Serum anti-Müllerian Hormone Research Articles

Study of Serum Anti-Mullerian Hormone in the Diagnosis of Ovarian Reserve Function in Patients with Premature Ovarian Insufficiency.

Objective To explore the diagnostic value of serum anti-Mullerian hormone (AMH) for patients with premature ovarian insufficiency (POI) and premature ovarian failure (POF). Methods Totally, 125 women with menstrual disorder treated in the Obstetrics and Gynecology Department of Ningbo Women & Children Hospital between January 2020 and December 2021 were enrolled. Among them, based on the follicle-stimulating hormone (FSH) level, 54 patients (25 IU/L < FSH ≤ 40 IU/L) were assigned to the POI group, and 71 patients (FSH > 40 IU/L) were assigned to the POF group. In addition, 72 individuals who went physical examination in the hospital and showed normal menstrual cycle were selected as the control (CON) group. Serum AMH in each group was quantified via enzyme-linked immunosorbent assay (ELISA) and Beckman Coulter Access active immunoassay analyzer, and the levels of serum neutral hormones [luteinizing hormone (LH), FSH, as well as estradiol (E2)] in each group were detected through the electrochemiluminescence method. The difference between AMH level acquired by the latest automatic method and that acquired by the traditional manual ELISA was compared, and the correlation of serum AMH with sex hormones was analyzed. In addition, receiver-operating characteristic (ROC) curves were drawn for determining the diagnostic value of serum AHM for POI ad POF. Results Beckman Coulter Access quantified AMH more accurately and fastly (Beckman Coulter Access: 35 minutes; manual quantification: 3-4 hours) and was more sensitive than ELISA, with a requirement to less serum. The levels of serum AMH and E2 in the POF group were 0.04 ± 0.10 ng/mL and 35.16 ± 53.06 ng/mL, respectively, which were notably lower than those in the POI group ((0.69 ± 1.46) ng/mL and (3.96 ± 2.82) ng/mL) and CON group ((76.31 ± 97.84) ng/mL and (113.19 ± 114.84) ng/mL). The LH and FSH levels in the POF group were 37.86 ± 19.44 IU/L and 75.05 ± 35.31 IU/L, which were higher than those in POI group ((22.66 ± 26.15) IU/L and (11.30 ± 17.05) IU/L) and the CON group ((29.81 ± 4.45) IU/L and (6.78 ± 3.45) IU/L) (P < 0.05). The POI group showed a notably lower serum AMH level and notably higher LH and FSH levels than the CON group (P < 0.05), and the POI group was similar to the CON group in the E2 level (P > 0.05). Serum AMH showed a positive correlation with E2 (r = 0.291, P < 0.05) and a negative association with both FSH (r = −0.476, P < 0.05) and LH (r = −0.143, P < 0.1). The optimal cut-off value of serum AMH in predicting POI was 0.83 ng/mL, and the corresponding sensitivity and specificity were 95.8% and 85.2%. The optimal cut-off of serum AMH in predicting POF was 0.075 ng/mL, and the corresponding sensitivity and specificity were 81.7% and 94.4%. The area under ROC curve (AUC) of serum AMH + FSH in the diagnosis of POF was close to 1. Conclusion Beckman Coulter Access AMH test is the latest automatic electrochemiluminescence sandwich immunoassay, with higher sensitivity and reproducibility than traditional manual ELISA and with ability to produce repeatable results. With the decline of ovarian function, the serum AMH of POI patients decreases gradually, and the serum AMH of POF patients decreases obviously, so serum AMH level has great value in predicting POI and POF and can be used as a sensitive index for early diagnosis of the two. Serum AMH combined with FSH can lift the diagnostic efficiency of POF.

Effect of barbed suture versus conventional suture in laparo-endoscopic single-site cystectomy for ovarian mature cystic teratoma: An ambispective cohort study.

To compare the effects of barbed suture (BS) and conventional suture (CS) on perioperative conditions and ovarian function in the excision of ovarian mature cystic teratoma (MCT) by laparo-endoscopic single-site surgery (LESS). The present study is an ambispective cohort study conducted in an affiliated tertiary hospital between May 2019 and October 2020. Women treated by LESS cystectomy for unilateral ovarian MCT were included. BS or CS were applied in the surgery. BS and CS groups were matched 1:1 for age, body mass index and ovarian cyst volume (40 women per group). There were no significant differences in baseline characteristics. Mean operating time (53.89 ± 14.80 versuss 67.93 ± 19.23 min, P=0.004) and suturing time (11.85 ± 6.68 versus 19.76 ± 12.75 min, P=0.006) were significantly shorter in the BS group than the CS group. No significant differences were found in serum anti-Müllerian hormone (AMH) levels between groups at baseline, postoperative day 1, 3months, and 12 months. However, serum AMH was significantly lower than baseline at postoperative day 1, 3months, and 12 months in both groups. BS provides shorter operating and suturing time than CS, without increasing damage to ovarian function in LESS cystectomy for ovarian MCT.

Anti-Müllerian Hormone and Polycystic Ovary Syndrome in Women and Its Male Equivalent

This article reviews the main findings on anti-Müllerian hormone (AMH) and its involvement in the pathogenesis of polycystic ovary syndrome (PCOS) and its male equivalent. In women, AMH is produced by granulosa cells from the mid-fetal life to menopause and is a reliable indirect marker of ovarian reserve. AMH protects follicles from atresia, inhibits their differentiation in the ovary, and stimulates gonadotrophin-releasing hormone neurons pulsatility. AMH overexpression in women with PCOS likely contributes to the increase of the follicle cohort and of androgen levels, leading to follicular arrest and anovulation. In the male, AMH is synthesized at high levels by Sertoli cells from fetal life to puberty when serum AMH falls to levels similar to those observed in women. AMH is involved in the differentiation of the genital tract during fetal life and plays a role in Sertoli and Leydig cells differentiation and function. Serum AMH is used to assess Sertoli cell function in children with disorders of sex development and various conditions affecting the hypothalamic–pituitary–testicular axis. Although the reproductive function of male relative of women with PCOS has been poorly investigated, adolescents have elevated levels of AMH which could play a detrimental role on their fertility.

Does the Ketogenic Diet Improve the Quality of Ovarian Function in Obese Women?

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, the prevalence of which ranges from 8 to 13%. It is characterized by metabolic, reproductive, and psychological alterations. PCOS prevalence is related to body mass index (BMI). Women with BMI < 25 kg/m2 have a prevalence of 4.3%, whereas women with BMI > 30 kg/m2 have a prevalence of 14%. Moreover, women with PCOS have a risk of type 2 diabetes mellitus (T2DM) two-fold higher than controls, independently of BMI. Both PCOS and T2DM are also consequences of lower serum sex-hormone-binding globulin (SHBG) levels, which is currently considered a biomarker of metabolic disorders, in particular T2DM. Aim: To evaluate the effect of the very-low-calorie ketogenic diet (VLCKD) on markers suggested to be predictive of metabolic and ovulatory dysfunction. These comprehend SHBG, anti-Mullerian hormone (AMH), and progesterone levels on day 21 of the menstrual cycle in a cohort of obese non-diabetic women with PCOS and regular menses. Methods: Twenty-five patients (mean age 25.4 ± 3.44 years) with obesity and PCOS underwent VLCKD for 12 weeks. Each of them underwent measurements of anthropometric parameters (body weight, height, and waist circumference) and blood testing to evaluate serum levels of SHBG, AMH, and progesterone before and after 12 weeks of VLCKD. Results: At enrollment, all patients had high BMI, WC, and AMH, whereas SHBG and progesterone levels were low. After VLCKD, the patients showed a significant reduction in BMI, WC, and HOMA index. In particular, 76% of patients (19/25) switched from obesity to overweight, and the HOMA index normalized, reaching values lower than 2.5 in 96% (24/25) of patients. In addition, serum AMH levels significantly decreased, and progesterone and SHBG significantly increased after VLCKD. Conclusions: This is the first study documenting the effects of VLCKD on ovarian reserve and luteal function in women with PCOS. VLCKD could be used to improve metabolic and ovulatory dysfunction in women with PCOS. Further studies are needed to understand the reasons for the AMH reduction.

In Children with 46, XY DSD; HCG Testing is not always the Best Answer for Testicular Function Assessment

Hormonal levels are the hallmark for the assessment of testicular function in XY DSD (Disorders of sex development). Traditionally, it has relied on testosterone level increment after hCG (human Chorionic Gonadotropin) stimulation testing. More recently role of Sertoli cell hormones is more emphasized. Objectives: Evaluating the role of serum anti-mullerian hormone and inhibin B on function of the pre-pubertal testis without the need for hCG stimulation test. Method: The study was conducted in the Endocrinology Clinic in Alexandria University Children’s Hospital. All patients who present with XY DSD were tested for Testosterone (T), Dihydrotestosterone (DHT), Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Anti-Mullerian Hormone (AMH), inhibin B. All cases had hCG stimulation test. Results: The hCG stimulation test was done for 32 cases. There was significant positive correlation between serum testosterone levels before and after hCG stimulation test (p &lt;0.001). Similarly, significant correlation was identified between basal AMH and testosterone increment after hCG stimulation (p &lt;0.001) and between basal levels of AMH and inhibin (MCp= 0.025). Conclusion: Single measurement of basal AMH and/or inhibin B can detect the presence and function of testes by a reliable non-invasive way. Basal AMH assessment is an important tool to distinguish between cryptorchidism and anorchia. hCG test is needed in the work-up of patients with inconclusive results.

SERUM ANTI-MÜLLERIAN HORMONE TO PREDICT THE CHANCE OF LIVE BIRTH AFTER SPONTANEOUS OR ASSISTED CONCEPTION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Serum anti-Müllerian hormone (AMH) level is a well-established marker of ovarian reserve and a good predictor of ovarian response after controlled ovarian hyperstimulation. However, literature is unclear whether its measurement can predict live birth (LB) in spontaneous or assisted conception. To clarify this issue, we undertook a systematic review and meta-analysis to analyze whether serum AMH level may predict the chances of LB in women having conceived naturally and/or the cumulative live birth (C.LB) in infertile women undergoing assisted reproductive technologies (ART).

Association of Anti-Mullerian Hormone with Some Physiological and immunological Parameters of Infertile Males.

The measurement of anti-Müllerian hormone (AMH), which is released in the serum and seminal fluid is a specific indicator of Sertoli cell function. This study aimed to evaluate AMH as a potential clinical indicator of infertility in maleswith normal and low sperm concentrations, as well as those with primary and secondary infertility. It was a retrospective analysis of 140 males chosen from sole infertility and IVF center in Erbil. without a known cause of infertility, 40 men with normal sperm counts, 100 men with primary, and 40 men with secondary infertility were assessed. An in-house ELISA was used to assess the serum AMH. Semen parameters, Semen and sera cytokines, and certain sex hormone mean levels were compared and correlated with AMH as the primary outcome measures. Seminal and serum AMH levels in infertile males were significantly lower. While an insignificant correlation was detected between AMH and LH, prolactin, or testosterone in azoospermic men, there was a significant adverse association between seminal AMH and FSH. A substantial positive association between seminal AMH and testosterone was found in oligospermia men, although no significant correlations were observed with FSH, LH, or prolactin. In conclusion, AMH in seminal plasma is a reliable marker of male infertility with a role in sperm production.

Effect of laparoscopic excision of the endometriotic cyst capsule on the ovarian reserve (a retrospective analysis)

Endometriotic cyst is one of manifestations of the endometriotic process and its incidence among all women with endometriosis varies from 17 to 44%. This chronic process in the ovary is accompanied by persistent inflammation, which leads to fibrosis of the ovarian cortex and loss of follicles. Laparoscopic excision of the endometriotic cyst capsule is by far the mainstay of treatment for cysts of 3 cm or more in diameter. This standard surgical procedure can reduce an ovarian reserve marker such as anti-Müllerian hormone (AMH), raising concerns about reduced fertility after surgery. The aim of the study was to analyze the effect of operative, in particular, laparoscopic cystectomy, on the ovarian reserve in women of fertile age with endometriotic cysts. A retrospective analysis of the data of 202 women with endometriotic cysts who underwent examination, surgery and outpatient observation from 2011 to 2020 was carried out. The analysis was carried out in comparison before and after surgical treatment of all cases. The state of the ovarian reserve was assessed by the level of serum AMH. At baseline, the mean AMH in women with bilateral cysts 1,78 (95% CI 1,62; 1,91) ng/ml was lower than in women with monolateral cysts 2,44 (95% CI 2,18; 2,54) ng/m (p&lt;0.001). When comparing AMH values 6 months after surgery, it was found that in all women the median AMH level significantly decreased by an average of 0,34 (95% CI 0,2-0,48) ng/ml (p&lt;0,001). Laparoscopic excision of the cyst capsule is the main method of treatment of endometriotic cysts, and its minimally invasiveness and acceptability of use in women of fertile age makes it the standard surgical approach. However, the analysis showed that, nevertheless, laparoscopic excision of the endometriotic cyst capsule does not guarantee the safety of the negative effect of this method on the ovarian reserve, both during and after its application, on the contrary, significantly reducing the AMH values in comparison with its levels before surgery.

Anti-Mullerian hormone levels in girls and adolescents.

Anti-Mullerian hormone (AMH) is a homodimeric glycoprotein which belongs to the TGF-beta superfamily of growth and differentiation factors. There are few studies that present AMH concentrations in premenarcheal and early postmenarcheal girls. The aim of this study is to evaluate AMH levels in girls. A serum AMH increase of 1 pmol/L is related with a higher possibility of menarche occurrence. AMH levels are significantly higher in postmenarcheal girls than in prepubertal girls.

Evaluation of the impact of platelet-rich plasma in women with reduced ovarian reserve

Introduction: Infertility is the most critical factor disrupting the marital relationship, which imposes high financial and psychological costs on couples. Despite vast advances, the problem of infertility has not yet been entirely resolved. The new method of injecting platelet-rich plasma (PRP) has been promising for couples. This study investigated the effect of PRP injection on the fertility of infertile women.&#x0D; Material and Method: In this study, 40 women with a history of infertility with a mean age of 37.75 were included in the study. Prior to the demographic information intervention, laboratory findings, including serum anti-mullerian hormone (AMH) levels and ultrasound for the number of antral follicles count (AFC) were performed. Autologous PRP was then prepared for each patient, and an intraovarian injection was performed. Two months after injection, serum levels of AMH and AFC levels were re-evaluated.&#x0D; Results: The mean AMH levels before and after the injection were 0.07±0.05 and 0.13±0.06, respectively (p

Laparoscopic surgeries for uterine fibroids and ovarian cysts reduce ovarian reserve via age- and surgical type-manner

Aim: Diminished ovarian reserve can be characterized by poor response to ovulation and low number of eggs. The risk factors include endometriosis, receiving cancer treatment, luteal phase deficiency and gynecologic surgery. Uterine fibroids and ovarian cysts are the most common benign gynecological diseases in women globally. This prospective study evaluated the influence of laparoscopic surgery treating benign gynecological diseases on ovarian reserve. Methods: A total of 121 patients with uterine fibroids or benign ovarian cysts who received laparoscopic surgeries (41 with hysterectomy, 36 with myomectomy, 18 with adnexectomy, and 26 with ovarian cystectomy) were included. The ovarian reserve status defined as serum anti-Mullerian hormone concentration was assessed at 1 month before and after surgery, respectively. Results: The anti-Mullerian hormone reduction level was 22.34% in cystectomy, 44.1% in adnexectomy, 24.92% in myomectomy, and 47.61% in hysterectomy (p < 0.001). Multivariate analysis showed that adnexectomy had significantly high risk of high serum anti-Mullerian hormone reduction level (adjusted odds ratio (aOR): 14.90, 95% confidence interval (CI): 2.56-86.93, p = 0.003). Conclusions: These 4 laparoscopic surgeries all reduced the AMH levels 1 month after the procedure. Further prospective studies with longer follow-up are necessary to know the real impact on the ovarian reserve. Adnexectomy was an independent factor of reduced ovarian reserve in 1 month after surgery.

Investigating the relationship between body composition, lifestyle factors, and anti-Müllerian hormone serum levels in women undergoing infertility assessment.

The impact of lifestyle factors such as adiposity, smoking, stress, exercise, and nutrition on anti-Müllerian hormone (AMH) levels remains an unresolved question. This study aims to examine the anthropometric and lifestyle characteristics of women undergoing infertility investigations and to examine the relationship between serum AMH levels and body fat percentage, body mass index (BMI), and lifestyle factors including smoking, alcohol intake, nutrition, exercise, and stress. Only women undergoing infertility investigations were included in the study. Those with a diagnosis of polycystic ovary syndrome (PCOS) were excluded. Body fat percentage was measured using the Tanita Body Composition Monitor and BMI calculated. Lifestyle factors were evaluated using the Simple Lifestyle Indicator Questionnaire (SLIQ). Ninety-six women took part in the study. Of these, 35.4% (n = 34) were obese, and 28.1% (n = 27) were overweight according to their BMI. According to body fat percentage, 47.9% (n = 46) were classified as obese. An "unhealthy " SLIQ score was measured in 25% (n = 24) of participating women. There was no relationship between AMH and anthropometric or lifestyle factors, namely, body fat percentage (B = - 0.11, p = 0.76), BMI (B = - 0.14, p = 0.76), smoking [currents smokers (B = - 1.86, p = 0.56), ex-smoker (B = 3.07, p = 0.41)], SLIQ score (B = 0.1.96, p = 0.29), stress (B = 0.12, p = 0.96), exercise (B = - 0.94, p = 0.77), alcohol (B = - 0.94, p = 0.77), or nutrition (B = - 3.14, p = 2.44). Body fat percentage, BMI, lifestyle choices, and high stress levels do not correlate with AMH levels in women seeking infertility investigations. We identified a high incidence of obesity and low levels of healthy lifestyle scores in our study population. Our study highlights the urgent need for patient education and optimization of pre-pregnancy health.

Anti-Mullerian Hormone as a Marker of Ovarian Reserve and Function.

Background: Ovarian reserve tests are required to screen women with a diminished ovarian reserve so that women who are more likely to exhibit poor response to ovarian stimulation and a lower likelihood of becoming pregnant with treatment can be identified.Aim and Objectives: This study aimed to determine whether serum anti-Mullerian hormone (AMH) level is a better predictor of ovarian reserve and function than other biochemical tests for ovarian reserve. The primary objective of this study was to find out the correlations of day 3 serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, inhibin B, AMH, ovarian volume, and antral follicle count (AFC) with advancing age; and a secondary objective was to find out the correlations between day 3 serum AMH, LH, FSH, estradiol, and inhibin B levels with AFC.Methods: This was a prospective, single-center, observational study. A total of 100 infertile women who attended the Gynecology outpatient department over a period of two years and met the inclusion criteria were included in the study. History, clinical examination, routine investigations, hysterosalpingography for tubal patency, estimation of day 3 serum AMH, LH, FSH, estradiol and inhibin B, measurement of ovarian volume, and AFC were done. Correlations of different parameters with advancing age and with AFC were found using Spearman’s rho correlations. p-value < 0.05 was considered significant.Results: The maximum infertile women were in the age group of 21-30 years (58 of 100). Serum AMH showed the strongest negative correlation (r=-0.931) with age, followed by AFC (r=-0.884), ovarian volume (r=-0.876), and inhibin B (r=-0.878), whereas serum LH, FSH, and estradiol showed a positive correlation (r=0.589, 0.408, and 0.638 respectively). Serum AMH also showed a strong positive correlation (r=0.972) with AFC followed by ovarian volume (r=0.919) and inhibin B (r=0.769), whereas serum LH, FSH, and estradiol showed a negative correlation (r=-0.504, -0.663, and -0.543 respectively) with AFC. Conclusion: Among all the different tests of ovarian reserve, serum AMH was the most reliable indicator of reproductive aging and decline in the ovarian pool as well as very closely related to AFC, which is one of the best predictors of ovarian reserve.

Extended LH administration as a strategy to increase the pool of recruitable antral follicles in hypothalamic amenorrhea: evidence from a case series.

New evidence is indicating a growing role of LH in promoting ovarian follicular growth and maturation, even at the early stages. LH seems to enhance the transition of follicles to the antral stage hence leading to an increase in the so-called functional ovarian reserve (recruitable antral follicles). Hypogonadotropic hypogonadism is characterized by low, and sometimes undetectable, serum LH and FSH levels, which may indeed explain the low anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) found in patients affected by this condition. We report here the cases of two young women affected by hypothalamic amenorrhea (HA) that presented for fertility treatment with very low functional ovarian reserve. The two patients were treated with exogenous LH for 1 and 2 months (extended LH administration: ELHA) at the dose of 187.5 IU LH every day and 150 IU LH every other day, respectively. In both the cases there was an increase in serum AMH levels and in the AFC. In one patient, the AMH and AFC increased from a baseline 1.3 ng/ml and 8 to 2.3 ng/ml and 14 at end of treatment, respectively. In the second case, serum AMH and AFC increased from 0.4 ng/ml and 6 to 1.6 ng/ml and 13, respectively. One patient underwent ovarian stimulation before and after ELHA, showing an increase in the number of mature oocytes recruited (3 versus 8 metaphase II (MII) oocytes before and after, respectively). The second patient underwent an IVF cycle after ELHA resulting in the retrieval of six MII oocytes and an ongoing pregnancy following transfer of a single blastocyst. Women with HA are characterized by chronic, low levels of gonadotrophins, which may impact not only on the cyclic recruitment of follicles but also the progression of small growing follicles through the first stages of folliculogenesis. Some women with HA may in fact show very low serum AMH and AFC. Our case series shows that the administration of LH at a dose of at least 150-187.5 IU every day or every other day may contribute to a clinically evident increase in the functional ovarian reserve (AFC), and probably accounts for a positive effect of LH on the progression of follicles throughout the early stages of folliculogenesis.

Evaluation of assisted reproductive technology treatment outcomes based on stimulation dosages and anti-Mullerian hormone levels

Background: Serum levels of anti-Müllerian hormone (AMH) have a significant association with ovarian response in the event of assisted reproductive technology (ART) treatment cycles. The present study was performed to evaluate the ovarian stimulation protocols selection with respect to serum AMH levels in patients and its impact on ART outcome. Methods: Based on the serum AMH, 191 women were classified as low, normal and high responders. Follicle Stimulating Hormone (FSH) and Human Menopausal Gonadotropin (HMG) dosages in controlled ovarian stimulation were determined. Retrieval, maturation, fertilization and utilization rates were measured. Subgroup analysis was done using one-way ANOVA followed by post hoc analysis. The relationship between AMH levels and fertilization was determined using Pearson’s correlation analysis. A p-value &lt;0.05 was considered as statistically significant. Results: According to AMH levels, the majority of the patients were normal responders (52.4%) followed by high responders (29.8%) and low responders (17.8%). The average FSH, HMG per day and number of days HMG required was found to be significant among the different responders. Further, retrieval rate and blastulation rate was found to be significant among the different responders. A positive correlation was found between AMH and the number of oocytes retrieved and number of oocytes successfully fertilized, which was found to be significant. In addition, there was a significant inverse relationship between AMH levels and age. Conclusions: The study outcomes revealed that the rates of retrieval, maturation, fertilization, embryo utilization and blastulation were higher among the high responders compared with the low responders. Thus, proper increase in dosages of ovarian stimulation protocol is required among the low responders to achieve quality embryos.

Anti-Müllerian hormone concentrations in female rabbits and its relation to spay status, pseudopregnancy and ovarian follicle numbers.

Anti-Müllerian hormone (AMH), known for its role during foetal sexual differentiation, is secreted by the Sertoli cells in males and the granulosa cells in females during post-natal life. As serum AMH concentrations correlate with follicle numbers, AMH is utilized as a marker of ovarian reserve in many species. In dogs and cats, AMH is used as a diagnostic tool to determine spay or neuter status. In the available literature, no research regarding serum AMH levels in rabbits has been published yet. The objectives of the present study were to (1) measure serum AMH concentrations in female rabbits and investigate the value of AMH as a diagnostic tool to differentiate between spayed and intact does and (2) relate measured AMH levels to pseudopregnancy and ovarian follicle numbers. For AMH measurement, serum samples were obtained from sexually intact (n=64) and spayed (n=22) female rabbits. Spayed does were of various breeds; intact rabbits were Zika hybrid rabbits. In the intact does, AMH measurement was complemented by determination of progesterone levels, gynaecological examination and histopathological evaluation of the uterus and ovaries, including follicle counts. Serum AMH and progesterone concentrations were measured using a human-based chemiluminescence immunoassay (CLIA) and an enzyme-linked fluorescence assay (ELFA), respectively. Depending on progesterone levels, sexually intact does were classified into follicular (n=52) or luteal phase (n=12). Median serum AMH levels were 1.53 ng/ml (range 0.77-3.36 ng/ml) in intact and 0.06 ng/ml (range ≤0.01-0.23 ng/ml) in spayed does. AMH concentrations between the intact and spayed rabbits differed significantly and did not overlap (p < .001). Receiver operating characteristic (ROC) curve analysis yielded a sensitivity and specificity of 100% for a cut-off level of 0.50 ng/ml. Follicular or luteal phase had no significant influence on measured AMH levels (t=0.061, df=62, p=.951). While the number of secondary follicles correlated significantly with AMH concentrations (rs =0.410, p=.001), the number of primary or antral follicles did not (rs =0.241, p=.055 and rs =0.137, p=.281, respectively). In conclusion, a single determination of serum AMH concentrations was adequate to distinguish spayed from intact female rabbits. Among sexually intact individuals, whether does were in follicular or luteal phase had no significant influence on measured serum AMH concentrations. The relationship between small growing follicles and AMH levels as described in other species could be partially confirmed, as secondary follicles correlated significantly with AMH.

Efficacy of serum anti-mullerian hormone (AMH) levels for prediction of polycystic ovary syndrome (PCOS) and its association with clinical, biochemical and hormonal parameters.

The online version contains supplementary material available at 10.1007/s12291-022-01058-4.

Association of Endometrioma Size with Serum Anti-mullerian Hormone.

To evaluate the relationship between the size of endometrioma and serum Anti-mullerian hormone (AMH). A Descriptive study. This study was conducted at the Bagcilar Training and Research Hospital, Istanbul, Turkey, from January 2015 to January 2020. Healthy women of reproductive age, who were found to have unilateral endometrioma in ultrasonography, were included in the study group. There were 82 female patients with unilateral endometrioma in the study group and 96 healthy female patients with male factor infertility in the control group. Women with autoimmune disease, a history of pelvic infection or surgery, polycystic ovary syndrome, pregnancy, those undergoing infertility treatment, family history of premature ovarian failure, and those with atypical or suspected endometrioma were excluded. Age, gravida, serum AMH value, and endometrioma size of the study and control groups were recorded. In addition, the endometrioma group was divided into 2 groups with a cut-off size of greater or less than 40 mm. AMH values ​​were evaluated in these two groups. AMH values ​​of women with endometrioma were significantly lower than the control group (2.03 ng/ml and 3.87 ng/ml, respectively, p<0.001). When the relationship between endometrioma size (greater than 40 mm and less than 40 mm) and AMH was examined, no statistically significant difference was found among serum AMH values (1.89 ng/ml and 2.07 ng/ml, respectively, p=0.65). The presence of endometrioma was associated with lower AMH suggesting lower ovarian reserve, but endometrioma size was not associated with significant difference in the AMH values. Endometrioma, AMH, Ovarian reserve, Endometrioma size.

Correlation of oocyte number with serum anti-Müllerian hormone levels measured by either Access or Elecsys in fresh in vitro fertilization cycles.

ObjectiveThe aim of this study was to assess the correlation of oocyte number with serum anti-Müllerian hormone (AMH) levels measured by two automated methods (Access or Elecsys) in fresh stimulated in vitro fertilization (IVF) cycles.MethodsIn this retrospective study at a university hospital, data were collected from 243 fresh stimulated IVF cycles performed from August 2016 to December 2020. The serum AMH level was measured by Access in 120 cycles and by Elecsys in 123 cycles. The cut-off of serum AMH for prediction of poor responders (three or fewer oocytes) or high responders (15 or more oocytes) was calculated by the receiver operating characteristic curve analysis.ResultsFor the two automated methods, the following equations were derived: total oocyte number=2.378+1.418×(Access-AMH) (r=0.645, p<0.001) and total oocyte number=2.417+2.163×(Elecsys-AMH) (r=0.686, p<0.001). The following combined equation could be derived: (Access-AMH)=0.028+1.525×(Elecsys-AMH). To predict poor responders, the cut-off of Access-AMH was 1.215 ng/mL (area under the curve [AUC], 0.807; 95% confidence interval [CI], 0.730–0.884; p<0.001), and the cut-off of Elecsys-AMH was 1.095 ng/mL (AUC, 0.848; 95% CI, 0.773–0.923; p<0.001). To predict high responders, the cut-off of Access-AMH was 3.450 ng/mL (AUC, 0.922; 95% CI, 0.862–0.981; p<0.001), and the cut-off of Elecsys-AMH was 2.500 ng/mL (AUC, 0.884; 95% CI, 0.778–0.991; p<0.001).ConclusionBoth automated methods for serum AMH measurement showed a good correlation with oocyte number and good performance for predicting poor and high responders in fresh stimulated IVF cycles. The Access method usually yielded higher measured serum AMH levels than the Elecsys method.

Effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cyst.

ObjectiveThis study aimed to evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cysts.Material and methodsThis prospective study was performed on 113 women with ovarian cysts in a tertiary referral teaching hospital. All patients underwent laparoscopic cystectomy. Serum levels of antimüllerian hormone (AMH) were measured pre-and, 3 months postoperatively. The primary outcome of the study was to assess the effect of laparoscopic cystectomy on ovarian reserve based on alterations in serum AMH levels. The secondary outcome of the present study was to evaluate the impact of the number of cauterizations, size and type of cysts, bilaterality (bilateral or unilateral), age, and body mass index (BMI) on the ovarian reserve after laparoscopic excision.ResultsLaparoscopic cystectomy reduced the serum AMH levels preoperatively (1.32 ± 4.48 ng/ml) to postoperatively (3.2 ± 1.93 ng/ml) and the difference (- 1.28 ng/ml) was statistically different (0.001 >P). There was a negative significant relationship between the number of cauterizations used and postoperative serum AMH levels (p ≤ 0.001). There was a significant relationship between the location (p ≤ 0.01), type of cyst (p ≤ 0.001) and the serum AMH levels reduction.ConclusionThe number of cauterizations used during surgery, the type of cyst, and bilaterality can affect AMH levels that need to be addressed.