (2) from age >14 years and thereafter for testosterone. At Tanner stages 4 and 5, 26%, 31%, and 18% of inhibin B, testosterone, and AMH values were below the 5th percentile in ow/ob subjects (P < .01). In multiple regression analyses, estradiol and total bone mineral density Z-score were negative predictors of inhibin B, fat mass percentage was a negative predictor of testosterone, and insulin was a negative predictor of AMH. Lower Sertoli and Leydig cell hormone levels during puberty were observed in the ow/ob boys.

Correlation Between Serum AMH Levels and Cardiometabolic Indices in PCOS Women.

Introduction:Polycystic ovary syndrome (PCOS) has a predilection for several cardio-metabolic disorders in future. Levels of anti-Mullerian hormone (AMH), a marker of ovarian ageing, are higher in women with PCOS women than in controls. However, whether and how AMH concentrations influence the cardio-metabolic risk in PCOS is yet to be established.Objectives:This study was done to determine the correlation between AMH levels and various cardiometabolic parameters in women with PCOS and to compare AMH levels in PCOS with and without metabolic syndrome (MS).Materials and Methods:In total, 144 women aged 20–40 years and diagnosed as PCOS by the Rotterdam criteria were included in this cross-sectional study. Their anthropometry and blood pressure were recorded. Fasting lipid profile, fasting glucose, fasting insulin, homeostasis model assessment-insulin resistance, total testosterone, and AMH were estimated. The correlation between AMH and cardiometabolic parameters was determined.Results:Serum AMH levels had no correlation with any component of MS. The AMH values were comparable between those with and without MS despite differences in the metabolic profile (11.39 ± 5.31 vs 11.56 ± 5.64 ng/mL, P = 0.861).Conclusion:AMH levels do not correlate with components of MS so it may not be useful as an indicator of cardiovascular risk, insulin resistance, or MS in PCOS.

The Value of Anti-Müllerian Hormone in the Prediction of Spontaneous Pregnancy: A Systematic Review and Meta-Analysis.

ObjectiveTo determine whether serum anti-Müllerian hormone (AMH) level is a predictor of clinical pregnancy in women trying to achieve a natural conception.MethodsThe PubMed, Embase, and Cochrane Library databases were searched for articles published until August 2020. Studies that met the inclusion and exclusion criteria were included in the meta-analysis; no language limitations were imposed. Quality was appraised using the Quality Assessment of Diagnostic Accuracy Studies-2 checklist. Heterogeneity due to the threshold effect was identified; thus, we plotted a summary receiver operating characteristic curve and calculated its area under the summary receiver operating characteristic curve (AUC) and Cochran’s Q index to assess whether AMH level is a predictor of spontaneous pregnancy. Publication bias and sensitivity were also assessed.ResultsEleven studies (4,388 women) were ultimately included in this meta-analysis. The AUC and Cochran’s Q indices were 0.5932 and 0.5702, respectively. For women younger than 35 years, the AUC was 0.6355 and the Q index was 0.6025. For those older than 35 years, the AUC was 0.5536 and the Q index was 0.5403. Subgroup analyses by study type and population characteristics showed results similar to the overall outcome. No publication bias was identified, and the sensitivity analysis confirmed the robustness of the final result.ConclusionsSerum AMH levels have poor predictive value for natural pregnancy. The predictive value of AMH was poor in the younger and older subgroups. Our findings suggest that low serum AMH levels are not associated with reduced fertility.IntroductionThis study investigated the predictive value of anti-Müllerian hormone (AMH) level for natural pregnancy. Other than age, few factors can predict the chances of natural fertility. AMH is an established biomarker of ovarian reserve that is widely used to predict oocyte yield in cases of in vitro fertilization (IVF) and menopause. In clinical practice, the applications of AMH are increasing. However, its predictive value for natural conception remains controversial. In this study, since AMH is closely related with ovarian reserve, we evaluated whether it has predictive value for natural pregnancy. Our findings will fine-tune the clinical application of AMH in pre-pregnancy counseling. The topic should be of wide interest to investigators in the reproductive endocrinology and gynecology fields.Systematic Review RegistrationPROSPERO 2020 CRD42020216265, Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020216265.

FACTORS AFFECTING THE RATES OF OOCYTE MATURATION AND CRYOPRESERVABLE BLASTOCYSTS IN GNRH ANALOG TRIGGER CASES

The objective of our study was to discover the factors which may affect oocyte maturity rate and the number of blastocysts suitable for freezing. Data were collected from Istanbul Memorial Hospital, ART and Reproductive Genetics Center. 2749 gonadotrophin releasing hormone agonist (GnRHa) trigger cycles between 2011 and 2020 were evaluated retrospectively. Linear regression analysis was used for evaluations of risk factors affecting the maturation rate, and the number of frozen blastocysts. Female age, anti-müllerian hormone (AMH), body mass index (BMI). day-2 LH, progesterone (P) and estradiol (e2) levels were recorded. On GnRHa trigger day e2, LH level and, in some cases P levels were recorded. On the day following GnRHa trigger, LH and P levels in cases where the LH level was below 1 IU/L on trigger day were measured. The total gonadotrophine dosage used, the total days of ovarian stimulation (COS) and the total number of follicles on trigger day were recorded. In addition, the use of pretreatment and additional recombinant LH (rLH) were included in the analysis. Linear regression analyses showed that a one unit increase in female age, day 2 LH value and total gonadotropin dosage, increases oocyte maturation rate with a level of 0.147, 0.274, 0.002; respectively and it was determined that a one-unit increases in AMH value and BMI decreased the maturation rate with a level of 0.242 and 0.212 respectively. Furthermore, a one unit increase in AMH, day 2 LH value trigger day e2 value and the total follicule number on trigger day, increases the number of cryopreservable blastocyst number with a level of 0.211, 0.098, 0.001 and 0.067; respectively. Whereas, a one-unit increases in female age, day-2 e2 value and LH value on trigger day, decreases the number of cryopreservable blastocyst number with a level of 0.142 , 0.011 and 0.263 respectively. However, when the trigger day LH levels were subcategorized as >1 IU/L, 1-0.5 IU/L and <0.5 IU/L and analysed, the oocyte maturation rate was found to be significantly lower in cases with an LH level of <0.5 IU/L. However, despite the lower maturation rate, there was a statistically significantly higher number of cryopreservable blastocyst developed compare to other LH groups on trigger day. This was due to the very high number of oocytes retrieved. In GnRHa trigger patients, female age, AMH, BMI, day-2 e2 and LH levels, total gonadotrophin dosage used, total number of follicles above 11mm on trigger day were the parameters correlated with oocyte maturation and cryopreservable blastocyst. When the trigger day LH levels were subcategorized as >1 IU/L, 1-0.5 IU/L and <0.5 IU/L and maturation rate was significantly lower in cases with an LH level of <0.5 IU/L.