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Ziaei R, Ghavami A, Ghasemi-Tehrani H, Movahedi M, Hashemi M, Hajhashemi M, Elyasi M, Vajdi M, Kalatehjari M. Dietary acid load and risk of diminished ovarian reserve: a case-control study. Reprod Biol Endocrinol 2024; 22:63. [PMID: 38835018 DOI: 10.1186/s12958-024-01238-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND The epidemiologic evidence on the association between acid load potential of diet and the risk of diminished ovarian reserve (DOR) is scarce. We aim to explore the possible relationship between dietary acid load (DAL), markers of ovarian reserve and DOR risk in a case-control study. METHODS 370 women (120 women with DOR and 250 women with normal ovarian reserve as controls), matched by age and BMI, were recruited. Dietary intake was obtained using a validated 80-item semi-quantitative food frequency questionnaire (FFQ). The DAL scores including the potential renal acid load (PRAL) and net endogenous acid production (NEAP) were calculated based on nutrients intake. NEAP and PRAL scores were categorized by quartiles based on the distribution of controls. Antral follicle count (AFC), serum antimullerian hormone (AMH) and anthropometric indices were measured. Logistic regression models were used to estimate multivariable odds ratio (OR) of DOR across quartiles of NEAP and PRAL scores. RESULTS Following increase in PRAL and NEAP scores, serum AMH significantly decreased in women with DOR. Also, AFC count had a significant decrease following increase in PRAL score (P = 0.045). After adjustment for multiple confounding variables, participants in the top quartile of PRAL had increased OR for DOR (OR: 1.26; 95%CI: 1.08-1.42, P = 0.254). CONCLUSION Diets with high acid-forming potential may negatively affect ovarian reserve in women with DOR. Also, high DAL may increase the risk of DOR. The association between DAL and markers of ovarian reserve should be explored in prospective studies and clinical trials.
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Affiliation(s)
- Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abed Ghavami
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hatav Ghasemi-Tehrani
- Fertility department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Minoo Movahedi
- Department of Obstetrics & Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hashemi
- Department of Obstetrics & Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hajhashemi
- Department of Obstetrics & Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahshid Elyasi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Vajdi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan, Iran
| | - Maryam Kalatehjari
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Werner L, van der Schouw YT, de Kat AC. A systematic review of the association between modifiable lifestyle factors and circulating anti-Müllerian hormone. Hum Reprod Update 2024; 30:262-308. [PMID: 38402486 DOI: 10.1093/humupd/dmae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/21/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Levels of anti-Müllerian hormone (AMH) are known to be associated with lifestyle determinants such as smoking and oral contraception (OC) use. When measuring AMH in clinical practice, it is essential to know which factors may influence circulating levels or ovarian reserve in general. OBJECTIVE AND RATIONALE To date, there is no systematic review or summarizing consensus of the nature and magnitude of the relation between AMH and modifiable lifestyle factors. The purpose of this review was to systematically assess the evidence on association of lifestyle behaviors with circulating AMH levels. SEARCH METHODS We performed a pre-registered systematic review of publications in Embase and PubMed on the lifestyle factors BMI, smoking, OC use, alcohol consumption, caffeine consumption, physical activity, and waist-hip ratio (WHR) in relation to circulating AMH levels up to 1 November 2023. The search strategy included terms such as 'Anti-Mullerian hormone', 'lifestyle', and 'women'. Studies were considered eligible if the association between at least one of the lifestyle factors of interest and AMH was assessed in adult women. The quality of included studies was assessed using the Study Quality Assessment Tools of the National Heart, Lung, and Blood Institute. The results were presented as ranges of the most frequently used association measure for studies that found a significant association in the same direction. OUTCOMES A total of 15 072 records were identified, of which 65 studies were eligible for inclusion, and 66.2% of the studies used a cross-sectional design. The majority of studies investigating BMI, smoking, OC use, and physical activity reported significant inverse associations with AMH levels. For WHR, alcohol, and caffeine use, the majority of studies did not find an association with AMH. For all determinants, the effect measures of the reported associations were heterogeneous. The mean difference in AMH levels per unit increase in BMI ranged from -0.015 to -0.2 ng/ml in studies that found a significant inverse association. The mean difference in AMH levels for current smokers versus non-smokers ranged from -0.4 to -1.1 ng/ml, and -4% to -44%, respectively. For current OC use, results included a range in relative mean differences in AMH levels of -17% to -31.1%, in addition to a decrease of 11 age-standardized percentiles, and an average decrease of 1.97 ng/ml after 9 weeks of OC use. Exercise interventions led to a decrease in AMH levels of 2.8 pmol/l to 13.2 pmol/l after 12 weeks in women with polycystic ovary syndrome or a sedentary lifestyle. WIDER IMPLICATIONS Lifestyle factors are associated with differences in AMH levels and thus should be taken into account when interpreting individual AMH measurements. Furthermore, AMH levels can be influenced by the alteration of lifestyle behaviors. While this can be a helpful tool for clinical and lifestyle counseling, the nature of the relation between the observed differences in AMH and the true ovarian reserve remains to be assessed. REGISTRATION NUMBER PROSPERO registration ID: CRD42022322575.
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Affiliation(s)
- Lotte Werner
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Annelien C de Kat
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
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Ziaei R, Ghasemi-Tehrani H, Movahedi M, Kalatehjari M, Vajdi M, Mokari-Yamchi A, Elyasi M, Ghavami A. The association between Diet Quality Index-International score and risk of diminished ovarian reserve: a case-control study. Front Nutr 2023; 10:1277311. [PMID: 38107746 PMCID: PMC10721967 DOI: 10.3389/fnut.2023.1277311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Although limited evidence exists on the beneficial reproductive effects of diet quality indices, the association is still largely unknown. We aimed to investigate the association between Diet Quality Index-International (DQI-I) and antral follicle count (AFC) and serum antimullerian hormone (AMH) as precise and sensitive markers of ovarian reserve and to assess the risk of diminished ovarian reserve (DOR) in women seeking fertility treatments. Methods In a case-control study, 370 women (120 women with DOR and 250 women with normal ovarian reserve as controls), matched by age and body mass index (BMI), were recruited. Dietary intake was obtained using a validated 80-item semi-quantitative food frequency questionnaire (FFQ). The quality of diets was assessed using DQI-I, which included four major dietary components: variety (0-20 points), adequacy (0-40 points), moderation (0-30 points), and overall balance (0-10 points). DQI-I score was categorized by quartiles based on the distribution of controls. AFC, serum AMH and anthropometric indices were measured. Logistic regression models were used to estimate multivariable odds ratio (OR) of DOR across quartiles of DQI-I score. Results Increased adherence to DQI-I was associated with higher AFC in women with DOR. After adjusting for potential confounders, the odds of DOR decreased with increasing DQI-I score (0.39; 95% CI: 0.18-0.86). Conclusion Greater adherence to DQI-I, as a food and nutrient-based quality index, may decrease the risk of DOR and improve the ovarian reserve in women already diagnosed with DOR. Our findings, though, need to be verified through prospective studies and clinical trials.
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Affiliation(s)
- Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hatav Ghasemi-Tehrani
- Fertility Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Minoo Movahedi
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Kalatehjari
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Vajdi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Mokari-Yamchi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahshid Elyasi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abed Ghavami
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Zhang M, Liu X, Xu X, Li J, Bu Z, Yang Q, Shi H, Niu W, Dai S, Liang Y, Guo Y. The reference value of anti-Müllerian hormone to diagnose polycystic ovary syndrome is inversely associated with BMI: a retrospective study. Reprod Biol Endocrinol 2023; 21:15. [PMID: 36726106 PMCID: PMC9890853 DOI: 10.1186/s12958-023-01064-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 01/19/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the cut-off value of anti-Müllerian hormone (AMH) combined with body mass index (BMI) in the diagnosis of polycystic ovary syndrome (PCOS) and polycystic ovary morphology (PCOM). METHODS This retrospective study included 15,970 patients: 3775 women with PCOS, 2879 women with PCOM, and 9316 patients as controls. Multivariate logistic regression analysis was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for AMH. We randomly divided the patients into two data sets. In dataset 1, a receiver operating characteristic (ROC) curve was generated to analyze the accuracy of basic AMH levels in diagnosing PCOS and PCOM. The optimal cut-off value was calculated in dataset 1 and validated in dataset 2, expressed as sensitivity and specificity. RESULTS In the PCOS group, obese patients had the lowest AMH levels, while underweight patients had the highest AMH level (P < 0.001). After adjusting for age, the ratio of luteinizing hormone (LH) and follicle stimulating hormone (FSH), serum testosterone level, and BMI, AMH was an independent predictor of PCOS and PCOM. In the group with BMI < 18.5 kg/m2, the optimistic AMH cut-off value was 5.145 ng/mL with a sensitivity of 84.3% and specificity of 89.1%, whereas in the BMI ≥ 28 kg/m2 group, the optimistic AMH cut-off value was 3.165 ng/mL with a sensitivity of 88.7% and specificity of 74.6%. For the BMI range categories of 18.5-24, 24.0-28 kg/m2, the optimistic AMH cut-off values were 4.345 ng/mL and 4.115 ng/mL, respectively. The tendency that the group with lower weight corresponded to higher AMH cut-off values was also applicable to PCOM. In the same BMI category, patients with PCOM had a lower AMH diagnosis threshold than those with PCOS (< 18.5 kg/m2, 5.145 vs. 4.3 ng/mL; 18.5-24 kg/m2, 4.345 vs. 3.635 ng/mL; 24.0-28 kg/m2, 4.115 vs. 3.73 ng/mL; ≥ 28 kg /m2, 3.165 vs. 3.155 ng/mL). These cut-off values had a good diagnostic efficacy in the validation dataset. Based on different phenotypes and severity of ovulation disorders, the distribution of AMH in PCOS were also significantly different (P < 0.001). CONCLUSIONS AMH is a potential diagnostic indicator of PCOS and is adversely associated with BMI. The AMH cut-off value for diagnosing PCOS was significantly higher than that for PCOM.
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Affiliation(s)
- Menghui Zhang
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xiaocong Liu
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xiaolu Xu
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Jing Li
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhiqin Bu
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Qingling Yang
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Hao Shi
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Wenbin Niu
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Shanjun Dai
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yuling Liang
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yihong Guo
- Reproductive Medicine Centre, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
- Henan Key Laboratory of Reproduction and Genetics, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Gouvea TM, Cota E Souza LA, Lima AA. Correlation of serum anti-Mullerian hormone with hormonal and environmental parameters in Brazilian climacteric women. Sci Rep 2022; 12:12065. [PMID: 35835777 PMCID: PMC9283385 DOI: 10.1038/s41598-022-15429-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/23/2022] [Indexed: 11/09/2022] Open
Abstract
This study aimed to identify the correlation among anti-Mullerian Hormone serum levels and 25-OH-D, obesity, metabolic syndrome (MetS), and sexual hormones in climacteric women classified according to stages of reproductive aging (SRA). A cross-sectional study was conducted with a total of 177 Brazilian climacteric women between 40 and 64 years old. Concentrations of AMH were measured using the Access 2 Immunoassay System. A multiple linear regression analysis was used to identify the relationship among AMH, 25-OH-D, obesity, MetS, sexual hormones, sociodemographic and lifestyle factors. AMH levels decreased with increased age (B = - 0.059; p < 0.001), and reproductive aging (B = - 0.483; p < 0.001). Obesity indicators, lifestyle characters, 25-OH-D levels and MetS were not significantly associated with AMH serum concentration. Negative correlation was found for FSH (B = - 0.009; p < 0.001) and LH (B = - 0.006; p = 0.004); positive correlation for E2 (B = 0.001; p = 0.011), DHEAS (B = 0.003; p < 0.001) and SHBG (B = 0.003; p = 0.005). In the model adjusted for SRA, FSH levels (p < 0.001) and DHEAS (p = 0.014) were associated with AMH. Although, with the adjustment for age, only FSH remained with a significant association (p = 0.001). Of the other analytes, none was associated with AMH, regardless of the model fit. Our findings confirm that serum AMH level decreased with age and FSH levels, but there is no correlation between AMH with obesity, 25-OH-D, MetS or other sexual hormones in Brazilian climacteric women.
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Affiliation(s)
- Thiago Magalhães Gouvea
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, CEP 35400-000, Brazil.
| | - Laura Alves Cota E Souza
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, CEP 35400-000, Brazil
| | - Angélica Alves Lima
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, CEP 35400-000, Brazil.,Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
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Wang Y, Wu L, Yang Z, Xu R, Duan Y, Lin J, Cui X, Fan C, Zhou Y, Bao W, Jin L, Liu Y. Association of body mass index with serum anti-Müllerian hormone and inhibin B levels among 8323 women attending a reproductive medical center: a cross-sectional study. Endocrine 2022; 75:284-292. [PMID: 34363585 DOI: 10.1007/s12020-021-02839-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the association of body mass index (BMI) with serum anti-Müllerian hormone (AMH) and inhibin B (InB) levels among women attending a reproductive medical center. METHODS We conducted a cross-sectional study of 8323 women (96.4% were Han race) without polycystic ovary syndrome (PCOS) from the reproductive medical center of Tongji Hospital in Wuhan, China for assisted reproductive technology treatment between January 2016 and May 2018. For each participant, BMI and levels of serum AMH and InB were measured at entry by trained clinical technicians. Multivariate linear regression models were used to quantitatively estimate the associations of continuous and categorical BMI with serum AMH and InB levels. RESULTS Each 1 kg/m2 increase in BMI was significantly associated with a 1.02% (95% CI: 0.40, 1.65%) and 3.59% (3.11, 4.06%) reduction in AMH and InB levels, respectively. No departure from linearity was observed for either AMH or InB (both P for nonlinear trend >0.05). Overweight and obesity were significantly associated with a 6.01% (0.70, 11.04%) and 18.64% (2.29, 32.26%) reduction in AMH level, and were significantly associated with a 18.80% (15.23, 22.23%) and a 35.44% (25.47, 44.08%) reduction in InB level, respectively. In addition, the association between BMI and AMH level was significantly stronger among women ≥32 years. CONCLUSIONS BMI was linearly and inversely associated with AMH and InB levels among women without PCOS. Both overweight and obesity were significantly associated with lower AMH and InB levels.
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Affiliation(s)
- Yaqi Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, Guangdong, 510080, China
| | - Li Wu
- Reproductive Medical Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Zhengyu Yang
- Melbourne School of Population & Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, Guangdong, 510080, China
| | - Yonggang Duan
- Shenzhen Key Laboratory of Fertility Regulation, Center of Assisted Reproduction and Embryology, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan First Road, Shenzhen, Guangdong, 518053, China
| | - Jiajia Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, Guangdong, 510080, China
| | - Xiuqing Cui
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, 35 Zhuodaoquan North Road, Wuhan, Hubei, 430079, China
| | - Chuangang Fan
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, 35 Zhuodaoquan North Road, Wuhan, Hubei, 430079, China
| | - Yun Zhou
- State Key Laboratory of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, Guangdong, 510120, China
- School of Public Health, Guangzhou Medical University, 1 Xinzao Road, Guangzhou, Guangdong, 511436, China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, Iowa, 52242, USA
| | - Lei Jin
- Reproductive Medical Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China.
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, Guangdong, 510080, China.
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Garba SR, Makwe CC, Osunkalu VO, Kalejaiye OO, Soibi-Harry AP, Aliyu AU, Afolabi BB. Ovarian reserve in nigerian women with sickle cell anaemia: a cross- sectional study. J Ovarian Res 2021; 14:174. [PMID: 34895288 PMCID: PMC8666009 DOI: 10.1186/s13048-021-00927-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/23/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Sickle cell disease is the most common monogenetic disorder worldwide. There have been reports of endocrine dysfunction and gonadal failure among affected individuals, especially in males. The findings on ovarian reserve and failure in women with sickle anaemia have been inconsistent. AIM AND OBJECTIVE The aim of this study was to determine and compare the ovarian reserve of Nigerian women with and without sickle cell anaemia attending a University Teaching Hospital. STUDY DESIGN This cross-sectional study was carried out at the Adult Sickle Cell Clinic and the Community Health Clinic of the Lagos University Teaching Hospital. METHODOLOGY A total of 166 participants who met the selection criteria, were recruited for the study. The study population consisted of two groups of women matched for age: 83 women with HbSS and 83 women with HbAA. The haemoglobin phenotype of each participant was determined on alkaline electrophoresis (pH 8.4) before analysis. Serum Anti-Mullerian Hormone (AMH) was determined using Enzyme-linked immunosorbent assay (ELISA) method (Calbiotech Inc. USA, Catalog no AM448T). RESULTS The mean ± SD of serum AMH level in women with HbSS was 3.64 ± 0.65 ng/mL and was lower than that of women with HbAA 7.35 ±1.19 ng/mL (p < 0.001). Serum AMH negatively correlated with age in both study groups (HbAA and HbSS). Also, a significant negative correlation was found between serum AMH and BMI in women with HbAA. CONCLUSION The study showed diminished ovarian reserve in women with HbSS when compared to age-matched women with HbAA.
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Affiliation(s)
- Sunusi Rimi Garba
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
| | - Christian Chigozie Makwe
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Vincent Oluseye Osunkalu
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Hematology and Blood Transfusion, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Olufunto Olufela Kalejaiye
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
- Department of Medicine, College of Medicine University of Lagos, Lagos, Nigeria
| | - Adaiah Priscillia Soibi-Harry
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
| | - Amina Umar Aliyu
- Department of Nursing, Lagos University Teaching Hospital, Idi-Araba Lagos, Lagos, Nigeria
| | - Bosede Bukola Afolabi
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba Lagos, Nigeria P.M.B. 12003, Surulere, Lagos, Nigeria
- Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
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Clendenen TV, Ge W, Koenig KL, Afanasyeva Y, Agnoli C, Bertone-Johnson E, Brinton LA, Darvishian F, Dorgan JF, Eliassen AH, Falk RT, Hallmans G, Hankinson SE, Hoffman-Bolton J, Key TJ, Krogh V, Nichols HB, Sandler DP, Schoemaker MJ, Sluss PM, Sund M, Swerdlow AJ, Visvanathan K, Liu M, Zeleniuch-Jacquotte A. Breast Cancer Risk Factors and Circulating Anti-Müllerian Hormone Concentration in Healthy Premenopausal Women. J Clin Endocrinol Metab 2021; 106:e4542-e4553. [PMID: 34157104 PMCID: PMC8530718 DOI: 10.1210/clinem/dgab461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT We previously reported that anti-Müllerian hormone (AMH), a marker of ovarian reserve, is positively associated with breast cancer risk, consistent with other studies. OBJECTIVE This study assessed whether risk factors for breast cancer are correlates of AMH concentration. METHODS This cross-sectional study included 3831 healthy premenopausal women (aged 21-57, 87% aged 35-49) from 10 cohort studies among the general population. RESULTS Adjusting for age and cohort, AMH positively associated with age at menarche (P < 0.0001) and parity (P = 0.0008) and inversely associated with hysterectomy/partial oophorectomy (P = 0.0008). Compared with women of normal weight, AMH was lower (relative geometric mean difference 27%, P < 0.0001) among women who were obese. Current oral contraceptive (OC) use and current/former smoking were associated with lower AMH concentration than never use (40% and 12% lower, respectively, P < 0.0001). We observed higher AMH concentrations among women who had had a benign breast biopsy (15% higher, P = 0.03), a surrogate for benign breast disease, an association that has not been reported. In analyses stratified by age (<40 vs ≥40), associations of AMH with body mass index and OCs were similar in younger and older women, while associations with the other factors (menarche, parity, hysterectomy/partial oophorectomy, smoking, and benign breast biopsy) were limited to women ≥40 (P-interaction < 0.05). CONCLUSION This is the largest study of AMH and breast cancer risk factors among women from the general population (not presenting with infertility), and it suggests that most associations are limited to women over 40, who are approaching menopause and whose AMH concentration is declining.
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Affiliation(s)
- Tess V Clendenen
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Wenzhen Ge
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Karen L Koenig
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Yelena Afanasyeva
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Farbod Darvishian
- Pathology, New York University School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Joanne F Dorgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Judith Hoffman-Bolton
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, Italy
| | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina, Chapel Hill; NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Patrick M Sluss
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Malin Sund
- Department of Surgery, Umeå University Hospital, Umeå, Sweden
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Mengling Liu
- Department of Population Health, New York University School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
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9
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Liu T, Liu D, Song X, Qu J, Zheng X, Li J, Yang R, Yang S, Zhang X, Wang H, Yan L, Ma C, Li R, Yan J, Qiao J. Lipid Metabolism Was Associated With Oocyte in vitro Maturation in Women With Polycystic Ovarian Syndrome Undergoing Unstimulated Natural Cycle. Front Cell Dev Biol 2021; 9:719173. [PMID: 34540838 PMCID: PMC8446356 DOI: 10.3389/fcell.2021.719173] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Hyperlipidemia are common polycystic ovarian syndrome (PCOS)-related metabolic dysfunctions and can adversely affect assisted reproductive technology (ART) outcomes in controlled ovarian hyperstimulation (COH) cycles. The objective of this study is to analyze the relationship between lipid metabolism and ART outcomes in unstimulated natural cycles without the utilization of ovarian induction drugs, which is still uncertain. Methods This retrospective study included infertile women with PCOS between 21 and 40 years old undergoing unstimulated natural cycles from January 01, 2006 to December 31, 2019. Lipid metabolism was measured by body mass index (BMI) and serum biochemical parameters including total cholesterol (TC), triglycerides (TG), high and low density lipoprotein cholesterol (HDL-C and LDL-C). ART outcomes were measured by number of oocytes retrieved, oocyte maturation quality and developmental potential, clinical pregnancy and live birth. Results A total of 586 patients were included in this study. Multivariate Poisson log-linear analysis showed that high TC (≥5.18 mmol/L), triglycerides (TG) (≥1.76 mmol/L), LDL-C (≥3.37 mmol/L) levelsand low HDL-C levels (≤1.04 mmol/L) were significantly (PTC = 0.001, PTG < 0.001, PHDL–C < 0.001, PLDL–C < 0.001) associated with increased number of oocytes retrieved. BMI was significantly negatively associated with maturation rate (P < 0.001), fertilization rate (P < 0.001) and transferrable embryo rate (P = 0.002). High TG levels and low HDL-C levels were also associated with decreased maturation rate (PTG < 0.001, PHDL–C = 0.026). Logistic regression analysis showed statistically significant association between obesity (≥28.0 kg/m2) and decreased live birth rate (P = 0.004) as well as cumulative live birth rate (P = 0.007). Conclusion This is the first study that focused on the relationship between basal lipid metabolism and ART outcomes in women with PCOS undergoing unstimulated natural cycles. The results showed that high levels of lipid metabolic parameters were associated with increased number of oocytes retrieved and obesity was closely associated with impaired oocyte maturation quality and developmental potential as well as poor live birth outcomes.
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Affiliation(s)
- Tao Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Dongming Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Xueling Song
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiangxue Qu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoying Zheng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Rui Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuo Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Xi Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Haiyan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Caihong Ma
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Jie Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, China.,Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproduction, Beijing, China.,Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
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10
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Song Y, Liu H. A review on the relationship between anti-mullerian hormone and fertility in treating young breast cancer patients. BMC WOMENS HEALTH 2021; 21:295. [PMID: 34376160 PMCID: PMC8353739 DOI: 10.1186/s12905-021-01420-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/06/2021] [Indexed: 11/18/2022]
Abstract
Despite the fact that the long-term survival rate of breast cancer patients had been significantly improved owing to the systemic breast cancer therapies, there are still some side effects such as amenorrhea and fertility retention to be resolved, leaving it an important thing to understand the possible side effects on fertility and fertility preservation strategies while undergoing breast cancer treatment, due to the fact that most young patients hope to become pregnant and have children after breast cancer treatment. With anti-müllerian hormone (AMH) being the most sensitive marker for predicting ovarian function in young premenopausal women with breast cancer, this review is aimed to provide the additional guidance for clinical application of AMH by exploring the impacts of AMH on the fertility of young breast cancer patients, the relationship between AMH and metabolism, and the relationship between BRAC gene mutation and fertility protection strategies.
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Affiliation(s)
- Yixuan Song
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Hong Liu
- The Second Surgical Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
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11
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Lim S, Kim S, Kim O, Kim B, Jung H, Ko KP, Lee H. Correlations among anti-Müllerian hormone levels, body mass index and lipid profile in reproductive-aged women: The Korea Nurses' Health Study. Nurs Open 2021; 8:2996-3005. [PMID: 34342177 PMCID: PMC8510772 DOI: 10.1002/nop2.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 04/25/2021] [Accepted: 07/10/2021] [Indexed: 11/23/2022] Open
Abstract
Aim This study aimed to evaluate the correlations among anti‐Müllerian hormone levels, body mass index and lipid profile in female nurses of reproductive age. Design This is a descriptive cross‐sectional study that used data from the Korea Nurses' Health Study, based on Nurses' Health Study 3 in the United States. Methods Participants included 448 female nurses of reproductive age. They provided details about their work experience, shift work, body mass index and history of polycystic ovary syndrome. Serum anti‐Müllerian hormone levels and lipid profile were measured using blood samples. Statistical analysis included quantile regression analysis using STATA 13.0. Data were collected between November 2016 and March 2017 from Module 5 of the Korean Nurses' Health Study. Results Approximately 12% of the participants were underweight, and roughly one‐tenth were either overweight or obese. Although linear regression showed no relationship between anti‐Müllerian hormone levels and body mass index, quantile regression showed that body mass index, total cholesterol levels and low‐density lipoprotein levels were negatively correlated with anti‐Müllerian hormone levels at the lower tails of the dependent variable. Meanwhile, high‐density lipoprotein levels were positively correlated with anti‐Müllerian hormone at the higher percentiles of anti‐Müllerian hormone levels. Conclusion These findings suggest the possibility that changes in the lipid profile may influence anti‐Müllerian hormone levels in women with diminished ovarian function, rather than obesity itself.
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Affiliation(s)
- Sarah Lim
- College of Nursing, Yonsei University, Seoul, Korea
| | - Sue Kim
- College of Nursing, Yonsei University, Seoul, Korea.,Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Korea.,Ewha Research Institute of Nursing Science, Seoul, Korea
| | - Bohye Kim
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Heeja Jung
- College of Nursing, Konyang University, Daejeon, Korea
| | - Kwang-Pil Ko
- Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyangkyu Lee
- College of Nursing, Yonsei University, Seoul, Korea.,Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
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12
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Do trends of adiposity and metabolic parameters vary in women with different ovarian reserve status? A population-based cohort study. ACTA ACUST UNITED AC 2021; 27:684-692. [PMID: 32301892 DOI: 10.1097/gme.0000000000001513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate whether trends of adiposity and glucose metabolism parameters in women with low ovarian reserve status based on their anti-Mullerian hormone (AMH) levels differ from those with high ovarian reserve. METHODS In this population-based prospective study, eligible women, aged 20 to 50 years, were selected from among participants of the Tehran Lipid and Glucose Study (TLGS). Generalized estimating equation (GEE) models were applied to compare changes in various adiposity and metabolic parameters across time between women in the first and fourth quartiles of age-specific AMH, after adjustment for confounders. Pooled logistic regression was used to compare progression of prediabetes mellitus (pre-DM) and diabetes mellitus (DM) between the women of these two age-specific AMH quartiles. RESULTS In this study of a total of 1,015 participants and with a median follow-up of 16 years, we observed that over time, both groups of women in the first and fourth quartiles of age-specific AMH experienced significant positive trends in their adiposity indices including central obesity, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), a body shape index (ABSI), and a negative trend in visceral adiposity index (VAI), whereas there was no significant difference in these parameters between the two groups. This study revealed that odds ratios of diabetes and prediabetes in women in the first quartile of age-specific AMH were not significantly different, compared with those in the fourth quartile. CONCLUSION Women with lower ovarian reserve do not experience different over time trends of adiposity and glucose metabolism parameters during their reproductive life span.
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13
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Akbari Sene A, Ashrafi M, Alaghmand-Fard N, Mohammadi N, Mortezapour Alisaraie M, Alizadeh A. Anti-Müllerian Hormone Predictive Levels to Determine The Likelihood of Ovarian Hyper-Response in Infertile Women with Polycystic Ovarian Morphology. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2021; 15:115-122. [PMID: 33687164 PMCID: PMC8052798 DOI: 10.22074/ijfs.2020.134614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 09/16/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND The objective of this study was to investigate serum levels of anti-Müllerian hormone (AMH) in normal-ovulatory infertile women with polycystic ovarian morphology (PCOM) and their association with ovarian hyper-response. MATERIALS AND METHODS This prospective cohort study was carried out on 100 infertile women with PCOM who were treated with an antagonist/agonist triggered stimulation protocol at Shahid Akbar-Abadi Hospital IVF Centre, Tehran, Iran. Serum AMH levels were measured before starting the assisted reproductive technology (ART) cycle and the ovarian hyper-response was evaluated by retrieved oocyte numbers, ooestradiol levels on the triggering day, and the incidence of ovarian hyper-stimulation syndrome (OHSS) clinical signs and symptoms. Logistic regression and the area under the curve (AUC) were used to estimate the effects of AMH and the accuracy of the test. RESULTS Receiver operating characteristic (ROC) curve analysis showed that AMH could significantly predict ovarian hyper-response in PCOM patients (AUC=0.73). The estimated threshold value was 4.95 ng/ml, with a specificity of 74.58% (95% confidence interval [CI]: 50.85, 93.22) and sensitivity of 73.17% (95% CI: 48.78, 92.68). Logistic regression results showed a significant interaction between AMH and body mass index (BMI, P=0.008), which indicated that BMI had a moderation effect. CONCLUSION Individualized stimulation protocols for patients with isolated PCOM and AMH greater than 4.95 ng/ml may significantly reduce the chances of developing OHSS. However, the AMH cut-off values to predict ovarian hyperresponse differ for different BMI categories among PCOM patients; thus, it becomes a more precise predictive marker with increasing BMI.
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Affiliation(s)
- Azadeh Akbari Sene
- Shahid Akbar-Abadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mahnaz Ashrafi
- Shahid Akbar-Abadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Nasim Alaghmand-Fard
- Department of Obstetrics and Gynaecology, Shahid Akbar-Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Neda Mohammadi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahad Alizadeh
- Metabolic Diseases Research Centre, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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14
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Age-specific reference intervals for anti-Müllerian hormone in Chinese boys: A population-based study. Clin Chim Acta 2020; 506:154-159. [DOI: 10.1016/j.cca.2020.03.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 03/10/2020] [Accepted: 03/17/2020] [Indexed: 01/14/2023]
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15
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Asemota O, Thornton K, Merhi Z, Berger DS, Williams L, Seki Y, Du XQ, Jindal S, Charron MJ, Buyuk E. Monocyte chemotactic protein-1 plays a role in ovarian dysfunction related to high-fat diet-induced obesity. Syst Biol Reprod Med 2020; 66:236-243. [PMID: 32603611 DOI: 10.1080/19396368.2020.1780649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Obesity, known to cause a systemic elevation in monocyte chemotactic protein-1 (MCP-1), adversely affects normal ovarian function. The aim of this study was to determine whether MCP-1 plays a role in ovarian dysfunction that is related to obesity induced by high-fat (HF) diet intake. Wild type (WT) C57BL/6J mice were fed either normal chow (NC) (Group 1, control group) or HF diet (Group 2). To assess whether MCP-1 is involved in HF-diet-induced ovarian dysfunction, MCP-1 knock-out mice were fed HF diet (Group 3). Body weight, body fat composition, number of oocytes collected following ovarian superovulation with gonadotropins, ovarian macrophage markers and expression of genes important in folliculogenesis and steroidogenesis were quantified in the 3 groups of animals. Animals in Group 2 gained significant body weight and body mass, produced the fewest number of oocytes following superovulation, and had significant alterations in ovarian genes involved in folliculogenesis and steroidogenesis as well as genes involved in inflammation. Although animals in Group 3 had the highest body weight and body fat composition, they produced similar number of oocytes compared to animals in Group 1 but had different ovarian gene expression compared to Group 2. These findings suggest that MCP-1 gene knockout could reverse some of the adverse effects of obesity induced by HF diet intake. Future studies assessing ovarian histology in MCP-1 knock out mouse model will confirm our findings. MCP-1 inhibition could represent a future therapeutic target to protect ovarian health from the adverse effects of HF diet ingestion.
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Affiliation(s)
- Obehi Asemota
- Montefiore's Institute for Reproductive Medicine and Health, Albert Einstein College of Medicine , Hartsdale, NY, USA.,Albert Einstein College of Medicine , Bronx, NY, USA.,Currently at Aspire Fertility , Atlanta, GA, USA
| | - Kimberley Thornton
- Montefiore's Institute for Reproductive Medicine and Health, Albert Einstein College of Medicine , Hartsdale, NY, USA.,Albert Einstein College of Medicine , Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai , New York, NY, USA
| | - Zaher Merhi
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, SUNY Downstate University , Brooklyn, NY, USA.,Department of Biochemistry, Albert Einstein College of Medicine , Bronx, NY, USA
| | - Dara S Berger
- Montefiore's Institute for Reproductive Medicine and Health, Albert Einstein College of Medicine , Hartsdale, NY, USA.,Albert Einstein College of Medicine , Bronx, NY, USA.,Currently at Department of Obstetrics and Gynecology, University of Pennsylvania , Philadelphia, PA, USA
| | - Lyda Williams
- Department of Biochemistry, Albert Einstein College of Medicine , Bronx, NY, USA.,Biology Department, Currently at the Lehman College , Bronx, NY, USA
| | - Yoshinori Seki
- Department of Biochemistry, Albert Einstein College of Medicine , Bronx, NY, USA
| | - Xiu Quan Du
- Department of Biochemistry, Albert Einstein College of Medicine , Bronx, NY, USA
| | - Sangita Jindal
- Montefiore's Institute for Reproductive Medicine and Health, Albert Einstein College of Medicine , Hartsdale, NY, USA.,Albert Einstein College of Medicine , Bronx, NY, USA
| | - Maureen J Charron
- Albert Einstein College of Medicine , Bronx, NY, USA.,Department of Biochemistry, Albert Einstein College of Medicine , Bronx, NY, USA.,Department of Medicine, Division of Endocrinology, Albert Einstein College of Medicine , Bronx, NY, USA
| | - Erkan Buyuk
- Montefiore's Institute for Reproductive Medicine and Health, Albert Einstein College of Medicine , Hartsdale, NY, USA.,Albert Einstein College of Medicine , Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai , New York, NY, USA
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16
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Tal R, Seifer CM, Khanimov M, Seifer DB, Tal O. High serum Antimullerian hormone levels are associated with lower live birth rates in women with polycystic ovarian syndrome undergoing assisted reproductive technology. Reprod Biol Endocrinol 2020; 18:20. [PMID: 32156287 PMCID: PMC7065318 DOI: 10.1186/s12958-020-00581-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/02/2020] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Antimullerian hormone (AMH) strongly correlates with ovarian reserve and response to controlled ovarian stimulation. Emerging data suggests that serum AMH level may also predict ART outcomes. However, AMH is characteristically elevated in PCOS women and it is unknown whether it may predict live birth outcomes in this population. METHODS This was a retrospective cohort study of 184 PCOS women (Rotterdam criteria) who underwent their first fresh IVF/ICSI cycle. Women were divided into 3 groups according to the <25th (low), 25 to 75th (average), or > 75th (high) percentile of serum AMH concentration. Cycle stimulation parameters and reproductive outcomes were compared between groups. RESULTS Women in the low serum AMH group were older than those in the average or high AMH (p < 0.05), and required greater gonadotropin dose for stimulation compared to the high AMH group (p < 0.05). Women with high AMH had greater testosterone level compared to women in the low or average AMH groups. No differences were noted between groups in terms of maximal E2, oocytes retrieved and fertilization rate. However, low serum AMH women had significantly greater live birth rates (p < 0.05) and showed a trend towards greater clinical pregnancy rates compared to women in the average and high AMH groups (p = 0.09). The significant association of AMH with live birth rate remained after adjusting for age, BMI, day of transfer and number of embryos transferred. CONCLUSIONS In PCOS women, elevated AMH concentrations are associated with hyperandrogenism and lower live birth rates.
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Affiliation(s)
- Reshef Tal
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
| | | | - Moisey Khanimov
- Genesis Fertility & Reproductive Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - David B Seifer
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
- Genesis Fertility & Reproductive Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Oded Tal
- School of Business and Hospitality, Conestoga College, Kitchener, Ontario, Canada
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Kohzadi M, Khazaei MR, Choobsaz F, Khazaei M. Relationship between Serum Levels of Anti-Mullerian Hormone, Adiponectin and Oxidative Stress Markers in Patients with Polycystic Ovary Syndrome. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:27-33. [PMID: 32112632 PMCID: PMC7139222 DOI: 10.22074/ijfs.2020.5809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/11/2019] [Indexed: 12/24/2022]
Abstract
Background Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Anti-Mullerian hormone (AMH) is a valid indicator of ovarian function and is used for PCOS diagnosis. Some studies have shown that adipokines affect the synthesis of AMH, and therefore they are somehow related in function. The aim of the present study was to determine the relationship between serum levels of AMH, adiponectin and oxidative stress markers in PCOS patients. Materials and Methods In this cross-sectional study, PCOS patients and healthy women (80 cases in total) were investigated. Serum levels of AMH, adiponectin, gonadotropins, androgens, total antioxidant capacity (TAC), nitric oxide (NO) and insulin resistance (IR) were measured by standard methods. An independent t test was used to compare the two groups and Pearson correlation coefficient was used to determine the relationship between variables. Results There was a significant difference between the means of AMH (5.16 ± 5.3 vs. 2.44 ± 2.5 ng/mL) (P=0.007) and adiponectin (24.55 ± 9.41 vs. 30.57 ± 14.2 μg/L) (P=0.029) among the PCOS and control groups, respectively. The correlation between AMH and adiponectin in the control group was statistically significant and negative (P=0.028, r=-0.35), while in the PCOS group it was not significant (P=0.11, r=-0.25). Conclusion Various biochemical and hormonal factors differ between PCOS and healthy women. Different factors can influence AMH and adiponectin levels independently of PCOS in women of reproductive age.
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Affiliation(s)
- Mozhgan Kohzadi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Rasool Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzaneh Choobsaz
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozafar Khazaei
- Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic Address:
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Kotlyar AM, Seifer DB. Ethnicity/Race and Age-Specific Variations of Serum AMH in Women-A Review. Front Endocrinol (Lausanne) 2020; 11:593216. [PMID: 33633682 PMCID: PMC7900163 DOI: 10.3389/fendo.2020.593216] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022] Open
Abstract
PURPOSE OF REVIEW In this review, we summarize ethnic/race- and age-related variation in AMH and discuss the underpinnings behind these differences. RECENT FINDINGS Anti-mullerian hormone (AMH) has become a widely used method of ovarian reserve testing over the last 15 years. Numerous studies have shown substantial ethnic/race and age-related differences. When compared to age-matched Caucasian women, AMH levels tend to be lower in black and Hispanic women. Chinese women tend to have significantly greater AMH levels prior to age 25 than Caucasian women. When considering subpopulations within ethnicities, at least one study noted lower AMH levels among Maya women compared to other Hispanic women. Age exhibits a positive trend with AMH up until at least 25 years of age with a consistent decline after 34 years of age extending to menopause. SUMMARY AMH levels are highly variable among ethnicities and race with higher age-matched levels typically seen in Caucasian women. Age does not exhibit a consistent linear relationship with AMH, but a consistent decline is seen starting in the third decade of life and proceeding to menopause.
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Is ovarian reserve associated with body mass index and obesity in reproductive aged women? A meta-analysis. Menopause 2019; 25:1046-1055. [PMID: 29738413 DOI: 10.1097/gme.0000000000001116] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The associations of body mass index (BMI) and obesity with ovarian reserve are controversial. This systematic review and meta-analysis was conducted to investigate the associations in reproductive-aged women. METHODS PubMed and Scopus were searched up to December, 2016. Original studies on the association of BMI with ovarian reserve markers, anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), inhibin β, and antral follicle count (AFC), either according to BMI categories or a continuous variable, were selected. Analyses were stratified into three groups based on polycystic ovary syndrome (PCOS) and fertility status of women. RESULTS Of 4,055 records identified, 45 studies were eligible for inclusion. Comparing the obese with nonobese, the pooled mean differences (MDs) and 95% confidence intervals (CIs) were -1.08 (95% CIs -1.52, -0.63) ng/mL for AMH, -0.22 (95% CIs -0.39, -0.06) mIU/mL for FSH, -0.09 (95% CIs -0.60, 0.42) for AFC, and -21.06 (95% CIs -41.18, -0.85) pg/mL for inhibin β in overall populations. The MDs were significant for AMH in fertile non-PCOS and PCOS women, and for FSH only in PCOS women. Fisher's Z showed significant correlations of BMI with AMH in the overall populations (-0.15 [95% CIs -0.20, -0.11]) and in all subgroups, and with FSH in the fertile non-PCOS women (-0.16 [95% CIs -0.28, -0.04]). CONCLUSION Ovarian reserve markers of AMH and FSH are significantly lower in obese than in nonobese women, and BMI is negatively correlated with AMH in all study populations, and with FSH in fertile non-PCOS subgroups. PCOS and fertility status do not appear to affect the associations.
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Oh SR, Choe SY, Cho YJ. Clinical application of serum anti-Müllerian hormone in women. Clin Exp Reprod Med 2019; 46:50-59. [PMID: 31181872 PMCID: PMC6572668 DOI: 10.5653/cerm.2019.46.2.50] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 05/22/2019] [Indexed: 12/18/2022] Open
Abstract
Anti-Müllerian hormone (AMH), a peptide growth factor of the transforming growth factor-β family, is a reliable marker of ovarian reserve. Regarding assisted reproductive technology, AMH has been efficiently used as a marker to predict ovarian response to stimulation. The clinical use of AMH has recently been extended and emphasized. The uses of AMH as a predictive marker of menopause onset, diagnostic tool for polycystic ovary syndrome, and assessment of ovarian function before and after gynecologic surgeries or gonadotoxic agents such as chemotherapy have been investigated. Serum AMH levels can also be affected by environmental and genetic factors; thus, the effects of factors that may alter AMH test results should be considered. This review summarizes the findings of recent studies focusing on the clinical application of AMH and factors that influence the AMH level and opinions on the use of the AMH level to assess the probability of conception before reproductive life planning as a “fertility test.”
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Affiliation(s)
- So Ra Oh
- Department of Obstetrics and Gynecology, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Sun Yi Choe
- Department of Obstetrics and Gynecology, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Yeon Jean Cho
- Department of Obstetrics and Gynecology, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
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Merhi Z, Bazzi AA, Bonney EA, Buyuk E. Role of adiponectin in ovarian follicular development and ovarian reserve. Biomed Rep 2019; 1:1-5. [PMID: 31258901 DOI: 10.3892/br.2019.1213] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/16/2019] [Indexed: 01/05/2023] Open
Abstract
Adiponectin levels are associated with anti-Müllerian hormone (AMH) and kisspeptin levels in non-ovarian tissues. The objective of the present study was to investigate the association between adiponectin and the genes important for ovarian follicular development and ovarian reserve, specifically AMH and kisspeptin, and their corresponding receptors. In the first experiment, the mRNA levels of anti-Müllerian hormone (amh) and its receptor (Amhr2), as well as those of kisspeptin (Kiss1) and its receptor (Kiss1r), were quantified by reverse transcription-polymerase chain reaction analysis in the ovaries of two groups of mice [adiponectin-knockout (KO) vs. control] that underwent oophorectomy. The second experiment measured follicular phase serum AMH and follicular fluid adiponectin levels in 25 women who underwent controlled ovarian hyperstimulation for in vitro fertilization. Compared with the control mice, adiponectin-KO mice had 6.5 times lower Kiss1 mRNA levels (P=0.009) and a tendency for lower ovarian Kiss1r mRNA expression levels (P=0.06). However, adiponectin-KO mice had significantly higher Amhr2 mRNA levels (P=0.01). In all women participants, there was a positive correlation between serum AMH and follicular fluid adiponectin concentrations (r=0.54, P=0.006). The findings of the present study indicate that adiponectin may play a role in ovarian physiology through its impact on genes crucial for ovarian follicular development and ovarian reserve, such as kisspeptin and AMH. Understanding the role of adiponectin in ovarian function may improve our knowledge of the pathophysiology underlying ovulatory dysfunction in obese women, who usually have low adiponectin levels, and overcome reproductive barriers.
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Affiliation(s)
- Zaher Merhi
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10463, USA.,2Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY 10019, USA
| | - Ali A Bazzi
- Department of Obstetrics and Gynecology, St. John Hospital and Medical Center, Detroit, MI 48236, USA
| | - Elizabeth A Bonney
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont College of Medicine, Burlington, VT 05401, USA
| | - Erkan Buyuk
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology and Women's Health, Montefiore's Institute for Reproductive Medicine and Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Bahri S, Tehrani FR, Amouzgar A, Rahmati M, Tohidi M, Vasheghani M, Azizi F. Overtime trend of thyroid hormones and thyroid autoimmunity and ovarian reserve: a longitudinal population study with a 12-year follow up. BMC Endocr Disord 2019; 19:47. [PMID: 31064360 PMCID: PMC6505305 DOI: 10.1186/s12902-019-0370-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 04/11/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Ovarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases. Despite alternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions and ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones, thyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age specific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran Thyroid Study (TTS). METHODS Reproductive age women(n = 775) without any thyroid disease or ovarian dysfunction were selected from the Tehran Thyroid Study cohort. Participants were divided into four age specific AMH quartiles (Q1-Q4), Q1, the lowest and Q4, the highest. AMH was measured at the initiation of study and thyroid stimulating hormone (TSH), free T4 (FT4), and TPO Ab were measured at baseline and at three follow up visits. RESULTS At baseline, there was no statistically significant difference in thyroid hormones between women of the four quartiles, although TPO Ab levels were higher in women of Q1. During the follow ups, FT4 was decreased in all quartiles (p < 0.05), whereas TPO Ab increased in Q1 (p = 0.02). Odds ratio of overall TPO Ab positivity in women of Q1 was 2.08 fold higher than those in Q4. (OR: 2.08, 95%CI: 1.16, 3.72; p = 0.01). CONCLUSION Women with the lowest ovarian reserves had higher levels of TPO Ab, with a positive trend of this antibody overtime in comparison to other quartiles, indicating that this group may be at a higher risk of hypothyroidism over time.
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Affiliation(s)
- Sara Bahri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atieh Amouzgar
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rahmati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Vasheghani
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Albu D, Albu A. The relationship between anti-Müllerian hormone serum level and body mass index in a large cohort of infertile patients. Endocrine 2019; 63:157-163. [PMID: 30238328 DOI: 10.1007/s12020-018-1756-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 09/09/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate the relationship between serum Anti-Müllerian hormone (AMH) level and body mass index (BMI) in infertile patients. METHODS Medical records of patients with infertility evaluated between January 2013 and February 2018 in the Reproductive Medicine Department of a private hospital were reviewed. Patients with the following criteria were excluded from the study: polycystic ovary syndrome, primary ovarian insufficiency, AMH values > 10 ng/mL, current oral contraceptive users and previous ovarian surgery or endometriosis, and anovulation of other causes, except decreased ovarian reserve. RESULTS A total of 2204 infertile patients were included (mean age 34.58 ± 4.3 years, mean BMI 22.35 ± 3.6 kg/m2, and mean serum AMH 2.44 ± 2.17 ng/ml). In the entire group of patients, serum AMH level was positively correlated with BMI after adjustment for age (beta = 0.059, p < 0.005). When the association between serum AMH level and BMI was analysed in subgroups of patients, after adjustment for age, we found a positive correlation between the two parameters in patients ≤ 35 years old (< 0.05), of normal weight (p < 0.05) and with normal ovarian reserve (p < 0.05). After adjustment for age, BMI ≥ 25 kg/m2 was significantly associated with higher AMH values in comparison to normal weight patients. CONCLUSIONS In infertile patients, AMH is positively correlated with BMI, especially in patients younger than 35 years, of normal weight and with normal ovarian reserve. Moreover, the presence of mild excess adiposity seems to be associated with higher AMH values. Our data contradict the previous studies showing a negative impact of excess adiposity on AMH serum levels.
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Affiliation(s)
- Dragos Albu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Maternal-foetal and Reproductive Medicine Department, Medlife, Calea Grivitei 365, Bucharest, Romania
| | - Alice Albu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
- Maternal-foetal and Reproductive Medicine Department, Medlife, Calea Grivitei 365, Bucharest, Romania.
- Endocrinology and Diabetes Department, Elias Hospital, 17 Marasti Street, Bucharest, Romania.
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Impact of Bariatric surgery on antimularian hormone in reproductive age women. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2018.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Shahrokhi SZ, Kazerouni F, Ghaffari F. Anti-Müllerian Hormone: genetic and environmental effects. Clin Chim Acta 2018; 476:123-129. [DOI: 10.1016/j.cca.2017.11.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 02/08/2023]
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Tal R, Seifer DB. Ovarian reserve testing: a user's guide. Am J Obstet Gynecol 2017; 217:129-140. [PMID: 28235465 DOI: 10.1016/j.ajog.2017.02.027] [Citation(s) in RCA: 232] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/08/2017] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
Abstract
Ovarian reserve is a complex clinical phenomenon influenced by age, genetics, and environmental variables. Although it is challenging to predict the rate of an individual's ovarian reserve decline, clinicians are often asked for advice about fertility potential and/or recommendations regarding the pursuit of fertility treatment options. The purpose of this review is to summarize the state-of-the-art of ovarian reserve testing, providing a guide for the obstetrician/gynecologist generalist and reproductive endocrinologist. The ideal ovarian reserve test should be convenient, be reproducible, display little if any intracycle and intercycle variability, and demonstrate high specificity to minimize the risk of wrongly diagnosing women as having diminished ovarian reserve and accurately identify those at greatest risk of developing ovarian hyperstimulation prior to fertility treatment. Evaluation of ovarian reserve can help to identify patients who will have poor response or hyperresponse to ovarian stimulation for assisted reproductive technology. Ovarian reserve testing should allow individualization of treatment protocols to achieve optimal response while minimizing safety risks. Ovarian reserve testing may inform patients regarding their reproductive lifespan and menopausal timing as well as aid in the counselling and selection of treatment for female cancer patients of reproductive age who receive gonadotoxic therapy. In addition, it may aid in establishing the diagnosis of polycystic ovary syndrome and provide insight into its severity. While there is currently no perfect ovarian reserve test, both antral follicular count and antimüllerian hormone have good predictive value and are superior to day-3 follicle-stimulating hormone. The convenience of untimed sampling, age-specific values, availability of an automated platform, and potential standardization of antimüllerian hormone assay make this test the preferred biomarker for the evaluation of ovarian reserve in women.
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Buyuk E, Asemota OA, Merhi Z, Charron MJ, Berger DS, Zapantis A, Jindal SK. Serum and follicular fluid monocyte chemotactic protein-1 levels are elevated in obese women and are associated with poorer clinical pregnancy rate after in vitro fertilization: a pilot study. Fertil Steril 2017; 107:632-640.e3. [DOI: 10.1016/j.fertnstert.2016.12.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/14/2016] [Accepted: 12/20/2016] [Indexed: 01/08/2023]
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Yue CY, Ying CM. Comparability of the effect of storage time and temperature on serum anti-Müllerian hormone measurement between original and modified enzyme-linked immunosorbent assay. Clin Chim Acta 2017; 464:79-84. [DOI: 10.1016/j.cca.2016.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 11/08/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
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Bernardi LA, Carnethon MR, de Chavez PJ, Ikhena DE, Neff LM, Baird DD, Marsh EE. Relationship between obesity and anti-Müllerian hormone in reproductive-aged African American women. Obesity (Silver Spring) 2017; 25:229-235. [PMID: 27925445 PMCID: PMC5182136 DOI: 10.1002/oby.21681] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/15/2016] [Accepted: 08/14/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine whether there is an association between obesity and anti-Müllerian hormone (AMH) among reproductive-aged African American women (AAW). METHODS From the women participating in an ongoing National Institute of Environmental Health Sciences study, 1,654 AAW aged 23 to 35 were included in this study. Anthropometric measurements, personal health information, and serum AMH and adipokine levels were analyzed. RESULTS The median body mass index (BMI) was 32.4 kg/m2 , and the median AMH was 3.18 ng/mL. Participants with obesity had AMH concentrations that were 23.7% lower than those with a BMI ≤25 kg/m2 (2.9 ng/mL vs. 3.8 ng/mL). In multivariable linear regression models, current BMI (β = -0.015; 95% CI -0.021 to -0.009), BMI at age 18 (β = -0.016; 95% CI -0.024 to -0.008), heaviest reported lifetime weight (β = -0.002; 95% CI -0.003 to -0.001), and leptin (β = -0.016; 95% CI -0.025 to -0.007) were inversely associated with AMH. There was no significant association between adiponectin and AMH. AMH was significantly lower (mean log = 0.91, SE = 0.11) in participants with obesity at age 18 and at enrollment when compared with those who were underweight or normal weight at age 18 but had obesity at enrollment (mean log = 1.16, SE = 0.12). CONCLUSIONS In reproductive-aged AAW there is a significant association between obesity and AMH, suggesting that excess adiposity may compromise ovarian reserve. Effects of obesity on AMH may be cumulative.
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Affiliation(s)
- Lia A. Bernardi
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, United States
| | - Mercedes R. Carnethon
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois 60611, United States
| | - Peter J. de Chavez
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois 60611, United States
| | - Deborah E. Ikhena
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, United States
| | - Lisa M. Neff
- Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, United States
| | - Donna D. Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709, United States
| | - Erica E. Marsh
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, United States
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Grossman LC, Safier LZ, Kline MD, Chan CW, Lobo RA, Sauer MV, Douglas NC. Utility of Ovarian Reserve Screening with Anti-Müllerian Hormone for Reproductive Age Women Deferring Pregnancy. J Womens Health (Larchmt) 2016; 26:345-351. [PMID: 27906603 DOI: 10.1089/jwh.2016.5842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ovarian reserve (OR) testing with serum anti-Müllerian hormone (AMH) can provide information about a woman's fertility potential. The aim of this study was to assess interest and knowledge about OR testing and investigate the utility of measuring AMH in women of reproductive age deferring pregnancy. METHODS Women ages 27-37 years currently delaying childbearing were invited to take a survey regarding attitudes and knowledge about OR testing before and after an AMH measurement with explanation of their results. RESULTS Of 121 women who took the pre-test survey, 96% believed OR testing was beneficial. The median AMH of the 97 women who underwent testing was 3.3 ng/mL (IQR 1.9-5.4 ng/mL). Nineteen percent of women had AMH <10th percentile for age and 3% had an undetectable AMH. Although 83% of these women were using hormonal contraception, none had known risk factors for diminished ovarian reserve. Seventy-eight percent of women with low AMH levels for age planned to seek fertility preservation or pregnancy, while those with AMH levels within established age normograms were reassured. On the post-test survey, 100% reported benefit in knowing their AMH level. Follow-up testing, 6-8 months after the initial measurement, showed stable AMH levels for most participants. CONCLUSIONS Women are interested in OR testing. Most women will be reassured by knowing their AMH level, whereas those with a lower AMH can be counseled on fertility preservation options or may attempt pregnancy earlier.
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Affiliation(s)
- Lisa C Grossman
- 1 Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| | - Lauren Zakarin Safier
- 1 Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| | - Melissa D Kline
- 1 Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| | | | - Rogerio A Lobo
- 1 Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| | - Mark V Sauer
- 1 Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
| | - Nataki C Douglas
- 1 Obstetrics and Gynecology, Columbia University Medical Center , New York, New York
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Verma AK, Rajbhar S, Mishra J, Gupta M, Sharma M, Deshmukh G, Ali W. Anti-Mullerian Hormone: A Marker of Ovarian Reserve and its Association with Polycystic Ovarian Syndrome. J Clin Diagn Res 2016; 10:QC10-QC12. [PMID: 28208941 DOI: 10.7860/jcdr/2016/20370.8988] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Anti-Mullerian Hormone (AMH) is a useful endocrine marker for assessing the ovarian reserve. AMH serum level reflects the number of follicles that have made the transition from the primordial pool into the growing follicle pool, and it is not controlled by gonadotropins. AIM The present study was conducted to correlate serum AMH levels with Polycystic Ovarian Syndrome (PCOS) and type of treatment protocol. MATERIALS AND METHODS Serum AMH levels were performed in the early follicular phase (on 2nd day of menstrual cycle) both in infertile females including PCOS and control women. The results were analyzed in relation to age, Body Mass Index (BMI), ovarian volume, serum Follicle Stimulating Hormone (FSH) levels, Antral Follicle Count (AFC), type of treatment protocols and also in association with PCOS patients. The serum levels of AMH were measured in all the participants on 2nd day of menstrual cycle using ultra sensitive Enzyme Linked Immunosorbent Assay (ELISA). RESULTS The plasma AMH levels were significantly higher in women with polycystic ovarian syndrome. The significant association was seen between FSH and AFC with AMH. However, no significant association was observed between AMH levels with age, BMI, ovarian volume and type of treatment protocols. CONCLUSION The serum AMH measurement was significantly higher in PCOS patients. No association with type of treatment protocol was obtained.
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Affiliation(s)
- Anil Kumar Verma
- Assistant Professor, Department of Pathology, School of Medical Sciences and Research, Sharda Hospital , Greater Noida, Uttar Pradesh, India
| | - Sarita Rajbhar
- Senior Resident, Department of Obstetrics and Gynaecology, PGIMER and Dr Ram Manohar Lohia Hospital , New Delhi, India
| | - Jyoti Mishra
- Assistant Professor, Department of Pathology, School of Medical Sciences and Research, Sharda Hospital , Greater Noida, Uttar Pradesh, India
| | - Mayank Gupta
- Senior Resident, Department of Radiology, PGIMER and Dr Ram Manohar Lohia Hospital , New Delhi, India
| | - Mratunjai Sharma
- Assistant Professor, Department of Pathology, School of Medical Sciences and Research, Sharda Hospital , Greater Noida, Uttar Pradesh, India
| | - Geeta Deshmukh
- Professor, Department of Pathology, School of Medical Sciences and Research, Sharda Hospital , Greater Noida, Uttar Pradesh, India
| | - Wahid Ali
- Associate Professor, Department of Pathology, King George's Medical University , Lucknow, Uttar Pradesh, India
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Okunola T, Olusegun Ajenifuja K, Morebise Loto O, Salawu A, Omitinde SO. Follicle Stimulating Hormone and Anti-Müllerian Hormone among Fertile and Infertile Women in Ile-Ife, Nigeria: Is there A Difference? INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 11:33-39. [PMID: 28367303 PMCID: PMC5215709 DOI: 10.22074/ijfs.2016.4645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 07/26/2016] [Indexed: 11/05/2022]
Abstract
Background Reduced ovarian reserve predicts poor ovarian response and poor suc-
cess rates in infertile women who undergo assisted reproductive technology (ART).
Ovarian reserve also decreases with age but the rate of decline varies from one woman
to another. This study aims to detect differences in ovarian reserve as measured by
basal serum follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH)
between a matched cohort of fertile and infertile regularly menstruating women, 18-45
years of age. Materials and Methods This case-control study involved 64 fertile and 64 subfertile
women matched by age at recruitment. Peripheral blood samples were taken from the
women recruited from the Gynecological and Outpatient Clinics of Obafemi Awolowo
University Teaching Hospital, Ile-Ife, Nigeria. Serum FSH and AMH were quantified
using ELISA at the Metabolic Research Laboratory of LAUTECH Teaching Hospital,
Ogbomoso, Nigeria. Results A significant difference existed in the mean FSH of fertile (6.97 ± 3.34) and
infertile (13.34 ± 5.24, P=0.013) women. We observed a significant difference in AMH
between fertile (2.71 ± 1.91) and infertile (1.60 ± 2.51, P=0.029) women. There was a
negative correlation between FSH and AMH in both fertile (r=-0.311, P=0.01) and infertile (r=-0.374, P=0.002) women. Conclusion The difference in ovarian reserve observed in this study suggests that reduced ovarian reserve in regularly menstruating women may be associated with early
ovarian ageing or subfertility.
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Affiliation(s)
- Temitope Okunola
- Department of Obstetrics and Gynecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | | | - Afolabi Salawu
- Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria
| | - Stephen Oluseyi Omitinde
- Department of Obstetrics and Gynecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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Nouri M, Aghadavod E, Khani S, Jamilian M, Amiri Siavashani M, Ahmadi S, Asemi Z. Association between BMI and gene expression of anti-Müllerian hormone and androgen receptor in human granulosa cells in women with and without polycystic ovary syndrome. Clin Endocrinol (Oxf) 2016; 85:590-5. [PMID: 27163385 DOI: 10.1111/cen.13098] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/31/2016] [Accepted: 05/04/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) is one of the most reliable markers of ovarian reserve. There is evidence which suggests that BMI may be associated with gene expression of AMH, AMH type II receptor (AMHR-II) and androgen receptor (AR) in human granulosa cells (GC) in women with and without polycystic ovary syndrome (PCOS). OBJECTIVE To investigate the association between BMI and gene expression of AMH, AMHR-II and AR in human GC in women with and without PCOS. DESIGN, PATIENTS AND MEASUREMENTS In a cross-sectional study, hormonal profiles were measured among 38 patients with PCOS and 38 subjects without PCOS aged 18-40. AMH, AMHR-II and AR mRNA levels were quantified in cumulus GC. Pearson correlation and multiple linear regressions were used to assess the relationships. RESULTS Quantitative RT-PCR demonstrated that AMH and AMHR-II expression were negatively correlated with BMI (r = -0·39, P < 0·001 for AMH and r = -0·49, P < 0·001 for AMHR-II), whereas AR expression was positively correlated with BMI (r = 0·46, P < 0·001). CONCLUSIONS There is a negative association between AMH, AMHR-II expression and BMI, and a positive association between AR expression and BMI in the GC of PCOS and non-PCOS women.
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Affiliation(s)
- Mohammad Nouri
- Women's Reproductive Health Research Center, Tabriz, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
| | - Sajad Khani
- Research Center for Pharmaceutical Nanotechnology, Research and Development Complex, Tabriz, Iran
| | - Mehri Jamilian
- Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mehrnush Amiri Siavashani
- Department of Gynecology and Obstetrics, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Shahnaz Ahmadi
- Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Gynecology and Obstetrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
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Marsh EE, Bernardi LA, Steinberg ML, de Chavez PJ, Visser JA, Carnethon MR, Baird DD. Novel correlates between antimüllerian hormone and menstrual cycle characteristics in African-American women (23-35 years-old). Fertil Steril 2016; 106:443-450.e2. [PMID: 27114331 DOI: 10.1016/j.fertnstert.2016.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/14/2016] [Accepted: 04/06/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To characterize normative antimüllerian hormone (AMH) levels and ascertain which factors are associated with AMH in a large cohort of reproductive-age women. DESIGN Cross-sectional study. SETTING Not applicable. PATIENT(S) A total of 1,654 African-American women (AAW) ages 23-34 at recruitment. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Serum AMH measured using an ultrasensitive ELISA. RESULT(S) The median AMH was 3.18 ng/mL, and there was a significant, but nonlinear, relationship between age and AMH, with levels peaking at age 25. As AMH was not normally distributed, log transformation was performed and used for all analyses. In a multivariable age-adjusted model, body mass index, current use of hormonal contraception, and history of a thyroid condition were inversely associated with AMH, while history of abnormal menstrual bleeding and menstrual cycles longer than 35 days were positively associated with AMH. CONCLUSION(S) While age is correlated with AMH, it accounts for only a portion of the variation seen. This study adds valuable information to the existing literature on normative AMH levels in young reproductive-age women. While our findings fill a critical data gap for ovarian reserve in AAW, the insights gained will be of benefit for all women.
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Affiliation(s)
- Erica E Marsh
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Lia A Bernardi
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Marissa L Steinberg
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Peter J de Chavez
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Jenny A Visser
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
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Singh AK, Singh R. Can anti-Mullerian hormone replace ultrasonographic evaluation in polycystic ovary syndrome? A review of current progress. Indian J Endocrinol Metab 2015; 19:731-743. [PMID: 26693422 PMCID: PMC4673800 DOI: 10.4103/2230-8210.167548] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Several studies over the past decade have now consistently indicated that the serum anti-Mullerian hormone (AMH) levels are at least 2-3-fold higher in the patients with polycystic ovary syndrome (PCOS), which also corresponds to the increased number of AMH producing preantral and small antral follicles. Moreover, AMH levels have been found to be associated in direct proportion to the follicle numbers per ovary or antral follicular count, assessed by the transvaginal ultrasound (TVS). Furthermore, AMH correlates directly with the rising serum testosterone and luteinizing hormone levels in PCOS. Hence, serum AMH in women with oligo-anovulation and/or hyperandrogenemia could indicate the presence of underlying PCOS, when reliable TVS is not feasible, or not acceptable, either due to the virginal status or psycho-social issue. In addition, the imaging quality of abdominal ultrasound is often impaired by obesity, which typically occurs in PCOS women. Indeed, PCOS occurs most commonly in young females who cannot be subjected to invasive TVS for various reasons; therefore, a desirable alternative to TVS is urgently required to diagnose the most prevalent endocrine abnormality of young women. This review will analyze the currently available evidence regarding the role of AMH in the diagnosis of PCOS.
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Affiliation(s)
- Awadhesh Kumar Singh
- Department of Endocrinology, GD Hospital and Diabetes Institute, Kolkata, West Bengal, India
- Department of Endocrinology, Sun Valley Diabetes Hospital, Guwahati, Assam, India
| | - Ritu Singh
- Department of Gynecology, GD Hospital and Diabetes Institute, Kolkata, West Bengal, India
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Cohen J, Chabbert-Buffet N, Darai E. Diminished ovarian reserve, premature ovarian failure, poor ovarian responder--a plea for universal definitions. J Assist Reprod Genet 2015; 32:1709-12. [PMID: 26463876 DOI: 10.1007/s10815-015-0595-y] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 10/05/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Diminished ovarian reserve (DOR) is characterized by poor fertility outcomes, and it represents a major challenge in reproductive medicine. Although consensus exists on the concept of DOR, its definition remains blurry. DOR has to be distinguished from premature ovarian failure (POF) and poor ovarian responders (POR), who are clearly defined. METHODS We performed a PubMed search with the terms "diminished ovarian reserve" and "in vitro fertilization (IVF)" to assess the homogeneity of the definition of DOR. RESULTS Out of 121 articles, 14 gave a definition for DOR. Only one definition was used by two different teams (basal follicle-stimulating hormone (FSH) value >10 IU/l) and eight teams used 11 different definitions. Among those, four definitions did not include antral follicular count (AFC) and seven studies did. Two definitions included the results from a previous cycle. CONCLUSIONS The heterogeneity in the definition of DOR used in these studies contributes to confusing results. Hence, there is a need for a clear definition of DOR. It appears that AFC and anti-Müllerian hormone (AMH) serum levels are the most relevant criteria. One option could be the use of the following definition: (i) woman with any of the risk factors for POR and/or (ii) an abnormal ovarian reserve test (i.e., antral follicular count (AFC) <5-7 follicles or AMH <0.5-1.1 ng/ml). This hypothesis requires validation.
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Affiliation(s)
- J Cohen
- Service de Gynécologie-Obstétrique, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC 6-UPMC Centre Expert en Endométriose (C3E), Université Pierre et Marie Curie Paris 6, Paris, France.
- Inserm UMRS938, Université Pierre et Marie Curie, Paris, France.
| | - N Chabbert-Buffet
- Service de Gynécologie-Obstétrique, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC 6-UPMC Centre Expert en Endométriose (C3E), Université Pierre et Marie Curie Paris 6, Paris, France
- Inserm UMRS938, Université Pierre et Marie Curie, Paris, France
| | - E Darai
- Service de Gynécologie-Obstétrique, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, GRC 6-UPMC Centre Expert en Endométriose (C3E), Université Pierre et Marie Curie Paris 6, Paris, France
- Inserm UMRS938, Université Pierre et Marie Curie, Paris, France
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Obesity adversely affects serum anti-müllerian hormone (AMH) levels in Caucasian women. J Assist Reprod Genet 2015; 32:1305-11. [PMID: 26194744 DOI: 10.1007/s10815-015-0538-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/06/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Previous studies regarding the effect of obesity on serum anti-müllerian hormone (AMH) levels have been conflicting. Our aim was to determine the effect of obesity on serum AMH levels among women from different racial backgrounds. METHODS The medical records of 350 women (159 Caucasian, 99 African-American, 58 Hispanic, 34 Asian with ages 16-46) evaluated for infertility at an academic-affiliated center and who had AMH levels measured as part of their evaluation were reviewed. Age, AMH, body mass index (BMI), self-reported race, etiology of infertility, smoking history, maximum serum early follicular follicle-stimulating hormone (FSH) levels, antral follicle count (AFC), and history of ovarian surgery, chemotherapy, or radiotherapy were recorded. RESULTS Age correlated negatively with AMH and antral follicle count across all races (p < 0.05). After adjusting for age, polycystic ovary syndrome diagnosis, and smoking, elevated BMI had a negative correlation with AMH in Caucasian women (β = 0.17, p = 0.01) but not in African-American, Hispanic, or Asian women. CONCLUSION Elevated BMI correlates negatively with AMH in Caucasian women but not in African-American, Hispanic, or Asian women. Additional studies are needed to elucidate further the effect of race on the interaction between obesity and ovarian reserve.
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Abstract
PURPOSE This study attempted to derive an objective and sophisticated definition of poor ovarian response (POR). MATERIALS AND METHODS A total of 176 consecutive in vitro fertilization (IVF) cycles (137 patients) with conventional ovarian stimulation during 2009 to 2012 were studied by retrospective analysis. Optimal oocyte number (total or mature) was determined by statistics-based (distribution of oocyte number) and prognosis-based approaches (prediction for IVF outcome). Receiver operating characteristics curve analysis was used to show what number of oocytes could predict IVF pregnancy and whether clinical and laboratory variables could predict newly defined POR. RESULTS The 25th percentile of the distribution corresponded to total oocytes ≤2 and mature oocyte ≤1. The cut-off values for the prediction of IVF outcomes were total oocytes >5 and mature oocyte >1. Considering the incidence of POR (34.1%), a reasonable definition of POR was decided as total oocytes ≤2 or mature oocyte ≤1. For the prediction of this new definition, the extreme cut-off value (by setting a false positive rate of 5%) of serum anti-Mullerian hormone (AMH) was ≤0.76 ng/mL, which was better than serum follicle stimulating hormone or age. A new simple definition of POR was derived as total oocytes ≤2 or mature oocyte ≤1 in a previous cycle or a serum AMH level of ≤0.76 ng/mL. When this simple criterion was re-applied to our data, the predictive performance was similar to the Bologna criteria. CONCLUSION We here propose a new definition of POR, which is simple and supported by statistical and prognostic analyses.
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Affiliation(s)
- Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
| | - Chang Suk Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
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Merhi Z, Polotsky AJ, Bradford AP, Buyuk E, Chosich J, Phang T, Jindal S, Santoro N. Adiposity Alters Genes Important in Inflammation and Cell Cycle Division in Human Cumulus Granulosa Cell. Reprod Sci 2015; 22:1220-8. [PMID: 25676576 DOI: 10.1177/1933719115572484] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine whether obesity alters genes important in cellular growth and inflammation in human cumulus granulosa cells (GCs). METHODS Eight reproductive-aged women who underwent controlled ovarian hyperstimulation followed by oocyte retrieval for in vitro fertilization were enrolled. Cumulus GC RNA was extracted and processed for microarray analysis on Affymetrix Human Genome U133 Plus 2.0 chips. Gene expression data were validated on GCs from additional biologically similar samples using quantitative real-time polymerase chain reaction (RT-PCR). Comparison in gene expression was made between women with body mass index (BMI) <25 kg/m(2) (group 1; n = 4) and those with BMI ≥25 kg/m(2) (group 2; n = 4). RESULTS Groups 1 and 2 had significantly different BMI (21.4 ± 1.4 vs 30.4 ± 2.7 kg/m(2), respectively; P = .02) but did not differ in age (30.5 ± 1.7 vs 32.7 ± 0.3 years, respectively; P = .3). Comparative analysis of gene expression profiles by supervised clustering between group 1 versus group 2 resulted in the selection of 7 differentially expressed genes: fibroblast growth factor 12 (FGF-12), protein phosphatase 1-like (PPM1L), zinc finger protein multitype 2 (ZFPM2), forkhead box M1 (FOXM1), cell division cycle 20 (CDC20), interleukin 1 receptor-like 1 (IL1RL1), and growth arrest-specific protein 7 (GAS7). FOXM1, CDC20, and GAS7 were downregulated while FGF-12 and PPM1L were upregulated in group 2 when compared to group 1. Validation with RT-PCR confirmed the microarray data except for ZFPM2 and IL1RL. As BMI increased, expression of FOXM1 significantly decreased (r = -.60, P = .048). CONCLUSIONS Adiposity is associated with changes in the expression of genes important in cellular growth, cell cycle progression, and inflammation. The upregulation of the metabolic regulator gene PPM1L suggests that adiposity induces an abnormal metabolic follicular environment, potentially altering folliculogenesis and oocyte quality.
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Affiliation(s)
- Zaher Merhi
- Division of Reproductive Biology, Department of Obstetrics and Gynecology, NYU Langone Medical Center, New York, NY, USA Division of Reproductive Endocrinology and Infertility, University of Vermont College of medicine, Burlington, VT, USA
| | - Alex J Polotsky
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, USA
| | - Andrew P Bradford
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, USA
| | - Erkan Buyuk
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Justin Chosich
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, USA
| | - Tzu Phang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, USA
| | - Sangita Jindal
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nanette Santoro
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, USA
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de Kat AC, Broekmans FJM, Laven JS, van der Schouw YT. Anti-Müllerian Hormone as a marker of ovarian reserve in relation to cardio-metabolic health: a narrative review. Maturitas 2015; 80:251-7. [PMID: 25640611 DOI: 10.1016/j.maturitas.2014.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 12/21/2014] [Indexed: 12/25/2022]
Abstract
The final hallmark of diminishing ovarian reserve is menopause, a state known to be inextricably linked to the deterioration of female cardiovascular health. The menopausal transition is associated with an increased risk of future cardiovascular morbidity and mortality, irrespective of chronological age. The aim of this narrative review is to identify studies investigating the association between Anti-Müllerian Hormone (AMH), a marker of ovarian reserve status, and factors of cardio-metabolic risk. Both for regularly cycling women and women with polycystic ovary syndrome (PCOS), current reports are conflicting and heterogeneous, with some indicating presence and others absence of a correlation between AMH and cardio-metabolic risk factors. The occurrence of hypertensive complications in pregnancy, known to increase the risk of later cardiovascular sequelae, is associated with reduced AMH levels in various study populations. Further research remains a prerequisite in order to further elucidate a possible common mechanism for ovarian and cardiovascular decline. More knowledge of the temporal or causal association between ovarian and cardiovascular decline may enable timely identification of women with increased risk of cardiovascular disease or early onset ovarian aging. Following this, AMH may in the future play a role beyond the scope of female reproduction.
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Affiliation(s)
- Annelien C de Kat
- Department for Reproductive Medicine, Division Female and Baby, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Frank J M Broekmans
- Department for Reproductive Medicine, Division Female and Baby, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joop S Laven
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Effect of ABO blood type on ovarian reserve in Chinese women. Fertil Steril 2014; 102:1729-32.e2. [PMID: 25313097 DOI: 10.1016/j.fertnstert.2014.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/12/2014] [Accepted: 09/06/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To explore the effect of ABO blood type on ovarian reserve in Chinese women. DESIGN Retrospective analysis. SETTING University-affiliated IVF center. PATIENT(S) The retrospective analysis involved 35,479 women who underwent in vitro fertilization and embryo transfer (IVF-ET) cycles between 2006 and 2012. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The association between ABO blood types and diminished ovarian reserve (DOR). RESULT(S) Among 35,479 Chinese women, 11,395 (32.12%) had blood type B, 10,583 (29.83%) had blood type O, 9,861 (27.79%) had blood type A, and 3,640 (10.26%) had blood type AB. There was a statistically significantly higher percentage of blood type O among those with follicle-stimulating hormone (FSH) levels ≤10 IU/L compared with those with FSH levels >10 IU/L. Conversely, among the women with DOR, there was statistically significantly higher percentage of those with blood types B and AB. Blood type A was not associated with DOR occurrence. Multivariate logistic regression analysis showed that blood type O was statistically significantly less often associated with DOR occurrence, whereas the B antigen (blood type B or AB) was statistically significantly associated with an increased risk of DOR. CONCLUSION(S) Our results have shown that there is an association between ABO blood type and DOR occurrence in Chinese women. Women with blood type O were statistically significantly less likely to have DOR, whereas those with B antigen (blood type B or AB) were statistically significantly more likely to have DOR. Blood type A was not associated with ovarian reserve.
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Broer SL, Broekmans FJ, Laven JS, Fauser BC. Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Update 2014; 20:688-701. [DOI: 10.1093/humupd/dmu020] [Citation(s) in RCA: 395] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Timberlake KS, Foley KL, Hurst BS, Matthews ML, Usadi RS, Marshburn PB. Association of blood type and patient characteristics with ovarian reserve. Fertil Steril 2013; 100:1735-9. [PMID: 24055049 DOI: 10.1016/j.fertnstert.2013.08.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 07/30/2013] [Accepted: 08/16/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess whether blood type was associated with diminished ovarian reserve (DOR) (day-3 follicle-stimulating hormone level >10 IU/L), controlling for history of tobacco smoking, body mass index (BMI), history of endometriosis, ovarian surgery, previous pregnancy, and maternal age. DESIGN Cross-sectional study. SETTING Academic medical center, Division of Reproductive Endocrinology and Infertility. PATIENT(S) Women undergoing in vitro fertilization (IVF) from 2006-2011 (n = 305). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Presence of DOR in relation to a patient's blood type. RESULT(S) Other investigators have reported an increased risk for DOR in patients with blood type O and a protective effect on ovarian reserve for blood type A. We observed no association between a woman's blood type and DOR. We found an increased risk for DOR in patients aged 35 and older. Obesity (BMI ≥ 30 vs. BMI <25) was associated with lower odds of DOR. CONCLUSION(S) In comparison with blood type A, blood type O is not associated with an increase in DOR. We found no clinical implications for using blood type as a risk factor for DOR.
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Determining an anti-Mullerian hormone cutoff level to predict clinical pregnancy following in vitro fertilization in women with severely diminished ovarian reserve. J Assist Reprod Genet 2013; 30:1361-5. [PMID: 23963620 DOI: 10.1007/s10815-013-0077-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 08/05/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Serum anti-Mullerian hormone (AMH) levels estimate ovarian reserve. The purpose of this study was to identify a minimum serum AMH level that correlates with acceptable clinical pregnancy rate (CPR) in women with severe diminished ovarian reserve (DOR) undergoing in vitro fertilization (IVF). METHODS(S) A historical cohort of severe DOR participants (age ≥35) with day 3 FSH of >10 ng/mL were included (n = 120). Participants were categorized into 3 groups: AMH <0.2 (Group 1, n = 38), AMH = 0.2-0.79 (Group 2, n = 57) and AMH ≥ 0.8 (Group 3, n = 25) ng/mL. The main outcome was CPR. The number of retrieved and mature oocytes, transferred embryos, spontaneous abortion (SAB) and live birth (LB) rates were also evaluated. RESULT(S) Among the three groups, there was no difference in day 3 FSH and estradiol, total gonadotropins dose used per cycle, or LB. Participants in Group 1 were two years older than those in Group 2 and had significantly higher BMI than those in Groups 2 and 3. The three groups significantly differed in AFC (Group 1< Group 2< Group 3; p = 0.001) and cycle cancellation rate (Group 1> Group 2> Group 3; p = 0.006), and had a trend toward significance in SAB rate (Group 1> Group 2> Group 3; p = 0.06). Group 3 had significantly more retrieved and mature oocytes than Groups 1 or 2. Group 2 and 3 had significantly higher CPR per cycle start compared to Group 1. Although Group 2 had significantly fewer oocytes retrieved and mature oocytes than Group 3, CPR per cycle start for both groups was not different. ROC curve indicated that the point of maximal inflection between lower and higher CPR represents an AMH value of 0.2 ng/mL. CONCLUSION(S) AMH of 0.2 ng/mL appears to be a meaningful threshold for predicting CPR in women with severe DOR at our practice. This information can be crucial during the pre-cycle counseling of these women.
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Abstract
Although it is widely appreciated that age is the primary determinant of the number of primordial follicles remaining within the ovary, it is now also recognized that for any given age two women can have a 100-fold difference in their ovarian reserve. Consequently, age alone has relatively poor accuracy in determining the reproductive potential for young women, and this has led to the development of additional biomarkers that more accurately reflect the ovarian reserve. In this review we discuss the strengths and limitations of the classical and novel biomarkers and provide a rationale for the adoption of biomarkers to facilitate the individualization of reproductive health.
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Affiliation(s)
- Stamatina Iliodromiti
- Maternal & Reproductive Medicine, School of Medicine, University of Glasgow, Glasgow G12 8QQ, UK.
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van Dorp W, Blijdorp K, Laven JSE, Pieters R, Visser JA, van der Lely AJ, Neggers SJCMM, van den Heuvel-Eibrink MM. Decreased ovarian function is associated with obesity in very long-term female survivors of childhood cancer. Eur J Endocrinol 2013; 168:905-12. [PMID: 23557987 DOI: 10.1530/eje-13-0114] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Obesity and gonadal dysfunction are known major side effects of treatment in adult childhood cancer survivors (CCS). In the general population, obesity has a negative influence on female fertility. We aimed to evaluate whether obesity and serum insulin are associated with decreased ovarian reserve markers in CCS. DESIGN Retrospective single-center cohort study. METHODS Data of 191 female survivors of childhood cancer were analyzed. Median follow-up time was 18.8 (2.348.8) years. Outcome measures were serum anti-Müllerian hormone (AMH) and total follicle count (FC). Potential risk factors were: BMI; body composition measures, determined by dual-energy X-ray absorptiometry (total fat percentage, lean body mass, and visceral fat percentage); and fasting insulin. RESULTS Lower serum AMH was found in obese subjects (β (%) -49, P=0.007) and in subjects with fasting insulin in the highest tertile (β (%) -43, P=0.039). Total fat percentage tends to be associated with serum AMH (β (%) -2.1, P=0.06). Survivors in the highest tertile of insulin had significantly lower FC than survivors in the lowest tertile (β -6.3, P=0.013). BMI and other measures of body composition were not associated with FC. Correlation between serum AMH and antral follicle count (AFC) was ρ=0.32 (P=0.08). CONCLUSIONS Obesity and insulin resistance are associated with gonadal damage, as reflected by decreased AMH and reduced FC in adult survivors of childhood cancer. In contrast to its highly predictive value for AFC in the healthy female population, serum AMH does not seem to correlate as well with AFC in CCS.
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Affiliation(s)
- W van Dorp
- Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Dr Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands.
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Merhi Z, Buyuk E, Berger DS, Zapantis A, Israel DD, Chua S, Jindal S. Leptin suppresses anti-Mullerian hormone gene expression through the JAK2/STAT3 pathway in luteinized granulosa cells of women undergoing IVF. Hum Reprod 2013; 28:1661-1669. [DOI: 10.1093/humrep/det072] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Anderson EL, Fraser A, McNally W, Sattar N, Lashen H, Fleming R, Nelson SM, Lawlor DA. Anti-müllerian hormone is not associated with cardiometabolic risk factors in adolescent females. PLoS One 2013; 8:e64510. [PMID: 23762215 PMCID: PMC3675909 DOI: 10.1371/journal.pone.0064510] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 04/15/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Epidemiological evidence for associations of Anti-Müllerian hormone (AMH) with cardiometabolic risk factors is lacking. Existing evidence comes from small studies in select adult populations, and findings are conflicting. We aimed to assess whether AMH is associated with cardiometabolic risk factors in a general population of adolescent females. METHODS AMH, fasting insulin, glucose, HDLc, LDLc, triglycerides and C-reactive protein (CRP) were measured at a mean age 15.5 years in 1,308 female participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Multivariable linear regression was used to examine associations of AMH with these cardiometabolic outcomes. RESULTS AMH values ranged from 0.16-35.84 ng/ml and median AMH was 3.57 ng/ml (IQR: 2.41, 5.49). For females classified as post-pubertal (n = 848) at the time of assessment median (IQR) AMH was 3.81 ng/ml (2.55, 5.82) compared with 3.25 ng/ml (2.23, 5.05) in those classed as early pubertal (n = 460, P≤0.001). After adjusting for birth weight, gestational age, pubertal stage, age, ethnicity, socioeconomic position, adiposity and use of hormonal contraceptives, there were no associations with any of the cardiometabolic outcomes. For example fasting insulin changed by 0% per doubling of AMH (95%CI: -3%,+2%) p = 0.70, with identical results if HOMA-IR was used. Results were similar after additional adjustment for smoking, physical activity and age at menarche, after exclusion of 3% of females with the highest AMH values, after excluding those that had not started menarche and after excluding those using hormonal contraceptives. CONCLUSION Our results suggest that in healthy adolescent females, AMH is not associated with cardiometabolic risk factors.
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Affiliation(s)
- Emma L Anderson
- MRC CAiTE Centre, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom.
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Tal R, Seifer DB. Potential mechanisms for racial and ethnic differences in antimüllerian hormone and ovarian reserve. Int J Endocrinol 2013; 2013:818912. [PMID: 24348557 PMCID: PMC3857838 DOI: 10.1155/2013/818912] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 10/21/2013] [Accepted: 10/21/2013] [Indexed: 12/23/2022] Open
Abstract
Accumulating evidence suggests that reproductive potential and function may be different across racial and ethnic groups. Racial differences have been demonstrated in pubertal timing, infertility, outcomes after assisted reproductive technology (ART) treatment, and reproductive aging. Recently, racial differences have also been described in serum antimüllerian hormone (AMH), a sensitive biomarker of ovarian reserve, supporting the notion that ovarian reserve differs between racial/ethnic groups. The existence of such racial/ethnic differences in ovarian reserve, as reflected by AMH, may have important clinical implications for reproductive endocrinologists. However, the mechanisms which may underlie such racial differences in ovarian reserve are unclear. Various genetic factors and environmental factors such as obesity, smoking, and vitamin D deficiency which have been shown to correlate with serum AMH levels and also display significant racial/ethnic variations are discussed in this review. Improving our understanding of racial differences in ovarian reserve and their underlying causes may be essential for infertility treatment in minority women and lead to better reproductive planning, improved treatment outcomes, and timely interventions which may prolong reproductive lifespan in these women.
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Affiliation(s)
- Reshef Tal
- Genesis Fertility & Reproductive Medicine, Division of Reproductive Endocrinology and Infertility, Maimonides Medical Center, 1355 84th Street, Brooklyn, NY 11228, USA
- *Reshef Tal:
| | - David B. Seifer
- Genesis Fertility & Reproductive Medicine, Division of Reproductive Endocrinology and Infertility, Maimonides Medical Center, 1355 84th Street, Brooklyn, NY 11228, USA
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Buggio L, Vercellini P, Somigliana E, Viganò P, Frattaruolo MP, Fedele L. "You are so beautiful"*: behind women's attractiveness towards the biology of reproduction: a narrative review. Gynecol Endocrinol 2012; 28:753-7. [PMID: 22394274 DOI: 10.3109/09513590.2012.662545] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Female beauty has always attracted human beings. In particular, beauty has been interpreted in terms of reproductive potential and advantage in selection of mates. We have reviewed the recent literature on female facial and physical beauty with the objective of defining which parameters could influence female attractiveness. Symmetry, averageness, and sexual dimorphism with regards to facial beauty, as well as waist-to-hip ratio (WHR), breast size, and body mass index (BMI) for physical beauty, have been assessed. In current societies, it appears that facial attractiveness results from a mixture of symmetry and averageness of traits, high forehead and cheekbones, small nose and chin, full lips, thin eyebrows, and thick hair. A low WHR reliably characterized physical attractiveness, whereas inconsistencies have been observed in the evaluation of breast size and BMI. The importance of breast size appears to vary with time and sex of evaluators, whereas the impact of BMI is related to socio-economic conditions. The various hypotheses behind beauty and the role of attractiveness in mate choice and sexual selection are here described in terms of continuation of human species. Intriguing associations are emerging between features of attractiveness and some reproductive disorders, as both are substantially influenced by sex steroid hormones.
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Affiliation(s)
- Laura Buggio
- Clinica Ostetrica e Ginecologica, Istituto Luigi Mangiagalli, Università degli Studi, and Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
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