Role Of anti-Müllerian Hormone Research Articles

Dissecting the shared genetic architecture between anti-Müllerian hormone and age at menopause based on genome-wide association study

BackgroundWhile the phenotypic association between anti-Müllerian hormone (AMH) and age at menopause has been widely studied, the role of AMH in predicting the age at menopause is currently controversial, and the genetic architecture or causal relationships underlying these two traits is not well understood. AimWe aimed to explore the shared genetic architecture between AMH and age at menopause, to identify shared pleiotropic loci and genes, and to investigate causal association and potential causal mediators. Study DesignUsing summary statistics from publicly available genome-wide association studies on AMH (N=7,049) and age at menopause (N=201,323) in Europeans, we investigated the global genetic architecture between AMH and age at menopause through linkage disequilibrium score regression. We employed pleiotropic analysis under composite null hypothesis (PLACO), Functional Mapping and Annotation of Genetic Associations (FUMA), Multimarker analysis of GenoMic annotation (MAGMA), and colocalization analysis to identify loci and genes with pleiotropic effects. Tissue enrichment analysis based on GTEx data was conducted using the Linkage Disequilibrium Score for the specific expression of genes analysis (LDSC-SEG). Functional genes that were shared were additionally identified through summary data-based Mendelian randomization (SMR). The relationship between AMH and age at menopause was examined through two-sample Mendelian randomization (MR), and potential mediators were further explored using colocalization and metabolite-mediated analysis. ResultsA positive genetic association (correlation coefficient = 0.88, P = 1.33 × 10-5) was observed between AMH and age at menopause. By using PLACO and FUMA, 42 significant pleiotropic loci were identified that were associated with AMH and age at menopause, and ten of these (rs10734411, rs61913600, rs2277339, rs75770066, rs28416520, rs9796, rs11668344, rs403727, rs6011452, and rs62237617) had colocalized loci. Additionally, 245 significant pleiotropic genes were identified by MAGMA. Genetic associations between AMH and age at menopause were markedly concentrated in various tissues including whole blood, brain, heart, liver, muscle, pancreas, and kidneys. Further, SMR analysis revealed nine genes that may have a causative effect on both AMH and age at menopause. A potential causal effect of age at menopause on AMH was suggested by two-sample MR analysis, with very-low-density lipoprotein identified as a potential mediator. ConclusionsOur study revealed a shared genetic architecture between AMH and age at menopause, providing a basis for experimental investigations and individual therapies to enhance reproductive outcomes. Furthermore, our findings emphasized that relying solely on AMH is not sufficient for accurately predicting the age at menopause, and a combination of other factors needs to be considered. Exploring new therapeutics aimed at delaying at the onset of menopause holds promise, particularly when targeting shared genes based on their shared genetic architecture.

The Adjunct Role of Anti Mullerian Hormone (AMH) in Diagnosing Polycystic Ovary Syndrome

The Adjunct Role of Anti Mullerian Hormone (AMH) in Diagnosing Polycystic Ovary Syndrome

Anti-Müllerian hormone induces autophagy to preserve the primordial follicle pool in mice.

The reserve pool of primordial follicles (PMFs) is finely regulated by molecules implicated in follicular growth or PMF survival. Anti-Müllerian hormone (AMH), produced by granulosa cells of growing follicles, is known for its inhibitory role in the initiation of PMF growth. We observed in a recent invivo study that injection of AMH into mice seemed to induce an activation of autophagy. Furthermore, injection of AMH into mice activates the transcription factor FOXO3A which is also known for its implication in autophagy regulation. Many studies highlighted the key role of autophagy in the ovary at different stages of folliculogenesis, particularly in PMF survival. Through an invitro approach with organotypic cultures of prepubertal mouse ovaries, treated or not with AMH, we aimed to understand the link among AMH, autophagy, and FOXO3A transcription factor. Autophagy and FOXO3A phosphorylation were analyzed by western blot. The expression of genes involved in autophagy was quantified by RT-qPCR. In our invitro model, we confirmed the decrease in FOXO3A phosphorylation and the induction of autophagy in ovaries incubated with AMH. AMH also induces the expression of genes involved in autophagy. Interestingly, most of these genes are known to be FOXO3A target genes. In conclusion, we have identified a new role for AMH, namely the induction of autophagy, probably through FOXO3A activation. Thus, AMH protects the ovarian reserve not only by inhibiting the growth of PMFs but also by enabling their survival through activation of autophagy.

The role of anti-mullerian hormone in determining ovarian reserve in patients with endometrioma and benign cysts

The role of anti-mullerian hormone in determining ovarian reserve in patients with endometrioma and benign cysts

The role of anti-Mullerian hormone in the context of modern pathogenetic approaches to the treatment of endometriosis (literature review)

Anti-Mullerian hormone (AMH) is well known as one of the key factors in reproductive development and the formation of sexual characteristics in the embryonic period in both sexes. In women, AMH is produced by granulosa cells of the preantral and early antral follicles of the ovaries and is a key biochemical marker of ovarian reserve. Recently, the role of AMH and its transmembrane receptor AMHRII as possible pathogenetic links in a number of gynecological diseases has been actively studied. The ability of AMH to cause regression of the Müllerian duct in male embryos suggests its inhibitory role for a number of benign and malignant gynecological tumors, as well as endometriosis. In this connection, active scientific research in this direction is currently underway. A number of studies have shown that AMH causes apoptosis of human endometrial stromal cells and endometriosis cells in vitro, and is also involved in the development of autophagy processes in endometriosis. The above studies demonstrate the important role of AMH in cell apoptosis in endometriosis, and indicate its therapeutic potential for a wide range of gynecological diseases. It is important to note that AMH, as a representativemember of the TGF-β superfamily, has high affinity and specificity for the AMHRII receptor, which. This fact makes further study of the function of AMH and AMHRII relevant both for assessing their effectinfluence on the processes of folliculogenesis, and reproductive aging processes, and for developing new targeting targeted therapy strategies therapy for a wide range of gynecological diseases, including endometriosis.

Role of anti mullerian hormone (AMH) in diagnosis of polycystic ovarian syndrome (PCOS) in Indian women

: Transvaginal ultrasound is an important part of the Rotterdam criteria, which are commonly used to diagnose polycystic ovary syndrome (PCOS). Specifically, the presence of polycystic ovarian morphology (PCOM) is a key factor in the criteria. Another useful indicator of PCOM is the Anti-Mullerian hormone (AMH) level.The objective is to evaluate the diagnostic accuracy of serum Anti-Mullerian hormone (AMH) in identifying polycystic ovary syndrome (PCOS) and determine whether it can be used as a substitute for polycystic ovarian morphology (PCOM) in the Rotterdam criteria. Additionally, we aim to investigate the relationship between AMH levels and hyperandrogenism in PCOS patients.A study was out in SSH BHU various parameters will be used in diagnosis. Serum AMH Radiology: By Transvaginal Sonography single observer obtained dimensions for ovarian volume and the maximum number of follicles in one section. AMH levels will be estimated using commercially available Gen-II ELISA assay. Biochemical evaluation will be done in the Department of Bio-Chemistry IMS BHU. The Anti-Mullerian hormone (AMH) serum levels will be measured using a commercially available ultra-sensitive Gen-II enzyme-linked immunosorbent assay (ELISA) kit from Beckman Coulter, CA. The ELISA has a lower limit of detectability (LoD) of 0.08 ng/ml, a lower limit of quantification (LoQ) of 0.17 mg/ml, and an intra-assay coefficient of variation of 5.8%. The unit of measurement is ng/mL (1ng/mL=7.14 pmol/L). The study showed that Anti-Mullerian hormone (AMH) levels were markedly higher in individuals with polycystic ovary syndrome (PCOS) than in controls. While AMH alone was not a reliable diagnostic marker for PCOS, the findings suggested that incorporating AMH levels as an additional factor in the existing Rotterdam criteria could improve the accuracy of PCOS diagnosis. Therefore, AMH levels have the potential as a useful adjunct marker for the diagnosis of PCOS.

The role of anti-Mullerian hormone and other correlates in patients with polycystic ovary syndrome

ABSTRACT Background Anti-Müllerian hormone (AMH) has recently emerged as a promising biomarker for the detection of polycystic ovarian morphology. In polycystic ovary syndrome (PCOS), an elevated level of AMH has been suggested to add value to the Rotterdam criteria in cases of diagnostic uncertainty. In this study, we evaluated the correlation between AMH and PCOS, and the potential role of AMH in PCOS diagnosis. Methods A case-control study was performed on a total of 200 females, 100 of which were diagnosed with PCOS as per Rotterdam revised criteria (2003) and 100 as the control (non-PCOS group). Patient medical records were therefore retrieved for clinical, biochemical and ultrasound markers for PCOS diagnosis. Sensitivity, specificity, area under receiver operating characteristic (AUROC) curve, and multivariate linear regression models were applied to analyze our data. Results Mean serum levels of LH and AMH, and LH/FSH ratio were significantly different between compared groups. In the PCOS group, the mean serum AMH level was 6.78 ng/mL and LH/FSH ratio was 1.53 while those of controls were 2.73 ng/mL and 0.53, respectively (p < .001). The most suitable compromise between 81% specificity and 79% sensitivity was obtained with a cutoff value of 3.75 ng/mL (26.78 pmol/L) serum AMH concentration for PCOS prediction, with an AUROC curve of 0.9691. Conclusion Serum AMH cutoff level of 3.75 ng/mL was identified as a convenient gauge for the prediction of PCOS and an adjuvant to the Rotterdam criteria.

Categorization of differences of sex development among Egyptian children and the role of antimullerian hormone and inhibin B.

Differences of sex development (DSD) are congenital conditions linked to atypical development of chromosomal, gonadal, or anatomical sex. The aim of this study was to demonstrate our experiences at the Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University in the field of DSD by focusing on the clinical presentation, laboratory profile, classification, and etiological diagnosis of these conditions. In addition, the present study intended to delineate the importance of serum anti-Müllerian hormone (AMH) and inhibin B in detecting the presence of functioning testicular tissue. This cohort study included 451 infants and children with various clinical presentations of DSD. The study performed a retrospective analysis on medical records of established DSD cases to evaluate the clinical importance of AMH and inhibin B. In addition, newly diagnosed patients were prospectively analyzed. Three hundred thirty-six (74.5%) patients were 46,XY DSD, 98 (21.7%) were 46,XX DSD, 14 patients had other karyotypes and 3 had missing karyotypes. Among the 46XY DSD patients, the most common cause was partial androgen insensitivity. In contrast, congenital adrenal hyperplasia constituted the most common diagnosis in 46,XX DSD cases. The cut off value of serum AMH was 14.5 ng/ml with 100% sensitivity and 55.1% specificity. Partial androgen insensitivity was the most important cause of 46,XY DSD in Egyptian children, and congenital adrenal hyperplasia was the most common cause of 46,XX DSD. AMH was valuable in detecting functioning testicular tissue.

Physiological role and diagnostic value of anti-Mullerian hormone in pediatrics

Background. Anti-Mullerian hormone (AMH) has now gained popularity as a marker of ovarian reserve. It is important to determine the place and role of AMH in children. The purpose of this work was to analyze the data of the scientific literature on the role of AMH in pediatric practice. Materials and methods. A review of the literature in PubMed was conducted, limiting itself to articles in English and updating the search in February 2022. The search term was “anti-Mullerian hormone”. A total of 437 manuscripts were found, including 37 review articles. The search was gradually narrowed with filters of clinical trials and systematic reviews to 75 articles. The references of the original and review articles were then checked to ensure a complete review. AMH is responsible for the differentiation of the gonads, provokes the regression of Mullerian ducts in the male fetus, correlates with karyotype, sexual development, levels of luteinizing hormone, follicle-stimulating hormone, and its serum levels reflect the ovarian reserve in women, even in childhood. Serum AMH is high from prenatal life to puberty. In postnatal period, the secretion of AMH by the testes is stimulated by follicle-stimulating hormone and strongly inhibited by androgens. AMH is of clinical value as a marker of testicular tissue in men with differences in sexual development and cryptorchidism, as well as in the assessment of persistent Mullerian duct syndrome. Determination of AMH is useful for assessing the function of the gonads without the need for stimulation tests and guides the etiological diagnosis of childhood male hypogonadism. In women, AMH is used as a prognostic marker of ovarian reserve and fertility. The use of criteria developed for adult women is problematic for adolescent girls, as clinical signs associated with polycystic ovary syndrome are normal phenomena of puberty. AMH can be used as an additional criterion in the diagnosis of polycystic ovary syndrome in adolescents. However, the lack of an international standard for AMH limits comparisons between AMH analyzes. Conclusions. AMH has broad clinical diagnostic utility in pediatrics, but interpretation is often complex and should be made in the context of not only the age and sex, but also the stage of development and puberty of the child. Recognition of the role of AMH beyond the development and maturation of the gonads may lead to new diagnostic and therapeutic applications that will further expand its use in pediatric practice.

Abstract #1316108: The Role of Anti-Mullerian Hormone and Other Correlates in Polycystic Ovary Syndrome Patients

Anti-Müllerian hormone (AMH) has recently emerged as a promising biomarker for the detection of polycystic ovarian morphology. In polycystic ovary syndrome (PCOS), an elevated level of AMH has been suggested to add value to the Rotterdam criteria in cases of diagnostic uncertainty. In this study we evaluated the correlation between AMH and PCOS, and the potential role of AMH in PCOS diagnosis.

Anti-Müllerian hormone-mediated preantral follicle atresia is a key determinant of antral follicle count in mice.

Does anti-Müllerian hormone (AMH) induce preantral follicle atresia in mice? The present findings suggest that AMH-mediated follicle atresia only occurs in early follicles before they become sensitive to FSH. Most prior studies have investigated the ability of AMH to inhibit primordial follicle activation. Our previous study showed that AMH-overexpressing mice had fewer preantral follicles than expected after accounting for primordial follicle inhibition but the reason for this was not determined. Cross-sectional-control versus transgenic/knockout mouse studies were carried out. Studies were conducted on female wild-type (Amh+/+), AMH-knockout (Amh-/-) and AMH overexpressing (Thy1.2-AMHTg/0) mice on a C57Bl/6J background (age: 42-120 days). The follicle counts were conducted for primordial, transitioning, primary, secondary and antral follicles in Amh-/- and Amh+/+ mice. After confirming that follicle development speeds were identical (proliferating cell nuclear antigen immunohistochemistry), the ratio of follicles surviving beyond each stage of folliculogenesis was determined in both genotypes. Evidence for increased rates of preantral follicle atresia was assessed by active caspase-3 immunohistochemistry in wild-type and Thy1.2-AMHTg/0 mice. Amh -/- mice at 100-120 days of age had lower primordial follicle counts but higher primordial follicle activation rates compared to Amh+/+ mice. These counteracting effects led to equivalent numbers of primordial follicles transitioning to the primary stage in Amh+/+ and Amh-/- mice. Despite this, Amh+/+ mice had fewer primary, secondary, small antral and medium antral follicles than Amh-/- mice indicating differing rates of developing follicle atresia between genotypes. Cleaved caspase-3 immunohistochemistry in Thy1.2-AMHTg/0 ovaries revealed high rates of granulosa cell and oocyte apoptosis in late primary/early secondary follicles of Thy1.2-AMHTg/0 mice. N/A. The findings were shown only in one species and additional research will be required to determine generalizability to other species. This study is consistent with prior studies showing that Amh-/- mice have increased primordial follicle activation but these new findings demonstrate that AMH-mediated preantral follicle atresia is a predominant cause of the increased small antral follicle counts in Amh-/- mice. This suggests that the role of AMH is not to conserve the ovarian reserve to prolong fertility, but instead to prevent the antral follicle pool from becoming too large. While this study may demonstrate a new function for AMH, the biological purpose of this function requires further investigation, particularly in mono-ovulatory species. This study was funded by the Health Research Council of New Zealand and the University of Otago. No competing interests to declare.

Testicular Sertoli Cell Hormones in Differences in Sex Development.

The Sertoli cells of the testes play an essential role during gonadal development, in addition to supporting subsequent germ cell survival and spermatogenesis. Anti-Müllerian hormone (AMH) is a member of the TGF-β superfamily, which is secreted by immature Sertoli cells from the 8th week of fetal gestation. lnhibin B is a glycoprotein, which is produced by the Sertoli cells from early in fetal development. In people with a Difference or Disorder of Sex Development (DSD), these hormones may be useful to determine the presence of testicular tissue and potential for spermatogenesis. However, fetal Sertoli cell development and function is often dysregulated in DSD conditions and altered production of Sertoli cell hormones may be detected throughout the life course in these individuals. As such this review will consider the role of AMH and inhibin B in individuals with DSD.

IVF Outcome in Patients with Different Stages of Endometriosis: Can AMH Be a Predictor?

Background and Objectives: The role of Anti Mullerian Hormone (AMH) in determining the outcome of in vitro fertilization (IVF) in endometriosis has been controversial. This study was conducted to assess whether AMH can predict poor response in endometriosis patients undergoing IVF and to compare the IVF outcomes among the different stages of endometriosis. Methodology: A retrospective study was conducted among 90 endometriosis patients undergoing IVF using the flexible antagonist protocol from January 2016 to December 2018 at DY Patil Medical College, Navi Mumbai. Serum AMH levels were obtained from different patients, primary outcome being clinical pregnancy rate (CPR) while the secondary outcome included the number of oocytes retrieved, number of mature oocytes obtained, fertilization rates (FR), and number of good quality embryos formed. Data was analyzed with SPSS 16.0. Mann-Whitney U and chi-square tests were used to compare the outcomes of IVF with AMH level in different stages of endometriosis. Receiver Operator Characteristic (ROC) curves were plotted to know the predictive ability of AMH by determining the area under the curve (AUC), P value &lt; 0.05 was considered significant for all statistical tests. Results: AUC was found to be significant for AMH in detecting poor response among those with late staged endometriosis but with poor accuracy (AUC = 0.65, P = 0.02∗). Considering a median AMH level of 1.24 ng/mL with sensitivity and specificity of &gt; 60%, the primary and secondary outcomes were significantly higher among those with median AMH levels of more than 1.24 ng/mL compared to those with the median ≤ 1.24 ng/mL. The significance, however, was mainly found in the late stages of endometriosis (P &lt; 0.05). Fertilization rates, good quality embryos, and CPR did not vary with AMH levels among those with early stages of endometriosis (P &gt; 0.05). The outcomes of IVF did not vary significantly across the different stages of endometriosis except for good quality embryos which were formed in patients with early staged endometriosis (P &lt; 0.05). Conclusion: AMH levels may be a predictor of nonconception with poor accuracy in late stages of endometriosis (III/IV), while good quality embryos were obtained in patients with early stages of endometriosis.

Role of AMH in Prediction of Menopause.

Anti-Müllerian Hormone (AMH) is produced by small antral follicles and has evolved over the past three decades as an assumed potential marker of the number of follicles in the human ovaries, also known as ovarian reserve. This quantitative measure, given the gradual decline over time and its non-replenishable feature, could be the dreamed marker for predicting the final exhaustion of ovarian storage: the post-menopause. This introductory chapter summarizes current knowledge with regard to the contribution of serum AMH measurements to predict age of normal menopause and critically discuss its potential in this regard. Furthermore, its predictive role in the context of menopause in association with several frequently occurring fertility disorders such as premature menopause, polycystic ovarian syndrome and endometriosis are discussed. Overall, while ovarian reserve markers including AMH are unmistakably related to age at menopause, they are insufficiently precise to inform on an individual’s journey of ovarian aging.

P–636 Anti-Müllerian-Hormone levels are not correlated to the probability of obtaining an ongoing pregnancy and time to pregnancy in women undergoing intra-uterine inseminations with donor sperm

Abstract Study question Is Anti-Müllerian hormone (AMH) level associated with the probability of obtaining an ongoing pregnancy (OP) and with time to pregnancy (TTP) in women undergoing d-IUI? Summary answer AMH is neither associated with the probability of obtaining an OP nor with time to pregnancy (TTP) in women undergoing d-IUI What is known already Anti-Müllerian hormone (AMH) is a glycoprotein produced by the granulosa cells of preantral and antral follicles. While AMH has been widely recognized as a quantitative marker of ovarian reserve used to predict ovarian responsiveness to ovarian stimulation in IVF, its relationship with fecundability in spontaneous conceptions is still a matter of debate. There is currently no consensus on the role of AMH on time to pregnancy in unassisted conceptions. The question of whether AMH is a qualitative marker of oocyte quality is therefore still unanswered. Study design, size, duration This prospective cohort study was carried out between 9/1/2017 and 12/30/2020 on 592 women aged 19 to 44, who underwent d-IUI in a natural cycle (n = 1788) the day after LH peak. Patients were single, homosexual, or heterosexual with an infertile partner and underwent 1 to maximum 6 d-IUI. All patients had regular ovulatory cycles and bilateral tubal patency confirmed before starting d-IUI. AMH evaluation was performed within the previous 3 months of the first d-IUI. Participants/materials, setting, methods The primary outcomes were the likelihood of obtaining an OP (&amp;gt;14 weeks) and TTP calculated as the number of d-IIU up to an OP. Multivariate logistic regression was used to compare the probability of obtaining an OP according to age and AMH levels. Kaplan-Meier curves with log-rank test were used to assess the TTP stratified by age groups (≤35, &amp;gt;35 to ≤ 39, and &amp;gt; 39 years old) and AMH groups (&amp;lt; 1ng/mL and ≥ 1ng/mL). Main results and the role of chance AMH levels were negatively correlated with age (p &amp;lt; 0.001). OP were significantly lower with increasing age (OR 0.92 (0.89–0.95) p &amp;lt; 0.001) but did not differ according to AMH levels (OR 1.07 (0.97–1.18) p = 0.18). When adjusting for AMH, the association between age and OP remained significant (OR 0.91 (0.88–0.95)). TTP was significantly different between age groups: ≤35 years old (n = 338), &amp;gt;35 to ≤ 39 years old (n = 136) and &amp;gt; 39 years old (n = 118) (p &amp;lt; 0.001), but did not differ significantly according to AMH levels &amp;lt; 1ng/mL (n = 130) and ≥1ng/mL (n = 462)(p = 0.55). Limitations, reasons for caution Our results concern d-IUI and can therefore not be extrapolated to natural conception. However, the study model is close to natural fecundity as there was no history of female infertility and as all IUI were performed on the day of ovulation with donor sperm proven to be fertile. Wider implications of the findings: While measuring AMH seems necessary for gonadotropin dose adjustment in ART, our data suggest that it cannot qualitatively assess fertility outcome and should therefore not be used routinely for preconception counseling in the absence of infertility history. Trial registration number P2017/396

Menopause, anti-Müllerian hormone and cognition in a cohort of women with persistent symptoms following TBI: a case for future research

ABSTRACT Objectives: Primary: To explore anti-Müllerian Hormone (AMH) levels in community dwelling women following TBI. Secondary: To explore the relation of AMH to menstrual cycle, cognition, distress and symptoms of menopause. Setting: Large adult TBI outpatient clinic in Toronto Canada. Research design: Prospective study of 10 women with persistent symptoms who were one or more years post TBI. Methods: Consenting participants provided a serum sample for AMH levels, and completed the Menopause Rating Scale (MRS), Symptom Checklist-90 r (SCL-90 r), Repeatable Battery for the Assessment of Neurological Status (RBANS) and a health questionnaire. Main outcomes and results: This study found lower than expected levels of AMH in 50% of participants relative to age matched norms and 50% of participants experienced new onset of menstrual changes. Also notable were findings of lower-than-expected cognitive scores in women over 35 and reports of menopause-related symptoms across all ages groups. Conclusions: As our understanding of the role of AMH grows, examining changes in this novel biomarker in the long-term post-TBI is warranted. Future research should be sufficiently powered to expand on and validate the study’s findings.

A role of anti-Mullerian hormone in external genital endometriosis

To understand a role for anti-Muller hormone (AMH) in the development and course of genital endometriosis, we sought out for and analyzed scientific papers in open electronic sources: PubMed, Scopus, eLibrary. We review a role of AMH in females as well as its importance in functioning of the reproductive system, noting that in developing external genital endometriosis its blood level decreases that may either due to ovarian damage or one of the links in the disease pathogenesis. Potential negative consequences of surgical interventions for ovaries as well as means for their prevention are described.

AMH Concentrations in Peritoneal Fluids of Women With and Without Endometriosis.

Background: As its name indicates, anti-Müllerian hormone (AMH) is primarily found as an inhibitor of the Müllerian duct in male fetus. On the other hand, AMH may act as a mediator of Müllerian duct-derived female tissue, such as endometrium in normal and pathological conditions. However, the role of AMH in the functional regulations of endometriosis is not well understood. It can be hypothesized that AMH in peritoneal fluids may affect the activity of peritoneal endometriosis. In this study, we investigated the levels of AMH in peritoneal fluids (PF) in women with and without endometriosis.Methods: PF were collected during laparoscopy from 90 women diagnosed as having advanced endometriosis (rASRM stage III, n = 30; stage IV, n = 60), and 32 women without endometriosis were served as control. Paired serum samples were also collected before the surgery. AMH in PF and serum were measured by ELISA. Individual clinical information was collected. AMH levels were compared according to the presence of endometriosis. The expression of AMHR2 in peritoneal endometriotic lesions obtained during laparoscopy was examined by immunohistochemistry.Results: AMH levels in PF were positively and significantly correlated with serum AMH levels in both women with and without endometriosis (R2 = 0.17, P < 0.0001; R2 = 0.30, P = 0.001, respectively). Serum AMH levels were inversely and significantly correlated with age in women with endometriosis (R2 = 0.092, P = 0.004) and in control women without statistical significance (R2 = 0.078, P = 0.12). AMH levels in PF were also inversely but not significantly correlated with age in women with and without endometriosis (R2 = 0.029, P = 0.11 and R2 = 0.027, P = 0.37, respectively). Mean age and serum AMH levels were not significantly different between two groups. On the other hand, AMH levels in PF were significantly lower in women with endometriosis compared to those of control women [2.15 ± 2.13 (mean ± SD) vs. 4.40 ± 4.77 ng/mL, P = 0.0001]. AMHR2 are localized at glandular epithelium and stromal cells in the ectopic endometrium of peritoneal endometriosis.Conclusions: Women with endometriosis may present lower PF AMH levels even if they retain serum levels similar to women without disease. As peritoneal endometriosis expresses a specific receptor for AMH, lower AMH levels in PF of women with advanced endometriosis may be involved in the pathophysiology of peritoneal endometriosis.

The Role of Follicular Fluid Anti-Mullerian Hormone in Success Rate of Intracytoplasmic Sperm Injection

BACKGROUND: The role of anti-Mullerian hormone (AMH) in the ovary is to participate in the regulation of ovarian function, especially in follicle development and selection. It inhibits the initiation of human primordial follicle growth and prevents multiple selection of a dominant follicle by reducing the sensitivity of follicles to follicle stimulating hormone.&#x0D; MATERIALS AND METHODS: In this prospective clinical trial, outcomes were followed in 60 women undergoing cycles of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) within El-Minia University Hospital. AMH concentration was estimated in pooled follicle fluid (FF) on day of oocyte pickup. Cycles were sorted into low and high groups according to median (50th centile) values of measurement. The fertilization rate (FR), implantation rate, blastocyst development, embryo quality, chemical pregnancy, clinical pregnancy, and ongoing pregnancy after ICSI were counted as the main outcomes.&#x0D; RESULTS: Low FF AMH group shows significantly higher percentage of top-quality oocytes (67.1 ± 24.3 vs. 49.6 ± 30.3 %, p = 0.014), FR (83.9 ± 20.9 vs. 72.4 ± 21.4%, p = 0.021), clinical pregnancy (57.57 vs. 16.67%, p &gt; 0.0001), and embryo implantation rates (57.7 vs. 16.7%, p = 0.001) compared to high FF AMH group. FF AMH shares an inverse correlation with FF E2 (Pearson r = −0.409, p &lt; 0.001) and clinical pregnancy (Pearson r = −0.618, p &lt; 0.001). Threshold value of FF AMH for pregnancy is &gt;1.75 ng/mg protein.&#x0D; CONCLUSION: FF AMH is a plausible specific indicator of functional viability and quality of oocyte in IVF cycles.&#x0D;

To assess serum Anti Mullerian Hormone (AMH) level as a biomarker for oocyte quality

Introduction: Oocyte competence is a factor that affects ART outcomes. Oocyte morphology assessment and scoring are laborious, have inter-observer variations and lack consensus on parameters to be assessed. Role of anti mullerian hormone (AMH) as a biomarker for oocyte quality and competence is investigated. Aim and Objectives: To evaluate day 2/3 serum AMH as a predictor of oocyte quality, embryo quality and fertilization rate in a stimulated ART cycle. Methods: Single centre, prospective observational study. All patients undergoing IVF-ICSI between August 2018 and February 2019 included. Total Oocyte Score calculated for all oocytes. and subsequently assessed for fertilization, cleavage and day 3 embryo grading. Correlations between AMH levels and TOS, PTOS, Fertilization and Cleavage rates assessed using appropriate statistical methods. Results: Of 86 patients and 780 oocytes studied,639 underwent ICSI with fertilization rate 86% (550/639) and cleavage rate 90.7%(499/550). Embryo grades were A-50.6%, B-38.9% and C-10.5%. Mean TOS score and PTOS scores were 0.3±1.99 and 0.44±1.21.TOS was predictive of fertilization [ROC-AUC=0.598(P = 0.004)]. Mean AMH levels were 3.66 ± 3.96 ng/ml [0.69±0.21ng/ml 75th centile] and decreased with increasing age. AMH levels correlated with TOS, PTOS, fertilization and cleavage rates. The r2 values were low suggesting poor clinical significance. AMH levels were not predictive of fertilization and embryo grade. Conclusion: AMH levels show weak correlation with oocyte quality and are poor predictor of oocyte competence.