Mean anti-Müllerian Hormone Concentration Research Articles

Anti-Müllerian hormone in female dromedary camel and its association with super-ovulatory response in embryo donors

Anti-Müllerian hormone (AMH) has a conserved role in regulating the reproductive cycle in several species. Its circulating concentration reflects the size of the growing primordial follicle reserve and is a reliable predictor of superovulation response in embryo/oocyte donors. This study investigated the possible application of AMH measurement in dromedary camels (Camelus dromedarius) multiple ovulation embryo transfer programs. In experiment 1, the follicular cycle of synchronized and naturally cycling camels (n = 12) was monitored. Blood was collected at 6 timepoints in 2 consecutive cycles corresponding to emergence, mid-cycle, and dominance in both group and hormonal fluctuations were evaluated for repeatability of measurements within and between cycles. In experiment 2, the correlation between circulating AMH concentrations prior to initiation of superovulation and the outcome of superovulation was evaluated. The results were compared between donors with higher (n = 7) and lower than median (n = 8) AMH values. Mean AMH concentrations in synchronized and non-synchronized camels were 1.46 ± 0.15 and 0.95 ± 0.09, respectively. Intercycle and intracycle values of AMH showed high repeatability in camels of both groups (>96.4% and >92.74%, respectively) with significant correlations between values at different stages of the ovarian cycle (Emergence and mid-cycle: R2 = 0.82; emergence and. dominance: R2 = 0.86; Mid-cycle and dominance: R2 = 0.93, P < 0.05). Total follicles, CLs, and recovered embryos were highly correlated with AMH values prior to superovulation (R2 = 0.64, R2 = 0.77, and R2 = 0.64, respectively, P < 0.05). A greater number of developed follicles prior to mating (17.00 ± 2.09 vs. 7.62 ± 1.06), CLs (12.58 ± 1.36 vs. 5.12 ± 0.93), transferable (10.85 ± 1,31 vs. 3.37 ± 0.82), and spherical embryos (8.14 ± 1.07 vs. 2.62 ± 0.7) were observed in camels with higher than median concentrations of AMH (P < 0.05). Fluctuations in estradiol and progesterone did not affect variations in mean AMH values (r2 < 0.19 and r2 < 0.24, respectively, P > 0.05). In conclusion, highly consistent AMH values in dromedary camels are a reliable predictor of superovulation response and outcome in dromedary camels.

P-684 Subclinical hypothyroidism and ovarian reserve indices in women with normogonadotropic anovulation

Abstract Study question Does subclinical hypothyroidism (SCH) affect ovarian reserve indices in women with Polycystic Ovary syndrome (PCOS) or other forms of Hypothalamic-Pituitary-Ovarian Axis Dysfunction (HPOD)? Summary answer SCH increases Anti-Müllerian hormone (AMH) concentration, but has no influence on Follicle-stimulating hormone (FSH). What is known already In PCOS, anovulation is caused by the arrest of growing follicles due to increased frequency and amplitude of luteinizing hormone (LH) pulses, resulting in increased number of pre-antral and antral follicles, and concentration of AMH. In other cases of HPOD, the causes of anovulation are more diverse and have not yet been clearly identified. Thyroid hormones can modify the function of the HPO axis, affecting the maturation of follicles. While overt hypothyroidism is treated to improve ovulation and fertility, the effect of subclinical hypothyroidism (SCH) and the presence of circulating antithyroid antibodies (ATA) on ovarian function is uncertain. Study design, size, duration A prospective cohort tertiary single-center study (consent no. 1072.6120.172.2022) included women aged 18-45, examined due to menstrual disorders and/or infertility, from July to August 2022. Only women without previously diagnosed thyroid dysfunction were included. All enrolled women gave informed written consent to participate in the study. Participants/materials, setting, methods Women underwent routine gynecological examination and pelvic ultrasound. Blood sample was tested for AMH, FSH, Luteinizing hormone (LH), Thyroid-stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies concentrations. The Rotterdam-ESHRE-ASRM criteria were used to diagnose PCOS and its phenotypes. HPOD was diagnosed according to WHO classification. SCH was defined as TSH &amp;gt; 2.5 uIU/ml with normal thyroid function. The above parameters within subpopulations were calculated using regression analysis, Kruskal-Wallis and post-hoc tests. Main results and the role of chance The study included 51 euthyroid women aged 18-40. PCOS was diagnosed in 42/51 (82.35%) women, including PCOS-A phenotype in 31/51 (60.78%), PCOS-B in 5/51 (9.8%), PCOS-D in 6/51 (11.76%) women, and HPOD in 9/51 (17.65%) women. There was a significant positive correlation between the concentration of TSH and AMH in the studied population - with the increase of TSH value, the concentration of AMH increased (r = 0.4, p = 0.0035). The mean AMH concentration significantly differed between the groups and equaled to 55.4, 39.4, 31.1, 24.0 pmol/l in PCOS-A, PCOS-B, PCOS-D and HPOD (p = 0.05), respectively. The mean anti-TPO concentration was significantly different between the groups and was equal to 18.2, 19.0, 14.6, 10.9 U/ml in PCOS-A, PCOS-B, PCOS-D and HPOD (p = 0.05), respectively. There was no significant difference in FSH, LH, TSH, anti-TG concentrations between the groups. Limitations, reasons for caution The limitations of the study are small study group and single-center nature. Wider implications of the findings SCH increases the concentration of AMH, which in PCOS may exacerbate the symptoms of anovulation. Whether treatment of subclinical hypothyroidism affects ovarian reserve indices and improves ovarian function remain a subject of further research. Trial registration number 1072.6120.172.2022

Age specific references for anti-mullerian hormone and use as a potential diagnostic marker of PCOS in an Indian population

: Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of reproductive age characterized by anovulatory infertility and diagnosed by Rotterdam criteria. The International evidence based guidelines for PCOS, confirms that raised levels of anti-Müllerian hormone (AMH) in patients with PCOS but lack of cutoff values in different age groups is limited. Hence the present study was aimed to determine a cutoff value of AMH in different age groups that could facilitate potential diagnostic marker of PCOS Chennai, India.: A total of 800 women aged 20 to 40 years, including 139 (17.3%) PCOS patients and 160 eumenorrheic non-hirsute control women were prospectively enrolled in this study between May 2020 and July 2021. The Rotterdam criteria were used for diagnosis of PCOS. The cut-off levels of AMH in different age categories were estimated, using the Bayesian method. Mann-Whitney and Chi-square statistical analysis were done for the variables.: Out of139 PCOS patients, 38/139 (27.3%) aged 20-25 years, 35/139 (25.1%) aged 26-30 years, 32/139 (23%) aged 31-35 years and 34 (24.4%) aged 36-40 years. Mean AMH concentrations in women with PCOS was higher 5.24 ± 3.61 ng/mL in comparison to controls 2.51 ± 1.74 ng/mL. The cutoff levels of PCOS in the age categories of 20-25, 26-30,31-35 and 36-40 years were 5.6 (95% CI: 5.20–6.18), 5.3 (95% CI: 5.14–4.28), 4.03 (95% CI: 3.55–4.42) and 3.52 (95% CI: 3.72–3.27), respectively.: Serum AMH concentration &amp;#62;3.52 ng/mL could be used as cutoff value as a potential diagnostic marker of PCOS in all age group. Further, studies needed with more PCOS patients to identify the reference intervals of serum AMH according to age groups and can be used an additional marker for PCOS diagnosis.

Association between uterine fibroids and antimüllerian hormone concentrations among African American women

To evaluate the extent to which uterine fibroids are associated with antimüllerian hormone (AMH) concentrations. Cross-sectional study. Baseline data from the Study of the Environment, Lifestyle, and Fibroids, which is a 5-year longitudinal study of African American women. A total of 1,643 women aged 23-35 years without a known history of fibroids. Fibroid presence. None. The primary outcome was percent difference in the mean AMH concentration between participants with fibroids and those without fibroids. The secondary outcomes were percent differences in the mean AMH concentrations in participants with different numbers, sizes, types, and positions of fibroids and the percent difference in the mean AMH concentration in participants with different uterine volumes. At least 1 fibroid was identified on ultrasound in 362 (22%) participants. There was a small difference in the mean AMH concentrations in participants with fibroids (age-adjusted model: -4.6%, 95% confidence interval (CI): -14.5% to 6.5%; multivariable model: -4.6%, 95% CI: -14.4% to 6.3%). The mean AMH concentrations were found to decrease with increasing fibroid number. Although differences in AMH concentrations were not statistically significant, compared with no fibroids, the mean percent differences in AMH concentrations for 1, 2-3, and ≥4 fibroids were -1.2% (95% CI: -13.2% to 12.5%), -7.1% (95% CI: -23.3% to 12.5%), and -17.5% (95% CI: -38.2% to 10.0%), respectively. There were no consistent associations between AMH concentrations and fibroid location, size, or uterine volume. The presence of fibroids was not materially associated with AMH concentrations. Other than a monotonic inverse relationship between fibroid number and AMH concentrations, no other fibroid characteristics were consistently or appreciably associated, although associations were imprecise.

Outdoor air pollution and anti-Müllerian hormone concentrations in the Sister Study.

Anti-Müllerian hormone (AMH) concentrations are a marker of ovarian reserve and are indicative of a woman's reproductive lifespan. Exposure to tobacco smoke has been associated with lower AMH concentrations; however, less is known about the association between ambient air pollution and ovarian reserve. For 883 premenopausal Sister Study participants recruited between 2003 and 2009 in the United States, adult residential annual average concentrations of PM2.5, PM10, and NO2 were estimated using validated universal kriging models incorporating land-use regression. We estimated the distance in meters to the nearest major road for both adult enrollment and childhood residences. Serum AMH was measured using an ultrasensitive ELISA assay. Samples with AMH concentrations below the detection limit were analyzed using a picoAMH ELISA assay. Multivariable-adjusted linear regression was used to estimate the percent change in AMH in relation to ambient residential air pollution, categorized in quartiles and per interquartile range increase, and distance to a major roadway. Overall, we observed little to no evidence of associations between AMH and air pollution concentrations or proximity to roadways. Women in the highest quartile of NO2 exposure, a traffic-related pollutant, had higher estimated AMH concentrations (Q4 vs. Q1, 42.9%; 95% CI = -3.4, 111.4) compared with the lowest quartile. However, lower mean AMH concentrations were observed for women living closer to a major roadway (<50 m to nearest roadway vs. ≥200 m = -32.9%; 95% CI = -56.1, 2.6). We saw little consistent evidence to support an association between outdoor air pollution and diminished ovarian reserve in US women ages 35-54.

Serum anti-Müllerian hormone levels in women are unstable in the postpartum period but return to normal within 5 months: a longitudinal study

Anti-Müllerian hormone (AMH) levels fall during pregnancy but the amount of time required for AMH levels to return to normal has not been accurately determined. We have previously shown that AMH levels have yet to return to normal in some women at 3-months postpartum. In this study, AMH levels were examined at 1- and 5-months postpartum to examine whether AMH levels had returned to normal within this interval. Longitudinal study involving 38 pregnant women, with serum samples taken in the first trimester, third trimester, 1-month postpartum, 5-months postpartum and 4-6 years postpartum. Participants were recruited from a tertiary maternity clinic (single centre). All women in the study were intending to breastfeed exclusively for at least 5 months, with all 38 participants achieving this at 1-month postpartum and 36/38 after 5 months. Serum AMH concentrations had not returned to expected non-pregnant levels by 1-month postpartum. At 5-months postpartum, mean AMH concentrations were similar to expected non-pregnant levels but the rank order of AMH concentrations was still dissimilar to the non-pregnant state. The regulation of AMH secretion appears to be distinctly different in non-pregnant, pregnant and postpartum populations. This may affect the conclusions that can be drawn from AMH measurements in women during pregnancy and the postpartum period.

Anti-Müllerian Hormone Concentrations Are Inversely Associated With Subclinical Atherosclerosis in Premenopausal Women.

Anti-Müllerian hormone (AMH), which is secreted by granulosa cells of late preantral and small antral follicles, is a marker of ovarian reserve. The association of ovarian reserve with subclinical atherosclerosis in women of reproductive age is currently unknown. We primary investigated whether AMH levels are associated with markers of subclinical atherosclerosis in healthy, normally menstruating women. In this cross-sectional study, vascular structure and function were assessed by measurement of carotid and femoral intima-media thickness (IMT), flow-mediated dilation, carotid-femoral pulse wave velocity and augmentation index. Lipid profile and serum AMH concentrations were also measured. Seventy premenopausal women, aged 32.7 ± 6.5 years, were included. Mean AMH levels were lower in smokers than in non-smokers and negatively associated with total cholesterol (TC) levels. An inverse association between mean AMH concentrations and femoral and carotid IMT in all segments was observed. No correlation with other markers of subclinical atherosclerosis or established cardiovascular (CV) risk factors was found. After multivariable adjustment, the association between AMH concentrations and combined carotid IMT or carotid bulb IMT remained significant. In conclusion, in healthy, normally ovulating women, AMH concentrations are negatively associated with subclinical atherosclerosis indices and TC levels, independently of established CV risk factors.

Association between in utero perfluoroalkyl substance exposure and anti-Müllerian hormone levels in adolescent females in a British cohort

Evidence indicates that in utero environmental exposures could influence reproduction in female offspring. Perfluoroalkyl substances (PFAS) are synthetic, ubiquitous endocrine disrupting chemicals that can cross the placental barrier. Lower levels of anti-Müllerian hormone (AMH), a biomarker of ovarian reserve, are associated with reduced fertility. We investigated the association between in utero PFAS exposure and AMH levels in female adolescents using data from the Avon Longitudinal Study of Parents and Children, a British pregnancy cohort recruited between 1991 and 1992. Maternal serum samples were collected during pregnancy and analyzed for concentrations of commonly found PFAS—perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). AMH levels were measured in serum of female offspring (mean age, 15.4 years) and log-transformed for analyses. We used a sample of 446 mother-daughter dyads for multivariable linear regression analyses, controlling for maternal age at delivery, pre-pregnancy body-mass index, and maternal education. Multiple imputation was utilized to impute missing values of AMH (61.2%) and covariates. Median PFAS concentrations (ng/mL) were as follows: PFOS 19.8 (IQR:15.1, 24.9), PFOA 3.7 (IQR: 2.8, 4.8), PFHxS 1.6 (IQR: 1.2, 2.2), PFNA 0.5 (IQR: 0.4, 0.7). The geometric mean AMH concentration was 3.9 ng/mL (95% CI: 3.8, 4.0). After controlling for confounders, mean differences in AMH per one ng/mL higher PFOA, PFOS, PFHxS, and PFNA were 3.6% (95% CI: 1.4%, 8.6%), 0.7% (95% CI: 0.2%, 1.5%), 0.9% (95% CI: 0.4%, 2.2%), and 12.0% (95% CI: 42.8%, 66.8%) respectively. These findings suggest there is no association between in utero PFAS exposure and AMH levels in female adolescents.

120 ANTRAL FOLLICLE COUNT OF 2-YEAR-OLD MARES IS HIGHLY CORRELATED WITH ANTI-MÜLLERIAN HORMONE CONCENTRATIONS AT 24 to 28 WEEKS OF AGE

Success of assisted reproductive techniques, as determined by the response to hormonal treatments and embryo quality, can successfully be predicted by the concentration of anti-Müllerian hormone (AMH) in plasma of several species. Being able to predict ovarian follicular reserve of prepubertal female horses (fillies) would help to select fertile broodmares and reduce costs associated with animal upkeep. The objectives of this work were to (1) assess AMH dynamics in female horses during the first year of life and (2) determine whether AMH concentrations detected in plasma of prepubertal fillies are correlated with AMH concentrations and antral follicle count (AFC) after puberty. Warmblood fillies (n = 14) born from February to May of 1 year in the same stud were used. Blood samples for AMH determinations were collected from birth onward every 4 weeks up to the age of 1 year. At 2 years, blood samples were collected and AFC was determined by transrectal ultrasonography. The AMH concentrations were determined by ELISA (AL-115, Ansh Laboratories, Webster, TX, USA). Transrectal ultrasonography was used to determine the AFC, which corresponds to the total number of antral follicles detected with ultrasound. Statistical analysis was done with the SPSS Statistics 24 software (SPSS Inc., Chicago, IL, USA). The AMH was detectable in the plasma of all animals from birth onward. At birth, mean AMH concentration was 4.5 ± 1.2 ng mL−1. The AMH concentration increased and peaked between 24 weeks (8.7 ± 4.4 ng mL−1) and 28 weeks (6.7 ± 2.1 ng mL−1) and subsequently decreased again (52 weeks: 3.9 ± 0.9 ng mL−1). Very high variation among individuals during the first year was lost at 2 years of age. The AMH concentration at 2 years was highly correlated with AMH concentration at birth (r = 0.62, P &lt; 0.05) and with AFC (r = 0.78, P &lt; 0.001). Also, AMH concentration (r = 0.73, P &lt; 0.01) and AFC (r = 0.6, P &lt; 0.05) at 2 years were highly correlated with AMH concentrations at 24 and 28 weeks. Gestational length (337 ± 1 days), parity of the dam (4.6 ± 0.8), and placental weight (6983 ± 352 g) did not influence AMH concentrations at any time. Our results demonstrate that AMH is detectable in blood of female horses from birth onward. Despite its high variability between individuals up to 52 weeks, strong correlations were observed during the first 2 years of life. High correlations to AFC at 2 years suggest that determination of AMH in prepubertal female horses helps to predict the ovarian reserve and fertility in postpubertal life.

Determination of the normal reference interval for anti-Müllerian hormone (AMH) in bitches and use of AMH as a potential predictor of litter size.

Anti-Müllerian hormone (AMH) is a reliable endocrine marker of ovarian reserve in many species with extensive literature in both humans and cattle. However, there are no known hormonal predictors of ovarian reserve and potential reproductive performance in the bitch. A prospective cohort study was performed involving 155 intact bitches of various ages (range 1.2-7.6years) and breeds that were presented for routine breeding management over a one-year period. All bitches were artificially inseminated with frozen or fresh semen using the transcervical insemination (TCI) technique. AMH concentrations were measured using a commercially available canine AMH ELISA (Ansh Labs® , Texas, USA), which we validated prior to performing the study. The reference interval (RI) for AMH for all bitches in the study, regardless of body weight, was 2.9-21.1ng/ml. There was a significant effect of bitch size and age on AMH concentrations. The RI for giant breeds was significantly (p<.01) lower (1.75-15.6ng/ml) than small-sized (5.6-24.2ng/ml), medium-sized (4.3-23.7ng/ml) and large-sized (4.3-21.0ng/ml) bitches. The mean AMH concentration in bitches less than 4years of age was 12.4ng/ml, whereas the mean AMH concentration in bitches older than 4years of age was 10.5ng/ml (p<.05). For each additional year of age above 1year of age, AMH concentrations fell by 0.5ng/ml. There was no effect of AMH concentration on the whelping rate. Smaller breeds had smaller litters (and higher AMH concentrations), but within each breed size category, bitches with higher AMH concentrations had significantly larger litter sizes (p<.01). For each 1ng/ml increase in AMH, litter size increased by 0.3pups/litter. In conclusion, we determined a normal reference interval for AMH in bitches based on body weight using a canine-specific assay. In agreement with findings in humans and other species, we found that there is a decline in AMH concentrations with advancing age in bitches. Finally, the significant positive correlation between AMH concentrations and litter size indicates that AMH may be a useful management tool for the selection of bitches in breeding programmes.

Antimüllerian hormone levels and numbers and sizes of antral follicles in regularly menstruating women of reproductive age referenced to true ovulation day

To assess menstrual cycle antimüllerian hormone (AMH) levels in reproductive age women and which/how many follicles substantially produce AMH. Prospective study of menstruating women using mixed-effects models to analyze AMH variability and correlation of follicle counts/size classes to AMH levels. Clinic. Regular menstruating women with ovulatory cycles (n = 40, aged 18-37 years) and no known subfertility. Women collected daily urine samples and visited the study center for blood samples/transvaginal ultrasound during one complete menstrual cycle (visits were every 2 days; daily from follicle size >16 mm until postovulation). AMH levels throughout the menstrual cycle, correlated with antral follicles as observed by ultrasound and identification of follicles producing AMH. Of all antral follicles visible by high-resolution ultrasound, AMH is produced substantially only by follicles up to 7 mm in diameter. For women with basal AMH >1 ng/mL, mean AMH concentrations vary across ovulatory menstrual cycles, showing a statistically significant decrease from -5 to 2 days after objective ovulation; significantly lower mean luteal AMH levels (-7.59% to mean follicular AMH) are detected. The number of antral follicles can be estimated from AMH (ng/mL) levels using the modified Beckman Coulter Generation II AMH assay for any day of the follicular phase. AMH concentrations vary across ovulatory menstrual cycles, showing a significant periovulatory decrease. The number of small antral follicles can be estimated from preovulatory AMH levels with relevance for patient management. NCT01802060.

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.

Normal serum anti-Müllerian hormone levels in the general female population and the relationship with reproductive history

Anti-Müllerian hormone (AMH) has been evaluated by several groups as a potential novel clinical marker of ovarian reserve. Considering the wide use of AMH measurement in daily clinical practice and the large number of conditions in which it may be used, it is essential to establish reference values in the healthy female population. In this study we aim to calculate the age-by-age normal values of circulating AMH. In addition, we report on AMH levels in women according to BMI, smoking status and reproductive history. The study was performed at the Institute of Obstetrics and Gynecology, University of Modena, between January 2008 and December 2010. A total of 416 healthy women (aged 18-51) were recruited and serum AMH levels were measured for all of them. The centiles of AMH distribution were estimated with the CG-LMS method. The relationship between AMH levels and the womens' characteristics such as BMI, smoking status and reproductive history was analysed by using the uni- and multi-variable regression analysis and the Chi-square test. Serum AMH concentrations show a progressive decline with female ageing. Age-related nomograms for the 5th, 25th, 50th, 75th, and 95th percentiles of AMH were produced. Mean AMH concentrations were not modified by smoking habit and BMI and were independent of parity of the women. In the present study, we established age-specific reference values for circulating AMH levels in the eumenorrheic female population. AMH measurement produces new information on ovarian pathophysiology and ovarian reserve and the establishment of reference values for AMH is the first step for a correct interpretation of the assay.

Intra-cycle fluctuations of anti-Müllerian hormone in normal women with a regular cycle: a re-analysis

Anti-Müllerian hormone (AMH) has emerged as an important marker of ovarian reserve. Its variation throughout the cycle, however, may still be a matter of debate. The objective of this study was to re-evaluate the intra-cycle fluctuations of AMH in individuals in a prospective clinical study with focus on the age-related effects on these fluctuations. Frequent blood samples were obtained from the mid-luteal phase of the first cycle to the mid-luteal phase of the second cycle in 44 healthy, regularly menstruating Caucasian women. Main outcome measures were individual fluctuations of AMH concentrations during the natural menstrual cycle. AMH concentrations exhibited large fluctuations throughout the cycle and did not follow a defined pattern. Female age was negatively correlated with mean AMH concentrations. The absolute intra-individual variation was also negatively associated with age, whereas the relative intra-individual variation was positively associated with age. Although the fluctuation in relative intra-individual variation was higher in the older group, the absolute variation is very low and these fluctuations might therefore be of limited clinical relevance in this age group. These data show that in younger women caution should be exerted with the interpretation of a single randomly taken AMH measurement as a representative of ovarian reserve.Anti-Müllerian hormone (AMH) is currently under investigation to evaluate its use as a marker for the number of eggs remaining in the ovary, also known as the ovarian reserve. Ovarian reserve is used for decision making in infertility treatment. Some say it is a reliable marker that can be measured once at any time in the cycle; others claim that AMH fluctuates throughout the menstrual cycle. The aim of the current study was to evaluate whether AMH fluctuates during the cycle and whether the amount by which it fluctuates is dependent on the age of the individual. To investigate this, we took frequent blood samples during two cycles in 44 healthy, regularly menstruating women. In conclusion, AMH concentrations showed large fluctuations throughout the cycle but did not follow a defined pattern. The AMH concentration decreased with age. The amount of fluctuation was larger in younger women. These data show that, in younger women, caution should be exerted if a single randomly taken AMH measurement is used for clinical decision making.

Normal serum concentrations of anti-Müllerian hormone in women with regular menstrual cycles

Anti-Müllerian hormone (AMH) has become the 'molecule of the moment' in the field of reproductive endocrinology. Indeed, it is valuable as a means of increasing understanding of ovarian pathophysiology and for guiding clinical management across a broad range of conditions. However, no normative values have been established for circulating AMH in healthy women. In this cross-sectional study, 277 healthy females (aged 18-50 years) were included. AMH was measured by commercial enzyme-linked immunosorbent assay. Serum AMH concentrations show a progressive decline with female ageing. The age-related changes in AMH were best fitted by a polynomial function. Mean AMH concentrations were not modified by past use of oral contraceptive and were independent of parity of women. Age-specific normative values for circulating AMH concentration were established. AMH concentrations seem to be independent of the reproductive history of the patient.

Anti-Müllerian hormone in early human development

Anti-Müllerian hormone (AMH) is a glycoprotein produced by immature Sertoli cells and responsible for the regression of Müllerian ducts in male fetuses. The ontogeny of the hormone in early human development was investigated. While no detectable AMH could be found in female fetal serum, in males, the mean ± S.E.M. AMH serum concentration was 40.5 ± 3.9 ng/ml from 19 to 30 weeks ( n = 13), and 28.4 ± 6.1 ng/ml from 30 weeks to term ( n = 9). The latter value is significantly different from the mean AMH concentration in serum from boys aged 2 months to 2 years (43.1 ± 3.7), suggesting that AMH production is sluggish during the perinatal period. The serum AMH concentration of a 46,XX male fetus was in the normal range for males. Using in situ hybridization, AMH transcripts were detected in the testicular tissue of all fetuses from 8 weeks onwards, but not in fetal ovaries nor in the yet undifferentiated gonadal tissue of a 7-week-old fetus bearing maledetermining DNA sequences. Together, these data indicate that AMH is a reliable marker for the presence of functional testicular tissue and, as such, may be helpful for the diagnosis of fetal sex, particularly in the presence.of sex chromosome abnormalities.