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de Morais R, Sousa AJDO, da Costa de Almeida NN, Ohashi OM, Santos SDSD, Monteiro BM, Rolim Filho ST, King WA, Miranda MDS. Do the blood anti-Müllerian hormone concentrations in young females correlate with the ovarian follicular population later in life in water buffalo? Reprod Domest Anim 2024; 59:e14564. [PMID: 38634152 DOI: 10.1111/rda.14564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/08/2024] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
In this longitudinal study, the anti-Müllerian hormone (AMH) levels in blood were determined in 32 Murrah buffalo females at 8, 10, 12, 16 and 19 months of age when females were synchronized and the antral follicular population (AFP) was estimated. Correlations of AFP to the AMH level at 19 months of age and retrospectively to younger ages were investigated. Then females were split into high and low AFP, and their AMH levels were compared for all ages and tested as predictors of AFP categories. The highest AMH level (p < .05) was detected at 8 months, reducing but not differing (p > .05) at 10, 12 and 16 months then reducing again (p < .05) at 19 months of age. The mean AFP was 17.6 ± 6.3 follicles, and it was positively correlated with AMH in all ages tested. High AFP females had approximately two times more antral follicles than low AFP (p < .05) and their AMH levels were higher (p < .01) than in low AFP ones in all ages. Only at 8 months, AMH levels can be used to precociously detect high AFP heifers (a cut-off point of 464.7 pg/mL; p < .05), while low AFP heifers could be detected by AMH measurements at 8, 10, 12 and 16 months of age (p < .05). We conclude that AMH of buffalo calves correlates with AFP of heifers later in life and depending on the age, its levels could be used to identify future females with low or high AFP.
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Affiliation(s)
- Rodrigo de Morais
- Federal Institute of Education, Science and Technology of Pará, Castanhal, Brazil
| | | | | | - Otávio Mitio Ohashi
- Institute of Biological Sciences of the Federal University of Pará, Belém, Brazil
| | | | - Bruno Moura Monteiro
- College of Veterinary Medicine, Federal Rural University of the Amazon, Belém, Brazil
| | | | | | - Moysés Dos Santos Miranda
- Institute of Biological Sciences of the Federal University of Pará, Belém, Brazil
- Institute of Veterinary Medicine, Federal University of Pará, Castanhal, Brazil
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2
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Dykgraaf RHM, Schalekamp-Timmermans S, Adank MC, van den Berg SAA, van de Lang-Born BMN, Korevaar TIM, Kumar A, Kalra B, Savjani GV, Steegers EAP, Louwers YV, Laven JSE. Reference ranges of anti-Müllerian hormone and interaction with placental biomarkers in early pregnancy: the Generation R Study, a population-based prospective cohort study. Endocr Connect 2023; 12:e220320. [PMID: 36524811 PMCID: PMC9986396 DOI: 10.1530/ec-22-0320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
Objective The primary objective of this study is to establish maternal reference values of anti-Müllerian hormone (AMH) in a fertile multi-ethnic urban pregnant population and to evaluate the effect of gestational age. The secondary objective of this study is to explore the association between AMH and placental biomarkers. Design This study was embedded in the Generation R Study, an ongoing population-based prospective cohort study from early pregnancy onwards. Setting City of Rotterdam, the Netherlands, out of hospital setting. Patients In 5806 women, serum AMH levels were determined in early pregnancy (median 13.5 weeks; 95% range 10.5-17.2). Intervention(s) None. Main outcome measures Maternal AMH levels in early pregnancy and its association with placental biomarkers, including human chorionic gonadotrophin (hCG), soluble fms-like tyrosine kinase-1 (sFLT), and placental growth factor (PLGF). Results A nomogram of AMH in early pregnancy was developed. Serum AMH levels showed a decline with advancing gestational age. Higher AMH levels were associated with a higher level of the placental biomarkers hCG and sFLT in early pregnancy. This last association was predominantly mediated by hCG. AMH levels were negatively associated with PLGF levels. Conclusion In this large study, we show that AMH levels in early pregnancy decrease with advancing gestational age. The association between AMH and the placental biomarkers hCG, sFLT, and PLGF suggests a better placental development with lower vascular resistance in mothers with higher AMH levels. Hence, AMH might be useful in predicting adverse pregnancy outcomes due to impaired placental development.
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Affiliation(s)
- R H M Dykgraaf
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - S Schalekamp-Timmermans
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M C Adank
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - S A A van den Berg
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - B M N van de Lang-Born
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - T I M Korevaar
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Kumar
- Ansh Labs, Webster, Texas, USA
| | - B Kalra
- Ansh Labs, Webster, Texas, USA
| | | | - E A P Steegers
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Obstetrics and Fetal Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Y V Louwers
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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McCredie S, An B, McShane M, Ledger W, Venetis CA. Serum anti-müllerian hormone (AMH) concentration during pregnancy: a longitudinal study. REPRODUCTION AND FERTILITY 2023; 4:RAF-22-0128. [PMID: 36952428 PMCID: PMC10160537 DOI: 10.1530/raf-22-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/23/2023] [Indexed: 03/25/2023] Open
Abstract
A prospective longitudinal cohort study aimed to longitudinally examine the kinetics of Anti-müllerian hormone (AMH) during the first two trimesters of pregnancy. Pregnant women with stored 1st trimester serum samples were recruited at 24-28 weeks gestation during their gestational diabetes testing, where they provided an additional serum sample. The samples were analysed for AMH, oestradiol and progesterone concentrations. A decrease in serum AMH was observed in 40 out of 45 (88.9%) (95% CI 75.9% to 96.3%) of the participants in this study. The median serum AMH concentration was 10.9 pmol/L in the 1st trimester and 6.5 pmol/L during the 2nd trimester, with a significantly different distribution of the values between the 1st and the 2nd trimester AMH samples (p<0.001). The median percentage of AMH difference of -39.8%. This study demonstrated a significant decrease in serum AMH levels from the 1st to the 2nd trimester of pregnancy. The absolute decrease in AMH levels seems to be positively associated with 1st trimester AMH levels, whereas the percentage of AMH difference is not. Further studies are required to elucidate the potential physiological mechanisms of this finding.
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Affiliation(s)
- Sarah McCredie
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
| | - Belinda An
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
| | - Monika McShane
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - William Ledger
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Christos A Venetis
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
- Royal Hospital for Women, Randwick, New South Wales, Australia
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Gelderblom ME, IntHout J, Dagovic L, Hermens RPMG, Piek JMJ, de Hullu JA. The effect of opportunistic salpingectomy for primary prevention of ovarian cancer on ovarian reserve: a systematic review and meta-analysis. Maturitas 2022; 166:21-34. [PMID: 36030627 DOI: 10.1016/j.maturitas.2022.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Opportunistic salpingectomy (OS) is an attractive method for primary prevention of ovarian cancer. Although OS has not been associated with a higher complication rate, it may be associated with earlier onset of menopause. OBJECTIVE To provide a systematic review and meta-analysis of the effect of OS on both age at menopause and ovarian reserve. METHODS A search was conducted in the Cochrane Library, Embase and MEDLINE databases from inception until March 2022. We included randomized clinical trials and cohort studies investigating the effect of OS on onset of menopause and/or ovarian reserve through change in anti-Müllerian hormone (AMH), antral follicle count (AFC), estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH). Data was extracted independently by two researchers. Random-effects meta-analyses were conducted to estimate the pooled effect of OS on ovarian reserve. RESULTS The initial search yielded 1047 studies. No studies were found investigating the effect of OS on age of menopause. Fifteen studies were included in the meta-analysis on ovarian reserve. Meta-analyses did not result in statistically significant differences in mean change in AMH (MD -0.07 ng/ml, 95%CI -0.18;0.05), AFC (MD 0.20 n, 95 % CI -4.91;5.30), E2 (MD 3.97 pg/ml, 95%CI -0.92;8.86), FSH (MD 0.33mIU/ml, 95%CI -0.15;0.81) and LH (MD 0.03mIU/ml; 95%CI -0.47;0.53). CONCLUSION Our study shows that OS does not result in a significant reduction of ovarian reserve in the short term. Further research is essential to confirm the absence of major effects of OS on menopausal onset since clear evidence on this subject is lacking. Registration number PROSPERO CRD42021260966.
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Affiliation(s)
- M E Gelderblom
- Radboud Institute for Health Sciences, Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - J IntHout
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L Dagovic
- Radboud Institute for Health Sciences, Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - R P M G Hermens
- Radboud Institute for Health Sciences, Department of IQ Health Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J M J Piek
- Department of Obstetrics and Gynecology and Catharina Cancer Institute, Catharina Hospital, Eindhoven, The Netherlands
| | - J A de Hullu
- Radboud Institute for Health Sciences, Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
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5
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Gültiken N, Yarim M, Aslan S, Gürler H, Yarim GF, Tuncay M, İnal S, Schäfer-Somi S. Expression of Anti-Müllerian Hormone and Its Type 2 Receptor in the Ovary of Pregnant and Cyclic Domestic Cats. Animals (Basel) 2022; 12:ani12070877. [PMID: 35405866 PMCID: PMC8997022 DOI: 10.3390/ani12070877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 01/26/2023] Open
Abstract
To evaluate the expression of AMH and its receptor AMHRII, ovaries of 33 p cats were investigated by western blot and immunohistochemistry. After ovariohysterectomy, the cats were grouped according to pregnancy stages and ovarian/placental endocrine activity: group I (n = 3, 24−29 days), II (n = 8, 32−40 days), III (n = 4, 41−46 days), IV (n = 6, 53−61 days) and according to cycle stages: V (n = 6, interestrus) and VI (n = 6, estrus). Serum progesterone- and AMH-concentration was measured. Follicle numbers did not differ between groups. The number of corpora lutea was higher in pregnant cats than in the non-pregnant cats. Serum AMH concentration was at maximum between day 30 and 50 of gestation, and was higher than in non-pregnant cats, then decreased towards term (p < 0.05). In the ovaries, AMH immunopositivity was observed in granulosa cells of secondary and antral follicles, and in interstitial cells of corpora lutea; highest percentage of immunopositive areas was detected in group III (p < 0.05). A positive correlation between the number of corpora lutea and the positive AMH signals in ovarian tissue was determined (r2 = 0.832, p < 0.05); however, only during mid-gestation (group II). Expression of AMHRII was in close co-localization with AMH and strong in the interstitial cells surrounding follicles undergoing atresia. AMHRII expression did not differ between pregnant groups but was higher compared to estrus cats (p ˂ 0.05). We conclude that AMH and AMHRII expression in the feline ovary is comparable to other species. The high serum AMH concentration and ovarian AMHRII expression between day 30 and 50 of gestation are probably related to ovarian activity and follicular atresia.
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Affiliation(s)
- Nilgün Gültiken
- Department of Obstetrics and Gynecology, University of Ondokuz Mayis, Samsun 55200, Turkey; (N.G.); (H.G.); (M.T.)
| | - Murat Yarim
- Department of Pathology, University of Ondokuz Mayis, Samsun 55200, Turkey; (M.Y.); (S.İ.)
| | - Selim Aslan
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Near East University, Nicosia 99138, Cyprus;
| | - Hande Gürler
- Department of Obstetrics and Gynecology, University of Ondokuz Mayis, Samsun 55200, Turkey; (N.G.); (H.G.); (M.T.)
| | - Gul Fatma Yarim
- Department of Biochemistry, Faculty of Veterinary Medicine, University of Ondokuz Mayis, Samsun 55200, Turkey;
| | - Müge Tuncay
- Department of Obstetrics and Gynecology, University of Ondokuz Mayis, Samsun 55200, Turkey; (N.G.); (H.G.); (M.T.)
| | - Sinem İnal
- Department of Pathology, University of Ondokuz Mayis, Samsun 55200, Turkey; (M.Y.); (S.İ.)
| | - Sabine Schäfer-Somi
- Platform for Artificial Insemination and Embryo Transfer, University of Veterinary Medicine, 1210 Vienna, Austria
- Correspondence:
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6
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Rotshenker-Olshinka K, Michaeli J, Srebnik N, Samueloff A, Magen S, Farkash R, Eldar-Geva T. Extended fertility at the Highly Advanced Reproductive age of 43-47 years is not related to Anti Mullerian Hormone (AMH) levels. Reprod Biomed Online 2022; 45:147-152. [DOI: 10.1016/j.rbmo.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
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7
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Neven ACH, Mousa A, Boyle JA, Teede HJ. Endocrine and metabolic interactions in healthy pregnancies and hyperinsulinemic pregnancies affected by polycystic ovary syndrome, diabetes and obesity. Front Endocrinol (Lausanne) 2022; 13:993619. [PMID: 36733795 PMCID: PMC9886898 DOI: 10.3389/fendo.2022.993619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/06/2022] [Indexed: 01/18/2023] Open
Abstract
During pregnancy, the fetoplacental unit is key in the pronounced physiological endocrine changes which support pregnancy, fetal development and survival, birth and lactation. In healthy women, pregnancy is characterized by changes in insulin sensitivity and increased maternal androgen levels. These are accompanied by a suite of mechanisms that support fetal growth, maintain glucose homeostasis and protect both mother and fetus from adverse effects of pregnancy induced insulin and androgen excess. In pregnancies affected by endocrine, metabolic disorders such as polycystic ovary syndrome (PCOS), diabetes and obesity, there is an imbalance of beneficial and adverse impacts of pregnancy induced endocrine changes. These inter-related conditions are characterized by an interplay of hyperinsulinemia and hyperandrogenism which influence fetoplacental function and are associated with adverse pregnancy outcomes including hypertensive disorders of pregnancy, macrosomia, preterm delivery and caesarean section. However, the exact underlying mechanisms and relationships of the endocrine and metabolic milieu in these disorders and the impact they have on the prenatal endocrine environment and developing fetus remain poorly understood. Here we aim to review the complex endocrine and metabolic interactions in healthy women during normal pregnancies and those in pregnancies complicated by hyperinsulinemic disorders (PCOS, diabetes and obesity). We also explore the relationships between these endocrine and metabolic differences and the fetoplacental unit, pregnancy outcomes and the developing fetus.
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Affiliation(s)
- Adriana C. H. Neven
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Jacqueline A. Boyle
- Monash Department of Obstetrics and Gynaecology, Monash Health, Clayton, VIC, Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
- *Correspondence: Jacqueline A. Boyle,
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
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8
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Sominsky L, Younesi S, De Luca SN, Loone SM, Quinn KM, Spencer SJ. Ovarian follicles are resistant to monocyte perturbations-implications for ovarian health with immune disruption†. Biol Reprod 2021; 105:100-112. [PMID: 33709094 DOI: 10.1093/biolre/ioab049] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/12/2020] [Accepted: 03/10/2021] [Indexed: 02/03/2023] Open
Abstract
Monocytes and macrophages are the most abundant immune cell populations in the adult ovary, with well-known roles in ovulation and corpus luteum formation and regression. They are activated and proliferate in response to immune challenge and are suppressed by anti-inflammatory treatments. It is also likely they have a functional role in the healthy ovary in supporting the maturing follicle from the primordial through to the later stages; however, this role has been unexplored until now. Here, we utilized a Cx3cr1-Dtr transgenic Wistar rat model that allows a conditional depletion of circulating monocytes, to investigate their role in ovarian follicle health. Our findings show that circulating monocyte depletion leads to a significant depletion of ovarian monocytes and monocyte-derived macrophages. Depletion of monocytes was associated with a transient reduction in circulating anti-Müllerian hormone (AMH) at 5 days postdepletion. However, the 50-60% ovarian monocyte/macrophage depletion had no effect on ovarian follicle numbers, follicle atresia, or apoptosis, within 5-21 days postdepletion. These data reveal that the healthy adult ovary is remarkably resistant to perturbations of circulating and ovarian monocytes despite acute changes in AMH. These data suggest that short-term anti-inflammatory therapies that transiently impact on circulating monocytes are unlikely to disrupt ovarian follicle health, findings that have significant implications for fertility planning relative to the experience of an immune challenge or immunosuppression.
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Affiliation(s)
- Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Simin Younesi
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Simone N De Luca
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Sophie M Loone
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Kylie M Quinn
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.,ARC Centre of Excellence for Nanoscale Biophotonics, RMIT University, Melbourne, Victoria, Australia
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9
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Pankhurst MW, de Kat AC, Jones S, Broekmans FJM, Wheeler BJ. Serum anti-Müllerian hormone levels in women are unstable in the postpartum period but return to normal within 5 months: a longitudinal study. Endocrine 2021; 71:225-232. [PMID: 32918141 DOI: 10.1007/s12020-020-02491-2] [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: 07/09/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Anti-Müllerian hormone (AMH) levels fall during pregnancy but the amount of time required for AMH levels to return to normal has not been accurately determined. We have previously shown that AMH levels have yet to return to normal in some women at 3-months postpartum. In this study, AMH levels were examined at 1- and 5-months postpartum to examine whether AMH levels had returned to normal within this interval. METHODS Longitudinal study involving 38 pregnant women, with serum samples taken in the first trimester, third trimester, 1-month postpartum, 5-months postpartum and 4-6 years postpartum. Participants were recruited from a tertiary maternity clinic (single centre). All women in the study were intending to breastfeed exclusively for at least 5 months, with all 38 participants achieving this at 1-month postpartum and 36/38 after 5 months. RESULTS Serum AMH concentrations had not returned to expected non-pregnant levels by 1-month postpartum. At 5-months postpartum, mean AMH concentrations were similar to expected non-pregnant levels but the rank order of AMH concentrations was still dissimilar to the non-pregnant state. CONCLUSIONS The regulation of AMH secretion appears to be distinctly different in non-pregnant, pregnant and postpartum populations. This may affect the conclusions that can be drawn from AMH measurements in women during pregnancy and the postpartum period.
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Affiliation(s)
- Michael W Pankhurst
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.
| | - Annelien C de Kat
- Department of Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Shirley Jones
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Frank J M Broekmans
- Department of Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Benjamin J Wheeler
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Ding A, Guerin A, Lujan ME, Velez MP. Polycystic Ovary Syndrome and Incidental Diagnosis of Mosaic Turner Syndrome. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:756-759. [PMID: 33158769 DOI: 10.1016/j.jogc.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common condition in women of reproductive age. Mosaic Turner syndrome (TS) is a genetic disorder with significant phenotypic variability. The occurrence of PCOS in women with mosaic TS has been infrequently studied. CASE A 30-year-old nulligravid woman presented with oligomenorrhea, hyperandrogenism, infertility, and ultrasound polycystic ovary morphology. She was diagnosed with PCOS and conceived following ovulation induction. After 2 inconclusive non-invasive prenatal screening results, she was referred to medical genetics. A maternal karyotype resulted in a diagnosis of 45,X/46,XX mosaic TS. She delivered a healthy 46,XY infant at term. CONCLUSION PCOS can affect women with mosaic TS. Further studies are needed to better characterize the reproductive profile of women with mosaic TS, including the presentation of concurrent PCOS.
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Affiliation(s)
- Avrilynn Ding
- Undergraduate Medical Education, Queen's University, Kingston, ON
| | - Andrea Guerin
- Department of Pediatrics, Queen's University, Kingston, ON
| | - Marla E Lujan
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Maria P Velez
- Department of Obstetrics and Gynaecology, Queen's University, Kingston, ON.
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11
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Moini A, Pirjani R, Rabiei M, Nurzadeh M, Sepidarkish M, Hosseini R, Hosseini L. Can delivery mode influence future ovarian reserve? Anti-Mullerian hormone levels and antral follicle count following cesarean section: a prospective cohort study. J Ovarian Res 2019; 12:83. [PMID: 31481111 PMCID: PMC6720941 DOI: 10.1186/s13048-019-0551-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/07/2019] [Indexed: 01/10/2023] Open
Abstract
Background The incidence of Cesarean has increased in recent years. The purpose of this study is to evaluate the effect of cesarean section on ovarian reserve. This is a prospective cohort study from January 2016 to November 2017. Inclusion criteria included singleton primigravid pregnant women whose gestational age was above 37 weeks. Exclusion criteria included history of infertility, pelvic surgery, underlying chronic diseases, any adverse pregnancy outcome and postpartum complication in current pregnancy and hormonal medication within six months of delivery. Anti-Mullerian hormone was measured at the admission time for delivery. The type of delivery was determined based on obstetrics indications. Six months after delivery, antral follicle count was performed and anti-Mullerian hormone was measured again. Result(s) First blood sample was taken from 730 women. After excluding 550 women, the second blood sample was taken from 180 participants. The mean of first anti-Mullerian hormone in women with cesarean and vaginal delivery were 1.01 ng/mL (95% CI 0.82 to 1.18) and 1.18 ng/mL (95% CI 0.96 to 1.40) respectively (P = 0.211). The mean of second anti-Mullerian hormone in women with cesarean and vaginal delivery were 4.77 ng/mL (95% CI:3.91 to 5.63) and 4.92 ng/mL (95% CI: 4.01 to 5.82) respectively (P = 0.818). No statistically significant difference existed in total AFC between cesarean and vaginal delivery groups (MD: 0.41, 95% CI: − 1.05 to 1.89, P = 0.576). Conclusion Antral follicle count and anti-Mullerian hormone, six month after delivery, are not affected by delivery mode even after adjusting for women’s age, baseline Anti-Mullerian hormone, body mass index, gestational age at delivery, breastfeeding, postpartum menstruation, neonatal sex and weight. Based on our best knowledge, this is the first report that investigates the effects of delivery mode on ovarian reserve. Decreased fertility following cesarean has been shown in some previous studies but most of them had assessed this association based on the incidence of subsequent pregnancy. Since subsequent pregnancy can be influenced by several confounding factors, we investigated the effect of cesarean on fertility using its impact on anti-Mullerian hormone levels and antral follicle count. We hope that this study will be a beginning of more detailed studies in this field. We believe that this link is yet to be studied.
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Affiliation(s)
- Ashraf Moini
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Reihaneh Pirjani
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran.
| | - Maryam Rabiei
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Maryam Nurzadeh
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
| | - Reihaneh Hosseini
- Obstetrics and Gynecology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Postal code: 1653915911, Iran
| | - Ladan Hosseini
- Research development center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
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12
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Giuliani E, Ellman EM, Chugh R, Moravek MB. Successful embryo cryopreservation immediately following a full-term delivery in a woman with newly diagnosed Ewing's sarcoma. J Assist Reprod Genet 2019; 36:1023-1028. [PMID: 30953232 DOI: 10.1007/s10815-019-01445-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/27/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Emma Giuliani
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA
| | - Erin M Ellman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA
| | - Rashmi Chugh
- Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Molly B Moravek
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA.
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13
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Jamil Z, Shahid S, Baig E, Ahmad R, Subhani F, Fatima SS. Serum anti mullerian hormone and renalase levels in predicting the risk of preeclampsia. Taiwan J Obstet Gynecol 2019; 58:188-191. [PMID: 30910136 DOI: 10.1016/j.tjog.2019.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2018] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The aim of the study was to explore the association of serum AMH and Renalase with the risk of preeclampsia thereby assessing them as screening tools, reducing the risk of gravid consequences of preeclampsia. MATERIALS AND METHODS This cross-sectional study recruited n = 95 pregnant women between 14 and 32 gestational weeks. They were categorized as a) women with gestational hypertension (n = 45); b) women with pre-eclampsia (n = 20) and c) normotensive pregnant women (n = 30) according to the ACOG criteria. Anthropometrics data and blood and urine samples were collected. AMH and Renalase levels were measured by ELISA assay. RESULTS The mean age of study cohort was 27.3 ± 6.2 year and weight was 65.1 ± 14.1 kg. Blood pressures were significantly higher in pre-eclamptic patients versus both the gestational hypertensive females and controls (p < 0.05). AMH was found to be significantly higher in controls but no difference was observed between gestational hypertensive and pre-eclamptic patients. No difference was seen for serum Renalase among the three groups (p > 0.05). AMH showed a negative weak correlation with diastolic blood pressure (r = -0.272; p = 0.008) that remained significant even after adjustment (r = -0.236; p = 0.023) whereas Renalase did not show any difference (r = -0.051; p > 0.05). Females with low levels of AMH were 1.07 times at risk of developing hypertension even after adjustment for age and BMI (p < 0.05). CONCLUSION Low AMH levels may lead to hypertension in pregnancy suggesting a role in detecting vascular diseases as well as its effect on ovarian aging. However, further research is required to establish a causal relationship.
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Affiliation(s)
- Zehra Jamil
- Department of Biological & Biomedical Sciences, Aga Khan University, Pakistan
| | - Sana Shahid
- Department of Physiology, Sir Syed College of Medical Sciences for Girls, Pakistan
| | - Erum Baig
- Medical Students, Aga Khan University, Pakistan
| | - Rida Ahmad
- Medical Students, Aga Khan University, Pakistan
| | | | - Syeda Sadia Fatima
- Department of Biological & Biomedical Sciences, Aga Khan University, Pakistan.
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14
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Detti L, Christiansen ME, Francillon L, Ikuwezunma G, Diamond MP, Mari G, Tobiasz AM. Serum Anti-Müllerian hormone (AMH) in mothers with polycystic ovary syndrome (PCOS) and their term fetuses. Syst Biol Reprod Med 2018; 65:147-154. [PMID: 30428262 DOI: 10.1080/19396368.2018.1537385] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We sought to determine serum AMH levels in the maternal circulation, and the umbilical artery and vein, in normal women and women with PCOS, and their neonates at time of delivery. This represents a cross-sectional study of 57 pregnant patients who presented to the labor and delivery suite and subsequently delivered. We obtained maternal, as well as fetal blood from both, umbilical artery and vein. We measured serum concentrations of estradiol, AMH, testosterone and FSH. A total of 30 patients delivered a female and 27 a male neonate. Of them, 18/30 and 18/27 had a diagnosis of PCOS by NIH criteria. Mean age, BMI, weight gain in pregnancy, and gestational age did not differ between the two groups of mothers. AMH serum levels were statistically higher in women with PCOS (p < 0.005) and in their fetuses, independently of gender. Testosterone was higher in women with PCOS (p < 0.001), but there was no PCOS-related difference in their fetuses. FSH levels were significantly lower in PCOS than non-PCOS mothers carrying a male (p = 0.022), but not a female, fetus. AMH was positively correlated with maternal serum testosterone (p = 0.001) and negatively with fetal serum FSH (p < 0.026). In PCOS pregnancies, AMH was negatively correlated with maternal BMI (p = 0.019), menstrual cycle length (p = 0.035), and fetal uterine vein FSH (p = 0.021). In conclusion, at time of delivery, fetuses of women with PCOS had higher AMH levels and similar testosterone levels compared to fetuses from non-PCOS mothers, irrespective of gender. Our results may help explaining developmental differences in offspring of PCOS women.
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Affiliation(s)
- Laura Detti
- a Department of Obstetrics and Gynecology, Rout Center , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Mary E Christiansen
- a Department of Obstetrics and Gynecology, Rout Center , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Ludwig Francillon
- a Department of Obstetrics and Gynecology, Rout Center , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Gini Ikuwezunma
- a Department of Obstetrics and Gynecology, Rout Center , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Michael P Diamond
- b Department of Obstetrics and Gynecology , Augusta University , Augusta , GA , USA
| | - Giancarlo Mari
- a Department of Obstetrics and Gynecology, Rout Center , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Ana M Tobiasz
- a Department of Obstetrics and Gynecology, Rout Center , University of Tennessee Health Science Center , Memphis , TN , USA
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15
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Grynnerup AGA, Lindhard A, Sørensen S, Ørskov M, Petersen KR, Madsen LB, Pilsgaard F, Løssl K, Pinborg A. Serum anti-Müllerian hormone concentration before and after salpingectomy for ectopic pregnancy. Reprod Biomed Online 2018; 37:624-630. [PMID: 30287173 DOI: 10.1016/j.rbmo.2018.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 12/01/2022]
Abstract
RESEARCH QUESTION Does salpingectomy for ectopic pregnancy affect the ovarian reserve measured by changes in pre- and post-operative levels of anti-Müllerian hormone (AMH)? DESIGN This is a prospective observational multicentre study of 64 women treated with salpingectomy for an ectopic pregnancy. AMH was measured in serum samples collected at admission before salpingectomy and at follow-up (median time to follow-up [interquartile range] was 3 [3-4] months). Changes in serum AMH levels were investigated using Wilcoxon signed-rank test and the relationship between changes in AMH and age, time to follow-up, and pre-operative serum AMH level was investigated using linear regression analysis. The biological variation of AMH was also calculated. RESULTS Serum AMH levels did not differ significantly before and after salpingectomy (median ∆AMH [follow-up value minus admission value] 0.40 pmol/l, interquartile range -2.0 to 4.0 pmol/l). ΔAMH was independent of age, time to follow-up and pre-operative serum AMH level. The intra-individual biological variation for AMH ranged from 12.1% to 26.3%, depending on time between the two samples. CONCLUSIONS This is the first paired study to investigate serum AMH values before and after salpingectomy in an unselected population of women presenting with an ectopic pregnancy, including both patients who conceived naturally and following fertility treatment. It was found that salpingectomy for ectopic pregnancy had no short-term effect on serum AMH levels, and changes in AMH levels were independent of age, time to follow-up, and pre-operative serum AMH level. Furthermore, the study demonstrated a 6-month biological variation of AMH of less than 30%.
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Affiliation(s)
- Anna Garcia-Alix Grynnerup
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark.
| | - Anette Lindhard
- Department of Obstetrics and Gynaecology, Zealand University Hospital Roskilde, Sygehusvej 10, DK-4000 Roskilde, Denmark
| | - Steen Sørensen
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark; Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, Hvidovre DK-2650, Denmark
| | - Mette Ørskov
- Department of Obstetrics and Gynaecology, Odense University Hospital, J. B. Winsløwsvej 4, Odense C Denmark, C DK-5000
| | - Kresten Rubeck Petersen
- Department of Obstetrics and Gynaecology, Odense University Hospital, J. B. Winsløwsvej 4, Odense C Denmark, C DK-5000
| | - Lisbeth Buss Madsen
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark
| | - Fie Pilsgaard
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark
| | - Kristine Løssl
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark
| | - Anja Pinborg
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Hvidovre, Kettegård Allé 30, DK-2650 Hvidovre, Denmark
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Köninger A, Kampmeier A, Schmidt B, Frank M, Strowitzki T, Kimmig R, Gellhaus A, Mach P. Trends in anti-Müllerian hormone concentrations across different stages of pregnancy in women with polycystic ovary syndrome. Reprod Biomed Online 2018; 37:367-374. [DOI: 10.1016/j.rbmo.2018.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 01/05/2023]
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17
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McLennan IS, Koishi K, Batchelor NJ, Pankhurst MW. Mice with either diminished or elevated levels of anti-Müllerian hormone have decreased litter sizes†. Biol Reprod 2017; 98:54-62. [DOI: 10.1093/biolre/iox151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/17/2017] [Indexed: 11/14/2022] Open
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18
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Ganer Herman H, Gluck O, Keidar R, Kerner R, Kovo M, Levran D, Bar J, Sagiv R. Ovarian reserve following cesarean section with salpingectomy vs tubal ligation: a randomized trial. Am J Obstet Gynecol 2017; 217:472.e1-472.e6. [PMID: 28455082 DOI: 10.1016/j.ajog.2017.04.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Epithelial ovarian cancer is assumed to derive from the fallopian tube. Salpingectomy has been previously demonstrated to reduce the risk of ovarian cancer, and may be used as a means of sterilization. OBJECTIVE We aimed to compare short-term ovarian reserve and operative complications in cases of salpingectomy and tubal ligation during cesarean section. STUDY DESIGN Study patients who underwent elective cesarean section at our institution and requested sterilization were randomized to bilateral salpingectomy or tubal ligation. Prior to surgery, blood samples were obtained for antimüllerian hormone. Surgical course was noted, including overall time, complications, and postoperative hemoglobin. Repeat antimüllerian hormone samples were obtained from patients 6-8 weeks following surgery. RESULTS In all, 46 patients were recruited for participation, of whom 33 completed a follow-up visit, and for whom repeat antimüllerian hormone levels were available. Patients in the salpingectomy group were slightly older (37.0 ± 3.9 vs 34.3 ± 4.1 years, P = .02). No differences were noted in patient parity, body mass index, or gestational age between the groups. Pregnancy and postdelivery antimüllerian hormone levels were not significantly different between the groups, with an average increase of 0.58 ± 0.98 vs 0.39 ± 0.41 ng/mL in the salpingectomy and tubal ligation groups, respectively (P = .45). Surgeries including salpingectomy were longer by an average 13 minutes (66.0 ± 20.5 vs 52.3 ± 15.8 minutes, P = .01). No difference was demonstrated between the groups regarding surgical complications and postoperative hemoglobin decrease. CONCLUSION Sterilization by salpingectomy appears to be as safe as tubal ligation regarding operative complications and subsequent ovarian reserve. As salpingectomy offers the advantage of cancer risk reduction, it may be offered in the settings of elective preplanned surgeries.
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19
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Peigné M, Robin G, Catteau-Jonard S, Giacobini P, Dewailly D, Pigny P. Les différentes trousses de dosage d’AMH en France en 2017 : comment s’y retrouver en pratique clinique quotidienne ? ACTA ACUST UNITED AC 2017; 45:558-565. [DOI: 10.1016/j.gofs.2017.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/29/2017] [Indexed: 02/06/2023]
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20
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Hutson JM, Lopez-Marambio FA. The possible role of AMH in shortening the gubernacular cord in testicular descent: A reappraisal of the evidence. J Pediatr Surg 2017; 52:1656-1660. [PMID: 28599968 DOI: 10.1016/j.jpedsurg.2017.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/12/2017] [Accepted: 05/19/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM Anti-Müllerian hormone (AMH), also called Müllerian inhibiting substance (MIS), is glycoprotein hormone secreted by the fetal Sertoli cells to regulate regression of the Müllerian ducts, the anlagen of the uterus, fallopian tubes, and upper vagina. After its existence was predicted in 1946 and its isolation and purification in the 1970's, a huge amount of information has been gathered on its molecular biology and function in the last 30-40years. Once thought to be a locally acting factor in the male fetus during sexual differentiation, it is now recognized as an endocrine hormone present in both sexes and with functions throughout life. One of the remaining controversies is the possible role of AMH during fetal testicular descent. In the human with aberrant AMH function, the boy has cryptorchidism with persistent Müllerian duct syndrome (PMDS), where the testes are often intraabdominal and on an abnormally long gubernacular cord. By contrast, in rodent models knockout of the AMH gene does not cause cryptorchidism. METHODS/RESULTS In this review we examined the evidence in the literature for and against a role for AMH in testicular descent and considered the implications of the different anatomy of the gubernacular cord in rodents versus children. CONCLUSION We conclude that AMH may have a role in shortening the gubernacular cord in humans which is concealed in rodent models by differences in anatomy of the gubernacular cord in rodents. The controversy could be resolved by re-examination of the gubernacular cord in boys with PMDS and mice with AMHKO. TYPE OF STUDY Review. LEVEL OF EVIDENCE V.
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Affiliation(s)
- John M Hutson
- Department of Paediatrics, University of Melbourne, Australia; Urology Department, The Royal Children's Hospital, Melbourne, Australia; F Douglas Stephens Surgical Research Group, Murdoch Childrens Research Institute, Melbourne, Australia.
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21
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Lambert-Messerlian GM, Straseski JA, Eklund EE, Palomaki GE, Haddow JE. Antimüllerian Hormone Levels Are Not Altered by Glucose Challenge or a Meal. J Appl Lab Med 2017; 2:238-243. [PMID: 32630977 DOI: 10.1373/jalm.2017.023622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/08/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Measurement of antimüllerian hormone (AMH) is used to assess ovarian reserve. Circulating levels of AMH correlate with antral follicle count, with relatively high levels indicating an ample reserve of primary and preantral follicles in the ovary. AMH levels are stable with dilution and freezer storage, and are not altered by hemolysis or menstrual cycle day in young women of reproductive age. We sought to examine whether glucose challenge or food intake modifies AMH levels compared with fasting. METHODS Residual plasma samples were available from 54 pregnant women under fasting conditions and then 1, 2, and 3 h after ingestion of a 100-g glucose challenge. These samples were collected as part of routine clinical care to identify gestational diabetes (GDM) at 24-28 weeks of gestation. Twelve of these women met criteria for GDM based on an increased glucose level at a minimum of 2 time points. A second set consisted of serum samples collected from 8 nonpregnant women at fasting and 1 h after a meal. Levels of AMH were measured using an ultrasensitive assay (Ansh Labs, Webster, TX). A 2-way ANOVA (sample timing and GDM status) or matched t-test was performed. AMH measurements were subject to a logarithmic transformation before analysis. RESULTS Median AMH levels in pregnant women at 1, 2, or 3 h after glucose challenge did not differ compared with AMH levels at fasting or by diagnosis of GDM. Similarly, there was no difference in median AMH levels in nonpregnant women of reproductive age at fasting and after a meal. CONCLUSION AMH levels are not altered by glucose or food intake.
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Affiliation(s)
- Geralyn M Lambert-Messerlian
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Alpert Medical School at Brown University, Providence, RI.,Department of Obstetrics and Gynecology, Women and Infants Hospital and Alpert Medical School at Brown University, Providence, RI
| | | | - Elizabeth E Eklund
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Alpert Medical School at Brown University, Providence, RI
| | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Alpert Medical School at Brown University, Providence, RI
| | - James E Haddow
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Alpert Medical School at Brown University, Providence, RI
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Tamirou F, Husson SN, Gruson D, Debiève F, Lauwerys BR, Houssiau FA. Brief Report: The Euro-Lupus Low-Dose Intravenous Cyclophosphamide Regimen Does Not Impact the Ovarian Reserve, as Measured by Serum Levels of Anti-Müllerian Hormone. Arthritis Rheumatol 2017; 69:1267-1271. [PMID: 28235250 DOI: 10.1002/art.40079] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/16/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The Euro-Lupus regimen of low-dose intravenous cyclophosphamide (IV CYC) (cumulative dose of 3 gm) was developed to reduce gonadal toxicity. To address the possibility of a marginal effect on the ovarian reserve, we measured serum titers of anti-Müllerian hormone (AMH) in patients with systemic lupus erythematosus (SLE) treated with the Euro-Lupus regimen and compared them with those measured in patients who were treated with higher doses of IV CYC or were never treated with IV CYC. METHODS Serum AMH levels were measured by enzyme-linked immunosorbent assay in a cohort of 155 premenopausal SLE patients; 30 of these patients had been treated with the Euro-Lupus regimen, and 24 had received higher doses of IV CYC. None had received oral CYC. AMH levels were age-adjusted using a slope computed from levels measured across the group of SLE patients who had not been treated with IV CYC. Demographic and clinical data were collected. RESULTS Serum titers of AMH measured in SLE patients treated with the Euro-Lupus IV CYC regimen (median dose 1.46 ng/ml) did not differ from those measured in patients never treated with the cytotoxic drug (median 1.85 ng/ml). As expected, patients given >6 gm of IV CYC had significantly lower serum titers of AMH (median 0.83 ng/ml) compared with those never treated with IV CYC (P = 0.047). Median serum AMH titers did not change before (1.24 ng/ml) and after (2.50 ng/ml) treatment with the Euro-Lupus IV CYC regimen in the subset of patients for whom paired samples could be tested (P = 0.43). CONCLUSION The Euro-Lupus regimen of low-dose IV CYC does not impact the ovarian reserve of SLE patients and can therefore be proposed as treatment in patients seeking to become pregnant.
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Affiliation(s)
- Farah Tamirou
- Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | | | - Damien Gruson
- Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Frédéric Debiève
- Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Bernard R Lauwerys
- Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Frédéric A Houssiau
- Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
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McLennan IS, Pankhurst MW. Is the understanding of AMH being confounded by study designs that do not adequately reflect that it is an atypical hormone? Hum Reprod 2016; 32:14-17. [PMID: 27927848 DOI: 10.1093/humrep/dew305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 10/15/2016] [Accepted: 11/06/2016] [Indexed: 01/30/2023] Open
Affiliation(s)
- I S McLennan
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - M W Pankhurst
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
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